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1

Superior vena cava syndrome.  

PubMed

Superior vena cava syndrome is a common complication of malignancy. The epidemiology, presentation, and diagnostic evaluation of patients presenting with the syndrome are reviewed. Management options including chemotherapy and radiation therapy and the role of endovascular stents are discussed along with the evidence for each of the therapeutic options. PMID:20488350

Wan, Jonathan F; Bezjak, Andrea

2010-06-01

2

Inferior Vena Cava Filter from Left-Sided Superior Vena Cava  

SciTech Connect

We describe the unusual case of a 71-year-old male with a history of deep vein thrombosis and recurrent multiple pulmonary embolism (PE) despite adequate anticoagulation. Computed tomography (CT) and brachiocephalic venography revealed a left-sided superior vena cava. We describe successful placement of an inferior vena cava filter via a left-sided superior vena cava.

Nair, Sujit, E-mail: drsnnair@hotmail.com; Ettles, Duncan; Robinson, Graham; Scott, Paul [Hull Royal Infirmary, Department of Radiology (United Kingdom)

2008-07-15

3

Superior vena cava syndrome: A medical emergency?  

PubMed Central

Superior vena cava (SVC) syndrome was originally described as being secondary to an infection. Currently, it is almost exclusively secondary to malignancy. A case of SVC syndrome presenting with dyspnea, facial swelling, neck distension and cough developed over a period of 10 days is reported. The approach included imaging studies and tissue diagnosis. Computed tomography scan of the chest revealed a lobulated mass on the right upper chest invading the mediastinum, and cytology obtained from bronchoscopy revealed squamous cell carcinoma. The etiology, diagnosis and treatment modalities of the SVC syndrome are discussed.

Cohen, Ronny; Mena, Derrick; Carbajal-Mendoza, Roger; Matos, Ninon; Karki, Nishu

2008-01-01

4

Superior vena cava obstruction caused by radiation induced venous fibrosis  

PubMed Central

Superior vena cava syndrome is most often caused by lung carcinoma. Two cases are described in whom venous obstruction in the superior mediastinum was caused by local vascular fibrosis due to radiotherapy five and seven years earlier. The development of radiation injury to greater vessels is discussed, together with the possibilities for treatment of superior vena cava syndrome.??

Van Putten, J W G; Schlosser, N; Vujaskovic, Z; Leest, A; Groen, H

2000-01-01

5

[Superior vena cava syndromes of benign etiology].  

PubMed

Superior vena cava syndromes are uncommon and usually caused by malignant diseases. In about 20% of the cases however, the cause is benign. Besides chronic mediastinitis, a growing number of cases are reported of thrombosis resulting from endovenous devices (central catheters, pacemaker leads...). Onset is often slow and insidious, good tolerance in the early stages being explained by the development of an effective collateral circulation. Bibrachial phlebography is still the reference exploration, but computed tomography and magnetic resonance imaging are contributive to diagnosis. Symptoms usually regress after medical treatment, sometimes requiring thrombolysis, however, in 10% of the patients, major functional impairment may require bypass surgery (autologous graft or endoprosthesis) or transluminal angioplasty. There is still some debate as to the precise indications for each method, but angioplasty, used recently, appears to be the most interesting technique for a disease in which prognosis is almost always favorable. PMID:8949625

Marlier, S; Bonal, J; Cellarier, G; Bouchiat, C; Talard, P; Dussarat, G V

1996-09-14

6

Persistent left superior vena cava and pacemaker implantation  

PubMed Central

Our study group read with interest the paper from Vijayvergiya et al describing the implantation of an implantable cardioverter-defibrillator lead in the presence of the persistence of the left superior vena cava. The issue of the identification a persistent left superior vena cava is of paramount importance in interventional cardiology, being the most common venous anomaly of the thoracic distribution, and because it may create some problem to any physician while performing a pacemaker lead implantation. In our letter we underscore the specific issues related to pacemaker implantation while encountering a persistent left superior vena cava (and maybe the absence of the right vena cava) and the workup that should be performed to obtain the preoperative diagnosis of the venous anomaly. More specifically, we consider avoiding any kind of defibrillator lead implantation through the coronary sinus for safety issues, and underscore the straightforward transthoracic ultrasound approach to identify the left superior vena cava.

Pontillo, Daniele; Patruno, Nicolino

2013-01-01

7

Superior vena cava syndrome masquerading as an allergic reaction.  

PubMed

Patients are often referred to the emergency department for further evaluation, yet the astute physician will maintain a broad differential to avoid anchoring on prior diagnoses. In this case, a 56-year-old man was referred to our emergency department from the radiology suite secondary to concerns for an “allergic reaction” to prior magnetic resonance imaging contrast. Upon presentation, he was noted to have facial swelling with ruddy appearance and vascular congestion extending to the midchest region; no airway compromise or dyspnea was noted. He had a smoking history and recent diagnosis of brain mass, which, combined with his current appearance,was concerning for superior vena cava syndrome. A chest x-ray that demonstrated right mediastinal mass was ordered, and a computed tomographic scan confirmed compression of the superior vena cava. A brief discussion on the history, etiologies, presentation, and evaluation of superior vena cava syndrome is discussed. PMID:22463972

Johnson, Jamie S; Kotora, Joseph G; Bechtel, Brett F

2012-03-29

8

Fatal Pericardial Tamponade After Superior Vena Cava Stenting  

SciTech Connect

We discuss a fatal complication of percutaneous superior vena cava (SVC) self-expandable stent placement in a patient with superior vena cava syndrome (SVCS). The SVCS was caused by a malignant mediastinal mass with total occlusion of the SVC. Twenty-four hours after the procedure, the patient died of a hemopericardial tamponade. In the literature, only seven cases have been described with this life-threatening complication. Patients with a necrotic tumor mass are more likely to develop this complication. Knowledge of this complication may increase patient survival.

Ploegmakers, Marieke J. M., E-mail: mjm.ploegmakers@gmail.com; Rutten, Matthieu J. C. M. [Jeroen Bosch Hospital, Department of Radiology (Netherlands)

2009-05-15

9

Cor triloculare biventriculare with left superior vena cava.  

PubMed

Cor triloculare biventriculare is a rare congenital malformation of the heart in which there is a complete absence of the atrial septum. It is usually associated with other anomalies like complete atrioventricular canal defect, polysplenic syndrome, isolated dextrocardia, Ellis-van Creveld syndrome, or persistent left superior vena cava. We report a case of a stillborn male foetus of 35 weeks gestation with common atrium, complete atrioventricular canal defect, and persistent left superior vena cava. The possible embryological basis and clinical implication of this variation are discussed. PMID:21630236

Sangam, M R; Devi, S S Sarada; Krupadanam, K; Anasuya, K

2011-05-01

10

Isolated right superior vena cava draining into the left atrium.  

PubMed

A 10-year-old male was admitted to our institution with complaints of mild cyanosis and dyspnea. Transthoracic echocardiography and angiography revealed a right superior vena cava (SVC) draining into the left atrium. At the time of surgery, the right SVC was connected to the right atrium. PMID:22978841

Gursoy, Mete; Salihoglu, Ece; Ozcobanoglu, Salih; Ozkan, Suleyman; Celiker, Alpay

2012-09-01

11

Quality Assurance Guidelines for Superior Vena Cava Stenting in Malignant Disease  

SciTech Connect

Superior vena cava stenting for the treatment of malignant superior vena cava obstruction is now well established. It offers simple, rapid, and safe palliation of a distressing and potentially fatal complication of mediastinal malignant disease and compares very favorably with standard therapies such as chemotherapy and radiotherapy. The following are quality assurance guidelines for superior vena cava stenting.

Uberoi, Raman [John Radcliffe Hospital, Department of Radiology (United Kingdom)], E-mail: raman.uberoi@orh.nhs.uk

2006-06-15

12

An unusual cause of intraoperative acute superior vena cava syndrome.  

PubMed

Acute intraoperative superior vena cava (SVC) syndrome is an exceedingly rare complication in the cardiac surgical population. We describe the case of a 71-year-old female undergoing multi-vessel coronary artery bypass grafting who developed acute intraoperative SVC syndrome following internal thoracic artery harvest retractor placement. Her symptoms included severe plethora, facial engorgement and scleral edema, which was associated with hypotension and severe elevation of central venous pressure. Transesophageal echocardiography was crucial in the diagnosis, management, and optimal retractor placement ensuring adequate SVC flow. Potential causes of intraoperative SVC syndrome are reviewed as well as management options. PMID:23545869

Amundson, Adam W; Pulido, Juan N; Hayward, Geoffrey L

13

Wallstent endovascular prosthesis for the treatment of superior vena cava syndrome  

Microsoft Academic Search

Objective: We assessed the clinical outcome of self-expanding Wallstent endovascular prosthesis in the treatment of superior vena cava\\u000a syndrome due to malignant tumors.Methods: Eleven patients with malignant superior vena cava syndrome were treated by percutaneous implantation of the self-expanding\\u000a Wallstent endovascular prosthesis across the stricture site. Patency was defined by the absence of symptoms and signs of superior\\u000a vena cava

Susumu Sasano; Takamasa Onuki; Masahiro Mae; Kunihiro Oyama; Motoki Sakuraba; Sumio Nitta

2001-01-01

14

Persistent left superior vena cava remnant causing cyanosis in a post-Fontan patient.  

PubMed

We report the successful surgical closure of a persistent left superior vena cava remnant draining into the pulmonary venous circulation causing cyanosis in a post-Fontan patient who had previously undergone Damus-Kaye-Stansel and bidirectional superior cavopulmonary connection followed by a transcatheter coil occlusion of his persistent left superior vena cava. PMID:23608291

Baslaim, Ghassan; Hussain, Arif

2013-05-01

15

Computed Tomography-Guided Central Venous Catheter Placement in a Patient with Superior Vena Cava and Inferior Vena Cava Occlusion  

SciTech Connect

An 18-year-old man with a gastrointestinal hypomotility syndrome required lifelong parenteral nutrition. Both the superior and inferior vena cava were occluded. Computed tomography guidance was used to place a long-term central venous catheter via a large tributary to the azygos vein.

Rivero, Maria A.; Shaw, Dennis W.W. [Department of Radiology CH-69, Children's Hospital and Medical Center, 4800 Sand Point Way NE, Seattle, WA 98105 (United States); Schaller, Robert T. Jr. [Department of Surgery, Children's Hospital and Medical Center, 4800 Sand Point Way NE, Seattle, WA 98105 (United States)

1999-01-15

16

A simple bypass technique for superior vena cava reconstruction.  

PubMed

Superior vena cava (SVC) clamping can be required during thoracic surgery for SVC replacement or repair. In such cases, bypass techniques can be necessary to avoid hemodynamic instability, cerebral venous hypertension and hypoperfusion. Here, we report a novel and simple SVC bypass technique which does not require full systemic heparinization, specialized cannulation techniques or pumping devices and which can be applied percutaneously in the preoperative phase or intraoperatively. The preoperative shunt consisted in two Swan-Ganz catheters inserted in the jugular and femoral veins and connected by perfusion tubing with a three way stopcock. The intraoperative shunt consisted of a Pruitt(®)-catheter inserted in the left innominate vein and connected to a femoral Swan-Ganz catheter by perfusion tubing. We validated our system in seven patients undergoing SVC reconstruction. We monitored the systemic arterial blood pressures, the heart rate and vasoactive peptide requirements throughout the procedure. We also determined the neurological status and the in-hospital morbidity and mortality for each patient. Using this bypass, SVC clamping caused no hemodynamic instability, no neurological impairments and no in-hospital complications or deaths. This simple temporary SVC bypass procedure is safe and avoids hemodynamic instability and cerebral venous hypertension. PMID:20937665

Perentes, Jean Y; Erling, Christoph C; Ris, Hans-Beat; Corpataux, Jean-Marc; Magnusson, Lennart

2010-10-11

17

Persistent left superior vena cava with an absent right superior vena cava in a 72-year-old male with multivessel coronary artery disease.  

PubMed

Congenital anomalies of systemic veins are usually asymptomatic and foundincidentally during ultrasonography, computed tomography (CT) or magneticresonance examinations performed for other clinical indications. Persistent leftsuperior vena cava (PLSVC) with absent right superior vena cava (RSVC) is thecongenital aberration in the thoracic venous system which occurs in only 0.09%to 0.13% of patients who have congenital heart defects. In this paper, we presentthe extremely rare case of a 72-year-old male with PLSVC associated withan absence of RSVC, referred for coronary CT angiography. Multidetector CTangiography is a powerful tool for the detection of venous anomalies, which isessential before invasive procedures such as the implantation of pacemakers. PMID:24068691

Szymczyk, K; Polguj, M; Szymczyk, E; Majos, A; Grzelak, P; Stefa?czyk, L

2013-08-01

18

Mitral valve repair in patient with absent right superior vena cava in visceroatrial situs solitus  

PubMed Central

We report on a 74-year-old woman with an absence of right superior vena cava in visceroatrial situs solitus who underwent mitral valve plasty for severe mitral regurgitation. Preoperative three-dimensional computed tomography revealed an absent right and persistent left superior vena cava that drained into the right atrium by way of the coronary sinus. Perioperaively, placement of pulmonary artery catheter, site of venous cannulation, and management of associated rhythm abnormalities were great concern. Obtaining the information about this central venous malformation preoperatively, we performed mitral valve plasty without any difficulties related to this anomaly.

2013-01-01

19

Intracranial hemorrhage due to intracranial hypertension caused by the superior vena cava syndrome.  

PubMed

We report a patient with intracranial hemorrhage secondary to venous hypertension as a result of a giant aortic pseudoaneurysm that compressed the superior vena cava and caused obstruction of the venous return from the brain. To our knowledge, this is the first patient reported to have an intracranial hemorrhage secondary to a superior vena cava syndrome. The condition appears to be caused by a reversible transient rise in intracranial pressure, as a result of compression of the venous return from the brain. Treatment consisted of surgery for the aortic pseudoaneurysm, which led to normalization of the intracranial pressure and resorption of the intracranial hemorrhage. PMID:23665082

Bartek, Jiri; Abedi-Valugerdi, Golbarg; Liska, Jan; Nyström, Harriet; Andresen, Morten; Mathiesen, Tiit

2013-05-09

20

Endovascular central venous stenosis treatment ended with superior vena cava perforation, pericardial tamponade, and exitus.  

PubMed

Venous hypertension and outflow stenosis of arteriovenous hemodialysis access managed using endovascular procedures usually present a high technical success rate, with few complications. We reported a rare and fatal complication of superior vena cava perforation with pericardial tamponade 3 months after subclavian vein stenting. Interventional recanalization with stenting for the management of superior vena cava syndrome or central vein stenosis is a safe procedure with a low complication rate. Stent misplacement, reocclusion, migration, or access-related complications appear to occur most frequently. PMID:22664297

Siani, Andrea; Marcucci, Giustino; Accrocca, Federico; Antonelli, Roberto; Mounayergi, Federica; Rosati, Maria Sofia; Gabrielli, Roberto

2012-07-01

21

Electrical remodeling of the canine superior vena cava after chronic rapid atrial pacing  

Microsoft Academic Search

Background The superior vena cava (SVC) might serve as the trigger and\\/or substrate for paroxysmal atrial fibrillation (AF). However, the electrophysiological properties of the SVC with chronic AF are unknown. The purposes of this study were to investigate the electrophysiological properties of the SVC and the electropharmacological effects of intravenous dl–sotalol on the canine SVC after chronic rapid atrial pacing

Shih-Huang Lee; Yi-Jen Chen; Ching-Tai Tai; Hung-I Yeh; Jun-Jack Cheng; Chi-Ren Hung; Shih-Ann Chen

2005-01-01

22

Cardiac Metastasis from Invasive Thymoma Via the Superior Vena Cava: Cardiac MRI Findings  

SciTech Connect

Cardiac tumors are rare, and metastatic deposits are more common than primary cardiac tumors. We present cardiac magnetic resonance imaging (MRI) findings of a 50-year-old woman with invasive thymoma. Cardiac MRI revealed a heterogeneous, lobulated anterior mediastinal mass invading the superior vena cava and extending to the right atrium. In cine images there was no invasion to the right atrial wall.

Dursun, Memduh, E-mail: memduhdursun@yahoo.com; Sarvar, Sadik; Cekrezi, Bledi [Istanbul University, Istanbul Faculty of Medicine, Department of Radiology (Turkey); Kaba, Erkan [Istanbul University, Istanbul Faculty of Medicine, Department of Thoracic Surgery (Turkey); Bakir, Baris [Istanbul University, Istanbul Faculty of Medicine, Department of Radiology (Turkey); Toker, Alper [Istanbul University, Istanbul Faculty of Medicine, Department of Thoracic Surgery (Turkey)

2008-07-15

23

Double superior vena cava on fistulogram: A case report and discussion  

PubMed Central

Patient: Female, 50 Final Diagnosis: Double superior vena cava Symptoms: — Medication: — Clinical Procedure: — Specialty: Nephrology Objective: Anatomical anomaly/variation Background: Superior vena cava anomalies are caused by variations in the development of the embryonic thoracic venous system. Duplication of the superior vena cava is a rare anomaly with an incidence in the general population of 0.3%. The majority of cases are asymptomatic and diagnosed incidentally by imaging done for another reason. Case Report: A fifty year old female patient presented to our care with a history of end stage renal disease that has been recently started on dialysis. Procedures performed included a fistulogram, PermaCath placement and angiogram of internal jugular vein. Angiogram was done and showed that the patient has a good sized cephalic vein which is wide open and mild to moderate stenosis at the subclavian area which proved to be a dual superior vena cava. Conclusions: Double SVC is a rare congenital anomaly. The literature available on this congenital anomaly is sparse. The majority of cases are diagnosed incidentally on imaging for other reasons, which can alert the physician of other congenital abnormalities that will need further work up. However, these venous anomalies should be recognized, as they can have significant clinical implications, especially during central venous catheter placement, radiofrequency ablation, pacemaker insertion or coronary artery bypass graft.

Cooper, Chad J.; Gerges, Anwar Soliman; Anekwe, Emmanuel; Hernandez, German T.

2013-01-01

24

Delayed Spontaneous Superior Vena Cava Perforation Associated with a SVC Wallstent  

Microsoft Academic Search

A patient was referred for superior vena cava (SVC) stenting prior to surgical biopsy of a mediastinal mass. A technically\\u000a satisfactory insertion was followed 6 months later by cardiac tamponade with two legs of the Wallstent having perforated the\\u000a wall of the SVC.

Simon L. Smith; Adrian R. Manhire; David M. Clark

2001-01-01

25

Comparison of superior vena cava and femoroiliac vein pressure according to intra-abdominal pressure  

PubMed Central

Background Previous studies have shown a good agreement between central venous pressure (CVP) measurements from catheters placed in superior vena cava and catheters placed in the abdominal cava/common iliac vein. However, the influence of intra-abdominal pressure on such measurements remains unknown. Methods We conducted a prospective, observational study in a tertiary teaching hospital. We enrolled patients who had indwelling catheters in both superior vena cava (double lumen catheter) and femoroiliac veins (dialysis catheter) and into the bladder. Pressures were measured from all the sites, CVP, femoroiliac venous pressure (FIVP), and intra-abdominal pressure. Results A total of 30 patients were enrolled (age 62?±?14?years; SAPS II 62 (52–76)). Fifty complete sets of measurements were performed. All of the studied patients were mechanically ventilated (PEP 3 cmH20 (2–5)). We observed that the concordance between CVP and FIVP decreased when intra-abdominal pressure increased. We identified 14?mmHg as the best intra-abdominal pressure cutoff, and we found that CVP and FIVP were significantly more in agreement below this threshold than above (94% versus 50%, P?=?0.002). Conclusions We reported that intra-abdominal pressure affected agreement between CVP measurements from catheter placed in superior vena cava and catheters placed in the femoroiliac vein. Agreement was excellent when intra-abdominal pressure was below 14?mmHg.

2012-01-01

26

Primary Pulmonary Artery Sarcoma Extending Retrograde into the Superior Vena Cava  

PubMed Central

Primary pulmonary artery sarcoma is a rare tumor that is highly fatal. It can be misdiagnosed as acute or chronic pulmonary thromboembolic disease. Herein, we report the case of a 22-year-old woman with a preoperative diagnosis of pulmonary embolism and superior vena caval thrombosis. Intraoperatively, an extensive sarcoma was seen to extend retrograde from the pulmonary artery, past the right ventricle and right atrium, and into the superior vena cava. Surgical resection of the tumor and reconstruction of the central pulmonary arteries, followed by adjuvant chemotherapy, relieved the clinical symptoms. The patient remained free of cancer at 14 months postoperatively. We believe that this is the 1st report of a primary pulmonary artery sarcoma that extended retrograde into the superior vena cava.

Portillo-Sanchez, Jose; Hessein-Abdou, Yasser; Puga-Alcalde, Eugenio; Perez-Martinez, Maria Angeles; del Carmen Jimenez-Meneses, Maria; Camacho-Pedrero, Agustin; Valdepenas-Herrero, Luis Ruiz

2011-01-01

27

Radiation-induced leiomyosarcoma of the great vessels presenting as superior vena cava syndrome  

SciTech Connect

A patient with a pleomorphic intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presented clinically with a superior vena cava syndrome. A latent period of 29 years elapsed between receiving orthovoltage radiation to the neck and right side of chest to treat recurrent ganglioneuroblastoma, and the appearance of a leiomyosarcoma and subsequent recurrences. The patient underwent partial resection of the tumor, received adjunct chemotherapy, and was shown to be free of disease by clinical tests and by magnetic resonance imaging (MRI) 17 months after completion of chemotherapy. The criteria for the diagnosis of radiation-induced sarcomas are reviewed in relation to the present case. The critical role of magnetic resonance imaging in both the diagnosis and continued follow-up of the patient is described. This would appear to be the first reported case of radiation-induced intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presenting as a superior vena cava syndrome.

Weiss, K.S.; Zidar, B.L.; Wang, S.; Magovern, G.J. Sr.; Raju, R.N.; Lupetin, A.R.; Shackney, S.E.; Simon, S.R.; Singh, M.; Pugh, R.P.

1987-09-15

28

Radiofrequency guide wire recanalization of venous occlusions in patients with malignant superior vena cava syndrome.  

PubMed

Fibrotic central venous occlusions in patients with thoracic malignancy and prior radiotherapy can be impassable with standard catheters and wires, including the trailing or stiff end of a hydrophilic wire. We report two patients with superior vena cava syndrome in whom we successfully utilized a radiofrequency guide wire (PowerWire, Baylis Medical, Montreal, Quebec, Canada) to perforate through the occlusion and recanalize the occluded segment to alleviate symptoms. PMID:21976039

Davis, Robert M; David, Elizabeth; Pugash, Robyn A; Annamalai, Ganesan

2012-06-01

29

Anaphylaxis and superior vena cava thrombus in a pediatric patient with acute lymphoblastic leukemia.  

PubMed

Pediatric patients with malignancies are at significant risk for complications from their underlying condition and medical therapy. Emergency medicine physicians must be quick to suspect life-threatening events, which can present insidiously. We describe a case of anaphylaxis and superior vena cava syndrome in an 18-year-old female patient after polyethylene glycol-conjugated asparaginase chemotherapy for acute lymphoblastic leukemia. Pertinent literature surrounding risk factors, diagnosis, and treatment is also reviewed. PMID:19018221

Creel, Amy M; Crawford, David; Prabhakaran, Priya

2008-11-01

30

Chylothorax and chylopericardial tamponade in a hemodialysis patient with catheter-induced superior vena cava stenosis.  

PubMed

Chylothorax and chylopericardium refer to the presence of milky, triglyceride-rich chylous fluid in the thoracic and pericardial spaces, respectively. Both conditions are extremely uncommon in end-stage renal disease patients on dialysis. We report the first known case of combined chylothorax and chylous pericardial tamponade in a dialysis patient associated with catheter-induced superior vena cava (SVC) stenosis. A successful outcome was achieved with drainage of both chylous effusions in combination with angioplasty of the SVC stenosis. PMID:19747178

Adekile, Ayoola; Adegoroye, Adeyinka; Tedla, Fasika; Levin, Daniel; Salifu, Moro O

2009-09-11

31

Stent-Graft in the Management of Superior Vena Cava Syndrome  

SciTech Connect

We report the use of a Dacron-covered Gianturco-Roesch Z (GRZ)-stent to treat malignant obstruction of the superior vena cava (SVC). Initial treatment with an uncovered GRZ-stent was suboptimal due to protrusion of tumor-thrombus through the stent struts into the SVC lumen. Placement of a coaxial Dacron-covered stent graft relieved the residual obstruction due to tumor within the SVC.

Chin, Don H.; Petersen, Bryan D.; Timmermans, Hans; Roesch, Josef [Dotter Interventional Institute, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd., L-605, Portland, OR 97201-3098 (United States)

1996-04-15

32

Absent Right Superior Vena Cava with Persistent Left Superior Vena Cava Which Drains to Unroofed Coronary Sinus in a Child with Atrioventricular Septal Defect and Cor Triatriatum Sinister: Preop Correct Diagnosis and Successful Surgery in a Single Session.  

PubMed

We report a unique case of a 4-year-old boy with intermediate-type atrioventricular septal defect, cor triatriatum sinister, persistent left superior vena cava, unroofed coronary sinus, and absent right superior vena cava. Persistent left vena cava draining into the unroofed coronary sinus was demonstrated easily using the agitated saline-contrast echocardiography. After conformation with angiographic evaluation, surgery was performed at a single session. Roofing of the coronary sinus with polytetrafluoroethylene patch, mitral cleft repair, tricuspid annuloplasty, atrioventricular defect repair with pericardial patch, and resection of the membrane in the left atrium was succeeded without complication. PMID:23602062

Doksöz, Onder; Güven, Bar??; Yozgat, Y?lmaz; Ozdemir, Rahmi; Me?e, Timur; Tavl?, Vedide; Alayunt, Emin Alp

2013-04-22

33

Compensatory dilatation of the Azygos Venous system Secondary To Superior Vena Cava Occlusion  

PubMed Central

Superior vena cava (SVC) occlusion can be clinically recognized in the acute setting when the stenosing process does not allow the development of collateral venous channels, which guarantee the venous drainage to the right heart. On the contrary, when the obstruction develops progressively, the diagnosis of SVC obstruction may remain undiagnosed. In the present case, the presence of SVC thrombosis was purely coincidental. In fact, the obstruction was first noticed on diagnostic tests performed because of the malfunction of a totally implantable Porth a Cath placed into the superior vena cava (through right subclavian access), five years before, in a patient suffering from non-Hodgkin disease. Venography is the most appropriate diagnostic methodology which reveals the presence of a dilated azygos vein as a compensatory mechanism. Comparison with computed tomography allows to confirm the diagnosis and to identify the possible causes. Dilatation of the azygos vein, secondary to superior vena cava thrombosis, although a rare event, should be taken into consideration in those patients with CVC and who present with frequent episodes of deep venous thrombosis.

Paoletti, Francesco; Pellegrino, Valeria; Antonelli, Melissa; Ripani, Umberto; Mosca, Stefano; Duri, Davide; Galzerano, Antonio

2009-01-01

34

Right superior vena cava draining in the left atrium associated with tetralogy of Fallot and pulmonary atresia.  

PubMed

We report a case of an anomalous drainage of the right superior vena cava to the left atrium with intact atrial septum associated with Tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries. PMID:23626439

Al-Biltagi, Mohammed A; Kouatli, Amjad; Al-Mousily, Faris

2013-01-01

35

Right superior vena cava draining in the left atrium associated with tetralogy of Fallot and pulmonary atresia  

PubMed Central

We report a case of an anomalous drainage of the right superior vena cava to the left atrium with intact atrial septum associated with Tetralogy of Fallot, pulmonary atresia, and major aortopulmonary collateral arteries.

Al-Biltagi, Mohammed A; Kouatli, Amjad; Al-Mousily, Faris

2013-01-01

36

Long-survival case of thymic carcinoma with superior vena cava tumor thrombus.  

PubMed

Sarcomatoid carcinoma of the thymus is rare and responds poorly to treatment. Invasion of great vessels and metastasis are significant predictors for poor prognosis. Thymic tumors commonly cause superior vena cava (SVC) obstruction by extrinsic compression or invasion, but intraluminal permeation is the most uncommon cause. We report a rare, long-surviving case of sarcomatoid carcinoma with SVC syndrome developed by tumor thrombus. She underwent SVC replacement and extended thymectomy. The resection indicated intracaval extension without direct invasion of thymic tumor, histologically diagnosed as sarcomatoid carcinoma. After adjuvant chemotherapy, she continues to show no apparent recurrence for five years. PMID:23098957

Matsuo, Yae; Takama, Noriaki; Yasuhara, Kiyomitsu; Koyano, Tetsuya; Obayashi, Tamiyuki; Sasaki, Toyoshi; Kanesawa, Norio; Kurabayashi, Masahiko

2012-11-01

37

Congenital Sternal Cleft along with Persistent Left-Sided Superior Vena Cava: A Rare Presentation.  

PubMed

Congenital sternal cleft is a rare abnormality resulting from fusion failure of sternum. It occurs in isolation or along with defects of abdominal wall, diaphragm, pericardium, and heart. Early surgical correction is required to protect the underlying structures for risk of cardiac compression. Here we report a case of 20-day female child presenting with congenital sternal cleft associated with multiple congenital heart disease and left-sided superior vena cava. She was operated by the cardiothoracic surgical team successfully and is doing well on followup. We discuss this rare case, imaging studies, and surgical strategy. PMID:23841006

Saha, Anindya Kumar; Sardar, Syamal Kumar; Sur, Amitava

2013-06-13

38

Permanent pacemaker-induced superior vena cava syndrome: successful treatment by endovascular stent.  

PubMed

The use of metallic stents in the management of benign and malignant superior vena cava syndrome (SVCS) is well documented. Symptomatic stenosis or occlusion of the SVC is a rare complication of a transvenous permanent pacemaker implant. Suggested treatments have included anticoagulation therapy, thrombolysis, balloon angioplasty and surgery. More recently, endovascular stenting has evolved as an attractive alternative but the data available in the literature are limited. We describe a case in which venous stenting with a Wallstent endoprosthesis was used successfully. The patient remains symptom free and with normal pacemaker function 36 months later. PMID:15061188

Lanciego, Carlos; Rodriguez, Mario; Rodriguez, Adela; Carbonell, Miguel A; García, Lorenzo García

39

Superior Vena Cava Stent Migration into the Pulmonary Artery Causing Fatal Pulmonary Infarction  

SciTech Connect

Migration of superior vena cava (SVC) stents is a well-recognised complication of their deployment, and numerous strategies exist for their retrieval. To our knowledge, only three cases of migration of an SVC stent to the pulmonary vasculature have previously been reported. None of these patients developed complications that resulted in death. We report a case of SVC stent migration to the pulmonary vasculature with delayed pulmonary artery thrombosis and death from pulmonary infarction. We conclude that early retrieval of migrated stents should be performed to decrease the risk of serious complications.

Anand, Girija, E-mail: gijanandm@hotmail.com; Lewanski, Conrad R.; Cowman, Steven A. [Charing Cross Hospital, Department of Clinical Oncology (United Kingdom); Jackson, James E. [Hammersmith Hospital, Department of Radiology (United Kingdom)

2011-02-15

40

Azygos Tip Placement for Hemodialysis Catheters in Patients with Superior Vena Cava Occlusion  

SciTech Connect

Chronic central venous access is necessary for numerous life-saving therapies. Repeated access is complicated by thrombosis and occlusion of the major veins, such as the superior vena cava (SVC), which then require novel vascular approaches if therapy is to be continued. We present two cases of catheterization of the azygos system in the presence of an SVC obstruction. We conclude that the azygos vein may be used for long-term vascular access when other conduits are unavailable and that imaging studies such as magnetic resonance venography, contrast-enhanced computed tomography or conventional venography can be employed prior to the procedure to aid with planning and prevent unforeseen complications.

Wong, Jeffrey J.; Kinney, Thomas B. [University of California, Department of Radiology (United States)], E-mail: tbkinney@ucsd.edu

2006-02-15

41

Life-threatening cerebral edema caused by acute occlusion of a superior vena cava stent.  

PubMed

A71-year-old man with advanced lung cancer developed a life-threatening cerebral edema caused by the acute occlusion of a superior vena cava (SVC) stent and was successfully treated by an additional stent placement. Although stent occlusion is a common early complication, no life-threatening situations have been reported until now. Our experience highlights the fact that acute stent occlusion can potentially lead to the complete venous shutdown of the SVC, resulting in life-threatening cerebral edema, after SVC stent placement. Immediate diagnosis and countermeasures are required. PMID:22588276

Sofue, Keitaro; Takeuchi, Yoshito; Arai, Yasuaki; Sugimura, Kazuro

2012-05-17

42

Permanent Pacemaker-Induced Superior Vena Cava Syndrome: Successful Treatment by Endovascular Stent  

SciTech Connect

The use of metallic stents in the management of benign and malignant superior vena cava syndrome (SVCS) is well documented. Symptomatic stenosis or occlusion of the SVC is a rare complication of a transvenous permanent pacemaker implant. Suggested treatments have included anticoagulation therapy, thrombolysis, balloon angioplasty and surgery. More recently, endovascular stenting has evolved as an attractive alternative but the data available in the literature are limited. We describe a case in which venous stenting with a Wallstent endoprosthesis was used successfully. The patient remains symptom free and with normal pacemaker function 36 months later.

Lanciego, Carlos [Hospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Unit of Interventional Radiology (Spain)], E-mail: clanciego@eresmas.com; Rodriguez, Mario [Hospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Unit of Intensive Care (Spain); Rodriguez, Adela; Carbonell, Miguel A. [Hospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Unit of Geriatrics (Spain); Garcia, Lorenzo Garcia [Hospital Virgen de la Salud, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Unit of Interventional Radiology (Spain)

2003-11-15

43

Treatment of Superior Vena Cava (SVC) Syndrome and Inferior Vena Cava (IVC) Thrombosis in a Patient with Colorectal Cancer: Combination of SVC Stenting and IVC Filter Placement to Palliate Symptoms and Pave the Way for Port Implantation  

SciTech Connect

Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Due to thrombus formation within the right vena jugularis interna, thrombosis of the inferior vena cava, and superior vena cava syndrome, a combined interventional procedure via a left jugular access with stenting of the superior vena cava and filter placement into the inferior vena cava was performed As a consequence, relief of the patient's symptoms, prevention of pulmonary embolism, and paving of the way for further venous chemotherapy were achieved.

Sauter, Alexander; Triller, Juergen; Schmidt, Felix; Kickuth, Ralph, E-mail: ralph.kickuth@insel.c [Inselspital, University of Berne, Department of Diagnostic, Interventional and Pediatric Radiology (Switzerland)

2008-07-15

44

Successful use of wearable cardioverter defibrillator in a patient with dextrocardia and persistent left superior vena cava.  

PubMed

Congenital disorders, such as dextrocardia and persistent left superior vena cava, are rare. However, their presence is often associated with other cardiac anomalies, and may lead to lethal ventricular tachyarrhythmias, which result in sudden cardiac death. Treating patients with these disorders can present a challenge to clinicians, as it may cause technical difficulties during interventional procedures, and more often, altered defibrillation techniques in a setting of prehospital sudden cardiac arrest. This report describes the first case of successful defibrillation therapy delivered by the wearable cardioverter defibrillator to a patient with dextrocardia and persistent left superior vena cava during a ventricular tachycardia arrest. PMID:24047495

Wan, Chingping; Oren, Jess W; Szymkiewicz, Steven J

2013-05-03

45

Spinal Uptake Mimicking Metastasis in SPECT/CT Bone Scan in a Patient With Superior Vena Cava Obstruction.  

PubMed

A 46-year-old female patient with a mediastinal neuroendocrine carcinoma complicated by superior vena cava syndrome was referred for a bone metastatic workup. Bone scan with SPECT/CT showed several vertebral fixations without alterations on the unenhanced CT, but a CT scan with injection of contrast media showed vertebral densities matched to the lesions described on the SPECT/CT. This pattern confirmed presence of collateral paths through vertebral veins due to superior vena cava syndrome. Lack of metastases was confirmed by MRI. PMID:24107870

Rager, Olivier; Nkoulou, René; Garibotto, Valentina; Boudabbous, Sana; Arditi, Daniel

2013-11-01

46

Absent right superior caval vein (vena cava) with normal atrial arrangement.  

PubMed Central

Eight cases of absent right superior caval vein (vena cava) with normal atrial arrangement from the Great Ormond Street database were reviewed. In each case the right subclavian vein and jugular vein drained into a persistent left superior caval vein through a bridging vein. In six cases the left superior caval vein drained into the right atrium by way of the coronary sinus, and in two cases it drained into the left atrium directly because of the complete unroofing of the coronary sinus. The frontal plane P wave axis was displaced leftwards and upwards in four out of seven cases in which an electrocardiogram was available. No case showed arrhythmia on a standard electrocardiogram preoperatively. Echocardiograms were available in four cases and in each case diagnosis of the anomalous connections of the systemic vein was possible. Only one third of the cases showed a crescentic shadow of the persistent left superior caval vein on chest x ray. A chest x ray and electrocardiogram do not provide the means of reliable diagnosis of this condition, though they may suggest the possibility of its existence. Definitive diagnosis requires cross sectional echocardiography or angiocardiography or both. Images Fig 1 Fig 2

Choi, J Y; Anderson, R H; Macartney, F J

1987-01-01

47

Use of contrast echocardiography in diagnosis of anomalous connection of right superior vena cava to left atrium.  

PubMed Central

A 4-month-old infant with cyanosis but without other abnormal cardiac findings is presented in whom the diagnosis of anomalous systemic venous connection to the left atrium was made by contrast echocardiography. The diagnosis was later confirmed by cardiac catheterisation and selective cineangiography. When saline was injected into a vein on the dorsum of each hand while echocardiographically recording the cardiac structures, the left atrium, left ventricle, and aorta were opacified without visualisation of the right ventricle. Similar study with injection into the right foot produced opacification of the right ventricle without visualisation of the left-sided structures. These data suggested normal drainage of the inferior vena cava with anomalous connection of the superior vena cava to the left atrium. A review of the previously reported cases of anomalous connection of the right superior vena cava to the left atrium is presented together with the possible embryological origin of this anomaly. Images

Truman, A T; Rao, P S; Kulangara, R J

1980-01-01

48

[Invasive thymoma with extensive growth in the superior vena cava;report of a case].  

PubMed

An anterior mediastinal tumor was incidentally found in a 58-year-old asymptomatic woman on a medical checkup. Computed tomography (CT) demonstrated a large tumor plugging the almost entire lumen of the superior vena cava (SVC), and 3 nodules in the bilateral lungs. The tumor seemed most likely an advanced thymoma or thymic carcinoma extending into the SVC and presenting with lung metastases. The patient underwent a combined resection of the invasive tumor and the SVC under cardiopulmonary bypass (CPB), and lung wedge resection for the nodules. The bilateral brachiocephalic veins were reconstructed with the separate grafts. The invasive tumor and the lung nodules were histologically confirmed as thymoma. Resection and reconstruction of the SVC was successfully performed under CPB for extirpation of an invasive thymoma with extensive intracaval growth. Combination chemotherapy for the relapsing lung metastases finally achieved complete response 41 months after surgery. PMID:22940667

Sakamaki, Yasushi; Shiono, Hiroyuki; Miura, Takuya

2012-09-01

49

Pacemaker electrode implantation in patients with persistent left superior vena cava.  

PubMed Central

Four out of 661 consecutive patients with permanent endocardial VVI pacing had the pacing lead introduced through a persistent left superior vena cava. It was difficult to introduce the lead from the right atrium into the right ventricle because the tip of the lead tended to be deflected away from the tricuspid orifice. This difficulty was overcome by shaping the lead into a pigtail with 3-4 cm wide loop. This avoided the risk of entering a branch of the coronary sinus in order to reach the right atrium. This technique made it easier to position the lead in the right ventricular apex. There were no complications in these four patients during a mean follow up of three years. Images

Zerbe, F; Bornakowski, J; Sarnowski, W

1992-01-01

50

Compression of the Superior Vena Cava by an Interatrial Septal Lipoma: A Case Report  

PubMed Central

Primary cardiac tumours are rare; their prevalence ranges from 0.0017% to 0.28% in various autopsy series. Cardiac lipomas are well-encapsulated benign tumours typically composed of mature fat cells, and their reported size ranges from 1 to 15?cm. They are usually seen in the left ventricle and the right atrium. Lipomas are true neoplasms, as opposed to lipomatous hypertrophy of the interatrial septum, which is a nonencapsulated hyperplastic accumulation of mature and foetal adipose tissue. Cardiac lipomas occur in patients of all ages, and the frequency of occurrence has been found to be equal in both sexes. Patients are usually asymptomatic, although the manifestation of symptoms depends upon both size and location of the tumour. We present the case of a patient with an interatrial septal lipoma, causing obstruction of the superior vena cava.

Grech, R.; Mizzi, A.; Grech, S.

2013-01-01

51

Obstruction of the superior vena cava or subclavian veins: Sonographic diagnosis  

SciTech Connect

The normal subclavian vein shows a respiratory rhythmicity on sonograms and responds to a sudden sniff maneuver by collapsing in a rapid, transient manner secondary to the sudden decrease in intrathoracic pressure. Of 11 patients studied using ultrasound (US) for possible superior vena cava (SVC) obstruction, five patients with proved SVC obstruction had no response of the enlarged subclavian veins to respiratory maneuvers. One patient with a partial obstruction had a minimal response on one side. Two patients with isolated subclavian vein obstructions had no response on the affected side and a normal response on the contralateral side. Three patients proved not to have SVC obstruction had normal responses. Sonography of the subclavian veins may be an effective, indirect screening technique for the presence of SVC obstruction and can also be used to evaluate the patency of the subclavian vein, although the the sensitivity and specificity of the method remain to be determined from a larger, prospective study.

Gooding, G.A.W.; Hightower, D.R.; Moore, E.H.; Dillon, W.P.; Lipton, M.J.

1986-06-01

52

Anomalous drainage of the right superior vena cava into the left atrium in a 61-year-old woman  

Microsoft Academic Search

This report describes a 61-year-old female with an anomalous drainage of the right superior vena cava into the left atrium. The patient presented progressively severe dyspnea and precordial pain on exertion, lightheadedness, easy fatiguability and a constant decline in her performance but normal cardiac and pulmonary findings. Following a suspicious lung perfusion scan, diagnosis was assessed by echocardiography and confirmed

Stephan Rosenkranz; Alexander Stäblein; Hans J Deutsch; Hans W Verhoeven; Erland Erdmann

1998-01-01

53

Dramatic response of follicular thyroid carcinoma with superior vena cava syndrome and tracheal obstruction to external-beam radiotherapy  

SciTech Connect

We report a patient with follicular thyroid carcinoma progressing to superior vena cava (SVC) syndrome and tracheal obstruction despite multiple doses of radioactive iodine therapy but subsequently responding dramatically to external-beam radiotherapy (RT). Although RT is not considered to be the treatment of choice for follicular carcinoma, RT in our patient produced unequivocal improvement of SVC syndrome and tracheal obstruction.

Wilford, M.R.; Chertow, B.S.; Lepanto, P.B.; Leidy, J.W. Jr. (Section of Endocrinology, Marshall University School of Medicine, Huntington, West Virginia (USA))

1991-06-01

54

[An autopsy case of invasive thymoma extending to the right atrium with superior vena cava syndrome as the initial manifestation].  

PubMed

We report a case of invasive thymoma presenting with superior vena caval obstruction and intracardiac extension. A 74-year-old man was admitted in July 2002 with swelling of the face and right upper extremity. Computed tomography of the chest revealed a small anterior mediastinal mass, which infiltrated the lumen of the superior vena cava extending into the right atrium. Invasive thymoma was strongly suspected, but he refused any medical treatment. His health declined steadily, with repeated right-sided heart failure. He died due to cardiac tamponade 50 months after his first visit. On autopsy, the tumor was diagnosed as a thymoma classified as type B3 according to the WHO histological classification. Formation of a tumor thrombus in the superior vena cava and the right atrium is a rare mode of extension of thymoma. In this respect, our case may be valuable for improving the understanding of the natural course of invasive thymoma. PMID:18186250

Noguchi, Saiko; Sogo, Yoko; Hamaguchi, Reo; Sugimoto, Hideyasu; Kobayashi, Akiko; Yamazaki, Keiichi; Jinn, Yasuto; Yoshimura, Nobuyuki; Inase, Naohiko; Yasuyuki, Yoshizawa

2007-12-01

55

Malignant superior vena cava obstruction: Stent placement via the subclavian route  

SciTech Connect

Over a 3-year period 23 patients with malignant superior vena cava obstruction were referred for interventional management. They underwent repeat localized central venography and deployment of self-expanding Wallstents. All patients (age range 26-89 years) were approached by the subclavian route using 29 stents. The stent was used to exclude thrombus in the contralateral brachiocephalic vein in five patients and histologic information was available in all patients. Retrospective analysis of the clinical records was used to assess symptom-free survival and symptom recurrence.All patients reported an improvement in symptoms within 24 hr of the procedure. There was 100% technical success. Primary clinical success was achieved in 19 of 23 patients followed-up to their death with no symptom recurrence (range 1-34, mean 15 weeks). In four patients symptoms recurred but only one patient was referred for re-intervention, which was successful. Complications included single cases of early post-stent rethrombosis, distal slip on deployment, and distal slip on balloon dilatation. There were no puncture-related complications.

Miller, John H.; McBride, Kieran [Royal Infirmary of Edinburgh, Department of Radiology (United Kingdom); Little, Felicity; Price, Allan [Western General Hospital, Department of Oncology (United Kingdom)

2000-03-15

56

Partial absence of superior vena cava in an adult patient : Case report and literature review.  

PubMed

Absence of the superior vena cava (SVC) is a rare variety of vascular anomaly. The purpose of this report is to describe the computed tomography (CT) findings of the partial absence of the SVC without persistent left SVC in a patient with no evidence of congenital cardiovascular disease and no prior history of central venous instrumentation. A 77-year-old woman with a history of colon cancer underwent thoracoabdominal CT imaging because of abdominal pain of uncertain cause. No tumor recurrence was observed. A complicated"investigation" confirmed a thymoid cancer surgery back in 1976, which was accompanied by resection of the SVC and the left brachiocephalic vein because of their invasion. Owing to the absence of the SVC and bilateral brachiocephalic veins, caval hypertension developed in the patient, resulting in the dilation of cavo-caval anastomoses. In addition, new anastomoses were opened. The clinical significance and possible embryogenesis of this anomaly are discussed. The extremely rare condition of the partial absence of the SVC appeared with subcutaneous dilated, tortuous collaterals in an asymptomatic adult patient. This anomaly is becoming clinically more relevant with the increasing use of minimally invasive vascular surgery. PMID:23324916

Tarnoki, D L; Tarnoki, A D; Nemeth, K; Bata, P; Berczi, V; Karlinger, K

2013-01-18

57

[Superior vena cava syndrome: cause of secondary raise of intracranial pressure after traumatic brain injury].  

PubMed

A 41-year-old male is admitted for cranial trauma, having fallen from his own height. His state of extreme agitation imposes sedation, intubation and mechanical ventilation. A CT-scan reveals acute right hemispheric subdural haematoma, with discrete midline shift, and diffuse cerebral oedema. ICP-monitoring reveals severely increased intracranial pressure, which is responsive to routine medical neuroprotective treatment. Ten days after admission, sedation and neuroprotective treatment is gradually withdrawn. At the end of the second week, a secondary ascent in ICP is observed. The presence of a right subclavian central venous line, in combination with the strong inflammatory response and septic state of the patient, has caused bilateral thrombosis of subclavian and internal jugular veins. This superior vena cava syndrome (SVCS) impedes cerebral venous drainage, thus raising ICP. Within a few days of anticoagulant therapy, SVCS resolved. Impeded cerebral venous drainage is often forgotten or ignored as a cause of secondary elevated ICP. In face of persisting or recurring raised ICP and cerebral oedema, or apparition of communicant hydrocephalus, cerebral venous drainage should be investigated. PMID:18835126

Piteaud, I; Abdennour, L; Icke, C; Stany, I; Lescot, T; Puybasset, L

2008-10-02

58

Persistent left superior vena cava mistaken for nodal metastasis: a case report  

PubMed Central

Introduction Evaluation of the mediastinum is crucial for patients with lung cancer. Mediastinal lymph node metastases play a dramatic role in the process of staging. Physicians should be aware of the potential pitfalls regarding mediastinal evaluation. This case report provides an example. Case presentation We report the case of a 57-year-old Caucasian man who presented with a four-month history of non-productive cough. He was diagnosed with non-small cell lung cancer. Initially, it was thought to be inoperable due to the presence of a para-aortic lymph node. A more careful examination of the mediastinum revealed that the "lymph node" was in fact a persistent left superior vena cava. Conclusions This study highlights the difficulties in mediastinal staging, especially when intravenous contrast is not used. The recognition of this vascular malformation dramatically changed the therapeutic decisions, giving our patient the opportunity of surgical resection. To the best of our knowledge, such correlation has not been described in English literature.

2010-01-01

59

Lutembacher Syndrome With Unroofed Left Superior Vena Cava: A Diagnostic Dilemma.  

PubMed

Lutembacher syndrome involving the association of congenital atrial septal defect (ASD), usually of the ostium secundum variety, and mitral valve disease is a well-known entity. Its association with a coronary sinus, ASD, and a persistent left superior vena cava (LSVC) draining into the left atrium (LA) (Raghib syndrome) is rarely described in the literature. This association in a 15-year-old boy erroneously deemed to be inoperable before referral to the authors' hospital due to cyanosis in the presence of atrial septal defect (ASD) and mitral stenosis is described in this report. Evaluation by echocardiography followed by cine angiography confirmed the cause of cyanosis to be drainage of the LSVC into the LA together with an ASD and rheumatic mitral stenosis, a combination of Raghib and Lutembacher syndromes. The boy underwent successful surgical correction. The authors believe this is the second such case to be reported in the English literature and the first of its kind to be managed by surgical intervention. PMID:23064838

Awasthy, Neeraj; Ambatkar, Pramod; Radhakrishnan, S; Iyer, K S

2012-10-13

60

Low Superior Vena Cava Flow and Effect of Inotropes on Neurodevelopment to 3 Years in Preterm Infants  

Microsoft Academic Search

OBJECTIVE.The goal was to report the 1- and 3-year outcomes of preterm infants with low systemic blood flow in the first day and the effect of dobutamine versus dopamine for treatment of low systemic blood flow. METHODS.A cohort of 128 infants born at 30 weeks of gestation underwent echocar- diographic measurement of superior vena cava flow at 3, 10, and

David A. Osborn; Nick Evans; Martin Kluckow; Jennifer R. Bowen; Ingrid Rieger

2010-01-01

61

Superior vena cava thrombectomy with the X-SIZER catheter system in a child with Fontan palliation.  

PubMed

A 4-year-old female with hypoplastic left heart syndrome and Fontan palliation presented with severe neurologic impairment from thrombosis of the superior vena cava (SVC). She underwent successful SVC thrombectomy with the X-SIZER Thrombectomy Catheter System, followed by balloon angioplasty. She demonstrated rapid improvement in her neurologic deficits after the procedure. This represents the first published use of the X-SIZER in a child and its first published use for SVC thrombectomy. PMID:17139678

Gossett, Jeffrey G; Rocchini, Albert P; Armstrong, Aimee K

2007-01-01

62

Superior Vena Cava Thrombosis and Paradoxical Embolic Stroke due to Collateral Drainage from the Brachiocephalic Vein to the Left Atrium  

PubMed Central

Thrombosis involving a permanent infusion catheter in the subclavian vein and superior vena cava is relatively common, especially in cancer patients. Edema of the arms and head is a well-known clinical consequence of this thrombosis, with an intrinsic risk of pulmonary embolism; however, systemic embolization into the cerebral circulation has not been reported as a sequela. Herein, we describe the case of a 56-year-old man with metastatic prostate cancer who developed superior vena cava syndrome due to extensive thrombosis in the presence of a central venous catheter that was used for long-term chemotherapy. The patient's case was complicated by a cerebrovascular accident that was most likely caused by a paradoxical air embolism. A clear mechanism for the embolism was provided by a network of collateral veins, which developed between the brachiocephalic vein and the left atrium due to the superior vena cava obstruction and resulted in a right-to-left shunt. We discuss diagnosis and treatment of the condition in our patient and in general terms.

Nascimbene, Angelo; Angelini, Paolo

2011-01-01

63

Intracardiac thrombus, superior vena cava syndrome, and pulmonary embolism in a patient with Behçet's disease: a case report and literature review  

Microsoft Academic Search

A 26-year-old woman with intermittent fever was admitted to our hospital, and gradually developed facial edema. Examinations\\u000a including computed tomography, transesophageal echocardiography, digital subtraction angiography, and pulmonary perfusion\\u000a scintigraphy revealed intracardiac thrombus, superior vena cava syndrome, and pulmonary embolism. Clinical findings and laboratory\\u000a data led us to make a diagnosis of Behçet's disease. Combination of intracardiac thrombus, superior vena cava

Takashi Kajiya; Ryuichiro Anan; Masahiro Kameko; Naoko Mizukami; Shinichi Minagoe; Shuichi Hamasaki; Ikuro Maruyama; Ryuzo Sakata; Chuwa Tei

2007-01-01

64

Management of fetal tachyarrhythmia based on superior vena cava/aorta Doppler flow recordings  

PubMed Central

Objective: To evaluate a management protocol of fetal supraventricular tachycardia (SVT) based on prior identification of the underlying mechanism. Design and setting: Prospective study in a mother–child tertiary university centre. Patients: During a consecutive 36 month period, 18 fetuses with sustained SVT underwent a superior vena cava/ascending aorta (SVC/AA) Doppler investigation in an attempt to determine the atrioventricular (AV) relation and to treat the arrhythmia according to a pre-established management protocol. Main outcome measure: Rate of conversion to sinus rhythm. Results: Seven fetuses had short ventriculoatrial tachycardia, five of these with a 1:1 AV conduction suggesting re-entrant tachycardia. The first choice drug was digoxin and all were converted. One fetus had AV dissociation leading to the diagnosis of junctional ectopic tachycardia, which was resistant to digoxin and sotalol; amiodarone achieved postnatal conversion. One fetus had SVT and first or second AV block; the diagnosis was atrial ectopic tachycardia (AET), which responded to sotalol given as a drug of first choice. Seven fetuses had long ventriculoatrial tachycardia: one with sinus tachycardia (no treatment), one with permanent junctional reciprocating tachycardia (PJRT), and three with AET. The first choice drug was sotalol and all were converted. One AET was classified postnatally as PJRT. Six fetuses had intra-atrial re-entrant tachycardia: five with 2:1 AV conduction and one with variable block. The first choice drug was digoxin. Conversion was achieved in all but one, who died after birth from advanced cardiomyopathy. Conclusion: The electrophysiological mechanisms of fetal SVT can be clarified with SVC/AA Doppler. The proposed management protocol has so far yielded a good rate of conversion to sinus rhythm.

Fouron, J-C; Fournier, A; Proulx, F; Lamarche, J; Bigras, J L; Boutin, C; Brassard, M; Gamache, S

2003-01-01

65

Systemic hypothermia and circulatory arrest combined with arterial perfusion of the superior vena cava. Effective intraoperative cerebral protection.  

PubMed

We have used retrograde arterial perfusion of the superior vena cava as an adjunct to deep hypothermia and systemic circulatory arrest for intraoperative cerebral protection in 43 adult patients (18 of whom were 70 years old or older). The indications for the use of circulatory arrest were thoracic aortic operations (37 patients) and atherosclerosis or calcification of the ascending aorta (6 patients) in patients needing aortic valve or coronary operations. In all patients systemic hypothermia (16 degrees to 18 degrees C) was achieved with cardiopulmonary bypass and the systemic arterial circulation was arrested. Retrograde arterial perfusion of the superior vena cava was established through a wire-reinforced venous cannula (with a superior vena cava tourniquet) at a temperature of 15 degrees C. In 36 patients a separate roller pump system was used for the retrograde cerebral perfusion. Central venous pressure was monitored at 25 to 30 mm Hg; mean flow rate was 250 ml/min. Periods of circulatory arrest and retrograde cerebral perfusion ranged from 4 to 110 minutes (mean 38 minutes), and for seven patients the period of circulatory arrest was longer than 60 minutes. Four postoperative deaths occurred, one related to stroke in a patient who had an aortic dissection during coronary surgery and the others related to noncerebral complications. Three nonfatal cerebral complications occurred, although all had completely resolved by late follow-up. Advantages of retrograde cerebral perfusion are (1) simplicity of use and avoidance of vascular trauma, (2) excellent exposure, (3) retrograde flow that minimizes embolization of air and atherosclerotic debris, and (4) effective cerebral oxygen delivery. Retrograde cerebral perfusion appears to be an important adjunct to hypothermia and circulatory arrest not only for patients undergoing operation for ascending aorta and aortic arch disease but also for patients with diffuse aortic atherosclerosis undergoing coronary or valve operations. PMID:7715222

Lytle, B W; McCarthy, P M; Meaney, K M; Stewart, R W; Cosgrove, D M

1995-04-01

66

Cardiac defibrillator implantation via persistent left superior vena cava - sometimes this approach is facile. A case report.  

PubMed

We report a case of persistent left superior vena cava (PLSVC) incidentally recognized during the implantation of a cardioverter-defibrillator. PLSVC is the most common venous anomaly of the thorax and drains into the right atrium. There are a lot of publications reporting success of pacemaker or defibrillator lead implantations via PLSVC. In this article we present the technique of approaching the right ventricle and right atrium via PLSVC; sometimes this method can be as straightforward as the classical way. Therefore, if PLSVC is recognized intra-operatively, we suggest continuing left-sided implantation, and considering a right venous access only in case of failure. PMID:22291750

Bissinger, Andrzej; Bahadori-Esfahani, Fardokht; Lubi?ski, Andrzej

2011-03-08

67

Periumbilical uptake of Tc-99m MAA on lung perfusion scanning in a patient with superior vena cava obstruction.  

PubMed

A 25-year-old woman with severe parenchymal lung disease of unknown etiology and existing for more than a decade was referred for ventilation-perfusion scintigraphy because of suspicion of pulmonary embolism. Both ventilation and perfusion images showed, apart from perfusion defects from her severe lung disease, a left apical pneumothorax and signs of recurrent pneumonia of the left lower lobe. Noteworthy was the periumbilical uptake of the Tc-99m macroaggregated albumin (MAA). Her medical history revealed iatrogenic superior vena cava (SVC) obstruction. In this case, the main collateral pathway of portosystemic shunting is probably, after recanalization of the left umbilical vein, a network of smaller paraumbilical veins. PMID:16550019

Balink, H; Nabers, J

2006-04-01

68

Transcatheter Treatment of Patent Foramen Ovale Combined with Abnormal Drainage of Left Superior Vena Cava to Left Upper Pulmonary Vein  

PubMed Central

Patent foramen ovale (PFO) has been known to be the cause of transient ischemic attacks or stroke, and transcatheter device closure has been the treatment of choice for these defects. Combined defect of abnormal drainage of left superior vena cava (LSVC) to left superior pulmonary vein (LSPV) in PFO patients is an uncommon combination, and both can act as a pathway for paradoxical embolism. We report a successful closure of PFO, using Amplatzer® PFO occluder (St. Jude Medical, St. Paul, MN, USA) and persistent LSVC connected to LSPV using an Amplatzer® Vascular Plug II (St. Jude Medical, St. Paul, MN, USA). Because this combined anomaly of PFO and persistent LSVC can be treated by a single transcatheter intervention, if clinically suspected, a complete evaluation for this anomaly should be considered.

Kim, Do Hoon; Park, Su-Jin; Jung, Jo Won; Kim, Nam Kyun

2013-01-01

69

Surviving a delayed trans-diaphragmatic hepatic rupture complicated by an acute superior vena cava and thoracic compartment syndromes.  

PubMed

We describe the first reported survivor of a delayed trans-diaphragmatic hepatic rupture complicated by acute superior vena cava (SVCS) and thoracic compartment syndromes (TCS). A thirty one year old male was involved in a boating accident. The patient was diagnosed with a grade IV liver laceration, which was initially managed with both angio-embolization and open surgical repair. Exactly one month from admission, the patient presented with an abrupt cardiac arrest, which was further complicated by a SVCS and TCS. The SVCS was managed with bilateral thoracostomies which revealed a delayed trans-diaphragmatic hepatic rupture into the right chest cavity. The TCS was managed with a decompressive thoraco-abdominal incision. The patient survived and is now leading a normal life. Our success was largely due to an integrated trauma system of physicians, nurses and technicians that prompted the early recognition of two potentially life threatening complications of a delayed trans-diaphragmatic hepatic rupture. PMID:21887041

Parra, Michael W; Rodas, Edgar B; Bartnik, Jakub P; Puente, Ivan

2011-07-01

70

Ectopic parathyroid carcinoma presenting with hypercalcemic crisis, ectopic uptake in bone scan and obstruction of superior vena cava.  

PubMed

A 28-year-old Chinese man diagnosed with hypercalcemic crisis was referred for Tc-99m sestamibi parathyroid imaging, which revealed a massive sestamibi-avid lesion in right-site of upper mediastinum. Contrast-enhanced CT demonstrated the lesion encroached and obstructed bilateral innominate veins and superior vena cava. Tc-99m methylene diphosphonate (MDP) bone scan and SPECT displayed ectopic uptakes in the lungs and stomach. Preoperative suspicion of parathyroid carcinoma prompted an en bloc surgery, which was confirmed in histopathology. Our case showed that although ectopic parathyroid carcinoma causing hypercalcemic crisis, extraskeletal microcalcifications, and great vessel obstruction is rare, parathyroid imaging and bone scan can help solve these diagnostic challenges. PMID:21552035

Meng, Zhaowei; Li, Dong; Zhang, Yujie; Zhang, Peng; Tan, Jian

2011-06-01

71

Apparent obstruction of the superior vena cava and a continuous murmur: signs of a fistula between a vein graft aneurysm and the right atrium  

PubMed Central

A previously undescribed complication of a saphenous vein aortocoronary bypass graft, namely formation of a fistula between a vein graft aneurysm and the right atrium is reported. A patient presented with a continuous murmur and a combination of signs suggesting superior vena cava obstruction. This pathology was shown by both echocardiography and angiography. Surgical treatment was attempted.

Richardson, Mark P; Thuraisingham, Surendran I; Dunning, John

1992-01-01

72

A case with dextrocardia, ventricular septal defect, persistent left superior vena cava and drainage of the great cardiac vein into the left internal thoracic vein  

Microsoft Academic Search

A 17-month-old female patient was operated on for ventricular septal defect and pulmonary stenosis. During the operation several cardiac anomalies were observed these were dextrocardia, ventricular septal defect, persistent left superior vena cava, drainage of the great cardiac vein into the left internal thoracic vein and a pericardial pouch. These anomalies have not previously been reported together.

N. Yener; H. S. Sürücü; R. Dogan; M. M. Aldur

2001-01-01

73

High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia  

PubMed Central

Background Persistent left superior vena cava (LSVC) is one of the common anomalies of the systemic veins. Its prevalence is 0.1–0.3% in the general population and is more common with congenital heart disease (CHD). The importance of detecting persistent LSVC prior to cardiac surgery is paramount for systemic veins cannulations. Aim The aim was to evaluate the prevalence of persistent LSVC in patients with CHD in Saudi Arabia. Methods All patients referred to our institution had echocardiography. All complete studies were reviewed for the presence of persistent LSVC. A computerized database was created including the demographic data, CHD diagnoses, and the presence of persistent LSVC. Results A total of 2,042 were examined with an age range of 1 day to 16 years. The complete echocardiographic studies were 1,832 (90%) of whom 738 (40%) patients had CHD. The prevalence of persistent LSVC in patients with CHD was 7.8% (OR 9.26, 95% CI 4.7–18.2, p<0.001). The most common cardiac defect associated with persistent LSVC was complete atrioventricular septal defect (AVSD); all patients with AVSD had Down syndrome. The total number of patients with AVSD was 41, and persistent LSVC was found in 11 (26%) of them (odds ratio 5.1, 95% CI 2.4–10.8, p<0.001). Conclusions The prevalence of persistent LSVC in the current population is almost double the reported prevalence obtained using the same echocardiographic screening tool.

Eldin, Ghada Shiekh; El-Segaier, Milad; Galal, Mohammed Omer

2013-01-01

74

Transbronchial fine needle aspiration biopsy and rapid on-site evaluation in the setting of superior vena cava syndrome.  

PubMed

There is a paucity of prospective data on flexible bronchoscopy with rapid on-site evaluation (ROSE) in the setting of superior vena cava (SVC) syndrome. The aims of this prospective study were to assess the diagnostic yield and safety of these investigations and specifically to evaluate the role of ROSE in limiting the need for tissue biopsies. Over a 5-year period 48 patients (57.4 ± 9.7 years) with SVC syndrome secondary to intrathoracic tumors underwent flexible bronchoscopy with TBNA and ROSE. Endobronchial Forceps biopsy was reserved for visible endobronchial tumors with no on-site confirmation of diagnostic material. ROSE confirmed diagnostic material in 41 cases (85.4%), and in only one of the remaining cases did the addition of a forceps biopsy increase the diagnostic yield (overall diagnostic yield of 87.5%). No serious complications were noted. The final diagnoses made included nonsmall lung cancer (n = 27), small cell lung cancer (n = 16), and metastatic carcinoma (n = 3). Two undiagnosed cases died of suspected advanced neoplasms (unknown primary tumors). We conclude that TBNA has a high diagnostic yield and is safe in the setting of SVC syndrome. With the addition of ROSE, tissue biopsy is required in the minority of cases. PMID:22102539

Brundyn, K; Koegelenberg, C F N; Diacon, A H; Louw, M; Schubert, P; Bolliger, C T; van den Heuvel, M M; Wright, C A

2011-11-18

75

Retroperitoneal extra-adrenal ganglioneuroma involving the infrahepatic inferior vena cava, celiac axis and superior mesenteric artery: A case report  

PubMed Central

INTRODUCTION Ganglioneuromas are rare benign neoplasms arising from the sympathetic neuroendocrine system. These tumors usually occur in the abdomen and tend to grow around major blood vessels making often their complete excision challenging and demanding. PRESENTATION OF CASE The authors present the challenging surgical management of a sizable retroperitoneal extra-adrenal ganglioneuroma involving the infrahepatic inferior vena cava, portal triad, celiac axis and superior mesenteric artery in a 23-year-old female patient. The tumor was safely and completely excised in toto with preservation of all neighboring vital anatomical structures using a midi laparotomy access. DISCUSSION Ganglioneuromas should be included in the differential diagnosis of any retroperitoneal mass. Their management involves total surgical excision however, in some instances; it can be challenging and demanding because of their tendency to engage neighboring vital anatomical structures. CONCLUSION A surgical strategy including meticulous operative dissection guided by the quality principles of surgical oncology although challenging and demanding can result to a safe and complete tumor excision, which is directly correlated with an improved patients’ postoperative outcome and excellent prognosis.

Vasiliadis, K.; Papavasiliou, C.; Fachiridis, D.; Pervana, S.; Michaelides, M.; Kiranou, M.; Makridis, C.

2012-01-01

76

High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia.  

PubMed

Background : Persistent left superior vena cava (LSVC) is one of the common anomalies of the systemic veins. Its prevalence is 0.1-0.3% in the general population and is more common with congenital heart disease (CHD). The importance of detecting persistent LSVC prior to cardiac surgery is paramount for systemic veins cannulations. Aim : The aim was to evaluate the prevalence of persistent LSVC in patients with CHD in Saudi Arabia. Methods : All patients referred to our institution had echocardiography. All complete studies were reviewed for the presence of persistent LSVC. A computerized database was created including the demographic data, CHD diagnoses, and the presence of persistent LSVC. Results : A total of 2,042 were examined with an age range of 1 day to 16 years. The complete echocardiographic studies were 1,832 (90%) of whom 738 (40%) patients had CHD. The prevalence of persistent LSVC in patients with CHD was 7.8% (OR 9.26, 95% CI 4.7-18.2, p<0.001). The most common cardiac defect associated with persistent LSVC was complete atrioventricular septal defect (AVSD); all patients with AVSD had Down syndrome. The total number of patients with AVSD was 41, and persistent LSVC was found in 11 (26%) of them (odds ratio 5.1, 95% CI 2.4-10.8, p<0.001). Conclusions : The prevalence of persistent LSVC in the current population is almost double the reported prevalence obtained using the same echocardiographic screening tool. PMID:24107708

Shiekh Eldin, Ghada; El-Segaier, Milad; Galal, Mohammed Omer

2013-10-08

77

Absence of right superior vena cava that was not detected by insertion of a pulmonary arterial catheter via the right internal jugular vein  

Microsoft Academic Search

Pulmonary arterial catheter (PAC) placement under fluoroscopy is a useful and safe method to diagnose certain congenital cardiac\\u000a anomalies [1]. However, when a PAC for intraoperative monitoring is placed without the aid of fluoroscopy, it may be inadvertently\\u000a placed into anomalous veins. The following report presents a case of persistent left superior vena cava (PLS VC) with absence\\u000a of right

Yoshiki Hara; Kazutomo Ota; Masao Fujita; Hidehiro Suzuki

1994-01-01

78

Intra-atrial rerouting and MAZE procedure for an Adult Patient in Cor Triatriatum, Persistent Left Superior Vena Cava, and Atrial Fibrillation  

Microsoft Academic Search

A combination of cor triatriatum and persistent left superior vena cava without communication to coronary sinus is not common. A 62-year-old male with this diagnosis conjunct with atrial fibrillation underwent successful intra-cardiac repair using a unique method. Following a maze procedure and enlargement the route from pulmonary veins to the mitral valve, a GoreTex conduit was bypassed between the orifice

Koichi Sughimoto; Kozo Matsuo; Masanao Ohba

79

Fistula from right internal mammary artery to superior vena cava after use of a laser sheath to extract a pacemaker lead.  

PubMed

A 55-year-old woman presented with dyspnea on exertion due to a right internal mammary artery-to-superior vena cava arteriovenous fistula that occurred after pacemaker lead extraction with a laser sheath. The fistula was successfully repaired by placing a covered stent in the right internal mammary artery. In this unusual location, endovascular stenting is a reasonable alternative to coil embolization or surgical repair of an arteriovenous fistula resulting from laser lead extraction. PMID:23109780

Azpurua, Federico E; Dougherty, Kathryn G; Massumi, Ali; Strickman, Neil E

2012-01-01

80

Fistula from Right Internal Mammary Artery to Superior Vena Cava after Use of a Laser Sheath to Extract a Pacemaker Lead  

PubMed Central

A 55-year-old woman presented with dyspnea on exertion due to a right internal mammary artery-to-superior vena cava arteriovenous fistula that occurred after pacemaker lead extraction with a laser sheath. The fistula was successfully repaired by placing a covered stent in the right internal mammary artery. In this unusual location, endovascular stenting is a reasonable alternative to coil embolization or surgical repair of an arteriovenous fistula resulting from laser lead extraction.

Azpurua, Federico E.; Dougherty, Kathryn G.; Massumi, Ali; Strickman, Neil E.

2012-01-01

81

Iatrogenic migration of VenaTech LP IVC filter to superior vena cava secondary to guidewire entrapment: case report and review of literature.  

PubMed

Modern inferior vena cava (IVC) filters are generally safe devices for preventing pulmonary embolus, with fewer complications compared to earlier techniques of caval interruption. Despite continuing improvement in filter designs and insertion methods, complications still occur. The IVC filter complications resulting from iatrogenic causes are rare and include but are not limited to misplacement, filter tilting, incomplete deployment, and filter migration. We recently experienced a problem in which the Vena Tech LP filter (B. Braun, Bethlehem, Pennsylvania) migrated to the superior vena cava (SVC) immediately after successful deployment of the filter in the infrarenal venacava. The root cause analysis of this case revealed that the complication was related to blind pullout of the J-tipped guidewire following deployment of the filter in the IVC. This report highlights the potential risks of using a wire while an IVC filter is in place. PMID:23203598

Almestady, Rajaa; Spain, James; Bayona-Molano, Maria Del Pilar; Wang, Weiping

2012-11-29

82

Chronic cyanosis due to persistent left superior vena cava draining into the left atrium in the absence of a coronary sinus.  

PubMed

We report a rare case of a 5-year-old child who presented with chronic hypoxemia and a normal cardiac examination, and was found to have a persistent left superior vena cava draining directly into the left atrium. The coronary sinus was absent. This case introduces a contradiction to the generally accepted concept that this anomalous connection can only occur in the presence of a partly or completely unroofed coronary sinus. High index of suspicion is required to include this pathology in the differential diagnosis for a patient with persistent cyanosis with normal cardiac examination. PMID:23334496

Sanchez Mejia, Aura; Singh, Himanshu; Bhalla, Sanjeev; Singh, Gautam K

2013-01-19

83

Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect  

SciTech Connect

A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported.

Erol, Ilknur [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Neurology Unit (Turkey)], E-mail: ilknur_erol@yahoo.co; Cetin, I. Ilker [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit (Turkey); Alehan, Fuesun [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Neurology Unit (Turkey); Varan, Birguel [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit (Turkey); Ozkan, Sueleyman [Baskent University Faculty of Medicine, Department of Cardiovascular Surgery (Turkey); Agildere, A. Muhtesem [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Tokel, Kursad [Baskent University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit (Turkey)

2006-06-15

84

Hemopericardium After Superior Vena Cava Stenting for Malignant SVC Obstruction: The Importance of Contrast-Enhanced CT in the Assessment of Postprocedural Collapse  

SciTech Connect

We report the complication of hemopericardium following superior vena cava (SVC) stenting with an uncovered Wallstent in a patient with malignant SVC obstruction. The patient collapsed acutely 15 min following stent placement with hypoxemia and hypotension. A CT scan demonstrated a hemopericardium which was successfully treated with a pericardial drain. The possible complications of SVC stenting, including hemopericardium, pulmonary embolism, mediastinal hematoma, and pulmonary edema from increased venous return resulting from improved hemodynamics, ensure a wide differential diagnosis in the post procedural collapsed patient and this case emphasizes the important role of contrast-enhanced CT in the peri-resuscitation assessment of these patients.

Brant, Jonathan; Peebles, Charles [Department of Radiology, Southampton General Hospital, Tremona Road, Southampton SO16 6YD (United Kingdom); Kalra, Paul [Department of Cardiology, Southampton General Hospital, Tremona Road, Southampton SO16 6YD (United Kingdom); Odurny, Allan [Department of Radiology, Southampton General Hospital, Tremona Road, Southampton SO16 6YD (United Kingdom)

2001-09-15

85

Nonoperative management of late failure of a Glenn anastomosis. Transvenous wafer occlusion of patent superior vena cava--right atrial junction.  

PubMed

A case is presented illustrating delayed failure of a right Glenn anastomosis due to patency of the superior vena cava-right atrial (SVC-RA) junction. Clinical deterioration was rectified by a unique nonoperative approach. A transvenous catheter was designed, constructed, and used to accurately place an umbrella-like occlusive wafer at the SVC-RA junction. In this manner the integrity of the cavopulmonary shunt was re-established. A gratifying and uncomplicated palliation has thus far been achieved. PMID:1249968

Bailey, L L; Freedom, R M; Fowler, R J; Trusler, G A

1976-03-01

86

Right superior vena cava drainage into the left atrium associated with a coronary-cameral fistula occluding an atrial-septal defect: first echocardiographic, angiographic, and surgical description.  

PubMed

Right superior vena cava (SVC) drainage into the left atrium causing hypoxemia is a very rare congenital malformation. This anomaly can result in complications of chronic cyanosis and paradoxical embolism. It rarely is associated with any other congenital malformation. This is the first case report of right SVC drainage into the left atrium associated with a coronary cameral fistula. During surgical repair, the aneurysmal part of the cameral fistula was noted to be occluding a defect in the atrial septum. Repair of the cameral fistula and rerouting of the SVC via the atrial septal defect were performed. PMID:18839237

Sushil, Azad; Raja, Joshi; Manvinder, Singh; Reena, Joshi; Vikas, Kohli

2008-10-07

87

Repositioning and Leaving In Situ the Central Venous Catheter During Percutaneous Treatment of Associated Superior Vena Cava Syndrome: A Report of Eight Cases  

SciTech Connect

Purpose: To describe a combined procedure of repositioning and leaving in situ a central venous catheter followed by immediate percutaneous treatment of associated superior vena cava syndrome (SVCS). Methods: Eight patients are presented who have central venous catheter-associated SVCS (n = 6 Hickman catheters, n = 2 Port-a-cath) caused by central vein stenosis (n = 4) or concomitant thrombosis (n = 4). With the use of a vascular snare introduced via the transcubital or transjugular approach, the tip of the central venous catheter could be engaged, and repositioned after deployment of a stent in the innominate or superior vena cava. Results: In all patients it was technically feasible to reposition the central venous catheter and treat the SVCS at the same time. In one patient flipping of the Hickman catheter in its original position provoked dislocation of the released Palmaz stent, which could be positioned in the right common iliac vein. Conclusion: Repositioning of a central venous catheter just before and after stent deployment in SVCS is technically feasible and a better alternative than preprocedural removal of the vascular access.

Stockx, Luc; Raat, Henricus [Department of Radiology, Catholic University of Leuven, University Hospitals, Herestraat 49, B-3000 Leuven (Belgium); Donck, Jan [Department of Nephrology, Catholic University of Leuven, University Hospitals, Herestraat 49, B-3000 Leuven (Belgium); Wilms, Guy; Marchal, Guy [Department of Radiology, Catholic University of Leuven, University Hospitals, Herestraat 49, B-3000 Leuven (Belgium)

1999-05-15

88

The diagnostic value of a single measurement of superior vena cava flow in the first 24 h of life in very preterm infants.  

PubMed

Low superior vena cava (SVC) flow has been associated with intraventricular haemorrhage (IVH) in very preterm infants. We studied the diagnostic value of a single measurement of SVC flow within the first 24 h of life in very preterm infants and its association with occurrence or extension of IVH in a setting of limited availability of neonatal echocardiography. Preterm infants who were born at less than 30 weeks gestation and who had an echocardiogram within 24 h after birth were eligible. Baseline, clinical and ultrasound data were collected. A total of 165 preterm infants were included. Low SVC flow (<41 ml/kg/min) occurred in six infants and was associated with severe IVH and extension of IVH, although this was not significant after adjusting for confounders. The only independently associated variable with low SVC flow was admission temperature (odds ratio 0.27, p?=?0.001). A review of SVC flow values shows that these are higher now than initially reported. This study does not show an association of low SVC flow and severe IVH or extension of IVH after adjusting for confounders as a single measurement of SVC flow did not add any diagnostic value in this cohort. Thus, the exact role of SVC flow measurements in the circulatory assessment of preterm infants remains to be elucidated. However, admission temperature may have an effect on systemic blood flow in very preterm infants. PMID:22638864

Holberton, James R; Drew, Sandra M; Mori, Rintaro; König, Kai

2012-05-26

89

Follow-up Results of 71 Patients Undergoing Metallic Stent Placement for the Treatment of a Malignant Obstruction of the Superior Vena Cava  

SciTech Connect

Purpose. To retrospectively clarify the utility of metallic stent placement for the treatment of the malignant obstruction of the superior vena cava (SVC) in 71 patients with VC syndrome (SVCS) on the basis of long-term follow-up data. Materials and Methods. Seventy-one patients underwent stent placement and were followed until death. The applicability of the spiral Z-stent (S-Z-stent) mainly used the initial and follow-up results, stent placement for bilateral BCV obstruction and the value of concurrent anticancer therapy were studied. Results. The technical success rate was 100%, the initial clinical success rate was 87% (62/71), the primary clinical patency rate was 88% (57/65), and the secondary clinical patency rate was 95% (62/65). The obstruction rate of the stent was 12% (8/65), and an additional stent was useful for relief of recurrent SVCS. Survival of 57 patients in whom there was no recurrence of SVCS until death ranged from 1 week to 29 months (mean, 5.4 months and the S-Z-stent appeared to be suitable for the treatment of the malignant obstruction of SVC. Unilateral stent placement was effective for relief of SVCS with bilateral BCV obstruction. Patients who received concurrent anticancer therapy survived 2 months longer than those who did not. Conclusion. Stent placement is an effective treatment for SVCS. Further, the utility of S-Z-stent for SVCS, an additional stent for recurrence, unilateral stent for patients with bilateral BCV obstruction, and anticancer therapy after stent placement were verified.

Nagata, Takeshi [Daiyukai General Hospital, Department of Radiology and Interventional Center (Japan)], E-mail: t-nagata@remus.dti.ne.jp; Makutani, Shiro [Nara Medical University, Department of Radiology and Radiation Oncology (Japan); Uchida, Hideo [Daiyukai General Hospital, Department of Radiology and Interventional Center (Japan); Kichikawa, Kimihiko [Nara Medical University, Department of Radiology and Radiation Oncology (Japan); Maeda, Munehiro [Aizenbashi Hospital, Department of Radiology (Japan); Yoshioka, Tetsuya [Nara Prefecture Hospital, Department of Radiology (Japan); Anai, Hiroshi; Sakaguchi, Hiroshi; Yoshimura, Hitoshi [Nara Medical University, Department of Radiology and Radiation Oncology (Japan)

2007-09-15

90

Successful management of multiple permanent pacemaker complications - infection, 13 year old silent lead perforation and exteriorisation following failed percutaneous extraction, superior vena cava obstruction, tricuspid valve endocarditis, pulmonary embolism and prosthetic tricuspid valve thrombosis  

PubMed Central

A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary embolism requiring TPA thrombolysis which was instantly successful. A review of literature of pacemaker endocarditis and tricuspid thrombosis along with the relevant management strategies is presented. We believe this case report is unusual on account of non operative management of right atrial lead perforation following an unsuccessful attempt at percutaneous removal of right sided infected pacemaker leads and the incidental discovery of the perforated lead 13 years later at sternotomy, presentation of pacemaker endocarditis with a massive load of vegetations along the entire pacemaker lead tract in superior vena cava, right atrial endocardium, tricuspid valve and right ventricular endocardium, leading to a functional and structural SVC obstruction, requirement of an unusually large dose of warfarin postoperatively occasioned, in all probability, by antibiotic drug interactions, presentation of tricuspid prosthetic valve thrombosis uniquely as vasovagal syncope and isolated hypoxia and near instantaneous resolution of tricuspid prosthetic valve thrombosis with Alteplase thrombolysis.

Kaul, Pankaj; Adluri, Krishna; Javangula, Kalyana; Baig, Wasir

2009-01-01

91

Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients  

PubMed Central

Persistent left superior vena cava (PLSVC) represents the most common congenital venous anomaly of the thoracic systemic venous return, occurring in 0.3% to 0.5% of individuals in the general population, and in up to 12% of individuals with other documented congential heart abnormalities. In this regard, there is very little in the literature that specifically addresses the potential importance of the incidental finding of PLSVC to surgeons, interventional radiologists, and other physicians actively involved in central venous access device placement in cancer patients. In the current review, we have attempted to comprehensively evaluate the available literature regarding PLSVC. Additionally, we have discussed the clinical implications and relevance of such congenital aberrancies, as well as of treatment-induced or disease-induced alterations in the anatomy of the thoracic central venous system, as they pertain to the general principles of successful placement of central venous access devices in cancer patients. Specifically regarding PLSVC, it is critical to recognize its presence during attempted central venous access device placement and to fully characterize the pattern of cardiac venous return (i.e., to the right atrium or to the left atrium) in any patient suspected of PLSVC prior to initiation of use of their central venous access device.

2011-01-01

92

Superior venacava syndrome  

Microsoft Academic Search

Superior vena cava syndrome (SVCS) affects approximately 15,000 people annually in the United States. Currently, mediastinal malignancies, primarily small cell lung cancer, account for the majority of cases of SVCS. Iatrogenic causes, predominantly long-term central venous catheters, account for approximately 7% of cases of SVCS, and the incidence is increasing. Historically, SVCS was considered an oncologic emergency that required urgent

Michael L Pearl; Ann Buhl; Paul A DiSilvestro; Fidel A Valea; Eva Chalas

2002-01-01

93

Crux vena cava filter.  

PubMed

Inferior vena cava filters are widely accepted for pulmonary embolic prophylaxis in high-risk patients with contraindications to anticoagulation. While long-term complications have been associated with permanent filters, retrievable filters are now available and have resulted in the rapid expansion of this technology. Nonetheless, complications are still reported with optional filters. Furthermore, device tilting and thrombus load may prevent retrieval in up to 30% of patients, thereby eliminating the benefits of this technology. The Crux vena cava filter is a novel, self-centering, low-profile filter that is designed for ease of delivery, retrievability and improved efficacy while limiting fatigue-related device complications. This device has been proven safe and user-friendly in an ovine model and has recently been implanted in human subjects. PMID:19751120

Murphy, Erin H; Johnson, Eric D; Kopchok, George E; Fogarty, Thomas J; Arko, Frank R

2009-09-01

94

Vena Cava 3D Contrast-Enhanced MR Venography: A Pictorial Review  

Microsoft Academic Search

Three-dimensional contrast-enhanced magnetic resonance venography (CE MRV) is a sensitive and accurate method for diagnosing vena cava pathologies. The commonly used indirect approach involves a nondiluted gadolinium contrast agent injected into an upper limb vein or, occasionally, a pedal vein for assessment of the superior or inferior vena cava. In our studies, a coronal 3D fast multi-planar spoiled gradient-echo acquisition

Jiang Lin; Kang-Rong Zhou; Zu-Wang Chen; Jian-Hua Wang; Zi-Ping Yan; Yi-Xiang J. Wang

2005-01-01

95

Vena Cava 3D Contrast-Enhanced MR Venography: A Pictorial Review  

SciTech Connect

Three-dimensional contrast-enhanced magnetic resonance venography (CE MRV) is a sensitive and accurate method for diagnosing vena cava pathologies. The commonly used indirect approach involves a nondiluted gadolinium contrast agent injected into an upper limb vein or, occasionally, a pedal vein for assessment of the superior or inferior vena cava. In our studies, a coronal 3D fast multi-planar spoiled gradient-echo acquisition was used. A pre-contrast scan was obtained to ensure correct coverage of the region of interest. We initiated contrast-enhanced acquisition 15 sec after the start of contrast agent injection and performed the procedure twice. The image sets were obtained during two 20-30-sec breath hold, with a breathing rest of 5-6 sec, to obtain the first-pass and delayed arteriovenous phases. For patients with Budd-Chiari syndrome, a third acquisition coinciding with late venous phase was collected to visualize the hepatic veins, which was carried out by one additional acquisition after a 5-6-sec breathing time. This review describes the clinical application of 3D CE MRV in vena cava congenital anomalies, superior and inferior vena cava syndrome, Budd-Chiari syndrome, peripheral vein thrombosis extending to the vena cava, pre-operational evaluation in portosystemic shunting and post-surgical follow-up, and road-mapping for the placement and evaluation of complications of central venous devices.

Lin Jiang; Zhou Kangrong; Chen Zuwang; Wang Jianhua; Yan Ziping [Zhongshan Hospital, Fudan University, Department of Radiology (China); Wang, Yi-Xiang J. [Current with Astrazeneca Pharmaceuticals (United Kingdom)], E-mail: yi-xiang.wang@astrazeneca.com

2005-12-15

96

Hepatic Veins and Inferior Vena Cava Thrombosis in a Child Treated by Transjugular Intrahepatic Portosystemic Shunt  

SciTech Connect

We report the case of a 9-year-old boy with portal hypertension, due to Budd-Chiari syndrome, and retrohepatic inferior vena cava thrombosis, submitted to a transjugular intrahepatic portosystemic shunt (TIPS) by connecting the suprahepatic segment of the inferior vena cava directly to the portal vein. After 3 months, the withdrawal of anticoagulants promoted the thrombosis of the TIPS. At TIPS revision, thrombosis of the TIPS and the main portal vein and clots at the splenic and the superior mesenteric veins were found. Successful angiography treatment was performed by thrombolysis and balloon angioplasty of a severe stenosis at the distal edge of the stent.

Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br; Santos, Aline Cristine Barbosa [Sao Paulo University Medical School, Interventional Radiology Unit, Radiology Institute, Hospital das Clinicas (Brazil); Tannuri, Uenis [Sao Paulo University Medical School, Liver Transplantation Unit, Children's Institute, Hospital das Clinicas (Brazil); Cerri, Giovanni Guido [Sao Paulo University Medical School, Interventional Radiology Unit, Radiology Institute, Hospital das Clinicas (Brazil)

2010-06-15

97

Thrombotic superior vena caval obstruction after repair of tetralogy of Fallot.  

PubMed Central

A case of tetralogy of Fallot is described, in which thrombotic obstruction of the superior vena cava developed after total correction. Partial thrombolysis was achieved with streptokinase therapy. Images

Mearns, A J; Davies, J A; Hoggard, C A; Watson, D A

1977-01-01

98

Vena cava filters for management of venous thromboembolism: A clinical review.  

PubMed

Venous thromboembolism (VTE) is the common cause of morbidity and mortality. Vena cava filters (VCF) represent an important alternative to anticoagulation for management of VTE. VCF use has increased dramatically with the availability of retrievable filters. Since indiscriminate use of VCF can be associated with net patient harm, knowledge of the risks and benefits of these devices is essential to optimal evidence-based practice. In this review, we will examine the characteristics of available permanent and optional VCF, their efficacy and safety in management of VTE and discuss appropriate, extended and unsubstantiated indications for VCF use. We will also review the clinical outcomes of VCF in alternative placement sites (supra-renal inferior vena cava and superior vena cava) and in specialized patient populations (bariatric surgery, cancer, etc.), recommendations regarding anticoagulation for prevention of thrombosis as well as recommended follow up for patients with VCF. PMID:23932118

Rajasekhar, Anita; Streiff, Michael B

2013-08-07

99

21 CFR 870.3260 - Vena cava clip.  

Code of Federal Regulations, 2013 CFR

...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3260 Vena cava clip. (a) Identification. A vena cava clip is an implanted extravascular...

2013-04-01

100

Complete atrioventricular block in an adult with congenitally corrected transposition of the great arteries with interrupted inferior vena cava  

PubMed Central

A 56-year-old man got admitted as he was suffering from dizziness for 3 days. Electrocardiogram (ECG) showed complete atrioventricular (AV) block with ventricular rhythm of 35/min. We found that he had no inferior vena cava (IVC) which drained into right atrium in the middle of temporary pacing lead insertion. Venous drainage into superior vena cava from dilated azygos vein was identified after venogram. Echocardiogram revealed a congenitally corrected transposition of the great arteries (CCTGA). Chest computed tomography (CT) angiogram revealed AV and ventriculoarterial discordance with reversed ventricles and interrupted IVC with azygos continuation. DDD pacemaker was implanted via left axillary vein without any problem.

Yoon, Namsik; Kim, Kye Hum; Park, Hyung Wook; Cho, Jeong Gwan

2012-01-01

101

Overview of current inferior vena cava filters.  

PubMed

Inferior vena cava (IVC) filter technology has expanded dramatically over the past decade. Improvements in catheter and filter technology have allowed for the safe and rapid insertion of IVC filters from multiple venous access sites, using increasingly lower-profile percutaneous delivery systems. While the currently available filters have slightly different designs and insertion techniques, all function in a similar fashion to prevent venous thromboembolic propagation through the inferior vena cava. This article describes the construction and deployment mechanisms of the various filters that are currently on the market. PMID:12953819

Kercher, Kent; Sing, Ronald F

2003-08-01

102

Caudal vena cava thrombosis-like syndrome in a horse  

PubMed Central

A 9-year-old Quarter horse was presented for chronic refractory pneumonia. On necropsy, an hepatic abscess, caudal vena cava thrombosis, pulmonary thromboembolism, and embolic pneumonia were identified. Similar lesions have been reported in cattle as caudal vena cava thrombosis syndrome, however this syndrome has not previously been reported in horses.

Schoster, Angelika; Anderson, Maureen E.C.

2010-01-01

103

Abdominal neuroblastoma in a child with inferior vena cava anomaly.  

PubMed

Congenital anomalies of the inferior vena cava are rare. Such anomalies pose great challenges to the surgeon in neuroblastoma surgery, especially when unrecognised preoperatively. We report the first case of an abdominal neuroblastoma detected in a child with a developmental anomaly of the left-sided inferior vena cava. The patient underwent surgical resection after good response to preoperative chemotherapy. PMID:24154588

Chui, C H

2013-10-01

104

Prosthetic replacement of the inferior vena cava for malignancy  

Microsoft Academic Search

Purpose: Invasion of the inferior vena cava (IVC) by tumor is generally considered a criterion of unresectability. This study was designed to review the outcomes of a strategy of aggressive resection of the vena cava to achieve complete tumor resection coupled with prosthetic graft placement to re-establish caval flow. Methods: Retrospective review of patients treated at a university referral center.

Rajabrata Sarkar; Frederick R. Eilber; Hugh A. Gelabert; William J. Quinones-Baldrich

1998-01-01

105

Magnetic resonance venography of double inferior vena cava.  

PubMed

Duplication of the inferior vena cava IVC is the most common anomaly affecting the vena cava. Variations of the IVC are diagnosed in routine dissection studies, in retroperitoneal surgeries, or in radiological studies for various reasons. In this paper, we present a case of double IVC with its magnetic resonance imaging findings. PMID:15756362

Tatar, Ilkan; Tore, Huseyin G; Celik, Hakan H; Karcaaltincaba, Musturay

2005-01-01

106

Computational Modeling of Blood Flow in the TrapEase Inferior Vena Cava Filter  

SciTech Connect

To evaluate the flow hemodynamics of the TrapEase vena cava filter using three dimensional computational fluid dynamics, including simulated thrombi of multiple shapes, sizes, and trapping positions. The study was performed to identify potential areas of recirculation and stagnation and areas in which trapped thrombi may influence intrafilter thrombosis. Computer models of the TrapEase filter, thrombi (volumes ranging from 0.25mL to 2mL, 3 different shapes), and a 23mm diameter cava were constructed. The hemodynamics of steady-state flow at Reynolds number 600 was examined for the unoccluded and partially occluded filter. Axial velocity contours and wall shear stresses were computed. Flow in the unoccluded TrapEase filter experienced minimal disruption, except near the superior and inferior tips where low velocity flow was observed. For spherical thrombi in the superior trapping position, stagnant and recirculating flow was observed downstream of the thrombus; the volume of stagnant flow and the peak wall shear stress increased monotonically with thrombus volume. For inferiorly trapped spherical thrombi, marked disruption to the flow was observed along the cava wall ipsilateral to the thrombus and in the interior of the filter. Spherically shaped thrombus produced a lower peak wall shear stress than conically shaped thrombus and a larger peak stress than ellipsoidal thrombus. We have designed and constructed a computer model of the flow hemodynamics of the TrapEase IVC filter with varying shapes, sizes, and positions of thrombi. The computer model offers several advantages over in vitro techniques including: improved resolution, ease of evaluating different thrombus sizes and shapes, and easy adaptation for new filter designs and flow parameters. Results from the model also support a previously reported finding from photochromic experiments that suggest the inferior trapping position of the TrapEase IVC filter leads to an intra-filter region of recirculating/stagnant flow with very low shear stress that may be thrombogenic.

Singer, M A; Henshaw, W D; Wang, S L

2008-02-04

107

[Leiomyosarcoma of the inferior vena cava (case report)].  

PubMed

The occur of resecable retroperitoneal tumours invading into inferiér vena cava is rare. The authors report in detail a case of fibrosarcoma of the inferior vena cava In article is presented case of 49-year-old female presented with echographic and computed tomographic evidence of solid formation below porta hepatis and ower head of pankreas, behinde duodenum, growed into inferior vena cava with trombus. Treatment of the abdominal and retroperitoneal tumours closely related to major blood vessels must be interdisciplinary, considering diagnostics, operability estimation and additional measures. The radical resection rate for involving important vesel may bee improved with vascular technique. PMID:22324252

Sváb, J; Lindner, J; Krska, Z; Plocová, K; Vondrácková, M

2011-10-01

108

Role of intraoperative echocardiography in surgical correction of the superior sinus venosus atrial septal defect.  

PubMed

Superior type of sinus venosus atrial septal defect (SVASD) is invariably associated with the unroofing of right upper pulmonary vein (RUPV). Warden procedure and pericardial patch repair with rerouting of the RUPV are commonly performed operations for the superior SVASD. Both operations involve the risk of obstruction to the flow of superior vena cava or rerouted pulmonary vein in the postoperative period. The sinus venosus defects are well visualized on the transesophageal echocardiography (TEE) because of the proximity of the TEE probe to these structures. We are reporting two cases operated for the superior SVASD with unroofed RUPV, highlighting the intraoperative echocardiographic features before and after the surgery. PMID:20075538

Gadhinglajkar, Shrinivas; Sreedhar, Rupa; Jayakumar, K; Misra, Manoranjan; Ganesh, S; Mathew, Thomas

109

The North Atlantic Oscillation affects the quality of Cava (Spanish sparkling wine).  

PubMed

This study explores the possible effects of the North Atlantic Oscillation (NAO) on the quality of Spanish Cava. We found a significant negative relationship between the mean NAO for the months of March through August of each year between 1970 and 2008 and the probability of obtaining a top quality Cava. The NAO is associated with temperature and rainfall variations in the Cava region, which affect vine physiological processes during grape maturity. The probability of obtaining a top quality Cava was highest when the mean value of the NAO was negative, which causes the mean temperature in the Cava area to decrease, with positive consequences on Cava quality. Although the overall discrimination capacity and explanatory power of the model were low, 80% of clearly favorable years were classified correctly as corresponding to top quality Cava, and 70% of clearly unfavorable years were classified correctly as non top quality Cava. PMID:22825404

Real, Raimundo; Báez, José Carlos

2012-07-24

110

Superior vena cava perforation in a child from a lawnmower projectile.  

PubMed

Lawnmowers are one of the most frequent causes of mutilating injuries to children. The majority of accidents are caused by negligence of the operator. Most injuries of this type are caused by direct contact with the spinning blade and, less frequently, by projectiles propelled by the blade. Such projectiles usually produce bruises, but can penetrate skin and soft tissues. This report presents a 6-year-old child who suffered a small, outwardly insignificant puncture wound of the chest from a lawnmower-propelled projectile who presented with fever and chest pain the following day. The diagnostic work up and treatment of this deceptively life-threatening wound are discussed. PMID:17641123

McKamie, Wesley A; Schmitz, Michael L; Johnson, Charles E; Ray, Trenda; Sanford, Garrett B; Dyamenahalli, Umesh; Imamura, Michiaki

2007-07-19

111

Persistent left superior vena cava mistaken for nodal metastasis: a case report  

Microsoft Academic Search

INTRODUCTION: Evaluation of the mediastinum is crucial for patients with lung cancer. Mediastinal lymph node metastases play a dramatic role in the process of staging. Physicians should be aware of the potential pitfalls regarding mediastinal evaluation. This case report provides an example. CASE PRESENTATION: We report the case of a 57-year-old Caucasian man who presented with a four-month history of

Vasilios Tzilas; Antonios Bastas; Aspasia Koti; Dimitra Papandrinopoulou; Georgios Tsoukalas

2010-01-01

112

Delayed presentation of totally avulsed right superior vena cava after extraction of permanent pacemaker lead.  

PubMed

Pacemaker lead extraction has been shown to be an effective and safe treatment for infected permanent pacemaker leads, however, they may lead to potentially serious complications, usually occurring during the extraction procedure. This report describes a case of a 48-year-old woman with a patent persistent left SVC and an infected permanent pacemaker lead of a DDD pacing system who underwent transvenous laser-assisted lead extraction using a combined SVC and femoral approach. Two days after the procedure the patient developed symptoms of SVC obstruction requiring surgical intervention. The right SVC was found to be almost completely destroyed with only a thin strip of the lateral wall intact and active bleeding. The probable causative mechanisms and surgical management are discussed. PMID:14764184

Leacche, Marzia; Katsnelson, Yan; Arshad, Hassan; Mihaljevic, Tomislav; Rawn, James D; Sweeney, Michael O; Byrne, John G

2004-02-01

113

Immunomodulatory Effects of an Enzymatic Extract from Ecklonia cava on Murine Splenocytes  

Microsoft Academic Search

We investigated whether the brown seaweed Alariaceae Ecklonia cava (E. cava) has immunological effects on splenocytes in vitro. For that purpose, we prepared an enzymatic extract from E. cava (ECK) by using the protease, Kojizyme. Here, ECK administered to ICR mice dramatically enhanced the proliferation of their\\u000a splenocytes and increased the number of their lymphocytes, monocytes and granulocytes. In flow

Ginnae Ahn; Insun Hwang; Eunjin Park; Jinhe Kim; You-Jin Jeon; Jehee Lee; Jae Woo Park; Youngheun Jee

2008-01-01

114

Radiological Management of Superior Vena Caval Stent Migration and Infection  

SciTech Connect

We report a case of venous obstruction secondary to Hodgkin's lymphoma. Multiple Wallstents were inserted into the superior vena cava to relieve obstructive symptoms secondary to tumor. This procedure was complicated by stent migration into the right ventricle and a presumed stent infection. We describe the percutaneous management of these complications and discuss the issues surrounding the use of stents in this setting. We conclude that these complications can be managed percutaneously. However, the technical details of stent placement are essential in minimizing complications of this type.

Srinathan, Sadeesh, E-mail: sadeesh@macunlimited.net; McCafferty, Ian; Wilson, Ian [Queen Elizabeth Hospital (United Kingdom)

2005-01-15

115

Primary leiomyosarcoma of the inferior vena cava: a case report.  

PubMed

Primary leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumor originating from the vein smooth muscle. We present one case of primary leiomyosarcoma of the IVC. The patient benefited of surgical exploration at seventh day after admission. Tumor located in the junction of the anterior wall of the IVC and the left and right renal vein. We carried out the tumor resection, vena cava artificial vascular patch prosthetics. The patient did not take anticoagulant drugs after surgery and was discharged at 12 days after surgery. Currently, the patient had survived for nearly six months, repeated abdominal computed tomography examinations showed no clear recurrence. PMID:23747672

Xu, Tu-bing; Liu, Wen-yuan; Chen, Geng; Wang, Huai-zhi; Bie, Ping

116

[Use of DIL-type cava filters for the prevention of thromboembolism of the pulmonary artery].  

PubMed

New type cava filters were employed to prevent pulmonary artery thromboembolism in 12 cases. DIL cava filter was used, that represents a string made of a special alloy that can 'memorize' its shape. The design of this filter is in principle different from all the known filters, for it functions as an intraluminal filter and at the same time stretches the vena cava inferior, enlarging its diameter in the frontal plane. The DIL cava filter proved to be effective in the majority of cases, but if the walls of vena cava inferior were too rigid, for example, if a tumor grew into them, it was difficult to place the filter properly. On the whole this filter is characterized by a number of advantages: it can be easily implanted via 7 F catheter without injuring the vena cava inferior walls. No cases of dislocation of cava filters in relation to bone markers were noted in 9 patients over 60 +/- 17 days. PMID:1441201

Savchenko, A P; Pavlov, N A

117

[Resection of leiomyosarcoma of the inferior vena cava].  

PubMed

Experience in treatment of leiomyosarcoma of the retrohepatic segment of the inferior vena cava at any separately taken clinic is scarce. Given a rare nature of the pathology involved, whose diagnosis and management require joint participation of various-specialty physicians, we have considered it wise to present our own clinical case report. PMID:23531676

Zotov, S P; Pyshkin, S A; Malyshev, M Iu; Safuanov, A Kh; Borovikov, D A; Siniukov, D M; Tereshin, O S; Panov, I O

2013-01-01

118

Vena Cava Filters in Spinal Cord Injuries: Evolving Technology  

PubMed Central

Background: Asymptomatic deep venous thrombosis (DVT) has been reported in 60% to 100% of persons with spinal cord injury (SCI). Several guidelines have been published detailing recommended venous thromboembolism (VTE) prophylaxis after acute SCI. Low-molecular-weight heparin, intermittent pneumatic compression (IPC) devices, and/or graduated compression stockings are recommended. Vena cava filters (VCFs) are recommended for secondary prophylaxis in certain situations. Objective: To clarify the use of vena cava filters in patients with SCI. Methods: Literature review. Results: Prophylactic use of vena cava filters has expanded in trauma patients, including individuals with SCI. Filter placement effectively prevents pulmonary emboli and has a low complication rate. Indications include pulmonary embolus while on anticoagulant therapy, presence of pulmonary embolus and contraindication for anticoagulation, and documented free-floating ileofemoral thrombus. VCFs should be considered in patients with complete motor paralysis caused by lesions in the high cervical cord (C2 and C3), with poor cardiopulmonary reserve, or with thrombus in the inferior vena cava despite anticoagulant prophylaxis. Three optional retrievable filters that are approved for use are discussed. Conclusion: Retrievable VCFs are a safe, feasible option for secondary prophylaxis of VTE in patients with SCI. Objective criteria for temporary and permanent placement need to be defined.

Johns, Jeffery S; Nguyen, Conner; Sing, Ronald F

2006-01-01

119

Inferior Vena Cava Filters in the Management of Venous Thromboembolism  

Microsoft Academic Search

Inferior vena cava (IVC) filters, both retrievable and permanent, are indicated for the prevention of pulmonary embolism (PE) in patients contraindicated for anticoagulant therapy, in those with anticoagulant therapy complications, and perhaps for those with recurrent PE despite therapeutic anticoagulation. Because of the lack of randomized controlled trials (only 1 has been published), clinicians have little evidence-based information to assist

Mark A. Crowther

2007-01-01

120

Long term complications of inferior vena cava thrombosis  

Microsoft Academic Search

AIMTo evaluate the long term outcome after paediatric inferior vena cava (IVC) thrombosis.METHODSA combined retrospective and prospective study on infants and children with IVC thrombosis treated at Aachen and Maastricht University Hospitals between 1980 and 1999.RESULTSForty patients were enrolled, including four with preceding cardiac catheterisation, 18 with central venous saphenous lines, and an additional eight with umbilical venous catheters. Six

M Häusler; D Hübner; T Delhaas; E G Mühler

2001-01-01

121

Penetrating injuries of the abdominal inferior vena cava.  

PubMed Central

This is a retrospective study of 74 patients with penetrating injuries of the abdominal inferior vena cava; the cause of injury was gunshot in 91% and stabbing in 9%. Of the patients, 77% underwent lateral venorrhaphy, 5% underwent infrarenal ligation of the inferior vena cava (IVC), and 18% died perioperatively before any caval repair could be carried out. There was an overall perioperative mortality of 39%. Persistent shock, the site of the venous injury, particularly in the retrohepatic position, and the number of associated vascular injuries were directly related to mortality. Irrespective of the improvements in resuscitation and the various operative methods available, penetrating trauma of the abdominal IVC remains a life-threatening injury.

Degiannis, E.; Velmahos, G. C.; Levy, R. D.; Souter, I.; Benn, C. A.; Saadia, R.

1996-01-01

122

[Surgical treatment of leiomyosarcoma of the inferior vena cava].  

PubMed

The presented review of the literature is generalization of the currently existing data of foreign and Russian literature concerning treatment of a rare non-organic retroperitoneal tumour from smooth-muscle tissue, i. e., leiomyosarcoma of the inferior vena cava. The authors also formulate and lay down the basic principles of surgical interventions depending on the scope and level of the lesion, as well statistical analysis of the outcomes of surgical management of the this severely ill patient cohort. PMID:23383429

Zotov, S P; Panov, I O; Tereshin, O S; Vazhenin, A V

2012-01-01

123

Modeling Flow Past a Tilted Vena Cava Filter  

SciTech Connect

Inferior vena cava filters are medical devices used to prevent pulmonary embolism (PE) from deep vein thrombosis. In particular, retrievable filters are well-suited for patients who are unresponsive to anticoagulation therapy and whose risk of PE decreased with time. The goal of this work is to use computational fluid dynamics to evaluate the flow past an unoccluded and partially occluded Celect inferior vena cava filter. In particular, the hemodynamic response to thrombus volume and filter tilt is examined, and the results are compared with flow conditions that are known to be thrombogenic. A computer model of the filter inside a model vena cava is constructed using high resolution digital photographs and methods of computer aided design. The models are parameterized using the Overture software framework, and a collection of overlapping grids is constructed to discretize the flow domain. The incompressible Navier-Stokes equations are solved, and the characteristics of the flow (i.e., velocity contours and wall shear stresses) are computed. The volume of stagnant and recirculating flow increases with thrombus volume. In addition, as the filter increases tilt, the cava wall adjacent to the tilted filter is subjected to low velocity flow that gives rise to regions of low wall shear stress. The results demonstrate the ease of IVC filter modeling with the Overture software framework. Flow conditions caused by the tilted Celect filter may elevate the risk of intrafilter thrombosis and facilitate vascular remodeling. This latter condition also increases the risk of penetration and potential incorporation of the hook of the filter into the vena caval wall, thereby complicating filter retrieval. Consequently, severe tilt at the time of filter deployment may warrant early clinical intervention.

Singer, M A; Wang, S L

2009-06-29

124

“Recovery™” Vena Cava Filter: Experience in 96 Patients  

Microsoft Academic Search

The purpose of the study was to assess the clinical safety and efficacy of the “RecoveryTM” (Bard) inferior vena cava (IVC) filter. We retrospectively evaluated the clinical and imaging data of patients who had a\\u000a “RecoveryTM” IVC filter placed between January 2003 and December 2004 in our institution. The clinical presentation, indications, and\\u000a procedure-related complications during placement and retrieval were

Sanjeeva P. Kalva; Christos A. Athanasoulis; Chieh-Min Fan; Marcio Curvelo; Stuart C. Geller; Alan J. Greenfield; Arthur C. Waltman; Stephan Wicky

2006-01-01

125

Aspirin improves the patency rate of seeded vena cava grafts.  

PubMed

The purpose of this study was to evaluate the effectiveness of aspirin (ASA) and porcine endothelial cell seeding in improving the patency rate of vena cava grafts. Thirty-nine dogs underwent infrarenal vena cava replacement by 10 cm lengths of 8 mm I.D. ringed polytetrafluoroethylene grafts. Thirty-one grafts were seeded with 1-1.5 x 10(6) porcine aortic endothelial cells while eight were not (GIII). Of the seeded group, 16 animals received no ASA (GI), while 15 others (GII) were given ASA (325 mg) daily starting two days preoperatively and continuing until sacrifice. Venograms were performed on the fourth postoperative day. Grafts were harvested 32 days after insertion and evaluated for patency rate and endothelialized surfaces. The 32-day patency rate was significantly higher for GII than for GI and III animals (67% vs. 13 and 25% respectively). Endothelialized surface was higher in GII than Gi and III (67% vs. 16% and 18% respectively). We conclude that endothelial cell seeding alone does not prevent graft closure and that a combination of ASA and cell seeding significantly increases the patency rate of vena cava grafts. PMID:2600123

Vo, N M; Arbogast, L Y; Friedlander, E; Stanton, P E; Arbogast, B

126

Self and Superior Assessment.  

National Technical Information Service (NTIS)

This theoretical paper begins by documenting the severity and pervasiveness of disagreements between superior and self assessments of work performance. To understand this disagreement, theoretical and applied work on self assessment is needed, similar to ...

C. D. Fisher G. Russ

1986-01-01

127

Aortic pseudoaneurysm from aortic penetration with a bird’s nest vena cava filter  

Microsoft Academic Search

This is a case report of a 29-year-old woman with an infected aortic pseudoaneurysm. Two years previously a bird’s nest vena cava filter was placed after complex gastric surgery. Imaging studies and operative findings showed that the pseudoaneurysm was caused by penetration of the aorta by a prong of the vena cava filter.

Joseph J Campbell; David Calcagno

2003-01-01

128

Fistula between the Jejunum and the Inferior Vena Cava after Esophagojejunal Anastomosis  

PubMed Central

Fistulas between the luminal gastrointestinal tract and vascular structures can result from a variety of etiologies. While there have been reports of fistulas between the inferior vena cava and the duodenum, we report the first case to our knowledge of a fistula between the jejunum and the inferior vena cava after esophagojejunal anastomosis for recurrent esophageal adenocarcinoma.

Oh, Young S.; Knechtges, Paul M.

2011-01-01

129

Effect of vasopressin antagonist on water excretion in inferior vena cava constriction  

Microsoft Academic Search

Effect of vasopressin antagonist on water excretion in inferior vena cava constriction. Elevated levels of plasma arginine vasopressin (AVP) have been suggested to impair water excretion in congestive heart failure. In the present study, to determine a role for AVP in the impaired water excretion in rats with the inferior vena cava constriction (IVC), two AVP antagonists were used in

San-e Ishikawa; Toshikazu Saito; Koji Okada; Kumiko Tsutsui; Takeshi Kuzuya

1986-01-01

130

Sturge-Weber and Klippel-Trenaunay syndromes with absence of inferior vena cava  

Microsoft Academic Search

A baby girl born at 33 weeks' gestation weighing 2250 g presented with Sturge-Weber syndrome, features of the Klippel-Trenaunay syndrome, and absence of the inferior vena cava. We suggest that aplasia of the vena cava may be a feature of Klippel-Trenaunay syndrome when the capillary malformation affects the trunk.

G Stewart; G Farmer

1990-01-01

131

Retrohepatic vena cava deroofing in living donor liver transplantation for caudate hepatocellular carcinoma.  

PubMed

The removal of tumor together with the native liver in living donor liver transplantation for hepatocellular carcinoma is challenged by a very close resection margin if the tumor abuts the inferior vena cava. This is in contrast to typical deceased donor liver transplantation where the entire retrohepatic inferior vena cava is included in total hepatectomy. Here we report a case of deroofing the retrohepatic vena cava in living donor liver transplantation for caudate hepatocellular carcinoma. In order to ensure clear resection margins, the anterior portion of the inferior vena cava was included. The right liver graft was inset into a Dacron vascular graft on the back table and the composite graft was then implanted to the recipient inferior vena cava. Using this technique, we observed the no-touch technique in tumor removal, hence minimizing the chance of positive resection margin as well as the chance of shedding of tumor cells during manipulation in operation. PMID:24103288

Chan, See Ching; Sharr, William W; Cheung, Tan To; Chan, Albert Cy; Tsang, Simon Hy; Chok, Kenneth Sh; Leung, Kin Chung; Lo, Chung Mau

2013-10-01

132

PORCINE VENA CAVA AS AN ALTERNATIVE TO BOVINE PERICARDIUM IN BIOPROSTHETIC PERCUTANEOUS HEART VALVES  

PubMed Central

Percutaneous heart valves are revolutionizing valve replacement surgery by offering a less invasive treatment option for high-risk patient populations who have previously been denied the traditional open chest procedure. Percutaneous valves need to be crimped to accommodate a small-diameter catheter during deployment, and they must then open to the size of heart valve. Thus the material used must be strong and possess elastic recoil for this application. Most percutaneous valves utilize bovine pericardium as a material of choice. One possible method to reduce the device delivery diameter is to utilize a thin, highly elastic tissue. Here we investigated porcine vena cava as an alternative to bovine pericardium for percutaneous valve application. We compared the structural, mechanical, and in vivo properties of porcine vena cava to those of bovine pericardium. While the extracellular matrix fibers of pericardium are randomly oriented, the vena cava contains highly aligned collagen and elastin fibers that impart strength to the vessel in the circumferential direction and elasticity in the longitudinal direction. Moreover, the vena cava contains a greater proportion of elastin, whereas the pericardium matrix is mainly composed of collagen. Due to its high elastin content, the vena cava is significantly less stiff than the pericardium, even after crosslinking with glutaraldehyde. Furthermore, the vena cava’s mechanical compliance is preserved after compression under forces similar to those exerted by a stent, whereas pericardium is significantly stiffened by this process. Bovine pericardium also showed surface cracks observed by scanning electron microscopy after crimping that were not seen in vena cava tissue. Additionally, the vena cava exhibited reduced calcification (46.64 ± 8.15 ?g Ca/mg tissue) as compared to the pericardium (86.79 ± 10.34 ?g/mg). These results suggest that the vena cava may enhance leaflet flexibility, tissue resilience, and tissue integrity in percutaneous heart valves, ultimately reducing the device profile while improving the durability of these valves.

Munnelly, Amy; Cochrane, Leonard; Leong, Joshua; Vyavahare, Naren

2011-01-01

133

[Two cases of malignant tumors of the inferior vena cava].  

PubMed

The malignant tumors of the inferior vena cava are rare. Their prognosis is bad. We report two cases of a 17-year-old and 46-year-old woman presenting the one an intimal sarcoma of the inferior vena cava and the other a metastatic of adenocarcinoma whose primary tumor was not identified. The aortic wall was invaded in both patients. The ureter repulsed in first case, was invaded in second case. The treatment consisted on resection of the tumor including the aortic wall with vein closure in both patients, with right nephrectomy in second patient. In the two cases, a prosthetic reconstruction of the arterial integrity was attempted with aortobiiliac bypass. The two patients died after relapse tumorous to the 6th month in first patient and by multisystem organ failure 5th day post-operative in second. Through these two personal cases, we try to point out the difficult problem of diagnosis that put these tumors and their bad prognosis despite an improvement of treatment. PMID:15182080

El Mahi, O; Bouarhroum, A; Alaoui, M; Sefiani, Y; Lekehal, B; Mahassini, N; El Mesnaoui, A; Benjelloun, A; Ammar, F; Bensaid, Y

2004-04-01

134

Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters  

SciTech Connect

Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long- or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application.

Iliescu, Bogdan; Haskal, Ziv J., E-mail: ziv2@mac.com [University of Maryland School of Medicine, Division of Vascular and Interventional Radiology (United States)

2012-08-15

135

An approach to intrapericardial inferior vena cava through the abdominal cavity, without median sternotomy, for total hepatic vascular exclusion.  

PubMed

In surgical resection for hepatocellular carcinoma with tumor thrombus extending into the inferior vena cava and other malignancies involving the retrohepatic inferior vena cava, the usefulness of total hepatic vascular exclusion has been reported by several authors. Total hepatic vascular exclusion usually consists of clamping at three points; at the infrahepatic inferior vena cava, at the suprahepatic inferior vena cava, and in Pringles' maneuver. Tumor thrombus extending into the inferior vena cava at the intrapericardial level below the right atrium can be resected without the use of cardio-pulmonary bypass. The inferior vena cava at the intrapericardial level has been reported to be usually approached by median sternotomy such as Chevron incision. We herein demonstrate an approach to the intrapericardial inferior vena cava through the abdominal cavity without median sternotomy. PMID:11677982

Miyazaki, M; Ito, H; Nakagawa, K; Shimizu, H; Yoshidome, H; Shimizu, Y; Ohtsuka, M; Togawa, A; Kimura, F

136

Superior Ptolemaic Model  

NSDL National Science Digital Library

The Ejs Superior Ptolemaic model illustrates Ptolemy's orbit for a superior planet. The model consists of a deferent circle, centered on a point some distance from Earth (at the eccentric point). Attached to this deferent is the center of another circle, the epicycle. The center of the epicycle moves around the deferent with constant angular speed as seen from the equant point, which is exactly opposite the center of the deferent from Earth (so the center of the epicycle does not move at constant speed along the deferent). The planet moves along the epicycle at constant speed. This model is capable of reproducing retrograde motion and variations in the planet's brightness. It can also reproduce variations in the apparent size and spacing of the retrograde arcs. In this simulation the planet is assumed to move in the plane of the ecliptic, so its latitude is always zero. You can modify this simulation if you have Ejs installed by right-clicking within the plot and selecting "Open Ejs Model" from the pop-up menu item. Ejs Superior Ptolemaic model was created using the Easy Java Simulations (Ejs) modeling tool. It is distributed as a ready-to-run (compiled) Java archive. Double clicking the ejs_astronomy_SuperiorPtolemaic.jar file will run the program if Java is installed. Ejs is a part of the Open Source Physics Project and is designed to make it easier to access, modify, and generate computer models. Additional Ejs models for astronomy are available. They can be found by searching ComPADRE for Open Source Physics, OSP, or Ejs.

Timberlake, Todd

2009-08-19

137

Evaporation From Lake Superior  

NASA Astrophysics Data System (ADS)

Evaporation is a critical component of the water balance of each of the Laurentian Great Lakes, and understanding the magnitude and physical controls of evaporative water losses are important for several reasons. Recently, low water levels in Lakes Superior and Michigan/Huron have had socioeconomic, ecological, and even meteorological impacts (e.g. water quality and quantity, transportation, invasive species, recreation, etc.). The recent low water levels may be due to increased evaporation, but this is not known as operational evaporation estimates are currently calculated as the residual of water or heat budgets. Perhaps surprisingly, almost nothing is known about evaporation dynamics from Lake Superior and few direct measurements of evaporation have been made from any of the Laurentian Great Lakes. This research is the first to attempt to directly measure evaporation from Lake Superior by deploying eddy covariance instrumentation. Results of evaporation rates, their patterns and controlling mechanisms will be presented. The direct measurements of evaporation are used with concurrent satellite and climate model data to extrapolate evaporation measurements across the entire lake. This knowledge could improve predictions of how climate change may impact the lake's water budget and subsequently how the water in the lake is managed.

Spence, C.; Blanken, P.; Hedstrom, N.; Leshkevich, G.; Fortin, V.; Charpentier, D.; Haywood, H.

2009-05-01

138

Inferior vena cava thrombosis: a review of current practice.  

PubMed

Inferior vena cava (IVC) thrombosis remains under-recognised as it is often not pursued as a primary diagnosis. The aetiology of IVC thrombosis can be divided into congenital versus acquired, with all aetiological factors found among Virchow's triad of stasis, injury and hypercoagulability. Signs and symptoms are related to aetiology and range from no symptoms to cardiovascular collapse. Painful lower limb swelling combined with lower back pain, pyrexia, dilatation of cutaneous abdominal wall veins and a concurrent rise in inflammatory markers are suggestive of IVC thrombosis. Following initial lower limb venous duplex, magnetic resonance imaging (MRI) is the optimal non-invasive imaging tool. Aetiology directs treatment, which ranges from anticoagulation and lower limb compression to open surgery, with endovascular therapies increasingly favoured. The objective of this review is to assess current literature on the aetiology, presentation, investigation, treatment, prognosis and other factors pertaining to IVC thrombosis. PMID:23439778

McAree, B J; O'Donnell, M E; Fitzmaurice, G J; Reid, J A; Spence, R A J; Lee, B

2013-02-01

139

Abdominal aortic aneurysm with inferior vena cava obstruction: case report.  

PubMed

Behçet's syndrome, a multisystem disorder, is characterized by recurrent oral and genital aphthous ulcerations, eye lesions, and skin changes. Other manifestations, although rare, may affect the nervous, gastrointestinal, or locomotor system, as well as veins and arteries. Vascular lesions occur in approximately 30% of reported cases. Although thrombosis in the larger veins is frequent, arterial thrombosis is somewhat less likely to occur. Only a few cases of arterial aneurysm have been documented in the literature. This report describes a patient who had suffered from Behçet's syndrome for fifteen years and in whom a complete obstruction of the inferior vena cava was demonstrated. An aortoiliac bypass was performed successfully, and the patient had had a good clinical recovery at long-term follow-up. PMID:2916772

Demircioglu, F F; Böke, E; Demircin, M; Dagsali, S; Küçükali, T

1989-03-01

140

Pheochromocytoma with inferior vena cava thrombosis: An unusual association  

PubMed Central

Pheochromocytomas have been described in association with vascular abnormalities like renal artery stenosis. A 48-year-old man was admitted to our hospital with the complaints of headache, sweating, anxiety, dizziness, nausea, vomiting and hypertension. For last several days, he was having a dull aching abdominal pain. Abdominal computed tomography (CT) revealed the presence of a left adrenal pheochromocytoma. An inferior vena cava (IVC) venogram via the right jugular vein demonstrated occlusion of the IVC inferior to the right atrium. Surgical removal of pheochromocytoma was done, followed by anticoagulant treatment for IVC thrombosis, initially with subcutaneous low molecular weight heparin, and then with oral warfarin, resulting in restoration of patency. To the best of our knowledge, the occurrence of pheochromocytoma in IVC thrombosis has not been reported so far from India. Possible mechanisms of such an involvement are discussed.

Kota, Sunil K.; Kota, Siva K.; Jammula, Sruti; Meher, Lalit K.; Modi, Kirtikumar D.

2012-01-01

141

Indications, Management, and Complications of Temporary Inferior Vena Cava Filters  

SciTech Connect

Purpose: We describe the results of a preliminary prospective study using different recently developed temporary and retrievable inferior vena cava (IVC) filters. Methods: Fifty temporary IVC filters (Guenther, Guenther Tulip, Antheor) were inserted in 47 patients when the required period of protection against pulmonary embolism (PE) was estimated to be less than 2 weeks. The indications were documented deep vein thrombosis (DVT) and temporary contraindications for anticoagulation, a high risk for PE, and PE despite DVT prophylaxis. Results: Filters were removed 1-12 days after placement and nine (18%) had captured thrombi. Complications were one PE during and after removal of a filter, two minor filter migrations, and one IVC thrombosis. Conclusion: Temporary filters are effective in trapping clots and protecting against PE, and the complication rate does not exceed that of permanent filters. They are an alternative when protection from PE is required temporarily, and should be considered in patients with a normal life expectancy.

Linsenmaier, Ulrich; Rieger, Johannes; Schenk, Franz; Rock, Clemens; Mangel, Eugen; Pfeifer, Klaus Juergen [Department of Radiology, Klinikum Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Nussbaumstrasse 20, D-80336 Munich (Germany)

1998-11-15

142

Vessel Wall Reaction after Vena Cava Filter Placement  

SciTech Connect

Purpose: To evaluate the interaction between the Cordis Keeper vena caval filter and vessel wall in aporcine model.Methods: Implantation of the filter was performed in five pigs. Radiologic data concerning inferior vena cava(IVC) diameter and filter patency, filter leg span, and stability were collected. At 2 or 6 months post-implantation, histopathologic analysis of the IVC wall was performed.Results: All filters remained patent with no evidence of migration. However, at 6 months follow-up, two legs of one filter penetrated the vessel wall and were adherent to the liver. These preliminary results suggest that with the observed gradual increase in the filter span, the risk of caval wall penetration increases with time, especially in a relatively small IVC(average diameter 16 mm).Conclusion: The Cordis Keeper filter was well tolerated, but seems to be prone to caval wall penetration in the long term.

Hoekstra, Arend [Bio-Medical Technology Center, University of Groningen, Hanzeplein 1, 9713 GZ Groningen (Netherlands); Elstrodt, Jan M. [AnimalResearch Laboratory, University of Groningen, A.Deusinglaan 50, 9713 AZ Groningen (Netherlands); Nikkels, Peter G.J.; Tiebosch, Anton T.M.G. [Department of Pathology and LaboratoryMedicine, University Hospital Groningen, Hanzeplein 1, 9713GZ Groningen (Netherlands)

2002-01-15

143

Thrombosis of the inferior vena cava related to Ormond's disease.  

PubMed

A 46-year-old female patient presenting with unspecific lower back pain, diffuse abdominal pain, and slightly elevated body temperature was referred to the hospital. The X-ray of the spine detected an unspecific sclerotic lesion of the third lumbar vertebra; an abdominal computed tomography (CT) scan was performed. In this scan, a sheeting of the infrarenal abdominal aorta, a streaky densification of the periaortal fatty tissue, and a nearly complete thrombotic occlusion of the inferior vena cava and both iliac veins was detected. As these findings are typical for acute aortitis and this is a life-threatening disease, the patient was transferred to a university hospital. Imaging work-up including ultrasound, magnetic resonance imaging, and 18-flourodeoxyglucose positron emission tomography were performed after transfer. These examinations showed acute aortitis due to Ormond's disease. Furthermore, there was a thrombotic occlusion of the inferior vena cava due to a compression of the vein by inflamed connective tissue. This is a rare finding in Ormond's disease. We decided to treat our patient with a combined therapy including glucocorticoids and tamoxifen for 2 years. During these 2 years and the further follow-up period, the patient showed no relapse of the inflammatory disease. Retroperitoneal fibrosis is a rare but increasingly recognized disease characterized by the presence of fibro-inflammatory tissue, usually surrounding the abdominal aorta and the iliac arteries. This fibrotic tissue extends into the retroperitoneum and thus encases structures, for example, the ureters. Retroperitoneal fibrosis is generally idiopathic. It can also be secondary to certain drugs, malignant diseases, infections, surgery, and other triggering factors. Ormond's disease may lead to serious complications like renal failure. This can be avoided by successful treatment when diagnosed early. PMID:23599947

Paetzold, Sascha; Gary, Thomas; Hafner, Franz; Brodmann, Marianne

2010-04-15

144

A New Method for Semiautomatic Suture Plication of the Inferior Vena Cava.  

National Technical Information Service (NTIS)

A new method of rapid precise suture plication of the inferior vena cava is described. Although clinical studies have not yet been performed, results in animals have been similar to those with conventional suture plication technics with effective trapping...

I. R. Berman H. F. Hamit R. H. Clauss

1969-01-01

145

Cutaneous aspects of congenital absence of the inferior vena cava in a newborn.  

PubMed

We present the case of a 9-day-old girl with venous dilatations in lower abdomen and legs associated to cyanosis. Radiological studies revealed a congenital agenesis of the entire inferior vena cava. PMID:22747743

López-Núñez, María; Tuneu-Valls, Anna; Jaka-Moreno, Ane; Lopez-Obregon, Cristina; Ormaechea-Perez, Nerea

2012-07-02

146

Endovascular Stent Reconstruction of the Inferior Vena Cava Complicated by Duodenocaval Fistula  

PubMed Central

A patient with retroperitoneal metastatic uterine adenocarcinoma resulting in symptomatic occlusion of the inferior vena cava underwent palliative endovascular stent reconstruction and subsequent radiation therapy. She then developed sepsis and massive lower gastrointestinal bleeding. Computed tomography (CT) and cavography demonstrated a fistulous communication between the duodenum and the stented segment of inferior vena cava. Deployment of endovascular stent graft devices successfully occluded the fistulous communication and resulted in clinical improvement.

Hamblin, James; Ryu, Robert K.

2011-01-01

147

[Congenital absence of inferior vena cava associated to polispleenism. Case report].  

PubMed

Interruption of the inferior vena cava with azygos continuation is an uncommon vascular anomaly that results from aberrant development during embryogenesis. We report a case of this anomaly in a young boy of 19 years old sent for our observation for presenting an hipotransparency in the chest x-ray, which study revealed a prominence of the azygos cross. Further evaluation by CT-scans disclosed the diagnosis of congenital absence of the inferior vena cava, associated to multiple spleens (polispleenism). PMID:17308622

Esteves, Joana; Carvalho, Carmen; Mendes da Costa, Rui; Vale, Sílvio; Morgado, Paulo; Maciel, Jorge

148

Leiomyosarcoma of the inferior vena cava: Angiographic and computed tomography findings  

Microsoft Academic Search

Leiomyosarcoma, a highly malignant tumor of the inferior vena cava, is rare. Only 55 cases have been reported in the world\\u000a literature, and of these only 18 were evaluated with a special vascular procedure, either arteriography or inferior vena cavography.\\u000a In two cases of leiomyosarcoma of the inferior vena cava, we performed arteriography and inferior vena cavography. In one,\\u000a computed

Mufiz A. Chauhan; Phillip L. Smith; Ernest J. Ferris; Ken Murphy; Kent Westbrook; John E. Slayden

1981-01-01

149

Radiofrequency Catheter Ablation Of Atrioventricular Nodal Reentry Tachycardia In A Patient With Inferior Vena Cava Anomaly  

PubMed Central

Curative radiofrequency catheter modification of the slow pathway is the recommended therapy for patients suffering from recurrent symptomatic atrioventricular nodal reentry tachycardia. This is usually performed via femoral vein and the inferior vena cava (IVC). Presence of venous occlusion or complex venous anomaly involving the IVC may preclude this approach. Here, we report a case with a complex venous anomaly involving the inferior vena cava, who underwent electrophysiological study and successful radiofrequency ablation by an alternative approach.

Karthigesan, Murugesan; Jayaprakash, Shenthar

2009-01-01

150

Transcatheter Arterial Chemoembolization for Advanced Hepatocellular Carcinoma with Inferior Vena Cava and Right Atrial Tumors  

SciTech Connect

Advanced hepatocelluar carcinoma (HCC) with invasion of venous systems usually indicates not only a poor prognosis but also a contraindication for transcatheter arterial chemoembolization (TACE). This study evaluated the feasibility of TACE for advanced HCC with inferior vena cava (IVC) and right atrium (RA) tumors and, also, to search for the ideal embolization particle size. Twenty-six patients who had HCC invasion into the IVC included five patients with coexistent RA tumors that were treated with TACE. The chemoembolization method was cisplatin, doxorubicin, and mitomycin C mixed with Lipiodol and Ivalon. The selection of Ivalon particles was divided into two groups based on their size: (A) >180 {mu}m, N = 9; and (B) 47-180 {mu}m, N = 17. The overall response rate was 53.8% (14/26). Based on the response to TACE, the median survival period of the entire group was 4.2 months (range, 1.5 to 76.7 months). The median survival period of the 14 responders was 13.5 months (1.5-76.7 months), and that of the 12 nonresponders, 3.3 months (2.1 to 24.3 months) (p < 0.002). Comparing the two Ivalon particle sizes, the response rate was 12.5% (1/9 patients) for group A and 76.5% for group B (13/17 patients) (p < 0.02). No serious complication was observed post-chemoembolization. In conclusion, TACE is a safe and effective treatment for advanced HCC with IVC and RA tumors, and small Ivalon particles (47-180 {mu}m) are superior to large ones (>180 {mu}m).

Chern, M. C., E-mail: mcchern@yahoo.com; Chuang, V. P., E-mail: vpc@mail.kfcc.org.tw; Cheng, T., E-mail: ticheng@mail.kfcc.org.tw; Lin, Z. H., E-mail: zoelin@mail.kfcc.org.tw; Lin, Y. M. [Koo Foundation Sun Yat-Sen Cancer Center, Department of Radiology (China)

2008-07-15

151

Tumour thrombus in the superior vena cava from anaplastic carcinoma of the thyroid: FDG-PET\\/CT imaging findings  

Microsoft Academic Search

A 46-year-old male patient presented with a growing tumour in the neck, dyspnoea and upper inflow congestion. Biopsy showed an anaplastic thyroid cancer. This figure shows the coronal PET (a) and fused PET\\/CT images (b), with “worm-like” increased FDG uptake (arrow) extending from the primary tumour (short arrow) into the mediastinum and ending just above the right atrium. The transaxial

K. Strobel; H. C. Steinert; U. Bhure; A. Y. Koma; N. Gassmann; S. J. Stöckli

2007-01-01

152

Statistics of superior records  

NASA Astrophysics Data System (ADS)

We study statistics of records in a sequence of random variables. These identical and independently distributed variables are drawn from the parent distribution ?. The running record equals the maximum of all elements in the sequence up to a given point. We define a superior sequence as one where all running records are above the average record expected for the parent distribution ?. We find that the fraction of superior sequences SN decays algebraically with sequence length N, SN˜N?? in the limit N??. Interestingly, the decay exponent ? is nontrivial, being the root of an integral equation. For example, when ? is a uniform distribution with compact support, we find ?=0.450265. In general, the tail of the parent distribution governs the exponent ?. We also consider the dual problem of inferior sequences, where all records are below average, and find that the fraction of inferior sequences IN decays algebraically, albeit with a different decay exponent, IN˜N??. We use the above statistical measures to analyze earthquake data.

Ben-Naim, E.; Krapivsky, P. L.

2013-08-01

153

Statistics of superior records.  

PubMed

We study statistics of records in a sequence of random variables. These identical and independently distributed variables are drawn from the parent distribution ?. The running record equals the maximum of all elements in the sequence up to a given point. We define a superior sequence as one where all running records are above the average record expected for the parent distribution ?. We find that the fraction of superior sequences S_{N} decays algebraically with sequence length N, S_{N}?N^{-?} in the limit N??. Interestingly, the decay exponent ? is nontrivial, being the root of an integral equation. For example, when ? is a uniform distribution with compact support, we find ?=0.450265. In general, the tail of the parent distribution governs the exponent ?. We also consider the dual problem of inferior sequences, where all records are below average, and find that the fraction of inferior sequences I_{N} decays algebraically, albeit with a different decay exponent, I_{N}?N^{-?}. We use the above statistical measures to analyze earthquake data. PMID:24032813

Ben-Naim, E; Krapivsky, P L

2013-08-28

154

Information Superiority through Data Warehousing.  

National Technical Information Service (NTIS)

The aim of a Command Support System is to achieve decision superiority by providing a knowledge edge to the Commander. A precursor to a knowledge edge is Information Superiority. Within most current Command Support Systems minimal integration and fusion o...

N. Warner

2001-01-01

155

Successful Percutaneous Retrieval of an Inferior Vena Cava Filter Migrating to the Right Ventricle in a Bariatric Patient  

SciTech Connect

The use of an inferior vena cava filter has an important role in the management of patients who are at high risk for development of pulmonary embolism. Migration is a rare but known complication of inferior vena cava filter placement. We herein describe a case of a prophylactic retrievable vena cava filter migrating to the right ventricle in a bariatric patient. The filter was retrieved percutaneously by transjugular approach and the patient did well postoperatively. A review of the current literature is given.

Veerapong, Jula [University of Chicago Hospitals, Department of General Surgery (United States); Wahlgren, Carl Magnus, E-mail: carl.wahlgren@karolinska.s [University of Chicago Hospitals, Section of Vascular Surgery, Department of Surgery (United States); Jolly, Neeraj [University of Chicago Hospitals, Section of Interventional Cardiology, Department of Medicine (United States); Bassiouny, Hisham [University of Chicago Hospitals, Section of Vascular Surgery, Department of Surgery (United States)

2008-07-15

156

Successful removal of a Gunther tulip vena cava filter with wall-embedded hook and migration during a retrieval attempt  

PubMed Central

Retrieval of a Gunther tulip vena cava filter implanted in a patient with inferior vena cava and right common iliac vein thrombosis was attempted by the standard method. Because the filter was tilted, the hook became attached to the vena cava wall and could not be snared. During attempts at removal by an alternative method, the filter migrated toward the right atrium. However, it was finally successfully removed.

Yamagami, Takuji; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko

2013-01-01

157

Doppler-ultrasonographic detection of retrograde pulsatile flow in the caudal vena cava of a puppy with cor triatriatum dexter.  

PubMed

A three-month-old puppy had ascites, but its heart was normal by auscultation. Abdominal ultrasonography revealed an enlarged liver, distended hepatic veins and a distended caudal vena cava. Doppler ultrasonography detected retrograde flow in the caudal vena cava and abnormally pulsatile flow in the hepatic veins and caudal vena cava. A non-selective venogram was used to detect the path of the blood from the caudal vena cava. A postmortem examination showed that the puppy had cor triatriatum dexter and a defect in the atrial septum. PMID:10958487

Szatmári, V; Sótonyi, P; Fenyves, B; Vörös, K

2000-07-15

158

Compression of the inferior vena cava in bowel obstruction.  

PubMed

Introduction. We investigated whether (a) the inferior vena cava (IVC) is compressed in bowel obstruction and (b) some tracts are more compressed than others. Methods. Two groups of abdominal computed tomography (CT) examinations were collected retrospectively. Group O (N = 69) scans were positive for bowel obstruction, group C (N = 50) scans were negative for diseases. IVC anteroposterior and lateral diameters (APD, LAD) were assessed at seven levels. Results. In group C, IVC section had an elliptic shape (APD/LAD: .76 ± .14), the area of which increased gradually from 1.9 (confluence of the iliac veins) to 3.1?cm(2)/m(2) of BSA (confluence of the hepatic veins) with a significant narrowing in the hepatic section. In group O, bowel obstruction caused a compression of IVC (APD/LAD: .54 ± .17). Along its course, IVC section area increased from 1.3 to 2.5?cm(2)/m(2). At ROC curve analysis, an APD/LAD ratio lower than 0.63 above the confluence of the iliac veins discriminated between O and C groups with sensitivity of 74% and specificity of 96%. Conclusions. Bowel obstruction caused a compression of IVC, which involved its entire course except for the terminal section. APD/LAD ratio may be useful to monitor the degree of compression. PMID:24151603

Cina, Alessandro; Zamparelli, Roberto; Venturino, Sara; Gargaruti, Riccardo; Semeraro, Vittorio; Cavaliere, Franco

2013-09-14

159

Compression of the Inferior Vena Cava in Bowel Obstruction  

PubMed Central

Introduction. We investigated whether (a) the inferior vena cava (IVC) is compressed in bowel obstruction and (b) some tracts are more compressed than others. Methods. Two groups of abdominal computed tomography (CT) examinations were collected retrospectively. Group O (N = 69) scans were positive for bowel obstruction, group C (N = 50) scans were negative for diseases. IVC anteroposterior and lateral diameters (APD, LAD) were assessed at seven levels. Results. In group C, IVC section had an elliptic shape (APD/LAD: .76 ± .14), the area of which increased gradually from 1.9 (confluence of the iliac veins) to 3.1?cm2/m2 of BSA (confluence of the hepatic veins) with a significant narrowing in the hepatic section. In group O, bowel obstruction caused a compression of IVC (APD/LAD: .54 ± .17). Along its course, IVC section area increased from 1.3 to 2.5?cm2/m2. At ROC curve analysis, an APD/LAD ratio lower than 0.63 above the confluence of the iliac veins discriminated between O and C groups with sensitivity of 74% and specificity of 96%. Conclusions. Bowel obstruction caused a compression of IVC, which involved its entire course except for the terminal section. APD/LAD ratio may be useful to monitor the degree of compression.

Cina, Alessandro; Zamparelli, Roberto; Venturino, Sara

2013-01-01

160

Inferior vena cava resection with hepatectomy: challenging but justified  

PubMed Central

Objective The aim of this study was to evaluate the clinical outcome of hepatectomy combined with inferior vena cava (IVC) resection and reconstruction for treatment of invasive liver tumours. Methods From February 1995 to September 2010, 2146 patients underwent liver resections in our hospital's hepatopancreatobiliary unit. Of these, 35 (1.6%) patients underwent hepatectomy with IVC resection. These patients were included in this study. Data were analysed from a prospectively collected database. Results Resections were carried out for colorectal liver metastasis (CRLM) (n = 21), hepatocellular carcinoma (n = 6), cholangiocarcinoma (n = 3) and other conditions (n = 5). Resections were carried out with total vascular occlusion in 34 patients and without in one patient. In situ hypothermic perfusion was performed in 13 patients; the ante situm technique was used in three patients, and ex vivo resection was used in six patients. There were four early deaths from multiple organ failure. Postoperative complications occurred in 14 patients, three of whom required re-operation. Median overall survival was 29 months and cumulative 5-year survival was 37.7%. Rates of 1-, 2- and 5-year survival were 75.9%, 58.7% and 19.6%, respectively, in CRLM patients. Conclusions Aggressive surgical management of liver tumours with IVC involvement offers the only hope for cure in selected patients. Resection by specialist teams affords acceptable perioperative morbidity and mortality rates.

Malde, Deep J; Khan, Aamir; Prasad, K Rajendra; Toogood, Giles J; Lodge, J Peter A

2011-01-01

161

Evaluation of Retrievability of the Gunther Tulip Vena Cava Filter  

SciTech Connect

Purpose. To evaluate the feasibility and safety of withdrawal of a Gunther tulip retrievable vena cava filter (GTF). Methods. Between June 2001 and December 2005, at our institution 86 GTFs were implanted for temporary caval filtration in 59 patients (37 women, 22 men; mean age 59.3 years, range 18-87 years). For GTFs retrieved thereafter, we retrospectively reviewed the following parameters: rate of success in retrieval, degree of trapped thrombus in the filter, and complications during retrieval. Results. Worsening of or new development of pulmonary embolism after filter implantation did not occur in any patient. Of the 86 GTFs implanted, retrieval of 80 was attempted. Among those 80 filters, 77 (96%) were successfully retrieved (with the standard method, n = 72; with the modified method, n = 5) without any complication. The period of implantation of the retrieved filters was 13.4 {+-} 4.2 days. In the 5 filters that were filled to a height of {>=} 1/4 with trapped thrombus, retrieval was performed after attempts were made to decrease trapped thrombi. In addition, a temporary filter or another GTF was temporarily placed at the cephalad level of the GTF during this removal procedure. Conclusion. GTFs can be retrieved in the majority of cases. Even when encountering situations in which the filter could not be removed using the standard method, withdrawal was possible in a high frequency of cases through various trials using modified methods.

Yamagami, Takuji, E-mail: yamagami@koto.kpu-m.ac.jp; Kato, Takeharu; Hirota, Tatsuya; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko [Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Department of Radiology (Japan)

2007-04-15

162

Superior oblique tendon lengthening for acquired superior oblique overactions.  

PubMed Central

Two patients who presented with compensatory head postures and diplopia are described. They both had marked unilateral superior oblique overaction, in one patient due to a large, incomitant skew deviation. Each underwent a superior oblique tendon lengthening procedure using a segment of silicone 240 retinal band as an expander, in combination with a contralateral superior rectus recession. Both achieved an excellent result with an improvement of the compensatory head posture and an increase in the field of binocular single vision. This surgical procedure is proposed as an option in the management of superior oblique overaction, including certain cases of skew deviation. Images

Manners, R M; O'Flynn, E; Morris, R J

1994-01-01

163

Inferior vena cava stenosis and pancreatic ascites complicating chronic calcific pancreatitis: a case report.  

PubMed

A 19-year-old Thai male, who was a regular drinker, presented with massive ascites, back pain and leg edema for four months. On examination there was obvious clinical evidence of an inferior vena cava obstruction. Inferior vena cavography showed narrowing of the hepatic portion of IVC with collateral circulation. Surgical dilatation of the inferior vena cava was performed. The ascites were diagnosed four months later as pancreatic ascites with a very high ascitic amylase level. Computerised axial tomography and endoscopic retrograde pancreatography showed evidence of chronic calcific pancreatitis and pseudocyst. After further medical treatment, ascites and inferior vena cava stenosis subsided which was confirmed by repeated vena cavography, computerised axial tomography and magnetic resonance imaging. The cause of inferior vena cava stenosis and clinical obstruction in this case most likely resulted from phlebitis secondary to pancreatitis. The etiology of chronic calcific pancreatitis in this case might be alcoholic abuse and/or nutritional tropical pancreatitis. Inferior vena cava stenosis and associated pancreatic ascites complicating chronic calcific pancreatitis has not been previously reported in Thailand. PMID:7964251

Wongpaitoon, V; Kurathong, S; Pekanan, P

1993-08-01

164

Transcatheter Closure of Patent Ductus Arteriosus and Interruption of Inferior Vena Cava with Azygous Continuation Using an Amplatzer Duct Occluder  

Microsoft Academic Search

Two cases with interrupted inferior vena cava and azygous continuation requiring patent ductus arteriosus (PDA) occlusion\\u000a per cardiac catheterization are presented. A technique is described enabelmy occlusion of PDA using an Amplatzer ductal occluder\\u000a despite interruption of inferior vena cava and azygous continuation.

Sadiq Al-Hamash

2006-01-01

165

Temporary and Permanent Inferior Vena Cava Filter Combination in a Young Patient: To Implant or Not to Implant?  

SciTech Connect

The decision to implant vena cava filters, either temporary or permanent, is difficult in young patients. We present the case of a young man with pulmonary embolism in whom temporary and permanent inferior vena cava filters were implanted. The decision process is discussed in relation to the current literature.

Kutlu, Ramazan, E-mail: rkutlu@inonu.edu.tr, E-mail: drkutlu@yahoo.com; Alkan, Alpay; Sigirci, Ahmet; Altinok, Tayfun [Inonu University School of Medicine, Malatya, Department of Radiology (Turkey); Yildirim, Zeki [Inonu University of School of Medicine, Malatya, Department of Chest Medicine (Turkey)

2003-09-15

166

Imaging of leiomyosarcoma of the inferior vena cava: comparison of 2 cases and review of the literature  

PubMed Central

Abstract Leiomyosarcoma of the inferior vena cava is a rare tumour arising from the smooth muscle fibres of the media with a mean size at diagnosis generally around 12?cm (range 2–38?cm). This study compares a 4-cm leiomyosarcoma of the inferior vena cava discovered incidentally with a symptomatic late stage leiomyosarcoma.

Iannicelli, Elsa; Caterino, Salvatore; D'Angelo, Francesco; Milione, Massimo; Ziparo, Vincenzo; David, Vincenzo

2010-01-01

167

Ryanodine receptors are uncoupled from contraction in rat vena cava.  

PubMed

Ryanodine receptors (RyR) are Ca(2+)-sensitive ion channels in the sarcoplasmic reticulum (SR) membrane, and are important effectors of SR Ca(2+) release and smooth muscle excitation-contraction coupling. While the relationship between RyR activation and contraction is well characterized in arteries, little is known about the role of RyR in excitation-contraction coupling in veins. We hypothesized that RyR are present and directly coupled to contraction in rat aorta (RA) and vena cava (RVC). RA and RVC expressed mRNA for all 3 RyR subtypes, and immunofluorescence showed RyR protein was present in RA and RVC smooth muscle cells. RA and RVC rings contracted when Ca(2+) was re-introduced after stores depletion with thapsigargin (1?M), indicating both tissues contained intracellular Ca(2+) stores. To assess RyR function, contraction was then measured in RA and RVC exposed to the RyR activator caffeine (20mM). In RA, caffeine caused contraction that was attenuated by the RyR antagonists ryanodine (10?M) and tetracaine (100?M). However, caffeine (20mM) did not contract RVC. We next measured contraction and intracellular Ca(2+) (Ca(2+)(i)) simultaneously in RA and RVC exposed to caffeine. While caffeine increased Ca(2+)(i) and contracted RA, it had no significant effect on Ca(2+)(i) or contraction in RVC. These data suggest that ryanodine receptors, while present in both RA and RVC, are inactive and uncoupled from Ca(2+) release and contraction in RVC. PMID:23177664

Tykocki, N R; Thompson, J M; Jackson, W F; Watts, S W

2012-11-22

168

Adjunctive Inferior Vena Cava Filter Placement for Acute Pulmonary Embolism  

SciTech Connect

Inferior vena cava (IVC) filters are sometimes placed as an adjunct to full anticoagulation in patients with significant pulmonary embolism (PE). We aimed to determine the prevalence of adjunctive IVC filter placement in individuals diagnosed with PE, as well as the effect of adjunctive filter placement on mortality in patients with right heart strain associated with PE. This was a retrospective study of patients with acute PE treated with full anticoagulation admitted to a single academic medical center. Information abstracted from patient charts included presence or absence of right heart strain and of deep-vein thrombosis, and whether or not an IVC filter was placed. The endpoint was in-hospital mortality. Over 2.75 years, we found that 248 patients were diagnosed with acute PE, with an in-hospital mortality rate of 4.4%. The prevalence of adjunctive IVC filter placement was 13.3% (33 of 248), and the prevalence of documented right heart strain was 27.0% (67 of 248). In-hospital mortality was 10.2% in the non-filter-treated group (5 of 49), whereas there were no deaths in the filter-treated group (0 of 18); however, the difference was not statistically significant (P = 0.37). Both the presence of deep-vein thrombosis and of right heart strain increased the likelihood that an adjunctive IVC filter was placed (P < 0.0001 and P < 0.001, respectively). At our institution, patients were treated with IVC filters in addition to anticoagulation in 13.3% of cases of acute PE. Prospective studies or large clinical registries should be conducted to clarify whether this practice improves outcomes.

Jha, V. M., E-mail: vjha@mfa.gwu.ed [George Washington University Medical Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine (United States); Lee-Llacer, J. [George Washington University Medical Center, Department of Anesthesiology and Critical Care Medicine (United States); Williams, J.; Ubaissi, H.; Gutierrez, G. [George Washington University Medical Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine (United States)

2010-08-15

169

Thermoregulatory catheter-associated inferior vena cava thrombus  

PubMed Central

The use of thermoregulatory catheters (TRCs) in critically ill patients has become increasingly popular. TRCs have been shown to be effective in regulating patient body temperature with improved outcomes. Critically ill patients, especially multitrauma patients and those with femoral catheters, are at high risk for deep vein thrombosis (DVT). Among patients for whom chemical DVT prophylaxis is not an option, inferior vena cava (IVC) filters are often placed prophylactically. The development of intravascular ultrasound (IVUS) has allowed placement of IVC filters at the bedside for patients who are too ill for transport to the operating room or cardiac catheterization lab. After encountering several patients with occult DVT of the IVC during bedside IVC filter placement, we performed a retrospective review to determine the incidence of DVT or pulmonary embolus (PE) in patients who had been treated with a TRC at Baylor University Medical Center at Dallas. Since 2008, IVC filters have been deployed at the bedside with the use of IVUS at Baylor University Medical Center. During that same time period, 83 patients had a TRC placed for either intravascular warming or cooling during their resuscitation. Forty-seven out of 83 patients who had a TRC placed survived their injuries. Ten of 47 patients (21%) were diagnosed with DVT or PE, and 6 of these 10 (60%) were found to have caval thrombus. We present this case series as evidence that undiagnosed IVC thrombus associated with TRCs may be higher than previously suspected, given that 5 out of 10 patients who had IVUS of their IVC for prophylactic IVC filter placement, as well as one patient diagnosed with PE, were found to have caval thrombus.

Shutze, William P.; Pearl, Gregory J.; Foreman, Michael L.; Hohmann, Stephen E.; Shutze, William P.

2013-01-01

170

Inferior Vena Cava Filter Placement during Pregnancy: An Adjuvant Option When Medical Therapy Fails  

PubMed Central

The authors present a case of a 27-year-old multiparous woman, with multiple thrombophilia, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. At 15th week of gestation, following an acute deep venous thrombosis of the right inferior limb, anticoagulant therapy with low-molecular-weight heparin (LMWH) was instituted without improvement in her clinical status. Subsequently, at 18 weeks of pregnancy, LMWH was switched to warfarin. At 30th week of gestation, the maintenance of high thrombotic risk was the premise for placement of an inferior vena cava filter for prophylaxis of pulmonary embolism during childbirth and postpartum. There were no complications and a vaginal delivery was accomplished at 37 weeks of gestation. Venal placement of inferior vena cava filters is an attractive option as prophylaxis for pulmonary embolism during pregnancy.

Serrano, Fatima; Torres, Rita; Borges, Augusta

2013-01-01

171

Inferior Vena Cava Filter Placement during Pregnancy: An Adjuvant Option When Medical Therapy Fails.  

PubMed

The authors present a case of a 27-year-old multiparous woman, with multiple thrombophilia, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. At 15th week of gestation, following an acute deep venous thrombosis of the right inferior limb, anticoagulant therapy with low-molecular-weight heparin (LMWH) was instituted without improvement in her clinical status. Subsequently, at 18 weeks of pregnancy, LMWH was switched to warfarin. At 30th week of gestation, the maintenance of high thrombotic risk was the premise for placement of an inferior vena cava filter for prophylaxis of pulmonary embolism during childbirth and postpartum. There were no complications and a vaginal delivery was accomplished at 37 weeks of gestation. Venal placement of inferior vena cava filters is an attractive option as prophylaxis for pulmonary embolism during pregnancy. PMID:23781361

Valadares, Sara; Serrano, Fátima; Torres, Rita; Borges, Augusta

2013-05-27

172

Successful urgent transplantation of an adult kidney into a child with inferior vena cava thrombosis.  

PubMed

Poor venous drainage options following inferior vena cava (IVC) thrombosis have been considered to complicate or preclude renal transplantation of adult kidneys into pediatric patients. We describe urgent renal transplantation in a 5-year-old (15.3 kg) male with IVC thrombosis using an adult living donor. Preoperative magnetic resonance venography revealed a patent infrahepatic/suprarenal vena cava and portal system. In surgery, the right liver lobe was mobilized sufficiently to anastomose the graft renal vein to the native IVC at the confluence of the native left renal vein and proximal vena cava. Graft function has remained excellent with serum creatinine of 0.5 mg/dL at 36 months. IVC thrombosis need not preclude successful transplantation of adult-sized kidneys into children. PMID:19519816

Stevens, R B; Yannam, G R; Hill, B C; Rigley, T H; Penn, D M; Skorupa, J Y

2009-06-10

173

Design optimization of vena cava filters: an application to dual filtration devices.  

PubMed

Pulmonary embolism (PE) is a significant medical problem that results in over 300,000 fatalities per year. A common preventative treatment for PE is the insertion of a metallic filter into the inferior vena cava that traps thrombi before they reach the lungs. The goal of this work is to use methods of mathematical modeling and design optimization to determine the configuration of trapped thrombi that minimizes the hemodynamic disruption. The resulting configuration has implications for constructing an optimally designed vena cava filter. Computational fluid dynamics is coupled with a nonlinear optimization algorithm to determine the optimal configuration of a trapped model thrombus in the inferior vena cava. The location and shape of the thrombus are parametrized, and an objective function, based on wall shear stresses, determines the worthiness of a given configuration. The methods are fully automated and demonstrate the capabilities of a design optimization framework that is broadly applicable. Changes to thrombus location and shape alter the velocity contours and wall shear stress profiles significantly. For vena cava filters that trap two thrombi simultaneously, the undesirable flow dynamics past one thrombus can be mitigated by leveraging the flow past the other thrombus. Streamlining the shape of the thrombus trapped along the cava wall reduces the disruption to the flow but increases the area exposed to low wall shear stress. Computer-based design optimization is a useful tool for developing vena cava filters. Characterizing and parametrizing the design requirements and constraints is essential for constructing devices that address clinical complications. In addition, formulating a well-defined objective function that quantifies clinical risks and benefits is needed for designing devices that are clinically viable. PMID:20887016

Singer, Michael A; Wang, Stephen L; Diachin, Darin P

2010-10-01

174

Design Optimization of Vena Cava Filters: An application to dual filtration devices  

SciTech Connect

Pulmonary embolism (PE) is a significant medical problem that results in over 300,000 fatalities per year. A common preventative treatment for PE is the insertion of a metallic filter into the inferior vena cava that traps thrombi before they reach the lungs. The goal of this work is to use methods of mathematical modeling and design optimization to determine the configuration of trapped thrombi that minimizes the hemodynamic disruption. The resulting configuration has implications for constructing an optimally designed vena cava filter. Computational fluid dynamics is coupled with a nonlinear optimization algorithm to determine the optimal configuration of trapped model thrombus in the inferior vena cava. The location and shape of the thrombus are parameterized, and an objective function, based on wall shear stresses, determines the worthiness of a given configuration. The methods are fully automated and demonstrate the capabilities of a design optimization framework that is broadly applicable. Changes to thrombus location and shape alter the velocity contours and wall shear stress profiles significantly. For vena cava filters that trap two thrombi simultaneously, the undesirable flow dynamics past one thrombus can be mitigated by leveraging the flow past the other thrombus. Streamlining the shape of thrombus trapped along the cava wall reduces the disruption to the flow, but increases the area exposed to abnormal wall shear stress. Computer-based design optimization is a useful tool for developing vena cava filters. Characterizing and parameterizing the design requirements and constraints is essential for constructing devices that address clinical complications. In addition, formulating a well-defined objective function that quantifies clinical risks and benefits is needed for designing devices that are clinically viable.

Singer, M A; Wang, S L; Diachin, D P

2009-12-03

175

The effect of stretching the superior vena caval--right atrial junction on right atrial receptors in the dog  

PubMed Central

1. Action potentials were recorded from fibres in the right cervical vagus, the receptor endings of which were localized to the endocardial surface of the superior vena caval—right atrial junction. 2. Stretching the junction between the superior vena cava and the right atrium without obstructing venous return caused an increase in the discharge of these fibres. This increase in impulse frequency was similar to that caused by small changes in mean right atrial pressure (range 0-13·5 cm H2O). 3. This evidence supports the earlier suggestion that stimulation of the right atrial receptors by stretching the superior vena caval—right atrial junction causes a reflex increase in heart rate.

Kappagoda, C. T.; Linden, R. J.; Snow, H. M.

1972-01-01

176

Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass  

PubMed Central

Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

Boudreau, Suzanne; Leveille, Felix; Lamothe, Marc; Chagnon, Patrick; Boulais, Isabelle

2013-01-01

177

Results From the TICO-CAVA Land Seismic Refraction Survey  

NASA Astrophysics Data System (ADS)

Project TICO-CAVA (Transects to Investigate the Crustal Origin of the Central American Volcanic Arc) is a key part of the MARGINS Subduction Factory initiative to quantify, characterize, and understand the volcanic crust produced in Costa Rica by seismically imaging its volume, extent, seismic properties, and lateral variability. From this information we hope to estimate the major-element composition of the arc crust and draw inferences about the processes controlling volcanic output of the subduction factory in Central America. We will do this with two intimately linked seismic surveys, an onshore explosion refraction survey (2005), and an onshore-offshore airgun survey (2008). Here we present results from Phase I of the project, an onshore explosion seismic refraction survey of the volcanic arc and look forward to phase II, a large onshore-offshore seismic survey in both the Atlantic and Pacific oceans. We acquired seismic refraction/wide-angle reflection data on two lines. Line 1 is 154 km long from the Pacific Ocean to the Caribbean Sea in central Costa Rica, intersecting the main volcanic arc at Volcán Barva. Line 2 is 280 km long and spans the entire length of the active arc in Costa Rica, from north of Volcán OrosÃÆ'í near the Nicaraguan border, to south of Volcán IrazÃÆ'ú. 748 seismometers were deployed on each transect, resulting in a ~200 m receiver spacing on Line 1 and ~370 m spacing on Line 2. Data quality ranges from fair to excellent. Data on the cross-arc line (Line 1) show upper-crustal refractions that can be tracked from coast to coast and, at the longest offsets, deep reflections that may be Moho reflections. Sediments on the Atlantic coastal plain (2-3 km/s) are about 1.5 km thick; beneath this and beneath the volcanic arc is a low-velocity carapace of volcanic material (3-5 km/s) that is 2-4 km thick. Beneath the low-velocity velocities reach 6.0-6.4 km/s at 5-10 km depth. Deeper structure will become better resolved as analysis continues and the onshore-offshore data are collected. The along-arc line (Line 2) shows evidence for distinctly different crustal structure beneath the Guanacaste volcanos and the Cordillera Central. In addition, low-velocity zones that may represent magma chambers exist beneath Poás volcano and between Irazu and Turrialba volcanoes.

Bullock, A. D.; Holbrook, W. S.; Lizarralde, D.; van Avendonk, H.; Mora, M. M.; Harder, S.; Alvarado, G.

2007-12-01

178

Resection and reconstruction of the inferior vena cava for neoplasms  

PubMed Central

AIM: To evaluate the results of an aggressive surgical approach of resection and reconstruction of the inferior vena cava (IVC). METHODS: The approach to caval resection depends on the extent and location of tumor involvement. The supra- and infra-hepatic portion of the IVC was dissected and taped. Left and right renal veins were also taped to control the bleeding. In 12 of the cases with partial tangential resection of the IVC, the flow was reduced to less than 40% so that the vein was primarily closed with a running suture. In 3 of the cases, the lumen of the vein was significantly reduced, requiring the use of a polytetrafluoroethylene (PTFE) patch. In 2 of the cases with segmental resection of the IVC, a PTFE prosthesis was used and in 1 case, the IVC was resected without reconstruction due to shunting the blood through the azygos and hemiazygos veins. RESULTS: The mean operation time was 266 min (230-310 min) with an average intraoperative blood loss of 300 mL (200-2000 mL). The patients stayed in intensive care unit for 1.8 d (1-3 d). Mean hospital stay was 9 d (7-15 d). Twelve patients (66.7%) had no complications and 6 patients (33.3%) had the following complications: acute bleeding in 2 patients; bile leak in 2 patients; intra abdominal abscess in 1 patient; pulmonary embolism in 2 patients; and partial thrombosis of the patch in 1 patient. General complications such as pneumonia, pleural effusion and cardiac arrest were observed in the same group of patients. In all but 1 case, the complications were transient and successfully controlled. The mortality rate was 11.1% (n = 2). One patient died due to cardiac arrest and pulmonary embolism in the operation room and the second one died 2 d after surgery due to coagulopathy. With a median follow-up of 24 mo, 5 (27.8%) patients died of tumor recurrence and 11 (61.1%) are still alive, but three of them have a recurrence on computed tomography. CONCLUSION: There are a variety of options for reconstruction after resection of the IVC that offers a higher resectable rate and better prognosis in selected cases.

Vladov, Nikola Nikolov; Mihaylov, Vassil Ivanov; Belev, Nikolai Vassilev; Mutafchiiski, Ventzislav Metodiev; Takorov, Ivelin Rumenov; Sergeev, Sergei Kirilov; Odisseeva, Evelina Hristova

2012-01-01

179

Clinical Sequelae of Thrombus in an Inferior Vena Cava Filter  

SciTech Connect

The purpose of this study was to assess the long-term clinical sequelae of inferior vena cava (IVC) filter thrombus and the effect of anticoagulation on filter thrombus. Of 1,718 patients who had IVC filters placed during 2001-2008, 598 (34.8%) had follow-up abdominal CT. Filter thrombus was seen in 111 of the 598 (18.6%). There were 44 men (39.6%). The mean age at filter placement was 64 years. The medical diseases included cancer in 64, trauma in 15, stroke in 12, and others in 20. The frequency of filter thrombus on CT and asymptomatic filter thrombus on CT was calculated. The frequency of pulmonary embolism (PE) in patients with filter thrombus was calculated. The frequency of thrombus progression or regression (on CT, available in 56) was calculated. The effect of anticoagulation on filter thrombus regression/progression was evaluated using the Fisher exact test by comparing the group of patients who received anticoagulants versus those who did not. A P-value of <0.05 was considered significant. The overall frequency of filter thrombus was 18.6%. Total occlusion of the IVC filter was seen in 12 of 598 (2%). The filter thrombus was asymptomatic in 110 (18.3%). Filter thrombus was detected after a median of 35 days (range, 0-2082) following filter placement. Thrombus extended above the filter in 4 (3.6%); IVC thrombus below the filter was seen in 35(31.5%). Thrombus in the filter occluded <25% of the filter volume in 58 (52.3%), 25-50% in 21 (18.9%), and 50-75% in 20 (18%). Total IVC occlusion was seen in 12 (10.8%). Eighty-three patients received anticoagulation. Sixteen patients developed symptoms of PE. PE was confirmed on CT in 3 of 15 (2.7%). On follow-up, filter thrombus regressed completely in 19 (33.9%) after a median of 6 months. Filter thrombus decreased in size in 13 (23.2%) and it progressed without IVC occlusion in 7 (12.6%). In one (1.7%), filter thrombus progressed to IVC occlusion. Filter thrombus remained stable in 16 (28.6%). There was no significant difference in thrombus regression or progression rates whether or not the patients received anticoagulation for filter thrombus. In conclusion, asymptomatic thrombus in the filter is common and it rarely progresses to complete caval occlusion. Anticoagulation has little effect on the resolution of filter thrombosis and future occurrence of PE.

Ahmad, Iftikhar; Yeddula, Kalpana; Wicky, Stephan; Kalva, Sanjeeva P., E-mail: skalva@partners.or [Massachusetts General Hospital and Harvard Medical School, Department of Radiology (United States)

2010-04-15

180

Avulsion of the superior labrum.  

PubMed

Snyder et al. coined the term superior labral anterior and posterior (SLAP) lesion and classified SLAP lesion into 4 types. Morgan et al. developed a secondary classification of Snyder type II lesions based on the anatomic location. Maffet et al. found that some lesions could not be classified according to classification of Snyder et al.; types V to VII were added to the 4-part classification. In this study, we present the case of a patient with a superior labral tear that could not be classified to any of the reported classification. The superior labrum was detached with cartilage exposing the underlying bone of the glenoid. PMID:15483552

Choi, Nam-Hong; Kim, Sung-Jae

2004-10-01

181

Balloon dialation of inferior vena cava stenosis causing hemodialysis graft failure  

Microsoft Academic Search

Inferior vena cava stenosis developed after an unsuccessful renal transplant in a 3-year-old child. Resulting venous outflow obstruction consequently prevented construction of a functional hemodialysis arteriovenous shunt at the femoral area. Transluminal balloon angioplasty of the stenosis completely eliminated the obstruction and allowed creation of the shunt.

Grigory Rozenblit; Khalid M. H. Butt

1995-01-01

182

Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty  

SciTech Connect

Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval of the cement embolus.

Athreya, S., E-mail: sathreya@stjoes.c [St. Joseph's Healthcare, Department of Radiology (Canada); Mathias, N. [Gartnavel General Hospital, Department of Radiology (United Kingdom); Rogers, P. [Gartnavel General Hospital, Department of Surgery (United Kingdom); Edwards, R. [Gartnavel General Hospital, Department of Radiology (United Kingdom)

2009-07-15

183

Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty  

Microsoft Academic Search

Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval of the cement embolus.

S. Athreya; N. Mathias; P. Rogers; R. Edwards

2009-01-01

184

Fatal Complications After Self-Expandable Metallic Stent Placement for Inferior Vena Cava Syndrome  

SciTech Connect

We present the case of a 71-year-old man with inferior vena cava syndrome due to metastatic lymph nodes from hepatocellular carcinoma with serious complications that were strongly suspected to result from rapid changes in hemodynamics after self-expandable metallic stent placement.

Yamagami, Takuji, E-mail: yamagami@koto.kpu-m.ac.jp; Nakamura, Toshiyuki; Kin, Yoko; Takimoto, Yukiko; Nishimura, Tsunehiko [Kyoto PrefecturalUniversity of Medicine, Kyoto, Department of Radiology (Japan)

2003-08-15

185

Venous thromboembolic disease: the use of "optional" inferior vena cava filters.  

PubMed

Approximately 140,000 to 200,000 patients die as a result of pulmonary embolism in the United States each year. If the diagnosis is made and therapy initiated, the mortality rate drops to 8%. Vena cava filters play a role in the management of patients with thromboembolic disease. Deployment of "optional" filters is changing practice paradigms. PMID:21326489

Venbrux, Anthony C; Ignacio, Elizabeth A; Sarin, Shawn N; Soltes, Amy P; Haskins, Noel C; Gagarin, Dmitri

2008-03-01

186

Thrombosis of the cranial vena cava in a cow with bronchopneumonia and traumatic reticuloperitonitis.  

PubMed

This paper reports the clinical findings, surgical and medical management, and necropsy of a 6-year-old cow with thrombosis of the cranial vena cava and thrombo-embolic pneumonia following traumatic reticuloperitonitis. The clinical diagnosis was confirmed by necropsy. PMID:22547845

Gerspach, Christian; Wirz, Mirjam; Schweizer-Knubben, Gabriela; Braun, Ueli

2011-11-01

187

Aggressive surgical resection for hepatic metastases involving the inferior vena cava  

Microsoft Academic Search

BACKGROUND: The implications of aggressive surgical approaches for hepatic metastases involving the inferior vena cava (IVC) have not been clarified yet. The aim of this study is to assess the preliminary results of aggressive surgical resection for hepatic metastases involving the IVC.METHODS:Sixteen patients with hepatic metastases involving the IVC underwent surgical resections with the repair and reconstruction of the IVC:

Masaru Miyazaki; Hiroshi Ito; Koji Nakagawa; Satoshi Ambiru; Hiroaki Shimizu; Atsushi Okuno; Yuji Nukui; Hideyuki Yoshitomi; Kimihiko Kusashio; Seiji Furuya; Nobuyuki Nakajima

1999-01-01

188

Atrial flutter ablation through the azygous continuation in a patient with inferior vena cava interruption.  

PubMed

Ablation of atrial flutter (AFL) requires linear radiofrequency application; these procedures are usually performed via a femoral approach from the inferior vena cava (IVC). Congenital anomalies of this venous system may limit catheter ablation. This report presents ablation of an AFL through the azygous continuation and also reviews the prevalence of congenital IVC interruption among patients referred for AFL ablation. PMID:21030393

Pérez-Silva, Armando; Merino, Jose L; Peinado, Rafael; Lopez-Sendon, Jose

2010-10-27

189

Imaging of fat thrombus in the inferior vena cava originating from an angiomyolipoma  

Microsoft Academic Search

A rare case of fat thrombus in the inferior vena cava originating from an angiomyolipoma is reported. Diagnostic imaging including ultrasonography, CT, MRI, and cavography was performed preoperatively. MRI allowed the most complete preoperative staging because of specific fatty signal intensity and good assessment of renal vein involvement.

Guy Moulin; Jean-François Berger; Christophe Chagnaud; Philippe Piquet; Jean-Michel Bartoli

1994-01-01

190

Ruptured Angiomyolipoma with Fatty Tumor Thrombus of the Renal Vein and Inferior Vena Cava  

Microsoft Academic Search

Renal angiomyolipoma is a benign clonal neoplasm that consists of three constituents, namely, blood vessels, adipose tissue and smooth muscle. Although renal angiomyolipoma has a benign nature and grows slowly, extrarenal occurrences have been reported in the hilar lymph nodes, retroperitoneum, liver, colon and direct extension to the renal vein and inferior vena cava as a tumor thrombus. Such a

Ching-Hwa Yang; Pei-Hui Chan; Siu-Kei La; Kuan-Ming Chiu

191

Inferior vena cava thrombosis in a pediatric patient of amebic liver abscess  

PubMed Central

Amebic liver abscess (ALA) in pediatric age group is rare. We describe a successful thrombectomy and open drainage of a large left lobe ALA associated with thrombus in the hepatic veins and inferior vena cava extending into the right atrium in a 6-year-old boy.

Gupta, Anubhav; Dhua, Anjan Kumar; Siddiqui, Mansoor Ahmed; Dympep, Badamutlang; Grover, Vijay; Gupta, Vijay Kumar; Sen, Amita

2013-01-01

192

Blood supply to the cranial venae cavae and the heart in the laboratory shrew (Suncus murinus).  

PubMed Central

The blood supply to the cranial venae cavae on both sides and to the heart was studied macroscopically in 40 adult laboratory shrews (Suncus murinus) of both sexes injected either with Neoprene latex into the abdominal aorta (25 animals) or with Mercox into the left ventricle (15 animals). The 1st branch of the left subclavian artery in 23 animals of the 1st group ramified caudal to the aortic arch and descended between the aorta and the trachea to supply mainly the large left cranial vena cava that lay on the dorsal surface of the left atrium, while a branch that arose between the 1st and 2nd intercostal arteries on the right in 25 animals supplied the right cranial vena cava caudally after giving rise to a branch to the oesophagus. In 2 animals the artery to the left vena cava arose directly from the thoracic aorta at the level of the 4th intercostal artery and then followed the course described above. From these considerations, these vessels in the laboratory shrew would correspond to the accessory coronary arteries of Halpern (1957) in the rat. In the 15 animals of the 2nd group, the left coronary artery was distributed to the atrium and the ventricle on left side and to the upper half of the interventricular septum, the artery on the right supplied the atrium and the ventricle on right side, the interatrial septum and lower half of the interventricular septum. Images Figs 1,2 Fig. 3 Fig. 5 Fig. 6

Isomura, G

1993-01-01

193

Surgical management of renal cell carcinoma with inferior vena cava tumor thrombus  

Microsoft Academic Search

Background: The successful excision of a renal cell carcinoma (RCC) invading the inferior vena cava (IVC) remains a technical intraoperative challenge and requires a careful preoperative surgical management planning. Although a radical operation remains the mainstay of the therapy for RCC, the optimal management of the patients with RCC causing IVC tumor thrombus remains unresolved. In this study, we reviewed

Sadi Kaplan; Sinan Ekici; R?za Do?an; Metin Demircin; Haluk Özen; Ilhan Pa?ao?lu

2002-01-01

194

SURGICAL MANAGEMENT OF LARGE ADRENAL MASSES WITH OR WITHOUT THROMBUS EXTENDING INTO THE INFERIOR VENA CAVA  

Microsoft Academic Search

PurposeSurgical extirpation is the only curative treatment for large adrenal masses with or without thrombus extending into the inferior vena cava. However, occasionally complex surgical techniques are required, including venovenous bypass or cardiopulmonary bypass (CPB). Additionally, applying techniques used for organ transplantation can provide better exposure with less blood loss to allow milking of the thrombus downward, limiting the need

SINAN EKICI; GAETANO CIANCIO

2004-01-01

195

Leiomyosarcoma of the Inferior Vena Cava: An Unusual Tumor Case Report and Review of Literature  

PubMed Central

A case of leiomyosarcoma of the inferior vena cava (IVC) is reported. Only 48 cases have been previously reported in the world literature. Pre-operative management is discussed with reference to diagnostic consideration. The case strengthens the concept of operative intervention in asymptomatic abdominal masses with minimal pre-operative workup and delay. ImagesFigure 1Figure 2Figure 3Figure 4

Warner, Clinton; Densler, James; Meadows, Warner; Marmolejo, A.

1980-01-01

196

Migration of an inferior vena cava filter to the right ventricle and literature review.  

PubMed

Migration of an inferior vena cava (IVC) filter to the heart after placement is an extremely rare complication. The case of a 42-year-old man who presented with ventricular arrhythmia and tricuspid valve regurgitation, and underwent open heart surgery to extract an IVC filter from the right ventricle 12 days after infrarenal IVC filter placement, is reported. PMID:15010749

Izutani, Hironori; Lalude, Omosalewa; Gill, Inderjit S; Biblo, Lee A

2004-02-01

197

Extraction of a defibrillator lead through an inferior vena cava filter.  

PubMed

We report an extraction of a chronic, previously cut and abandoned, active-fixation implantable cardioverter-defibrillator lead through an inferior vena cava filter. A long workstation sheath that crossed the filter was used, allowing the lead and all hardware to be withdrawn through a single opening in the filter. PMID:15546316

Henrikson, Charles A; Brinker, Jeffrey A

2004-11-01

198

Comparison of superior vena caval and inferior vena caval access using a radioisotope technique during normal perfusion and cardiopulmonary resuscitation  

SciTech Connect

Recent studies of thoracic pressure changes during external cardiopulmonary resuscitation (CPR) suggest that there may be a significant difference in the rate of delivery of intravenous drugs when they are administered through the extrathoracic inferior vena cava (IVC) rather than the intrathoracic superior vena cava (SVC). Comparison of delivery of a radionuclide given using superior and inferior vena caval access sites was made during normal blood flow and during CPR. Mean times from injection to peak emission count in each ventricle were determined. There were no significant differences between mean peak times for SVC or IVC routes during normal flow or CPR. When peak times were corrected for variations in cardiac output, there were no significant differences between IVC and SVC peak times during normal flow. During CPR, however, mean left ventricular peak time, when corrected for cardiac output, was significantly shorter (P less than .05) when the SVC route was used. The mean time for the counts to reach half the ventricular peak was statistically shorter (P less than .05) in both ventricles with the SVC route during the low flow of CPR. This suggests that during CPR, increased drug dispersion may occur when drugs are infused by the IVC route and thus may modify the anticipated effect of the drug bolus. These results suggest that during CPR, both the cardiac output and the choice of venous access are important variables for drug delivery.

Dalsey, W.C.; Barsan, W.G.; Joyce, S.M.; Hedges, J.R.; Lukes, S.J.; Doan, L.A.

1984-10-01

199

Inferior vena cava filter placement for pulmonary embolism risk reduction in super morbidly obese undergoing bariatric surgery  

Microsoft Academic Search

BackgroundPulmonary embolism (PE) is a leading cause of mortality after bariatric surgery. We evaluated inferior vena cava (IVC) filter use for PE risk reduction in high-risk super morbidly obese bariatric surgery patients.

Christa M. Trigilio-Black; Chad D. Ringley; Corrigan L. McBride; Victor J. Sorensen; Jon S. Thompson; G. Matthew Longo; Iraklis I. Pipinos; Jason M. Johanning

2007-01-01

200

In Vitro Evaluation of a Rheolytic Thrombectomy System for Clot Removal from Five Different Temporary Vena Cava Filters  

SciTech Connect

Purpose: To evaluate the feasibility of thrombus removal from temporary vena cava filters using a rheolytic thrombectomy device and to assess the embolization rate of this procedure. Methods: Five temporary vena cava filters together with porcine thrombi were placed in a vena cava flow model (semitranslucent silicone tube of 23 mm diameter, pulsatile flow at a mean flow rate of 4 L/min). A rheolytic thrombectomy system (Hydrolyser) was used with a 9 Fr guiding catheter to remove the clots. The effluent was passed through filters of different size and the amount of embolized particles as well as the remaining thrombus were measured. Results: Thrombus removal rates ranged from 85% to 100%. Embolization rates between 47% and 60% were calculated for the different filters. Conclusion: The Hydrolyser is able to remove sufficiently high amounts of thrombus from temporary vena cava filters. However, the amount of embolized particles makes it impossible to utilize this method without special precautions against embolization.

Buecker, Arno; Neuerburg, Joerg; Schmitz-Rode, Thomas; Vorwerk, Dierk; Guenther, Rolf W. [Clinic for Diagnostic Radiology, University of Technology Aachen, Pauwelsstrasse 30, D-52074 Aachen (Germany)

1997-11-15

201

Scimitar syndrome and azygos continuation of the inferior vena cava diagnosed in an adult--an unusual association.  

PubMed

Anormal drainage of the pulmonary veins into the inferior vena cava is known as scimitar syndrome. Scimitar syndrome often presents during infancy and rarely during adulthood, and the adult patients are mostly asymptomatic. It is usually in association with dextrocardia, hypoplasia of right lung, and congenital heart defects. However, interruption of inferior vena cava with azygous continuation is rarely associated with this syndrome. PMID:22469461

Celik, Murat; Celik, Turgay; Iyisoy, Atila; Ayten, Omer

2012-04-02

202

Desequilibrios en la educación superior  

Microsoft Academic Search

Una de las cuestiones que se debaten en la educación privada y pública de hoy es la dicotomía que existe entre el sistema primario y secundario con respecto al universitario. En los últimos años, diversos analistas han denunciado el declive en la educación primaria (Beck, 1986) (Bauman, 2005) (Sanguineti, 2006) (Korstanje, 2008). No obstante, la demanda de educación superior ha

Maximiliano E. Korstanje

2009-01-01

203

Air Superiority: Blunting Nearsighted Criticism.  

National Technical Information Service (NTIS)

'Everything is possible if you have air superiority-little is possible if you lose it.' General Charles Horner, architect of the decisive DESERT STORM Air Campaign, clearly articulates a need to control the medium of air. While the logic of General Horner...

J. D. Corley

1993-01-01

204

The use of retrievable inferior vena cava filters in trauma: implications for the trauma team.  

PubMed

Prevention of venothromboembolic complications remains a challenge in trauma care. Guidelines for prophylaxis published by the Eastern Association for the Surgery of Trauma stratify patients by risk and recommend therapies based on scientific evidence. New innovations such as retrievable inferior vena cava filters are being used by trauma surgeons for patients at risk for pulmonary embolism but in whom anticoagulation is contraindicated. Some available devices offer a limited timeframe for retrieval beyond which the device becomes permanent. The increased utilization of this technology presents case management challenges to trauma teams. Patients who are unreliable or may be difficult to track posthospitalization (homeless, migrant workers, prison system, etc.) run the risk of not having their filters removed as initially intended. Nurses can play a critical role in helping to manage and direct the discharge plan and case management of trauma patients with retrievable inferior vena cava filters. PMID:16884132

FitzPatrick, Mary Kate; Reilly, Patrick; Stavropoulos, S William

205

Patent abdominal subcutaneous veins caused by congenital absence of the inferior vena cava: a case report  

PubMed Central

Introduction Patent paraumbilical and abdominal subcutaneous veins are found frequently as collaterals in patients due to portal hypertension mainly in liver cirrhosis. Case presentation For evaluation of portal hypertension in a 72-year-old Caucasian man without liver cirrhosis, magnetic resonance imaging with gadolinium contrast-enhancement was performed and demonstrated a missing inferior vena cava. A blood return from the lower extremities was shown through enlarged collateral veins of the abdominal wall, vena azygos and hemiazygos continuation, and multiple liver veins emptying into the right cardiac atrium. We describe a rare case of abdominal subcutaneous wall veins as collaterals caused by a congenitally absent infrarenal inferior vena cava with preservation of a hypoplastic suprarenal segment. Conclusion Knowledge of these congenital variations can be of clinical importance and it is imperative for the reporting radiologist to identify these anomalies as they can have a significant impact on the clinical management of the patient.

2010-01-01

206

Simultaneous pulmonary and inferior vena cava thromboembolism secondary to pelvic osteosarcoma.  

PubMed

Thromboembolism presenting with malignancy is common in adults but rare in children. We describe the case of a 17-year-old boy admitted to our hospital with syncope. Computed tomography revealed thromboembolism in both the lungs. Magnetic resonance imaging found thromboembolism in the inferior vena cava and a large heterogeneous mass in the pelvis. Pelvic osteosarcoma was confirmed by computed tomography-guided biopsy. Despite intensive chemotherapy and local radiation, only transient response was noted, the tumor remaining unresectable. To our knowledge, this is the first reported case of simultaneous pulmonary and inferior vena cava thromboembolism secondary to pelvic osteosarcoma in children. We also emphasize syncope as a unique feature of pulmonary thromboembolism. Accordingly, thromboembolism should be kept in mind as the first manifestation of occult malignancy, even in children. PMID:23274375

Lin, Wei-Ching; Lin, Chien-Heng; Chao, Yu-Hua; Lin, Hsiao-Chuan; Chen, Pei-Yu; Wu, Han-Ping; Wu, Kang-Hsi

2013-11-01

207

Temporary Vena Cava Filters and Ultrahigh Streptokinase Thrombolysis Therapy: A Clinical Study  

SciTech Connect

Purpose: To assess the efficacy of temporary vena cava filters in patients undergoing ultrahigh-dose streptokinase thrombolysis for iliocaval thrombosis and to determine therapy success and filter and therapy complications.Methods: Forty-five patients were studied regarding extension and characteristics of thrombosis, duration, success, and complications of thrombolysis therapy, filter type, access route, pulmonary embolisms, and filter complications.Results: Complete recanalization was achieved in 57% of cases. Filters were inserted predominantly via a transbrachial route. One fatal pulmonary embolism (2%) occurred 1 day after starting thrombolysis. No other pulmonary embolism was noted. Other complications were induced by thrombolysis alone (n = 12), thrombolysis and filter (n = 9), and filter alone (n = 11).Conclusion: Fatal pulmonary embolisms as a complication of ultrahigh-dose treatment of pelvic or caval thrombosis can not safely be prevented by the temporary vena cava filters currently available. Filter design needs to be improved.

Lorch, Heike; Zwaan, Martin [Department of Radiology, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck (Germany); Siemens, Hans-Joachim; Wagner, Thomas [Department of Internal Medicine, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck (Germany); Kagel, Christiane; Weiss, Hans-Dieter [Department of Radiology, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck (Germany)

2000-07-15

208

Inferior vena cava filters for HIV infected patients with pulmonary embolism and contraindications to anticoagulation  

PubMed Central

Objectives: To describe the mode of presentation, interventions, and outcome of HIV infected patients with pulmonary embolism and a contraindication to anticoagulation, who were treated with a bird's nest filter. Methods: Retrospective review of case records and imaging department database at UCL Hospitals, London, UK. Results: Three patients had pulmonary embolism and contraindications to anticoagulation. Contraindications were concomitant intracerebral pathology in two patients (one also had bleeding from gastric Kaposi's sarcoma and the other was cognitively impaired with HIV associated dementia complex) and alcohol induced liver disease/binge drinking in the third patient. Anticoagulation was avoided by introducing a bird's nest filter into the inferior vena cava via the common femoral vein. During follow up (7, 8, and 21 months) no complications or recurrent pulmonary emboli occurred. Conclusion: The bird's nest inferior vena cava filter has a role in preventing further pulmonary emboli in HIV infected patients with contraindications to anticoagulation. Key Words: pulmonary embolism; HIV; AIDS; haemorrhage; anticoagulation

Shahmanesh, M.; Brooks, J.; Shaw, P.; Miller, R.

2000-01-01

209

Leiomyosarcoma of the inferior vena cava: report of a case and review of the literature.  

PubMed Central

Leiomyosarcoma of the inferior vena cava is a rare and usually fatal disease. Only 45 cases have been reported in the world literature. The authors add one case and review all previous reports. The disease is one primarily of elderly women, arising from the middle third of the inferior vena cava with a wide range of symptomatology, varying form the Budd-Chiari syndrome to a few asymptomatic cases. The tumor may grow very slowly or occasionally very rapidly, shows extensive local invasion, and metastasizes more frequently than previously believed. While radiotherapy and chemotherapy have not been adequately studied, aggresive surgical intervention using the recent advances in vascular surgery appears to offer long term palliation and hopefully cures of this disease in the future. Images Fig. 1. Fig. 2. Fig. 3.

Bailey, R V; Stribling, J; Weitzner, S; Hardy, J D

1976-01-01

210

Retrieval of Cement Embolus from Inferior Vena Cava After Percutaneous Vertebroplasty  

Microsoft Academic Search

Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and\\u000a malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a\\u000a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval\\u000a of the cement embolus.

S. Athreya; N. Mathias; P. Rogers; R. Edwards

2009-01-01

211

Value-added fermentation of Ecklonia cava processing by-product and its antioxidant effect  

Microsoft Academic Search

The interest in the extraction of polyphenolic compounds from plant materials is focused on upgrading of the large amount\\u000a of by-products coming from food or cosmetics industries from which the press residues have particularly high contents of phenolics.\\u000a In this study, for value-added use of the brown seaweed Ecklonia cava processing by-product (ECPB), which can be obtained after polyphenolic extraction

W. A. J. P. Wijesinghe; Lee Won-Woo; Kim Young-Mog; Kim Young-Tae; Kim Se-Kwon; Jeon Byong-Tae; Kim Jin-Soo; Heu Min-Soo; Jung Won-Kyo; Ginnae Ahn; Ki-Wan Lee; You-Jin Jeon

212

[Polysplenia with duplication of the inferior vena cava. Apropos of a case].  

PubMed

A case of polysplenia fortuitously discovered in an adult by sonography, then studied by computed tomography and inferior vena cavography, is reported. In the absence of cardiac anomalies, the different elements of the syndrome are discussed: multiple spleens, abdominal heterotaxia and vascular malformations. The duplication of the inferior vena cava is exceptional in this disease. Its original characteristic is shown by the cavography and brought to its embryologic origin. PMID:3585859

Boyer, B; Gisserot, D; Le Vot, J; Muyard, B; Abgrall, J; Jan, P

1987-04-01

213

Technical Error During Deployment Leads to Vena Cava Filter Migration and Massive Pulmonary Embolism  

SciTech Connect

The Guenther Tulip vena cava filter is a safe, effective, well-established device for pulmonary embolism prophylaxis. We report a patient in whom there was migration of the filter to the right atrium, 2 weeks after insertion, caused by a technical error during deployment. An attempt to retrieve the filter percutaneously failed, necessitating removal at open-heart surgery. The potential causes of migration are described and the lessons learned from this unusual case are outlined.

Fotiadis, Nikolas I., E-mail: fotiadis.nicholas@gmail.com; Sabharwal, Tarun; Dourado, Renato [Guy's and St. Thomas' Hospital, Interventional Radiology Department (United Kingdom); Fikrat, Shabbo [Guy's and St. Thomas' Hospital, Department of Cardiothoracic Surgery (United Kingdom); Adam, Andreas [Guy's and St. Thomas' Hospital, Interventional Radiology Department (United Kingdom)

2008-07-15

214

Sonographic measurement of the inferior vena cava as a predictor of shock in trauma patients  

Microsoft Academic Search

Detecting and monitoring blood loss is always a challenging dilemma in emergency settings. The diameter of the inferior vena\\u000a cava (IVC) in trauma patients may be useful in this way. This has been classically done with computed tomography (CT); however,\\u000a doing it with ultrasound as a bedside easily available modality is a relatively novel approach. Between January 2006 and March

S. Sefidbakht; R. Assadsangabi; H. R. Abbasi; A. Nabavizadeh

2007-01-01

215

Successful Management of Pulmonary and Inferior Vena Cava Tumor Embolism from Renal Cell Carcinoma  

PubMed Central

Pulmonary tumor embolism can be a cause of respiratory failure in patients with cancer even though it occurs rarely. We describe a 56-year-old man who underwent a pulmonary tumor embolectomy using cardiopulmonary bypass on beating heart combined with inferior vena cava embolectomy and right radical nephrectomy. Aggressive surgical treatment in this severe case is necessary not only to reduce the fatal outcome of pulmonary embolism in the short run, but also to improve the oncological prognosis in the long term.

Shim, Hunbo; Kim, Young-Wook; Yang, Shin-Seok; Kim, Duk-Kyung

2012-01-01

216

Surgical Treatment for an Invasive Leiomyosarcoma of the Inferior Vena Cava  

PubMed Central

A 49-year-old woman presented with right lumbar pain and edema in both legs. Computed tomography showed a large low attenuated mass around and in the S7 segment of the liver involving the right kidney and multiple enlarged mesenteric lymph nodes. There were multiple variably sized discrete nodules in both lungs. Cavography showed subtotal occlusion of the inferior vena cava (IVC). She was successfully treated by wide resection and IVC reconstruction with partial cardiopulmonary bypass and metastasectomy.

Lee, Hee Moon; Park, Pyo Won; Kim, Wook Sung; Sung, Kiick; Lee, Young Tak

2013-01-01

217

Antiproliferative and antioxidant properties of an enzymatic hydrolysate from brown alga, Ecklonia cava  

Microsoft Academic Search

The potential antiproliferative and antiradical activities of an enzymatic extract of Ecklonia cava together with its crude polysaccharide (CpoF) and crude polyphenolic fractions (CphF) were evaluated in vitro. Tested extracts showed strong selective cell proliferation inhibition on all cancer cell lines tested, especially CphF extract, containing high polyphenol amount, showed 5.1?g\\/ml of IC50 value on murine colon cancer (CT-26) cell

Yasantha Athukorala; Kil-Nam Kim; You-Jin Jeon

2006-01-01

218

[Inferior vena cava cannulation using Forgaty catheter for partial cardiopulmonary bypass].  

PubMed

Partial cardiopulmonary bypass is adopted in operation for aneurysm of descending aorta or DeBakey IIIb dissection. Cannulation from left common femoral vein to inferior vena cava (IVC) is often difficult because of operative position and anatomical relation of iliac veins to IVC. In this paper, IVC cannulation using Forgaty catheter is reported to be easy and safe for prevention of IVC perforation. PMID:12428337

Masuda, M; Imamaki, M; Shimura, S; Hirano, M; Nishimura, K; Nakajima, N; Miyazaki, M

2002-11-01

219

Anchoring a migrating inferior vena cava stent with use of a T-fastener.  

PubMed

An attempt to treat symptomatic stenosis of the inferior vena cava in a patient with metastatic liver disease was complicated by migration of a Wallstent into the right atrium. Effective palliation was achieved by insertion of a second stent, which was anchored by transhepatic insertion of a T-fastener into the intracaval stent. This anchoring maneuver was performed safely under sonographic and fluoroscopic guidance. PMID:11487682

Wittich, G R; Goodacre, B W; Kennedy, P T; Mathew, P

2001-08-01

220

Anti-inflammatory effect of fucoidan extracted from Ecklonia cava in zebrafish model.  

PubMed

Fucoidan extracted from Ecklonia cava had strong anti-inflammatory activities. However, the direct effects of fucoidan of E. cava on anti-inflammatory activities in vivo model remained to be determined. Therefore, the present study was designed to assess in vivo anti-inflammatory effect of fucoidan extracted from E. cava (ECF) using tail-cutting-induced and lipopolysaccharide (LPS)-stimulated zebrafish model. Treating zebrafish model with tail-cutting and LPS-treatment significantly increased the ROS and NO level. However, ECF inhibited this tail-cutting-induced and LPS-stimulated ROS and NO generation. These results show that ECF alleviated inflammation by inhibiting the ROS and NO generation induced by tail-cutting and LPS-treatment. In addition, ECF has a protective effect against the toxicity induced by LPS exposure in zebrafish embryos. This outcome could explain the potential anti-inflammatory activity of ECF, which might have a beneficial effect during the treatment of inflammatory diseases. PMID:23218269

Lee, Seung-Hong; Ko, Chang-Ik; Jee, Youngheun; Jeong, Yoonhwa; Kim, Misook; Kim, Jin-Soo; Jeon, You-Jin

2012-10-02

221

Direct Cannulation of the Infrahepatic Vena Cava for Emergent Cardiopulmonary Bypass Support  

PubMed Central

Cannulation for cardiopulmonary bypass, although seemingly routine, can pose technical challenges. In patients undergoing repeat sternotomy, for example, peripherally established cardiopulmonary bypass may be necessary to ensure safe entry into the chest; however, establishing bypass in this way can sometimes be complicated by patients' body habitus. We describe a technique for direct cannulation of the infrahepatic abdominal vena cava that was required for emergent cardiopulmonary bypass. The patient was a 62-year-old woman who had presented with severely symptomatic left main coronary stenosis 3 months after elective aortic valve replacement. She had gone into cardiogenic shock as general anesthesia was being induced for repeat sternotomy and myocardial revascularization. Emergent establishment of femorofemoral cardiopulmonary bypass was precluded by difficulties in advancing the femoral venous cannula beyond the pelvic brim. Hence, an emergent celiotomy was performed, and the abdominal vena cava was directly cannulated to establish venous drainage for cardiopulmonary bypass. The rest of the operation was uneventful. Our technique for direct cannulation of the infrahepatic abdominal vena cava may be used in exceptional circumstances. Necessary precautions and potential pitfalls are also presented.

Gopaldas, Raja R.; Patel, Kirti P.; Livesay, James J.; Cooley, Denton A.

2009-01-01

222

Gastric varices without portal hypertension: role of left inferior vena cava?  

PubMed

A variant vascular anatomy was detected during regular analysis of multidetector computed tomography angiography of the abdomen in a 70 year-old female patient, referred to the department of surgery for laparoscopic right colectomy for colon cancer. The anomalous vessel was located left to the aorta, and was consistent with a persistent left inferior vena cava. It was connected by two retroaortic rootlets to the dorsal surface of the regular right inferior vena cava and had four notable tributaries - an anastomosis with the iliolumbar trunk, ovarian vein, renal vein and the inferior phrenic vein. In the upper abdomen, the left inferior vena cava took a tortuous course, passing at first between the spleen and the diaphragm, then curving below the inferior splenic border and terminating in an irregular network in the posterior region of gastric fundus and cardia, close to the splenic hilum, without supradiaphragmatic continuation. Despite this extraordinary termination, there were no signs of portal hypertension or data on previous occurrence of this condition. PMID:23198370

Stimec, B V; Grønvold, L A B; Ignjatovic, D; Fasel, J H D

223

Effect of phlorotannins isolated from Ecklonia cava on angiotensin I-converting enzyme (ACE) inhibitory activity  

PubMed Central

Inhibition of angiotensin I-converting enzyme (ACE) activity is the most common mechanism underlying the lowering of blood pressure. In the present study, five organic extracts of a marine brown seaweed Ecklonia cava were prepared by using ethanol, ethyl acetate, chloroform, hexane, and diethyl ether as solvents, which were then tested for their potential ACE inhibitory activities. Ethanol extract showed the strongest ACE inhibitory activity with an IC50 value of 0.96 mg/ml. Five kinds of phlorotannins, phloroglucinol, triphlorethol-A, eckol, dieckol, and eckstolonol, were isolated from ethanol extract of E. cava, which exhibited potential ACE inhibition. Dieckol was the most potent ACE inhibitor and was found to be a non-competitive inhibitor against ACE according to Lineweaver-Burk plots. Dieckol had an inducible effect on the production of NO in EAhy926 cells without having cytotoxic effect. The results of this study indicate that E. cava could be a potential source of phlorotannins with ACE inhibitory activity for utilization in production of functional foods.

Wijesinghe, W.A.J.P.; Ko, Seok-Chun

2011-01-01

224

Complications in right-sided paraaortic lymphadenectomy: ventral tributaries of the inferior vena cava.  

PubMed

The purpose of this study was to describe the distribution and structure of ventral tributaries leading into the inferior vena cava where right-sided paraaortic lymphadenectomy is performed. The study examined 21 retroperitoneal specimens by graphic reconstruction, statistical evaluation, and histological examination of ventral tributaries (VTs). Seventy VTs were identified. The average number per specimen was 3.33. There were 20, 40, and 40% of VTs found in Levels I, II, and III, respectively. During the preparation, we observed an unusual arrangement of the IVC wall, into which VTs were led through a preformed sleeve-like channel and anchored near the lumen. This finding is a key mechanism that explains the ease with which VTs are extracted during surgery. Knowledge of the distribution and histological structure of VTs allows proper orientation of the retroperitoneal area of the front wall of inferior vena cava, which is essential for uncomplicated right-sided paraaortic lymphadenectomy. The histological structure of the VT ostium within the wall of the inferior vena cava explains why injury is easy during the procedure. PMID:23692119

Turyna, Radovan; Kachlik, David; Kucera, Eduard; Kujal, Petr; Feyereisl, Jaroslav; Baca, Vaclav

2013-05-21

225

A novel deployment design of vena cava filters might be the solution to their blockage problem.  

PubMed

The blockage of a vena cava filter (VCF) by the captured blood clots presents a serious problem to the patients. Commercially available cone-shaped VCFs such as the Gunther Tulip filter has an inherent structural flaw that leads the captured blood clots to be trapped in their front spire areas where the flow-induced shear stress is relatively low so that the clots cannot dissolve fast enough and will accumulate, gradually block the central passages of the filters. It is well known that for a Hagen-Poiseuille flow in a circular tube, the flow-induced shear stress is highest at the wall of the tube and lowest along its axis. Herein, we hypothesize that by reversely deploying a cone-shaped filter in the vena cava, the filter's blockage problem might be prevented. First of all, this kind of deployment scenario can force the captured blood clots to stay in the peripheral areas of the vena cava and keep the central passage of the filter unblocked. Secondly, this scenario can expose the captured blood clots to relatively high shear stress that may dissolve the clots faster. PMID:21903340

Chen, Zengsheng; Fan, Yubo; Deng, Xiaoyan

2011-09-07

226

Neoadjuvant targeted molecular therapies in patients undergoing nephrectomy and inferior vena cava thrombectomy: is it useful?  

PubMed

OBJECTIVE: To assess the effect of neoadjuvant targeted molecular therapies (TMTs) on size and level of inferior vena cava tumor thrombi and to evaluate their impact on surgical management. METHODS: We retrospectively analyzed the data of 14 patients treated for a clear cell renal cell carcinoma with inferior vena cava thrombi by neoadjuvant TMT before nephrectomy. Clinical, pathological and perioperative data were gathered retrospectively at each institution. The primitive tumor size and the thrombus size were defined by computed tomography before TMT. The tumor thrombus level was defined according to the Novick's classification. RESULTS: Before TMT, thrombus level was staged I for 1 (7 %), II for 10 (72 %) and III (21 %) for 3 patients. First-line therapy was sunitinib in 11 cases and sorafenib in 3 cases. Median therapy duration was two cycles (1-5). Three patients experienced major adverse effects (grade III) during TMT. Following TMT, 6 (43 %) patients had a measurable decrease, 6 (43 %) had no change, and 2 (14 %) had an increase in the thrombus. One patient (7 %) had a downstage of thrombus level, 12 (85 %) had stable thrombi, and 1 (7 %) had an upstage. Regarding primary tumor, 7 (50 %), 5 (36 %) and 2 (14 %) patients had a decrease, stabilization and an increase in tumor size, respectively. CONCLUSION: Neoadjuvant TMT appears to have limited effects on renal tumor thrombi. This retrospective study failed to demonstrate a significant impact of neoadjuvant TMT on surgical management of clear cell renal cell carcinoma with inferior vena cava tumor thrombi. PMID:23624719

Bigot, Pierre; Fardoun, Tarek; Bernhard, Jean Christophe; Xylinas, Evanguelos; Berger, Julien; Rouprêt, Morgan; Beauval, Jean-Baptiste; Lagabrielle, Samuel; Lebdai, Souhil; Ammi, Myriam; Baumert, Hervé; Escudier, Bernard; Grenier, Nicolas; Hétet, Jean-François; Long, Jean-Alexandre; Paparel, Philippe; Rioux-Leclercq, Nathalie; Soulié, Michel; Azzouzi, Abdel-Rahmène; Bensalah, Karim; Patard, Jean-Jacques

2013-04-27

227

Writing superiority in cued recall  

PubMed Central

In list learning paradigms with free recall, written recall has been found to be less susceptible to intrusions of related concepts than spoken recall when the list items had been visually presented. This effect has been ascribed to the use of stored orthographic representations from the study phase during written recall (Kellogg, 2001). In other memory retrieval paradigms, by contrast, either better recall for modality-congruent items or an input-independent writing superiority effect have been found (Grabowski, 2005). In a series of four experiments using a paired associate learning paradigm we tested (a) whether output modality effects on verbal recall can be replicated in a paradigm that does not involve the rejection of semantically related intrusion words, (b) whether a possible superior performance for written recall was due to a slower response onset for writing as compared to speaking in immediate recall, and (c) whether the performance in paired associate word recall was correlated with performance in an additional episodic memory recall task. We observed better written recall in the first half of the recall phase, irrespective of the modality in which the material was presented upon encoding. An explanation for this effect based on longer response latencies for writing and hence more time for memory retrieval could be ruled out by showing that the effect persisted in delayed response versions of the task. Although there was some evidence that stored additional episodic information may contribute to the successful retrieval of associate words, this evidence was only found in the immediate response experiments and hence is most likely independent from the observed output modality effect. In sum, our results from a paired associate learning paradigm suggest that superior performance for written vs. spoken recall cannot be (solely) explained in terms of additional access to stored orthographic representations from the encoding phase. Our findings rather suggest a general writing-superiority effect at the time of memory retrieval.

Fueller, Carina; Loescher, Jens; Indefrey, Peter

2013-01-01

228

Writing superiority in cued recall.  

PubMed

In list learning paradigms with free recall, written recall has been found to be less susceptible to intrusions of related concepts than spoken recall when the list items had been visually presented. This effect has been ascribed to the use of stored orthographic representations from the study phase during written recall (Kellogg, 2001). In other memory retrieval paradigms, by contrast, either better recall for modality-congruent items or an input-independent writing superiority effect have been found (Grabowski, 2005). In a series of four experiments using a paired associate learning paradigm we tested (a) whether output modality effects on verbal recall can be replicated in a paradigm that does not involve the rejection of semantically related intrusion words, (b) whether a possible superior performance for written recall was due to a slower response onset for writing as compared to speaking in immediate recall, and (c) whether the performance in paired associate word recall was correlated with performance in an additional episodic memory recall task. We observed better written recall in the first half of the recall phase, irrespective of the modality in which the material was presented upon encoding. An explanation for this effect based on longer response latencies for writing and hence more time for memory retrieval could be ruled out by showing that the effect persisted in delayed response versions of the task. Although there was some evidence that stored additional episodic information may contribute to the successful retrieval of associate words, this evidence was only found in the immediate response experiments and hence is most likely independent from the observed output modality effect. In sum, our results from a paired associate learning paradigm suggest that superior performance for written vs. spoken recall cannot be (solely) explained in terms of additional access to stored orthographic representations from the encoding phase. Our findings rather suggest a general writing-superiority effect at the time of memory retrieval. PMID:24151483

Fueller, Carina; Loescher, Jens; Indefrey, Peter

2013-10-18

229

Double elevator weakening for unilateral congenital superior oblique palsy with ipsilateral superior rectus contracture and lax superior oblique tendon.  

PubMed

In unilateral congenital superior oblique palsy, a large hypertropia is sometimes associated with ipsilateral contracture of the superior rectus muscle and apparent overaction of the contralateral superior oblique. Ipsilateral double elevator weakening is one surgical approach; however, this procedure could compromise supraduction. We report a series of three consecutive patients who underwent ipsilateral superior rectus and inferior oblique recessions for unilateral superior oblique palsy. Intraoperatively, all three patients were found to have a lax ipsilateral superior oblique tendon. Postoperatively, all three patients had satisfactory correction of the hypertropia and abnormal head position with minimal supraduction defect. This procedure seems to be an acceptable initial surgical option for treating congenital superior oblique muscle palsy with ipsilateral contracture of the superior rectus muscle, even when the ipsilateral superior oblique tendon is lax. PMID:22681951

Khan, Arif O

2012-06-01

230

INTERDEPENDENT SUPERIORITY AND INFERIORITY FEELINGS  

PubMed Central

It is postulated that in neurotic persons who have unrealistic feelings of superiority and inferiority the two are interdependent. This is a departure from the concept of previous observers that either one or the other is primary and its opposite is overcompensation. The author postulates considerable parallelism, with equal importance for each. He submits that the neurotic person forms two logic-resistant compartments for the two opposed self-estimates and that treatment which makes inroads of logic upon one compartment, simultaneously does so upon the other. Two examples are briefly reported. The neurotic benefits sought in exaggeration of capability are the same as those sought in insistence upon inferiority: Presumption of superiority at once bids for approbation and delivers the subject from the need to prove himself worthy of it in dreaded competition; exaggeration of incapability baits sympathy and makes competition unnecessary because failure is conceded. Some of the characteristics of abnormal self-estimates that distinguish them from normal are: Preoccupation with self, resistance to logical explanation of personality problems, inconsistency in reasons for beliefs in adequacy on the one hand and inadequacy on the other, unreality, rationalization of faults, and difficulty and vacillation in the selection of adequate goals.

Ingham, Harrington V.

1949-01-01

231

Development of a spontaneously beating vein by cardiomyocyte transplantation in the wall of the inferior vena cava in a rat: A pilot study  

PubMed Central

Purpose The puopose of this study was to determine whether it is feasible to develop a vein that rhythmically beats by implanting immature cardiomyocytes in its wall. Methods and Results Neonatal cardiomyocytes (n=6, 5×106 cells each) or medium (n=6) only were transplanted into the wall of the inferior vena cava in female Fisher rats. At 3 weeks after transplantation, the grafted site of the inferior vena cava was exposed and videotaped. The vena cava was processed for histology. Distinct rhythmic beating of the vena cava at the site of cell injection (at a rate lower than aortic beating) was observed in 6 of 6 rats treated with neonatal cardiomyocyte injections, but 0 of 6 animals receiving media. The vena cava continued to beat spontaneously and rhythmically after the aortas were clamped and after the heart was excised. The beating was manifest by visual contraction and relaxation of the vessel wall. The spontaneous beating rate was 101 ± 7 beats per minute at 1~3 minutes after excision of the heart. Hematoxylin and eosin staining showed viable grafts in the wall of the vena cava in 6/6 vena cava implanted with neonatal cardiac cells; but in 0/6 vena cava receiving medium. Neonatal cardiomyocytes in the graft matured with cross striations and stained positive for the muscle marker sacromeric actin. Conclusions The present study demonstrates that neonatal cardiomyocytes survive, mature, and spontaneously and rhythmically contract when implanted in the wall of a vein.

Dai, Wangde; Hale, Sharon L.; Kloner, Robert A.

2007-01-01

232

75 FR 28542 - Superior Resource Advisory Committee  

Federal Register 2010, 2011, 2012, 2013

...the new Superior Resource Advisory Committee members on their roles and responsibilities. DATES: The meeting will be held on Friday...The following business will be conducted: Overview of the roles and responsibilities of the Superior Resource Advisory...

2010-05-21

233

Superior semicircular canal occlusion--Transmastoid approach  

PubMed Central

INTRODUCTION The condition superior semi-circular canal dehiscence was first described by Minor et al. in 1998. PRESENTATION Of Case We describe a novel surgical approach to the management of superior semicircular canal dehiscence. Our surgical technique involves a transmastoid rather than middle cranial fossa approach to the superior semicircular canal. CONCLUSION We conclude that the transmastoid approach, if anatomically feasible, carries significant advantages compared to middle cranial fossa craniotomy approach for the management of superior semicircular canal dehiscence.

Wijaya, C.; Dias, A.; Conlon, B.J.

2011-01-01

234

Animal Experience in the Gunther Tulip Retrievable InferiorVena Cava Filter  

Microsoft Academic Search

  Purpose: To assess the retrievability of\\u000a the Gunther Tulip temporary inferior vena cava filter from a\\u000a technical viewpoint, and consider the histopathologic changes that\\u000a occur at the anchoring site of the filter prongs to the vein\\u000a endothelium in Landrace pigs.\\u000a Methods: Twenty-two\\u000a Gunther Tulip retrievable filters were inserted in 22\\u000a experimental Landrace pigs via the jugular vein. Device implantation\\u000a time

M. A. de Gregorio; M. J. Gimeno; R. Tobio; F. Lostale; A. Mainar; J. M. Beltran; B. Madariaga; E. R. Alfonso; J. Medrano; A. Viloria

2001-01-01

235

Large renal arteriovenous fistula with left-sided inferior vena cava.  

PubMed

Idiopathic renal arteriovenous fistulas (RAVFs) are uncommon, and a left-sided inferior vena cava (IVC) is also rare. We report a large idiopathic RAVF in a 36-year-old woman who had progressive congestive heart failure. An abdominal computed tomographic scan revealed an enlarged IVC on the left side and a 5.0- × 4.5-cm RAVF with a single communication between the left renal artery and vein. Transcatheter embolization was not performed because complete flow control by a balloon catheter could not be achieved. Because of the size of the RAVF and the left-sided position of the IVC, nephrectomy was performed. PMID:23891255

Obara, Hideaki; Tanaka, Katsunori; Matsubara, Kentaro; Miyajima, Akira; Inoue, Masanori; Hashimoto, Subaru; Kuribayashi, Sachio; Kitagawa, Yuko

2013-07-26

236

Retrievable inferior vena cava filters in high-risk patients undergoing bariatric surgery  

Microsoft Academic Search

Background   Placement of retrievable inferior vena cava filters (rIVCF) may be beneficial in high-risk morbidly obese patients undergoing\\u000a bariatric procedures. Patients with a previous history of venous thromboembolism (VTE) are at high risk for postoperative\\u000a deep venous thrombosis (DVT) and pulmonary embolism (PE). \\u000a \\u000a \\u000a \\u000a Methods  A prospective database of bariatric surgery patients was studied from April 2003 to May 2007. A total

Khashayar Vaziri; Parag Bhanot; Eric S. Hungness; Mark D. Morasch; Jay B. Prystowsky; Alexander P. Nagle

2009-01-01

237

Detection of iatrogenic cardiac tamponade by transesophageal echocardiography during vena cava filter procedure  

Microsoft Academic Search

Purpose: To present a patient who developed cardiac tamponade during insertion of an inferior vena cava (IVC) filter. Intraoperative\\u000a transesophageal echocardiography (TEE) was used as a means to diagnose the cardiac tamponade and to facilitate guiding of\\u000a pericardiocentesis.\\u000a \\u000a \\u000a Clinical features: A 45-yr-old man with protein S deficiency complicated by repeated attacks of deep vein thrombosis and pulmonary thromboembolism\\u000a was scheduled

Shih-Tai Hsin; Hsiang-Ning Luk; Su-Man Lin; Kwok-Han Chan; Mei-Yung Tsou; Tak-Yu Lee

2000-01-01

238

Partial inferior vena cava snaring to control ischemic left ventricular dysfunction  

Microsoft Academic Search

Purpose  To describe the hemodynamic and intraoperative transesophageal echocardiographic evaluation of cardiac systolic and diastolic\\u000a function in a patient undergoing off-pump coronary artery bypass graft (OP-CABG) surgery who developed pulmonary artery hypertension\\u000a controlled by inferior vena cava (IVC) snaring.\\u000a \\u000a \\u000a \\u000a Clinical features  A 63-yr-old man was referred to our hospital for elective OP-CABG surgery. His preoperative ventriculopathy revealed a decreased\\u000a systolic function (ejection

Pierre Couture; André Y. Denault; Peter Sheridan; Stephan Williams; Raymond Cartier

2003-01-01

239

Aortic pseudoaneurysm after penetration by a Simon nitinol inferior vena cava filter.  

PubMed

This report describes an unusual complication related to inferior vena cava (IVC) filter placement. A 50-year-old woman undergoing long-term anticoagulation presented to her primary care physician with abdominal pain after a motor vehicle accident. An IVC filter had been placed 7 years earlier. Computed tomography of the abdomen demonstrated a moderate perisplenic hematoma and a fragmented IVC filter penetrating the aorta. A small infrarenal aortic pseudoaneurysm had developed at the penetration site. Wallgraft placement successfully sealed the aneurysm. PMID:15802454

Putterman, Daniel; Niman, Dmitri; Cohen, Gary

2005-04-01

240

Retrievable inferior vena cava filters may be safely applied in gastric bypass surgery  

Microsoft Academic Search

Introduction  Pulmonary embolus (PE) is a potentially devastating and fatal postoperative complication in morbidly obese patients. This\\u000a study was undertaken to review the safety and efficacy of retrievable prophylactic inferior vena cava (IVC) filters in high-risk\\u000a morbidly obese patients undergoing gastric bypass.\\u000a \\u000a \\u000a \\u000a Methods  Patients who underwent gastric bypass surgery and preoperative insertion of retrievable IVC filters had their records reviewed.\\u000a Indications for

Rob Schuster; Judith C. Hagedorn; Myriam J. Curet; John M. Morton

2007-01-01

241

Inferior vena cava filters in the management of cancer-associated venous thromboembolism: a systematic review  

Microsoft Academic Search

This study systematically reviews outcomes after inferior vena cava (IVC) filtration in cancer-associated venous thromboembolism\\u000a (VTE). A comprehensive review of the English language literature was performed using MEDLINE, COCHRANE library, Embase and\\u000a CINAHL on outcomes (i.e., pulmonary embolism, recurrent DVT, post-phlebitic syndrome and survival) following IVC filtration\\u000a in cancer-associated VTE. Fourteen studies with 2,154 cancer patients receiving IVC filters post-VTE

Rachna RamanPhilip; Philip D. Leming; Manish Bhandari; Daniel Long; Michael B. Streiff

2010-01-01

242

Persistent left cranial vena cava causing oesophageal obstruction and consequent megaoesophagus in a dog.  

PubMed

A 2-month-old Brittany spaniel dog was presented for persistent regurgitation, first observed soon after weaning. Clinical examination and diagnostic imaging suggested megaoesophagus associated with a vascular ring anomaly. The normal location of the trachea on the X-ray was not consistent with a persistent right aortic arch. Post-mortem examination revealed a persistent left cranial vena cava that formed a non-elastic fibrous band enclosing the oesophagus and trachea, and causing constriction of the oesophagus. This uncommon congenital vascular defect has never previously been associated with megaoesophagus in the dog. PMID:16952369

Larcher, T; Abadie, J; Roux, F A; Deschamps, J-Y; Wyers, M

2006-09-06

243

Left common iliac artery to inferior vena cava abdominal wall arteriovenous graft for hemodialysis access.  

PubMed

We describe a novel arteriovenous graft configuration in the abdominal wall for hemodialysis in a 51-year-old woman with sickle cell disease. Upper extremity access sites were exhausted, and intrathoracic central veins occluded. Because of diminished quality of the left groin due to scar tissue from previous infected access, inadequate vasculature, and the presence of functional femoral catheter in the right groin with common iliac vein stenosis, we decided to create an arteriovenous graft from the left common iliac artery to the inferior vena cava. Adequate thrill and uneventful postoperative recovery was observed. At 4 months, the patient has been successfully using her graft. PMID:22494692

Zamani, Nader; Anaya-Ayala, Javier E; Ismail, Nyla; Peden, Eric K

2012-04-10

244

Duodenocaval fistula from inferior vena cava filter penetration masquerading as lower gastrointestinal bleeding.  

PubMed

Asymptomatic penetration of the inferior vena cava (IVC) wall with retrievable filters is not uncommon. Occasionally, this can be a cause for morbidity, and rarely for mortality. We present a case of duodenocaval fistula, secondary to penetration from a strut of retrievable IVC filter that presented as lower gastrointestinal bleeding and discuss the subsequent management. Although newer generation retrievable filters provide a longer time for retrieval, they are associated with an increased incidence of IVC wall penetration, caudal migration, and occasionally symptomatic presentation, thereby necessitating surgical intervention. Close follow-up is warranted, and prompt retrieval of such devices should be done when their use is no longer indicated. PMID:21835583

Bathla, Lokesh; Panwar, Aru; Fitzgibbons, Robert J; Balters, Marcus

2011-08-11

245

Retrohepatic Vena Cava Resection Associated With Right Trisectionectomy and Caudate Lobectomy for Colorectal Liver Metastases  

Microsoft Academic Search

Background  In case of colorectal liver metastases invading the retrohepatic vena cava (RHVC) and the hepatocaval confluence major liver\\u000a resection and venous resection are the treatment of choice. The use of venovenous bypass is still a matter of debate. We describe\\u000a our technique without the use of venovenous bypass for resection of a tumor invading the RHVC.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A 61-year-old woman was

Gerardo Sarno; Hassan Z. Malik; Stephen W. Fenwick; Ali A. Al-Sarira; Graeme J. Poston

2010-01-01

246

Scoliosis, Superior Mesenteric Artery Syndrome, and Adolescents  

Microsoft Academic Search

Adolescent idiopathic scoliosis is defined as a lateral curva- ture of the spine that can occur in any region of the spinal column. For curves that require surgical correction, spinal fusion is the surgical treatment, and superior mesenteric artery syndrome is a possible complication. Risk factors for superior mesenteric artery syndrome include a small aorta- superior mesenteric artery angle, spinal

Amy Schwartz

2007-01-01

247

Proximal superior mesenteric arterial and venous injuries  

Microsoft Academic Search

In a review of more than 1000 patients with operatively managed abdominal trauma, eight patients with injuries to the proximal parts of the superior mesenteric artery or vein were identified: three with either a superior mesenteric artery or vein injury and two with combined superior mesenteric vessel injuries. All patients were in shock on arrival, and had associated abdominal injuries.

Ari K. Leppäniemi; Hannu O. Savolainen; Jarmo A. Salo; Pertti T. Aarnio

1995-01-01

248

The superior orbital fissure and its contents  

Microsoft Academic Search

Topographic landmarks for the superior orbital fissure are useful for general orientation and approach to the middle fossa, cavernous sinus and orbit. In this study, the microsurgical anatomy and morphometry of the superior orbital fissure and its related structures were examined in 57 disarticulated sphenoid bones, 102 skull bases and 58 adult cadaveric heads. The superior orbital fissure was observed

F. Govsa; G. Kayalioglu; M. Erturk; T. Ozgur

1999-01-01

249

The superior orbital fissure and its contents  

Microsoft Academic Search

Summary Topographic landmarks for the superior orbital fissure are useful for general orientation and approach to the middle fossa, cavernous sinus and orbit. In this study, the microsurgical anatomy and morphometry of the superior orbital fissure and its related structures were examined in 57 disarticulated sphenoid bones, 102 skull bases and 58 adult cadaveric heads. The superior orbital fissure was

F. Govsa; G. Kayalioglu; M. Erturk; T. Ozgur

1999-01-01

250

Iatrogenic superior vena caval syndrome.  

PubMed

The superior vena caval (SVC) syndrome is a common oncological emergency requiring the quick initiation of appropriate therapy. However, it may also result from a medical procedure e.g. central catheter or temporary pacing wire insertion, with symptoms usually developing acutely and dramatically. If symptoms persist despite removal of the offending device, chemotherapy and radiotherapy are obviously precluded. Alternative treatment modalities include thrombolysis, thrombectomy devices, stents, and surgery. Clinically covert thrombosis is not uncommon, and as interventions and invasive procedures requiring central venous cannulations become commonplace, this iatrogenic complications will inevitably occur more often. Even the use of ultrasound guided insertion does not avoid catheter related obstruction. A case of an iatrogenc haemodialysis catheter related SVCS is presented and the aetiopathogensis, signs and symptoms, diagnosis, and management are discussed. PMID:19813691

Khan, Burhan Ahmad; Mahmood, Qasim

2009-10-01

251

Transjugular Approach to Device Closure of Atrial Septal Defect in a Child with Heterotaxia and Interrupted Inferior Vena Cava  

PubMed Central

In heterotaxia syndrome with left atrial isomerism, the distinguishing feature is interrupted inferior vena cava with azygos continuation. We report using a transjugular approach to device closure of an atrial septal defect in an 8-year-old boy with heterotaxia syndrome. We found that device closure of the child's atrial septal defect through a jugular venous approach was safe when an inferior vena cava approach was not possible. To our knowledge, ours is the first report of the use of internal jugular vein access to close an atrial septal defect in a child.

Ozbarlas, Nazan; Kiziltas, Alev; Kucukosmanoglu, Osman; Erdem, Sevcan

2012-01-01

252

Abdominal wall phlebitis due to Prevotella bivia following renal transplantation in a patient with an occluded inferior vena cava.  

PubMed

Pre-existing occlusion of the inferior vena cava may complicate renal transplantation. Suppurative abdominal wall phlebitis following renal transplantation was diagnosed in a patient with pre-existing thrombosis of the inferior vena cava of unknown cause. The phlebitis developed in the subcutaneous collateral veins of the abdominal wall contra-laterally to the renal transplant. Cultures from abdominal wall micro-abscesses yielded Prevotella bivia as the causative agent. This complication has not been described before in the context of renal transplantation. The pathogenesis and management of this serious complication are discussed in this paper. PMID:23001520

Janssen, S; van Donselaar-van der Pant, K A M I; van der Weerd, N C; Develter, W; Bemelman, F J; Grobusch, M P; Idu, M M; Ten Berge, I J M

2012-09-23

253

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

254

Effects of ethanolic extracts from Eschscholtzia californica and Corydalis cava on dimerization and oxidation of enkephalins.  

PubMed

The endogenous pentapeptides, met-enkephalin and leuenkephalin, similar to their parent structures, beta-endorphin or dynorphin, bind to opioid receptors of the nociceptive system thus provoking analgesic responses. Peroxidases and phenolases (tyrosinase, catecholase) were shown to dimerize these pentapeptides thus possibly modulating their activity and/or lifetime. Extracts from plants from the order of the Papaverales contain isoquinoline alkaloids. Since the benzoisoquinolines are known to possess sedative-hypnotic activities, the potential effects of extracts from two species from this plant group, Eschscholtzia californica (Papaveraceae) and tyrosinase-catalyzed dimerization and/or oxidation of met-enkephalin were investigated. The results of the study show that the peroxidase-catalyzed dimerization via the tyr-residues is especially inhibited by the C. cava extract. The tyrosinase-catalyzed reaction yields five different products A-E, according to their HPLC-retention times. Consisting of the 4:1 (v/v) combination of the extracts from E. californica and C. cava, Phytonoxon N (abbreviated as PN) stimulates the formation of minor products A, B and E, whereas the formation of the major products C and D is inhibited. Only products C and D exhibit properties similar to the peroxidase-derived dimer. Product A is likely to be identical to DOPA-enkephalin. PMID:7710433

Reimeier, C; Schneider, I; Schneider, W; Schäfer, H L; Elstner, E F

1995-02-01

255

[Suprarenal leiomyoma of the vena cava. A rare differential adrenal gland tumor diagnosis].  

PubMed

Leiomyomas are benign tumors that can arise in the smooth muscle and can appear practically everywhere; hence, they must be taken into consideration as a rare possibility in the differential diagnosis of numerous tumors. While leiomyomas of the peripheral vessels are a relatively common finding, they are rarely found in the central vessels. Only a few cases of leiomyomas in the vena cava are known. In contrast to malignant leiomyosarcomas, leiomyomas usually grow towards the lumen. We report on the rare case of a leiomyoma in the inferior vena cava that appeared in the image to be located in the adrenal gland. Therefore, transperitoneal extirpation of the site was undertaken. It was only during surgery that a tumor emanating from the vessel wall became apparent. Thus, after an initial laparoscopic approach it became necessary to change to open resection of the tumor with cavotomy and resection of the vessel wall. The histopathological work-up revealed a benign leiomyoma and further imaging diagnostics gave no indication for the presence of metastases. PMID:12524949

Friedrich, M G; Witte, A; Hautmann, S H; Saeger, W

2002-11-01

256

Retrievable Vena Cava Filters in Major Trauma Patients: Prevalence of Thrombus Within the Filter  

SciTech Connect

The purpose of this study was to report the prevalence of thrombus within a retrievable vena cava filter inserted prophylactically in major trauma patients referred for filter extraction. Between November 2002 and August 2005, 80 retrievable inferior vena cava filters (68 Optease and 12 Gunther-Tulip) were inserted into critically injured trauma patients (mean injury severity score 33.5). The filters were inserted within 1 to 6 (mean 2) days of injury. Thirty-seven patients were referred for filter removal (32 with Optease and 5 with Gunther-Tulip). The indwelling time was 7 to 22 (mean 13) days. All patients underwent inferior vena cavography prior to filter removal. There were no insertion-related complications and all filters were successfully deployed. Forty-three (54%) of the 80 patients were not referred for filter removal, as these patients continued to have contraindications to anticoagulation. Thirty-seven patients (46%) were referred for filter removal. In eight of them (22%) a large thrombus was seen within the filters and they were left in place, all with the Optease device. The other 29 filters (36%) were removed uneventfully.We conclude that the relatively high prevalence of intrafilter thrombi with the Optease filter may be explained by either spontaneous thrombus formation or captured emboli.

Mahrer, Arie; Zippel, Douglas; Garniek, Alexander; Golan, Gil; Bensaid, Paul; Simon, Daniel; Rimon, Uri, E-mail: rimonu@sheba.health.gov.i [Tel-Aviv University, Sackler School of Medicine (Israel)

2008-07-15

257

Superior oblique tendon expansion in the management of superior oblique dysfunction.  

PubMed Central

Traditional superior oblique weakening procedures may be unpredictable and lead to superior oblique underaction. The use of 240 retinal band as a spacer to lengthen the superior oblique tendon has been proposed as a more controlled approach than superior oblique tenotomy and related procedures. The use of this technique is reported in a patient with diplopia following an orbital floor blow out fracture, and in a child with Brown's superior oblique tendon sheath syndrome. Images

Clarke, M P; Bray, L C; Manners, T

1995-01-01

258

Abrahán Enseña astronomía: el prototipo bíblico del estudio del cómputo en las abadías Benedictinas de Cava de' Tirreni y Ripoll  

Microsoft Academic Search

In two miscellanies of computus from the abbeys of Cava de' Tirreni (XI century) and Santa María de Ripoll (XII century) an interesting illumination with the patriarch Abraham teaching three Egyptian disciples in secrets of cosmos was represented. The image, not documented in the Vulgata, is derived from a Jewish-Hellenistic tradition that presented Hebrews preceding Egyptians and Greeks in scientific

M. A. Castiñeiras González

1997-01-01

259

Polysplenia syndrome: a case associated with transhepatic portal vein, short pancreas, and left inferior vena cava with hemiazygous continuation.  

PubMed

This paper presents a 57-year-old asymptomatic patient with the polysplenia syndrome with abdominal manifestations. In addition to multiple spleens, the abdominal findings included a left inferior vena cava with hemiazygous continuation, a striking portal anomaly with the portal vein following an "intraperitoneal-left transhepatic" route to reach the porta hepatis, and a congenitally short pancreas. PMID:8161909

Sener, R N; Alper, H

260

Iatrogenic atrial septum defect and aortoatrial fistula in a patient with endovascular prosthesis in the inferior vena cava  

Microsoft Academic Search

Percutaneous procedures and endovascular prostheses are becoming increasingly frequent, replacing classic interventions, and new complications are now appearing. We report the case of a liver transplant patient with a stenosis in the anastomosis of the suprahepatic veins to inferior vena cava, treated by self-expanding prosthesis, who developed an aorto–right atrial fistula and an atrial septum defect. Open heart surgery was

María Teresa Barrio-López; Alejandro Martín-Trenor; Stefano Mastrobuoni; Juan José Gavira-Gómez

261

Azygos Vein Dialysis Catheter Placement Using the Translumbar Approach in a Patient with Inferior Vena Cava Occlusion  

SciTech Connect

We describe percutaneous, translumbar placement of a 14-Fr dialysis catheter into an ascending lumbar vein to achieve tip position in an enlarged azygos vein. The patient had thrombosis of all traditional vascular sites, as well as the inferior vena cava. This catheter functioned well for 7 months before fatal catheter-related infection developed.

Jaber, Mohammad R., E-mail: raffatj@msn.co [Loma Linda University Medical Center, Department of Internal Medicine (United States); Thomson, Matthew J.; Smith, Douglas C. [Loma Linda University Medical Center, Department of Radiology (United States)

2008-07-15

262

Use of a retrievable inferior vena cava filter in term pregnancy: case report and review of literature.  

PubMed

Venous thromboembolism is a significant cause of morbidity and mortality in obstetrics. Management with anticoagulation can be problematic, especially peripartum. We report the successful placement and retrieval of an inferior vena cava filter as prophylaxis for peripartum pulmonary embolism in a woman with a large, proximal, deep venous thrombosis at term. PMID:19566571

Milford, William; Chadha, Yogesh; Lust, Karin

2009-06-01

263

Focal hepatic activity during ventilation-perfusion scintigraphy due to systemic-portal shunt due to superior vena cava obstruction from histoplasmosis-induced fibrosing mediastinitis.  

PubMed

A 59-year-old woman with a history of fibrosing mediastinitis secondary to histoplasmosis diagnosed on mediastinoscopy presented with dyspnea. A ventilation-perfusion scan demonstrated decreased perfusion to the entire right lung. In addition, the perfusion images demonstrated focal abnormal activity in part of the liver. On computed tomography of the chest, there was significant soft tissue opacification in the mediastinum occluding the right pulmonary artery, with passage of the injected contrast via collateral vessels to the liver. The main collateral pathway was via the right internal thoracic vein and the umbilical vein. Pulmonary angiography confirmed complete occlusion of the right pulmonary artery. PMID:17710024

Mackie, Gavin C; Thomas, Aju; Greenspan, Bennett; Singh, Amolak

2007-09-01

264

Balloon Dilation of the Superior Vena Cava (SVC) Resulting in SVC Rupture and Pericardial Tamponade: A Case Report and Brief Review  

SciTech Connect

Stent placement is an accepted primary treatment for SVC syndrome. Balloon dilation is frequently performed prior to stent placement. Although various stent-related hemorrhagic complications have been reported, as well as reports of iatrogenic catheter and guidewire perforations, there has been only one previous report of balloon dilation-related SVC rupture. We report a second case, including the clinical scenario, in the hope that should this complication occur, it might be recognized quickly and treated successfully.

Brown, Karen T., E-mail: brown6@mskcc.org; Getrajdman, George I. [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States)

2005-04-15

265

OptEase and TrapEase Vena Cava Filters: A Single-Center Experience in 258 Patients  

SciTech Connect

We aimed to evaluate the efficacy and safety of the OptEase and TrapEase (both from Cordis, Roden, Netherlands) vena cava filters in the prevention of pulmonary embolism (PE). Between May 2004 and December 2008, OptEase (permanent/retrievable; n = 228) or TrapEase (permanent; n = 30) vena cava filters were placed in 258 patients (160 female and 98 male; mean age 62 years [range 22 to 97]). Indications were as follows: prophylaxis for PE (n = 239), contraindication for anticoagulation in the presence of PE or DVT (n = 10), and development of PE or DVT despite anticoagulation (n = 9). Medical records were retrospectively reviewed for indications, clinical results, and procedure-related complications during placement and retrieval. Clinical PE did not develop in any of the patients. However, radiologic signs of segmental PE were seen in 6 of 66 patients with follow-up imaging data. Migration or fracture of the filter or cava perforation was not seen in any of the patients. Except for a single case of asymptomatic total cava thrombosis, no thrombotic occlusion was observed. One hundred forty-one patients were scheduled to undergo filter removal; however, 17 of them were not suitable for such based on venography evaluation. Removal was attempted in 124 patients and was successful in 115 of these (mean duration of retention 11 days [range 4 to 23]). Nine filters could not be removed. Permanent/retrievable vena cava filters are safe and effective devices for PE prophylaxis and for the management of venous thromboembolism by providing the option to be left in place.

Onat, Levent, E-mail: levonat2@yahoo.com; Ganiyusufoglu, Ali Kursat; Mutlu, Ayhan [Florence Nightingale Hospital, Department of Radiology (Turkey); Sirvanci, Mustafa; Duran, Cihan [Bilim University, Department of Radiology, Faculty of Medicine (Turkey); Ulusoy, Onur Levent [Florence Nightingale Hospital, Department of Radiology (Turkey); Hamzaoglu, Azmi [Florence Nightingale Hospital, Department of Orthopedic Surgery (Turkey)

2009-09-15

266

PROTEIN METABOLISM AND EXCHANGE AS INFLUENCED BY CONSTRICTION OF THE VENA CAVA  

PubMed Central

Constriction of inferior vena cava above the diaphragm is used to produce experimental ascites in the dog. This type of experimental ascites drains the body protein reserves, reduces the level of circulating plasma proteins, and in effect is an internal plasmapheresis. As the ascitic fluid is withdrawn and the proteins measured, we observe a production of ascitic protein (80–90 gm. per week) comparable to that removed by plasmapheresis (bleeding and replacement of red cells in saline). High protein diet tends to decrease the ascites but the protein content of the ascitic fluid may increase. Sodium chloride increases notably the volume of the ascites which accumulates and the total ascitic protein output increases. Sodium-free salt mixtures have a negative influence. High protein diet low in sodium salts gives minimal ascitic accumulation under these conditions. The question of circulation of the ascitic fluid is raised—how rapid is the absorption and the related accumulation?

McKee, Frank W.; Schloerb, Paul R.; Schilling, John A.; Tishkoff, Garson H.; Whipple, George H.

1948-01-01

267

Sclerosing epithelioid fibrosarcoma of the liver infiltrating the inferior vena cava  

PubMed Central

Sclerosing epithelioid fibrosarcoma (SEF) is a rare and distinct variant of fibrosarcoma, composed of epithelioid tumor cells arranged in strands, nests, cords, or sheets embedded within a sclerotic collagenous matrix. We report a 39-year-old man with SEF of the liver, which infiltrated the inferior vena cava (IVC). The SEF of the liver was successfully resected, and the infiltrated IVC was also removed together with the liver tumor. Histopathological examination of the tumor showed typical histopathology of SEF. Immunohistochemically, the tumor was positive for vimentin. Recurrence was noted 7 mo after surgery. After chemotherapy, the recurrent tumor was resected surgically, and histopathological examination showed similar findings to those of the primary tumor. To our knowledge, this is the first report of SEF of the liver with tumor invasion of the IVC.

Tomimaru, Yoshito; Nagano, Hiroaki; Marubashi, Shigeru; Kobayashi, Shogo; Eguchi, Hidetoshi; Takeda, Yutaka; Tanemura, Masahiro; Kitagawa, Toru; Umeshita, Koji; Hashimoto, Nobuyuki; Yoshikawa, Hideki; Wakasa, Kenichi; Doki, Yuichiro; Mori, Masaki

2009-01-01

268

Leiomyosarcoma of inferior vena cava: a case series of four cases.  

PubMed

Vascular leiomyosarcomas are rare tumors, arising most frequently from inferior vena cava (IVC). They are mostly seen in sixth decade, with a female predominance. Their diagnosis is often challenging, as patients may present with non-specific complaints such as dyspnea, malaise, weight loss, abdominal pain, or back pain, preceding the diagnosis by several years. Leiomyosarcoma of the IVC most frequently occurs in the middle segment. The final diagnosis can be made by an ultrasound or computed tomography guided biopsy. Because of limited experience with this disease, optimal management of IVC leiomyosarcoma is unknown. Curative surgical resection remains the current treatment of choice for primary leiomyosarcoma of IVC. Neoadjuvant therapy may be given to downsize the tumor and increase resectability rates. Nonetheless, when complete resection is not possible, debulking combined with radiation therapy still provides good palliation. We, hereby, report four cases of this rare entity with emphasis on management. PMID:22499308

Yadav, Rajni; Kataria, Kamal; Mathur, Sandeep R; Seenu, V

269

Inferior vena cava thrombosis: a rare complication of fibrocalcific pancreatic diabetes.  

PubMed

A 42-year-old man presented with a history of recurrent loose motions for the previous 7 months. The patient also had a history of diabetes mellitus for the last 10 years and was uncontrolled on oral hypoglycaemic agents but responded to insulin. There was no history of any addiction. Examination and investigations showed the presence of malabsorption along with a calcified pancreas. The presence of a thrombus was also noted in the inferior vena cava. In the absence of alcohol intake, a diagnosis of fibrocalcific pancreatic diabetes was made and the patient was investigated for other hypercoagulable states but none was found. The patient was put on oral anticoagulants, insulin and pancreatic enzyme supplements, and currently, he is under regular follow-up for diabetes. PMID:23608838

Mishra, R; Yathish, B E; Himanshu, D; Usman, K

2013-04-22

270

Inferior Vena Cava Filtration in the Management of Venous Thromboembolism: Filtering the Data  

PubMed Central

Venous thromboembolism (VTE) is a common cause of morbidity and mortality. This is especially true for hospitalized patients. Pulmonary embolism (PE) is the leading preventable cause of in-hospital mortality. The preferred method of both treatment and prophylaxis for VTE is anticoagulation. However, in a subset of patients, anticoagulation therapy is contraindicated or ineffective, and these patients often receive an inferior vena cava (IVC) filter. The sole purpose of an IVC filter is prevention of clinically significant PE. IVC filter usage has increased every year, most recently due to the availability of retrievable devices and a relaxation of thresholds for placement. Much of this recent growth has occurred in the trauma patient population given the high potential for VTE and frequent contraindication to anticoagulation. Retrievable filters, which strive to offer the benefits of permanent filters without time-sensitive complications, come with a new set of challenges including methods for filter follow-up and retrieval.

Molvar, Christopher

2012-01-01

271

Inferior Vena Cava Filters for Primary Prophylaxis: When Are They Indicated?  

PubMed Central

Over the past several years there has been a rapid increase in the number of inferior vena cava (IVC) filters placed for primary thromboprophylaxis. Increased use has occurred in settings where other methods of thromboprophylaxis are viewed to be inadequate, technically challenging, or that place patients at an unacceptably high bleeding risk. These clinical services include trauma, bariatric surgery, neurosurgery, cancer, intensive care unit populations, and patients with a relative contraindication to anticoagulation. We review the studies to date addressing filter placement for these indications. Although preliminary data are promising, the patient populations most likely to benefit from prophylactic IVC filter placement have not been well defined, and randomized studies demonstrating efficacy have not been conducted. Moving forward, it will be critical to accomplish these two tasks if IVC filters are to continue to have a role in primary thromboprophylaxis.

Wehrenberg-Klee, Eric; Stavropoulos, S. William

2012-01-01

272

STATUS OF MYSIS RELICTA IN LAKE SUPERIOR  

EPA Science Inventory

The status of different components of the lower food web is reported for Lake Superior. Results are preliminary summaries from the Binational collaboration in 2005, which measured the lower food web at the request of the Lake Superior Fisheries Technical Committee and Lake Superi...

273

Lake Effects: The Lake Superior Curriculum Guide.  

ERIC Educational Resources Information Center

|This curriculum guide was launched in response to a need for Lake Superior-specific educational materials and contains lessons and activities that can be used to teach about Lake Superior. The lessons in this book are divided into four sections. Each of the first three sections has a background section that provides basic information about Lake…

Beery, Tom; And Others

274

Remodelling of the Superior Caval Vein After Angioplasty in an Infant with Superior Caval Vein Syndrome  

SciTech Connect

An 8-month old girl was presented with superior caval vein syndrome early after cardiac surgery. Angiography showed severe stenosis of the superior caval vein with 50 mmHg pressure gradient. Following balloon angioplasty, the pressure gradient was reduced to 7 mmHg with some residual stenosis of the superior caval vein. When the patient was reevaluated 5 months after the procedure, angiography revealed a normal diameter of the superior caval vein without a pressure gradient.

Mert, Murat [Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery (Turkey)], E-mail: mmert@superonline.com; Saltik, Levent [Istanbul University, Cerrahpasa Medical School, Department of Pediatric Cardiology (Turkey); Gunay, Ilhan [Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery (Turkey)

2004-08-15

275

Differentiation in Coregonus zenithicus in Lake Superior  

USGS Publications Warehouse

Morphological variation in Coregonus zenithicus has long plagued biologists working on Lake Superior ciscoes. Some of this variation is due to allometric growth; earlier workers incorrectly recognized large C. zenithicus as a distinct species, C. nigripinnis cyanopterus. Coregonus reighardi dymondi is a variant of C. zenithicus in northern bays of Lake Superior and Lake Nipigon. The morphological differences between members of spring and fall spawning populations of C. zenithicus in Lake Superior are no greater than those between geographically separate populations. We conclude that spawning time and geographic isolation act similarly in effecting differentiation of coregonine populations, and that populations with different spawning times do not necessarily represent different species.

Todd, Thomas N.; Smith, Gerald R.

1980-01-01

276

Living donor liver transplantation for Budd-Chiari syndrome with hepatic inferior vena cava obstruction after open pericardial procedures.  

PubMed

Living donor liver transplantation (LDLT) for Budd-Chiari syndrome (BCS) presents a unique challenge as it does not involve replacement of the hepatic inferior vena cava (IVC). We report a case of successful LDLT in a patient with BCS associated with occlusion of the hepatic veins as well as the IVC. A 34-year-old woman with a history of two open pericardial procedures had decompensated liver failure and portal hypertension. Venography showed complete obstruction of the hepatic IVC and well-developed collateral vessels. We performed LDLT via sternotomy and laparotomy, with an end-to-end anastomosis between the left hepatic vein of the donor and the patient's suprahepatic vena cava in the pericardium. The patient recovered uneventfully and has been doing well for 5 years. LDLT without caval replacement for BCS in a patient with hepatic IVC obstruction is feasible if the patient has good functional collaterals before liver transplantation. PMID:23188387

Fukuda, Akinari; Ogura, Yasuhiro; Kanazawa, Hiroyuki; Mori, Akira; Kawaguchi, Michiya; Takada, Yasutsugu; Uemoto, Shinji

2012-11-28

277

Successful treatment of acute inferior vena cava and unilateral renal vein thrombosis by local infusion of recombinant tissue plasminogen activator.  

PubMed

Renal vein thrombosis can occur as a complication of nephrotic syndrome. We present the case of a young man with nephrotic syndrome caused by minimal change disease who developed acute inferior vena cava and left renal vein thrombosis. He was treated initially with intravenous heparin. Because of the persistence of severe left flank pain and gross hematuria, local infusion of recombinant tissue plasminogen activator was tried, with resolution of thrombi and subsidence of symptoms. Functional preservation of the involved kidney is good, as indicated by Tc-99m DMSA scan (involved kidney, 47.4%; uninvolved kidney, 52.6%). Anticoagulation is usually recommended as the treatment of choice in renal vein thrombosis. We believe that in cases with critical presentations, such as bilateral involvement, extension into inferior vena cava, acute renal failure, pulmonary embolism or severe flank pain, thrombolytic therapy should be considered as a second-line treatment if good response is not obtained with heparin. PMID:9856527

Lam, K K; Lui, C C

1998-12-01

278

[Anomalous connection of inferior vena cava to left atrium: infrequent entity that can be a diagnosis and surgical challenge].  

PubMed

This is the diagnostic experiences as well as the surgical mode of treatment used in a 31 years old women suffering diversion of the inferior vena cava into the left atrium associated with atrial septal defect. The patient had been previously studied and operated thrice under conventional circumstances at different institutions in order to solve the septal defect. The hemodynamic solution had not been reached due to a missing pathological definition. The cineangiogram through the saphenous vein specified the left atrium form the inferior vena cava. Some considerations are made on the surgical methods used for the fourth operation, and in regard of the fact that the patient refused blood transfusion because of religious convictions (Jehova Witness). PMID:11534101

Archundia García, A; Gómez Alvarez, E; Ixcamparij Rosales, C; Blanco Canto, M; Hernández Ruiz, M A

279

Inferior vena cava thrombosis presenting as non-immune hydrops in the fetus of a woman with diabetes.  

PubMed

We present a rare case of non-immune hydrops fetalis (NIHF) caused by a thrombus in the inferior vena cava in a neonate with low levels of anti-thrombin III. The diagnosis of (NIHF) was made in utero in a 43-year-old woman with poorly controlled gestational diabetes who subsequently developed pre-eclampsia. Cesarean section was performed due to fetal compromise and worsening pre-eclampsia. The thrombus resolved after neonatal treatment with heparin. PMID:14770403

Weissmann-Brenner, A; Ferber, A; O'Reilly-Green, C; Avila, C; Grassi, A; Divon, M Y

2004-02-01

280

CT demonstration of extension of renal angiomyolipoma into the inferior vena cava in a patient with tuberous sclerosis  

Microsoft Academic Search

The authors present a case of tumor thrombus in the inferior vena cava produced by angiomyolipoma in a young woman with tuberous\\u000a sclerosis. Diagnosis was made by computed tomography (CT) by measuring the attenuation values of the tumor thrombus. The values\\u000a obtained were characteristic of fat, demonstrating that tumoral invasion was the cause of the thrombus. To our knowledge,\\u000a this

F. Camfifiez; J. Lafuente; R. Robledo; A. Echenagusia; M. Pérez; G. Simo; F. Gfilvez

1988-01-01

281

Vena cava and aortic smooth muscle cells express transglutaminases 1 and 4 in addition to transglutaminase 2.  

PubMed

Transglutaminase (TG) function facilitates several vascular processes and diseases. Although many of these TG-dependent vascular processes have been ascribed to the function of TG2, TG2 knockout mice have a mild vascular phenotype. We hypothesized that TGs besides TG2 exist and function in the vasculature. Biotin-pentylamide incorporation, a measure of general TG activity, was similar in wild-type and TG2 knockout mouse aortae, and the general TG inhibitor cystamine reduced biotin-pentylamine incorporation to a greater extent than the TG2-specific inhibitor Z-DON, indicating the presence of other functional TGs. Additionally, 5-hydroxytryptamine-induced aortic contraction, a TG-activity-dependent process, was decreased to a greater extent by general TG inhibitors vs. Z-DON (maximum contraction: cystamine = abolished, monodansylcadaverine = 28.6 ± 14.9%, and Z-DON = 60.2 ± 15.2% vehicle), providing evidence for the importance of TG2-independent activity in the vasculature. TG1, TG2, TG4, and Factor XIII (FXIII) mRNA in rat aortae and vena cavae was detected by RT-PCR. Western analysis detected TG1 and TG4, but not FXIII, in rat aortae and vena cavae and in TG2 knockout and wild-type mouse aortae. Immunostaining confirmed the presence of TG1, TG2, and TG4 in rat aortae and vena cavae, notably in smooth muscle cells; FXIII was absent. K5 and T26, FITC-labeled peptide substrates specific for active TG1 and TG2, respectively, were incorporated into rat aortae and vena cavae and wild-type, but not TG2 knockout, mouse aortae. These studies demonstrate that TG2-independent TG activity exists in the vasculature and that TG1 and TG4 are expressed in vascular tissues. PMID:22307675

Johnson, Kyle B; Petersen-Jones, Humphrey; Thompson, Janice M; Hitomi, Kiyotaka; Itoh, Miho; Bakker, Erik N T P; Johnson, Gail V W; Colak, Gozde; Watts, Stephanie W

2012-02-03

282

Surgical interruption of a left inferior vena cava following the transfemoral implantation of a permanent pacing lead.  

PubMed

This report describes the case of a patient in whom, after an unsuccessful attempt through the subclavian vein, a permanent pacing lead was inserted through the femoral vein and a left inferior vena cava with azygos continuation. The procedure was followed 4 months later by a pulmonary embolism complicating a right femoroiliac thrombosis. The patient was successfully treated by a percutaneous lead extraction procedure combined with an inferior vena caval surgical interruption. PMID:9170140

Trigano, A J; Paganelli, F; Alimi, Y; Juhan, C

1997-05-01

283

Superior QRS axis in ventricular septal defect.  

PubMed Central

The relation between the superior orientation of the QRS axis and the anatomical site of the defect in the ventricular septum in patients with a ventricular septal defect was studied. Of 1031 patients with a ventricular septal defect, 64 (6.2%) had a superior axis on their electrocardiogram. In 59% of these patients the defect was in the inlet portion of the ventricular septum or affected this area. None of the cases was classified as an isolated ventricular septal defect of the persistent atrioventricular canal type. While there is an association between a superior axis and perimembranous inlet ventricular septal defect, a superior QRS axis does not characterise a ventricular septal defect as being of the atrioventricular canal type.

Shaw, N J; Godman, M J; Hayes, A; Sutherland, G R

1989-01-01

284

Brook Trout Rehabilitation Plan for Lake Superior.  

National Technical Information Service (NTIS)

The goal for brook trout (Salvelinus fontinalis) rehabilitation in Lake Superior is to maintain widely distributed, self-sustaining populations throughout their original habitats. Reaching the goal will require, singly or in combination, actions to restor...

L. E. Newman R. B. DuBois T. N. Halpern

2003-01-01

285

78 FR 21116 - Superior Supplier Incentive Program  

Federal Register 2010, 2011, 2012, 2013

...relations would be granted Superior Supplier Status (SSS). Contractors that achieve SSS could receive more favorable contract terms and conditions in DoN contracts. In addition to recognition of SSS at the business unit level, multi-business...

2013-04-09

286

[A too short superior labial frenum].  

PubMed

A too short superior labial frenum is quite normal in babies and little children. Usually, the strong frenum disappears at twelve years of age. Before considering surgical intervention beyond this age, one should exclude the presence of a tooth size or arch length discrepancy, a mesiodens or a severe dysgnathia. In this article the consequences of a too short superior labial frenum and its treatment are discussed. PMID:15181714

Baart, J A; Bosgra, J F

2004-05-01

287

Chronic amiodarone therapy impairs the function of the superior sinoatrial node in patients with atrial fibrillation.  

PubMed

Background:?The mechanisms underlying amiodarone-induced sinoatrial node (SAN) dysfunction remain unclear, so we used 3-dimensional endocardial mapping of the right atrium (RA) to investigate. Methods and Results:?In a matched-cohort design, 18 patients taking amiodarone before atrial fibrillation (AF) ablation (amiodarone group) were matched for age, sex and type of AF with 18 patients who had undergone AF ablation without taking amiodarone (no-amiodarone group). The amiodarone group had a slower heart rate than the no-amiodarone group at baseline and during isoproterenol infusion. Only the amiodarone group had sick sinus syndrome (n=4, 22%, P=0.03) and abnormal (>550ms) corrected SAN recovery time (n=5, 29%; P=0.02). The median distance from the junction of the superior vena cava (SVC) and RA to the most cranial earliest activation site (EAS) was longer in the amiodarone group than in the no-amiodarone group at baseline (20.5 vs. 10.6mm, P=0.04) and during isoproterenol infusion (12.8 vs. 6.3mm, P=0.03). The distance from the SVC-RA junction to the EAS negatively correlated with the P-wave amplitudes of leads II (r=-0.47), III (r=-0.60) and aVF (r=-0.56) (P<0.001 for all). Conclusions:?In a quarter of the AF patients, amiodarone causes superior SAN dysfunction, which results in a downward shift of the EAS and reduced P-wave amplitude in leads II, III and aVF at baseline and during isoproterenol infusion.??(Circ J?2013; 77: 2255-2263). PMID:23739532

Mun, Hee-Sun; Shen, Changyu; Pak, Hui-Nam; Lee, Moon-Hyoung; Lin, Shien-Fong; Chen, Peng-Sheng; Joung, Boyoung

2013-06-04

288

Reducción y reciclaje de residuos sólidos urbanos en centros de educación superior: Estudio de caso  

Microsoft Academic Search

The municipal waste generated by CINVESTAV-Mérida was characterized for a period of three years. The municipal solid waste was composed of 48 % organics; 20% cardboard and paper; 8 % soft drinks or purified water plastic bottles (polyethylene terephthalate, PET) and diverse plastics; 5 % glass bottles or containers and broken laboratory glass; 2 % aluminium cans, and 17 %

L. Maldonado

2006-01-01

289

Superior versus anteroinferior plating of clavicle fractures.  

PubMed

Plate fixation of displaced clavicle fractures has proven to be reliable and reproducible, leading to high union rates and a low rate of associated complications. However, the decision of whether to place the plate superiorly or anteroinferiorly on the clavicle has remained controversial. The authors performed a retrospective review on a consecutive series of patients who underwent plate fixation for a displaced midshaft clavicle fracture at a Level I urban trauma center. A review of surgical records identified 138 patients with a displaced midshaft clavicle fracture requiring operative stabilization. A total of 105 patients who met the inclusion criteria were included in the analysis. Both superior and anteroinferior techniques resulted in a similar time to radiographic union (12.6±4.8 vs 11.3±5.2 weeks, respectively) and identical union rates (95%). At final follow-up, patient-reported implant prominence was nearly double in patients with a retained superior plate (54% vs 29%, respectively; P=.04). No significant difference existed in mean visual analog scale score at a mean of 2.77 years postoperatively, although a significant difference existed in the Oxford Shoulder Score questionnaire, with a mean score of 41.4 in the superior group and 44.4 in the anteroinferior group (P=.008). Implant removal occurred more frequently after superior plating but was not significant. Both superior and anteroinferior clavicle plating are safe treatment methods for displaced clavicle fractures. Superior plating leads to an increased rate of patient-reported implant prominence and may prompt more requests for implant removal. PMID:23823047

Formaini, Nathan; Taylor, Benjamin C; Backes, Jeffrey; Bramwell, Thomas J

2013-07-01

290

First Magnetic Resonance Imaging-Guided Aortic Stenting and Cava Filter Placement Using a Polyetheretherketone-Based Magnetic Resonance Imaging-Compatible Guidewire in Swine: Proof of Concept  

SciTech Connect

The purpose of this study was to demonstrate feasibility of percutaneous transluminal aortic stenting and cava filter placement under magnetic resonance imaging (MRI) guidance exclusively using a polyetheretherketone (PEEK)-based MRI-compatible guidewire. Percutaneous transluminal aortic stenting and cava filter placement were performed in 3 domestic swine. Procedures were performed under MRI-guidance in an open-bore 1.5-T scanner. The applied 0.035-inch guidewire has a PEEK core reinforced by fibres, floppy tip, hydrophilic coating, and paramagnetic markings for passive visualization. Through an 11F sheath, the guidewire was advanced into the abdominal (swine 1) or thoracic aorta (swine 2), and the stents were deployed. The guidewire was advanced into the inferior vena cava (swine 3), and the cava filter was deployed. Postmortem autopsy was performed. Procedural success, guidewire visibility, pushability, and stent support were qualitatively assessed by consensus. Procedure times were documented. Guidewire guidance into the abdominal and thoracic aortas and the inferior vena cava was successful. Stent deployments were successful in the abdominal (swine 1) and thoracic (swine 2) segments of the descending aorta. Cava filter positioning and deployment was successful. Autopsy documented good stent and filter positioning. Guidewire visibility through applied markers was rated acceptable for aortic stenting and good for venous filter placement. Steerability, pushability, and device support were good. The PEEK-based guidewire allows either percutaneous MRI-guided aortic stenting in the thoracic and abdominal segments of the descending aorta and filter placement in the inferior vena cava with acceptable to good device visibility and offers good steerability, pushability, and device support.

Kos, Sebastian, E-mail: skos@gmx.d [University Hospital Basel, Institute of Radiology (Switzerland); Huegli, Rolf [Kantonsspital Bruderholz, Institute of Radiology (Switzerland); Hofmann, Eugen [Biotronik, Vascular Intervention (Switzerland); Quick, Harald H.; Kuehl, Hilmar [University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany); Aker, Stephanie [University of Duisburg-Essen, Institute of Pathophysiology (Germany); Kaiser, Gernot M. [University of Duisburg-Essen, Department of General, Visceral, and Transplantation Surgery (Germany); Borm, Paul J. A. [MagnaMedics GmbH (Germany); Jacob, Augustinus L.; Bilecen, Deniz [University Hospital Basel, Institute of Radiology (Switzerland)

2009-05-15

291

Combined resection of a tumor and the inferior vena cava: report of two cases.  

PubMed

Tumor resection and caval tumor thrombectomy, with or without cavotomy and inferior vena cava (IVC) replacement are sometimes performed in patients with renal cell carcinoma (RCC) extending into the IVC or liver tumors invading the IVC. Two such cases were treated. Case 1: a 68-year-old female was transferred with a diagnosis of right RCC with tumor thrombus extending into the IVC. A plication was performed to prevent extension into the right atrium before the nephrectomy and cavotomy with removal of the tumor thrombus was accomplished, because the IVC was almost completely obstructed and the hemodynamics were stable during cross-clamping of the IVC. Case 2: a 37-year-old female was transferred with a diagnosis of a giant metastatic liver tumor. A trisegmentectomy with resection of the invaded IVC and IVC replacement was performed while the abdominal aorta was cross-clamped to maintain the hemodynamics. Therefore, abdominal aortic cross-clamping was convenient to maintain the hemodynamics when the IVC replacement was performed during IVC cross-clamping. PMID:23001534

Jibiki, Masatoshi; Inoue, Yoshinori; Kudo, Toshifumi; Toyofuku, Takahiro; Saito, Kazutaka; Kihara, Kazunori; Kudo, Atsushi; Ban, Daisuke; Arii, Shigeki

2012-09-22

292

Left-sided and duplicate inferior vena cava: A case series and review.  

PubMed

Left-sided and duplicate inferior vena cava (IVC) are two major anatomical variants within the spectrum of IVC malformations, both of which are developmental abnormalities of the supracardinal veins. Four clinical cases are described to highlight the computed tomographic appearances of these vascular malformations and provide novel data on venous dimensions. A systematic review of the recent literature (2000-2011) was conducted focusing on the anatomy, demographics, and associated pathology (congenital and acquired) of isolated left-sided and duplicate IVC. A total of 73 relevant articles were retrieved, consisting of case reports and small case series. The prevalence of left-sided IVC is about 0.1-0.4% and that for duplicate IVC about 0.3-0.4%; both anomalies show a slight male preponderance. In each condition, there are documented variations in the course and tributaries of the IVC. The clinical importance of these anomalies lies in three principal areas: the potential for misdiagnosis on imaging; technical difficulties during retroperitoneal surgery (particularly abdominal aortic aneurysm repair and live donor nephrectomy); and their significance in relation to the etiology and management of venous thromboembolism. Clin. Anat. 26:990-1001, 2013. © 2012 Wiley Periodicals, Inc. PMID:22576868

Ang, Wee Choen; Doyle, Terry; Stringer, Mark D

2012-05-10

293

Improving the Tracking and Removal of Retrievable Inferior Vena Cava Filters  

PubMed Central

Therapeutic and prophylactic inferior vena cava (IVC) filters should be placed based on currently accepted indications to prevent a fatal pulmonary embolism (PE). The protective effect of filters is offset by the potential for lower extremity deep venous thrombosis (DVT), caval thrombosis, and possible otherwise unnecessary life-long anticoagulation (AC). The duration of treatment for most DVTs or PEs is 3 to 6 months of AC/filter. Filters should be retrieved when duration of treatment for a DVT/PE has been met, the risk of a PE is no longer high, and/or there is no longer a contraindication to AC. An effective system that leads to improving the retrieval rate of filters must include education of the patient, a tracking system to minimize patient lost to follow-up, and dedicated personnel to oversee the process. If these goals are accomplished, interventionalists can help decrease the incidence of a fatal PE during the high-risk period, and also decrease the risk of a DVT or the use of otherwise unnecessary life-long AC in subsequent years. Currently, there is much room for improvement in the frequency that IVCF patients are systematically followed and filters are retrieved. The principles discussed in this report will be helpful in this process.

Goei, Anthony D.; Josephs, Shellie C.; Kinney, Thomas B.; Ray, Charles E.; Sacks, David

2011-01-01

294

Clinical review: Inferior vena cava filters in the age of patient-centered outcomes.  

PubMed

Abstract Inferior vena cava filter (IVCF) use continues to increase in the United States (US) despite questionable clinical benefit and increasing concerns over long-term complications. For this review we comprehensively examine the randomized, prospective data on IVC filter efficacy, compare relative rates of IVCF placement in onsidered guidelines for IVCF indications, and the current data on IVCF complications. Searches of MEDLINE and Cochrane databases were conducted for randomized prospective IVCF studies. Only three randomized prospective studies for IVCFs were identified. Commonly cited IVCF guidelines were reviewed with attention to their evolution over time. No evidence has shown a survival benefit with IVCF use. Despite this, continued rising utilization, especially for primary prophylactic indications, is concerning, given increasing evidence of long-term filter-related complications. This is particularly noted in the US where IVCF placements for 2012 are projected to be 25 times that of an equivalent population in Europe (224,700 versus 9,070). Pending much-needed randomized controlled trials that also evaluate long-term safety, we support the more stringent American College of Chest Physicians (ACCP) guidelines for IVCF placement indications and advocate a close, structured follow-up of retrievable IVCFs to improve filter retrieval rates. PMID:24099038

Wang, Stephen L; Lloyd, Allen J

2013-11-01

295

The Guenther temporary inferior vena cava filter for short-term protection against pulmonary embolism  

SciTech Connect

Purpose. To evaluate clinically the Guenther temporary inferior vena cava (IVC) filter. Methods. Eleven IVC filters were placed in 10 patients. Indications for filter placement were surgical pulmonary embolectomy in seven patients, pulmonary embolism in two patients, and free-floating iliofemoral thrombus in one patient. Eight filters were inserted from the right femoral approach, three filters from the left. Follow-up was by plain abdominal radiographs, cavography, and duplex ultrasound (US). Eight patients received systemic heparinization. Follow-up, during 4-60 months after filter removal was by clinical assessment, and imaging of the lungs was performed when pulmonary embolism (PE) was suspected. Patients received anticoagulation therapy for at least 6 months. Results. Ten filters were removed without complications 7-14 days (mean 10 days) after placement. One restless patient pulled the filter back into the common femoral vein, and a permanent filter was placed. In two patients a permanent filter was placed prior to removal. One patient developed sepsis, and one an infection at the insertion site. Clinically no recurrent PE developed with the filter in place or during removal. One patient had recurrent PE 7 months after filter removal. Conclusion. The Guenther temporary IVC filter can be safely placed for short-term protection against PE. The use of this filter is not appropriate in agitated or immunocompromised patients.

Vos, Louwerens D.; Tielbeek, Alexander V. [Catharina Hospital, Department of Radiology (Netherlands); Bom, Ernst P. [Sophia Hospital, Department of Radiology (Netherlands); Gooszen, Harm C. [Catharina Hospital, Department of Pulmonology (Netherlands); Vroegindeweij, Dammis [Catharina Hospital, Department of Radiology (Netherlands)

1997-03-15

296

Braile vena cava filter and greenfield filter in terms of centralization.  

PubMed

The aim of this study was to evaluate complications experienced during implantation of the Braile Vena Cava filter (VCF) and the efficacy of the centralization mechanism of the filter. This retrospective cohort study evaluated all Braile Biomédica VCFs implanted from 2004 to 2009 in Hospital de Base Medicine School in São José do Rio Preto, Brazil. Of particular concern was the filter's symmetry during implantation and complications experienced during the procedure. All the angiographic examinations performed during the implantation of the filters were analyzed in respect to the following parameters: migration of the filter, non-opening or difficulties in the implantation and centralization of the filter. A total of 112 Braile CVFs were implanted and there were no reports of filter opening difficulties or in respect to migration. Asymmetry was observed in 1/112 (0.9%) cases. A statistically significant difference was seen on comparing historical data on decentralization of the Greenfield filter with the data of this study. The Braile Biomédico filter is an evolution of the Greenfield filter providing improved embolus capture and better implantation symmetry. PMID:23459189

de Godoy, José Maria Pereira; Menezes da Silva, Adinaldo A; Reis, Luis Fernando; Miquelin, Daniel; Torati, José Luis Simon

2013-01-31

297

Ecklonia cava Inhibits Glucose Absorption and Stimulates Insulin Secretion in Streptozotocin-Induced Diabetic Mice  

PubMed Central

Aims of study. Present study investigated the effect of Ecklonia cava (EC) on intestinal glucose uptake and insulin secretion. Materials and methods. Intestinal Na+-dependent glucose uptake (SGU) and Na+-dependent glucose transporter 1 (SGLT1) protein expression was determined using brush border membrane vesicles (BBMVs). Glucose-induced insulin secretion was examined in pancreatic ?-islet cells. The antihyperglycemic effects of EC, SGU, and SGLT1 expression were determined in streptozotocin (STZ)-induced diabetic mice. Results. Methanol extract of EC markedly inhibited intestinal SGU of BBMV with the IC50 value of 345??g/mL. SGLT1 protein expression was dose dependently down regulated with EC treatment. Furthermore, insulinotrophic effect of EC extract was observed at high glucose media in isolated pancreatic ?-islet cells in vitro. We next conducted the antihyperglycemic effect of EC in STZ-diabetic mice. EC supplementation markedly suppressed SGU and SGLT1 abundance in BBMV from STZ mice. Furthermore, plasma insulin level was increased by EC treatment in diabetic mice. As a result, EC supplementation improved postprandial glucose regulation, assessed by oral glucose tolerance test, in diabetic mice. Conclusion. These results suggest that EC play a role in controlling dietary glucose absorption at the intestine and insulinotrophic action at the pancreas contributing blood glucose homeostasis in diabetic condition.

Kim, Hye Kyung

2012-01-01

298

14 CFR 385.7 - Exercise of authority by superiors.  

Code of Federal Regulations, 2013 CFR

...2013-01-01 2013-01-01 false Exercise of authority by superiors. 385.7...ASSIGNMENTS General Provisions § 385.7 Exercise of authority by superiors. ...responsibility, the superior may choose to exercise the assigned power personally....

2013-01-01

299

Polyphenol-Rich Fraction of Brown Alga Ecklonia cava Collected from Gijang, Korea, Reduces Obesity and Glucose Levels in High-Fat Diet-Induced Obese Mice  

PubMed Central

Ecklonia cava (E. cava) is a brown alga that has beneficial effects in models of type 1 and type 2 diabetes. However, the effects of E. cava extracts on diet-induced obesity and type 2 diabetes have not been specifically examined. We investigated the effects of E. cava on body weight, fat content, and hyperglycemia in high-fat diet- (HFD) induced obese mice and sought the mechanisms involved. C57BL/6 male mice were fed a HFD (60% fat) diet or normal chow. After 3 weeks, the HFD diet group was given extracts (200?mg/kg) of E. cava harvested from Jeju (CA) or Gijang (G-CA), Korea or PBS by oral intubation for 8 weeks. Body weights were measured weekly. Blood glucose and glucose tolerance were measured at 7 weeks, and fat pad content and mRNA expression of adipogenic genes and inflammatory cytokines were measured after 8 weeks of treatment. G-CA was effective in reducing body weight gain, body fat, and hyperglycemia and improving glucose tolerance as compared with PBS-HFD mice. The mRNA expression of adipogenic genes was increased, and mRNA expression of inflammatory cytokines and macrophage marker gene was decreased in G-CA-treated obese mice. We suggest that G-CA reduces obesity and glucose levels by anti-inflammatory actions and improvement of lipid metabolism.

Park, Eun Young; Kim, Eung Hwi; Kim, Mi Hwi; Seo, Young Wan; Lee, Jung Im; Jun, Hee Sook

2012-01-01

300

Superior area 6 afferents from the superior parietal lobule in the macaque monkey  

Microsoft Academic Search

Superior area 6 of the macaque monkey frontal cortex is formed by two cytoarchitectonic areas: F2 and F7. In the present experiment, we studied the input from the superior parietal lobule (SPL) to these areas by injecting retrograde neural tracers into restricted parts of F2 and F7. Additional injections of retrograde tracers were made into the spinal cord to define

Massimo Matelli; Paolo Govoni; Claudio Galletti; Dieter F. Kutz; Giuseppe Luppino

1998-01-01

301

Nociceptive neurones in rat superior colliculus  

Microsoft Academic Search

Accumulating evidence suggests that the rodent superior colliculus (SC) plays as important a role in avoidance and defensive behaviours as it does in orientation and approach. These two complementary behaviours are associated with two anatomically segregated tectofugal output pathways, such that orientation and approach are mediated by the crossed descending projection, whereas avoidance and defence are subserved via the uncrossed

Peter Redgrave; John G. McHaffie; Barry E. Stein

1996-01-01

302

Intrinsic connectivity of human superior colliculus  

Microsoft Academic Search

The superior colliculus (SC) is believed to play an important role in sensorimotor integration and orienting behavior. It is classically divided into superficial layers predominantly containing visual neurons and deep layers containing multisensory and premotor neurons. Investigations of intrinsic connectivity within the SC in non-human species initially led to controversy regarding the existence of interlaminar connections between superficial and deep

Eric Tardif; Brigitte Delacuisine; Alphonse Probst; Stephanie Clarke

2005-01-01

303

Water Pollution Investigation: Duluth-Superior Area.  

National Technical Information Service (NTIS)

The Lower St. Louis River Basin from Brookston to Lake Superior was sampled in late 1973. The resultant data were combined with historical data for verification of a water quality model--the St. Louis River Basin Model. The model was used to evaluate the ...

A. D. McElroy S. Y. Chiu

1974-01-01

304

Perturbation Resilience and Superiorization of Iterative Algorithms  

PubMed Central

Iterative algorithms aimed at solving some problems are discussed. For certain problems, such as finding a common point in the intersection of a finite number of convex sets, there often exist iterative algorithms that impose very little demand on computer resources. For other problems, such as finding that point in the intersection at which the value of a given function is optimal, algorithms tend to need more computer memory and longer execution time. A methodology is presented whose aim is to produce automatically for an iterative algorithm of the first kind a “superiorized version” of it that retains its computational efficiency but nevertheless goes a long way towards solving an optimization problem. This is possible to do if the original algorithm is “perturbation resilient,” which is shown to be the case for various projection algorithms for solving the consistent convex feasibility problem. The superiorized versions of such algorithms use perturbations that steer the process in the direction of a superior feasible point, which is not necessarily optimal, with respect to the given function. After presenting these intuitive ideas in a precise mathematical form, they are illustrated in image reconstruction from projections for two different projection algorithms superiorized for the function whose value is the total variation of the image.

Censor, Y; Davidi, R; Herman, G T

2010-01-01

305

Perturbation resilience and superiorization of iterative algorithms  

NASA Astrophysics Data System (ADS)

Iterative algorithms aimed at solving some problems are discussed. For certain problems, such as finding a common point in the intersection of a finite number of convex sets, there often exist iterative algorithms that impose very little demand on computer resources. For other problems, such as finding that point in the intersection at which the value of a given function is optimal, algorithms tend to need more computer memory and longer execution time. A methodology is presented whose aim is to produce automatically for an iterative algorithm of the first kind a 'superiorized version' of it that retains its computational efficiency but nevertheless goes a long way toward solving an optimization problem. This is possible to do if the original algorithm is 'perturbation resilient', which is shown to be the case for various projection algorithms for solving the consistent convex feasibility problem. The superiorized versions of such algorithms use perturbations that steer the process in the direction of a superior feasible point, which is not necessarily optimal, with respect to the given function. After presenting these intuitive ideas in a precise mathematical form, they are illustrated in image reconstruction from projections for two different projection algorithms superiorized for the function whose value is the total variation of the image.

Censor, Y.; Davidi, R.; Herman, G. T.

2010-06-01

306

Perturbation Resilience and Superiorization of Iterative Algorithms.  

PubMed

Iterative algorithms aimed at solving some problems are discussed. For certain problems, such as finding a common point in the intersection of a finite number of convex sets, there often exist iterative algorithms that impose very little demand on computer resources. For other problems, such as finding that point in the intersection at which the value of a given function is optimal, algorithms tend to need more computer memory and longer execution time. A methodology is presented whose aim is to produce automatically for an iterative algorithm of the first kind a "superiorized version" of it that retains its computational efficiency but nevertheless goes a long way towards solving an optimization problem. This is possible to do if the original algorithm is "perturbation resilient," which is shown to be the case for various projection algorithms for solving the consistent convex feasibility problem. The superiorized versions of such algorithms use perturbations that steer the process in the direction of a superior feasible point, which is not necessarily optimal, with respect to the given function. After presenting these intuitive ideas in a precise mathematical form, they are illustrated in image reconstruction from projections for two different projection algorithms superiorized for the function whose value is the total variation of the image. PMID:20613969

Censor, Y; Davidi, R; Herman, G T

2010-06-01

307

Silent racism and intellectual superiority in Peru  

Microsoft Academic Search

Historically, racism as it is understood in South Africa or in parts of the Southern United States has not existed in Peru. The absence or at least the existence to a lesser degree of this type of tension grants us a superiority over our northern neighbours. In Peru, emancipation of slaves was relatively easy. This is not to say that

Marisol De La Cadena

1998-01-01

308

Organic carbon biogeochemistry of Lake Superior  

Microsoft Academic Search

We examined the organic carbon budget for the Earth's largest lake, Lake Superior, in the Laurentian Great Lakes. This is a unique, ultra-oligotrophic system with many features similar to the oligotrophic oceanic gyres, such as dominance of microbial biomass and dissolved organic carbon in biogeochemical processes. Photo-autotrophy is the dominant source of reduced organic matter in the lake. Areal rates

James B. Cotner; Bopaiah A. Biddanda; Wataru Makino; Edward Stets

2004-01-01

309

Surgical Management of Superior Sulcus Tumors  

Microsoft Academic Search

Superior sulcus tumor refers to any primary lung can- cer presenting with constant pain in the nerve distribution of the eighth cervical, first and second thoracic nerve roots and Horner's syndrome caused by invasion of the stellate ganglion. The pain is steady, severe, and unrelent- ing, involving the shoulder, the vertebral margin of the scapula and ulnar distribution of the

PHILIPPE DARTEVELLE

310

The Woman Principal: Superior to the Male?  

ERIC Educational Resources Information Center

Research indicates that women are better principals than men. Reasons for superiority include greater teaching experience and higher qualifications for the principalship. Women should not be satisfied to view the administrator's position as a "man's job" but should feel that it is also a position appropriate for women. (Author/BEF)

Tibbetts, Sylvia-Lee

1980-01-01

311

Synthetic organic toxicants in Lake Superior  

Microsoft Academic Search

Numerous synthetic organic toxicants have been reported in Lake Superior in the past quarter century although relatively few industrial centers are located on its shores. The chemicals enter the lake primarily through atmospheric deposition via transport from regional and distant sources. This contribution discusses research issues regarding the processes by which the chemicals enter and exit the lake, their in-lake

J. A. Perlinger; M. F. Simcik; D. L. Swackhamer

2004-01-01

312

Significant Reading Experiences of Superior English Students.  

ERIC Educational Resources Information Center

|Superior high school students (975 finalists in the NCTE Achievement Awards Program) were surveyed to find what one book was most significant to each of them in their high school experiences, and the reason for the significance. In response to questionnaires, the students cited 416 different titles, 72% of which were novels. The top 10 books were…

Whitman, Robert S.

1964-01-01

313

RESONANT OSCILLATION IN DULUTH-SUPERIOR HARBOR  

EPA Science Inventory

The treatment of Duluth-Superior Harbor inlets as coupled oscillators yields Helmholtz resonance periods of 2.1-2.3 h. Analysis of water level oscillations in the harbor and currents in an inlet channel shows a 2.1-h mode, which seems to be excited by lake oscillations of nearly ...

314

The Holocene Paleolimnology of Lake Superior  

NASA Astrophysics Data System (ADS)

This study describes contributions of glacial meltwater to Lake Superior over the last 11,000 cal BP. Rhythmites (interpreted as varves), lithological and mineralogical variations, and radiocarbon dating were used to establish chronostratigraphic correlation among four sediment cores from Lake Superior (Duluth, Caribou and Ile Parisienne basins, Thunder Bay Trough). Glacial sediments were deposited between 10,850 and 8,800 cal BP. The oxygen-isotope compositions of ostracodes record the presence of glacial meltwater in ancient Lake Superior as the Laurentide Ice Sheet waxed and waned. Glacial meltwater was increasingly dominant between ~10,850 and ~9,250 cal BP, particularly as thick varves formed in northern portions of the Lake Superior Basin (10,400-10,200, 9,900 and 9,300-9,200 cal BP). Glacial meltwater supply was reduced in the Thunder Bay Trough between 9,250 and 8,950 cal BP, but returned from 8,950 to 8,800 cal BP. Glacial meltwater flow from the Lake Superior Basin probably bypassed the Huron Basin several times during this period. Final termination of glacial meltwater supply occurred at 8,800 cal BP - coincident with cessation of varve formation and inception of ancient Lakes Agassiz-Ojibway and Houghton. Primary productivity was very low and algal growth occurred under conditions of extreme nitrogen deficiency - as determined using TOC, TN and C/N ratios - until glacial meltwater supply to the Basin was ended. The postglacial sediments are non-calcareous. The diatom silica proxy record shows that oxygen-isotope compositions of water rapidly increased after glacial meltwater termination, reaching -10 per mil during the Holocene Thermal Maximum. The oxygen-isotope compositions of water decreased at 3,000 cal BP in response to the Holocene Neoglacial Interval before gradually rising to Lake Superior’s modern value of -8.7 per mil. Aquatic primary productivity, inferred using TOC, TN, and the carbon- and nitrogen isotope compositions, has increased gradually since 8,800 cal BP.

Hyodo, A.; Longstaffe, F. J.

2010-12-01

315

Clinical Outcome after Intrahepatic Venous Stent Placement for Malignant Inferior Vena Cava Syndrome  

SciTech Connect

We evaluated the clinical outcome of malignant inferior vena cava (IVC) syndrome after intrahepatic IVC stent placement by retrospective analysis of 50 consecutive patients (25 men, 25 women, age 32-83 years) with malignant IVC syndrome who were treated with intrahepatic stent placement. Gianturco-Rosch-Z (GRZ) stents (n = 45), and Wallstents (n = 5) were inserted. Clinical outcome was assessed from patients' records using a score based on leg swelling, scrotal/vulvar edema, ascites and anasarca before and after stent placement, as well as at last follow-up visit before death. Clinical follow-up was supplemented by duplex sonography in 36 patients. Inferior venocavography was performed in 5 patients prior to re- intervention. Follow-up time ranged from 1 to 932 days (mean 62 days). Mean pressure gradient in the IVC was reduced from 14 {+-} 4.1 mmHg before to 2.9 {+-} 3.2 mmHg after stent placement (p < 0.001). Four patients had stent occlusion, 2 of whom were successfully re-stented. Primary and secondary patency was 59% and 100%, respectively at 540 days. Immediate clinical data were available in 44 patients: 38 improved; 6 did not respond. Last follow-up visit data were available in 36 patients: 24 showed persistent symptom relief till death. All symptom scores were significantly improved after stent placement (p < 0.001) and with the exception of ascites, remained significantly improved (p < 0.05) until the last follow-up. Increased serum bilirubin was a common characteristic of clinical failures and recurrences. Intrahepatic IVC stent placement resulted in significant symptomatic relief in patients with malignant IVC syndrome. Palliation was effective even in patients with a very short life expectancy.

Brountzos, Elias N.; Binkert, Christoph A.; Panagiotou, Irene E.; Petersen, Bryan D.; Timmermans, Hans; Lakin, Paul C. [Dotter Interventional Institute, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road, L342, Portland OR 97201-3098 (United States)

2004-03-15

316

Thrombogenesis with continuous blood flow in the inferior vena cava: A novel mouse model  

PubMed Central

Summary Several rodent models have been used to study deep venous thrombosis (DVT). However, a model that generates consistent venous thrombi in the presence of continuous blood flow, to evaluate therapeutic agents for DVT, is not available. Mice used in the present study were wild-type C57BL/6 (WT), plasminogen activator inhibitor-1 (PAI-1) knock out (KO) and Delta Cytoplasmic Tail (?CT). An electrolytic inferior vena cava (IVC) model (EIM) was used. A 25G stainless-steel needle, attached to a silver coated copper wire electrode (anode), was inserted into the exposed caudal IVC. Another electrode (cathode) was placed subcutaneously. A current of 250 ?Amps over 15 minutes was applied. Ultrasound imaging was used to demonstrate the persence of IVC blood flow. Analyses included measurement of plasma soluble P-selectin (sP-Sel), thrombus weight (TW), vein wall morphometrics, P-selectin and Von Willebrand factor (vWF) staining, transmission electron microscopy (TEM), scanning electron microscopy (SEM); and the effect of enoxaparin on TW was evaluated. A current of 250 ?Amps over 15 minutes consistently promoted thrombus formation in the IVC. Plasma sP-Sel was decreased in PAI-1 KO and increased in ?CT vs. WT (WT/PAI-1: p=0.003, WT/?CT: p=0.0002). Endothelial activation was demonstrated by SEM, TEM, P-selection and vWF immunohistochemistry and confirmed by inflammatory cell counts. Ultrasound imaging demonstrated thrombus formation in the presence of blood flow. Enoxaparin significantly reduced the thrombus size by 61% in this model. This EIM closely mimics clinical venous disease and can be used to study endothelial cell activation, leukocyte migration, thrombogenesis and therapeutic applications in the presence of blood flow.

Diaz, Jose A.; Hawley, Angela E.; Alvarado, Christine M.; Berguer, Alexandra M.; Baker, Nichole K.; Wrobleski, Shirley K.; Wakefield, Thomas W.; Lucchesi, Benedict R.; Myers, Daniel D.

2011-01-01

317

Transcatheter thrombolytic therapy for symptomatic thrombo-occlusion of inferior vena cava filter  

PubMed Central

Thrombus within an inferior vena cava (IVC) filter reduces filter patency and venous return from the lower extremities, and may progress to complete IVC occlusion. The clinical experiences and outcomes of transcatheter thrombolytic therapy for symptomatic IVC thrombosis following filter implantation have not been widely reported. The aim of the current study was to evaluate the efficiency and safety of trans-catheter thrombolysis for the treatment of symptomatic IVC thrombosis in patients with implanted IVC filters. Transcatheter thrombolysis was used to treat 5 patients with thrombosis of the filter-bearing IVC causing symptoms in 10 limbs from October 2005 to September 2010. The patients were implanted with a second IVC filter through the right internal jugular vein, followed by recanalization of the occluded IVC and intravenous transcatheter thrombolysis. The IVC filters were retrieved through the femoral or right internal jugular vein after the thrombus had dissolved. Technical and clinical outcome, complications and postoperative pulmonary embolism were monitored. A total of 5 filters were implanted and 6 filters were retrieved later. Technically and clinically successful recanalization and thrombolysis were achieved in 5 of 5 patients and 10 of 10 symptomatic limbs. The median thrombolysis period was 13 days (range, 8–14 days). The median dwell time for the filters that were removed was 50.5 days (range, 14–73 days). No major bleeding occurred during the current study. During clinical follow-up, no clinically detectable pulmonary embolism was observed. Endovascular recanalization and transcatheter thrombolysis of IVC thrombosis are efficient, feasible and safe in the presence of an IVC filter.

XIAO, LIANG; SHEN, JING; TONG, JIA-JIE; ZHANG, ZHE; MU, XIAO-LIN; YI, ZHENG-JIA; BAI, SHUO; XU, KE

2013-01-01

318

Cytotoxic activity of proteins isolated from extracts of Corydalis cava tubers in human cervical carcinoma HeLa cells  

PubMed Central

Background Corydalis cava Schweigg. & Koerte, the plant of numerous pharmacological activities, together with the studied earlier by our group Chelidonium majus L. (Greater Celandine), belong to the family Papaveraceae. The plant grows in Central and South Europe and produces the sizeable subterraneous tubers, empty inside, which are extremely resistant to various pathogen attacks. The Corydalis sp. tubers are a rich source of many biologically active substances, with the extensive use in European and Asian folk medicine. They have analgetic, sedating, narcotic, anti-inflammatory, anti-allergic and anti-tumour activities. On the other hand, there is no information about possible biological activities of proteins contained in Corydalis cava tubers. Methods Nucleolytic proteins were isolated from the tubers of C. cava by separation on a heparin column and tested for DNase activity. Protein fractions showing nucleolytic activity were tested for cytotoxic activity in human cervical carcinoma HeLa cells. Cultures of HeLa cells were conducted in the presence of three protein concentrations: 42, 83 and 167 ng/ml during 48 h. Viability of cell cultures was appraised using XTT colorimetric test. Protein fractions were separated and protein bands were excised and sent for identification by mass spectrometry (LC-ESI-MS/MS). Results The studied protein fractions showed an inhibiting effect on mitochondrial activity of HeLa cells, depending on the administered dose of proteins. The most pronounced effect was obtained with the highest concentration of the protein (167 ng/ml) - 43.45 ± 3% mitochondrial activity of HeLa cells were inhibited. Mass spectrometry results for the proteins of applied fractions showed that they contained plant defense- and pathogenesis-related (PR) proteins. Conclusions The cytotoxic effect of studied proteins toward HeLa cell line cells has been evident and dependent on increasing dose of the protein. The present study, most probably, represents the first investigations on the effect of purified PR proteins from tuber extracts of a pharmacologically active plant on cell lines.

2010-01-01

319

A case of intravenous leiomyomatosis of uterine origin, extending through the inferior vena cava to right atrium.  

PubMed

Intravenous leiomyomatosis (IVL) is a rare benign tumor that originates from uterus, and sometimes extends to the right heart. We report a case of IVL that extended to right atrium through the inferior vena cava (IVC) which was resected using partial cardiopulmonary bypass. Multi detector computed tomography and ultrasound played a vital role in arriving at the diagnosis. Complete resection of tumor in the heart and great vein, and separation of the tumor stump from the IVC are essential in the treatment of IVL. PMID:22627954

Osawa, Hiroshi; Hosaka, Shigeru; Akashi, Okihiko; Furukawa, Hiroshi; Egi, Koso

2012-05-25

320

PET/CT in primary hepatic lymphoma with hepatic vein thrombus that extended into the inferior vena cava.  

PubMed

Primary hepatic lymphoma (PHL) is an extremely rare manifestation of extranodal non-Hodgkin's lymphoma (0.016% of all cases). Presented are CT, MRI, ultrasound, and (18)F fluoro-2-deoxy-D-glucose (FDG) PET/CT images, which characterized PHL and demonstrated hepatic vein thrombus that extended into the inferior vena cava--a feature not previously described. Recognition of this imaging pattern may help in the differential diagnosis of future such cases. FDG PET/CT was critical in confirming the diagnosis, staging, and demonstrating response to treatment. PMID:23334136

Diehl, Kevin; Sarwani, Nabeel E; Tulchinsky, Mark

2013-02-01

321

Inferior vena cava resection and reconstruction: Technical considerations in the surgical management of renal cell carcinoma with tumor thrombus.  

PubMed

The mainstay of treatment for renal cell carcinoma with invasion of the inferior vena cava (IVC) is complete surgical extirpation. Cases complicated by adherent or invasive tumor thrombus represent a special technical challenge due to the need for resection of a large segment of the IVC. The aim of this review is to describe the indications and surgical approach for radical nephrectomy with en bloc resection of the IVC with or without venous reconstruction. In addition, special attention is paid to the relevant anatomical and hemodynamic considerations related to the development of venous collateral pathways secondary to IVC obstruction. PMID:23499500

González, Javier; Gorin, Michael A; Garcia-Roig, Michael; Ciancio, Gaetano

2013-03-14

322

Idiopathic Thrombosis of the Inferior Vena Cava and Bilateral Femoral Veins in an Otherwise Healthy Male Soldier  

PubMed Central

Thrombosis of the inferior vena cava is less common than deep venous thrombosis of the lower extremities, particularly in the absence of an obvious congenital caval abnormality or hypercoagulable state. We present a case of IVC thrombosis in an otherwise healthy and active 28-year-old male soldier secondary to dehydration and venous webbing. IVC thrombosis is an uncommon and underrecognized condition; in this case, the patient's caval thrombosis was initially mistaken for acute back strain. Prompt recognition is necessary to minimize long-term sequelae.

Gordon, Sarah; Kerns, Tamie; Londeree, William; Ching, Brian

2013-01-01

323

Scalp Metastasis from Leiomyosarcoma of the Inferior Vena Cava Sign as the First Clinical Sign: A Case Report  

PubMed Central

The presentation of scalp metastases from leiomyosarcoma of the vena cava is an extremely infrequent event. There are no other publications that describe such finding and very few of leiomyosarcoma in vessels. About this event we have reviewed the English literature describing studies on scalp metastases and skin metastases in general: their incidence, origin, clinical appearance, meaning, and diagnosis. The case we describe would be the second one presented worldwide because, as far as we know, it has been only one more published in 2005.

Prieto Munoz, Isabel; Pardo Masferrer, Jose

2012-01-01

324

Scalp metastasis from leiomyosarcoma of the inferior vena cava sign as the first clinical sign: a case report.  

PubMed

The presentation of scalp metastases from leiomyosarcoma of the vena cava is an extremely infrequent event. There are no other publications that describe such finding and very few of leiomyosarcoma in vessels. About this event we have reviewed the English literature describing studies on scalp metastases and skin metastases in general: their incidence, origin, clinical appearance, meaning, and diagnosis. The case we describe would be the second one presented worldwide because, as far as we know, it has been only one more published in 2005. PMID:23091758

Prieto Muñoz, Isabel; Pardo Masferrer, Jose

2012-10-10

325

Renal angiomyolipoma with coexistent hemorrhagic aneurysm formation and fatty thrombus in inferior vena cava: a rare presentation.  

PubMed

Angiomyolipoma (AML) is known as the most common benign mesenchymal tumor of kidney. Usually AMLs present as benign lesions without local invasion or complication. However, few cases of renal AML have been reported with complications such as tumor thrombus extension into inferior vena cava (IVC) or hemorrhagic aneurysm formation. We report a complicated case of renal AML with CT and angiography evidence of hemorrhagic aneurysm formation and IVC thrombus, treated by a combination of selective arterial embolization, radical nephrectomy and thrombectomy. Radiologists and clinicians should be aware that AMLs could have such aggressive behaviors. PMID:22450723

Li, Hao-ming; Yeh, Lee-ren; Lu, Kevin

2013-02-01

326

Diabetes alters vascular mechanotransduction: pressure-induced regulation of mitogen activated protein kinases in the rat inferior vena cava  

PubMed Central

Background Diabetes mellitus is an important risk factor for increased vein graft failure after bypass surgery. However, the cellular and molecular mechanism(s) underlying vessel attrition in this population remain largely unexplored. Recent reports have suggested that the pathological remodeling of vein grafts may be mediated by mechanically-induced activation of the mitogen activated protein kinase (MAPK) signaling pathways and the MAPK-related induction of caspase-3 activity. On the basis of these findings, we hypothesized that diabetes may be associated with alterations in how veins "sense" and "respond" to altered mechanical loading. Methods Inferior venae cavae (IVC) from the non-diabetic lean (LNZ) and the diabetic obese (OSXZ) Zucker rats were isolated and incubated ex vivo under basal or pressurized conditions (120 mmHg). Protein expression, basal activation and the ability of increased pressure to activate MAPK pathways and apoptosis-related signaling was evaluated by immunoblot analysis. Results Immunoblot analyses revealed differential expression and activation of extracellular signal-regulated kinase (ERK1/2), p38 and c-Jun NH2-terminal kinase (JNK) MAPKs in the IVCs of diabetic rats as compared to non-diabetic rats. In particular, the expression and basal phosphorylation of p38?- (52.3 ± 11.8%; 45.8 ± 18.2%), JNK 1- (21.5 ± 9.3%; 19.4 ± 11.6%) and JNK3-MAPK (16.8 ± 3.3%; 29.5 ± 17.6%) were significantly higher (P < 0.05) in the diabetic vena cava. An acute increase in IVC intraluminal pressure failed to increase the phosphorylation of ERK1-, JNK-2, or any of the p38-MAPKs in the diabetic obese Zucker rats. Also, IVC loading in the LNZ led to a 276.0 ± 36.0% and 85.8 ± 25.1% (P < 0.05) increase in the cleavage of caspase-3 and caspase-9, respectively, with no effect on these molecules in the OSXZ. No differences were found in the regulation of Bax and Bcl-2 between groups. However, basal expression levels of Akt, phospho-Akt, PTEN, phospho-PTEN and phospho-Bad were higher in the diabetic venae cavae (P < 0.05). Conclusion These data suggest that diabetes is associated with significant alteration in the ability of the vena cava to activate MAPK- and apoptosis-related signaling. Whether these changes are associated with the increased vein graft attrition seen in the diabetic population will require further investigation.

Rice, Kevin M; Desai, Devashish H; Kakarla, Sunil K; Katta, Anjaiah; Preston, Deborah L; Wehner, Paulette; Blough, Eric R

2006-01-01

327

Catheter-Directed Thrombolysis of Inferior Vena Cava Thrombosis in a 13-Day-Old Neonate and Review of Literature  

SciTech Connect

Complete inferior vena cava thrombosis (IVC) in neonates is uncommon, but may cause significant morbidity. A 13-day-old neonate suffered IVC thrombosis secondary to antithrombin III deficiency, possibly contributed to by a mutation in the methyl tetrahydrofolate reductase gene. Catheter-directed thrombolysis (CDT) with recombinant tissue plasminogen activator (rt-PA, Alteplase) was used successfully to treat extensive venous thrombosis in this neonate without complications. We also review the literature on CDT for treatment of IVC thrombosis in critically ill neonates and infants.

Khan, Jawad U. [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science (United States); Takemoto, Clifford M.; Casella, James F. [Johns Hopkins University School of Medicine, Department of Pediatrics (United States); Streiff, Michael B. [Johns Hopkins University School of Medicine, Department of Medicine (United States); Nwankwo, Ikechi J.; Kim, Hyun S., E-mail: sikhkim@jhmi.ed [Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science (United States)

2008-07-15

328

[The use of politetrafluoroethylene stent-graft and vena cava filter in the endovascular treatment of ruptured abdominal aortic aneurysm with aortocaval fistula].  

PubMed

We report on a the endovascular treatment of ruptured abdominal aortic aneurysm with aortocaval fistula. The stent-graft was placed with the patient under general anaesthesia, and the abdominal aorta aneurysm was successfully treated. To prevent pulmonary embolism vena cava filter was deployed before the implantation of the sten-graft. The aneurysm was excluded and no endoleak or communication between the aorta and inferior vena cava was seen on computed tomographic imaging at the 3-month evaluation. Endovascular treatment offers an attractive therapeutic alternative to open repair in case of aortocaval fistula. PMID:19873928

Janczak, Dariusz; Pupka, Artur; Garcarek, Jerzy; Szyber, Piotr

2009-01-01

329

Longevity of Lake Superior lake trout  

USGS Publications Warehouse

The age structure of mature lake trout Salvelinus namaycush from the Wisconsin waters of Lake Superior increased following a population recovery that has taken place since the 1960s. As the population aged, it became apparent that scales were unreliable aging structures. Beginning in 1986, we examined both scale and sagittal otolith ages from tagged fish with a known period at liberty. We found large discrepancies in scale and sagittal otolith ages of mature fish, such that scale ages were biased low. We estimated lake trout living up to 42 years, which is greater than previously reported from Lake Superior. Investigators studying lake trout population dynamics in the Great Lakes should be aware that lake trout can live longer than previously thought.

Schram, Stephen T.; Fabrizio, Mary C.

1998-01-01

330

Superior Temporal Gyrus, Language Function, and Autism  

Microsoft Academic Search

Deficits in language are a core feature of autism. The superior temporal gyrus (STG) is involved in auditory processing, including language, but also has been implicated as a critical structure in social cognition. It was hypothesized that subjects with autism would display different size-function relationships between the STG and intellectual-language-based abilities when compared to controls. Intellectual ability was assessed by

Erin D. Bigler; Sherstin Mortensen; E. Shannon Neeley; Sally Ozonoff; Lori Krasny; Michael Johnson; Jeffrey Lu; Sherri L. Provencal; William McMahon; Janet E. Lainhart

2007-01-01

331

Superior mesenteric artery aneurysm stent graft  

Microsoft Academic Search

Visceral artery aneurysms represent 0.1% to 0.2% of all vascular aneurysms. They are mostly asymptomatic, but rupture is associated\\u000a with a high mortality rate. We present a case of an asymptomatic aneurysm of the proximal superior mesenteric artery in a\\u000a 64-year-old man that was successfully treated by implantation of a covered stent graft. The use of endovascular techniques\\u000a to manage

R. Drescher; O. Köster; T. von Rothenburg

2006-01-01

332

Reperfusion Hemorrhage Following Superior Mesenteric Artery Stenting  

SciTech Connect

Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

Moore, Michael; McSweeney, Sean [Cork University Hospital, Department of Radiology (Ireland); Fulton, Gregory [Cork University Hospital, Department of Vascular Surgery (Ireland); Buckley, John; Maher, Michael, E-mail: m.maher@ucc.ie; Guiney, Michael [Cork University Hospital, Department of Radiology (Ireland)

2008-07-15

333

Lightning activity during the 1999 Superior derecho  

Microsoft Academic Search

On 4 July 1999, a severe convective windstorm, known as a derecho, caused extensive damage to forested regions along the United States\\/Canada border, west of Lake Superior. There were 665,000 acres of forest destroyed in the Boundary Waters Canoe Area Wilderness (BWCAW) in Minnesota and Quetico Provincial Park in Canada, with approximately 12.5 million trees blown down. This storm resulted

Colin G. Price; Brian P. Murphy

2002-01-01

334

Laparoscopic Duodenojejunostomy for Superior Mesenteric Artery Syndrome  

PubMed Central

Background: Superior mesenteric artery (SMA) syndrome, also called Wilkie's syndrome, is a rare clinical phenomenon believed to be caused by compression of the third portion of the duodenum by the overlying superior mesenteric artery. We present the case of a 32-year-old female who presented with epigastric pain, weight loss, and vomiting. Methods: Her workup included a normal upper endoscopy as well as an abdominal CT scan and upper GI contrast study that confirmed the diagnosis of superior mesenteric artery syndrome. The patient was taken to the operating room and underwent successful treatment with laparoscopic duodenojejunostomy. Results: The patient achieved complete relief of her symptoms and is able to eat a regular diet without difficulty. SMA syndrome is a real anatomic clinical pathology resulting in chronic, consistent obstructive symptoms. An upper GI series and CT scan with contrast can confirm the diagnosis. Conclusion: Laparoscopic duodenojejunostomy should be considered the treatment of choice for these patients, because it offers a high likelihood of excellent outcome based on the current literature.

St. Peter, Shawn D.; Hughes, Jenevieve H.; Swain, James M.

2009-01-01

335

Gunther Tulip Inferior Vena Cava Filter Placement During Treatment for Deep Venous Thrombosis of the Lower Extremity  

SciTech Connect

Purpose. To evaluate the efficacy and safety of Gunther tulip retrievable vena cava filter (GTF) implantation to prevent pulmonary embolism during intravenously administered thrombolytic and anticoagulation therapy and interventional radiological therapy for occlusive or nonocclusive deep venous thrombosis (DVT) of the lower extremity. Methods. We evaluated placement of 55 GTFs in 42 patients with lower extremity DVT who had undergone various treatments including those utilizing techniques of interventional radiology. Results. Worsening of pulmonary embolism in patients with existing pulmonary embolism or in those without pulmonary embolism at the time of GTF insertion was avoided in all patients. All attempts at implantation of the GTF were safely accomplished. Perforation and migration experienced by one patient was the only complication. Mean period of treatment for DVT under protection from pulmonary embolism by the GTF was 12.7 {+-} 8.3 days (mean {+-} SD, range 4-37 days). We attempted retrieval of GTFs in 18 patients in whom the venous thrombus had disappeared after therapy, and retrieval in one of these 18 cases failed. GTFs were left in the vena cava in 24 patients for permanent use when the DVT was refractory to treatment. Conclusion. The ability of the GTF to protect against pulmonary embolism during treatment of DVT was demonstrated. Safety in both placement and retrieval was clarified. Because replacement with a permanent filter was not required, use of the GTF was convenient when further protection from complicated pulmonary embolism was necessary.

Yamagami, Takuji, E-mail: yamagami@koto.kpum.ac.jp; Kato, Takeharu; Iida, Shigeharu; Hirota, Tatsuya; Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology Graduate School of Medical Science (Japan)

2005-05-15

336

Improvising hepatic venous outflow and inferior vena cava reconstruction for combined heart and liver and sequential liver transplantations.  

PubMed

Liver transplantation is a standard treatment for patients with familial amyloidotic polyneuropathy (FAP) with disease progression. Given the multiorgan involvement by amyloidosis, the heart is often involved. When poor cardiac function becomes prohibitive to liver transplantation, a combined heart-liver transplantation (CHLT) is the only realistic treatment. This article records a CHLT for a patient with FAP whose removed liver was immediately transplanted as an amyloidotic hepatic allograft (AHA) to a patient having hepatocellular carcinoma and cirrhosis in a sequential liver transplantation. In the CHLT, the heart and liver are donated by a deceased donor. The newly implanted heart did not tolerate cross clamping of the inferior vena cava (IVC), so a side-to-side anastomosis was performed to connect the IVC and that of the liver graft. Therefore, the AHA was devoid of an IVC. The infrarenal cava procured from the deceased donor was used for reconstruction of the AHA to match a whole graft used in routine deceased-donor liver transplantation. Venoplasty was performed using the graft right hepatic vein and the middle and left hepatic vein stump to form a single cuff. The reconstructed AHA was implanted to the recipient conveniently like a usual whole graft. PMID:23522761

Chan, See Ching; Cheng, Lik Cheung; Ho, Ka Lai; Chok, Kenneth S H; Sharr, William W; Dai, Wing Chiu; Lo, Chung Mau

2012-10-12

337

Estimation of Right Atrial Pressure from the Inspiratory Collapse of the Inferior Vena cava in Pediatric Patients  

PubMed Central

Objective Paucity of data exists between mean right atrial pressure (RAP) and inferior vena cava (IVC) size and collapsibility in pediatric patients with congenital heart disease. Methods In a prospective study, fifty consecutive pediatric patients with different congenital heart diseases who had right side cardiac catheterization were studied, comparing right atrial pressure with simultaneous M-mode echocardiographic measurement of inferior vena cava diameter. Mean age of the patients was 4.96±4.05 years (30 male and 20 female). Patients were categorized into two groups according to their right atrial pressure (RAP) as measured by cardiac catheterization: Group 1 (40 patients) were those with mean RAP <8 mmHg and group 2 (10 patients) who had a mean RAP? 8 mmHg. Findings In M-mode echocardiography IVC size was statistically different (P=0.004 and 0.009) in inspiration and expiration in the two groups. Mean RAP was estimated to be>8 mmHg when IVC diameter in inspiration was >3.6 (sensitivity of 100%, specificity of 47.5%, +LR=1.9) or if IVC diameter was >6mm in expiration (sensitivity of 70%, specificity of 87%, +LR=4.67). Conclusion This study showed that measurement of IVC size in inspiration and expiration can be used as a reliable method for estimation of mean right atrial pressure.

Amoozgar, Hamid; Zare, Khobiar; Ajami, Gholamhossein; Borzoee, Mohammad

2010-01-01

338

Long-Term Results of Vena Cava Filters: Experiences with the LGM and the Titanium Greenfield Devices  

SciTech Connect

Purpose: Vena cava filter (VCF) application is the method of choice to prevent recurrent pulmonary embolism in patients with deep venous thrombosis. Because of the reported complications after VCF placement we summarize our long-term follow-up results with the LGM and Titanium Greenfield (TG) devices. Methods: Eighty-seven LGM VCF and 17 TG VCF were placed in 104 patients (average age 64 years). The follow-up examinations were performed by color-coded duplex sonography, plain radiographs, cavography, and computed tomo-graphy (CT). The maximum observation time was 81 months. Results: Filter migration occurred in 11% (8/76) of the LGM VCF and 15% (2/13) of the TG VCF. Vena cava thrombosis was seen in 17% (13/76) of the patients with an LGM VCF and in 31% (4/13) of those with a TG VCF. The patency rate was 95% (72/76) for the LGM VCF and 92% (12/13) for the TG VCF. Pulmonary embolism was noted in 3 patients after LGM VCF insertion and in no patient after TG VCF insertion. Conclusion: A VCF should only be inserted in a patient after pulmonary embolism and when there is strict proof of the indication.

Wittenberg, Guenther; Kueppers, Vera; Tschammler, Alexander [Institut fuer Roentgendiagnostik der Universitaet WuerzburgJosef-Schneider-Strasse 2, D-97080 Wuerzburg (Germany); Scheppach, Wolfgang [Medizinische Klinik der Universitaet Wuerzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg (Germany); Kenn, Werner; Hahn, Dietbert [Institut fuer Roentgendiagnostik der Universitaet WuerzburgJosef-Schneider-Strasse 2, D-97080 Wuerzburg (Germany)

1998-05-15

339

Physiologic Effect of Stent Therapy for Inferior Vena Cava Obstruction Due to Malignant Liver Tumor  

SciTech Connect

Purpose. To understand systemic the influence of stent therapy for inferior vena cava (IVC) obstruction due to advanced liver tumor. Methods. Seven patients with symptomatic IVC obstruction due to advanced primary (n 4) or secondary (n = 3) liver tumor were subjected to stent therapy. Enrollment criteria included high IVC pressure over 15 mmHg and the presence of edema and ascites. Z-stents were deployed using coaxial sheath technique via femoral venous puncture. Physiologic and hematobiochemical parameters were analyzed. Results. All procedures were successful, and the stents remained patent until patient death. Promptly after stent placement, the IVC flow recovered, and the venous blood pressure in the IVC below the obstruction level showed a significant decrease from 20.8 {+-} 1.2 mmHg (mean {+-} SE) to 10.7 {+-} 0.7 mmHg (p < 0.01). Transient mild increase of right atrial pressure was observed in 1 patient. During the following week prominent diuresis was observed in all patients. Mean urine output volume in the 3 days before the stent therapy was 0.81 {+-} 0.09 l/day compared with 2.1 {+-} 0.2 l/day (p < 0.01) in the 3 days after. The edema and ascites decreased in all patients. The caval pressure change correlated well (r > 0.6) with the urine volume increase, and with the decreased volume of edema and ascites. The urine volume increase correlated well with the decrement of edema, but not with that of ascites. Improvements for various durations in the levels of blood urea nitrogen, serum creatinine, lactate dehydrogenase, fibrinogen, and platelet count were found (p < 0.05). These hematobiochemical changes were well correlated with each other and with the decrement of ascites. Two patients showed a low blood sodium level of 128.5 mEq/l after intensive natriuresis, and one of them died on day 21 with hepatic failure, which was interpreted as maladaptation aggravation. The mean survival time was 94.1 {+-} 34.1 days (mean {+-} SD), ranging from 21 to 140 days after stent treatment. Conclusion. The stent therapy for IVC obstruction due to malignant liver tumors was followed by a series of physiologic and hematobiochemical consequences, most of them favorable but some possibly unfavorable. Rational interpretations and predictions of sequelae based on physiologic science including cardiology, hepatology, and nephrology would facilitate the best management of stent therapy for malignant IVC obstruction.

Kishi, Kazushi [Wakayama Medical University, Department of Radiology (Japan)], E-mail: kkishi@wakayama-med.ac.jp; Sonomura, Tetsuo [Kishiwada Tokushukai Hospital, Department of Radiology (Japan); Fujimoto, Hisashi [Wakayama Medical University, Department of Emergency and Critical Care Medicine (Japan); Kimura, Masashi; Yamada, Katsuya; Sato, Morio [Wakayama Medical University, Department of Radiology (Japan); Juri, Masanobu [Saiseikai Wakayama Hospital, Department of Surgery (Japan)

2006-02-15

340

'Recovery{sup TM}' Vena Cava Filter: Experience in 96 Patients  

SciTech Connect

The purpose of the study was to assess the clinical safety and efficacy of the 'Recovery{sup TM}' (Bard) inferior vena cava (IVC) filter. We retrospectively evaluated the clinical and imaging data of patients who had a 'Recovery{sup TM}' IVC filter placed between January 2003 and December 2004 in our institution. The clinical presentation, indications, and procedure-related complications during placement and retrieval were evaluated. Follow-up computed tomography (CT) examinations of the abdomen and chest were evaluated for filter-related complications and pulmonary embolism (PE), respectively. 'Recovery' filters were placed in 96 patients (72 males and 24 females; age range: 16-87 years; mean: 46 years). Twenty-four patients presented with PE, 13 with deep vein thrombosis (DVT) and 2 with both PE and DVT. The remaining 57 patients had no symptoms of thromboembolism. Indications for filter placement included contraindication to anticoagulation (n = 27), complication of anticoagulation (n = 3), failure of anticoagulation (n = 5), and prophylaxis (n = 61). The device was successfully deployed in the infrarenal (n = 95) or suprarenal (n = 1) IVC through a femoral vein approach. Retrieval was attempted in 11 patients after a mean period of 117 days (range: 24-426). The filter was successfully removed in nine patients (82%). Failure of retrieval was due to technical difficulty (n = 1) and the presence of thrombus in the filter (n = 1). One of the nine patients who had the filter removed developed IVC thrombus after retrieval and another had an intimal tear of the IVC. Follow-up abdominal CT (n = 40) at a mean of 80 days (range: 1-513) showed penetration of the IVC by the filter arms in 11, of which 3 had fracture of filter components. In one patient, a broken arm migrated into the pancreas. Asymmetric deployment of the filter legs was seen in 12 patients and thrombus within the filter in 2 patients. No filter migration or caval occlusion was encountered. Follow-up chest CT (n = 27) at a mean of 63 days (range: 1-386) showed PE in one patient (3%). During clinical follow-up, 12 of 96 patients developed symptoms of PE and only 1 of the 12 had PE on CT. There was no fatal pulmonary embolism in our group of patients following 'Recovery' filter placement. However, the current version of the filter is associated with structure weakness, a high incidence of IVC wall penetration, and asymmetric deployment of the filter legs.

Kalva, Sanjeeva P., E-mail: skalva@partners.org; Athanasoulis, Christos A.; Fan, C.-M.; Curvelo, Marcio; Geller, Stuart C.; Greenfield, Alan J.; Waltman, Arthur C.; Wicky, Stephan [Massachusetts General Hospital, Department of Radiology (United States)

2006-08-15

341

Use of Retrievable Compared to Permanent Inferior Vena Cava Filters: A Single-Institution Experience  

SciTech Connect

The purpose of this study was to review the use, safety, and efficacy of retrievable inferior vena cava (IVC) filters in their first 5 years of availability at our institution. Comparison was made with permanent filters placed in the same period. A retrospective review of IVC filter implantations was performed from September, 1999, to September, 2004, in our department. These included both retrievable and permanent filters. The Recovery nitinol and Guenther tulip filters were used as retrievable filters. The frequency of retrievable filter used was calculated. Clinical data and technical data related to filter placement were reviewed. Outcomes, including pulmonary embolism, complications associated with placement, retrieval, or indwelling, were calculated. During the study period, 604 IVC filters were placed. Of these, 97 retrievable filters (16%) were placed in 96 patients. There were 53 Recovery filter and 44 Tulip filter insertions. Subjects were 59 women and 37 men; the mean age was 52 years, with a range of from 18 to 97 years. The placement of retrievable filters increased from 2% in year 1 to 32% in year 5 of the study period. The total implantation time for the permanent group was 145,450 days, with an average of 288 days (range, 33-1811 days). For the retrievable group, the total implantation time was 21,671 days, with an average of 226 days (range, 2-1217 days). Of 29 patients who returned for filter retrieval, the filter was successfully removed in 28. There were 14 of 14 successful Tulip filter retrievals and 14 of 15 successful Recovery filter retrievals. In one patient, after an indwelling period of 39 days, a Recovery nitinol filter could not be removed secondary to a large clot burden within the filter. For the filters that were removed, the mean dwell time was 50 days for the Tulip type and 20 days for the Recovery type. Over the follow-up period there was an overall PE incidence of 1.4% for the permanent group and 1% for the retrieval group. In conclusion, there was an increase in the use of retrievable filters over the study period and an overall increase in the total number of filters implanted. The increased use of these filters appeared to be due to expanded indications predicated by their retrievability. Placement and retrieval of these filters have a low risk of complications, and retrievable filters appeared effective, as there was low rate of clinically significant pulmonary embolism associated with these filters during their indwelling time.

Ha, Thuong G. Van [University of Chicago, Department of Radiology, Section of Vascular and Interventional Radiology (United States)], E-mail: tgvanha@uchicago.edu; Chien, Andy S. [Pritzker School of Medicine, University of Chicago (United States); Funaki, Brian S.; Lorenz, Jonathan [University of Chicago, Department of Radiology, Section of Vascular and Interventional Radiology (United States); Piano, Giancarlo [University of Chicago, Department of Surgery (United States); Shen, Maxine [Pritzker School of Medicine, University of Chicago (United States); Leef, Jeffrey [University of Chicago, Department of Radiology, Section of Vascular and Interventional Radiology (United States)

2008-03-15

342

Complex Adaptive Special Operations (CASO).  

National Technical Information Service (NTIS)

Success in future war requires Special Operations Forces (SOF) to operate as a complex adaptive system. This paper offers a future operating concept called Complex Adaptive Special Operations (CASO), which incorporates the intrinsically unorthodox nature ...

P. R. Burns

2007-01-01

343

Unusual variant of scimitar syndrome associated with an absent right pulmonary artery, stenosis of the inferior vena cava, hemi-azygous continuation and the VACTERL association.  

PubMed

We report on a two-month-old infant with an unusual form of scimitar syndrome, associated with an absent right pulmonary artery, obstructed inferior vena cava, hemi-azygous continuation and the VACTERL association. The infant posed a major management problem and eventually died from a lower respiratory tract infection. PMID:23728126

Takawira, Farirai F; Omar, Fareed

2013-04-23

344

Congenital Absence of the Inferior Vena Cava and Genetic Coagulation Abnormalities: A Rare Associated Risk Factor for Recurrent Idiopathic Deep Vein Thrombosis  

Microsoft Academic Search

Congenital absence of the inferior vena cava (AIVC) has been reported as a risk factor of deep vein thrombosis (DVT) in young people. DVT is caused by an interaction between congenital coagulation abnormalities and acquired risk factors. We observed an 18-year-old patient with AIVC who developed recurrent deep vein thrombosis at the left leg. Molecular studies showed an etherozigousity for

Matteo Parma; Daniela Belotti; Sara Marinoni; Enrico Maria Pogliani

2003-01-01

345

Laparoscopic management of superior mesenteric artery syndrome.  

PubMed

Superior mesenteric artery syndrome (SMAS) is a rare clinical condition that should be considered in patients with long-standing abdominal complaints where endoscopic and conventional roentgenographical findings are often negative. It has been claimed that SMAS is caused by intermittent obstruction of the horizontal portion of the duodenum between the superior mesenteric artery and the spine and the aorta. The main target of this presentation is to present our experience in the laparoscopic management of 4 cases of documented SMAS after failure of medical treatment. The laparoscopic severing of the ligament of Treitz is a feasible and safe technique. It could bring about total relief of symptoms in three out of the four patients. The operative time rapidly decreased with the acquaintance of the field. The visualization (exposure) is quite satisfactory. the technique offers added precision and accuracy to the dissection manoeuvres. Recovery was uneventful and rapid with minimal needs for postoperative analgesia. We recommend the use of mini-endoshear (pediatric). Phases of dissection from the mesocolon and retro-pancreatically are presented. We stress the finding of the drainage of the inferior mesenteric vein into the superior mesenteric vein instead of the splenic vein. This could put the inferior mesenteric vein (looking as a fibrous band) in jeopardy. Also it reduces the area of access to the retropancreatic dissection. We raise the possibility of an etiological role of this anatomical variation to the duodenal compression and call upon the study of such a possibility. The importance to attain the proper retropancreatic space has been shown by the possibility of dissecting between the uncinate process and the rest of the pancreas. The psychological impact of a minimal invasive approach together with symptoms relief was quite rewarding. PMID:8740677

Massoud, W Z

346

Treatment of superior sulcus tumor (Pancoast tumor).  

PubMed

It appears that combined preoperative radiation and surgery continue to offer the best survival results in patients with superior sulcus tumors. Patients with involvement of the brachial plexus, Horner's syndrome, rib invasion, and ipsilateral neck node metastases are still candidates for combined modality therapy, with expectations of survival of about 30 to 40 per cent. However, those presenting with invasion of vertebrae, involvement of subclavian vessels, and mediastinal lymph node metastases do poorly. In this latter group, treatment by high-dose external radiation alone may prove to be as effective as combined modality treatment. PMID:3629433

Hilaris, B S; Martini, N; Wong, G Y; Nori, D

1987-10-01

347

Spontaneous Dissection of the Superior Mesenteric Artery  

SciTech Connect

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection [1]. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of SMA dissection [2-5]. We present two recent cases of spontaneous SMA dissection in which enhanced spiral CT was instrumental in following the disease process and guiding clinical decision making.

Sheldon, Patrick J. [Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States); Esther, James B. [Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, CC308E, One Deaconess Road, Boston, MA 02215 (United States); Sheldon, Elana L. [Department of Medicine, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States); Sparks, Steven R. [Department of Surgery, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States); Brophy, David P. [Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, CC308E, One Deaconess Road, Boston, MA 02215 (United States); Oglevie, Steven B. [Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States)

2001-09-15

348

Superior labrum anterior-to-posterior tear.  

PubMed

The patient was a 25-year-old male college student with a chief complaint of right shoulder pain. The patient was initially diagnosed with bicipital tendinitis by his physician and had been treated for 4 weeks by a physical therapist. However, his symptoms did not improve and he was unable to return to his preinjury activity levels, so he sought the services of another physical therapist for a second opinion. Due to concern for a labrum tear, the physical therapist referred the patient to an orthopaedic surgeon. Magnetic resonance arthrography revealed findings consistent with a superior labrum anterior-to-posterior tear. PMID:23202247

Sum, Jonathan C; Omid, Reza

2012-11-30

349

Laparoscopic Duodenojejunostomy for Superior Mesenteric Artery Syndrome  

PubMed Central

Background: Superior mesenteric artery (Wilkie's) syndrome is a rare condition. Only 400 cases have been reported so far. The symptoms may be acute or chronic, the chronic form being more common. Vomiting is the most common symptom. About 15 causal factors have been found. Conservative management is the rule for acute cases. Surgery is indicated for chronic cases and failure of conservative management. Laparoscopy has been used in only 8 cases so far. Case Report: We report the ninth case of superior mesenteric artery syndrome managed by laparoscopic duodenojejunostomy. The patient was a 14-year-old boy with chronic symptoms since childhood. The procedure was relatively straightforward. The case is being reported for its rarity and the possibility of laparoscopic management. Discussion: Laparoscopic severing of Treitz's ligament is another surgical option, though gastrojejunostomy is of no use. Conservative management is useful only in acute cases. Conclusion: Duodenojejunostomy is the procedure of choice and is effective in 90% of patients. We conclude that it is very effective in this condition, especially laparoscopically.

Palanivelu, Chinnusamy; Senthilkumar, Rangaswamy; Parthasarathi, Ramakrishnan; Jani, Kalpesh

2006-01-01

350

2. GREAT NORTHERN ELEVATORS (STEEL) 1900 SUPERIOR WISCONSIN; ANNEX NO. ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. GREAT NORTHERN ELEVATORS (STEEL) 1900 SUPERIOR WISCONSIN; ANNEX NO. 3 (LEFT) ANNEX NO. 1 (RIGHT) 1920'S; CONVEYOR LINE LEADS TO ELEVATOR X. - Great Northern Elevator "S", Saint Louis Bay, Superior, Douglas County, WI

351

Abnormal Response of Superior Sinoatrial Node to Sympathetic Stimulation Is a Characteristic Finding in Patients With Atrial Fibrillation and Symptomatic Bradycardia  

PubMed Central

Background We hypothesize that unresponsiveness of superior sinoatrial node (SAN) to sympathetic stimulation is strongly associated with the development of symptomatic bradycardia in patients with atrial fibrillation (AF). Methods and Results We performed 3-dimensional endocardial mapping in healthy control (Group 1, n=10) and in patients with AF without (Group 2, n=57) or with (Group 3, n=15) symptomatic bradycardia at baseline and during isoproterenol infusion. Corrected SAN recovery time was abnormal in 0%, 11% and 36% of groups 1, 2 and 3, respectively (p=0.02). At baseline, 90%, 26% and 7% (p<0.001) of the patients had multicentric SAN activation patterns. For groups 1, 2 and 3, respectively, the median distance from the superior vena cava-right atrial junction to the most cranial earliest activation site (EAS) was 5.0 (25–75 percentile range, 3.5–21.3) mm, 10.0 (4–20) mm and 17.5 (12–34) mm at baseline (p=0.01), and was 4.0 (0–5) mm, 5.0 (1–10) mm and 15.0 (5.4–33.3) mm during isoproterenol infusion (p=0.01), suggesting upward shift of EAS during isoproterenol infusion. However, while the EAS during isoproterenol infusion was at the upper 1/3 of crista terminalis in 100% of Group 1 and 78% of Group 2 patients, only 20% of the groups 3 patients moved EAS to that region (p < 0.001). Conclusions Superior SAN serves as the EAS during sympathetic stimulation in normal patients and in most patients with AF without symptomatic bradycardia. In contrast, unresponsiveness of superior SAN to sympathetic stimulation is a characteristic finding in patients with AF and symptomatic bradycardia.

Joung, Boyoung; Hwang, Hye Jin; Pak, Hui-Nam; Lee, Moon-Hyoung; Shen, Changyu; Lin, Shien-Fong; Chen, Peng-Sheng

2011-01-01

352

Hepatobiliary resection with concomitant resection of the inferior vena cava for advanced intrahepatic cholangiocarcinoma: report of a case.  

PubMed

A 65-year-old female was diagnosed with intrahepatic cholangiocarcinoma involving the inferior vena cava (IVC). The patient underwent right trisectionectomy and caudate lobectomy with bile duct resection and concomitant resection of the IVC. The IVC was reconstructed using the right external iliac vein. Histologically, the tumor had invaded the IVC. Despite the administration of postoperative prophylactic anticoagulant therapy, IVC thrombosis developed, probably due to the difference in diameter between the IVC and the graft. Following the development of collateral vessels, the patient was discharged and is now healthy without recurrence 18 months after surgery. IVC reconstruction using an external iliac vein graft may lead to the development of IVC thrombosis. Therefore, the graft used for IVC reconstruction should be very carefully selected. PMID:22961194

Nakagawa, Akifumi; Igami, Tsuyoshi; Sugawara, Gen; Ebata, Tomoki; Yokoyama, Yukihiro; Takahashi, Yu; Ando, Harumitsu; Nagino, Masato

2012-09-09

353

Intrahepatic venous collaterals forming via the inferior right hepatic vein in 3 patients with obstruction of the inferior vena cava  

SciTech Connect

When the inferior vena cava is obstructed, collateral veins enlarge, connecting with the inferior (acessory) right hepatic vein (IRHV) and thence through various hepatic veins to the right atrium. Three such cases are described. In one patient, most contrast material flowed into the IRHV and from there to the left hepatic vein. The second patient had several large collaterals arising from the IRHV and flowing into the right and middle hepatic veins, while the third patient demonstrated anastomoses between the IRHV and the middle hepatic vein. All of these hepatic venous shunts eventually drained into the right atrium. There were no clinical manifestations such as ascites, edema, or dilatation of the abdominal veins. Cavography alone or combined with computed tomography proved to be diagnostic in the assessment of these intrahepatic collaterals.

Takayasu, K.; Moriyama, N.; Muramatsu, Y.; Goto, H.; Shima, Y.; Yamada, T.; Makuuchi, M.; Yamasaki, S.; Hasegawa, H.; Hojo, K.

1985-02-01

354

Extensive venous thrombosis in a healthy young man with a short inferior vena cava syndrome treated successfully with rivaroxaban.  

PubMed

We report a case of an incidental finding of congenital absence of the intrahepatic segment of the inferior vena cava (IVC) complicated by extensive bilateral deep venous thrombosis (DVT) with significant oedema following a long-distance road trip. Initially the patient failed treatment with standard anticoagulation therapy with enoxaparin and warfarin. However, he has responded to the new oral antifactor-Xa anticoagulant (rivaroxaban). Within a few days, rivaroxaban improved the oedema and DVT. The significant features of this case are the unusual presentation, the poor response to initial standard anticoagulation therapy and the beneficial outcomes when managed with the novel new anticoagulant. The patient has continued the new treatment regularly for the last 12 months with good toleration and without side effects. This report presents the findings, management and outcomes in a case of extensive bilateral DVT in a previously healthy young man who was found to have a congenital short IVC. PMID:23162029

Khalafallah, Alhossain A; Renu, Shamsunnaher; Sharp, Colin; Hannan, Terry

2012-11-15

355

CT-Guided Percutaneous Fine-Needle Aspiration Biopsy of the Inferior Vena Cava Wall: A Posterior Coaxial Approach  

SciTech Connect

A 72-year-old man was referred to our department with an incidentally diagnosed bronchogenic carcinoma of the right upper lobe. Positron emission tomography (PET) combined with computed tomography (PET-CT) revealed an unexpected hot spot in the ventral wall of the infrarenal segment of the inferior vena cava (IVC). Diagnostic biopsy of this lesion was performed under CT guidance with semiautomated 20G fine-needle aspiration (FNA) through a 19G coaxial needle. Cytology revealed few carcinoma cells, which led to the remarkable diagnosis of a distant metastasis to the IVC wall. Both the immediate postinterventional CT control and the further surveillance period of the patient were unremarkable; in particular, no signs of bleeding complications were detected. We conclude that coaxial FNA of an IVC wall lesion is technically feasible and may even help diagnose distant metastasis.

Kos, Sebastian, E-mail: skos@gmx.de; Bilecen, Deniz [University Hospital Basel, Institute of Radiology (Switzerland); Baumhoer, Daniel [University Hospital Basel, Institute of Pathology (Switzerland); Guillaume, Nicolas [University Hospital Basel, Institute of Nuclear Medicine (Switzerland); Jacob, Augustinus L. [University Hospital Basel, Institute of Radiology (Switzerland)

2010-02-15

356

Collateral pathways observed by radionuclide superior cavography in 70 patients with superior vena caval obstruction.  

PubMed

Schematic representations of collateral pathways that have developed in association with superior vena caval obstruction have been established in studies using radionuclide superior cavography (RNSC). However, these were hampered by the poor resolution of earlier scintillation cameras. Using a modern scintillation camera, we performed RNSC in 70 patients with obstruction of the superior vena caval system, and examined the differences in collateral pathways in the presence or absence of obstruction of the azygos vein. RNSC visualized the site of obstruction and collateral pathways far more readily than in prior studies. When the orifice of the azygos vein was not obstructed, collateral flow drained into the azygos system. When it was obstructed, however, the collaterals drained into the inferior vena caval system. An important collateral pathway comprising the contralateral brachiocephalic vein and the jugular venous arch was also found, which has not previously been reported. Our diagrams of collateral circulation may provide a means of determining the site of obstruction in the superior vena caval system by RNSC. PMID:1647285

Muramatsu, T; Miyamae, T; Dohi, Y

1991-05-01

357

Organization of the human superior olivary complex.  

PubMed

The distinctive morphology of the human superior olivary complex reflects its primate origins, but functional evidence suggests that it plays a role in auditory spatial mapping which is similar to olivary function in other mammalian species. It seems likely that the well-developed human medial olivary nucleus is the basis for extraction of interaural time and phase differences. The much smaller human lateral olivary nucleus probably functions in analysis of interaural differences in frequency and intensity, but the absence of a human nucleus of the trapezoid body implies some difference in the mechanisms of this function. A window on human olivary function is provided by the evoked auditory brainstem response (ABR), including its binaural interaction component (BIC). Anatomical, electrophysiological, and histopathological studies suggest that ABR waves IV and V are generated by axonal pathways at the level of the superior olivary complex. Periolivary cell groups are prominent in the human olivary complex. The cell groups located medial, lateral, and dorsal are similar to periolivary nuclei of other mammals, but the periolivary nucleus at the rostral pole of the human olivary complex is very large by mammalian standards. Within the periolivary system, immunostaining for neurotransmitter-related substances allows us to identify populations of medial and lateral olivocochlear neurons. The human olivocochlear system is unique among mammals in the relatively small size of its lateral efferent component. Some consideration is given to the idea that the integration provided by periolivary cell groups, particularly modulation of the periphery by the olivocochlear system, is an extension of the spatial mapping function of the main olivary nuclei. PMID:11071722

Moore, J K

2000-11-15

358

Protective efficacy of an Ecklonia cava extract used to treat transient focal ischemia of the rat brain.  

PubMed

Phlorotannins (marine algal polyphenols) have been reported to exhibit beneficial biological activities, serving as both antioxidants and anti-inflammatory agents. Among marine algae, Ecklonia cava, a member of the Laminariaceae, is a very popular food regarded as healthy in Korea and Japan. Recently, benefits afforded by phlorotannins in the treatment of various clinical conditions have been reported, but any therapeutic effects of such materials in the treatment of neurodegenerative diseases such as stroke remain unclear. Also, the mechanisms of action of the algal components remain poorly understood. In the present in vivo study, administration of Ecklonia cava polyphenols (ECP) at 10 mg/kg and 50 mg/kg intraperitoneally (i.p.) significantly decreased infarct size and the extent of brain edema in the rat after induction of transient focal ischemia via middle cerebral artery occlusion (MCAO). Further, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay revealed dose-dependent blockage of neuronal apoptosis upon intravenous ECP treatment. Neurobehavioral tests performed over the 6 days after MCAO revealed a reduction in neurological motor performance in control animals, but administration of ECP (50 mg/kg i.p.) prevented this decline. In vitro, a significant neuroprotective effect of ECP was evident when cell viability was assayed after induction of H(2)O(2)-mediated oxidative stress, upon retinoic acid treatment, in the differentiated neuroblastoma cell line SH-SY5Y. Interestingly, ECP blocked the rise in cytosolic calcium, in a dose-dependent manner, in differentiated SH-SY5Y cells exposed to H(2)O(2). Together, the results suggest that ECP exerts neuroprotective effects in the focally ischemic brain by reducing Ca(2+)-mediated neurotoxicity. PMID:22822465

Kim, Jeong Hwan; Lee, Nam Seob; Jeong, Yeong Gil; Lee, Je-Hun; Kim, Eun Ji; Han, Seung Yun

2012-06-30

359

[Unilateral congenital ptosis with ipsilateral superior rectus muscle overaction].  

PubMed

Congenital ptosis may be frequently accompanied by weakness of the ipsilateral superior rectus muscle. We report a case of ptosis with ipsilateral superior rectus muscle overaction. The 45-year-old patient presented with unilateral congenital ptosis. Ipsilateral superior rectus muscle overaction was found in the upgaze, with an inferior sclera show. This can be found in 40% of congenital ptosis. The authors give two possible causes: either an exaggerated Bell reflex or misdirection innervations of the superior rectus muscle by the superior division of the oculomotor nerve, initially innervating the upper eyelid elevator muscle. Histological or electrophysiological studies can be useful to determine the physiopathology of this association. PMID:21665327

Ben Rayana, N; Knani, L; Touzani, F; Ben Hadj Hamida, F

2011-06-12

360

Extended deep vein and inferior vena cava thrombosis in a 15-year-old boy: successful lysis with recombinant tissue-type plasminogen activator 2 weeks after onset of symptoms.  

PubMed

We present the case of a 15-year-old boy with thrombosis of the inferior vena cava, the femoral, inguinal, and renal veins of unknown origin. Although the thrombosis was 2 weeks old, thrombolytic therapy with recombinant tissue-type plasminogen activator (maximum dosage: 0.4 mg/kg/h) was started as this appeared to be the only change to re-establish normal kidney function. After 1 week, treatment was discontinued because of generalized bleeding. At this time, the infrarenal inferior vena cava was again patent with complete lysis of all other clots. Phlebography 3 months after lysis documented an abnormal renal vein, a tubular, subhepatical stenosis of the inferior vena cava and a large collateral vessel between the inferior vena cava and the azygos vein. PMID:8131815

Rosenbaum, T; Rammos, S; Kniemeyer, H W; Göbel, U

1993-12-01

361

Complex Adaptive System of Systems (CASoS) Engineering Applications Version 1.0.  

National Technical Information Service (NTIS)

Complex Adaptive Systems of Systems, or CASoS, are vastly complex eco-socio-economic-technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching ...

A. L. Ames J. M. Linebarger R. J. Glass S. L. Maffitt T. J. Brown W. E. Beyeler

2011-01-01

362

Transmastoid repair of superior semicircular canal dehiscence.  

PubMed

Objective/Hypothesis?Superior semicircular canal (Sup SC) dehiscence syndrome is a rare condition, causing a variety of auditory and vestibular symptoms. The traditional surgical management is a middle cranial fossa, extradural approach to resurface the Sup SC. Recently, a transmastoid approach for plugging of the Sup SC has been developed. We present further data supporting the use of the transmastoid approach in preference to the middle fossa approach. Design?This is a retrospective multi-institutional case series. Method?We included 10 patients in this case series from two tertiary otology institutions. Sup SC dehiscence was confirmed by correlation of clinical symptoms with positive audiometric, vestibular evoked myogenic potential, and computed tomography findings. A transmastoid approach was used for plugging of the Sup SC. Either a single fenestration was created at the site of dehiscence or separate fenestrations sited ampullopetal and ampullofugal to the dehiscence. Results?All patients who underwent this procedure had good symptom control and hearing preservation postoperatively. Conclusion?In patients with adequate temporal bone pneumatization, the transmastoid approach provides a safe and effective alternative to the middle cranial fossa approach. This series has demonstrated excellent symptom control and preservation of hearing with the transmastoid approach. PMID:23904997

Zhao, Yi Chen; Somers, Thomas; van Dinther, Joost; Vanspauwen, Robby; Husseman, Jacob; Briggs, Robert

2012-08-01

363

Superior wear resistance of aggregated diamond nanorods.  

PubMed

The hardness of single-crystal diamond is superior to all other known materials, but its performance as a superabrasive is limited because of its low wear resistance. This is the consequence of diamond's low thermal stability (it graphitizes at elevated temperature), low fracture toughness (it tends to cleave preferentially along the octahedral (111) crystal plains), and large directional effect in polishing (some directions appear to be "soft", i.e., easy to abrade, because diamond is anisotropic in many of its physical properties). Here we report the results of measurements of mechanical properties (hardness, fracture toughness, and Young's modulus) of aggregated diamond nanorods (ADNRs) synthesized as a bulk sample. Our investigation has shown that this nanocrystalline material has the fracture toughness 11.1 +/- 1.2 MPa.m(0.5), which exceeds that of natural and synthetic diamond (that varies from 3.4 to 5.0 MPa.m(0.5)) by 2-3 times. At the same time, having a hardness and Young's modulus comparable to that of natural diamond and suppressed because of the random orientation of nanorods "soft" directions, ADNR samples show the enhancement of wear resistance up to 300% in comparison with commercially available polycrystalline diamonds (PCDs). This makes ADNRs extremely prospective materials for applications as superabrasives. PMID:16608291

Dubrovinskaia, Natalia; Dub, Sergey; Dubrovinsky, Leonid

2006-04-01

364

[Isotonic contraction of rabbit superior rectus muscle].  

PubMed

It is well known that the mammalian extraocular muscle has slow muscle fiber morphologically. But the contraction speed of slow muscle fiber has not been mentioned in previous reports. We studied the isotonic contraction of slow muscle fiber and compared it with fast muscle fiber. Each fiber bundle was isolated from the rabbit superior rectus muscle. Both light microscopic findings and the reaction to isotonic contraction in Ca2+ free Ringer's solution could identify each of the two muscle fiber types. Contraction speed depended on the frequency of stimuli (40-200 Hz) in both slow and fast muscle fiber. Maximum velocities of slow and fast fiber bundles were 4.3 +/- 1.53 mm/sec and 26.9 +/- 3.48mm/sec at 200Hz, respectively. It was suggested that the relaxation of slow muscle fiber did not interfere with the contraction of the fast muscle fiber. The relation between contraction velocity and afterload showed an approximately right angle hyperbolic curve. PMID:2248162

Umemoto, T; Sawa, M; Ohyachi, H; Takeda, M; Matsuda, S; Hasegawa, I

1990-09-01

365

Superior colliculus lesions preferentially disrupt multisensory orientation.  

PubMed

The general involvement of the superior colliculus (SC) in orientation behavior and the striking parallels between the multisensory responses of SC neurons and overt orientation behaviors have led to assumptions that these neural and behavioral changes are directly linked. However, deactivation of two areas of cortex which also contain multisensory neurons, the anterior ectosylvian sulcus and rostral lateral suprasylvian sulcus have been shown to eliminate multisensory orientation behaviors, suggesting that this behavior may not involve the SC. To determine whether the SC contributes to this behavior, cats were tested in a multisensory (i.e. visual-auditory) orientation task before and after excitotoxic lesions of the SC. For unilateral SC lesions, modality-specific (i.e. visual or auditory) orientation behaviors had returned to pre-lesion levels after several weeks of recovery. In contrast, the enhancements and depressions in behavior normally seen with multisensory stimuli were severely compromised in the contralesional hemifield. No recovery of these behaviors was observed within the 6 month testing period. Immunohistochemical labeling of the SC revealed a preferential loss of parvalbumin-immunoreactive pyramidal neurons in the intermediate layers, a presumptive multisensory population that targets premotor areas of the brainstem and spinal cord. These results highlight the importance of the SC for multisensory behaviors, and suggest that the multisensory orientation deficits produced by cortical lesions are a result of the loss of cortical influences on multisensory SC neurons. PMID:14980725

Burnett, L R; Stein, B E; Chaponis, D; Wallace, M T

2004-01-01

366

INADEQUAÇÃO ERGONÔMICA E DESCONFORTO DAS SALAS DE AULA EM INSTITUIÇÃO DE ENSINO SUPERIOR DO RECIFE-PE Classrooms' ergonomic inadequacy and discomfort at a private academic institution in Recife-PE  

Microsoft Academic Search

RESUMO Objetivos: Verificar a adequação ergonômica das salas de aula e o nível de conforto atribuído pelos alunos ao ambiente escolar de uma instituição privada de ensino superior na cidade de Recife, Pernambuco. Métodos: Estudo de série de casos, transversal e descritivo, realizado de agosto a dezembro de 2006, tendo como população os alunos matriculados nos seguintes cursos: Fisioterapia, Direito,

Gisela Rocha de Siqueira; Aline Bezerra de Oliveira; Ricardo Alexandre Guerra

2008-01-01

367

[Radical nephrectomy and thrombectomy in patients with renal cell cancer complicated by tumoral thrombosis of the renal vein and vena cava inferior].  

PubMed

Surgical treatment was conducted in 81 patients, suffering renocellular cancer (RCC), complicated by a renal vein and vena cava inferior thrombosis. According to the Mayo clinic classification, the level of a tumoral thrombus spread was established: the 0 level--in 37 patients, the level I--in 19, the level II--in 17, the level III --in 6, and the level IV--in 2. There were substantiated the optimal surgical accesses and technique of radical nephrectomy and thrombectomy for RCC, complicated by a renal vein and vena cava inferior thrombosis. It is recommended to apply transabdominal accesses: the extended median laparotomic, bilateral subcostal of a "Chevron" or "Mercedes" type. There was shown, that the access choice depends on the level of the tumoral thrombus localization. PMID:23610939

Rusyn, V I; Korsak, V V; Rusyn, A V; Bo?ko, S O

2013-01-01

368

Changes in gut and liver glucose, lactate, insulin, and oxygen flux in mature ewes during mesenteric or abdominal vena cava glucose infusion.  

PubMed

The objective of the study was to determine whether exogenous glucose infusion affects endogenous glucose production in ewes. Mature ewes with catheters placed in the abdominal aorta, two mesenteric veins, the hepatic portal vein and the hepatic vein were used to determine the effect of exogenous glucose infusion on net glucose, insulin, lactate and oxygen flux by the portal-drained viscera (PDV) and liver of conscious sheep. Net hepatic glucose release was determined, and glucose was subsequently infused into either a mesenteric vein or an abdominal vena cava at an equal rate (mmol/L) for 240 min, and net fluxes were determined every 30 min. Arterial concentrations of glucose and insulin increased over time, whereas lactate concentration decreased over time (P < 0.05). Hepatic glucose release decreased linearly over time when glucose was infused into the mesenteric vein (P = 0.03) and tended to decrease linearly when glucose was infused into the abdominal vena cava (P = 0.06). Net PDV and splanchnic plasma insulin release during the vena cava infusion increased linearly over time (P < 0.02). Net PDV blood lactate release did not differ between infusion sites (P = 0.75), nor did the release rate change over time (P > 0.10). Net splanchnic lactate release in the abdominal vena++ cava infusion, however, did decrease over time (P = 0.05). Net hepatic oxygen consumption decreased quadratically over time (P = 0.004) when glucose was infused into the mesenteric vein. In conclusion, infusion of glucose results in a decrease in hepatic glucose production. PMID:8613896

Freetly, H C; Klindt, J

1996-04-01

369

Antioxidant activities of phlorotannins purified from Ecklonia cava on free radical scavenging using ESR and H 2 O 2 -mediated DNA damage  

Microsoft Academic Search

The potential antioxidant activities of three phlorotannins (phloroglucinol, eckol and dieckol) purified from Ecklonia cava collected in Jeju Island were investigated to evaluate their potential value as the natural products for foods or cosmetic\\u000a application. In this study, antioxidant activities were measured by electron spin resonance spectrometry (ESR) technique for\\u000a scavenging effects of free radicals such as 1,1-diphenyl-2-picrylhydrazyl (DPPH), alkyl,

Gin-Nae Ahn; Kil-Nam Kim; Seon-Heui Cha; Choon-Bok Song; Jehee Lee; Moon-Soo Heo; In-Kyu Yeo; Nam-Ho Lee; Young-Heun Jee; Jin-Soo Kim; Min-Soo Heu; You-Jin Jeon

2007-01-01

370

Surgical Treatment of Inferior Vena Cava Invasion in Patients with Renal Pelvis Transitional Cell Carcinoma by Use of Human Cadaveric Aorta  

PubMed Central

We herein report a case of radical nephroureterectomy and replacement of the inferior vena cava (IVC) with ahuman cadaveric aortic graft for a patient with renal pelvis transitional cell carcinoma associated with IVC infiltration. In advanced disease, radical surgery is essential to achieve long-term survival. This case entails the use of another treatment option among the numerous options currently available for the management of patients with advanced renal cancer associated with IVC invasion.

Nam, Jong Kil; Moon, Ki Myung; Park, Sung Woo

2012-01-01

371

Receptor-mediated effects of serotonin and 5-methoxytryptamine on noradrenaline release in the rat vena cava and in the heart of the pithed rat  

Microsoft Academic Search

In segments of the rat inferior vena cava preincubated with 3H-noradrenaline, it was examined whether presynaptic serotonin (5-HT) receptors exist on the postganglionic sympathetic nerves of the circulatory system; for this purpose the effects of 5-HT receptor agonists and antagonists on the electrically evoked 3H overflow were studied. Furthermore, vagotomized pithed rats (treated with atropine and captopril) were used to

M. Göthert; E. Schlicker; P. Kollecker

1986-01-01

372

Multi-Objective Lake Superior Regulation  

NASA Astrophysics Data System (ADS)

At the direction of the International Joint Commission (IJC) the International Upper Great Lakes Study (IUGLS) Board is investigating possible changes to the present method of regulating the outflows of Lake Superior (SUP) to better meet the contemporary needs of the stakeholders. In this study, a new plan in the form of a rule curve that is directly interpretable for regulation of SUP is proposed. The proposed rule curve has 18 parameters that should be optimized. The IUGLS Board is also interested in a regulation strategy that considers potential effects of climate uncertainty. Therefore, the quality of the rule curve is assessed simultaneously for multiple supply sequences that represent various future climate scenarios. The rule curve parameters are obtained by solving a computationally intensive bi-objective simulation-optimization problem that maximizes the total increase in navigation and hydropower benefits of the new regulation plan and minimizes the sum of all normalized constraint violations. The objective and constraint values are obtained from a Microsoft Excel based Shared Vision Model (SVM) that compares any new SUP regulation plan with the current regulation policy. The underlying optimization problem is solved by a recently developed, highly efficient multi-objective optimization algorithm called Pareto Archived Dynamically Dimensioned Search (PA-DDS). To further improve the computational efficiency of the simulation-optimization problem, the model pre-emption strategy is used in a novel way to avoid the complete evaluation of regulation plans with low quality in both objectives. Results show that the generated rule curve is robust and typically more reliable when facing unpredictable climate conditions compared to other SUP regulation plans.

Asadzadeh, M.; Razavi, S.; Tolson, B.

2011-12-01

373

The detection of renal carcinoma extension into the renal vein and inferior vena cava: a prospective comparison of venacavography and magnetic resonance imaging.  

PubMed

Accurate preoperative evaluation of the inferior vena cava and renal vein in patients with renal cell carcinoma is mandatory to plan a successful surgical approach. The presence of venous extension may alter transfusion and anesthetic requirements, as well as require the addition of a vascular surgeon to the operative team. Venacavography traditionally has been considered the most reliable method to identify tumor thrombus, although magnetic resonance imaging has been proposed as a possible noninvasive alternative. We compared prospectively the accuracy of these 2 methods in 44 consecutive patients with renal cell carcinoma who subsequently underwent nephrectomy. Of the 44 patients 11 (25%) had tumor extension into the inferior vena cava and 17 (39%) had involvement of the renal vein at operation. Venacavography and magnetic resonance imaging correctly identified 9 of the 11 patients (82%) with inferior vena caval thrombus. When the results of both tests were combined, all 11 cases of vena caval extension were identified. Venacavography was slightly more sensitive (71%) in identifying the presence of renal vein thrombus than magnetic resonance imaging (65%) but these differences were not statistically significant. Magnetic resonance imaging better localized the thrombus within the renal vein. We conclude that venacavography and magnetic resonance imaging offer equal diagnostic accuracy in the identification of venous extension of renal cell carcinoma. The combination of both tests results in higher diagnostic yield than either test alone. Neither test by itself is reliable in the presence of a large, bulky adenopathic lesion that compresses the inferior vena cava. PMID:2795748

Horan, J J; Robertson, C N; Choyke, P L; Frank, J A; Miller, D L; Pass, H I; Linehan, W M

1989-10-01

374

Complex Adaptive Systems of Systems (CASoS) engineering and foundations for global design.  

SciTech Connect

Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which must be recognized and reckoned with to design a secure future for the nation and the world. Design within CASoS requires the fostering of a new discipline, CASoS Engineering, and the building of capability to support it. Towards this primary objective, we created the Phoenix Pilot as a crucible from which systemization of the new discipline could emerge. Using a wide range of applications, Phoenix has begun building both theoretical foundations and capability for: the integration of Applications to continuously build common understanding and capability; a Framework for defining problems, designing and testing solutions, and actualizing these solutions within the CASoS of interest; and an engineering Environment required for 'the doing' of CASoS Engineering. In a secondary objective, we applied CASoS Engineering principles to begin to build a foundation for design in context of Global CASoS

Brodsky, Nancy S.; Finley, Patrick D.; Beyeler, Walter Eugene; Brown, Theresa Jean; Linebarger, John Michael; Moore, Thomas W.; Glass, Robert John, Jr.; Maffitt, S. Louise; Mitchell, Michael David; Ames, Arlo Leroy

2012-01-01

375

Complex Adaptive System of Systems (CASoS) Engineering Applications. Version 1.0.  

SciTech Connect

Complex Adaptive Systems of Systems, or CASoS, are vastly complex eco-socio-economic-technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to highly-saturated interdependencies and allied vulnerabilities to cascades in associated systems. The Phoenix initiative approaches this high-impact problem space as engineers, devising interventions (problem solutions) that influence CASoS to achieve specific aspirations. CASoS embody the world's biggest problems and greatest opportunities: applications to real world problems are the driving force of our effort. We are developing engineering theory and practice together to create a discipline that is grounded in reality, extends our understanding of how CASoS behave, and allows us to better control those behaviors. Through application to real-world problems, Phoenix is evolving CASoS Engineering principles while growing a community of practice and the CASoS engineers to populate it.

Linebarger, John Michael; Maffitt, S. Louise (New Mexico Institute of Mining and Technology, Albuquerque, NM); Glass, Robert John, Jr.; Beyeler, Walter Eugene; Brown, Theresa Jean; Ames, Arlo Leroy

2011-10-01

376

Phoenix : Complex Adaptive System of Systems (CASoS) engineering version 1.0.  

SciTech Connect

Complex Adaptive Systems of Systems, or CASoS, are vastly complex ecological, sociological, economic and/or technical systems which we must understand to design a secure future for the nation and the world. Perturbations/disruptions in CASoS have the potential for far-reaching effects due to pervasive interdependencies and attendant vulnerabilities to cascades in associated systems. Phoenix was initiated to address this high-impact problem space as engineers. Our overarching goals are maximizing security, maximizing health, and minimizing risk. We design interventions, or problem solutions, that influence CASoS to achieve specific aspirations. Through application to real-world problems, Phoenix is evolving the principles and discipline of CASoS Engineering while growing a community of practice and the CASoS engineers to populate it. Both grounded in reality and working to extend our understanding and control of that reality, Phoenix is at the same time a solution within a CASoS and a CASoS itself.

Moore, Thomas W.; Quach, Tu-Thach; Detry, Richard Joseph; Conrad, Stephen Hamilton; Kelic, Andjelka; Starks, Shirley J.; Beyeler, Walter Eugene; Brodsky, Nancy S.; Verzi, Stephen J.; Brown, Theresa Jean; Glass, Robert John, Jr.; Sunderland, Daniel J.; Mitchell, Michael David; Ames, Arlo Leroy; Maffitt, S. Louise; Finley, Patrick D.; Russell, Eric Dean; Zagonel, Aldo A.; Reedy, Geoffrey E.; Mitchell, Roger A.; Corbet, Thomas Frank, Jr.; Linebarger, John Michael

2011-08-01

377

Word superiority, pseudoword superiority, and learning to read: a comparison of dyslexic and normal readers.  

PubMed

Identification of letters embedded in briefly presented words (e.g., TABLE), pseudowords (e.g., TOBLE), and illegal nonwords (e.g., TPBFE) was measured using the Reicher-Wheeler paradigm. Children diagnosed as dyslexic and showing a clear disadvantage in recognizing and reading aloud words and pseudowords (compared to chronological age-matched controls) showed a pattern of results that was qualitatively identical to both reading age and chronological age control children. In all three groups a small nonsignificant advantage was obtained for letter identification in words compared to pseudowords, and a massive advantage for letter identification in pseudowords compared to illegal nonwords. A group of adult participants tested with the same materials showed the classic word superiority effect as well as a pseudoword advantage over illegal nonwords. These results suggest that the pseudoword superiority effect is subtended by regularities operating at the level of sublexical orthographic representations (orthotactic constraints). This phenomenon could provide a useful tool for future investigations of the development of orthotactic constraints during reading acquisition. PMID:14642545

Grainger, Jonathan; Bouttevin, Sébastien; Truc, Cathy; Bastien, Mireille; Ziegler, Johannes

2003-12-01

378

Superior Mesenteric and Portal Vein Thrombosis following Laparoscopic Nissen Fundoplication  

Microsoft Academic Search

This case report describes superior mesenteric and portal vein thrombosis after laparoscopic Nissen fundoplication. As a thromboembolic prophylaxis, 2,500 IU of dalteparin was given preoperatively. After postoperative day 19, the patient experienced gradually increasing abdominal pain, mostly related to meals. Physical examination and laboratory tests were normal. CT scan revealed a portal and superior mesenteric vein thrombosis. Dalteparin and warfarin

Esko Kemppainen; Arto Kokkola; Jukka Sirén; Tuula Kiviluoto

2000-01-01

379

Superiority and Countermeasure of Buckwheat Industry Development in Ningxia  

Microsoft Academic Search

The superiority of buckwheat industry of the development has been elaborated through the analysis of present situation and problems in buckwheat industry in Ningxia province. It is proposed that the government should increase the investment in agriculture technologies by setting up the technology system which would support the breeding and generalizing the superior buckwheat varieties, together with optimizing the region

Guo Bingcheng

380

1. PEAVEY GLOVE ELEVATOR, SUPERIOR, WI 1887; WORKHOUSE (NO. 1 ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. PEAVEY GLOVE ELEVATOR, SUPERIOR, WI 1887; WORKHOUSE (NO. 1 HOUSE) WOOD FRAME CONSTRUCTION. VIEW FROM NORTHERN PACIFIC TRAIN BED, LOOKING APPROXIMATELY SOUTHEAST; NO. 2 HOUSE IN CENTER; NO. 3 HOUSE ON EXTREME RIGHT. - Peavey Globe Elevator, No. 1 House, West Gate Basin & Howard's Bay, east side of slip, Superior, Douglas County, WI

381

Reunion of the Rabbit Superior Oblique Tendon After Weakening Procedures  

PubMed Central

Purpose To investigate the degree of reunion in rabbit eyes of the superior oblique tendon after several surgical weakening procedures. Methods A total of 32 rabbits (64 eyes) were used in this study. The rabbits were randomly assigned to four groups, eight rabbits (16 eyes) in the tenotomy group, eight rabbits (16 eyes) in the tenectomy group, eight rabbits (16 eyes) in the disinsertion group and eight rabbits (16 eyes) in the recession group. The degree of reunion or reattachment of the superior oblique tendon on the globe were examined on four eyes in each group at postoperative weeks two, four, six and eight. Results At eight weeks, the newly created insertion site remained at the same site in all eyes in the recession group, and the distal end of the superior oblique tendon was reattached at the medial border of the superior rectus muscle in all four eyes in the tenotomy and disinsertion groups, and in three of four eyes in the tenectomy group. Conclusions From this experimental study, it was speculated that superior oblique recession is more effective than other superior oblique weakening procedures. This result could be helpful in the prediction of time of recurrence for superior oblique overaction after superior oblique weakening procedures.

Kang, Dae Wook; Oh, Ji Hye; Chun, Bo Young

2009-01-01

382

Nitrogen and carbon uptake dynamics in Lake Superior  

Microsoft Academic Search

Despite a fivefold rise in nitrate concentration over the last century, many fundamental aspects of Lake Superior's N and C cycles are still very poorly understood. We present here the first measurements of inorganic N uptake and in situ C uptake rates in Lake Superior, one of the largest lakes in the world. A profile of C uptake suggests that

Sanjeev Kumar; Robert W. Sterner; Jacques C. Finlay

2008-01-01

383

A comprehensive review of superior mesenteric artery syndrome  

Microsoft Academic Search

\\u000a Zusammenfassung  GRUNDLAGEN: Das Arteria mesenterica superior-Syndrom ist eine der seltensten gastrointestinalen Erkrankungen. Durch Kompression\\u000a des distalen Duodenums zwischen Arteria mesenterica superior und Aorta kommt es zu intestinaler Obstruktion. METHODIK: PubMed-Analyse\\u000a zu \\

M. T. Mandarry; L. Zhao; C. Zhang; Z. Q. Wei

2010-01-01

384

Impairments in Tactile Search Following Superior Parietal Damage  

ERIC Educational Resources Information Center

The superior parietal cortex is critical for the control of visually guided actions. Research suggests that visual stimuli relevant to actions are preferentially processed when they are in peripersonal space. One recent study demonstrated that visually guided movements towards the body were more impaired in a patient with damage to superior

Skakoon-Sparling, Shayna P.; Vasquez, Brandon P.; Hano, Kate; Danckert, James

2011-01-01

385

Impairments in Tactile Search Following Superior Parietal Damage  

ERIC Educational Resources Information Center

|The superior parietal cortex is critical for the control of visually guided actions. Research suggests that visual stimuli relevant to actions are preferentially processed when they are in peripersonal space. One recent study demonstrated that visually guided movements towards the body were more impaired in a patient with damage to superior

Skakoon-Sparling, Shayna P.; Vasquez, Brandon P.; Hano, Kate; Danckert, James

2011-01-01

386

Superior mesenteric arteriovenous fistula: imaging findings and endovascular treatment.  

PubMed

Arteriovenous fistulae (AVF) of the superior mesenteric vasculature are rarely encountered. We present a case of an iatrogenic superior mesenteric AVF following subtotal colectomy, which was successfully treated with coil embolization. Cross-sectional imaging and angiographic findings are reviewed along with the options for endovascular therapy. PMID:23129586

Temin, Nathaniel N; Flacke, Sebastian; Ahari, Heideh K

2012-11-01

387

Manufacturing of the superior inconel alloy ingot by ESR process.  

National Technical Information Service (NTIS)

The purpose of this research is to gather the fundamental data for manufacturing superior ingot from the VIM-treated Inconel 690 alloy electrode by ESR process. In the manufacturing of the superior ingot by ESR process, efforts are made to establish the r...

S. S. Kim H. U. Kwan T. G. Kim

1994-01-01

388

Endovascular Treatment of Ruptured Abdominal Aneurysm into the Inferior Vena Cava in Patient After Stent Graft Placement  

SciTech Connect

We report the case of a patient who underwent endovascular repair and then reintervention as a result of the presence of a persistent endoleak complicated by an aortocaval fistula. A 76-year-old patient with a history of endovascular treatment for abdominal aortic aneurysm 2 years earlier had a palpable abdominal mass, high-output cardiac failure, and renal failure. A computed tomographic scan and angiography revealed bending of the right iliac limb, a type I endoleak, and rupture of the aneurysm into the inferior vena cava with aortocaval fistula formation. An iliac extension was positioned in the right external iliac artery. The procedure was finished successfully. Control angiography showed normal flow within the endoprosthesis, and both iliac arteries were without signs of endoleakage and aortocaval fistula. Ectatic common iliac artery may lead to a late distal attachment site endoleak. The application of a stent graft in cases of secondary aortocaval fistula after stent graft repair is a good option, particularly in emergency cases.

Juszkat, Robert, E-mail: radiologiamim@wp.p [Poznan University of Medical Sciences, Department of Radiology (Poland); Pukacki, Fryderyk [Poznan University of Medical Sciences, Department of General and Vascular Surgery (Poland); Zarzecka, Anna; Kulesza, Jerzy [Poznan University of Medical Sciences, Department of Radiology (Poland); Majewski, Waclaw [Poznan University of Medical Sciences, Department of General and Vascular Surgery (Poland)

2009-07-15

389

Failed Retrieval of an Inferior Vena Cava Filter During Pregnancy Because of Filter Tilt: Report of Two Cases  

SciTech Connect

Thromboembolic disease during pregnancy is an important cause of obstetric morbidity and mortality. Pregnant patients with venous thromboembolism are usually managed by conventional anticoagulation. However, this must be discontinued during vaginal or caesarian delivery to avoid haemorrhage and to reduce the risk of possible epidural haematoma. Retrievable inferior vena cava filters (IVCFs) offer protection against pulmonary embolism during this high-risk period, when anticoagulation is discontinued, while avoiding potential long-term sequelae of a permanent IVCF. Here we report two patients who presented in the third trimester of pregnancy with floating ileofemoral deep vein thrombosis. Both patients were initially treated with standard anticoagulation; however, shortly before delivery both patients had a retrievable IVCF placed in a suprarenal position. In both patients, retrieval failed at 28 days after insertion because of filter tilt. The timing and mechanism of filter tilt remains uncertain. We believe that a number of factors could have been involved, including change in the anatomic configuration with lateral displacement of the IVCF as a result of the gravid uterus as well as forceful uterine contractions during labour, which modified the shape and diameter of the IVC. We showed that failure to retrieve the IVCF has had considerable implications for the two young patients regarding long-term anticoagulation and have highlighted the need for further clinical trials regarding the safe use of retrievable IVCFs during pregnancy.

McConville, R. M., E-mail: richard_mcconville@hotmail.com; Kennedy, P. T.; Collins, A. J.; Ellis, P. K. [Royal Victoria Hospital, Department of Radiology (Ireland)

2009-01-15

390

Dieckol, a SARS-CoV 3CL(pro) inhibitor, isolated from the edible brown algae Ecklonia cava.  

PubMed

SARS-CoV 3CL(pro) plays an important role in viral replication. In this study, we performed a biological evaluation on nine phlorotannins isolated from the edible brown algae Ecklonia cava. The nine isolated phlorotannins (1-9), except phloroglucinol (1), possessed SARS-CoV 3CL(pro) inhibitory activities in a dose-dependently and competitive manner. Of these phlorotannins (1-9), two eckol groups with a diphenyl ether linked dieckol (8) showed the most potent SARS-CoV 3CL(pro) trans/cis-cleavage inhibitory effects (IC(50)s = 2.7 and 68.1 ?M, respectively). This is the first report of a (8) phlorotannin chemotype significantly blocking the cleavage of SARS-CoV 3CL(pro) in a cell-based assay with no toxicity. Furthermore, dieckol (8) exhibited a high association rate in the SPR sensorgram and formed extremely strong hydrogen bonds to the catalytic dyad (Cys145 and His41) of the SARS-CoV 3CL(pro). PMID:23647823

Park, Ji-Young; Kim, Jang Hoon; Kwon, Jung Min; Kwon, Hyung-Jun; Jeong, Hyung Jae; Kim, Young Min; Kim, Doman; Lee, Woo Song; Ryu, Young Bae

2013-04-22

391

The Superior Transvelar Approach to the Fourth Ventricle and Brainstem  

PubMed Central

Objective?The superior transvelar approach is used to access pathologies located in the fourth ventricle and brainstem. The surgical path is below the venous structures, through the superior medullary velum. Following splitting the tentorial edge, near the tentorial apex, the superior medullary velum is split in the cerebello-mesencephalic fissure. Using the supracerebellar infratentorial, transtentorial or parietal interhemispheric routes, the superior medullary velum is approached. Splitting this velum provides a detailed view of the fourth ventricle and its floor. Materials and Methods?A total of 10 formalin-fixed specimens were dissected in a stepwise manner to simulate the superior transvelar approach to the fourth ventricle. The exposure gained the distance from the craniotomy site and the ease of access was assessed for each of the routes. We also present an illustrative case, operated by the senior author (AN). Results?The superior transvelar approach provides access to the entire length of the fourth ventricle floor, from the aqueduct to the obex, when using the parietal interhemispheric route. In addition, this approach provides access to the entire width of the floor of the fourth ventricle; however, this requires retracting the superior cerebellar peduncle. Using the supracerebellar infratentorial route gives a limited exposure of the superior part of the fourth ventricle. The occipital interhemispheric route is a compromise between these two. Conclusion?The superior transvelar approach to the fourth ventricle provides a route for approaching the fourth ventricle from above. This approach does not require opening the posterior fossa in the traditional way, and provides a reasonable alternative for accessing the superior fourth ventricle.

Ezer, Haim; Banerjee, Anirban Deep; Bollam, Papireddy; Guthikonda, Bharat; Nanda, Anil

2012-01-01

392

Parents' perceptions of factors affecting the reading development of intellectually superior accelerated readers and intellectually superior nonreaders  

Microsoft Academic Search

The study investigates differences in written language experiences of intellectually superior nonreaders and intellectually superior accelerated readers. The subjects were 30 four? and five?year?old children, 15 nonreaders and 15 accelerated readers. The mothers responded to a 269 item questionnaire designed to assess the home environment with respect to print concepts and a variety of literary experiences. A multivariate analysis of

Jeanne M. Burns; Martha D. Collins

1987-01-01

393

Superior mesenteric and portal vein thrombosis following laparoscopic nissen fundoplication.  

PubMed

This case report describes superior mesenteric and portal vein thrombosis after laparoscopic Nissen fundoplication. As a thromboembolic prophylaxis, 2,500 IU of dalteparin was given preoperatively. After postoperative day 19, the patient experienced gradually increasing abdominal pain, mostly related to meals. Physical examination and laboratory tests were normal. CT scan revealed a portal and superior mesenteric vein thrombosis. Dalteparin and warfarin treatment was started, and symptoms relieved rapidly. In a control Doppler ultrasound 1 month after the onset of the treatment, a good flow in the portal and superior mesenteric vein was seen. Possible mechanisms are discussed. PMID:10867463

Kemppainen, E; Kokkola, A; Sirén, J; Kiviluoto, T

2000-01-01

394

Combination of Transarterial Chemoembolization and Three-Dimensional Conformal Radiotherapy for Hepatocellular Carcinoma With Inferior Vena Cava Tumor Thrombus  

SciTech Connect

Purpose: To evaluate the effects of transarterial chemoembolization (TACE) and three-dimensional conformal radiotherapy (CRT) in patients with hepatocellular carcinoma (HCC) and inferior vena cava tumor thrombus (IVCTT). Methods and Materials: A total of 42 consecutive patients who underwent TACE and CRT (TACE+CRT group) for the treatment of HCC with IVCTT were prospectively enrolled from July 2004 to October 2006. As historical controls, 29 HCC patients with IVCTT who received TACE alone (TACE group) between July 2003 and June 2004 were included. CRT was designed to target only the IVCTT and to deliver a median total dose of 45 Gy (range, 28-50 Gy). Results: Most baseline characteristics of the two groups were similar (p > 0.05). The response and progression-free rates of IVCTT were significantly higher in the TACE+CRT group than in the TACE group (42.9% and 71.4% vs. 13.8% and 37.9%, respectively; p < 0.01 for both rates). Overall, patient survival was significantly higher in the TACE+CRT group than in the TACE group (p < 0.01), with a median survival time of 11.7 months and 4.7 months, respectively. Treatment with TACE+CRT (hazard ratio [HR] = 0.38; 95% confidence interval [CI], 0.20-0.71), progression of IVCTT (HR = 4.05; 95% CI, 2.00-8.21), Child-Pugh class B (HR = 3.44; 95% CI, 1.79-6.61), and portal vein invasion (HR = 2.31; 95% CI, 1.19-4.50) were identified as independent predictors of mortality by multivariable analysis. Conclusions: The combination of TACE and CRT is more effective in the control of IVCTT associated with HCC and improves patient survival compared with TACE alone.

Koo, Ja Eun [Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Jong Hoon [Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Lim, Young-Suk, E-mail: limys@amc.seoul.k [Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2010-09-01

395

Xanthogranulomatous Pyelonephritis in a male child with renal vein thrombus extending into the inferior vena cava: a Case Report  

PubMed Central

Background We present a case of Xanthogranulomatous pyelonephritis (XGPN) in a male child with renal vein thrombus extending into the inferior vena cava. This is a rare presentation. XGPN is a rare type of renal infection characterised by granulomatous inflammation with giant cells and foamy histiocytes. The peak incidence is in the sixth to seventh decade with a female predominance. XGPN is rare in children. Case presentation An 11 year old male child presented with a history of high grade fever and chills, right flank pain and progressive pyuria for two months. He had a history of vesical calculus for which he was operated four years back. In our case, a subcapsular right nephrectomy was performed. The surgical specimens were formalin fixed and paraffin embedded. The sections were stained with routine Hematoxylin & Eosin stain. Grossly; the kidney was enlarged with adherent capsule and thickening of the perinephric tissue. The pelvicalyceal system was dilated and was filled with a cast of pus. Histological evaluation revealed diffuse necrosis of the renal parenchyma and perinephric fat. Neutrophils, plasma cells, sheets of foamy macrophages and occasional multinucleate giant cells were seen. The renal vein was partially occluded by an inflammatory thrombus with fibrin, platelets and mixed inflammatory cells. The thrombus was focally adherent to the vein wall with organization. Conclusions The clinical presentation and the macroscopic aspect, together with the histological pattern, the cytological characteristics addressed the diagnosis towards XGPN with a vena caval thrombus. Our case illustrates that the diagnosis of XGPN should be considered even in paediatric age group when renal vein and vena caval thrombi are present.

2010-01-01

396

Impact of intra-abdominal pressure on retrohepatic vena cava shape and flow in mechanically ventilated pigs.  

PubMed

Conflicting results have been found regarding correlations between right atrial pressure (RAP) and inferior vena cava (IVC) diameter in mechanically ventilated patients. This finding could be related to an increase in intra-abdominal pressure (IAP). This study was designed to clarify whether variations in IVC flow rate caused by positive pressure ventilation are associated with changes in the retrohepatic IVC cross-section (?IVC) during major changes in volume status and IAP. Nine pigs were anesthetized, mechanically ventilated and equipped. IAP was set at 0, 15 and 30 mmHg during two conditions, i.e. normovolemia and hypovolemia, generated by blood removal to obtain a mean arterial pressure value lower than 60 mmHg. At each IAP increment, cardiac output, IVC flow and surface area were respectively assessed by flowmeters and transesophageal echocardiography. At normal IAP, even in presence of respiratory changes in IVC flows, no ?IVC were observed during the two conditions. At high IAP, neither ?IVC nor modulations of IVC flow were observed whatever the volemic status. The majority of animals with an IVC area of less than 0.65 cm(2) showed evidence of IAP greater than RAP values. Negative RAP-IAP pressure gradients were found to occur with an IVC area of less than 0.65 cm(2), suggesting that IVC dimensions determined using standard ultrasound techniques may indicate the direction of the RAP-IAP gradient. The clinical relevance of the present findings is that volume status should not be estimated from retrohepatic IVC dimensions in cases of high IAP. PMID:22418601

Bendjelid, Karim; Viale, Jean-Paul; Duperret, Serge; Colling, Joëlle; Piriou, Vincent; Merlani, Paolo; Jacques, Didier

2012-03-15

397

Rehabilitation Plan for Walleye Populations and Habitats in Lake Superior.  

National Technical Information Service (NTIS)

The walleye (Stizostedion vitreum vitreum) has been historically important in regional fisheries and fish communities in large bays, estuaries, and rivers of Lake Superior. Significant negative impacts on the species caused by overharvesting, habitat degr...

M. H. Hoff

2003-01-01

398

Toward an Interpersonal Paradigm for Superior-Subordinate Communication.  

National Technical Information Service (NTIS)

The purpose of this dissertation is to report formulative research on an interpersonal paradigm for superior-subordinate communication. The suggested paradigm goes beyond traditional structural approaches to leadership and rests on the interpersonal perce...

T. L. Bangs

1983-01-01

399

Land Use Activities and Western Lake Superior Water Quality.  

National Technical Information Service (NTIS)

Geographic Information Systems (GIS), computer systems which can analyze mapped information, can help reduce nonpoint source pollution in the Lake Superior basin by providing researchers and managers with a tool for predicting the consequences of land use...

C. A. Johnston

1990-01-01

400

DO GRAZING CATTLE SEEK NUTRITIONALLY SUPERIOR PORTIONS OF PASTURES?  

Technology Transfer Automated Retrieval System (TEKTRAN)

This study evaluated the hypothesis that grazing cattle will most often frequent nutritionally superior portions of large pastures. Forage quantity/quality characteristics were mapped among three pastures and cattle grazing patterns subsequently tracked with GPS collars. Cattle preferred locations...

401

Treatment of superior vena caval obstruction following permanent pacemaker extraction.  

PubMed

Superior vena caval (SVC) obstruction following permanent pacemaker lead extraction is a serious but uncommon complication. This report describes the case of an 83-year-old man treated by balloon angioplasty and femoral pacemaker implantation. PMID:12520683

Newall, Nick; Stables, Rod; Palmer, Nick; Ramsdale, David

2002-12-01

402

Cortical vestibular representation in the superior temporal gyrus.  

PubMed

We present the unique case of a patient with a circumscribed solitary cerebral metastasis of a malignant melanoma extending from the medial part of the superior temporal gyrus to the lower part of the 1st long insular gyrus causing gait and stance instability and an ipsiversive tilt of the subjective visual vertical. Oculomotor disorders could not be detected. We suggest that the superior temporal gyrus is likely to be involved in spatial orientation presumably using otolithic information. PMID:15156094

Hegemann, Stefan; Fitzek, Sabine; Fitzek, Clemens; Fetter, Michael

2004-01-01

403

Bidirectional superior cavopulmonary anastomosis: how young is too young?  

Microsoft Academic Search

OBJECTIVE--To define the lowest age at which the bidirectional superior cavopulmonary anastomosis can safely be used in infants with complex congenital heart defects. DESIGN--A retrospective analysis of clinical, echocardiographic, haemodynamic, and angiographic data in four consecutive patients undergoing bidirectional superior cavopulmonary anastomosis below the age of 2 months. PATIENTS--Between November 1990 and September 1993, four infants less than 8 weeks

Z. Slavik; R. K. Lamb; S. A. Webber; A. M. Devlin; B. R. Keeton; J. L. Monro; A. P. Salmon

1996-01-01

404

Spatial disparity coding in the superior colliculus of the cat  

Microsoft Academic Search

Cells in the superficial layers of the superior colliculus of the cat have mainly binocular receptive fields. The aim of the\\u000a present experiment was to investigate the sensitivity of these cells to horizontal spatial disparity. Unit recordings were\\u000a carried out in the superficial layers of the superior colliculus of paralyzed and anesthetized cats. Centrally located receptive\\u000a fields were mapped, separated

B. A. Bacon; J. Villemagne; A. Bergeron; F. Lepore; J.-P. Guillemot

1998-01-01

405

Endovascular Repair of Iatrogenic Superior Mesenteric Arteriovenous Fistula  

Microsoft Academic Search

Arteriovenous fistulas between the superior mesenteric artery and vein are extremely rare and often a late complication of bowel resection. We report a case of a 42-year-old male, who presented with abdominal pain and dyspnoea 9 years after ileo-caecal resection. A superior mesenteric arteriovenous fistula was detected and treated endovascularly with an Amplatzer Vascular Plug, thereby reducing the cardiac output

J. P. Eiberg; M. Bundgaard-Nielsen; M. A. Hansen; N. H. Secher

2009-01-01

406

Fish community change in Lake Superior, 1970–2000  

Microsoft Academic Search

Abstract: Changes,in Lake Superior’s fish community,are reviewed,from 1970 to 2000. Lake trout (Salvelinus namaycush) and lake whitefish (Coregonus,clupeaformis) stocks have increased substantially and may,be approaching ancestral states. Lake herring (Coregonus artedi) have also recovered, but under sporadic recruitment. Contaminant levels have declined and are in equilibrium with inputs, but toxaphene levels are higher than in all other Great Lakes. Sea

Charles R. Bronte; Mark P. Ebener; Donald R. Schreiner; David S. DeVault; Michael M. Petzold; Douglas A. Jensen; Carl Richards; Steven J. Lozano

2003-01-01

407

Casos Empresariales No. 2. II Serie  

Microsoft Academic Search

En el ámbito de la disciplina administrativa se utilizan los casos empresariales como estrategia de aprendizaje. El presente texto desarrolla una casuística que surge de la realidad empresarial colombiana al estudiar los casos de prácticas gerenciales innovadoras de SQL Software, Impsat y Davivienda, como una medio para comprender el fenómeno organizacional latinoamericano y así fortalecer y renovar las pedagogías y

Facultad de Administración de Empresas

408

A five-year, retrospective, comparison review of survival in neurosurgical patients diagnosed with venous thromboembolism and treated with either inferior vena cava filters or anticoagulants  

Microsoft Academic Search

Bacground  The optimal role of inferior vena cava filters (IVCF) in the management of venous thromboembolism (VTE) is not well defined.\\u000a The purpose of this study was to compare mortality risk for VTE patients treated with IVCF or anticoagulants.\\u000a \\u000a \\u000a \\u000a Methods  Analyses were based on data from 175 VTE patients, who had concurrent conditions of central nervous system (CNS) cancer or\\u000a brain hemorrhage, and

Amanda J. Ghanim; Constantine Daskalakis; David J. Eschelman; Walter K. Kraft

2007-01-01

409

Congenital Absence of Inferior Vena Cava with Azygos Continuation Revealed by Vascular Echo in a Patient with Pulmonary Thromboembolism and Deep Vein Thrombosis: A Case Report  

PubMed Central

A 44-year-old man with an isolated anomaly of azygos continuation of the inferior vena cava (IVC) presented with dyspnea due to pulmonary thromboembolism (PTE) and deep-vein thrombosis (DVT). Sono-graphic examination disclosed not only pulmonary hypertension and DVT, but also infrahepatic interruption of the IVC with azygos continuation. A rare anomaly of azygos continuation of IVC could cause DVT and PTE. Vascular echo could play an important role in the examination of DVT and/or venous anomalies.

2013-01-01

410

[A case of advanced hepatocellular carcinoma with inferior vena cava tumor thrombus and multiple intrahepatic metastases treated successfully by transcatheter arterial chemoembolization and radical hepatectomy].  

PubMed

A 76-year-old man, who had been treated with interferon-?(IFN-?) for hepatitis C, was diagnosed with multiple hepatocellular carcinomas (HCC; S7/8, S8, S5, S2) with right hepatic vein tumor thrombus (Vv2). He initially underwent transcatheter arterial chemoembolization(TACE). One month after TACE, the hepatic vein tumor thrombi extended into the inferior vena cava(Vv3). No distant metastasis was observed, and his liver function was well-preserved. Therefore, we performed a posterior segmentectomy, partial hepatectomy(S8, S5, S2), inferior vena cava tumor thrombus excision, and cholecystectomy. Four months after the operation, intrahepatic recurrences were detected, and these lesions were controlled via TACE. Four years and 2 months after the initial treatment, the patient survived and presently, is in a good condition. This case suggested that long-term survival is possible by surgery and repeated TACE in case of good liver function by a sustained virologic response (SVR) via treatment with IFN-? for hepatitis C virus. PMID:23267897

Yamanaka, Chihiro; Wada, Hiroshi; Hama, Naoki; Kobayashi, Shogo; Akita, Hirofumi; Kawamoto, Koichi; Marubashi, Shigeru; Eguchi, Hidetoshi; Tanemura, Masahiro; Umeshita, Koji; Doki, Yuichiro; Mori, Masaki; Nagano, Hiroaki

2012-11-01

411

[Successful treatment of massive thrombosis of the vena cava inferior with nephrotic syndrome and chronic bilateral pulmonary artery thromboembolism in a patient with genetic thrombophilia].  

PubMed

A case is reported of a 23-year-old male patient who developed, after severe blunt injury of the lumbar region, massive thrombosis of the vena cava inferior (VCI), both renal veins, bilateral pulmonary artery thromboembolism (PATE), nephrotic syndrome (NS). In spite of anticoagulant therapy, the condition of the patient progressively aggravated for 1.5 year: thrombosis involved the ileac and femoral arteries on the right, thrombus floated in the right atrium with PATE recurrent episodes, pulmonary hypertension reached 120 mm Hg with formation of decompensated cor pulmnonale, proteinuria and hypoalbuminemia deteriorated, anasarca edema developed Multigenic thrombophilia was diagnosed (1 homozygous and 5 heterozygous mutations). A radical one-stage operation was successful: thromboectomy from the VCI, right ileac and left renal veins, thrombendarterectomy from the pulmonary arteries, suture of the interatrial septum defect, installation of cava-filter After the operation pulmonary pressure lowered to 40-45 mm Hg, right heart volume normalized, immunosuppressive therapy with prednisolone and cyclosporine led to nephropathy remission. The discussion covers mechanisms and factors (including genetic) of thrombosis progression, correlations between intravascular thrombosis, NS and chronic glomerulonephritis (possible NS development due to bilateral thrombosis of the renal veins and nephropathy role in thrombosis progression), approaches to conservative and surgical treatment of such patients. Global experience in conduction of pulmonary thrombendarterectomy and thrombectomy from VCI is reviewed (one-stage operations were not described earlier). PMID:22616531

Blagova, O V; Dzemeshkevich, S L; Kozlovskaia, N L; Nedostup, A V; Sarkisova, N D; Frolova, Iu V; Raskin, V V; Dzemeshkevich, A S; Abugov, S A; Skipenko, O G; Shilov, E M; Sedov, V P; Gagarina, N V; Sinitsyn, V E; Mershina, E A; Volkova, E Iu

2012-01-01

412

Percutaneous mechanical thrombectomy of superior mesenteric artery embolism  

PubMed Central

Background The present series present three consecutive cases of successful percutaneous mechanical embolectomy in acute superior mesenteric artery ischemia. Superior mesenteric artery embolism is a rare abdominal emergency that commonly leads to bowel infarction and has a very high mortality rate. Prompt recognition and treatment are crucial for successful outcome. Endovascular therapeutic approach in patients with acute SMA embolism in median portion of its stem is proposed. Case reports. Three male patients had experienced a sudden abdominal pain and acute superior mesenteric artery embolism in median portion of its stem was revealed on computed tomography angiography. No signs of intestinal infarction were present. The decision for endovascular treatment was made in concordance with the surgeons. In one patient 6 French gauge Rotarex® device was used while in others 6 French gauge Aspirex® device were used. All patients experienced sudden relief of pain after the procedure with no signs of intestinal infarction. Minor procedural complication – rupture of a smaller branch of SMA during Aspirex® treatment was successfully managed by coiling while transient paralytic ileus presented in one patient resolved spontaneously. All three patients remained symptom-free with patent superior mesenteric artery during the follow-up period. Conclusions Percutaneous mechanical thrombectomy seems to be a rapid and effective treatment of acute superior mesenteric artery embolism in median portion of its stem in absence of bowel necrosis. Follow-up of our patients showed excellent short- and long-term results.

Kuhelj, Dimitrij; Kavcic, Pavel; Popovic, Peter

2013-01-01

413

Specialization along the Left Superior Temporal Sulcus for Auditory Categorization  

PubMed Central

The affinity and temporal course of functional fields in middle and posterior superior temporal cortex for the categorization of complex sounds was examined using functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) recorded simultaneously. Data were compared before and after subjects were trained to categorize a continuum of unfamiliar nonphonemic auditory patterns with speech-like properties (NP) and a continuum of familiar phonemic patterns (P). fMRI activation for NP increased after training in left posterior superior temporal sulcus (pSTS). The ERP P2 response to NP also increased with training, and its scalp topography was consistent with left posterior superior temporal generators. In contrast, the left middle superior temporal sulcus (mSTS) showed fMRI activation only for P, and this response was not affected by training. The P2 response to P was also independent of training, and its estimated source was more anterior in left superior temporal cortex. Results are consistent with a role for left pSTS in short-term representation of relevant sound features that provide the basis for identifying newly acquired sound categories. Categorization of highly familiar phonemic patterns is mediated by long-term representations in left mSTS. Results provide new insight regarding the function of ventral and dorsal auditory streams.

Desai, Rutvik; Ellingson, Michael M.; Ramachandran, Brinda; Desai, Anjali; Binder, Jeffrey R.

2010-01-01

414

The superior trapezius myocutaneous flap in head and neck reconstruction.  

PubMed

The superior trapezius myocutaneous flap, based on the paraspinous perforating branches of the intercostal vessels, is generally not a first-line choice for reconstruction of head and neck defects. However, after wound breakdown following radical neck dissection and radiation therapy, the superior trapezius flap is extremely reliable for coverage of exposed major neck vessels. The flap was used in 30 patients undergoing lateral neck reconstruction. All 30 patients had undergone prior neck dissection and all but two had undergone prior radiation therapy. There were no flap failures. The superior trapezius flap is unique among other regional myocutaneous flaps presently in use in that it has a superiorly based pedicle, which reduces the problem of gravitational pull on the suture lines of severely unfavorable recipient beds. Another advantage of using the denervated muscle of this flap is that it imposes no additional functional loss. The deficiencies of this flap are primarily related to its limited arc of rotation, thereby precluding its use when resurfacing defects that extend beyond the midline of the neck. The reliability of the superior trapezius flap after neck dissection can be explained by the angiosome concept. Based on that concept, previous ligation of the transverse cervical vessels during a neck dissection serves to simultaneously stage this flap, thereby improving its reliability and potential surface area available. PMID:1627289

Aviv, J E; Urken, M L; Lawson, W; Biller, H F

1992-07-01

415

Specialization along the left superior temporal sulcus for auditory categorization.  

PubMed

The affinity and temporal course of functional fields in middle and posterior superior temporal cortex for the categorization of complex sounds was examined using functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) recorded simultaneously. Data were compared before and after subjects were trained to categorize a continuum of unfamiliar nonphonemic auditory patterns with speech-like properties (NP) and a continuum of familiar phonemic patterns (P). fMRI activation for NP increased after training in left posterior superior temporal sulcus (pSTS). The ERP P2 response to NP also increased with training, and its scalp topography was consistent with left posterior superior temporal generators. In contrast, the left middle superior temporal sulcus (mSTS) showed fMRI activation only for P, and this response was not affected by training. The P2 response to P was also independent of training, and its estimated source was more anterior in left superior temporal cortex. Results are consistent with a role for left pSTS in short-term representation of relevant sound features that provide the basis for identifying newly acquired sound categories. Categorization of highly familiar phonemic patterns is mediated by long-term representations in left mSTS. Results provide new insight regarding the function of ventral and dorsal auditory streams. PMID:20382643

Liebenthal, Einat; Desai, Rutvik; Ellingson, Michael M; Ramachandran, Brinda; Desai, Anjali; Binder, Jeffrey R

2010-04-09

416

Large cell non-Hodgkin's lymphoma masquerading as renal carcinoma with inferior vena cava thrombosis: a case report  

PubMed Central

Introduction Many cancers are associated with inferior vena cava (IVC) obstruction, but very few cancers have the ability to propagate within the lumen of the renal vein or the IVC. Renal cell carcinoma is the most common of these cancers. Renal cancer with IVC extension has a high rate of recurrence and a low five year survival rate. Case presentation A 62-year-old Caucasian woman previously in good health developed the sudden onset of severe reflux symptoms and right-sided abdominal pain that radiated around the right flank. A subsequent ultrasound and CT scan revealed a right upper pole renal mass with invasion of the right adrenal gland, liver, left renal vein and IVC. This appeared to be consistent with stage III renal cancer with IVC extension. Metastatic nodules were believed to be present in the right pericardial region; the superficial anterior abdominal wall; the left perirenal, abdominal and pelvic regions; and the left adrenal gland. The pattern of these metastases, as well as the invasion of the liver by the tumor, was thought to be atypical of renal cancer. A needle biopsy of a superficial abdominal wall mass revealed a surprising finding: The malignant cells were diagnostic of large-cell, B-cell non-Hodgkin's lymphoma. The lymphoma responded dramatically to systemic chemotherapy, which avoided the need for nephrectomy. Conclusion Lymphomas only rarely progress via intraluminal vascular extension. We have been able to identify only one other case report of renal lymphoma with renal vein and IVC extension. While renal cancer would have been treated with radical nephrectomy and tumor embolectomy, large-cell B-cell lymphomas are treated primarily with chemotherapy, and nephrectomy would have been detrimental. It is important to remember that, rarely, other types of cancer arise from the kidney which are not derived from the renal tubular epithelium. These may be suspected if an atypical pattern of metastases or unusual invasion of surrounding organs is present. A preoperative or intraoperative biopsy may be helpful in these cases.

2011-01-01

417

Superior mesenteric vein thrombosis following laparoscopic Nissen fundoplication.  

PubMed

This report describes the second case of a superior mesenteric and portal vein thrombosis following an uneventful laparoscopic Nissen fundoplication. The patient presented on postoperative day 10 with acute onset of abdominal pain and inability to tolerate oral food. A computed tomography (CT) scan revealed superior mesenteric and portal venous thrombosis with questionable viability of the proximal small bowel. He was heparinized and taken for emergent exploratory laparotomy. At surgery and at a planned re-exploration the following day, the bowel was viable and no resection was needed. Despite continuation on anticoagulation therapy, he developed a pulmonary embolism. A hypercoagulable workup was normal. After continued anticoagulation therapy and supportive care, a duplex ultrasound 2 months after the event showed normal flow in both the superior mesenteric and portal veins. Possible mechanisms are discussed along with a review of the pertinent literature. PMID:12856849

Steele, Scott R; Martin, Matthew J; Garafalo, Thomas; Ko, Tak-ming; Place, Ronald J

418

Superior Mesenteric Vein Thrombosis Following Laparoscopic Nissen Fundoplication  

PubMed Central

This report describes the second case of a superior mesenteric and portal vein thrombosis following an uneventful laparoscopic Nissen fundoplication. The patient presented on postoperative day 10 with acute onset of abdominal pain and inability to tolerate oral food. A computed tomography (CT) scan revealed superior mesenteric and portal venous thrombosis with questionable viability of the proximal small bowel. He was heparinized and taken for emergent exploratory laparotomy. At surgery and at a planned re-exploration the following day, the bowel was viable and no resection was needed. Despite continuation on anticoagulation therapy, he developed a pulmonary embolism. A hypercoagulable workup was normal. After continued anticoagulation therapy and supportive care, a duplex ultrasound 2 months after the event showed normal flow in both the superior mesenteric and portal veins. Possible mechanisms are discussed along with a review of the pertinent literature.

Martin, Matthew J.; Garafalo, Thomas; Ko, Tak-ming; Place, Ronald J.

2003-01-01

419

5 CFR 531.212 - Superior qualifications and special needs pay-setting authority.  

Code of Federal Regulations, 2010 CFR

... Superior qualifications and special needs pay-setting authority. 531... Superior qualifications and special needs pay-setting authority. ...the superior qualifications and special needs pay-setting authority...

2010-01-01

420

5 CFR 531.212 - Superior qualifications and special needs pay-setting authority.  

Code of Federal Regulations, 2010 CFR

... Superior qualifications and special needs pay-setting authority. 531... Superior qualifications and special needs pay-setting authority. ...the superior qualifications and special needs pay-setting authority...

2009-01-01

421

Triple disruption of the superior shoulder suspensory complex  

PubMed Central

The superior shoulder suspensory complex (SSSC) is an extremely important structure composed of a ring of bone and soft tissues at the superior aspect of the shoulder. Double disruption leads to instability of the construct and usually requires operative treatment. Triple disruption of the SSSC is extremely rare and is encountered in high-energy trauma cases often in association with other injuries. The authors experienced a case of triple disruption involving the acromion, coracoid process, and acromioclavicular separation. This type of SSSC disruption is unlikely to have been caused by a single impact and is rather caused by multiple impacts during one traumatic event.

Kim, Sae Hoon; Chung, Seok Won; Kim, Se Ho; Shin, Seung Han; Lee, Young Ho

2012-01-01

422

A rare cause of obstructive jaundice: superior mesenteric artery pseudoaneurysm.  

PubMed

Visceral arterial aneurysm and pseudoaneurysm are uncommon forms of vascular disease that have a significant potential for rupture or erosion into an adjacent viscera, resulting in life-threatening hemorrhage. Pseudoaneurysms related to the superior mesenteric artery are a recognized complication of trauma to the vessel, and successful treatment with stenting has been previously described. Percutaneous techniques offer an alternative form of therapy, and the number of reported cases treated with embolization has been rising steadily. We present the case of a 26-year-old patient with a large pseudoaneurysm of the superior mesenteric artery complicated with obstructive jaundice. PMID:23785041

Cinar, Celal; Bozkaya, Halil; Parildar, Mustafa; Oran, Ismail

2013-06-19

423

A rare anatomic variant of the superior glenohumeral ligament.  

PubMed

The attachment of the superior glenohumeral ligament (SGHL) to the upper pole of the glenoid is variable and 3 types have been described. We report an anatomic variant of SGHL attachment to the upper pole of the glenoid that has not heretofore been reported in the literature. In this case, the SGHL overrode the biceps origin, continued to the superior labrum posteriorly, and had no attachment to the middle glenohumeral ligament or the anterior labrum. This variant was detected during routine arthroscopic examination undertaken before surgery on a rotator cuff tear. PMID:11154383

Pradhan, R L; Itoi, E; Watanabe, W; Yamada, S; Nagasawa, H; Shimizu, T; Wakabayashi, I; Sato, K

2001-01-01

424

Unilateral superior pellucid marginal degeneration in a case with ichthyosis.  

PubMed

A 47-year-old man with ichthyosis vulgaris presented to our hospital complaining of reduced visual acuity and ocular discomfort in the left eye. Slit-lamp biomicroscopy revealed a thinning about 2mm from the superior limbus and superficial punctate corneal lesions in the left eyes. Corneal topography was 'butterfly-like' in an area of increased elevation in the left eye. Although ichthyosis vulgaris and unilateral superior pellucid marginal degeneration are both uncommon conditions, this is first report about these two conditions in studied together. PMID:21084217

Dundar, Huseyin; Kara, Necip; Kaya, Vedat; Bozkurt, Ercument; Yazici, Ahmet Taylan; Hekimhan, Pelin Kaynak

2010-11-16

425

Anterior superior iliac spine avulsion in a young soccer player.  

PubMed

Avulsion fractures of the anterior superior iliac spine are rare. They usually occur in teenagers during sport activities. Cases concerning adults are very uncommon. We report here the case of a 23-year-old man who was admitted for recent pain of the left hip that worsened while kicking a ball in a soccer match eight days earlier. The examination found pain when moving the left hip in extension. Radiographs showed an avulsion fracture of the left anterior superior iliac spine, which was confirmed by computer tomography. The treatment was conservative consisting in rest and non-weight bearing with releasing of pain a few weeks later. PMID:20869938

Bendeddouche, I; Jean-Luc, B B; Poiraudeau, S; Nys, A

2010-09-21

426

A Comparison of Aorta and Vena Cava Medial Message Expression by cDNA Array Analysis Identifies a Set of 68 Consistently Differentially Expressed Genes, All in Aortic Media  

Microsoft Academic Search

We performed a systematic analysis of gene expression in arteries and veins by comparing message profiles of macaque aorta and vena cava media using a cDNA array containing 4048 known human genes, '35% of currently named human genes ('11 000). The data show extensive differences in RNA expression in artery versus vein media. Sixty-eight genes had consistent elevation in message

Lawrence D. Adams; Randolph L. Geary; Bruce McManus; Stephen M. Schwartz

427

Love v. Superior Court: Mandatory AIDS Testing and Prostitution  

Microsoft Academic Search

The AIDS epidemic has brought one of our most fundamental constitutional rights into sharp focus in California. The relationship between the Fourth Amendment right to be free from unreasonable searches and seizures and the government's ability to mandate AIDS testing was the topic of a recent California case, Love v. Superior Court. In a unanimous decision the California Court of

Karin Zink

2010-01-01

428

Superior mesenteric artery aneurysms: Is presence an indication for intervention?  

Microsoft Academic Search

Introduction: Although rare, superior mesenteric artery (SMA) aneurysms have a definite rupture risk. Past reports have suggested that this risk is low, yet most investigators recommend repair in selected patients. We reviewed our experience with 21 patients to try to determine when intervention was indicated. Methods: A retrospective review of the medical records of all patients with SMA aneurysms at

W. M. Stone; M. Abbas; Kenneth J. Cherry; Richard J. Fowl; P. Gloviczki

2002-01-01

429

Visuospatial Superiority in Developmental Dyslexia: Myth or Reality?  

ERIC Educational Resources Information Center

Anecdotal evidence indicates that dyslexia is positively associated with superior visuospatial ability but empirical evidence is inconsistent. We explicitly tested the hypothesis that dyslexia is associated with visuospatial advantage in 20 dyslexic and 21 unimpaired adult readers using paper-and-pencil measures and tests of "everyday"…

Brunswick, Nicola; Martin, G. Neil; Marzano, Lisa

2010-01-01

430

Biological Motion Task Performance Predicts Superior Temporal Sulcus Activity  

ERIC Educational Resources Information Center

|Numerous studies implicate superior temporal sulcus (STS) in the perception of human movement. More recent theories hold that STS is also involved in the "understanding" of human movement. However, almost no studies to date have associated STS function with observable variability in action understanding. The present study directly associated STS…

Herrington, John D.; Nymberg, Charlotte; Schultz, Robert T.

2011-01-01

431

Structural packing proven superior for TEG gas driving  

Microsoft Academic Search

This paper reports on structured packing for natural gas dehydration which has proven superior to trayed columns in tests. Structured packing provides roughly twice the capacity and up to 50% greater efficiency. The combination of high gas capacity and reduced height of an equilibrium stage (HETP), compared with trayed contactors, makes the application of structured packing desirable for both new

J. A. Kean; H. M. Turner; B. C. Price

1992-01-01

432

Temperate viruses and lysogeny in Lake Superior bacterioplankton  

Microsoft Academic Search

The morphology and abundance of free viruses were measured in spring, summer, and fall at one site in Lake Superior. Free viral head sizes ranged from 10 to 70 nm and tail length ranged from 10 to 110 nm. The vast majority (98%) of free viral head sizes were 560 nm, smaller than reported in most freshwater habitats. Most of

Mark A. Tapper; Randall E. Hicks

1998-01-01

433

Behavior Analysis in Education. Focus on Measurably Superior Instruction.  

ERIC Educational Resources Information Center

|This book was written to disseminate measurably superior instructional strategies to those interested in advancing sound, field-tested educational practices. Part 1 contains chapters that give two views of the future of behavior analysis in education, while part 2 focuses on promoting applied behavior analysis. Part 3 addresses issues in early…

Gardner, Ralph, III, Ed.; And Others

434

Superior mesenteric vein rotation: a CT sign of midgut malrotation  

Microsoft Academic Search

Computed tomography (CT) of the pancreas, with its excellent display of peripancreatic anatomy, allows visualization of the major vessels entering the mesenteric root. In scans of the normal upper abdomen obtained at or just below the level of the uncinate process of the pancreas, the proximal superior mesenteric vein (SMV) easily can be identified lying on the right ventral aspect

D. M. Nichols; D. K. Li

1983-01-01

435

Superior Overcurrent Protection with Motor Short-Circuit Protectors  

Microsoft Academic Search

A never ending stream of magazine articles, IEEE papers, National Electrical Code proposals and revisions attest to the need for better protection of motors, controllers, and branch circuits. Superior branch circuit overcurrent protection can be obtained by a combination of specially designed motor short-circuit protectors and especially approved motor controllers. This paper explains the protection provided and mentions test results

Kenneth W. Swain

1972-01-01

436

Long Range Recording of Lake Superior 1966 Shot Points.  

National Technical Information Service (NTIS)

Observations of seismic waves generated by explosions in Lake Superior during the Early Rise Experiment have been made westward to a range of 2600 km. A phase filtering technique involving the vertical and horizontal motion, used to enhance the body phase...

C. A. Borcherdt B. T. R. Lewis R. P. Meyer J. R. Van Schaack

1968-01-01

437

Microbial ecology of Lake Superior Bacteria and Archaea: An overview  

Microsoft Academic Search

Microorganisms are ubiquitously distributed in all types of lakes of varying trophic state. They play an important role in aquatic ecosystems, performing the tasks of decomposing organic matter, cycling nutrients and forming the base of microbial food webs. Bacterial abundance is generally lower in ultraoligotrophic Lake Superior than in other great lakes, ranging from 0.06 to 0.07 × 10 cells

Andrew J. Reed; Randall E. Hicks

2011-01-01

438

Biological Motion Task Performance Predicts Superior Temporal Sulcus Activity  

ERIC Educational Resources Information Center

Numerous studies implicate superior temporal sulcus (STS) in the perception of human movement. More recent theories hold that STS is also involved in the "understanding" of human movement. However, almost no studies to date have associated STS function with observable variability in action understanding. The present study directly associated STS…

Herrington, John D.; Nymberg, Charlotte; Schultz, Robert T.

2011-01-01

439

Escitalopram: Superior to Citalopram or a Chiral Chimera?  

Microsoft Academic Search

Background: Escitalopram is the active isomer of the antidepressant citalopram. In theory single-isomer drugs may be superior but few have been found to have clinically significant advantages. The manufacturer claims that escitalopram has more efficacy and a faster onset of effect than citalopram. The purpose of this study was to assess how far these claims are justified. Methods: Relevant trial

Staffan Svensson; Peter R. Mansfield

2004-01-01

440

Lake Superior Periphyton in Relation to Water Quality.  

National Technical Information Service (NTIS)

Laboratory and field studies were conducted to evaluate the importance of periphyton in western Lake Superior with special reference to the make-up and distribution of the periphyton growths and to the overall importance of productive capacity of this ass...

T. A. Olson T. O. Odlaug

1972-01-01

441

Biogeochemical silica mass balances in Lake Michigan and Lake Superior  

Microsoft Academic Search

Silica budgets for Lake Michigan and Lake Superior differ in several respects. Mass balance calculations for both lakes agree with previous studies in that permanent burial of biogenic silica in sediments may be only about 5% of the biogenic silica produced by diatoms. Because dissolution rates are large, good estimates of permanent burial of diatoms can not be obtained indirectly

Claire L. Schelske

1985-01-01

442

AIRBORNE MERCURY IN PRECIPITATION IN THE LAKE SUPERIOR REGION  

EPA Science Inventory

Mercury was measured in accumulated snow (March 1982) sampled from around Lake Superior and in rainfall from Duluth, Minnesota (June-September 1982 and March-November 1983), Forbes Township, and Dorset in northwestern and central Ontario, respectively (May-September 1983). Method...

443

The Quagga mussel invades the Lake Superior basin - journal article  

EPA Science Inventory

Prior studies recognized the presence of a single dreissenid species in Lake Superior--the zebra mussel Dreissena polymorpha. However, taxonomic keys based on traditional shell morphology are not always able to differentiate dreissenid species with confidence. We thus employed ge...

444

Lake Superior Seismic Experiment: Shots and Travel Times.  

National Technical Information Service (NTIS)

An extensive and detailed study of the crust and upper mantle in the Lake Superior region was undertaken as part of the International Upper Mantle Project. The shot and station locations and the first-arrival travel times of the 13 participating instituti...

J. S. Steinhart

1964-01-01

445

ZOOBENTHOS ASSEMBLAGES AS INDICATORS OF LAKE SUPERIOR COASTAL WETLAND CONDITIONS  

EPA Science Inventory

Little is known about the diversity or structure of zoobenthos assemblages in Great Lakes coastal wetlands. As part of a comparative study in western Lake Superior we wanted to investigate whether these assemblages might be useful as indicators of wetland condition. We also wante...

446

Information Operations: The Military's Role in Gaining Information Superiority.  

National Technical Information Service (NTIS)

The use of Information Operations (IO) as an integration process is paramount in today's information environment to achieve information superiority. If it is true that information is an element of national power, then IO is the U.S. military's contributio...

M. J. Dominique

2009-01-01

447

Status of Lake Superior Benthic Macroinvertebrates, 1994-2003  

NASA Astrophysics Data System (ADS)

Recently documented changes to benthic communities in the lower Great Lakes have created concerns about the status of benthic macroinvertebrates in Lake Superior. This lakewide study was conducted to ascertain their status in U.S. nearshore waters of Lake Superior. Benthic macroinvertebrates were collected from 27 sites representing the U.S. nearshore waters (20 to 110 m) of Lake Superior in 1994, 2000, and 2003. No significant differences in total benthic macroinvertebrate abundance, or abundances of oligochaetes, clams or chironomids were detected between years. Abundance of the amphipod Diporeia spp. was lower in 2000 than in 1994 and 2003. The oligochaete trophic index, a measure of relative abundance of species tolerant of varying degrees of organic enrichment, did not differ between years. Diporeia exhibited a bimodal depth distribution, with peaks in abundance at depths of 30 to 40 and 60 to 70 m. Oligochaetes were most abundant at 50 to 60 m depth, clams between 30 and 70 m, and chironomids at less than 30 m, with a secondary peak at 50 to 60 m. The spatial and temporal variability observed in Lake Superior benthic macroinvertebrate communities has implications for sampling design for environmental assessment. This abstract does not necessarily reflect USEPA policy.

Scharold, J.; Lozano, S. J.; Corry, T. D.

2005-05-01

448

Douglass Houghton and the Precambrian of Lake Superior  

Microsoft Academic Search

The first chronological subdivision of Precambrian rocks in the Lake Superior area was made in 1841 by Douglass Houghton for the Upper Peninsula of Michigan. In spite of the fact that the then prevailing philosophy of geologic history was quite different from that of today, Houghton's chronological subdivision became the commonly accepted framework for Precambrian studies on the south shore

Merk

1985-01-01

449

Denitrification Rates in a Lake Superior Coastal Wetland  

EPA Science Inventory

Inputs of anthropogenic nitrogen to the Nationâ??s aquatic ecosystems have increased substantially over the past several decades. Nitrogen inputs to Lake Superior since about 1900 have increased at a rate of about 2% per year, doubling about every 35 years (Bennett, 1986), althoug...

450

Localization of the superior laryngeal nerve during carotid endarterectomy  

Microsoft Academic Search

Knowledge of the topographic anatomy is essential to prevent iatrogenic damage of the superior laryngeal nerve (SLN) in carotid endarterectomy (CEA). The purpose of this study was to analyze the anatomic relationship between the SLN and carotid arteries in order to prevent iatrogenic nerve injury. Anatomic dissections similar to CEA were performed bilaterally in 50 fresh human adult cadavers. The

J. C. Furlan; R. de Magalhães; E. de Aguiar; S. Shiroma

2002-01-01

451

Superior temporal gyrus volumes in pediatric generalized anxiety disorder  

Microsoft Academic Search

Background: The essential symptoms of generalized anxiety disorder (GAD) are intrusive worry about everyday life circumstances and social competence, and associated autonomic hyperarousal. The amygdala, a brain region involved in fear and fear-related behaviors in animals, and its projections to the superior temporal gyrus (STG), thalamus, and to the prefrontal cortex are thought to comprise the neural basis of our

Michael D De Bellis; Matcheri S Keshavan; Heather Shifflett; Satish Iyengar; Ronald E Dahl; David A Axelson; Boris Birmaher; Julie Hall; Grace Moritz; Neal D Ryan

2002-01-01

452

Ileocolic Arteriovenous Fistula with Superior Mesenteric Vein Aneurism: Endovascular Treatment  

Microsoft Academic Search

We report a case of a venous aneurysm secondary to an acquired ileocolic arteriovenous fistula in a 64-year-old woman with recurrent abdominal pain and history of appendectomy. The aneurysm was diagnosed by ultrasound and computed tomography. Angiography showed an arteriovenous fistula between ileocolic branches of the superior mesenteric artery and vein. This vascular abnormality was successfully treated with coil embolization.

Miguel Angel De Gregorio; Maria José Gimeno; Joaquin Medrano; Caudio Schönholz; Juan Rodriguez; Horacio D’Agostino

2004-01-01

453

Monitoring land cover change in the Lake Superior basin  

Microsoft Academic Search

Consistent, repeatable and broadly applicable land use, land cover data is needed across the Lake Superior basin to facilitate ecosystem condition assessment and trend analysis. Such a data set collected regularly through time could inform and focus field monitoring efforts, and help prioritize restoration and mitigation efforts. Unfortunately, few data sets exist that are bi-nationally consistent in time, classification method,

T. P. Hollenhorst; L. B. Johnson; J. Ciborowski

2011-01-01

454

Why Is Visual Search Superior in Autism Spectrum Disorder?  

ERIC Educational Resources Information Center

|This study investigated the possibility that enhanced memory for rejected distractor locations underlies the superior visual search skills exhibited by individuals with autism spectrum disorder (ASD). We compared the performance of 21 children with ASD and 21 age- and IQ-matched typically developing (TD) children in a standard static search task…

Joseph, Robert M.; Keehn, Brandon; Connolly, Christine; Wolfe, Jeremy M.; Horowitz, Todd S.

2009-01-01

455

Military Culture, War Crimes and the Defence of Superior Orders  

Microsoft Academic Search

This thesis seeks to examine the military culture of obedience and the standards that exist relating to the defence of superior orders. It will explore laws and practices for this defence that have been adopted nationally and internationally. It will also propose guidelines for differentiating legal from illegal orders.

Aziz Mohammed

2008-01-01

456

Total variation superiorization schemes in proton computed tomography image reconstruction  

Microsoft Academic Search

Purpose: Iterative projection reconstruction algorithms are currently the preferred reconstruction method in proton computed tomography (pCT). However, due to inconsistencies in the measured data arising from proton energy straggling and multiple Coulomb scattering, noise in the reconstructed image increases with successive iterations. In the current work, we investigated the use of total variation superiorization (TVS) schemes that can be applied

S. N. Penfold; R. W. Schulte; Y. Censor; A. B. Rosenfeld

2010-01-01

457

Total variation superiorization schemes in proton computed tomography image reconstruction  

PubMed Central

Purpose: Iterative projection reconstruction algorithms are currently the preferred reconstruction method in proton computed tomography (pCT). However, due to inconsistencies in the measured data arising from proton energy straggling and multiple Coulomb scattering, the noise in the reconstructed image increases with successive iterations. In the current work, the authors investigated the use of total variation superiorization (TVS) schemes that can be applied as an algorithmic add-on to perturbation-resilient iterative projection algorithms for pCT image reconstruction. Methods: The block-iterative diagonally relaxed orthogonal projections (DROP) algorithm was used for reconstructing GEANT4 Monte Carlo simulated pCT data sets. Two TVS schemes added on to DROP were investigated; the first carried out the superiorization steps once per cycle and the second once per block. Simplifications of these schemes, involving the elimination of the computationally expensive feasibility proximity checking step of the TVS framework, were also investigated. The modulation transfer function and contrast discrimination function were used to quantify spatial and density resolution, respectively. Results: With both TVS schemes, superior spatial and density resolution was achieved compared to the standard DROP algorithm. Eliminating the feasibility proximity check improved the image quality, in particular image noise, in the once-per-block superiorization, while also halving image reconstruction time. Overall, the greatest image quality was observed when carrying out the superiorization once per block and eliminating the feasibility proximity check. Conclusions: The low-contrast imaging made possible with TVS holds a promise for its incorporation into future pCT studies.

Penfold, S. N.; Schulte, R. W.; Censor, Y.; Rosenfeld, A. B.

2010-01-01

458

Lake Superior supports novel clusters of cyanobacterial picoplankton.  

PubMed

Very little is known about the biodiversity of freshwater autotrophic picoplankton (APP) in the Laurentian Great Lakes, a system comprising 20% of the world's lacustrine freshwater. In this study, the genetic diversity of Lake Superior APP was examined by analyzing 16S rRNA gene and cpcBA PCR amplicons from water samples. By neighbor joining, the majority of 16S rRNA gene sequences clustered within the "picocyanobacterial clade" consisting of freshwater and marine Synechococcus and Prochlorococcus. Two new groups of Synechococcus spp., the pelagic Lake Superior clusters I and II, do not group with any of the known freshwater picocyanobacterial clusters and were the most abundant species (50 to 90% of the sequences) in samples collected from offshore Lake Superior stations. Conversely, at station Portage Deep (PD), located in a nearshore urbanized area, only 4% of the sequences belonged to these clusters and the remaining clones reflected the freshwater Synechococcus diversity described previously at sites throughout the world. Supporting the 16S rRNA gene data, the cpcBA library from nearshore station PD revealed a cosmopolitan diversity, whereas the majority of the cpcBA sequences (97.6%) from pelagic station CD1 fell within a unique Lake Superior cluster. Thus far, these picocyanobacteria have not been cultured, although their phylogenetic assignment suggests that they are phycoerythrin (PE) rich, consistent with the observation that PE-rich APP dominate Lake Superior picoplankton. Lastly, flow cytometry revealed that the summertime APP can exceed 10(5) cells ml-1 and suggests that the APP shifts from a community of PE and phycocyanin-rich picocyanobacteria and picoeukaryotes in winter to a PE-rich community in summer. PMID:17468271

Ivanikova, Natalia V; Popels, Linda C; McKay, R Michael L; Bullerjahn, George S

2007-04-27