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1

Chronic total coronary occlusions.  

PubMed

Chronic total coronary occlusions (CTO) occur in up to one-third of patients undergoing coronary angiography. Indications for opening CTOs include relief of angina, improving left ventricular function, decreasing the need for coronary artery bypass surgery, and improved long-term survival. Newer technology, wire-based and non-wired-based, has improved the ability to cross these previously uncrossable lesions, thereby improving the acute success rates of opening these lesions. Also, the advent of drug-eluting stents has markedly increased the long-term patency of these complex lesions. Therefore, the clinical demand for opening these chronically occluded arteries has increased. PMID:16781941

Braden, Gregory A

2006-05-01

2

Contemporary crossing techniques for infrapopliteal chronic total occlusions.  

PubMed

The synergism of technical refinement and advanced technology has significantly increased the popularity of infrapopliteal intervention. Since chronic total occlusion (CTO) is a common disorder among patients with symptomatic infrapopliteal artery disease, infrapopliteal CTO intervention is now evolving rapidly in the field of endovascular intervention. Guidewire crossing through the CTO is essential for a successful procedure. We review up-to-date infrapopliteal CTO crossing techniques based on the current literature. PMID:24754287

Kawarada, Osami; Sakamoto, Shingo; Harada, Koichiro; Ishihara, Masaharu; Yasuda, Satoshi; Ogawa, Hisao

2014-04-01

3

Current status of percutaneous coronary intervention of chronic total occlusion  

PubMed Central

This paper describes the current status of percutaneous coronary intervention (PCI) for totally occluded coronary arteries. Chronic total occlusion is associated with 10%–20% of all PCI procedures. Results show that opening an occluded vessel, especially one supplying a considerable area of myocardium, may be beneficial for a patient’s angina relief and heart function. We describe the devices used currently in re-canalization such as new wires, microcatheters (including Tonus and Cosair) and intravascular ultrasound guidance. Different techniques to improve the success rate and reduce complications are discussed in detail.

Ge, Jun-bo

2012-01-01

4

Advances in the management of coronary chronic total occlusions.  

PubMed

Chronic total occlusions (CTOs) have been called "the last frontier" of percutaneous coronary intervention (PCI) due to traditionally low success rates and high risk for restenosis and re-occlusion. Recent advances in equipment and crossing techniques have significantly increased CTO PCI success rates while maintaining low risk of complications. Specifically, the retrograde approach and controlled antegrade dissection and re-entry in conjunction with advanced guidewires and microcatheters have significantly improved procedural success rates. Moreover, the introduction of the "hybrid" approach has created a unified framework for operators to approach CTOs in a systematic and efficient fashion. Finally, drug-eluting stents, especially second generation, have improved long-term patency after CTO PCI. PMID:24634196

Brilakis, Emmanouil S; Karmpaliotis, Dimitri; Vo, Minh N; Garcia, Santiago; Michalis, Lampros; Alaswad, Khaldoon; Doshi, Parag; Lombardi, William L; Banerjee, Subhash

2014-06-01

5

Chronic total occlusion: To treat or not to treat  

PubMed Central

Over the last two decades, there has been increasing interest in new techniques for the percutaneous treatment of coronary chronic total occlusions (CTO), which have a success rate that is much higher than that of a few years ago. The rise in percutaneous treatment for these lesions is due to its ability to improve the symptoms and prognosis of patients in the chronic and stable phase of coronary disease. Current data suggest that successful percutaneous coronary intervention for CTO is associated with improvement in patient symptoms, quality of life, left ventricular function, and survival, compared with those with unsuccessful CTO PCI. However, all the scientific evidence supporting this treatment comes from observational studies, and no randomized study comparing percutaneous treatment with medical treatment has yet been published. A major limitation of these studies is their observational design, with limited information with regard to potential baseline differences between the successful vs unsuccessful cohorts. Pending randomized studies, patients should be selected very carefully, especially if they are asymptomatic or very few symptoms, and the benefits obtained in terms of complications during the procedure, the quality of life obtained and further ischemic events avoided should be evaluated systematically. In this review, we will consider the available information supporting percutaneous treatment for chronic occlusions, as well as the areas of uncertainty where more research projects are required.

Bardaji, Alfredo; Rodriguez-Lopez, Judit; Torres-Sanchez, Mauricio

2014-01-01

6

Contemporary overview and clinical perspectives of chronic total occlusions.  

PubMed

Chronic total occlusions (CTOs) are often detected on diagnostic coronary angiograms, but percutaneous coronary intervention (PCI) for CTO is currently infrequently performed owing to high technical difficulty, perceived risk of complications, and a lack of randomized data. However, successful CTO-PCI can significantly increase a patient's quality of life, improve left ventricular function, reduce the need for subsequent CABG surgery, and possibly improve long-term survival. A number of factors must be taken into account for the selection of patients for CTO-PCI, including the extent of ischaemia surrounding the occlusion, the level of myocardial viability, coronary location of the CTO, and probability of procedural success. Moreover, in patients with ST-segment elevation myocardial infarction, a CTO in a noninfarct-related artery might lead to an increase in infarct area, increased end-diastolic left ventricular pressure, and decreased left ventricular function, which are all associated with poor clinical outcomes. In this Review, we provide an overview of the anatomy and histopathology of CTOs, perceived benefits of CTO-PCI, considerations for patient selection for this procedure, and a summary of emerging techniques for CTO-PCI. PMID:24866424

Hoebers, Loes P; Claessen, Bimmer E; Dangas, George D; Råmunddal, Truls; Mehran, Roxana; Henriques, José P S

2014-08-01

7

Chronic total artery occlusions in noninfarct-related coronary arteries.  

PubMed

It has been rarely encountered some patients in clinical practice with coronary artery chronic total occlusion (CTO) on angiography but no any clinical history or electrocardiographic, echocardiographic, or left ventriculographic evidence of previous myocardial infarction. These noninfarct-related artery CTO (non-IRA CTO) lesions may be used as a clinical role model of endogenous cardioprotective mechanisms in addition to continuing the process of atherosclerosis. The objective of this study was to characterize the clinical characteristics of patients with non-IRA CTO patients and compared them to those with infarct-related CTO (IRA-CTO). We reviewed our invasive cardiology database searching for the CTO of any major coronary arteries, and assessed whether or not they have the clinical history or electrocardiographic, echocardiographic, and left ventriculographic evidence of previous myocardial infarction. Interestingly, we detected that all these patients with non-IRA CTO had diabetes mellitus, and the clinical and demographic features of these non-IRA CTO patients were compared with age- and sex-matched diabetic IRA-CTO patients with regard to conventional coronary risk factors and the angiographic collateral grading system. There were total 99 CTO patients (49 patients with non-IRA CTO and 50 patients with IRA-CTO).All patients with non-IRA CTO had better collateral circulation (96 vs. 40% p?

Ozeke, Ozcan; Gungor, Mutlu; Topaloglu, Serkan; Aras, Dursun; Ozer, Can

2014-03-01

8

Developments in coronary chronic total occlusion percutaneous coronary interventions: 2014 state-of-the-art update.  

PubMed

Percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) is a rapidly developing field. In the present review, we summarize the most important CTO PCI related literature published in 2013. PMID:24907082

Brilakis, Emmanouil S; Karmpaliotis, Dimitri; Werner, Gerald S; Spratt, James C; Uretsky, Barry F; Luna, Michael; Banerjee, Subhash

2014-06-01

9

Chronic total occlusion successfully treated with a bioresorbable everolimus-eluting vascular scaffold  

PubMed Central

Fully bioresorbable vascular scaffolds (BVS) are a new approach to the percutaneous treatment of coronary artery disease. The BVS have not yet been fully tested in complex lesions, including chronic total occlusion (CTO). We report a CTO case successfully treated with a second-generation bioabsorbable drug-eluting scaffold.

Mattesini, Alessio; Dall'Ara, Gianni; Mario, Carlo Di

2014-01-01

10

Distal open sesame and hairpin wire techniques to facilitate a chronic total occlusion intervention.  

PubMed

We describe a novel distal "open sesame" and "hairpin wire" technique application in a right coronary artery (RCA) chronic total occlusion intervention. Antegrade wiring was successful in entering an acute marginal branch distal to the occlusion, but not the mid RCA. After predilation, antegrade flow was restored but the mid RCA could not be wired in spite of using multiple different guidewires. A "hairpin" was created in a polymer jacketed guidewire, advanced into the acute marginal branch, and withdrawn, allowing wiring of the mid RCA, which was successfully stented using a variety of guide support and lesion preparation techniques. PMID:22388317

Michael, Tesfaldet; Banerjee, Subhash; Brilakis, Emmanouil S

2012-03-01

11

Early assessment of percutaneous coronary interventions for chronic total occlusions analyzed by novel echocardiographic techniques  

PubMed Central

OBJECTIVE: Successful revascularization of chronic total occlusions has been associated with improved left ventricular systolic function, reduced anginal symptoms, increased exercise capacity, and increased survival. This study was conducted to determine the impact of revascularization in chronic total occlusion on left ventricular function using novel echocardiographic techniques. METHODS: A total of 129 patients with chronic total occlusion who underwent revascularization between April 2011 and November 2012 were included in this study. Echocardiographic assessments with two-dimensional speckle tracking echocardiography and real-time three-dimensional echocardiography were performed before the procedure and one month after the procedure. The left ventricular ejection fraction, left ventricular volumes, and three-dimensional systolic dyssynchrony index were quantified. RESULTS: An immediate procedural success was obtained in 118 patients (91.5%). There were no acute or subacute stent thromboses during follow-up. The mean left ventricular ejection fraction significantly increased (p<0.001), while the left ventricular end-diastolic and end-systolic volumes significantly decreased (p?=?0.001 and p<0.001, respectively). The three-dimensional systolic dyssynchrony index also decreased significantly (p<0.001). The global longitudinal strain showed a significant increase after successful revascularization (p<0.001). An increase in the global longitudinal strain was correlated with an increase in the left ventricular ejection fraction (r?=?0.27, p?=?0.02). The patients with a left ventricular ejection fraction ?50% displayed a greater improvement in the global longitudinal strain, and the patients with diabetes showed less improvement. CONCLUSIONS: Using novel echocardiographic techniques, our results showed that restoring the coronary blood flow in chronic total occlusion patients reduces the left ventricular volumes and improves the left ventricular ejection fraction and the global longitudinal strain of hibernating myocardium.

Erdogan, Ercan; Akkaya, Mehmet; Bacaksiz, Ahmet; Tasal, Abdurrrahman; Sonmez, Osman; Elbey, Mehmet Ali; Kul, Seref; Vatankulu, Mehmet Akif; Turfan, Murat; Goktekin, Omer

2013-01-01

12

Percutaneous revascularization of a chronic total occlusion of the left lower pulmonary vein.  

PubMed

Pulmonary vein stenosis occurs in 1.3% of patients undergoing pulmonary vein isolation procedures for atrial fibrillation. Complete occlusion can occur and is often associated with symptoms including dyspnea and chest pain. Percutaneous intervention with angioplasty and stenting is frequently performed for pulmonary vein stenosis, but management of pulmonary vein occlusion remains challenging. We report the case of a 47-year-old female who presented with dyspnea and history of two previous radiofrequency ablation procedures for paroxysmal atrial fibrillation. Initial imaging with a ventilation/perfusion scan showed absent perfusion of the lower one-third of the left lung, and occlusion of the left lower pulmonary vein was confirmed by computed tomography (CT). Under sedation, with transesophageal echocardiographic and fluoroscopic guidance, the left atrium was accessed via the right femoral vein and a transseptal puncture. Initially, hydrophilic coronary guidewires were not able to cross the occlusion, but antegrade wire-escalation strategies usually reserved for coronary chronic total occlusion (CTO) cases were successful. The lesion was successfully stented, with prompt resolution of symptoms and stent patency demonstrated at follow-up. PMID:24717274

Murdoch, Dale; Poon, Karl; Walters, Darren L

2014-04-01

13

Crossing chronic total occlusions of the iliac and femoral-popliteal vessels and the use of true lumen reentry devices.  

PubMed

Treatment of chronic total occlusions of the iliac and femoral-popliteal vessels with endovascular techniques has become the standard approach for shorter lesions and is increasingly applied to long, complex arterial occlusive lesions. As the complexity of the arterial occlusions increases, the demands for technical skills and devices needed to successfully cross and treat the occlusion also increases. We describe here our technique for treatment of iliac and femoral-popliteal occlusions. Important aspects of that that have allowed for a high technical success include (1) the use of hydrophilic wires and catheters to traverse occlusions in the subintimal plane, (2) femoral access with axially supported catheters or sheaths to apply the force needed for successful recanalization, and (3) the use of true lumen reentry devices when, after crossing the occlusion, the wire or catheter cannot be manipulated into the true lumen beyond the occlusion. PMID:16628327

Jacobs, Donald L; Cox, Daniel E; Motaganahalli, Raghunandan

2006-03-01

14

Subintimal distal anchor technique for "balloon-uncrossable" chronic total occlusions.  

PubMed

Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) presents unique challenges and potential complications. The two most common failure modes are inability to cross the lesion with a guidewire and failure to cross the CTO with a balloon after successful guidewire crossing ("balloon-uncrossable" CTO). We present a creative solution to assist crossing of balloon-uncrossable CTOs that entails use of a balloon placed over a wire that has been advanced though the subintimal space to "anchor" the guidewire that has crossed through the CTO true lumen enabling lesion crossing with a balloon. PMID:24088432

Michael, Tesfaldet T; Banerjee, Subhash; Brilakis, Emmanouil S

2013-10-01

15

Coronary Stenting or Balloon Angioplasty for Chronic Total Coronary Occlusions: The Taiwan Experience (A Single-Center Report)  

Microsoft Academic Search

The authors conducted this study to compare the restenosis and reocclusion rates of primary balloon angioplasty alone versus angioplasty followed by stenting in Taiwanese patients with chronic total occlusions. They also evaluated whether stenting reduced the incidence of restenosis and improved left ventricular function in these patients. From October 1998 to April 2000, a total of 294 patients with chronic

Ching-Chang Fang; Yeun Tarl Fresner N. Jao; Yi Chen; Shih-Pu Wang

2005-01-01

16

Chronic total occlusion in ostium of right coronary artery - retrograde approach as the first-choice method of revascularization?  

PubMed Central

Recanalization of chronic total occlusion (CTO) located in the ostium may require the operator's ability to use the retrograde approach. We present a case of opening a chronically occluded right coronary artery (RCA) by the retrograde approach after an unsuccessful attempt of recanalization by classic antegrade technique.

Kameczura, Tomasz; Surowiec, Slawomir; Janus, Bogdan; Derlaga, Boguslaw; Dudek, Dariusz; Czarnecka, Danuta

2013-01-01

17

Dorsal-Plantar Loop Technique Using Chronic Total Occlusion Devices via Anterior Tibial Artery  

PubMed Central

The effectiveness of below-the-knee (BTK) percutaneous transluminal angioplasty to obtain successful revascularization in patients with critical limb ischemia has been well established, and many of these patients with chronic lower-extremity disease have been treated by endovascular intervention as the firstline treatment. Dorsal-plantaer loop technique is one of the new BTK interventional techiniques, and includes recanalization of both pedal and plantar arteries and their anatomical anastomoses. This method generally needs two approaches simultaneously, including antegrade and retrograde. In this report, however, we describe a case in which dorsal-plantar loop technique with only one antegrade approach, using chronic total occlusion devices via anterior tibial artery, was used to successfully recanalize BTK arteries. We think that this new technique, which may represent a safe and feasible endovascular option to avoid more invasive, time-consuming, and riskier surgical procedures, especially in end-stage renal disease and diabetes, should be considered whenever the foot is at risk, and results of above-the-ankle percutaneous transluminal angioplasty remain unsatisfactory or insufficient to achieve limb salvage.

Kim, Seunghwan; Shin, Sanghoon; Shin, Dong-Ho; Kim, Jung-Sun; Kim, Byeong-Keuk; Ko, Young-Guk; Hong, Myeong-Ki; Jang, Yangsoo

2013-01-01

18

Left main coronary artery aneurysm with chronic total occlusion of both left coronary arteries in a young athlete  

Microsoft Academic Search

Aneurysms of the left main coronary arteries are found in 0.1% of angiograms. This case involves an athlete with a left main coronary artery aneurysm, which was combined with chronic total occlusion of the proximal left anterior descending and proximal left circumflex coronary arteries. The extraordinary clinical presentation in this patient may be associated with good coronary collaterals, which may

S-H Park; S-E Kim; S K Ryu

2001-01-01

19

Preprocedural coronary CT angiography significantly improves success rates of PCI for chronic total occlusion.  

PubMed

Chronic total occlusions of coronary arteries occur in about 20% of patients with suspected coronary artery disease and are more frequent with increasing age. The success rate of interventions is lower (55-80%) compared to conventional lesions (>90%). Coronary CT angiography (coronary CTA) provides information about the occluded segment, which cannot be obtained from invasive angiograms (XA). We therefore hypothesized that preprocedural coronary CTA may improve success rates of percutaneous coronary intervention (PCI) for coronary arteries (CTO). 30 patients with chronic total coronary artery occlusions (mean age 73 years, 26 men) and predicted high complexity were imaged by coronary CTA prior to PCI for CTO. CT data sets were acquired with a 64 detector row dual source scanner and retrograde ECG gating, 0.6 mm collimation and z-flying focal spot, yielding isovoxel spatial resolution of about 0.4 mm. Based on the CT data sets, established complexity criteria for CTO (Euro CTO club, Di Mario et al. in EuroIntervention 3(1):30-43, 2007) were evaluated and compared to invasive coronary angiography. Three-dimensional volume-rendered images of the occluded coronary artery were displayed in the catheterization lab during PCI to guide the advancement of the wire. PCI success, defined as the ability to advance the guide wire into the distal lumen with thrombolysis in myocardial infarction III flow was compared to 43 controls without coronary CTA using propensity score matching based on established criteria of procedural success. The course of the occluded segments was visualized by coronary CTA in all cases. Calcification, lesion length, stump morphology and presence of side branches were underestimated by invasive angiograms when compared to coronary CTA. PCI success rate in 30 patients who underwent pre-procedural CTA was significantly higher than in patients without prior coronary CTA [unmatched: CT 90% (27/30) vs. no CT 63% (27/43), p = 0.009; matched: CT 88% (22/25) vs. no CT 64% (16/25) p = 0.03]. Through information not readily seen on invasive coronary angiography, coronary CTA can significantly enhance success rates of PCI for CTO. PMID:23793727

Rolf, Andreas; Werner, Gerald S; Schuhbäck, Annika; Rixe, Johannes; Möllmann, Helge; Nef, Holger M; Gundermann, Constantin; Liebetrau, Christoph; Krombach, Gabriele A; Hamm, Christian W; Achenbach, Stephan

2013-12-01

20

Efficacy of metal tip catheter for chronic total occlusion lesions in peripheral arterial disease.  

PubMed

We performed several techniques for chronic total occlusion (CTO) lesions in peripheral arterial disease (PAD). We evaluated the cases using the metal tip catheter (MT). We performed peripheral endovascular therapy (EVT) using MT in 31 cases 32 lesions of PAD from March 2007 to March 2011. Twenty-nine cases were CTO lesions using MT for back up of guidewire or MT alone in order to penetrate like a bougie with the blunt tip of MT. Two cases were acute arterial thrombosis for thrombectomy. Seven cases were CTO of the iliac artery (IA) and 25 cases were of the femoral artery (FA). Seven cases were in-stent restenosis. All 7 cases of IA were successfully treated with the initial techniques. We were unable to penetrate by MT(MT-) in 7 cases of FA, and in 2 cases out of the 7, we were even unable to cross the guidewire. Mean lesion length was 80 ± 42 mm in IA and 188 ± 88 mm in SFA. Among them, MT- was 164 ± 67 mm with no significant differences. Procedure time of EVT for CTO using MT was significantly shorter than other strategies. We had no complications such as perforation by using MT. MT provides high initial success rate by spectacular penetration performance and pushability. MT is a safe and effective device for CTO in PAD. PMID:24122636

Ihara, Minoru; Yamazaki, Tsugiyoshi; Kudo, Masaharu; Murai, Osamu; Tsukamoto, Yoshiaki

2012-01-01

21

Successful percutaneous coronary intervention of chronic total occlusion of the right coronary artery using "bidirectional kissing-balloon" technique.  

PubMed

We report on a 74-year-old man with chronic total occlusion (CTO) of the right coronary artery treated with percutaneous coronary intervention using the bidirectional kissing-balloon technique. When an antegrade approach fails, a retrograde approach to recanalize a CTO is reasonable. However, when the exit of the CTO is bifurcated and a protection wire does not advance antegrade into the side branch after wire externalization, loss of blood flow after ballooning or stenting may result. We report on the usefulness of the bidirectional kissing-balloon technique for a retrograde approach to chronically totally occluded coronary arterial bifurcation lesions. PMID:24907092

Numasawa, Yohei; Hamazaki, Yuji; Takahashi, Toshiyuki

2014-06-01

22

Single 6 fr transradial guiding catheter for retrograde recanalization of left coronary artery chronic total occlusions: a case series.  

PubMed

The retrograde approach for percutaneous coronary intervention, using multiple arterial accesses for contralateral injection and large guiding catheters (7-8 Fr), has largely improved the success rate of recanalization of chronic total occlusions (CTOs). Radial approach and downsizing in this type of intervention are challenging. Our cases series demonstrates that in selected anatomies it is possible, feasible, and safe to perform single 6 Fr transradial guiding catheter retrograde recanalization of left-sided CTO via ipsilateral epicardial or septal collateral channels. PMID:24993996

Chung, Tak-Shun; Agostoni, Pierfrancesco

2014-07-01

23

Comparative luminescent analysis of healthy and calcified arteries for catheter guidance in chronic total occlusion revascularization  

Microsoft Academic Search

The work is devoted to photoluminescence investigation of arterial walls in order to create a new navigation method for minimally invasive treatment of cardiovascular decease in the presence of chronic total oc- clusions. The comparative analysis of luminescent spectra for healthy and calcified arterial tissue was realized in two types of investigations: integral spectral measurements of the samples and spectroscopic

Ludmila Bakueva; Lukasz Brzozowski; Ivan Gorelikov; J. Graham; K. Courtney; Stephen E. Fremes; A. Wright; John A. Rowlands

24

Utility of the Safe-Cross-guided radiofrequency total occlusion crossing system in chronic coronary total occlusions (results from the Guided Radio Frequency Energy Ablation of Total Occlusions Registry Study).  

PubMed

The Safe-Cross radiofrequency guidewire (IntraLuminal Therapeutics, Carlsbad, California) combines 3 capabilities: (1) steerability of a conventional 0.014-in intermediate-stiffness guidewire, (2) optical coherence reflectometry to warn the operator when the wire tip approaches within 1 mm of the vessel wall, and (3) delivery of radiofrequency energy pulses to the wire tip to facilitate passage through an occluded segment. The Guided Radio Frequency Energy Ablation of Total Occlusions Registry was a prospective, nonrandomized, multicenter registry that enrolled 116 patients who had long-term coronary total occlusions and in whom a >10-minute good-faith attempt to cross the occlusion using conventional guidewires had failed. The median known duration of occlusion was 22 months (32%; >1 year), and the median length of the occluded segment was 25 mm (25%; >30 mm). Device success was achieved in 63 of 116 of patients (54.3%), and major adverse events occurred in 6.9%, consisting predominantly of isolated increases in cardiac enzymes with no procedure-related deaths, Q-wave myocardial infarctions, or emergency bypass operations. Clinical perforation occurred in 2.6% of patients; of these, perforation in only 1 patient (0.9%) was adjudicated to be directly related to the Safe-Cross radiofrequency wire rather than to the stiff and/or hydrophilic wires used after an inability to advance with the Safe-Cross. Based on these data, the device has been approved in Europe and was recently (January 2004) granted 510K clearance by the Food and Drug Administration. PMID:15464664

Baim, Donald S; Braden, Greg; Heuser, Richard; Popma, Jeffrey J; Cutlip, Donald E; Massaro, Joseph M; Marulkar, Sachin; Arvay, Linda J; Kuntz, Richard E

2004-10-01

25

Chronic Total Occlusion and Successful Drug-Eluting Stent Placement in Takayasu Arteritis-Induced Renal Artery Stenosis  

PubMed Central

Takayasu arteritis-induced renal artery stenosis (TARAS) is a condition rarely described in the literature. Although percutaneous transluminal angioplasty and stenting has been well-described in the treatment of atherosclerotic renal artery stenosis, its role has not been established in non-atherosclerotic TARAS. We report a case of a female, age 17 years, with Takayasu arteritis who presented to the hospital with seizures and hypertensive crisis. A renal angiogram showed chronic total occlusion (CTO) of the left renal artery. Renal angioplasty and stenting was successfully performed after multiple attempts to deliver a wire distal to the CTO. After sequential balloon predilation, a drug-eluting stent was deployed, resulting in full reperfusion of the kidney. The patient’s blood pressure improved dramatically, and patency of the stent was demonstrated with magnetic resonance angiography over 9 months after the procedure.

Agarwal, Guarav; Vats, Hemender S.; Raval, Amish N.; Yevzlin, Alexander S.; Chan, Micah R.; Gimelli, Giorgio

2013-01-01

26

Trans-collateral angioplasty for the treatment of long chronic total occlusions of superficial femoral arteries: a novel wiring technique.  

PubMed

Endovascular therapy (EVT) utilizing percutaneous transluminal angioplasty has become a standard technique to re-establish sufficient blood flow in ischemic limbs of patients with peripheral arterial disease (PAD). Long chronic total occlusion (CTO) of the superficial femoral artery (SFA) remains one of the challenging lesions in the field of EVT for PAD patients, despite the recent introduction of many dedicated interventional devices such as high-performance guidewires. In this article, we report a novel interventional technique, trans-collateral angioplasty (TCA), to improve the initial success rate of EVT for long SFA-CTO lesions. We present one representative case, and describe the technical tips and appropriate device selection criteria for the TCA procedure. The outcomes of TCA for long SFA-CTO performed last year at our institution are also summarized and discussed. PMID:21796093

Urasawa, K; Sato, K; Koshida, R; Honma, Y

2014-06-01

27

Real-Time MRI-Guided Endovascular Recanalization of Chronic Total Arterial Occlusion in a Swine Model  

PubMed Central

Background Endovascular recanalization (guidewire traversal) of peripheral artery chronic total occlusion (CTO) can be challenging. X-Ray angiography resolves CTO poorly. Virtually “blind” device advancement during X-ray-guided interventions can lead to procedure failure, perforation and hemorrhage. Alternatively, magnetic resonance imaging (MRI) may delineate the artery within the occluded segment to enhance procedural safety and success. We hypothesized that real-time MRI (rtMRI) guided CTO recanalization can be accomplished in an animal model. Methods and Results Carotid artery CTO was created by balloon injury in 19 lipid overfed swine. After 6–8 weeks, two underwent direct necropsy analysis for histology, three underwent primary X-ray-guided CTO recanalization attempts, and the remaining 14 underwent rtMRI-guided recanalization attempts in a 1.5T interventional MRI system. rtMRI intervention used custom CTO catheters and guidewires that incorporated MRI receiver antennae to enhance device visibility. The mean length of the occluded segments was 13.3 ± 1.6cm. rtMRI-guided CTO recanalization was successful in 11/14 swine and only 1/3 swine using X-ray alone. After unsuccessful rtMRI (n = 3), X-ray-guided attempts also were all unsuccessful. Conclusions Recanalization of long CTO is feasible entirely using rtMRI guidance. Low profile clinical-grade devices will be required to translate this experience to humans. Endovascular recanalization of chronic total arterial occlusion (CTO) is challenging under conventional X-ray guidance because devices are advanced almost blindly. MRI can image CTO borders and luminal contents, and could potentially guide these procedures. We test the feasibility of real-time MRI guided wire traversal in a swine model of peripheral artery CTO using custom active MRI catheters.

Raval, Amish N.; Karmarkar, Parag V.; Guttman, Michael A.; Ozturk, Cengizhan; Sampath, Smita; DeSilva, Ranil; Aviles, Ronnier J.; Xu, Minnan; Wright, Victor J.; Schenke, William H.; Kocaturk, Ozgur; Dick, Alexander J.; Raman, Venkatesh K.; Atalar, Ergin; McVeigh, Elliot R.; Lederman, Robert J.

2006-01-01

28

Multi-Modality Image Fusion to Guide Peripheral Artery Chronic Total Arterial Occlusion Recanalization in a Swine Carotid Artery Occlusion Model: Unblinding the Interventionalist!  

PubMed Central

Objectives To demonstrate the feasibility of magnetic resonance imaging (MRI) to x-ray fluoroscopy (XRF) image fusion to guide peripheral artery chronic total occlusion (CTO) recanalization. Background Endovascular peripheral artery CTO revascularization is minimally invasive, but challenging, because the occlusion is poorly visualized under XRF. Devices may steer out of the artery which can lead to severe perforation. Merging pre-acquired MRI of the CTO to the live XRF display may permit upfront use of aggressive devices and improve procedural outcomes. Methods Swine carotid artery CTO’s were created using a balloon injury model. Up to 8 weeks later, MRI of the carotid arteries was acquired and segmented to create 3D surface models, which were then registered onto live XRF. CTO recanalization was performed using incrementally aggressive CTO devices (Group A) or an upfront aggressive directed laser approach (Group B). Procedural success was defined as luminal or sub-intimal device position without severe perforation. Results In this swine model, MRI to XRF fusion guidance resulted in a procedural success of 57% in Group A and 100% in Group B, which compared favorably to 33% using XRF alone. Fluoroscopy time was significantly less for Group B (8.5 min ± 2.6 min) compared to Group A (48.7 min ± 23.9 min), p value<0.01. Contrast dose used was similar between Groups A and B. Conclusions MRI to XRF fusion guided peripheral artery CTO recanalization is feasible. Multi-modality image fusion may permit upfront use of aggressive CTO devices with improved procedural outcomes compared to XRF guided procedures.

Klein, Andrew J.; Tomkowiak, Michael T.; Vigen, Karl K.; Hacker, Timothy A.; Speidel, Michael A.; VanLysel, Michael S.; Shah, Nehal; Raval, Amish N.

2012-01-01

29

Use of a thrombectomy catheter for contrast injection: a novel technique for preventing extension of an aortocoronary dissection during the retrograde approach to a chronic total occlusion.  

PubMed

Percutaneous coronary intervention of a chronic total occlusion can be complicated by aortocoronary dissection. To prevent extension of the dissection, repeat contrast injections are discouraged; however, they are sometimes required to confirm optimal distal angiographic result. We describe use of a thrombectomy catheter for distal contrast injection in one such patient that allowed distal vessel visualization without propagating the aortocoronary dissection. PMID:24791726

Al Salti Al Krad, Hani; Kaminsky, Brian; Brilakis, Emmanouil S

2014-05-01

30

Navifocus WR is the promising intravascular ultrasound for navigating the guidewire into true lumen during the coronary intervention for chronic total occlusion.  

PubMed

We describe an initial clinical chronic total occlusion (CTO) case in which CTO-specific intravascular ultrasound (IVUS): Navifocus WR was useful for navigating the second guidewire into the true lumen under the IVUS observation from the subintimal space. PMID:24101093

Okamura, Atsunori; Iwakura, Katsuomi; Date, Motoo; Nagai, Hiroyuki; Sumiyoshi, Akinori; Fujii, Kenshi

2014-04-01

31

Use of the retrograde approach for preserving the distal bifurcation after antegrade crossing of a right coronary artery chronic total occlusion.  

PubMed

Percutaneous coronary intervention (PCI) of a chronic total occlusion (CTO) can be challenging when a bifurcation is present at the distal cap. We describe a case of combined use of the antegrade and retrograde approach for preserving a distal cap bifurcation during CTO PCI. PMID:24717282

Kotsia, Anna; Christopoulos, George; Brilakis, Emmanouil S

2014-04-01

32

The Straight Wire Sign: recognizing guidewire exit during percutaneous coronary intervention for chronic total occlusion.  

PubMed

Coronary perforation during PCI may be life threatening. Use of stiff wires during instrumentation of totally occluded arteries is a contributing factor. The "Straight Wire" sign presented here was realized from a case of coronary perforation encountered at our cath lab. The identification of this sign in another patient prompted immediate response and avoided further complications. PMID:17134776

Mosseri, Morris; Banai, Shmuel; Jabara, Refat; Rott, David

2007-04-01

33

Guidewires Used in First Intentional Single Wiring Strategy for Chronic Total Occlusions of the Left Anterior Descending Coronary Artery  

PubMed Central

Background: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of the left anterior descending (LAD) specifically is associated with improved long-term 5 year survival as compared to PCI failure. The procedure is associated with usage of different types of dedicated guidewires by simple or complex techniques aiming to reopen the occluded artery. Aim: To describe types and outcome of guidewires used in LAD-CTO utilizing a first intentional single wiring simple strategy. Methods: A single center prospective registry for all consecutive patients with a PCI attempt to a native LAD CTO. The initial strategy for lesion crossing was Single wiring. Results: A total of 30 patients with LAD CTO lesions (100%), were recorded. Mean age was 71.6 + 15 years, 77% were Males, risk factors Hypertension in 63%, Diabetes 27%, Dyslipidemia 57%, smoking 40%, hereditary in 13% of patients. Isolated guidewire (GW) success rate was very high 93%. Single wiring was the prevailing technique used in 97% of successfull lesions (83% of total cases) while only 3% were by multiple wiring techniques. Successful single antegrade wiring represented 63% with a GW success rate of 92% of cases. Successful single retrograde wiring represented 13% with a GW success rate of 67%. Successful Crossing GW types in our patients were 44% Soft Tapered GWs; fielder XT (44%), 36% were Soft Non Tapered Pilot 50 (28%), whisper (8%), while 16% were Stiff Non tapered GWs; Miracle 12 (8%), Miracle 6 (4%), Miracle 3 (4%), and 4% were Stiff Tapered GWs; Progress 200 (4%). Conclusions: Single wiring as an initial strategy in PCI for LAD-CTO lesions has a high success rate and is associated with a 44% majority of Soft Tapered GWs, 36% Soft Non Tapered, 16% Stiff Non tapered GWs, and 4% Stiff Tapered GWs.

Nassar, Yasser S.; Boudou, Nicolas; Dumonteil, Nicolas; Lhermusier, Thibault; Carrie, Didier

2013-01-01

34

Endovascular Treatment of Infrainguinal Chronic Total Occlusions Using the TruePath Device: Features, Handling, and 6-Month Outcomes.  

PubMed

Purpose : To report experience with a recently approved peripheral chronic total occlusion (CTO) crossing device in the superficial femoral (SFA), popliteal, and below-the-knee (BTK) arteries. Methods : Thirteen patients (all men; mean age 68.6±7.9 years) from the XLPAD registry (ClinicalTrials.gov identifier NCT01904851) were treated between April 2012 and August 2013 with the TruePath device after an unsuccessful guidewire crossing attempt. More than half of the patients had diabetes mellitus. Most lesions were TASC classification type C (n=5) or D (n=6), with mean lesion length 169.8±83.3 mm; 12 lesions were de novo and severely calcified. Procedure success was defined as successful revascularization of the CTO. Technical success was placement of a guidewire beyond the distal CTO cap into the true lumen without the need for a re-entry device. Results : All CTOs were successfully crossed using the TruePath, but 3 subintimal recanalizations required the use of a re-entry device (77% technical success). Eight lesions were stented, while the remaining were treated with balloon angioplasty and/or atherectomy. Average fluoroscopy time was 41.1±18.3 minutes, during which a mean 200.0±46.2 mL of iodinated contrast were used (radiation dose area product 211.2±202.6 Gy*cm(2)). There were no periprocedural complications. Significant improvement was seen in the 6-month ankle-brachial index (p=0.018) and Rutherford class (p=0.019). The 6-month clinically indicated target vessel revascularization rate was 8%. Conclusion : TruePath facilitated successful crossing of infrainguinal CTOs following an unsuccessful guidewire recanalization, with significant improvement in symptoms and no complications. PMID:24754288

Banerjee, Subhash; Sarode, Karan; Das, Thomas; Hadidi, Omar; Thomas, Rahul; Vinas, Ariel; Garg, Puja; Mohammad, Atif; Baig, Mirza S; Shammas, Nicolas W; Brilakis, Emmanouil S

2014-04-01

35

Short-term effect of percutaneous recanalization of chronic total occlusions on QT dispersion and heart rate variability parameters  

PubMed Central

Background QT dispersion (QTd), which is a measure of inhomogeneity of myocardial repolarization, increases following impaired myocardial perfusion. Its prolongation may provide a suitable substrate for life-threatening ventricular arrhythmias. We investigated the changes in QTd and heart rate variability (HRV) parameters after successful coronary artery revascularization in a patient with chronic total occlusions (CTO). Material/Methods This study included 139 successfully revascularized CTO patients (118 men, 21 women, mean age 58.3±9.6 years). QTd was measured from a 12-lead electrocardiogram and was defined as the difference between maximum and minimum QT interval. HRV analyses of all subjects were obtained. Frequency domain (LF: HF) and time domain (SDNN, pNN50, and rMSSD) parameters were analyzed. QT intervals were also corrected for heart rate using Bazett’s formula, and the corrected QT interval dispersion (QTcd) was then calculated. All measurements were made before and after percutaneous coronary intervention (PCI). Results Both QTd and QTcd showed significant improvement following successful revascularization of CTO (55.83±14.79 to 38.87±11.69; p<0.001 and 61.02±16.28 to 42.92±13.41; p<0.001). The revascularization of LAD (n=38), Cx (n=28) and RCA (n=73) resulted in decrease in HRV indices, including SDDN, rMSSD, and pNN50, but none of the variables reached statistical significance. Conclusions Successful revascularization of CTO may result in improvement in regional heterogeneity of myocardial repolarization, evidenced as decreased QTcd after the PCI. The revascularization in CTO lesions does not seem to have a significant impact on HRV.

Erdogan, Ercan; Akkaya, Mehmet; Bacaks?z, Ahmet; Tasal, Abdurrahman; Sonmez, Osman; Asoglu, Emin; Kul, Seref; Sah?n, Musa; Turfan, Murat; Vatankulu, Mehmet Akif; Goktekin, Omer

2013-01-01

36

Determinants of success of coronary angioplasty in patients with a chronic total occlusion: a multiple logistic regression model to improve selection of patients  

Microsoft Academic Search

OBJECTIVE--To study the determinants of success of coronary angioplasty in patients with chronic total occlusions, and to formulate a multiple logistic regression model to improve selection of patients. DESIGN--A retrospective analysis of clinical and angiographic data on a consecutive series of patients. PATIENTS--312 patients (mean age 55, range 31 to 79 years, 86% men) who underwent coronary angioplasty procedure for

K H Tan; N Sulke; N A Taub; E Watts; S Karani; E Sowton

1993-01-01

37

Rationale and design of EXPLORE: a randomized, prospective, multicenter trial investigating the impact of recanalization of a chronic total occlusion on left ventricular function in patients after primary percutaneous coronary intervention for acute ST-elevation myocardial infarction  

PubMed Central

Background In the setting of primary percutaneous coronary intervention, patients with a chronic total occlusion in a non-infarct related artery were recently identified as a high-risk subgroup. It is unclear whether ST-elevation myocardial infarction patients with a chronic total occlusion in a non-infarct related artery should undergo additional percutaneous coronary intervention of the chronic total occlusion on top of optimal medical therapy shortly after primary percutaneous coronary intervention. Possible beneficial effects include reduction in adverse left ventricular remodeling and preservation of global left ventricular function and improved clinical outcome during future coronary events. Methods/Design The Evaluating Xience V and left ventricular function in Percutaneous coronary intervention on occLusiOns afteR ST-Elevation myocardial infarction (EXPLORE) trial is a randomized, prospective, multicenter, two-arm trial with blinded evaluation of endpoints. Three hundred patients after primary percutaneous coronary intervention for ST-elevation myocardial infarction with a chronic total occlusion in a non-infarct related artery are randomized to either elective percutaneous coronary intervention of the chronic total occlusion within seven days or standard medical treatment. When assigned to the invasive arm, an everolimus-eluting coronary stent is used. Primary endpoints are left ventricular ejection fraction and left ventricular end-diastolic volume assessed by cardiac Magnetic Resonance Imaging at four months. Clinical follow-up will continue until five years. Discussion The ongoing EXPLORE trial is the first randomized clinical trial powered to investigate whether recanalization of a chronic total occlusion in a non-infarct related artery after primary percutaneous coronary intervention for ST-elevation myocardial infarction results in a better preserved residual left ventricular ejection fraction, reduced end-diastolic volume and enhanced clinical outcome. Trial registration trialregister.nl NTR1108.

2010-01-01

38

The utility of a guideliner™ catheter in retrograde percutaneous coronary intervention of a chronic total occlusion with reverse cart-the "capture" technique.  

PubMed

The hybrid approach to percutaneous treatment of chronic total occlusion (CTO) of coronary arteries requires both antegrade and retrograde skillsets. In the retrograde approach, wire externalization through the antegrade guide catheter often requires the use of a short donor guide catheter and a long (>150 cm) micro-catheter. Despite this there are occasions where the micro-catheter is unable to reach the anterograde guide catheter because of long collateral channels particularly when the retrograde limb involves a bypass graft. We report such a case where retrograde intervention was used to treat a right coronary artery (RCA) CTO in a patient with stable angina. The retrograde limb involved a saphenous vein graft to the native circumflex artery, which in turn provided collateral channels to the distal RCA. After performing reverse controlled anterograde and retrograde sub-intimal tracking (CART), the retrograde micro-catheter was only able to reach the mid RCA. To solve this, a Guideliner™ catheter was passed on the antegrade wire and successfully advanced over and "captured" the retrograde micro-catheter. Wire externalization was then completed and the RCA was subsequently stented with a good final angiographic result. This case illustrates a novel approach to completing wire externalization and provides a further indication for the role of the Guideliner™ catheter in treating CTOs. PMID:24089343

Mozid, Abdul M; Davies, John R; Spratt, James C

2014-05-01

39

High-Resolution 3D Arteriography of Chronic Total Peripheral Occlusions Using a T1-W Turbo Spin-Echo Sequence With Inner-Volume Imaging  

PubMed Central

Percutaneous revascularization of peripheral artery chronic total occlusion (CTO) is challenging under X-ray guidance without direct image feedback, due to poor visualization of the obstructed segment and underappreciation of vessel tortuosity. Operators are required to steer interventional devices relatively “blindly,” and therefore procedural failure or perforation may occur. Alternatively, MRI may allow complete visualization of both patent and occluded arterial segments. We designed and implemented a 3D high-resolution, T1-weighted (T1-W) turbo spin-echo (TSE) MRI sequence with inner-volume (IV) imaging to enable detailed peripheral artery CTO imaging. Using this sequence, high-resolution volumes of interest (VOIs) around the vessel were achieved within 5-10 min. This imaging approach may be used for rapid pre- and postprocedural evaluations, and as a 3D roadmap that can be overlaid during real-time X-, MR-, or XMR-guided catheterization. Experiments were successfully performed on a carotid CTO model in swine ex vivo, and in peripheral arteries in normal volunteers and patients in vivo. Delineation of the vascular architecture, including contrast differences between the patent and occluded artery segments, and lesion morphology heterogeneity were visualized.

Sampath, Smita; Raval, Amish N.; Lederman, Robert J.; McVeigh, Elliot R.

2007-01-01

40

Clinical Significance of A Single Multi-Slice CT Assessment in Patients with Coronary Chronic Total Occlusion Lesions Prior to Revascularization  

PubMed Central

Accurate assessment of coronary chronic total occlusion (CTO) lesion is essential to design an appropriate procedural strategy before revascularization. The present study aims to evaluate the significance of a single multislice computed tomography (MSCT) examination in patients with CTO lesion. We retrospectively analyzed the clinical data of 23 CTO lesions in twenty patients underwent computed tomography coronary angiography (CTCA) and SPECT. The CTCA was more powerful and sensitive to determine the CTO lesion length (100% v.s 47.8%) and to identify the length and location of calcification in occluded vessels compared with the coronary angiography (CAG). The LVEF measured by MSCT was comparable to that from the gated SPECT. Myocardial perfusion imaging showed that the location of the early defect region identified by MSCT was corresponded to the nuclide filling defect on the stressed 201thallium-SPECT imaging. The late hyperenhancement on MSCT was presented as incomplete nuclide filling on the 99mTc-MIBI imaging. The results suggested that a single MSCT examination in previous myocardial infarction without revascularization facilitates to provide some valuable information on the nature of the occluded lesion, myocardial perfusion and globe cardiac function, which would be helpful to design appropriate revascularization strategy in these subjects.

Qu, Xinkai; Fang, Weiyi; Gong, Kaizheng; Ye, Jianding; Guan, Shaofeng; Li, Ruogu; Xu, Yingjia; Shen, Yan; Zhang, Min; Liu, Hua; Xie, Wenhui

2014-01-01

41

Immediate- and short-term outcome following recanalization of long chronic total occlusions (> 50 mm) of native coronary arteries with the Frontrunner catheter.  

PubMed

Thirty percent of diagnostic angiograms have at least 1 chronic total occlusion (CTO). The 10-year survival of patients with a CTO is improved if they have the CTO successfully recanalized. The success of recanalization with conventional wires is 50% and the impact of new technology on recanalization is unknown. This abstract reports a single center experience with one such new device, the Lumend Frontrunner catheter in revascularization of this difficult lesion subset. A consecutive series of 18 patients with CTO's of native coronary arteries were enrolled in this single center, single operator series. The mean age of the CTO was 5.3 years. The indication for attempt at recanalization was ischemia in the territory of the CTO on SPECT imaging. Success was defined as TIMI flow restoration and < 40% residual stenosis. Primary success (defined as TIMI 3 Flow restoration and < 40% residual stenosis) was achieved in 77% of patients. At 30 days and out to 6 months, clinical TVR was 11% (2/18) in this difficult lesion subset. Conventional predictors of failure to recanalize CTOs do not appear to hold true with the use of the Frontrunner catheter. In this small series, dual cusp injections and use of the Microglide catheter appears to correlate with favorable outcomes. Fluoroscopy times and contrast use are high when attempting recanalization of CTOs with this technology. PMID:16775901

Loli, Akil; Liu, Rex; Pershad, Ashish

2006-06-01

42

Clinical Significance of A Single Multi-Slice CT Assessment in Patients with Coronary Chronic Total Occlusion Lesions Prior to Revascularization.  

PubMed

Accurate assessment of coronary chronic total occlusion (CTO) lesion is essential to design an appropriate procedural strategy before revascularization. The present study aims to evaluate the significance of a single multislice computed tomography (MSCT) examination in patients with CTO lesion. We retrospectively analyzed the clinical data of 23 CTO lesions in twenty patients underwent computed tomography coronary angiography (CTCA) and SPECT. The CTCA was more powerful and sensitive to determine the CTO lesion length (100% v.s 47.8%) and to identify the length and location of calcification in occluded vessels compared with the coronary angiography (CAG). The LVEF measured by MSCT was comparable to that from the gated SPECT. Myocardial perfusion imaging showed that the location of the early defect region identified by MSCT was corresponded to the nuclide filling defect on the stressed 201thallium-SPECT imaging. The late hyperenhancement on MSCT was presented as incomplete nuclide filling on the 99mTc-MIBI imaging. The results suggested that a single MSCT examination in previous myocardial infarction without revascularization facilitates to provide some valuable information on the nature of the occluded lesion, myocardial perfusion and globe cardiac function, which would be helpful to design appropriate revascularization strategy in these subjects. PMID:24905494

Qu, Xinkai; Fang, Weiyi; Gong, Kaizheng; Ye, Jianding; Guan, Shaofeng; Li, Ruogu; Xu, Yingjia; Shen, Yan; Zhang, Min; Liu, Hua; Xie, Wenhui

2014-01-01

43

Evaluation of the Effect of Concurrent Chronic Total Occlusion and Successful Staged Revascularization on Long-Term Mortality in Patients with ST-Elevation Myocardial Infarction  

PubMed Central

Aims. To investigate the impact of chronic total occlusion (CTO) in non-infarct-related artery (IRA) on the long-term prognosis and evaluate the clinical significance of staged revascularization in patients with ST-segment elevation myocardial infarction (STEMI). Methods. 1266 STEMI patients with primary percutaneous coronary intervention (PCI) were categorized as single-vessel disease (SVD), multivessel disease (MVD) without and with CTO. We study the clinical outcomes of patients after primary PCI in the following 3 years. Additionally, patients with CTO received staged revascularization, and major adverse cardiac events (MACE) during 3-year follow-up were recorded. Results. Presence of CTO was a predictor of both early mortality [hazard ratio (HR) 3.4, 95% confidence interval (CI) 2.4–4.5, P < 0.01] and late mortality (HR 1.9, 95% CI 1.4–3.6, P < 0.01), whereas MVD without CTO was only a predictor of early mortality (HR 1.7, 95% CI 1.3–2.3, P < 0.05). In CTO group, 100 patients had successful CTO recanalization, and 48 patients failed. During 3-year follow-up, patients with failed procedure had higher cardiac mortality (22.9% versus 9.0%, P = 0.020) and lower MACE-free survival (50.0% versus 72.0%, P = 0.009) compared to patients with successful procedure. Conclusion. The presence of CTO and not MVD alone is associated with long-term mortality. Successful revascularization of CTO in the non-IRA is associated with improved clinical outcomes in patients with STEMI undergoing primary PCI.

Shi, Guoxiang; He, Pengcheng; Liu, Yuanhui; Lin, Yaowang; Yang, Xing; Chen, Jiyuan; Zhou, Yingling; Tan, Ning

2014-01-01

44

Application of the "hybrid approach" to chronic total occlusions in patients with previous coronary artery bypass graft surgery (from a Contemporary Multicenter US registry).  

PubMed

Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) has been traditionally associated with lower success rates in patients with previous coronary artery bypass graft surgery (CABG). We sought to examine the success and complication rates of CTO PCI using the "hybrid" crossing algorithm among patients with a history of previous CABG. The procedural outcomes of 496 consecutive CTO PCIs performed at 5 high-volume PCI centers in the United States from January 2012 to August 2013 were assessed. The outcomes of patients with previous CABG were compared with those of patients without previous CABG. Compared with patients without previous CABG (n = 320), patients with previous CABG (n = 176, 35%) were older, had more coronary artery disease risk factors, and had less favorable baseline angiographic CTO characteristics. Technical and procedural success was slightly lower among patients with previous CABG (88.1% vs 93.4%, p = 0.044 and 87.5 vs 92.5%, p = 0.07, respectively). Patients with previous CABG more commonly underwent CTO PCI using the retrograde approach (39% vs 24%, respectively, p <0.001) and received higher air kerma radiation exposure (4.8 [interquartile range 3.0 to 6.4] vs 3.1 [1.9 to 5.3] Gray, p <0.001) and fluoroscopy time (59 [38 to 77] vs 34 [21 to 55] minutes, p <0.001). Major procedural complications were similar in the 2 groups: 2 of 176 (1.1%) patients with previous CABG versus 7 of 320 (2.1%) patients without previous CABG (p = 0.40). In conclusion, with application of the "hybrid" approach to CTO PCI, success was slightly lower, and complication rates were similar between patients with and without previous CABG. PMID:24793678

Christopoulos, Georgios; Menon, Rohan V; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Lombardi, William; Grantham, J Aaron; Michael, Tesfaldet T; Patel, Vishal G; Rangan, Bavana V; Kotsia, Anna P; Lembo, Nicholas; Kandzari, David E; Lee, James; Kalynych, Anna; Carlson, Harold; Garcia, Santiago; Banerjee, Subhash; Thompson, Craig A; Brilakis, Emmanouil S

2014-06-15

45

Stent implantation versus balloon angioplasty in chronic coronary occlusions: results from the GISSOC trial  

Microsoft Academic Search

Objectives. In this multicenter, randomized trial we evaluated whether stent implantation after successful recanalization of a chronic coronary occlusion reduced the incidence of restenosis.Background. Percutaneous transluminal coronary angioplasty (PTCA) in chronic total occlusions is associated with a higher rate of angiographic restenosis and reocclusion than PTCA in subtotal stenoses. Preliminary reports have suggested a decreased restenosis rate after stent implantation

Paolo Rubartelli; Luigi Niccoli; Edoardo Verna; Corinna Giachero; Marco Zimarino; Alessandro Fontanelli; Corrado Vassanelli; Luigi Campolo; Eugenio Martuscelli; Giorgio Tommasini

1998-01-01

46

Magnum Meier wires with Crag Fx wire catheter for total occlusive coronary arteries.  

PubMed

Magnum Meier wire was used with Crag Fx wire catheter instead of Magnum balloon catheter to facilitate wire crossing through total occlusion by improving flexibility of the system without losing wire pushability. Of 372 coronary angioplasty procedures performed between January 1994 and April 1995, there were 12 subacute occlusions with an interval of 3 wk or less and 30 chronic occlusions with an interval of > 3 wk. Regular over-the-wire-type balloon catheters failed to dilate four subacute occlusions and nine chronic total occlusions. Magnum Meier wire with Crag Fx wire catheter was tried for one subacute occlusion and four chronic occlusions that were undilatable with a regular balloon system and successfully dilated the subacute occlusion and three of the chronic occlusions. The lesions successfully dilated by this new approach were either long or tandem lesions in vessels that were excessively tortuous or showed an acute angle at the orifice. Thus the Magnum Meier wire with Crag Fx wire catheter can be a useful tool for dilating totally occluded lesions in tortuous coronary arteries. PMID:9047067

Kitazume, H; Kubo, I; Iwama, T

1997-02-01

47

74?Pro-Angiogenic Effects of the Prolyl-hydroxylase Inhibitor FG-2216/BIQ: Therapeutic Angiogenesis for the Treatment of Chronic Total Occlusions.  

PubMed

: Percutaneous coronary intervention (PCI) is now the dominant revascularisation therapy for coronary artery disease, with nearly 3 million PCIs undertaken per annum world-wide. One of the last remaining challenges to PCI success is in cases of chronic total occlusions (CTO), where average UK success rates are around 66% (BCIS Data). It is only in the more experienced hands that success rates of 80-90% are achieved (EuroCTO club data).There is a need to develop alternative, effective therapies for CTO failures and to this end we have explored therapeutic angiogenesis to enhance antegrade collateral circulation and provide symptom relief in difficult CTO cases. We have investigated the stimulation of endothelial cell (EC) angiogenesis via stabilisation of hypoxia inducible factor (HIF) using two prolyl-hydroxylase inhibitors (PHI). We previously reported that di-methyl oxalylglycine (DMOG) loaded onto a polymer-coated stent increased collateral neovascularisation in a porcine CTO model. We now describe the actions of the PHI FG-2216/BIQ, which unlike DMOG has already been approved for use in man being trialled in patients with renal anaemia. Human umbilical vein endothelial cells (HUVECs) were cultured on growth factor reduced Matrigel in the presence of FG-2216 at a range of doses (from 0 to 500 ?M). Endothelial cell (EC) tubule formation was measured at 6 h by image analysis of photomicrographs (image J). Western blotting was used to assess expression of HIF-1? in HUVEC after treatment with 500 ?M FG-2216/BIQ for up to 24 h. Quantitative real time RT-PCR (qPCR) was used to examine the expression of vascular endothelial cell growth factor (VEGF) mRNA from treated HUVEC (up to 24 h). We report that as with DMOG, FG-2216 has a dose response, pro-angiogenic effect on HUVEC, with significantly enhanced tubule formation on Matrigel, compared to control (107 vs 21, p < 0.05) (Figure 1). Western blotting analysis of HUVEC protein demonstrated stabilisation of HIF-1? protein within 1-2 h of treatment with FG-2216, and qPCR results showed an increase in mRNA for the main angiogenic target of HIF-1?, vascular endothelial cell growth factor (VEGF). heartjnl;100/Suppl_3/A43-a/F1F1F1 Abstract 74 Figure 1 These proof of concept investigations confirm that FG-2216 has a pro-angiogenic effect in-vitro and is valid for testing in in-vivo models of CTO, with the potential for translation to man.We are currently developing novel strategies for the local, sustained delivery/release of FG-2216 such as drug eluting absorbable stenting and micro-sphere delivery as well as routine DES delivery to ensure slow release over long periods. These will be tested in the porcine CTO model developed by our group. We have a novel approach to perfusion by inducing therapeutic angiogenesis as an effective, innovative therapy for difficult CTO in man. Spin off therapies include peri-infarct ischaemia. PMID:24922865

Barnett, Georgina; Schofield, Christopher; Gershlick, Anthony

2014-06-01

48

Balloon Occlusion of the Contralateral Iliac Artery to Assist Recanalization of the Ipsilateral Iliac Artery in Total Aortoiliac Occlusion: A Technical Note  

PubMed Central

Endovascular recanalization of chronic total aortoiliac occlusion is technically challenging. Inability to reenter the true aortic lumen, following retrograde iliac recanalization, is one of the most common causes of failure. We describe a case of a total aortoiliac occlusion where balloon occlusion of the right common iliac artery, following its recanalization from a brachial approach, was used to facilitate antegrade recanalization of the occluded contralateral left common iliac artery.

Jaffan, Abdel Aziz A.

2013-01-01

49

Intracoronary thrombectomy: a new approach to total occlusion.  

PubMed

After initial failure with conventional angioplasty of a total right coronary artery occlusion, we were successful in obtaining patency using a combination of intracoronary thrombectomy and thrombolysis. This represents the first report of this technique in the therapy of total right coronary occlusions. PMID:2605628

Kipperman, R M; Feit, A S; Einhorn, A M; Co, J A

1989-12-01

50

Total bowel ischemia after carbon dioxide angiography in a patient with inferior mesenteric artery occlusion.  

PubMed

A 70-year-old man with a history of hypertension and chronic renal failure experienced claudication in his left leg. He was treated by endovascular stenting in his left leg. We used CO2 angiography to prevent contrast-induced nephropathy. After the procedure, livedo vasculitis and lactic acidosis developed. We diagnosed the patient with CO2-induced ischemic colitis, after which we changed his position and administered conservative therapy. Contrast-enhanced computed tomography showed total bowel ischemia and total occlusion at the ostium of the inferior mesenteric artery. This rare complication after CO2 angiography might be related to the atherosclerotic occlusion of the inferior mesenteric artery. PMID:24142488

Mizuno, Atsushi; Nishi, Yutaro; Niwa, Koichiro

2014-07-01

51

Comparison of five-year outcomes of patients with and without chronic total occlusion of noninfarct coronary artery after primary coronary intervention for ST-segment elevation acute myocardial infarction.  

PubMed

The aim of the present study was to evaluate the effect of concurrent chronic total occlusion (CTO) in a noninfarct-related artery (IRA) on the long-term prognosis in patients with ST-segment elevation myocardial infarction and multivessel coronary disease. Of 1,658 consecutive patients with ST-segment elevation myocardial infarction, 666 with multivessel coronary disease who underwent percutaneous coronary intervention from 1999 to 2004 were included in the present analysis. The patients were divided into 2 groups: no CTO and CTO. The first group included 462 patients without CTO (69%) and the second group included 204 patients with CTO in a non-IRA (31%). The in-hospital mortality rate was 6.3% and 21.1% (p < 0.0001) and the 5-year mortality rate was 22.5% and 40.2% (p < 0.0001) for the no-CTO and CTO patients, respectively. Multivariate analysis revealed that after correction for baseline differences CTO in a non-IRA was a strong, independent predictor of 5-year mortality in patients undergoing percutaneous coronary intervention (hazard ratio 1.85; 95% confidence interval 1.35 to 2.53; p = 0.0001). In conclusion, the presence of CTO in a non-IRA in patients with ST-segment elevation myocardial infarction and multivessel coronary disease is a strong and independent risk factor for greater 5-year mortality. PMID:21996144

Tajstra, Mateusz; Gasior, Mariusz; Gierlotka, Marek; Pres, Damian; Hawranek, Micha?; Trzeciak, Przemys?aw; Lekston, Andrzej; Polonski, Lech; Zembala, Marian

2012-01-15

52

Improved global and regional left ventricular function after angioplasty for chronic coronary occlusion  

Microsoft Academic Search

Percutaneous transluminal coronary angioplasty can be performed safely and effectively in patients with chronic total coronary occlusion. To investigate the effect on left ventricular function, global and regional left ventricular ejection fraction were analyzed by contrast angiography in 49 patients before and 10±6 weeks after successful recanalization. Coronary angiography at follow-up showed reocclusion in 12 patients (24%). In 37 patients

E. Engelstein; W. Terres; D. Hofmann; L. Hansen; C. W. Hamm

1994-01-01

53

Navigating a guide wire through total occlusions: clinical experience  

NASA Astrophysics Data System (ADS)

One of the last remaining frontiers in angioplasty interventions is successfully recanalizing arteries containing total occlusions. The primary limiting condition is the inability to pass a guide wire safely across the total occlusion to facilitate therapeutic interventions. The operator has to perform the intervention without the assistance of x-ray imaging to define the vessel's path since the contrast media flow is blocked by the occlusion. To overcome this limitation, a guide wire system has been developed that transmits low coherence near-infrared light through an optical fiber internal to the guide wire and illuminates the tissue adjacent the distal end. Differences in the scattering of near-infrared light by the normal arterial wall and occluding tissues are detected by optical coherence reflectometry (OCR) techniques. Through a real-time monitoring system and display, the physician is warned if the guide wire approaches the normal arterial wall, allowing the guide wire to be redirected to prevent perforating the vessel. The system has been used in clinical coronary angioplasty cases demonstrating the ability to cross 10 out of 11 total occlusions without any perforations or dissections. The OCR guide wire system has demonstrated clinical potential and will require additional testing for clinical efficacy claims.

Neet, John M.; Winston, Thomas R.; Hedrick, Allan D.; Koolen, Jaques J.; Bonnier, Hans

2000-05-01

54

Percutaneous Endovascular Treatment of Chronic Iliac Artery Occlusion  

SciTech Connect

Purpose: To evaluate the clinical and radiological long-term results of recanalization of chronic occluded iliac arteries with balloon angioplasty and stent placement.Methods: Sixty-nine occluded iliac arteries (mean length 8.1 cm; range 4-16 cm) in 67 patients were treated by percutaneous transluminal angioplasty and stent placement. Evaluations included clinical assesment according to Fontaine stages, Doppler examinations with ankle-brachial index (ABI) and bilateral lower extremity arteriograms. Wallstent and Cragg vascular stents were inserted for iliac artery recanalization under local anesthesia. Follow-up lasted 1-83 months (mean 29.5 months).Results: Technical success rate was 97.1% (67 of 69). The mean ABI increased from 0.46 to 0.85 within 30 days after treatment and was 0.83 at the most recent follow-up. Mean hospitalization time was 2 days and major complications included arterial thrombosis (3%), arterial rupture (3%) and distal embolization (1%). During follow-up 6% stenosis and 9% thrombosis of the stents were observed. Clinical improvement occurred in 92% of patients. Primary and secondary patency rates were 75% and 95%, respectively.Conclusion: The long-term patency rates and clinical benefits suggest that percutaneous endovascular revascularization with metallic stents is a safe and effective treatment for patients with chronic iliac artery occlusion.

Carnevale, F. C. [Institute of Radiology, University of Sao Paulo, Department of Interventional Radiology (Brazil)], E-mail: fcarnevale@uol.com.br; De Blas, Mariano; Merino, Santiago; Egana, Jose M. [Hospital De Guipuzcoa, Department of Radiology (Spain); Caldas, Jose G.M.P. [Institute of Radiology, University of Sao Paulo, Department of Interventional Radiology (Brazil)

2004-09-15

55

Prevalence of central venous occlusion in patients with chronic defibrillator leads  

Microsoft Academic Search

Background Many patients with previously implanted ventricular defibrillators are candidates for an upgrade to a device capable of atrial-ventricular sequential or multisite pacing. The prevalence of venous occlusion after placement of transvenous defibrillator leads is unknown. The purpose of this study was to determine the prevalence of central venous occlusion in asymptomatic patients with chronic transvenous defibrillator leads. Methods Thirty

Christian Sticherling; Steven P. Chough; Robert L. Baker; Kristina Wasmer; Hakan Oral; Hiroshi Tada; Laura Horwood; Michael H. Kim; Frank Pelosi; Gregory F. Michaud; S. Adam Strickberger; Fred Morady; Bradley P. Knight

2001-01-01

56

Bilateral ischemic lumbosacral plexopathy from chronic aortoiliac occlusion presenting with progressive paraplegia.  

PubMed

Spinal cord ischemia is rare but causes significant morbidity and mortality. Spinal cord ischemia has been reported after open and endovascular interventions of the thoracic and abdominal aorta, and, rarely, acute occlusion of aorta from in situ thrombosis or acute embolic occlusion. Acute interruption of the critical blood supply to the spinal cord or root contributes to this devastating neurologic deficit. However, gradually worsening lumbosacral plexopathy and consequent paraplegia related to chronic aortic occlusion is extremely rare. We present a case of a 58-year-old man with progressive lower limb paralysis from atherosclerotic aortoiliac occlusion without history of aortic surgery or evidence of thromboembolism. PMID:23726871

Kim, Hyangkyoung; Kang, Si Hyun; Kim, Don-Kyu; Seo, Kyung Mook; Kim, Tha Joo; Hong, Joonhwa

2014-01-01

57

Occlusal Therapy in the Management of Chronic Orofacial Pain  

PubMed Central

Review of the literature indicates that most routine orofacial dysfunctions are characterized by deep pain. Various disorders of the masticatory systems, particularly musculoskeletal conditions, are thought to be triggered by occlusal disharmonies. The pain component develops following a pattern of bruxism, muscle hyperactivity, fatigue and spasm. Treatment for most disorders has been to modify the occlusion, although the rational for doing so appears questionable. Critical issues in the field of occlusion related to orofacial pain are reviewed: occlusal disharmonies, coincidence of retruded-intercuspal contact positions, non-working side interferences, maximum intercuspation of teeth, occlusal adjustment, and occlusal appliances. The studies reviewed fail to support the clinical objective of obtaining equal contact at retruded and intercuspal positions and that the lateral pterygoid muscles stabilize the temporomandibular joint. The relationship between non-working side interferences and pain dysfunction is also not readily supported by controlled studies. Occlusal adjustment appears to be unsatisfactory as a modality for management of pain: not all patients improved following treatment, some relapse occurs even with the most stable contacts, and other treatments such as intra-articular injections of corticosteroids reduced symptoms more readily. Occlusal splints seem to reduce most clinical signs and symptoms on both a short-term and long-term basis. Placement of mandibular orthopedic repositioning appliances results in reduction of pain in some patients, but usually this treatment is followed by extensive rehabilitation. Six major areas are suggested for clinical studies that attempt to relate occlusion to management of orofacial pain. These include: establishment of an ideal jaw position, sequencing of symptoms in the pain history, relationship of pain to other symptoms, development of physiological methods to assess how occlusal modification affects pain perception and pain tolerance, and determination of which treatment modalities produce the most effective relief of pain.

Bush, Francis M.

1984-01-01

58

Improved global and regional left ventricular function after angioplasty for chronic coronary occlusion.  

PubMed

Percutaneous transluminal coronary angioplasty can be performed safely and effectively in patients with chronic total coronary occlusion. To investigate the effect on left ventricular function, global and regional left ventricular ejection fraction were analyzed by contrast angiography in 49 patients before and 10 +/- 6 weeks after successful recanalization. Coronary angiography at follow-up showed reocclusion in 12 patients (24%). In 37 patients with patent arteries global ejection fraction increased from 55.8 +/- 7.1% at baseline to 62.5 +/- 11.3% at follow-up (P < 0.001), and regional wall motion assessed by the centerline method improved from -1.7 +/- 1.0 to -0.6 +/- 1.5 standard deviations/chord (P < 0.001). In contrast, in patients with reocclusion neither global ejection fraction nor regional wall motion were significantly different at follow-up compared with baseline. Changes in global or regional left ventricular function after coronary recanalization were unrelated to other parameters such as severity of angina, duration of occlusion, history of myocardial infarction, presence or absence of visible collaterals, or baseline left ventricular function. Thus in patients with primarily successful recanalization of chronically occluded coronary arteries persistent vessel patency is the major determinant of global and regional improvement of left ventricular function. PMID:7950155

Engelstein, E; Terres, W; Hofmann, D; Hansen, L; Hamm, C W

1994-06-01

59

Hemihepatic versus total hepatic inflow occlusion during hepatectomy: A systematic review and meta-analysis  

PubMed Central

AIM: To evaluate the clinical outcomes of patients undergoing hepatectomy with hemihepatic vascular occlusion (HHO) compared with total hepatic inflow occlusion (THO). METHODS: Randomized controlled trials (RCTs) comparing hemihepatic vascular occlusion and total hepatic inflow occlusion were included by a systematic literature search. Two authors independently assessed the trials for inclusion and extracted the data. A meta-analysis was conducted to estimate blood loss, transfusion requirement, and liver injury based on the levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Either the fixed effects model or random effects model was used. RESULTS: Four RCTs including 338 patients met the prede?ned inclusion criteria. A total of 167 patients were treated with THO and 171 with HHO. Meta-analysis of AST levels on postoperative day 1 indicated higher levels in the THO group with weighted mean difference (WMD) 342.27; 95% confidence intervals (CI) 217.28-467.26; P = 0.00?001; I2 = 16%. Meta-analysis showed no significant difference between THO group and HHO group on blood loss, transfusion requirement, mortality, morbidity, operating time, ischemic duration, hospital stay, ALT levels on postoperative day 1, 3 and 7 and AST levels on postoperative day 3 and 7. CONCLUSION: Hemihepatic vascular occlusion does not offer satisfying benefit to the patients undergoing hepatic resection. However, they have less liver injury after liver resections.

Wang, Hai-Qing; Yang, Jia-Yin; Yan, Lu-Nan

2011-01-01

60

A hybrid approach to recanalization of a chronic iliofemoral occlusion.  

PubMed

The Viabahn covered stent (W. L. Gore and Associates Inc, Flagstaff, Ariz) is made of expanded polytetrafluoroethylene attached to an external nitinol stent and is primarily used in the endovascular treatment of lower extremity arterial occlusive disease. The use of this device as an open conduit for lower extremity revascularization has been rarely reported. We expand on this experience by presenting a case of hybrid endovascular and open iliofemoral bypass in which we used the Viabahn endoprosthesis to recanalize an occluded iliac artery, followed by direct suturing of the distal portion of the Viabahn stent graft to the native common femoral artery bifurcation. PMID:22963813

Ahanchi, Sadaf Sadie; Panneton, Jean Michel; Stout, Christopher Lee

2013-01-01

61

Occlusive disease of the renal arteries and chronic renal failure: The limits of reconstructive surgery  

Microsoft Academic Search

In order to investigate the value of renal revascularization in patients with chronic renal failure and associated occlusive lesions of the renal arteries, the long-term results of 48 revascularizations in 43 patients operated upon between January 1980 and May 1988 were analyzed. There were 36 men and 7 women whose mean age was 61.8 years (range 36 to 79 years).

Claude Mercier; Philippe Piquet; Yves Alimi; Pierre Tournigand; Jean-Jacques Albrand

1990-01-01

62

Occlusal Disorders among Patients with Total Clefts of Lip, Alveolar Bone, and Palate  

PubMed Central

Clefts are common birth defects. They are accompanied by various malformations, including disturbances in facial look as well as skeletal disorders that include malocclusions, most frequently crossbites and class III anomalies. The aim of the study was to present the commonest malocclusions in patients with total cleft of the lip, alveolar bone and palate (n = 154) and compare the results to the healthy on-cleft patients (n = 151). Normal occlusion, characteristic for I angle class, was observed in 50% of the control group and 30% of the examined. In the examined patients with clefts, most frequently crossbite and open bite on the cleft side was observed. In patients with clefts, only 2 out of 154 patients presented isolated dental anomalies. In healthy individuals the commonest occlusal disorder was distal occlusion and dental anomalies. The commonest malocclusions among patients with clefts are crossbites and class III malocclusions.

Paradowska-Stolarz, Anna

2014-01-01

63

Probe exchange catheter used for angioplasty of total coronary artery occlusions.  

PubMed

Percutaneous transluminal coronary angioplasty (PTCA) for total occlusions frequently fails, because the guidewire fails to pass the occlusion. With the use of the Probe exchange catheter (PEC), however, stiffness of the guidewire is increased and a higher pushability is obtained in order to manipulate the guidewire beyond the lesion. Once the guidewire has passed, the PEC is advanced and a non-over-the-wire dilatation catheter can be introduced through the PEC. This paper describes the technique in a representative case. The results of this technique in 19 consecutive patients with class III-IV/IV(NYHA) angina due to an occluded coronary artery are presented. In 16 patients the PEC reached the lesion (84%) and in all these patients the guidewire could pass the occlusion. A successful PTCA was performed in 14 patients (74%). PMID:2139804

Kiemeneij, F; Suwarganda, J S; van der Wieken, L R

1990-04-01

64

Stent Recanalization of Chronic Portal Vein Occlusion in a Child  

SciTech Connect

An 8-year-old boy with a 21/2 year history of portal hypertension and repeated bleedings from esophageal varices, was referred for treatment. The 3.5-cm-long occlusion of the portal vein was passed and the channel created was stabilized with a balloon-expandable stent; a portosystemic stent-shunt was also created. The portosystemic shunt closed spontaneously within 1 month, while the recanalized segment of the portal vein remained open. The pressure gradient between the intrahepatic and extrahepatic portal vein branches dropped from 17 mmHg to 0 mmHg. The pressure in the portal vein dropped from 30 mmHg to 17 mmHg and the bleedings stopped. The next dilation of the stent was performed 12 months later due to an increased pressure gradient; the gastroesophageal varices disappeared completely. Further dilation of the stent was planned after 2, 4, and 6 years.

Cwikiel, Wojciech [Department of Diagnostic Radiology, University Hospital, S-221 85 Lund (Sweden); Solvig, Jan [Department of Diagnostic Radiology, University Hospital, Skejby, DK-8200 Aarhus (Denmark); Schroder, Henrik [Department of Pediatric Medicine, University Hospital, Skejby, DK-8200 Aarhus (Denmark)

2000-07-15

65

Wire-Probing Technique to Revascularize Subacute or Chronic Internal Carotid Artery Occlusion  

PubMed Central

Summary During endovascular revascularization of subacute and chronic occlusion of the cervical internal carotid artery (ICA) it may be difficult to penetrate the lesion. Selecting the appropriate “true lumen”, a remnant of what had been the arterial lumen, at the initial step may facilitate the procedure. Because plaque at the carotid bifurcation is known to propagate from the posterior wall, a gateway to this “true lumen” should exist in the anterior side of the occluded stump. This hypothesis was studied retrospectively in our series of revascularizing ICA subacute and chronic occlusion. Eleven patients underwent endovascular revascularization for symptomatic cervical ICA occlusion. Procedures were performed by initially penetrating the occluded stump with a guidewire, followed by supporting catheter advancement through the occluded segment to secure the distal normal arterial lumen. Cases were analyzed with regard to the location of initial guidewire penetration. Eight patients underwent successful revascularization. In five cases, the entry point to the occluded stump was located at the anterior side, and in three, at the posterior side. Two posterior stump penetration cases were met with resistance in guidewire advancement, whereas penetration was smooth in the anterior cases. In addition, two posterior stump penetration cases resulted in contrast stasis in the posterior ICA wall. In our series of revascularizing cervical ICA subacute and chronic occlusion, initially targeting the anterior side of the occluded stump resulted in favorable results. This may be the result of selecting the “true lumen” at the beginning of the procedure.

Namba, K.; Shojima, M.; Nemoto, S.

2012-01-01

66

The Use of a Re-Entry Catheter in Recanalization of Chronic Inflow Occlusions of the Common Iliac Artery  

SciTech Connect

Endovascular treatment of iliac artery occlusions can be unsuccessful due to a failure to break back into the true lumen, and lesions without a proximal stump can be particularly problematic. True lumen re-entry catheters have not been previously used for this type of lesion. The authors report eight patients, five males and three females, with lifestyle-limiting intermittent claudication referred for endovascular treatment. Imaging demonstrated unilateral chronic total occlusion of the common iliac artery in six patients and two patients with short patent stumps at the origin of the occluded common iliac artery. Endovascular therapy was initially unsuccessful due to an inability to re-enter the true lumen after crossing the occlusion in the subintimal plane. With the assistance of the Outback LTD catheter it was possible to achieve continuity of the dissecting tract with the true lumen, thus facilitating successful primary stenting in all eight patients. To our knowledge this is the first report of the use of the Outback LTD catheter in this type of lesion.

Ramjas, Greg; Thurley, Peter, E-mail: peter.thurley@ntlworld.com; Habib, Said [Nottingham University Hospitals NHS Trust, Department of Radiology, Queens Medical Centre (United Kingdom)], E-mail: said.habib@nuh.nhs.uk

2008-05-15

67

Local cerebral glucose utilization in chronic middle cerebral artery occlusion in the cat.  

PubMed

This study examines the correlation between local CMRglc (LCMRglc) alterations and clinicopathological changes in a chronic middle cerebral artery (MCA) occlusion model in the cat. The left MCA was occluded for a period of 2 h. The animals were grouped into mild, moderate, and severe ischemia based on the depression of the EEG 30 min after the MCA occlusion. Following release of the clip, the animals were allowed to recover for a week during which time daily neurological examinations were performed. On the seventh day [14C]2-deoxyglucose was injected for the determination of LCMRglc. Alternative blocks were processed for histological evaluation in which both neuronal and phagocytic changes were graded into four categories (0 = normal to 3 = severe). LCMRglc (mumol/100 g/min) in the ischemic hemisphere (all histological grades) was significantly lower than the metabolic rate in comparable regions of the sham MCA occlusion group. Regions with significant phagocytosis (grade 2 and 3) invariably exhibited activated glucose metabolism (57.4 +/- 8.4 and 105.9 +/- 6.8 mumol/100 g/min, respectively), which was significantly higher than in regions without phagocytosis (30.4 +/- 0.8 mumol/100 g/min). There was a significant gradient of metabolism in the central, peripheral, and boundary zone and the non-MCA territory in the animals with severe ischemic lesions. LCMRglc in the central MCA territory was well correlated with the EEG amplitude changes (r = 0.82, p less than 0.05) and the morphological score (r = -0.89, p less than 0.05). The metabolic rate was significantly depressed in both the ipsilateral and the contralateral central MCA territories in comparison with the sham occlusion animals. The depression in LCMRglc in the contralateral hemisphere correlated well with the concomitant depression in the contralateral EEG amplitude. These studies demonstrate that local heterogeneous metabolic alterations and contralateral cortical diaschisis exist chronically following temporary MCA occlusion and that the increases in local cerebral glucose metabolism seen in chronic stroke may be due to phagocytotic activity. PMID:2738118

Komatsumoto, S; Greenberg, J H; Hickey, W F; Reivich, M

1989-08-01

68

[Non-occlusive mesenteric ischemia in a chronic dialysis patient: a case report].  

PubMed

We report non-occlusive mesenteric ischemia (NOMI) in a patient with hemodialysis-dependent chronic renal failure who presented with acute onset of abdominal pain. On abdominal computed tomography (CT) and CT angiography, pneumatosis intestinalis of the small intestine and mesenteric venous gas were found with patent superior and inferior mesenteric arteries. CT also showed bowel wall thickening with fat stranding at terminal ileum. In emergency laparotomy, necrosis of the terminal ileum over a 4 cm area was identified and the ischemic segment was resected. Histopathological exam was consistent with gangrenous enteritis. Herein, we present exquisite imaging findings of a NOMI case with an overview of related literature. PMID:18781426

Co?kun, Figen; Aksu, Nalan Metin; Akpinar, Erhan; Bozkurt, Sebnem; Akka?, Meltem; Balas, Sener; Karakiliç, Evvah

2008-07-01

69

The Benefits of Internal Thoracic Artery Catheterization in Patients With Chronic Abdominal Aortic Occlusion  

SciTech Connect

Occlusion of the abdominal aorta may be caused by an embolic lesion, but more commonly by thrombotic disease at the aortoiliac area, progressing retrograde. However, the visualization of the distal run-off via internal thoracic-epigastric inferior artery collateral channel may be a very important diagnostic tool, especially in countries with poor technical equipment. This study was designed to show the benefit of the selective internal thoracic angiography in cases with complete aortic occlusion. We present 30 patients with chronic aortic abdominal occlusion who were submitted to the transaxillary aortography and selective ITA angiography with purpose of distal run off evaluation. Angiographic evaluation was performed by two independent radiologists according to previously defined classification. Good angiographic score via internal thoracic angiography by first observer was achieved in 19 (63.3%) patients and in 18 (60%) by a second observer. Transaxillary aortography showed inferior results: good angiographic score by the first observer in six (20%) patients and by the second observer in three (3%) patients. Low extremity run-off is better visualized during internal thoracic angiography than during transaxillary aortography.

Ilic, Nikola, E-mail: fosafosa75@yahoo.com; Davidovic, Lazar; Koncar, Igor; Dragas, Marko; Markovic, Miroslav; Colic, Momcilo; Cinara, Ilijas [Clinical Center Serbia, Clinic of Vascular and Endovascular Surgery (Serbia)

2011-04-15

70

The benefits of internal thoracic artery catheterization in patients with chronic abdominal aortic occlusion.  

PubMed

Occlusion of the abdominal aorta may be caused by an embolic lesion, but more commonly by thrombotic disease at the aortoiliac area, progressing retrograde. However, the visualization of the distal run-off via internal thoracic-epigastric inferior artery collateral channel may be a very important diagnostic tool, especially in countries with poor technical equipment. This study was designed to show the benefit of the selective internal thoracic angiography in cases with complete aortic occlusion. We present 30 patients with chronic aortic abdominal occlusion who were submitted to the transaxillary aortography and selective ITA angiography with purpose of distal run off evaluation. Angiographic evaluation was performed by two independent radiologists according to previously defined classification. Good angiographic score via internal thoracic angiography by first observer was achieved in 19 (63.3%) patients and in 18 (60%) by a second observer. Transaxillary aortography showed inferior results: good angiographic score by the first observer in six (20%) patients and by the second observer in three (3%) patients. Low extremity run-off is better visualized during internal thoracic angiography than during transaxillary aortography. PMID:20532775

Ilic, Nikola; Davidovic, Lazar; Koncar, Igor; Dragas, Marko; Markovic, Miroslav; Colic, Momcilo; Cinara, Ilijas

2011-04-01

71

Kissing iliac artery stent technique for salvage of a total occlusion of a jailed common iliac artery.  

PubMed

A 70-year-old female was admitted to our hospital due to claudication of the left leg. The patient was diagnosed with peripheral artery disease and received endovascular therapy (EVT) with a stent implanted in the right common iliac artery (CIA) at another hospital 3 months earlier. The left CIA was jailed by the stent. We performed EVT for the chronic total occlusion (CTO) of the jailed left CIA. A kissing-stent strategy was selected because the strut could not be fully opened. The wire was crossed through the stent strut, since passing the wire outside of the stent was problematic. A balloon was dilated at the stent strut and further inserted while dilated in order to create a space between the implanted stent and opposite aorta wall. Finally, a wire was successfully crossed outside of the stent in this space. A balloon-expandable stent was implanted at the aorta to left CIA in order to perform the kissing-stent technique. Additionally, a self-expandable stent was deployed at the left external iliac artery. To facilitate kissing-stent technique for a jailed CIA CTO lesion, inserting the balloon while inflated at the bifurcation was useful to create space for advancing the guidewire along the stent. PMID:24610512

Ishizuka, Shuichi; Habara, Maoto; Nasu, Kenya

2014-03-01

72

The Use of Total Cervical Occlusion along with McDonald Cerclage in Patients with Recurrent Miscarriage or Preterm Deliveries  

PubMed Central

Objectives To study the fetal outcome with the use of McDonald cerclage and total cervical occlusion in women with recurrent mid-trimester miscarriages or preterm deliveries, as well as complications of total cervical occlusion in the women. Methods Prospective descriptive observational study on patients with two or more mid-trimester miscarriages, deliveries before 36 weeks, or patients who have experienced failure of transvaginal cerclage. Results Twenty-six women were studied. Of these, 92% delivered at term. Two women delivered at 33 and 35 weeks, respectively. There was one neonatal death. Take home baby rate was 96.2%. There was no serious maternal morbidity among the patients. Conclusion The addition of external cervical OS occlusion to McDonald cerclage could improve fetal outcome in women with recurrent mid-trimester miscarriages and preterm deliveries.

Zayyan, Marliyya; Suhyb, Sanusi R.; Laurel, Nwaorga O'C

2012-01-01

73

Exercise training increases basal tone in arterioles distal to chronic coronary occlusion  

PubMed Central

Endurance exercise training increases basal active tone in coronary arteries and enhances myogenic tone in coronary arterioles of control animals. Paradoxically, exercise training has also been shown to augment nitric oxide production and nitric oxide-mediated relaxation in coronary arterioles. The purpose of the present study was to examine the effect of exercise training on basal active tone of arterioles (~150 µm ID) isolated from the collateral-dependent region of hearts exposed to chronic coronary occlusion. Ameroid occluders were surgically placed around the proximal left circumflex coronary artery of miniature swine. Arterioles were isolated from both the collateral-dependent and nonoccluded myocardial regions of sedentary (pen confined) and exercise-trained (treadmill run; 14 wk) pigs. Coronary tone was studied in isolated arterioles using microvessel myographs and standard isometric techniques. Exposure to nominally Ca2+-free external solution reduced resting tension in all arterioles; decreases were most profound (P < 0.05) in arterioles from the collateral-dependent region of exercise-trained animals. Furthermore, nitric oxide synthase (NOS) inhibition (N?-nitro-l-arginine methylester; 100 µM) unmasked markedly increased nitric oxide-sensitive tone in arterioles from the collateral-dependent region of exercise-trained swine. Blockade of K+ channels revealed significantly enhanced K+ channel contribution to basal tone in collateral-dependent arterioles of exercise-trained pigs. Protein content of endothelial NOS (eNOS) and phosphorylated eNOS (pS1179), determined by immunoblot, was elevated in arterioles from exercise-trained animals with the greatest effect in collateral-dependent vasculature. Taken together, we demonstrate the interaction of opposing exercise training-enhanced arteriolar basal active tone, nitric oxide production, and K+ channel activity in chronic coronary occlusion, potentially enhancing the capacity to regulate blood flow to collateral-dependent myocardium.

Heaps, Cristine L.; Mattox, Mildred L.; Kelly, Katherine A.; Meininger, Cynthia J.; Parker, Janet L.

2014-01-01

74

Primary Stenting Versus Balloon Angioplasty in Occluded Coronary Arteries The Total Occlusion Study of Canada (TOSCA)  

Microsoft Academic Search

Background—Balloon angioplasty (PTCA) of occluded coronary arteries is limited by high rates of restenosis and reocclusion. Although stenting improves results in anatomically simple occlusions, its effect on patency and clinical outcome in a broadly selected population with occluded coronary arteries is unknown. Methods and Results—Eighteen centers randomized 410 patients with nonacute native coronary occlusions to PTCA or primary stenting with

Christopher E. Buller; Vladimir Dzavik; Ronald G. Carere; G. B. John Mancini; Gerald Barbeau; Charles Lazzam; Todd J. Anderson; Merril L. Knudtson; Jean-Francois Marquis; Takahiko Suzuki; Eric A. Cohen; Rebecca S. Fox; Koon K. Teo

75

Craniofacial structure in children with juvenile chronic arthritis (JCA) compared with healthy children with ideal or postnormal occlusion.  

PubMed

The aim of the present study was to evaluate the influence of condylar destruction on the craniofacial growth of children with juvenile chronic arthritis (JCA) and to compare their craniofacial structure with that of healthy children with ideal or postnormal occlusion. Thirty-five children (7 to 16 years) affected by JCA were compared with 136 children (7 to 16 years) with normal facial structure and occlusion (ideal group) and 62 children (7 to 12 years) with postnormal occlusion (postnormal group). Panoramic radiographs and lateral cephalograms were taken to detect condylar lesions and analyze facial structure. Multiple regression analysis was applied to test the possible relationships between the groups. The present study largely confirms earlier findings that the JCA group has a characteristic craniofacial structure. Their structure differed not only from the facial characteristics of children with ideal, but also to some extent, from children with postnormal occlusion. Furthermore, the craniofacial structure of children with JCA varied greatly, and radiographs showed that the most extreme craniofacial changes, particularly the mandibular structure, were associated with condylar lesions. In conclusion, the arthritic condylar lesions seem to be the main etiologic reason for the altered facial structure and changes in the occlusion in children with JCA. Influences of other factors, such as masticatory muscular function, are also discussed. PMID:7817963

Kjellberg, H; Fasth, A; Kiliaridis, S; Wenneberg, B; Thilander, B

1995-01-01

76

The use of telescoped flow diverters as an endovascular bypass in the management of symptomatic chronic carotid occlusion.  

PubMed

Flow diverters constitute a new generation of flexible self-expanding, stent-like devices with a high-metal surface-area coverage for the endovascular management of wide-necked, fusiform, large, and giant unruptured intracranial aneurysms. They achieve aneurysm occlusion through endoluminal reconstruction of the dysplastic segment of the parent artery that gives rise to the aneurysm. To our knowledge, there is no report on the use of flow diverters for the management of occlusive cerebrovascular disease. We describe the novel use of telescoped flow diverters in a construct that acts as an endovascular bypass for the management of symptomatic chronic carotid occlusion. In long carotid occlusions with a burden of extensive clots and atherosclerotic plaque, we found that the reduced porosity of the diverter mesh serves as an effective barrier to in-stent clot protrusion and distal embolization. Diverter implantation allows subsequent angioplasty. With this patient report, we propose a new potential application for flow diverters in the management of occlusive cerebrovascular disease. The optimal application of these devices will continue to be defined as clinical experience evolves. PMID:22555126

Cohen, José E; Gomori, John M; Ben-Hur, Tamir; Moscovici, Samuel; Itshayek, Eyal

2012-07-01

77

Positive outcome of occlusal freeway space reestablishment in patients with medication overuse due to chronic migraine.  

PubMed

Considering the great chapter of migraines, it is important to note the signs and symptoms caused by an alteration of the relationship of the facial musculature and the occlusal freeway space (FWS) that is the distance from maximal intercuspation to the habitual rest position (measurable in 1.4-2.5 mm). To any mandible position changing (detected by periodontal, muscle and joint proprioceptors), there is an influence on the neuromuscular system and then an alteration of the FWS. A group of 60 patients with chronic migraine (CM) underwent a withdrawal of overused medication and were subjected to electromyographic and kinesiographic evaluation. All those who presented an alteration of the FWS at rest position have been subjected to treatment with orthosis device for about 12 months. The aim of our work is to obtain and define a correct mandibular position, physiological, in agreement with the neuromuscular structures of the patient. Clinical results obtained on this pool of patients, in terms of reduction of the VAS, let us understand the importance of the inviolability of the FWS and to eliminate any type of mandibular deviation with respect to the closure trajectory induced by TENS in patients suffering from CM. PMID:23695073

Didier, H; Marchetti, C; Marchetti, A; D'Amico, D; Tullo, V; Proietti Cecchini, A; Di Fiore, P; Bussone, G; Santoro, F

2013-05-01

78

Total venous inflow occlusion and pericardial auto-graft reconstruction for right atrial hemangiosarcoma resection in a dog  

PubMed Central

A sizeable right atrial hemangiosarcoma in a 6-year-old Bordeaux dog, World Health Organization (WHO) stage 2, was excised using total venous inflow occlusion. The defect was restored with a non-vascularized pericardial auto-graft. The dog had a disease-free interval of 7 mo. The dog was euthanized 9 months later, at which time there were distant metastases but no indication of local recurrence.

Verbeke, Fei; Binst, Dominique; Stegen, Ludo; Waelbers, Tim; de Rooster, Hilde; Van Goethem, Bart

2012-01-01

79

Open-label, uncontrolled, 6-week clinical trial of beraprost in patients with chronic occlusive arterial disease  

Microsoft Academic Search

The efficacy and tolerability of beraprost sodium, sodium (±)-(1R,2R,3aS,8bS)-2,3,3a,8b-tetrahydro-2-hydroxy-1-[(E)-(3S,4RS)-3-hydroxy-4-methyl-1-octen-6-ynyl]-1H cyclopenta[b]benzofuran-5 butyrate, a prostacyclin analogue, were investigated in 23 patients (21 men and 2 women; mean age, 49.6 ± 15.4 years; mean body weight, 59.9 ± 8.0 kg) with chronic occlusive arterial disease and its complications, arteriosclerosis obliterans, and thromboangiitis obliterans with ischemic limb ulceration. In this open-label, uncontrolled study, beraprost

Bo Yang Suh; Koing Bo Kwun; Tae Weon Kwun; Suk Koo Kim; Jun O Yoon; Minoru Yamamoto

1998-01-01

80

Retrograde Distal Superficial Femoral Artery Approach in the Supine Position for Chronic Superficial Femoral Artery Occlusion  

PubMed Central

Subintimal angioplasty is an effective method for the treatment of long superficial femoral artery (SFA) occlusions. One of the major limiting factors for the success of this procedure is the failure to re-enter the true lumen. The recently introduced luminal re-entry devices provide a high technical success rate, but failures can occur. In such cases, a retrograde popliteal approach can serve as a potential backup option. However, the need to reposition the patient remains a drawback. Here, we report a case of an 81-year-old male with a long SFA occlusion treated using a retrograde distal SFA approach in the supine position after the initial failure of antegrade angioplasty.

Shin, Sanghoon; Kim, Seunghwan; Ko, Young-Guk; Hong, Myeung-Ki; Jang, Yangsoo

2014-01-01

81

The Effect of Chronic Hypoxemia on Regional Myocardial Blood Flow in the Conscious Dog After Acute Coronary Artery Occlusion  

PubMed Central

Chronic hypoxemia was produced in 16 dogs by surgical transposition of the caudal vena cava to the left atrium to determine if chronic hypoxemia would alter the response of the myocardium to acute ischemia. An electromagnetic aortic flow probe, left atrial tube, and occlusive cuff on the left circumflex coronary artery were permanently implanted in 11 hypoxemic and 26 normal control dogs. The animals were studied in the conscious state after recovery from the surgery. Dogs with hypoxemia had a blood hematocrit value of 54.3 ± 1.0% (SE), arterial PO2 of 43.2 ± 1.4 mm Hg, and 80.2 ± 1.6% oxygen saturation. There was no difference from control animals in the ratio of left ventricular weight to body weight, but the right ventricular weight was significantly decreased in the hypoxemic dogs. Cardiac output from the left ventricle was twice that of the right ventricle. Aortic blood flow was 3.68 ± 0.22 liters/min in hypoxemic animals and 2.64 ± 0.19 liters/min in normal dogs. Myocardial blood flow measured with 15-? diameter tracer microspheres was increased from 79 ± 10 and 59 ± 8 ml/100 g/min in left ventricular endocardial and epicardial halves, respectively, in normal dogs to 212 ± 48 and 172 ± 39 in dogs with chronic hypoxemia. There were no deaths in 10 hypoxemic dogs within 24 hours after complete circumflex coronary artery occlusion; 7 of 26 (27%) normal dogs died after circumflex coronary artery occlusion during the conscious state. Gross infarct size was extremely variable in both groups. Median infarct size was smaller in dogs with hypoxemia and was directly correlated with arterial PO2 in hypoxemic dogs. There was a mild, but statistically not significant, increase in the anastomotic index of hypoxemic dogs compared with that of normal animals, suggesting that a metabolic adaptive change rather than increased collateral circulation may have been responsible for the decreased mortality and smaller infarct size in hypoxemic dogs.

Bishop, Sanford P.; White, Francis C.; Bloor, Colin M.

1977-01-01

82

Electromechanical Characterization of Chronic Myocardial Infarction in the Canine Coronary Occlusion Model  

Microsoft Academic Search

Background—Defining the presence, extent, and nature of the dysfunctional myocardial tissue remains a cornerstone in diagnostic cardiology. A nonfluoroscopic, catheter-based mapping technique that can spatially associate endocardial mechanical and electrical data was used to quantify electromechanical changes in the canine chronic infarction model. Methods and Results—We mapped the left ventricular (LV) electromechanical regional properties in 11 dogs with chronic infarction

Lior Gepstein; Alexander Goldin; Jonathan Lessick; Gal Hayam; Shlomo Shpun; Yitzhak Schwartz; Guil Hakim; Rona Shofty; Aharon Turgeman; Dina Kirshenbaum; Shlomo A. Ben-Haim

83

Chronic Intrinsic Transient Tracheal Occlusion Elicits Diaphragmatic Muscle Fiber Remodeling in Conscious Rodents  

PubMed Central

Background Although the prevalence of inspiratory muscle strength training has increased in clinical medicine, its effect on diaphragm fiber remodeling is not well-understood and no relevant animal respiratory muscle strength training-rehabilitation experimental models exist. We tested the postulate that intrinsic transient tracheal occlusion (ITTO) conditioning in conscious animals would provide a novel experimental model of respiratory muscle strength training, and used significant increases in diaphragmatic fiber cross-sectional area (CSA) as the primary outcome measure. We hypothesized that ITTO would increase costal diaphragm fiber CSA and further hypothesized a greater duration and magnitude of occlusions would amplify remodeling. Methodology/Principal Findings Sprague-Dawley rats underwent surgical placement of a tracheal cuff and were randomly assigned to receive daily either 10-minute sessions of ITTO, extended-duration, 20-minute ITTO (ITTO-20), partial obstruction with 50% of cuff inflation pressure (ITTO-PAR) or observation (SHAM) over two weeks. After the interventions, fiber morphology, myosin heavy chain composition and CSA were examined in the crural and ventral, medial, and dorsal costal regions. In the medial costal diaphragm, with ITTO, type IIx/b fibers were 26% larger in the medial costal diaphragm (p<0.01) and 24% larger in the crural diaphragm (p<0.05). No significant changes in fiber composition or morphology were detected. ITTO-20 sessions also yielded significant increases in medial costal fiber cross-sectional area, but the effects were not greater than those elicited by 10-minute sessions. On the other hand, ITTO-PAR resulted in partial airway obstruction and did not generate fiber hypertrophy. Conclusions/Significance The results suggest that the magnitude of the load was more influential in altering fiber cross-sectional area than extended-duration conditioning sessions. The results also indicated that ITTO was associated with type II fiber hypertrophy in the medial costal region of the diaphragm and may be an advantageous experimental model of clinical respiratory muscle strength training.

Smith, Barbara K.; Martin, A. Daniel; Vandenborne, Krista; Darragh, Brittany D.; Davenport, Paul W.

2012-01-01

84

Juxtarenal aortic occlusion.  

PubMed Central

The authors' experience with 113 aortic occlusions in 103 patients during a 26-year period (1965 to 1991) is reviewed. The authors found three distinct patterns of presentation: group I (n = 26) presented with acute aortic occlusion, group II (n = 66) presented with chronic aortic occlusion, and group III (n = 21) presented with complete occlusion of an aortic graft. Perioperative mortality rates were 31%, 9%, and 4.7% for each respective group and achieved statistical significance when comparing group I with group II (p = 0.009) and group I with group III (p = 0.015). Group I presented with profound metabolic insults due to acute ischemia and fared poorly. Group II presented with chronic claudication and did well long-term. Group III presented with acute ischemia but did well because of established collateral circulation. The treatment and expected outcome of aortic occlusion depends on the cause.

Tapper, S S; Jenkins, J M; Edwards, W H; Mulherin, J L; Martin, R S; Edwards, W H

1992-01-01

85

The impact of chronic intrauterine inflammation on the physiologic and neurodevelopmental consequences of intermittent umbilical cord occlusion in fetal sheep.  

PubMed

Objective: To determine the effect of intrauterine inflammation on fetal responses to umbilical cord occlusion (UCO). Study Design: In pregnant sheep, lipopolysaccharide (LPS) or saline (SAL) was infused intra-amniotically for 4 weeks from 80 days of gestation (d). At 110 d, fetuses were instrumented for UCOs (5 × 2-minutes, 30-minute intervals: LPS + UCO, n = 6; SAL + UCO, n = 8) or no UCO (sham, n = 6) on 117 and 118 d. Tissues were collected at 126 d. Results: Fetal physiological responses to UCO were similar between LPS + UCO and SAL + UCO. Histologic chorioamnionitis and increased amniotic fluid interleukin 8 (IL-8) were observed in LPS + UCO pregnancies (versus SAL + UCO, P < .05). CNPase-positive oligodendrocyte number in the cerebral white matter was lower in LPS + UCO and SAL + UCO than sham (P < .05); there was no effect on astrocytes or activated microglia/macrophages. Two of the SAL + UCO fetuses had white matter lesions; none were observed in LPS + UCO or sham. Conclusion: Chronic pre-existing intrauterine inflammation did not exacerbate fetal brain injury induced by intermittent UCO. PMID:21421894

Nitsos, Ilias; Newnham, John P; Rees, Sandra M; Harding, Richard; Moss, Timothy J M

2014-05-01

86

Influence of brotizolam on the ventilatory and mouth-occlusion pressure response to hypercapnia in patients with chronic obstructive pulmonary disease  

PubMed Central

1 Effect of 0.25 mg brotizolam on patients with chronic obstructive lung disease of moderate to severe degree was studied. 2 There was no difference between the slopes of ventilation vs alveolar CO2 for brotizolam and placebo as compared with base line values. Mouth-occlusion pressures did not change under the influence of drug or placebo. 3 Brotizolam (0.25 mg) is without adverse side-effects on respiratory centre output or on mechanics of ventilation.

Sybrecht, G. W.

1983-01-01

87

The effect of chronic kidney disease on total hip arthroplasty.  

PubMed

Patients with chronic kidney disease (CKD) undergoing total hip arthroplasty (THA) were evaluated for risk of revision, surgical site infection (SSI), thromboembolic events, mortality and readmission. 20,720 primary TKA cases were included (smaller sample for readmission evaluation, N = 9322). The prevalence of CKD among THA patients was 6.1% (N = 1269). After adjustment for age, gender, race, general health, and diabetes, CKD patients were at 1.4 (95% confidence interval 1.1-1.8) increased risk of readmission within 90 days. The adjusted risks for revision (overall, aseptic, and septic), SSI (deep and superficial), deep vein thrombosis, pulmonary embolism, and mortality (30-day, 90-day, ever) were not significantly different between patients with CKD and those without CKD. However, increased risk for 90-day readmission underscores that CKD patients are a fundamentally different population of patients. PMID:24556110

Miric, Alexander; Inacio, Maria C S; Namba, Robert S

2014-06-01

88

[Consideration on the treatment of chronic occlusive lesions of the iliac arteries].  

PubMed

This study addresses the problem of the best treatment for chronic unilateral obstructive lesions of the aorto-iliac arterial axis. After making a review of the literature, some considerations are made. In recent years this disease has increasingly been treated by endovascular methods with dilation (angioplasty) and stents. However, the classic indications (short stenotic obstruction), supported by national and international guidelines, are being continually widened by operators acquiring growing skills with this method. Nevertheless, no long term studies have demonstrated a clear superiority, in severe cases, of endovascular methods over traditional surgical methods (by-pass), as regards either long term results or costs. Among the traditional methods, many surgeons prefer the femoro-femoral by-pass to the orthopic aorto-femoral by-pass, particularly because of its lesser invasiveness. However, it should be noted that comparisons of the two methods have yielded results in favour of the orthotopic procedure, above all about long term results. PMID:18834574

Cardia, G; Catalano, G; Memeo, R; De Fazio, M

2008-01-01

89

Dietary protein, urea nitrogen appearance and total nitrogen appearance in chronic renal failure and CAPD patients  

Microsoft Academic Search

Dietary protein, urea nitrogen appearance and total nitrogen appearance in chronic renal failure and CAPD patients. This study was carried out to examine the mathematical relationships between the urea nitrogen appearance (UNA), total nitrogen appearance (TNA) and dietary nitrogen intake (DNI) in patients with chronic renal failure. Studies were conducted in 20 nondialyzed patients with advanced chronic renal failure (CRF)

Joel D Kopple; Xiu-Lin Gao; David Peiyuan Qing

1997-01-01

90

Evolution of myocardial ischemia and left ventricular function in patients with angina pectoris without myocardial infarction and total occlusion of the left anterior descending coronary artery and collaterals from other coronary arteries  

Microsoft Academic Search

Repeated episodes of myocardial ischemia might lead to progressive impairment of left ventricular (LV) function. This radionuclide study assessed myocardial ischemia and LV function several years after documented coronary occlusion without myocardial infarction. Over 5 years, 24 consecutive patients, who underwent cardiac catheterization for angina pectoris without myocardial infarction, had isolated total occlusion of the left anterior descending coronary artery

Y. Juilliere; Pierre Y. Marie; Nicolas Danchin; Gilles Karcher; Alain Bertrand; François Cherrier

1991-01-01

91

Biphasic Functional Regulation in Hippocampus of Rat with Chronic Cerebral Hypoperfusion Induced by Permanent Occlusion of Bilateral Common Carotid Artery  

PubMed Central

Background Chronic cerebral hypoperfusion induced by permanent occlusion of the bilateral common carotid artery (BCCAO) in rats has been commonly used for the study of Alzheimer’s disease and vascular dementia. Despite the apparent cognitive dysfunction in rats with BCCAO, the molecular markers or pathways involved in the pathological alternation have not been clearly identified. Methods Temporal changes (sham, 21, 35, 45, 55 and 70 days) in gene expression in the hippocampus of rats after BCCAO were measured using time-course microarray analysis. Gene Ontology (GO) and pathway analyses were performed to identify the functional involvement of temporally regulated genes in BCCAO. Results Two major gene expression patterns were observed in the hippocampus of rats after BCCAO. One pattern, which was composed of 341 early up-regulated genes after the surgical procedure, was dominantly involved in immune-related biological functions (false discovery rate [FDR]<0.01). Another pattern composed of 182 temporally delayed down-regulated genes was involved in sensory perception such as olfactory and cognition functions (FDR<0.01). In addition to the two gene expression patterns, the temporal change of GO and the pathway activities using all differentially expressed genes also confirmed that an immune response was the main early change, whereas sensory functions were delayed responses. Moreover, we identified FADD and SOCS3 as possible core genes in the sensory function loss process using text-based mining and interaction network analysis. Conclusions The biphasic regulatory mechanism first reported here could provide molecular evidence of BCCAO-induced impaired memory in rats as well as mechanism of the development of vascular dementia.

Lee, In Sun; Han, Jung-Soo; Kim, Bu-Yeo

2013-01-01

92

Effect of the ganglioside GM1 on neurologic function, electroencephalogram amplitude, and histology in chronic middle cerebral artery occlusion in cats.  

PubMed

The effect of the ganglioside GM1 on amplitude of the electroencephalogram, neurologic function, and histology has been studied in chronic middle cerebral artery occlusion in cats. Ischemia was produced by a 2-hour occlusion of the left middle cerebral artery and was followed by a 7-day observation period. GM1 was intravenously administered 30 minutes after occlusion and daily during the observation period. Using the reduction in the electroencephalogram amplitude to measure stroke severity, three cats with mild, three cats with moderate, and three cats with severe stroke were treated with 5 mg/kg GM1. Nine cats, three in each group, were treated with 30 mg/kg GM1, while nine cats, three in each group, received middle cerebral artery occlusion but no treatment. In all cats there was a precipitous fall in mean electroencephalogram amplitude during occlusion, followed by a secondary fall during the observation period. Treated cats showed better recovery of electroencephalogram amplitude during the first 4 hours of reperfusion and a smaller secondary fall than untreated cats. Treated cats, especially those treated with 5 mg/kg GM1, showed significant recovery of neurologic deficits compared with untreated cats. Histologic damage was less in treated cats than in untreated cats. Some cats treated with 30 mg/kg GM1 exhibited convulsions, whereas no untreated cat showed any seizure activity. Our findings suggest that gangliosides may improve the recovery of both neurologic deficits and morphologic damage in the central nervous system. These positive effects might be tentatively explained by stimulation of enzymatic activities such as Na+, K+-ATPase and adenyl cyclase. PMID:3400101

Komatsumoto, S; Greenberg, J H; Hickey, W F; Reivich, M

1988-08-01

93

Totally implantable robot to treat chronic atrial fibrillation.  

PubMed

Chronic atrial fibrillation affects millions of people worldwide. Its surgical treatment often fails to restore the transport function of the atrium. This study first introduces the concept of an atrial assist device (AAD) to restore the pump function of the atrium. The AAD is developed to be totally implantable in the human body with a transcutaneous energy transfer system to recharge the implanted battery. The ADD consists of a motorless pump based on artificial muscle technology, positioned on the external surface of the atrium to compress it and restore its muscular activity. A bench model reproduces the function of a fibrillating atrium to assess the circulatory support that this pump can provide. Atripump (Nanopowers SA, Switzerland) is a dome-shaped silicone-coated nitinol actuator 5 mm high, sutured on the external surface of the atrium. A pacemaker-like control unit drives the actuator that compresses the atrium, providing the mechanical support to the blood circulation. Electrical characteristics: the system is composed of one actuator that needs a minimal tension of 15 V and has a maximum current of 1.5 A with a 50% duty cycle. The implantable rechargeable battery is made of a cell having the following specifications: nominal tension of a cell: 4.1 V, tension after 90% of discharge: 3.5 V, nominal capacity of a cell: 163 mA h. The bench model consists of an open circuit made of latex bladder 60 mm in diameter filled with water. The bladder is connected to a vertically positioned tube that is filled to different levels, reproducing changes in cardiac preload. The Atripump is placed on the outer surface of the bladder. Pressure, volume and temperature changes were recorded. The contraction rate was 1 Hz with a power supply of 12 V, 400 mA for 200 ms. Preload ranged from 15 to 21 cm H(2)O. Maximal silicone membrane temperature was 55 degrees C and maximal temperature of the liquid environment was 35 degrees C. The pump produced a maximal work of 16 x 10(-3) J. Maximal volume pumped was 492 ml min(-1). This artificial muscle pump is compact, follows the Starling law and reproduces the hemodynamic performances of a normal atrium. It could represent a new tool to restore the atrial kick in persistent atrial fibrillation. PMID:18667758

Tozzi, Piergiorgio; Hayoz, Daniel; Thévenaz, Pierrick; Roulet, Jean-Yves; Salchli, Francois; von Segesser, Ludwig K

2008-09-01

94

Neurocognitive improvement after carotid artery stenting in patients with chronic internal carotid artery occlusion: a prospective, controlled, single-center study.  

PubMed

Symptomatic internal carotid artery (ICA) occlusion with hemodynamic impairment remains a dismal disease when untreated. In this prospective, single-center, controlled study, we investigated the feasibility, safety, and long-term outcome of stenting by endovascular recanalization for patients with chronic ICA occlusion. Forty patients with symptomatic chronically occluded ICA were assigned to receive endovascular recanalization (group A, n = 18) or conservative management (group B, n = 22). The primary end point was 100% complete recanalization of the primary occlusion at 60 minutes, and secondary end points were improvement in neurologic function and cognitive function. Patients in the 2 groups were comparable in demographic and baseline characteristics. Successful recanalization was achieved in 88.9% (16 of 18) of patients with the restoration of Thrombolysis in Myocardial Ischemia/Thrombolysis in Cerebral Ischemia 2 or 3 flow. There was no procedural or new cerebral ischemic event. Improvement in brain perfusion was observed in 12 (12 of 18, 75%) patients on single-photon emission computed tomography. Improvement in neurologic function defined as a reduction of ?4 points on the National Institutes of Health Stroke Scale (NIHSS) at 6 months was observed in group A (baseline, 6.83 ± 3.01 vs 6 months, 2.61 ± 1.20; P < .01) and group B (baseline, 6.05 ± 2.75 vs 6 months, 4.77 ± 1.69; P < .05). A significant difference in NIHSS scores was noted between group A and B at 1, 3, and 6 months (P < .05 or .001). Improvement in cognitive function defined as an increase of ?8 on the Montreal Cognitive Assessment (MoCA) was observed in group A at 3 and 6 months (baseline, 14.67 ± 3.56 vs 3 months, 24.17 ± 3.55 and 6 months, 24.72 ± 2.85; P < .01). Significant improvement in MoCA was also observed in group B (P < .01). Furthermore, a significant difference in MoCA scores was noted between group A and B at 1, 3, and 6 months (P < .05 or .001). Endovascular recanalization is feasible and safe for patients with symptomatic chronic carotid artery occlusion. Successful carotid artery stenting can improve neurological function and global cognitive function than nonrevascularization. PMID:24643000

Fan, Yi-Ling; Wan, Jie-Qing; Zhou, Zheng-Wen; Chen, Lei; Wang, Yong; Yao, Qing; Jiang, Ji-Yao

2014-05-01

95

[Effect of adjuvant infusion therapy of low molecular weight dextrans (Infukoll M 40) and deproteinized hemoderivate (Actovegin) in Fontaine stage IV chronic arterial occlusive diseases].  

PubMed

A selected group of 18 patients (among them 16 diabetics) with chronic disorders of arterial blood flow at Stage IV according to Fontaine received treatment by a standardised therapeutic scheme. None of the cases was suitable for reconstruction by vascular surgery. Infusion treatment, using Infukoll M 40 and Actovegin, was to be checked for its capability of providing sufficient improvement in blood flow and thus eliminating the need for imminent high-level amputation. Evaluation was undertaken on the basis of clinical and laboratory-chemical parameters. The rate of above-knee amputation was reduced by 14 per cent. Hence, the above therapeutic concept has proved to be suitable for treatment of Stage IV chronic arterial occlusion. PMID:2461011

Stoltz, J; Bartel, M

1988-01-01

96

Improvement of Left Ventricular Function and Wall Motion Abnormalities after Recanalization of Total Occlusion of Left Anterior Descending Coronary Artery by Percutaneous Transluminal Coronary Angioplasty.  

PubMed

PTCA was performed in 262 consecutive patients (pts) with total LAD occlusion. TIMI 3 flow was established in 164 pts (success rate was 62.6%). After 4Ð6 months a follow-up angiography of 72 pts showed restenosis in 39 pts (restenosis rate was 54.2%). In 33 pts without restenosis there was a significant increase in ejection fraction (EF) (54.6 +/- 15 versus 59.8 +/- 18.1 before and after PTCA respectively, p = 0.02). Improvement of wall motion abnormalities (WMA) in 12 of 26 pts was observed. Anterolateral-apical (AL-A) aneurysm disappeared in 6 pts and limited to apex in 2 pts. AL-A hypokinesia in 3 and akinesia in 1 reversed to normal wall motion (NWM). There was not a significant change in EF in either of the groups of pts with reocclusion (24 pts) or restenosis (15 pts) (p > 0.05). However, AL-A aneurysm disappeared in 2 of 12 pts with WMA before PTCA although there was restenosis (but TIMI 3 flow) on follow-up coronary angiogram. In 3 pts with restenosis but not reocclusion AL-A hypokinesia, akinesia and apical dyskinesia returned to NWM. No significant changes were observed in the left ventricular end diastolic pressures (LVEDP) in both pt groups with or without improvement of WMA(p > 0.05). Filling fractions (FF) did not change in patients with or without restenosis. CONCLUSION: The observations in patients with successful total LAD occlusion angioplasty and no restenosis are as follows: 1) There was a significant increase in EF; 2) There was no significant decrease in LVEDP and no increase in FF; 3) The rate of improvement of WMA was 46.2%; 4) There was no relation between improvement of WMA and the age of occlusion, the grade of coronary collateral vessels and involvement of other coronary arteries. However, it has been emphasized that in 11 of 12 pts (91.6%) with improvement of WMA the age of occlusion was < 3 months, in 10 (83.3%) the grade of coronary collateral vessels was 2 or 3 and in 10 (83.3%) the other coronary arteries were normal. The improvement of WMA in 41.6% of pts. who had also subtotal restenosis but not reocclusion was observed. Finally in 72 pts with follow-up coronary angiography, the rate of improvement of wall motion was 23.5 %. PMID:10762934

Pamir; Oral; Omurlu; Erol; Kervancioglu; Akgun; Golbasi

1997-07-01

97

Comparison of beraprost and ticlopidine in Chinese patients with chronic peripheral arterial occlusion: a multicenter, single-blind, randomized, controlled study  

PubMed Central

Background: Chronic peripheral arterial occlusion (CPAO) is a progressive disease that is associated with a variety of symptoms, the 4 most common being a sensation of coolness in the limbs, intermittent claudication (in which pain occurs on walking), limb pain (which occurs spontaneously at rest), and ischemic leg ulcers. Beraprost sodium is an oral prostaglandin I2 analogue that may ameliorate these symptoms. Objective: The aim of this study was to compare the efficacy and tolerability of beraprost sodium and ticlopidine hydrochloride in the treatment of patients with CPAO in China. Methods: In this multicenter, single-blind, controlled study, patients with CPAO were randomly assigned to receive beraprost 120-?g tablet TID or ticlopidine 500-mg tablet BID, both administered orally. The clinical efficacy of the drugs was assessed using the 4 main symptoms of CPAO. Ankle-brachial index (ABI) also was measured as a clinical pharmacologic procedure. Adverse events were assessed throughout the study. Results: A total of 124 patients (96 men, 28 women; mean [SD] age, 65 [12] years) were enrolled in 3 hospitals. Data from 119 patients (93 men, 26 women; mean [SD] age, 65 [12] years) were included in the efficacy analysis (64 and 55 patients in the beraprost and ticlopidine groups, respectively). Although all 4 symptoms of CPAO were ameliorated after 3 and 6 weeks of treatment with both drugs, only the cool sensation was significantly improved with beraprost compared with ticlopidine at 6 weeks (P<0.05). ABI was significantly increased with both beraprost and ticlopidine at 6 weeks versus baseline (P<0.001 and P<0.01, respectively), suggesting that this pharmacologic action may have led to their beneficial effect on various symptoms. The tolerability analysis included 123 patients (65 and 58 patients in the beraprost and ticlopidine groups, respectively). The numbers of patients who (1) experienced adverse events (AEs), (2) experienced adverse drug reactions, and (3) withdrew due to AEs were significantly smaller in the beraprost group than in the ticlopidine group (P<0.001, P<0.05, and P<0.05, respectively). Conclusions: In this study population of patients with CPAO, beraprost ameliorated cool sensation in the limbs, intermittent claudication, limb pain, and ischemic/leg ulcers. Beraprost was more efficacious in relieving CPAO symptoms and was better tolerated than ticlopidine. Beraprost may be useful for the treatment of patients with CPAO, but more studies are needed.

Guan, Heng; Wang, Yuqi; Zhang, Baigen; Ye, Wei; Fu, Weiguo; Liang, Wei; Liu, Changwei; Yang, Jue; Zhang, Jiwei; Li, Yongjun; Guo, Daqiao; Zhang, Hao; Zheng, Yuehong; Ye, Jianrong; Huang, Xiaozhong; Liu, Bao; Chen, Bin; Jiang, Junhao; Fan, Longhua; Shi, Zhenyu; Yamamoto, Minoru

2003-01-01

98

Total nitric oxide production is low in patients with chronic renal disease1  

Microsoft Academic Search

Total nitric oxide production is low in patients with chronic renal disease.BackgroundA deficiency of the endogenous vasodilator nitric oxide (NO) has been implicated as a potential cause of hypertension in chronic renal disease (CRD) patients. This study was conducted to determine whether 24-hour NOX (NO2 and NO3) excretion (a qualitative index of total NO production) is reduced in patients with

Rebecca J Schmidt; Chris Baylis

2000-01-01

99

Neurohistological and behavioral changes following the four-vessel occlusion/internal carotid artery model of chronic cerebral hypoperfusion: comparison between normotensive and spontaneously hypertensive rats.  

PubMed

Chronic cerebral hypoperfusion (CCH) may be a prodromal feature of aging-related dementias, and chronic hypertension is a major risk factor. We used a permanent, four-vessel occlusion/internal carotid artery (4-VO/ICA) model to evaluate the cognitive and neurohistological outcomes of CCH in both young and middle-aged rats. Young rats are asymptomatic after permanent 4-VO/ICA, and we tested the hypothesis that chronic hypertension aggravates the outcomes of CCH. Young normotensive rats (NTRs) and young spontaneously hypertensive rats (SHRs) were first subjected to 4-VO/ICA and then examined for hippocampal and cortical neurodegeneration 7, 15, and 30 days later. In a second experiment, both NTRs and SHRs were then trained in a modified, non-food-rewarded aversive radial maze (AvRM) task until acquiring asymptotic performance and then subjected to 4-VO/ICA. Thirty days later, they were assessed for memory retention of the previously acquired cognition. In a third, post hoc experiment, middle-aged NTRs were trained in the AvRM, subjected to 4-VO/ICA, and tested for memory retention 30 days later. Compared with NTRs, both SHRs and middle-aged NRTs had severe hippocampal and cortical damage, but they did not differ from each other, regardless of the chronicity of 4-VO/ICA. In contrast, NTRs were behaviorally asymptomatic, and retrograde memory performance was persistently impaired in SHRs. This amnesic effect in the SHR group was very similar to the middle-aged NTR group. These findings suggest that chronic hypertension deteriorates the capacity of the brain to adaptively respond to CCH. This influence of hypertension may parallel the effect of aging. PMID:23727150

Valério Romanini, Cássia; Dias Fiuza Ferreira, Emilene; Correia Bacarin, Cristiano; Verussa, Mario Henrique; Weffort de Oliveira, Rúbia Maria; Milani, Humberto

2013-09-01

100

Endovascular Sharp Recanalization for Calcified Femoropopliteal Artery Occlusion  

PubMed Central

Endovascular intervention of peripheral chronic total occlusion (CTO) is technically challenging and time consuming. Various techniques and devices are used to facilitate lesion crossing and improve the success rate of the procedure. However, these new devices are quite expensive and not readily available. We report 2 cases of peripheral CTO wherein the occlusions were successfully crossed by using stiff end of Terumo glidewire. This sharp recanalization may be a useful technique for the recanalization of calcified peripheral CTOs when conventional techniques fail and new devices are not readily available, but it is accompanied by the risk of distal atheroembolism.

Huang, Hsuan-Li; Chou, Hsin-Hua; Wu, Tien-Yu

2012-01-01

101

Inspiratory-to-Total Lung Capacity Ratio Predicts Mortality in Patients with Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Static lung hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease. We analyzed the power of lung hyperinflation as measured by the inspiratory capacity-to-total lung capacity ratio (IC\\/TLC) to predict mortality in a cohort of 689 patients with chronic obstructive pulmonary disease (95% males; FEV1, 1.17 L) with a mean follow-up of 34 months. We also compared

Ciro Casanova; Claudia Cote; Juan P. de Torres; Armando Aguirre-Jaime; Jose M. Marin; Victor Pinto-Plata; Bartolome R. Celli

102

Creatine supplementation does not decrease total plasma homocysteine in chronic hemodialysis patients  

Microsoft Academic Search

Creatine supplementation does not decrease total plasma homocysteine in chronic hemodialysis patients.BackgroundHyperhomocysteinemia is present in the majority of chronic hemodialysis patients. Treatment with folic acid, vitamin B12, and vitamin B6 cannot fully normalize plasma homocysteine concentrations (tHcy). Previously we have demonstrated the tHcy-lowering effect of creatine supplementation in an animal model of uremia (Kidney Int 64:1331–1337, 2003). The present study

Youri E. C. Taes; Joris R. Delanghe; DIRK DE BACQUER; MICHEL LANGLOIS; LUT STEVENS; INGE GEEROLF; Norbert H. Lameire; An S. De Vriese

2004-01-01

103

Collateral function in patients with coronary occlusion evaluated by 201 thallium scintigraphy.  

PubMed

The present study evaluated the impact of the angiographically documented collaterals on regional myocardial perfusion measured by 201thallium scintigraphy in patients with a chronic total occlusion. The study included 60 patients with chronic total occlusion who underwent rest-stress myocardial perfusion scintigraphy and coronary angiography. All patients had angiographic evidence of coronary collaterals. Patients were divided into two groups: group one had well-developed coronary collateral vessels (n=35) and group II had poor coronary collateral development (n=25). Patients with chronic total occlusion had severe and extensive stress-induced myocardial perfusion defects regardless of the grade of angiographic coronary collaterals. The perfusion defects in the group with good collaterals were predominantly reversible, suggesting that coronary collaterals preserved myocardial viability in the regions subtended by a total coronary occlusion. A significant correlation between good collaterals with complete protection and poor collaterals with no protection was noted. Our results demonstrate a protective effect of collaterals on myocardial perfusion during coronary occlusion. The effective angiographic collaterals may prevent resting regional wall motion abnormalities but do not appear to protect against stress-induced perfusion defect. PMID:19125699

Hasanovi?, Aida

2008-11-01

104

Rates of peripheral arterial occlusive disease in patients with chronic myeloid leukemia in the chronic phase treated with imatinib, nilotinib, or non-tyrosine kinase therapy: a retrospective cohort analysis.  

PubMed

Peripheral arterial occlusive disease (PAOD) occurs in patients with chronic phase chronic myeloid leukemia (CML-CP) treated with tyrosine kinase inhibitors (TKIs). The risk of developing PAOD on TKI therapy is unknown and causality has not been established. Patients with CML-CP from three randomized phase III studies (IRIS, TOPS and ENESTnd) were divided into three cohorts: no TKI (cohort 1; n=533), nilotinib (cohort 2; n=556) and imatinib (cohort 3; n=1301). Patients with atherosclerotic risk factors were not excluded. Data were queried for terms indicative of PAOD. Overall, 3, 7 and 2 patients in cohorts 1, 2 and 3, respectively, had PAOD; 11/12 patients had baseline PAOD risk factors. Compared with that of cohort 1, exposure-adjusted risks of PAOD for cohorts 2 and 3 were 0.9 (95% CI, 0.2-3.3) and 0.1 (95% CI, 0.0-0.5), respectively. Multivariate logistic regression revealed that nilotinib had no impact on PAOD rates compared with no TKI, whereas imatinib had decreased rates of PAOD compared with no TKI. Nilotinib was associated with higher rates of PAOD versus imatinib. Baseline assessments, preferably within clinical studies, of PAOD and associated risk factors should occur when initiating TKI therapy in CML; patients should receive monitoring and treatment according to the standard of care for these comorbidities. PMID:23459450

Giles, F J; Mauro, M J; Hong, F; Ortmann, C-E; McNeill, C; Woodman, R C; Hochhaus, A; le Coutre, P D; Saglio, G

2013-06-01

105

Evolution of myocardial ischemia and left ventricular function in patients with angina pectoris without myocardial infarction and total occlusion of the left anterior descending coronary artery and collaterals from other coronary arteries  

SciTech Connect

Repeated episodes of myocardial ischemia might lead to progressive impairment of left ventricular (LV) function. This radionuclide study assessed myocardial ischemia and LV function several years after documented coronary occlusion without myocardial infarction. Over 5 years, 24 consecutive patients, who underwent cardiac catheterization for angina pectoris without myocardial infarction, had isolated total occlusion of the left anterior descending coronary artery with well-developed collateral vessels. Five patients were successfully treated by coronary bypass grafting and 3 by coronary angioplasty. Among the 16 medically treated patients, 1 was lost to follow-up and 1 died (extracardiac death). The mean (+/- standard deviation) follow-up (14 patients) was 48 +/- 15 months. At follow-up, 8 patients still had clinical chest pain, 11 received antianginal therapy, 4 patients had no stress ischemia and the other 10 had greater than or equal to 1 sign of stress ischemia. All patients had a normal LV ejection fraction at rest (mean 60 +/- 3%; range 55 to 65%). Collateral circulation preserves LV function at the time of occlusion and, in some cases, prevents the development of myocardial ischemia; in patients with persisting myocardial ischemia after well-collateralized coronary occlusion, LV function is not impaired at long-term follow-up.

Juilliere, Y.; Marie, P.Y.; Danchin, N.; Karcher, G.; Bertrand, A.; Cherrier, F. (CHU Nancy-Brabois, Vandoeuvre-les-Nancy (France))

1991-07-01

106

[Investigation of anticardiolipin antibodies in chronic hepatitis B infection together with total anti-delta positivity].  

PubMed

Anticardiolipin antibodies (ACAs) are formed against phospholipids in various clinical conditions such as autoimmune diseases, malignancy, infectious diseases, alcohol-related and hepatic cirrhosis. The aims of this study were to investigate the presence of ACAs in patients with chronic hepatitis B together with positive total anti-delta antibodies, and to investigate the relationship between age, gender, and some laboratory parameters (ALT, AST, albumin, globulin, platelet number) of patients with chronic hepatitis delta virus (HDV) infection, who were positive or negative for ACAs. A total of 60 patients (43 male, 17 female) with chronic hepatitis D infection [HBsAg positive, HBeAg negative, anti-HBe positive, anti-HBc IgG positive, anti-HBc IgM negative, total anti-delta positive, anti-HCV negative] and 30 patients (21 male, 9 female) without hepatitis D infection [HBsAg positive, HBeAg negative, anti-HBe positive, anti-HBc IgG positive, anti-HBc IgM negative, total anti-delta negative, anti-HCV negative] as control group were included to the study. ACA IgG and IgM were searched by a commercial microELISA kit (Euroimmun, Germany). The statistical evaluation was performed with Pearson's chi-square test, Student's t-test, and Fisher's exact test. Total ACAs positivity rate of 60 patients with chronic HDV infection, was found as 13.3%, in which four of the patients were positive for only ACA IgM, while four was positive for only IgG. Positivity for both ACA IgG and ACA IgM could not be detected in these patients. No patients in the control group had positivity for ACAs (IgG and/or IgM). A statistically significant difference was observed in terms of ACA positivity between patients with and without HDV infection (p< 0.05). After all, there was no statistically significant correlation between ACAs positivity and the age, sex, and laboratory parameters of the patients with chronic HDV infection, except lower serum albumin levels (p= 0.004). Although the data of this study revealed a statistically significant positive correlation between chronic HDV infection and anticardiolipin antibodies, it is clear that there is a need for further studies on this subject. PMID:18822893

Me?e, Sevim; Ozekinci, Tuncer; Atmaca, Selahattin; Arikan, Eralp; Akin, Davut

2008-07-01

107

Research and Development for the Ackerman Artificial Heart System: A Non-Pulsatile, Non-Occlusive Total Artificial Heart for Human Implantation.  

National Technical Information Service (NTIS)

We are proposing a two phase program to design and develop a motor-driven, non-pulsatile, non-occlusive pump system capable of being implanted within the chest cavity as an artificial heart. Phase I will design, fabricate and test in the laboratory, a non...

1987-01-01

108

Retinal Vessel Occlusion  

MedlinePLUS

... the arteries involved in classic retinal artery occlusion. Retinal Vein Occlusion The retinal vein carries blood away from the retina. When the ... as "closing a curtain" on 1 eye. Although retinal vein occlusion also causes painless loss of vision, this ...

109

Endovascular recanalization of infrapopliteal occlusions in patients with critical limb ischemia  

PubMed Central

Background Endovascular therapies are increasingly used for treatment of critical limb ischemia (CLI). Infrapopliteal (IP) occlusions are common in CLI, and successful limb salvage may require restoration of arterial flow in the distribution of a chronically occluded vessel. We sought to describe the procedural characteristics and outcomes of patients with IP occlusions who underwent endovascular intervention for treatment of CLI. Methods All patients with IP interventions for treatment of CLI from 2006 to 2012 were included. Angiographic and procedural data were compared between patients who underwent intervention for IP occlusions vs IP stenosis. Restenosis was determined by Doppler ultrasound imaging. Limb salvage was the primary end point of the study. Additional end points included primary patency, primary assisted patency, secondary patency, occlusion crossing success, procedural success, and amputation-free survival. Results A total of 187 patients with CLI underwent interventions for 356 IP lesions, and 77 patients (41%) had interventions for an IP occlusion. Patients with an intervention for IP occlusion were more likely to have zero to one vessel runoff (83% vs 56%; P < .001) compared with interventions for stenosis. Compared with IP stenoses, IP occlusions were longer (118 ± 86 vs 73 ± 67 mm; P < .001) and had a smaller vessel diameter (2.5 ± 0.8 vs 2.7 ± 0.5 mm; P =.02). Wire crossing was achieved in 83% of IP occlusions, and the overall procedural success for IP occlusions was 79%. The overall 1-year limb salvage rate was 84%. Limb salvage was highest in the stenosis group, slightly lower in the successful occlusion group, and lowest in the failed occlusion group (92% vs 75% vs 58%, respectively; P = .02). Unsuccessfully treated IP occlusions were associated with a significantly higher likelihood of major amputation (hazard ratio, 5.79; 95% confidence interval, 1.89–17.7) and major amputation or death (hazard ratio, 2.69; 95% confidence interval, 1.09–6.63). Conclusions Successful endovascular recanalization of IP occlusions can be achieved with guidewire and support catheter techniques in most patients. In patients selected for an endovascular-first approach for IP occlusions in CLI, this strategy can be successfully implemented with favorable rates of limb salvage.

Singh, Gagan D.; Armstrong, Ehrin J.; Yeo, Khung-Keong; Singh, Satinder; Westin, Gregory G.; Pevec, William C.; Dawson, David L.; Laird, John R.

2014-01-01

110

Pregabalin reduces opioid consumption and improves outcome in chronic pain patients undergoing total knee arthroplasty.  

PubMed

Introduction: Recently, multimodal pain control has been used to manage postoperative pain in patients undergoing total knee arthroplasty (TKA). This approach combines numerous modalities, such as opioids, nonsteroidal anti-inflammatory drugs, local anesthetics, and acetaminophen, in an effort to reduce overall opioid consumption and also to provide better pain control. Gabapentinoids are a class of drugs that have been used as part of multimodal approach, and may be effective in patients who are previous users of chronic pain medication. The hypothesis of this study was that the addition of pregabalin reduces opioid consumption and/or improves pain after TKA, even in patients who are previous users of chronic pain medications. Methods: Using a prospectively collected database, 262 consecutive patients undergoing primary TKA between December 2011 and April 2012 were identified who received multimodal analgesia after surgery that included pregabalin. Using the same database, these patients were compared with 268 patients undergoing TKA from January to December 2010 who also received multimodal analgesia but were not given pregabalin. The clinical records of these patients were reviewed in detail to determine the incidence and nature of postoperative complications, opioid consumption, and visual analog scale (VAS) pain scores. Results: The incidence of respiratory, renal, and hemodynamic complications was significantly lower in the patients who received pregabalin. Gastrointestinal complications, which included nausea, were not significantly different between the groups. Patients receiving pregabalin had a lower average opioid consumption, and their minimum and maximum levels of opioid consumption were also reduced. Previous users of chronic pain medications had higher VAS scores but the same opioid consumption compared with those who were not previous users of chronic pain medications. No difference was seen in the maximum VAS scores between patients who received pregabalin and those who did not. Conclusion: Pregabalin in the context of multimodal pain management may be associated with reduced opioid consumption and other medical complications in patients undergoing TKA, including previous users of chronic pain medications. PMID:24875968

Sawan, Hind; Chen, Antonia F; Viscusi, Eugene R; Parvizi, Javad; Hozack, William J

2014-05-01

111

Skeletal toxicity associated with chronic ethanol exposure in a rat model using total enteral nutrition.  

PubMed

Chronic alcohol abuse decreases bone mass, inhibits osteoblast differentiation and function, increases fracture incidence, and delays fracture healing. Four studies were designed to use intragastric ethanol delivery as part of a total enteral nutrition (TEN) system to determine the negative systemic effects of chronic ethanol on 1) the rat skeleton and 2) local rapid bone formation during limb lengthening (distraction osteogenesis, DO). In study 1, three-point bending tests demonstrated that after 75 days of ethanol exposure, the tibiae had significantly lower load to failure versus control diet (p = 0.0006) or ad libitum chow-fed rats (p = 0.0029). Study 2 examined alcohol's effects on the density and cross-sectional area of the proximal tibial metaphysis using peripheral quantitative computed tomography and found that after 25 days of ethanol exposure the trabecular volumetric bone mineral density (p = 0.011) and cortical cross-sectional area (p = 0.011) were lower compared with controls. In study 3, a comparison of distracted tibial radiographs and histological sections demonstrated ethanol-related decreases in both gap mineralization (p = 0.03) and bone column formation (p = 0.01). Histological comparisons in study 4 reproduced the ethanol-related deficits in new bone formation during DO (p = 0.001). These results indicate that the TEN system is a viable model to study ethanol's effects on the skeleton and that chronic ethanol delivery via TEN decreases trabecular bone density, cortical area, and mature bone strength. Also, the DO studies demonstrate, for the first time, that chronic ethanol inhibits rapid bone formation during limb lengthening. PMID:12023547

Brown, Elizabeth C; Perrien, Daniel S; Fletcher, Terry W; Irby, David J; Aronson, James; Gao, Guan G; Hogue, William J; Skinner, Robert A; Suva, Larry J; Ronis, Martin J J; Hakkak, Reza; Badger, Thomas M; Lumpkin, Charles K

2002-06-01

112

Latest recanalization techniques for complex superficial femoral artery occlusions.  

PubMed

Complex, long segment lesions of the superficial femoral artery (SFA) are common, occurring in 40% of patients with peripheral vascular disease. In particular, chronic total occlusions (CTOs) continue to pose a challenge in the endovascular management of SFA disease. Several conventional wire and catheter based techniques have been described including subintimal recanalization and retrograde techniques. In addition, advances in endovascular technology have led to the development of a series of new devices aimed specifically at facilitating the crossing of long segment SFA occlusions or establishing re-entry of the true lumen. Here we present an overview of the minimally invasive techniques used to recanalize CTOs of the SFA and the latest specialized devices available for both recanalization and re-entry, as well as a summary of the literature supporting their application. PMID:22854529

Gonzalez, L; Chen, A; Lin, P H; Pisimisis, G; Barshes, N R; Bechara, C F; Kougias, P

2012-08-01

113

Occlusion and orthodontics.  

PubMed

The importance of considering the functional aspects as well as the static concepts of an occlusion was demonstrated in the case of an 11-year-old girl with postorthodontic temporomandibular joint muscle pain dysfunction. The following characteristics of an ideal occlusion were discussed as they relate to the entire masticatory system: 1. There should be no slide in centric; that is, there should be a stable jaw relationship when occlusal contact is made in centric relation closure. 2. There should be freedom in centric, that is, freedom for the mandible to move from centric relation to centric occlusion and slightly anterior to centric occlusion without interference. 3. Centric relation should be at the same contact vertical dimension as centric occlusion. 4. There should be no buccolingual thrust or impact to any tooth on closure to contact in centric relation or to centric occlusion. 5. Between centric relation and centric occlusion there should be an unrestricted glide with maintained occlusal contact. 6. Complete freedom for smooth-gliding occlusal contact movements in various excursions from both centric occlusion and centric relation. 7. Occlusal guidance should be on the working or functioning side rather than on the balancing or nonfunctioning side. 8. There should be no soft-tissue impingment from occlusal contacts. In effect, the occlusion should be related to centric relation and centric occlusion prior to, during, and at the completion of active treatment. The final occlusion should provide unhindered closure in centric relation, smooth-sliding lateral and protrusive movements, and an optimal bilateral vertical contact dimension. Orthodontic treatment must include proper occlusal adjustment procedures to obtain the goals of an ideal occlusion in most instances. PMID:1066050

Timm, T A; Herremans, E L; Ash, M M

1976-08-01

114

Total nitric oxide production is low in patients with chronic renal disease1  

PubMed Central

Total nitric oxide production is low in patients with chronic renal disease. Background A deficiency of the endogenous vasodilator nitric oxide (NO) has been implicated as a potential cause of hypertension in chronic renal disease (CRD) patients. This study was conducted to determine whether 24-hour NOX (NO2 and NO3) excretion (a qualitative index of total NO production) is reduced in patients with CRD. Methods Measurements were made in 13 CRD patients and 9 normotensive healthy controls after 48 hours on a controlled low-NOX diet. Urine was collected over the second 24-hour period for analysis of 24-hour NOX, and cGMP and blood drawn at the completion. Plasma levels of arginine (the substrate for endogenous renal NO synthesis), citrulline (substrate for renal arginine synthesis), and the endogenous NO synthesis inhibitor asymmetrical dimethylarginine (ADMA) and its inert isomer and symmetrical dimethylarginine (SDMA) were also determined. Results Systolic blood pressure was higher in CRD patients (12 of whom were already on antihypertensive therapy) than in controls (P < 0.05). Twenty-four–hour urinary NOX excretion was low in CRD patients compared with controls despite similar dietary NO intake, suggesting that net endogenous NO production is decreased in renal disease. In contrast, the 24-hour urinary cGMP did not correlate with UNOXV. Plasma citrulline was increased in CRD patients, possibly reflecting reduced conversion of citrulline to arginine. Plasma arginine was not different, and plasma ADMA levels were elevated in CRD versus controls, changes that would tend to lower NO synthase. Conclusion These results suggest that NO production is low in CRD patients and may contribute to hypertension and disease progression in CRD.

Schmidt, Rebecca J.; Baylis, Chris

2009-01-01

115

Total central vein obstruction: Resolution with angioplasty and fibrinolysis  

Microsoft Academic Search

Percutaneous transluminal angioplasty (PTA) has assumed an important role in the chronic management of malfunctioning and failed fistulas [1–8]. Stenotic lesions, most commonly occurring in the venous limbs of such fistulas, are the most common anatomic cause of malfunction [4]. If left untreated, these stenoses may progress to total occlusion. Central vein stenosis has emerged as a serious new medical

Glenn E Newman; Mohsin Saeed; Steve Himmelstein; Richard H Cohan; Steve J Schwab

1991-01-01

116

Immediate occlusal loading the same day or the after implant placement: comparison of 2 different time frames in total edentulous lower jaws.  

PubMed

Immediate loading of endosseous implants is becoming a widespread therapeutic procedure for the rehabilitation of patients with edentulous jaws. The purpose of this prospective clinical trial was to evaluate the long-term success rate of endosseous implants placed in the edentulous lower jaw and loaded on either the same day of surgery or the next day. Nineteen patients were enrolled in the study. Eleven patients, accounting for 64 implants, received their provisional prosthesis the same day of implant placement, and 8 patients, accounting for 52 implants, were rehabilitated the day after surgery. All patients were rehabilitated by a hybrid prosthesis supported by 5 to 6 Osseotite implants. Two implants failed in the group of patients who had their implants loaded the same day (96.9% success rate), whereas 1 implant failed in the other group (98.1% success rate). The overall implant success rate was 97.4%. All failures occurred within 2 months of function. No other complication was reported. The mean follow-up for this interim report was 37.8 +/- 16.5 months (range 8-65 months). Crestal bone loss was similar to that reported for standard delayed loading protocols. The results of this study suggest that the rehabilitation of the edentulous lower jaw by an immediate occlusally loaded implant-supported hybrid prosthesis is equally successful when loading is applied the same day or the day after implant placement. Immediate loading with 5 to 6 implant-supported prostheses represents a viable alternative treatment to classic delayed loading protocols. PMID:15587021

Testori, Tiziano; Del Fabbro, Massimo; Galli, Fabio; Francetti, Luca; Taschieri, Silvio; Weinstein, Roberto

2004-01-01

117

Inheritance of Occlusal Topography: A Twin Study  

PubMed Central

Aim This was to determine the relative contribution of genetic factors on the morphology of occlusal surfaces of mandibular primary first molars by employing the twin study model. Methods The occlusal morphology of mandibular primary first molar teeth from dental casts of 9 monozygotic (MZ) twin pairs and 12 dizygotic (DZ) twin pairs 4 to 7 years old, were digitized by contact-type three-dimensional (3D) scanner. To compare the similarity of occlusal morphology between twin sets, each twin pair of occlusal surfaces was superimposed to establish the best fit by using computerized least squared techniques. Heritability was computed using a variance component model, adjusted for age and gender. Results DZ pairs demonstrated a greater degree of occlusal morphology variance. The total amount of difference in surface overlap was 0.0508 mm (0.0018 (inches) for the MZ (n=18) sample and 0.095 mm (0.0034 inches) for the DZ (n=24) sample and were not statistically significant (p=0.2203). The transformed mean differences were not statistically significantly different (p=0.2203). Heritability estimates of occlusal surface areas for right and left mandibular primary first molars were 97.5% and 98.2% (p<0.0001), respectively. Conclusions Occlusal morphology of DZ twin pairs was more variable than that of MZ twin pairs. Heritability estimates revealed that genetic factors strongly influence occlusal morphology of mandibular primary first molars.

Su, C-Y.; Corby, P.M.; Elliot, M.A.; Studen-Pavlovich, D.A.; Ranalli, D.N.; Rosa, B.; Wessel, J.; Schork, N.J.; Hart, T.C.; Bretz, W.A.

2011-01-01

118

Potential cardiovascular risk factors in chronic kidney disease: AGEs, total homocysteine and metabolites, and the C-reactive protein  

Microsoft Academic Search

Potential cardiovascular risk factors in chronic kidney disease: AGEs, total homocysteine and metabolites, and the C-reactive protein.BackgroundTotal homocysteine (tHcy) and advanced glycation end-products (AGEs) are implicated in the pathogenesis of vascular damage. This study aimed to investigate whether elevated serum levels of the AGEs pentosidine, N?-carboxymethyllysine (CML) and imidazolone; tHcy, cystathionine, methylmalonic acid (MMA), and 2-methylcitric acid (2-MCA), as well

MARTIN BUSCH; SYBILLE FRANKE; ANDREAS MÜLLER; MARCO WOLF; JENS GERTH; UNDINE OTT; TOSHIMITSU NIWA; GÜNTER STEIN; med. Martin Busch

2004-01-01

119

Serum lipids and total fatty acids in chronic alcoholic liver disease at different stages of cell damage  

Microsoft Academic Search

Summary Lipid classes and per cent composition of total fatty acids were investigated in serum of normal subjects and patients with chronic alcoholic liver disease. In view of the histological findings, the latter were classified in 5 groups according to the severity of their liver damage.

A. Marzo; P. Ghirardi; D. Sardini; B. D. Prandini; A. Albertini

1970-01-01

120

Total inspiratory and expiratory impedance in patients with severe chronic obstructive pulmonary disease  

PubMed Central

OBJECTIVES: Several studies have confirmed the high potential of the forced oscillation technique for the assessment of respiratory modifications related to chronic obstructive pulmonary disease. However, most of these studies did not employ within-breath analyses of the respiratory system. The aim of this study is to analyze respiratory impedance alterations in different phases of the respiratory cycle of chronic obstructive pulmonary disease patients and to evaluate their clinical use. METHODS: 39 individuals were evaluated, including 20 controls and 19 individuals with chronic obstructive pulmonary disease who experienced severe airway obstruction. We evaluated the mean respiratory impedance (Zm) as well as values for inspiration (Zi) and expiration cycles (Ze), at the beginning of inspiration (Zbi) and expiration (Zbe). The peak-to-peak impedance (Zpp), and the impedance change (?Zrs) were also analyzed. The clinical usefulness was evaluated by investigating the sensibility, specificity and the area under the receiver operating characteristic curve. RESULTS: The respiratory impedance increased in individuals with chronic obstructive pulmonary disease in all of the studied parameters (Zm, Zi, Ze, Zbi, Zbe, ?Zrs and Zpp). These changes were inversely associated with spirometric parameters. Higher impedances were observed in the expiratory phase of individuals with chronic obstructive pulmonary disease. All of the studied parameters, except for ?Zrs (area under the receiver operating characteristic <0.8), exhibited high accuracy for clinical use (area under the receiver operating characteristic >0.90; Sensibility ? 0.85; Sp ? 0.85). CONCLUSIONS: The respiratory alterations in severe chronic obstructive pulmonary disease may be identified by the increase in respiratory system impedance, which is more evident in the expiratory phase. These results confirm the potential of within-breath analysis of respiratory impedance for the assessment of respiratory modifications related to chronic obstructive pulmonary disease.

Silva, Karla Kristine Dames; Lopes, Agnaldo Jose; Jansen, Jose Manoel; de Melo, Pedro Lopes

2011-01-01

121

Total Flavonoids Extracted from Xiaobuxin-Tang on the Hyperactivity of Hypothalamic-Pituitary-Adrenal Axis in Chronically Stressed Rats  

PubMed Central

Our previous studies have demonstrated that the total flavonoids (XBXT-2) isolated from the extract of Xiaobuxin-Tang (XBXT), a traditional Chinese herbal decoction, ameliorated behavioral alterations and hippocampal dysfunctions in chronically stressed rats. Studies over the last decades have suggested that the hyperactivity of hypothalamic-pituitary-adrenal (HPA) axis is one of the most consistent findings in stress-related depression. Herein, we used the same chronic mild stress model of rats as before to further investigate the effect of XBXT-2 on the hyperactivity of HPA axis, including the stress hormones levels and glucocorticoid receptors (GRs) expression. Our ELISA results showed that chronic administration of XBXT-2 (25, 50?mg?kg?1, p.o., 28 days, the effective doses for behavioral responses) significantly decreased serum corticosterone level and its upstream stress hormone adrenocorticotropic hormone (ACTH) level in chronically stressed rats. Furthermore, western blotting result demonstrated XBXT-2 treatment ameliorated stress-induced decrease of GRs expression in hippocampus, an important target involved in the hyperactivity of HPA axis. These results were similar to that of classic antidepressant imipramine treatment (10?mg?kg?1, p.o.). In conclusion, the modulation of HPA axis produced by XBXT-2, including the inhibition of stress hormones levels and up-regulation of hippocampal GRs expression, may be an important mechanism underlying its antidepressant-like effect in chronically stressed rats.

An, Lei; Zhang, You-Zhi; Liu, Xin-Min; Yu, Neng-Jiang; Chen, Hong-Xia; Zhao, Nan; Yuan, Li; Li, Yun-Feng

2011-01-01

122

Recanalization of a total occlusion with marked retrograde collateral supply: impact of collateral circulation on fractional flow reserve measurements of donor artery.  

PubMed

Fractional flow reserve (FFR)-based coronary interventions of intermediate-severity lesions are safe, cost effective, and have prognostic importance. Although FFR is not affected by heart rate or blood pressure, collateral circulation might affect FFR results. Intermediate stenosis at the donor artery might be overestimated with FFR measurement due to coronary steal. Moreover, the amount of collateral circulation might be a strong determinant of this inaccurate measurement. In this report, we present 8 patients who underwent percutaneous coronary intervention for totally or subtotally occluded recipient vessels that were collateralized by a vessel with intermediate-degree stenosis proximal to the separation of the donor side branch evaluated by quantitative coronary angiography (QCA). In patients with Rentrop grade-2 or grade-3 collateral flow, FFR value of the donor artery was increased at least 0.10 after revascularization of the recipient artery. However, FFR value did not change significantly in patients with Rentrop grade- 0 or grade-1 collateral flow following revascularization. In this case series, we suggest that well-developed collateral circulation might result in overestimation of the FFR value in the donor artery with mild stenosis. Therefore, in patients undergoing intervention to the recipient artery with a well-developed collateral supply and an intermediate stenosis at the donor artery, hemodynamic significance of the stenotic lesion should be evaluated not only before but also after coronary intervention. However, if there is no sufficient collateral circulation to totally occluded arteries, FFR values of donor arteries seem to be relatively stable both before and after PCI to the recipient artery. PMID:24907090

Tigen, Kursat; Durmu?, Erdal; Sari, Ibrahim

2014-06-01

123

Gastric mucosal proliferative and total tyrosine kinases activities increase in Helicobacter pylori -induced chronic gastritis  

Microsoft Academic Search

Background. The intestinal type of gastric cancer is thought to originate from cancer precursor lesions, progressing from H. pylori-induced chronic gastritis, atrophic gastritis, to intestinal metaplasia (IM) and dysplasia. Tyrosine kinases (tyr-k) represent\\u000a the family of proteins that are widely expressed during cell metabolism and are considered as secondary markers for cellular\\u000a proliferation and malignant transformation.\\u000a \\u000a \\u000a Aim of Study. The

Justyna Kotynia; Radzislaw Kordek; Alicja Kozlowska; Ewa Malecka-Panas

2005-01-01

124

Vertebrobasilar Artery Occlusion  

PubMed Central

The presentation of vertebrobasilar artery occlusion varies with the cause of occlusion and location of ischemia. This often results in delay in diagnosis. Areas of the brain supplied by the posterior circulation are difficult to visualize and usually require angiography or magnetic resonance imaging. Intravenous thrombolysis and local-intra arterial thrombolysis are the most common treatment approaches used. Recanalization of the occluded vessel significantly improves morbidity and mortality. Here we present a review of the literature and a case of a patient with altered mental status caused by vertebrobasilar artery occlusion.

Schoen, Jessica C.; Boysen, Megan M.; Warren, Chase R.; Chakravarthy, Bharath; Lotfipour, Shahram

2011-01-01

125

Acute arterial occlusion - kidney  

MedlinePLUS

... occlusion of the kidney is a sudden, severe blockage of the artery that supplies blood to the ... impair kidney function. If it continues, a complete blockage of blood flow to the kidney often results ...

126

Occlusive Peripheral Arterial Disease  

MedlinePLUS

... Pericardial Disease Sports and the Heart Heart Tumors Atherosclerosis Coronary Artery Disease Peripheral Arterial Disease Aneurysms and ... Disease Occlusive peripheral arterial disease often results from atherosclerosis. Symptoms depend on which artery is blocked and ...

127

Removable partial denture occlusion.  

PubMed

No single occlusal morphology, scheme, or material will successfully treat all patients. Many patients have been treated, both successfully and unsuccessfully, using widely varying theories of occlusion, choices of posterior tooth form, and restorative materials. Therefore, experience has demonstrated that there is no one righ r way to restore the occlusion of all patients. Partially edentulous patients have many and varied needs. Clinicians must understand the healthy physiologic gnathostomatic system and properly diagnose what is or may become pathologic. Henderson [3] stated that the occlusion of the successfully treated patient allows the masticating mechanism to carry out its physiologic functions while the temporomandibular joints, the neuromuscular mechanism, the teeth and their supporting structures remain in a good state of health. Skills in diagnosis and treatment planning are of utmost importance in treating these patients, for whom the clinician's goals are not only an esthetic and functional restoration but also a lasting harmonious state. Perhaps this was best state by DeVan [55] more than 60 years ago in his often-quoted objective. "The patient's fundamental need is the continued meticulous restoration of what is missing, since what is lost is in a sense irretrievably lost." Because it is clear that there is no one method, no one occlusal scheme, or one material that guarantees success for all patients, recommendations for consideration when establishing or reestablishing occlusal schemes have been presented. These recommendations must be used in conjunction with other diagnostic and technical skills. PMID:15261799

Ivanhoe, John R; Plummer, Kevin D

2004-07-01

128

Conventional occlusion versus pharmacologic penalization for amblyopia  

PubMed Central

Background Amblyopia is defined as defective visual acuity in one or both eyes without demonstrable abnormality of the visual pathway, and is not immediately resolved by wearing glasses. Objectives To assess the effectiveness and safety of conventional occlusion versus atropine penalization for amblyopia. Search methods We searched CENTRAL, MEDLINE, EMBASE, LILACS, the WHO International Clinical Trials Registry Platform, preference lists, science citation index and ongoing trials up to June 2009. Selection criteria We included randomized/quasi-randomized controlled trials comparing conventional occlusion to atropine penalization for amblyopia. Data collection and analysis Two authors independently screened abstracts and full text articles, abstracted data, and assessed the risk of bias. Main results Three trials with a total of 525 amblyopic eyes were included. One trial was assessed as having a low risk of bias among these three trials, and one was assessed as having a high risk of bias. Evidence from three trials suggests atropine penalization is as effective as conventional occlusion. One trial found similar improvement in vision at six and 24 months. At six months, visual acuity in the amblyopic eye improved from baseline 3.16 lines in the occlusion and 2.84 lines in the atropine group (mean difference 0.034 logMAR; 95% confidence interval (CI) 0.005 to 0.064 logMAR). At 24 months, additional improvement was seen in both groups; but there continued to be no meaningful difference (mean difference 0.01 logMAR; 95% CI ?0.02 to 0.04 logMAR). The second trial reported atropine to be more effective than occlusion. At six months, visual acuity improved 1.8 lines in the patching group and 3.4 lines in the atropine penalization group, and was in favor of atropine (mean difference ?0.16 logMAR; 95% CI ?0.23 to ?0.09 logMAR). Different occlusion modalities were used in these two trials. The third trial had inherent methodological flaws and limited inference could be drawn. No difference in ocular alignment, stereo acuity and sound eye visual acuity between occlusion and atropine penalization was found. Although both treatments were well tolerated, compliance was better in atropine. Atropine penalization costs less than conventional occlusion. The results indicate that atropine penalization is as effective as conventional occlusion. Authors' conclusions Both conventional occlusion and atropine penalization produce visual acuity improvement in the amblyopic eye. Atropine penalization appears to be as effective as conventional occlusion, although the magnitude of improvement differed among the three trials. Atropine penalization can be used as first line treatment for amblyopia.

Li, Tianjing; Shotton, Kate

2013-01-01

129

Endovascular Treatment Strategies in Aortoiliac Occlusion  

SciTech Connect

The aim of this study was to report our experience in endovascular treatment of total aortoiliac occlusion. Five patients who underwent endovascular recanalization procedures including manual aspiration thrombectomy, balloon angioplasty, and stent placement for total aortoiliac occlusion in a 4-year period were reviewed retrospectively. The mean age of patients was 51 years (range, 43 to 58 years). All patients had abdominal aorta and bilateral common iliac artery occlusion with or without external iliac artery occlusion. All patients either had a contraindication to surgery or refused it. Initial technical success was obtained in four of five (80%) patients. Endovascular techniques were successful in four patients who had good distal runoff and short-segment aortoiliac occlusion, but failed in a patient who had the worst distal runoff and long-segment aortoiliac occlusion. We observed two major complications, one of which was bilateral rupture of the common iliac arteries treated with covered stent placement. Another patient had extension of intra-aortic thrombus into the iliac stent after primary stenting. This was successfully treated with manual aspiration thrombectomy. Aortic and iliac stents remained patent during the follow-up period (median, 18 months; range, 3 to 26 months) in four patients. Primary patency rates at 6, 12, and 24 months were all 80%. In conclusion, endovascular treatment can be an alternative for aortoiliac occlusion in selected patients. Short- to midterm follow-up so far is satisfactory. Removal of intra-aortic thrombus with manual aspiration thrombectomy before balloon angioplasty and/or stenting is possible and a good alternative to thrombolysis.

Ozkan, Ugur, E-mail: radugur@yahoo.com; Oguzkurt, Levent, E-mail: loguzkurt@yahoo.com; Tercan, Fahri, E-mail: ftercan@yahoo.com; Gumus, Burcak, E-mail: burcakgumus73@yahoo.co [Baskent University Faculty of Medicine, Department of Radiology (Turkey)

2009-05-15

130

Effect of Chronic Variate Stress on Thiobarbituric-Acid Reactive Species and on Total Radical-Trapping Potential in Distinct Regions of Rat Brain  

Microsoft Academic Search

It has been suggested that oxidative stress is involved in aging and neuropathologic disorders. In addition, chronic stress and high corticosterone levels are suggested to induce neuronal death. The aim of this study is to verify the effect of chronic variate stress on lipoperoxidation and on the total radical-trapping potential (TRAP) in hippocampus, hypothalamus and cerebral cortex. Adult male Wistar

L. P. Manoli; G. D. Gamaro; P. P. Silveira; C. Dalmaz

2000-01-01

131

Urea, creatinine, uric acid, and phosphate spaces and their relationship to total body water during chronic hemodialysis  

SciTech Connect

The authors determined total body water (TBW) with tritium in 11 patients on chronic hemodialysis and compared this space to that estimated by 60% of body weight, and removal spaces of urea, creatinine, uric acid, and phosphate (PO4). The latter spaces were determined by dividing the total amount of substance (measured in total dialysate) by pre- minus post-dialysis concentrations. Body water X 0.6 was more than 10% less than the tritium space, and showed a maximal variation of 10 liters, or 24%. The removal space of urea was 80% of the tritium space, but correlated closely with it. The difference between total body water and urea removal space was variable and dependent on fluid excess (edema) in the patients. Creatinine, uric acid, and phosphate removal spaces were highly variable and not correlated to total body water. The authors suggest that actual measured TBW should be used, rather than estimations using BW X 0.6, for V in K X T/V, where K = clearance, T = duration of dialysis, and V = the removal space of urea. Furthermore, one may need to introduce a correction factor for urea removal space over TBW in the equation to allow better quantification of dialysis in edematous patients and during very fast dialyses.

Ericsson, F.; Odar-Cederloef, I.E.; Eriksson, C.G.; Lindgren, S.; Kjellstrand, C.M.

1988-07-01

132

Combining technologies: a computerized occlusal analysis system synchronized with a computerized electromyography system.  

PubMed

Current advances in computer technologies have afforded dentists precision ways to examine occlusal contacts and muscle function. Recently, two separate computer technologies have been synchronized together, so that an operator can record their separate diagnostic data simultaneously. The two systems are: the T Scan II Occlusal Analysis System and the Biopak Electromyography Recording System. The simultaneous recording and playback capacity of these two computer systems allows the operator to analyze and correlate specific occlusal moments to specific electromyographic changes that result from these occlusal moments. This synchronization provides unparalleled evidence of the effect occlusal contact arrangement has on muscle function. Therefore, the occlusal condition of an inserted dental prosthesis or the occlusal scheme of the natural teeth (before and after corrective occlusal adjustments) can be readily evaluated, documented, and quantified for both, quality of occlusal parameters and muscle activity and the responses to the quality of the occlusal condition. This article describes their synchronization and illustrates their use in performing precision occlusal adjustment procedures on two patients: one who demonstrates occlusal disharmony while exhibiting the signs and symptoms of chronic myofascial pain dysfunction syndrome, and the other who had extensive restorative work accomplished but exhibits occlusal discomfort post-operatively. PMID:15134409

Kerstein, Robert B

2004-04-01

133

Endovascular occlusion of a ruptured popliteal artery aneurysm.  

PubMed

Popliteal artery aneurysms are the most common of the peripheral aneurysms. Rupture is a rare complication of these aneurysms. Here we present a case of a ruptured popliteal aneurysm in a patient with severe joint disease and immobility due to rheumatoid arthritis. The condition was treated endovascularly with an Amplatzer arterial occlusion device. The aneurysm was successfully thrombosed without inducing critical limb ischemia, as the distal popliteal was chronically occluded. Ligation of peripheral aneurysms is an infrequent treatment without simultaneous bypass graft placement. Endovascular occlusion of ruptured popliteal aneurysms should be considered a valid therapeutic strategy where exclusion bypass is not required due to distal arterial occlusion. PMID:20356867

Smith, R J Paul; Gajendragadkar, Parag R; Winterbottom, Andrew P; Cooper, David G; Hayes, Paul D; Boyle, Jonathan R

2010-05-01

134

Manifestations of chronic selenium deficiency in a child receiving total parenteral nutrition13  

Microsoft Academic Search

A child receiving total parenteral nutrition for about 1 i\\/? yr developed intermittent leg muscle pain and tenderness and elevation in serum activities of glutamic oxaloacetic transam- inase, glutamic pyruvic transaminase, and creatine kinase. Approximately 6 months later he developed white fingernail beds. Detailed cardiological evaluation revealed no evidence of cardiac muscle cell damage despite markedly elevated serum activities of

C Lawrence Kien; Howard E Ganther

135

Total expression of HLA-G and TLR-9 in chronic lymphocytic leukemia patients.  

PubMed

Suppressed immune status facilitates immune escape mechanisms that allow chronic lymphocytic leukemia cells to proliferate and expand. The expression of HLA-G could effectively inhibit the immune response. In immune response inhibitory signals follow activation of immune system which might be occur during bacterial or viral infection in CLL patients. In the current study we characterized two components of immune system, inhibitory molecule HLA-G with its receptor - CD85j and Toll-like receptor 9. The material was obtained from 41 CLL patients and 41 HV with similar median age. In CLL patients expression of intracellular and surface HLA-G and soluble HLA-G levels were significantly higher than in HV. We found higher expression of CD85j compared to HV and the positive correlation between expression of HLA-G and CD85j. All the CLL cells expressed TLR-9, and the level of expression positively correlated with expression of HLA-G and CD85j. Patients with higher expression of intracellular expression of TLR-9 have significantly longer treatment-free survival than patients with low expression of TLR-9 (57 months vs. 8 months, respectively). Summarizing in CLL we characterized activatory and inhibitory components of immune system that might be connected functionally. Analysis of TLR-9 expression might have additional prognostic value for CLL patients. PMID:23994589

W?asiuk, Paulina; Tomczak, Waldemar; Zaj?c, Ma?gorzata; Dmoszy?ska, Anna; Giannopoulos, Krzysztof

2013-12-01

136

A unique technique for intentional occlusion of an abdominal aortic aneurysm.  

PubMed

We report the case of a 78-year-old man with coronary artery disease, chronic obstructive pulmonary disease, and chronic renal insufficiency with an enlarging 6.7-cm infrarenal abdominal aortic aneurysm. He also had a 4-cm right common iliac artery aneurysm, and right external iliac artery occlusion. The patient had a history of an axillobifemoral bypass graft placed 10 years prior for aortoiliac occlusive disease. We describe the use of an infrarenal aorto-uni-iliac graft and subsequent intentional graft occlusion as an endovascular solution to treat aneurysmal disease in this sick patient. He remains asymptomatic after surgery, with demonstrated occlusion of his aneurysms. PMID:23876510

Garg, Karan; Berland, Todd L; Veith, Frank J; Cayne, Neal S

2014-06-01

137

Retinal vaso-occlusion in sickling hemoglobinopathies.  

PubMed

Sickle cell retinopathy, in all of its manifestations, represents the effects of arteriolar and capillary occlusions. Increased viscosity of circulating whole blood plus the microembolic action of individual sickled erythrocytes contribute to vasoocclusion. Decreased oxygenation and increased acidosis develop and lead to further sickling -- and further vaso-occlusion. The cycle of erythrostasis that characterizes sickling throughout the body is also applicable to the retina. The transparent media of the eye permit direct visualization of vaso-occlusions which occur preferentially in and about the macula and in the far periphery of the retina. Many of the occlusive episodes are transient. There dynamic events are simultaneously occurring elsewhere in the body but can only be visualized in the eye. The net effect in the retina is a remodeling of its vasculature, as some vessels close and others reopen. After the onset of arteriolar closure in the retina, affected blood vessels embark on a spontaneous, naturally evolving course of events leading to arteriolarvenular anastomoses, neovascular proliferations, vitreous hemorrhages, and retinal detachment. The advanced stages of proliferative sickle retinopathy are most commonly observed in SC disease and in Sthal, possibly because these two forms of sickling have significantly higher than normal whole blood viscosity. Retinal vaso-occlusions can also lead to blow-out hemorrhages which may evolve into salmon patches, iridescent spots, schisis cavities, and black sunbursts. In some respects sickle retinopathy is unique, but many of its manifestations are similar to those of retinopathies found in diabetes mellitus, AC hemoglobinopathy, Takayasu pulseless disease, sarcoidosis, chronic myelogenous leukemia, branch retinal vein occlusion, retrolental fibroplasia, and Eales disease. PMID:782601

Goldberg, M F

1976-01-01

138

Changes of total content of magnesium and zinc status in patients with chronic toxoplasmosis  

Microsoft Academic Search

The aim of this study was to investigate the effects of the Toxoplasma gondii infection on the total content of the essential elements Zn and Mg levels. Plasma zinc and magnesium concentrations were\\u000a measured in 158 patients whose anti-T gondii IgG antibodies were positive. Scores were obtained for the patients and their age- and sex-matched 82 sero-negative healthy\\u000a controls. The

Süleyman Yazar; Eser Kilic; Recep Saraymen

2003-01-01

139

Successful penetration and bougie dilatation with Brockenbrough needle for severely calcified occlusion in superficial femoral artery.  

PubMed

A 75-year-old hemodialysis patient with right critical limb ischemia received endovascular therapy for a chronic total occlusion (CTO) in a diffusely calcified superficial femoral artery (SFA). During a retrograde approach, a Brockenbrough needle (BN) was able to penetrate the calcified hard plaque formed in the middle segment of the CTO. Moreover, bougie dilatation with the BN allowed balloon crossing and stent deployment, even after failure to pass a 2.0-mm monorail balloon across the plaque. These results suggest that the BN offers a new therapeutic option in the penetration and modification of severely calcified CTO in SFA. PMID:23979907

Makita, Toshio; Suzuki, Kenji; Takizawa, Kaname; Ootomo, Tatsushi; Inoue, Naoto; Meguro, Taiichirou

2014-04-01

140

Fludarabine Phosphate, Low-Dose Total-Body Irradiation, and Peripheral Blood Stem Cell Transplant Followed By Donor Lymphocyte Infusion in Treating Older Patients With Chronic Myeloid Leukemia  

ClinicalTrials.gov

Accelerated Phase Chronic Myelogenous Leukemia; Childhood Chronic Myelogenous Leukemia; Chronic Myelogenous Leukemia, BCR-ABL1 Positive; Chronic Phase Chronic Myelogenous Leukemia; Relapsing Chronic Myelogenous Leukemia

2013-12-02

141

Voxel-Space Ambient Occlusion.  

National Technical Information Service (NTIS)

Ambient occlusion adds important detail to a scene. This paper presents a multiresolution screen-space voxel based ambient occlusion technique, which improves G-buffer based techniques, avoiding artifacts such as haloing. Our technique is scalable to the ...

C. Wyman R. Penmatsa

2012-01-01

142

Intravascular ultrasound-guided revascularization of a chronically occluded left main coronary artery  

PubMed Central

We describe a case of a left main coronary artery (LMCA) chronic total occlusion (CTO), which we elected to treat through percutaneous coronary intervention (PCI). In this case report, we briefly review the prevalence of LMCA CTO, discuss the feasibility of PCI versus surgical revascularization and highlight the importance of intravascular ultrasound in the guidance of these complex procedures.

De Caterina, Alberto Ranieri; Cuculi, Florim; Banning, Adrian P.

2013-01-01

143

Endovascular Treatment of Veno-Occlusive Behcet's Disease  

SciTech Connect

Purpose: To retrospectively evaluate the outcome of endovascular treatments for patients with chronic veno-occlusive disease in different vascular beds secondary to Behcet's disease (BD). There are few case reports on the subject, and this is the largest study to date. Materials and Methods: From January 2001 through October 2009, chronic venous occlusions were treated in 10 patients (all male [age range 18-76 years]) with BD using percutaneous transluminal angioplasty and/or stent placement. All patients were symptomatic and had chronic iliofemoral deep venous thrombosis (DVT; n = 5), central venous occlusion (n = 3), or Budd-Chiari syndrome (BCS; n = 2). All patients met criteria of the International Study Group on Behcet's Disease. Results: Two of five patients with DVT had unsuccessful recanalization attempts. Three patients had successful recanalization with stent placement. All three veins were occluded within 1 month with unsuccessful reinterventions. Three patients with chronic central venous occlusion had successful recanalization with percutaneous transluminal angioplasty (n = 1) and stent placement (n = 2). Two patients had reocclusion with successful reintervention. Two BCS patients had successful treatment with stent placements. Overall technical success was 69%, and no procedural complications were encountered. None of the patients with chronic DVT had patent veins; however, all patients with central venous occlusion or BCS had patent veins on color Doppler ultrasonography at follow-up ranging from 3 to 48 months after intervention. Conclusion: Endovenous treatment for chronic iliofemoral DVT due to BD had a poor outcome. However, long-term outcome after endovenous treatment for upper-extremity central venous occlusion and BCS syndrome was good.

Tekbas, Guven, E-mail: drgtekbas@gmail.com [Dicle University School of Medicine, Department of Radiology (Turkey); Oguzkurt, Levent, E-mail: loguzkurt@yahoo.com; Gur, Serkan, E-mail: mserkangur@yahoo.com [Baskent University School of Medicine, Department of Interventional Radiology, Adana Hospital (Turkey); Onder, Hakan, E-mail: drhakanonder@hotmail.com [Dicle University School of Medicine, Department of Radiology (Turkey); Andic, Cagatay, E-mail: cagatayandic@gmail.com [Baskent University School of Medicine, Department of Interventional Radiology, Adana Hospital (Turkey)

2012-08-15

144

Occlusal considerations in restorative dentistry.  

PubMed

This article reviews the recent literature related to occlusal considerations in restorative dentistry. The major topics include the assessment and treatment of occlusal wear, the controversies surrounding treatment position of the mandibular condyles, occlusal considerations in osseointegrated prostheses, the two-way relationship between occlusal factors and temporomandibular disorders, design criteria and longevity studies in resin-bonded, fixed-partial dentures, and a potpourri of articles on other topics of interest. Five textbooks and 32 journal articles are cited. PMID:1777665

Parker, M W

1991-04-01

145

Motion segmentation using occlusions.  

PubMed

We examine the key role of occlusions in finding independently moving objects instantaneously in a video obtained by a moving camera with a restricted field of view. In this problem, the image motion is caused by the combined effect of camera motion (egomotion), structure (depth), and the independent motion of scene entities. For a camera with a restricted field of view undergoing a small motion between frames, there exists, in general, a set of 3D camera motions compatible with the observed flow field even if only a small amount of noise is present, leading to ambiguous 3D motion estimates. If separable sets of solutions exist, motion-based clustering can detect one category of moving objects. Even if a single inseparable set of solutions is found, we show that occlusion information can be used to find ordinal depth, which is critical in identifying a new class of moving objects. In order to find ordinal depth, occlusions must not only be known, but they must also be filled (grouped) with optical flow from neighboring regions. We present a novel algorithm for filling occlusions and deducing ordinal depth under general circumstances. Finally, we describe another category of moving objects which is detected using cardinal comparisons between structure from motion and structure estimates from another source (e.g., stereo). PMID:15943429

Ogale, Abhijit S; Fermüller, Cornelia; Aloimonos, Yiannis

2005-06-01

146

Predictors of Outcome and the Lack of Effect of Percutaneous Coronary Intervention Across the Risk Strata in Patients With Persistent Total Occlusion After Myocardial Infarction. Results From the Occluded Artery Trial (OAT)  

PubMed Central

Objectives To determine predictors of outcome and examine the influence of baseline risk on therapeutic impact of late mechanical opening of a persistently occluded infarct related artery (IRA) after myocardial infarction (MI) in stable patients. Background Previous studies in patients with acute coronary syndromes suggest that the impact of IRA recanalization on clinical outcome is greatest in patients at highest risk. Methods Of 2201 patients (age 58.6+/-11.0) with IRA occlusion on days 3 to 28 after MI in the Occluded Artery Trial (OAT), 1101 were assigned to PCI and 1100 to medical therapy alone, and followed for a mean of 3.2 years. The primary end point was a composite of death, reinfarction, or NYHA class IV heart failure. Interaction of treatment effect with tertiles of predicted survival were examined using the Cox survival model. Results The 5-year rate for the primary endpoint was 18.9% versus 16.1% for patients assigned PCI and medical treatment alone (MED) respectively (HR=1.14;95% CI:0.92-1.43, p=0.23). Lack of benefit of PCI was consistent across the risk spectrum for both the primary endpoint and total mortality, including for the highest tertile (33.9% PCI versus 27.3 % MED, HR=1.27;99% CI:0.87-1.85 primary endpoint and 23.5% PCI versus 21.7% MED, HR=1.16,99% CI: 0.73-1.85 mortality). The independent predictors of the composite outcome were: history of heart failure (HR=2.06,p<0.001), peripheral vascular disease (HR=1.93,p=0.001), diabetes (HR=1.49,p=0.002), rales (HR=1.88,p<0.001), decreasing: ejection fraction (HR=1.48 per 10%,p<0.001), days from MI to randomization (HR=1.04 per day,p<0.001), and glomerular filtration rate (HR=1.11 per 10mL/min/1.73m2,p<0.001). Conclusions In OAT, there was no variation in the effect of PCI on clinical outcomes at different levels of patient risk, including the subset with very high event rates.

Kruk, Mariusz; Kadziela, Jacek; Reynolds, Harmony R.; Forman, Sandra A.; Sadowski, Zygmunt; Barton, Bruce A.; Mark, Daniel B.; Maggioni, Aldo P.; Leor, Jonathan; Webb, John G.; Kapeliovich, Michael; Marin-Neto, Jose A.; White, Harvey D.; Lamas, Gervasio A.; Hochman, Judith S.

2009-01-01

147

Comparison of total body irradiation vs chlorambucil and prednisone for remission induction of active chronic lymphocytic leukemia: an ECOG study. Part I: total body irradiation-response  

SciTech Connect

Twenty-six evaluable patients were entered into two fractionated total body irradiation (TBI) programs; 11 patients received a course of 150 rad TBI (x 3 if tolerated) and 15 patients received a lower dose course of 50 rad (x 3 if tolerated). Complete remissions (CR) were not produced by either course; however, the higher dose course (Plan I) yielded a partial response (PR) rate of 73%, while the lower dose course yielded a PR of 47%. Although fraction size seemed trivial in both TBI plans, an unexpected high degree of hematologic toxicity was encountered, and was parallel to the response rates: in Plan I 73% of patients experienced severe to life-threatening depression of platelets or granulocytes, whereas in Plan II this rate was 47%. This was of short duration with rapid return of blood counts to normal levels. One death can be attributed to TBI. The chemotherapy arm of the study demonstrated superiority in terms of complete responses. Twenty-three percent of patients treated by cholrambucil and prednisone attained CR, in contrast to 0% of TBI patients. PR for chemotherapy was similar to that obtained with TBI. Chemotherapy also proved superior in terms of overall response rate, number of patients in remission, and in the median duration of response, but not in the median duration of survival. Fractional TBI techniques for active chronic lymphocytic leukemia (CLL) should be interrupted when the platelet count dips below 100,000 and the granulocyte count is lower than 2,000. Future studies should combine TBI radiation therapy and chemotherapy.

Rubin, P.I. (Univ. of Rochester Cancer Center, NY); Bennett, J.M.; Begg, C.; Bozdech, M.J.; Silber, R.

1981-12-01

148

Transcatheter left atrial appendage occlusion.  

PubMed

Occlusion of the left atrial appendage (LAA) may reduce the risk of stroke in patients with atrial fibrillation (AF). Trials comparing LAA occlusion to warfarin anticoagulation in patients with nonvalvular AF showed a reduction in hemorrhagic stroke, although an increase in safety events due to procedural complications. Long-term follow-up suggests possible superiority of LAA occlusion due to fewer strokes and bleeding events. The superior dosing and safety profiles of the novel oral anticoagulants raise the accepted threshold for safety and efficacy of LAA occlusion procedures, and underscore the need for randomized studies comparing LAA occlusion with these newer anticoagulants. PMID:23931100

Don, Creighton W; Fuller, Cindy J; Reisman, Mark

2013-08-01

149

Study of insulin resistance, TNF-?, total antioxidant capacity and lipid profile in patients with chronic heart failure under exercise.  

PubMed

Gluco-metabolic syndrome, oxidative stress and inflammation are common in chronic heart failure (CHF). Exercise training programmes are known to improve oxidative status, insulin sensitivity and endothelial function. In this study, the effects of walking on improving lipid and glucose metabolism in CHF patients, under statin treatment, were investigated. Fasting glucose, serum insulin, tumor necrosis factor-? (TNF-?), total antioxidant capacity (TAC), uric acid (UA), total cholesterol, triglycerides, high-density lipoproteins (HDL), direct low-density lipoproteins (LDL-dir), apolipoprotein-B, apolipoprotein-A1, and lipoprotein-a (Lp(a)) were monitored. Insulin resistance was depicted by fasting insulin resistance index (FIRI) (FIRI?2.94±1.41). HDL significantly increased with walking and was positively correlated with the non-significant triglyceride decrease and significant Lp(a) decrease. Significant correlations were found in all CHF patients at baseline between FIRI and New York Heart Association (NYHA) functional class, ejection fraction, HDL, triglycerides and TNF-?. All non-diabetic CHF patients were characterized by insulin resistance. Serum insulin and fasting glucose significantly decreased with walking, while decrease in FIRI was positively associated with patients' adherence to the walking program. Elevated uric acid and TNF-? levels also significantly decreased. In conclusion, the present study demonstrated that moderate, unsupervised, everyday physical activity was able to ameliorate the lipid and glycemic profile of CHF patients, with simultaneous attenuation of inflammation and oxidative stress. PMID:22021702

Tsarouhas, Konstantinos; Tsitsimpikou, Christina; Haliassos, Alexander; Georgoulias, Panagiotis; Koutsioras, Ioannis; Kouretas, Demetrios; Kogias, John; Liosis, Ioannis; Rentoukas, Elias; Kyriakides, Zenon

2011-01-01

150

Division or occlusion of patent ductus arteriosus?  

PubMed

The traditional and most effective form of treatment of persistent ductus arteriosus is surgical ductal division. New therapeutic techniques such as intraluminal ductal occlusion are currently recommended to replace the traditional treatment procedure. The purpose of this paper is to analyze the state of the art of these new therapeutic modalities. From reports in the medical literature, the authors analyzed the indications, results, and complications of the intraluminal ductal occlusion procedures. They applied the Student's t test for independent samples to evaluate the results of intraluminal patent ductus arteriosus occlusion by means of umbrellas, buttons, coils, and Gianturco-Grifka and Amplatzer occluders, respectively, in 2,691 patients collected from the medical literature. According to their analysis the results of intraluminal ductal occlusion with coils were as follows: success 83.7 +/- 12.2%, failure 3.9 +/- 2.8%, incomplete ductal occlusion 17.5 +/- 15.3%, need for surgery 2.8 +/- 3.8%, need for a second intraluminal procedure 5.8 +/- 9.9%, and device embolization 6.2 +/- 7.2%. The use of the Gianturco-Grifka device showed the following results: success 96.0 +/- 5.6%, failure 4.0 +/- 5.6%, incomplete ductal occlusion 4.0 +/- 5.6%, need for surgery 0%, need for a second intraluminal procedure 4.0 +/- 5.6%, and device embolization 4.0 +/- 5.6%. The Amplatzer occluder showed the following results: success 92.8 +/- 6.1%, failure 7.2 +/- 6.1%, incomplete ductal occlusion 2.0 +/- 4.3%, need for surgery 0%, need for a second intraluminal procedure 0.8 +/- 1.7%, and device embolization 0.5 +/- 1.3%. According to the state of the art, intraluminal ductal occlusion with Gianturco-Grifka device and Amplatzer occluder reduces the proportion of incomplete obstructions and need for surgery. Additionally, the use of the Amplatzer occluder reduces need for a second procedure and the embolization rate. Although the results obtained with the new procedures are better than those obtained previously, they are still not totally satisfactory. PMID:14666958

Rangel, Alberto; Pérez-Redondo, Héctor; Farell, Javier; Basave, Marcelo Noé; Zamora, Carlos

2003-01-01

151

An alternative treatment of occlusal wear: cast metal occlusal surface.  

PubMed

Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, denture instability, temporomandibular joint disturbances, etc. There are various treatment options available like, use of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. Several articles have described methods to construct gold and metal occlusal surfaces, however, these methods are time-consuming, expensive and requires many cumbersome steps. These methods also requires the patient to be without the prosthesis for the time during which the laboratory procedures are performed. This article presents a quick, simple and relatively inexpensive procedure for construction of metal occlusal surfaces on complete dentures. PMID:22945724

Kumar, Sandeep; Arora, Aman; Yadav, Reena

2012-01-01

152

Acute Total and Chronic Partial Sleep Deprivation: Effects on Neurobehavioral Functions, Waking EEG and Renin-Angiotensin System  

NASA Technical Reports Server (NTRS)

Total sleep deprivation leads to decrements in neurobehavioral performance and changes in electroencephalographic (EEG) oscillations as well as the incidence of slow eye movements ad detected in the electro-oculogram (EOG) during wakefulness. Although total sleep deprivation is a powerful tool to investigate the association of EEG/EOG and neurobehavioral decrements, sleep loss during space flight is usual only partial. Furthermore exposure to the microgravity environment leads to changes in sodium and volume homeostasis and associated renal and cardio-endocrine responses. Some of these changes can be induced in head down tilt bedrest studies. We integrate research tools and research projects to enhance the fidelity of the simulated conditions of space flight which are characterized by complexity and mutual interactions. The effectiveness of countermeasures and physiologic mechanisms underlying neurobehavioral changes and renal-cardio endocrine changes are investigated in Project 3 of the Human Performance Team and Project 3 of the Cardiovascular Alterations Team respectively. Although the. specific aims of these two projects are very different, they employ very similar research protocols. Thus, both projects investigate the effects of posture/bedrest and sleep deprivation (total or partial) on outcome measures relevant to their specific aims. The main aim of this enhancement grant is to exploit the similarities in research protocols by including the assessment of outcome variables relevant to the Renal-Cardio project in the research protocol of Project 3 of the Human Performance Team and by including the assessment of outcome variables relevant to the Quantitative EEG and Sleep Deprivation Project in the research protocols of Project 3 of the Cardiovascular Alterations team. In particular we will assess Neurobehavioral Function and Waking EEG in the research protocols of the renal-cardio endocrine project and renin-angiotensin and cardiac function in the research protocol of the Quantitative EEG and Waking Neurobehavioral Function project. This will allow us to investigate two additional specific aims: 1) Test the hypothesis that chronic partial sleep deprivation during a 17 day bed rest experiment results in deterioration of neurobehavioral function during waking and increases in EEG power density in the theta frequencies, especially in frontal areas of the brain, as well as the nonREM- REM cycle dependent modulation of heart-rate variability. 2) Test the hypothesis that acute total sleep deprivation modifies the circadian rhythm of the renin-angiotensin system, changes the acute responsiveness of this system to posture beyond what a microgravity environment alone does and affects the nonREM-REM cycle dependent modulation of heart-rate variability.

Dijk, Derk-Jan

1999-01-01

153

Safety of total dose iron dextran infusion in geriatric patients with chronic kidney disease and iron deficiency anemia.  

PubMed

Abstract There are limited data on total dose infusion (TDI) using iron dextran in geriatric chronic kidney disease (CKD) patients with iron-deficiency anemia (IDA). Our goal was to evaluate the safety of TDI in this setting. We conducted a retrospective chart review spanning a 5 year period (2002-2007), including all patients with CKD and IDA who were treated with iron dextran TDI. Patient demographics were noted, and laboratory values for creatinine, hemoglobin and iron stores were recorded pre- and post-dose. TDI diluted in normal saline was administered intravenously over 4-6 hours after an initial test dose. One hundred fifty-three patients received a total of 250 doses of TDI (mean?±?SD?=?971?±?175?mg); age was 69?±?12 years and creatinine 3.3?±?1.9?mg/dL. All stages of CKD were represented (stage 4 commonest). Hemoglobin and iron stores improved post-TDI (P?

Dossabhoy, Neville R; Turley, Steven; Gascoyne, Rebecca; Tapolyai, Mihaly; Sulaiman, Karina

2014-08-01

154

The relation between the two forms of COPT and levels of total IgG and IgM in acute and chronic schistosomiasis mansoni.  

PubMed

COPT was performed on 55 acute and 48 chronic male patients with schistosomiasis mansoni as well as on 20 control normal subject. The percentage of the segmented and the bleb reactions were determined. The total levels of IgG, IgM and IgA were measured. There was no distinct evidence that COPT shows only bleb precipitations in acute cases and only segmented reactions in chronic cases. The total levels of IgG were higher in patients who showed segmented that in those who showed bleb reactions especially in the segmented but not the bleb reactions especially in chronic cases. IgM may be responsible for the bleb reactions in acute cases. PMID:2496180

Seitz, H M; Khalil, H M; Makled, M K; el Missiry, A G; el Serougy, A O

1989-06-01

155

Chronic obstructive pulmonary disease symptom effects of long-term cumulative exposure to ambient levels of total oxidants and nitrogen dioxide in California Seventh-Day Adventist residents  

SciTech Connect

To assess the risk of chronic obstructive pulmonary disease symptoms due to long-term exposure to ambient levels of total oxidants and nitrogen dioxide (NO2), symptoms were ascertained using the National Heart, Lung, and Blood Institute (NHLBI) respiratory symptoms questionnaire. A total of 7,445 Seventh-day Adventist (SDA) nonsmokers who were 25 yr of age or older and had resided at least 11 yr in areas of California with high to low photochemical air pollution were included in this study. Cumulative exposures to each pollutant in excess of four thresholds were estimated for each participant, using zip codes for months of residence and interpolated dosages from state air-monitoring stations. Multiple logistic regression analyses were conducted individually and together for pollutants and included eight covariables, including passive smoking. A statistically significant association with chronic symptoms was seen for total oxidants above 10 pphm (196 mcg/m3) (p less than .004, relative risk of 1.20 for 750 hr/yr). Chronic respiratory disease symptoms were not associated with relatively low NO2 exposure levels in this population. When these pollutant exposures were studied with exposures to total suspended particulates (TSP) and sulfur dioxide (SO2), only TSP exposure above 200 mcg/m3 showed statistical significance (p less than .01). Exposure to TSP is either more strongly associated with symptoms of chronic obstructive pulmonary disease than the other measured exposures or is the best single surrogate representing the mix of pollutants present.

Euler, G.L.; Abbey, D.E.; Hodgkin, J.E.; Magie, A.R.

1988-07-01

156

OcclusionGood occlusal practice in advanced restorative dentistry  

Microsoft Academic Search

In most patients the existing occlusal scheme will be functional, comfortable and cosmetic; and so if a tooth or teeth need to be restored, the most appropriate way to provide the restoration(s) would be to adopt a 'conformative' approach: that is to provide treatment within the existing envelope of static and dynamic occlusal relationships. There will, however, be situations where

R M J Gray; S A Whitehead; S J Davies

2001-01-01

157

Coronary artery occlusions diagnosed by transthoracic Doppler  

PubMed Central

Background Our aim was to assess whether anterograde flow velocities in septal perforating branches could identify an occluded contralateral coronary artery, and to assess the feasibility and accuracy of diagnosing occlusions in the three main coronary arteries by the combined use of several noninvasive parameters indicating collateral flow. Methods A total of 108 patients scheduled for coronary angiography because of chest pain or acute coronary syndromes were studied using transthoracic Doppler echocardiography. Results Anterograde peak diastolic flow velocities (pDV) in septal perforating branches were higher in patients with angiographic occluded contralateral artery compared with corresponding velocities in patients without significant disease in the contralateral artery (0.80?±?0.31 m/sec versus 0.37?±?0.13 m/sec, p?occlusion. With this combined use of several parameters, 25 of 28 coronary occlusions were identified. Conclusions By investigating several parameters indicating collateral flow, we were able to identify most of the main coronary occlusions in the patient cohort. Furthermore, our study demonstrated that coronary artery occlusions may result in complex and diverging coronary pathophysiology depending on which coronary artery segment is occluded and the extent of accompanying coronary artery disease. Trial registration ClinicalTrials.gov number NTC00281346.

2014-01-01

158

Total arsenic concentrations in toenails quantified by two techniques provide a useful biomarker of chronic arsenic exposure in drinking water  

SciTech Connect

Accurate quantitation of any contaminant of interest is critical for exposure assessment and metabolism studies that support risk assessment. A preliminary step in an arsenic exposure assessment study in Nevada quantified total arsenic (TAs) concentrations in tissues as biomarkers of exposure. Participants in this study (n=95) were at least 45 years old, had lived in the area for more than 20 years, and were exposed to a wide range of arsenic concentrations in drinking water (3-2100ppb). Concentrations of TAs in blood, urine, and toenails determined by hydride generation-atomic fluorescence spectrometry (HG-AFS) ranged from below detection to 0.03, 0.76, and 12ppm, respectively; TAs in blood rarely exceeded the limit of detection. For comparison, TAs in toenails determined by neutron activation analysis (NAA) ranged from below detection to 16ppm. Significant (P<0.0001) positive regressions were seen between the TAs concentration in toenails and in drinking water (adjusted r{sup 2}=0.3557 HG-AFS, adjusted r{sup 2}=0.3922 NAA); TAs concentrations in urine were not described by drinking water As (adjusted r{sup 2}=0.0170, P=0.1369). Analyses of TAs in toenails by HGAFS and NAA yielded highly concordant estimates (r=0.7977, P<0.0001). These results suggest that toenails are a better biomarker of chronic As exposure than urine in the current study, because the sequestration of As in toenails provides an integration of exposure over time that does not occur in urine.

Adair, Blakely M. [Experimental Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, North Carolina (United States)]. E-mail: adair.blakely@epa.gov; Hudgens, Edward E. [Human Studies Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, North Carolina (United States); Schmitt, Michael T. [Human Studies Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, North Carolina (United States); Calderon, Rebecca L. [Human Studies Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, North Carolina (United States); Thomas, David J. [Experimental Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, North Carolina (United States)

2006-06-15

159

Appearance models for occlusion handling  

Microsoft Academic Search

Objects in the world exhibit complex interactions. When captured in a video sequence, some interactions manifest themselves as occlusions. A visual tracking system must be able to track objects, which are partially or even fully occluded. In this paper we present a method of tracking objects through occlusions using appearance models. These models are used to localize objects during partial

Andrew W. Senior; Arun Hampapur; Ying-li Tian; Lisa M. G. Brown; Sharath Pankanti; Ruud M. Bolle

2006-01-01

160

Photodynamic retinal vascular thrombosis. Rate and duration of vascular occlusion.  

PubMed

Dye-sensitized photochemical thrombosis is a new method of producing vascular occlusion in the eye for experimental purposes. The rate and duration of photodynamic occlusions of branch retinal vessels was measured in pigmented and albino rat eyes after intravenous injection of the photosensitizing dye, rose bengal. Selected vessels were exposed to focused, white light until vascular occlusion was observed biomicroscopically. A slit lamp was used for a light source in this procedure, allowing adjustment of spot size, shape, and orientation. Arterioles occluded more rapidly than venules, and the time required to produce vascular occlusion decreased when animals breathed pure oxygen administered by face mask. Rose bengal doses of 40 and 80 mg/kg were effective, 20 mg/kg was partially effective, and 1 and 10 mg/kg were ineffective in producing branch arteriole occlusion at a light intensity of 73.5 mW/cm2. The total light energy required to produce occlusion increased from an average of 0.06 J using 80 mg/kg to 0.50 J using 20 mg/kg of rose bengal. Lower light intensities produced vessel occlusion less rapidly (46 mW/cm2) or not at all (17.5 mW/cm2). The rate of retinal arteriolar occlusion was not affected by ocular pigmentation. The duration of branch vessel occlusion depended on length of vessel treated and did not exceed 3 days in arterioles and 4 days in venules. Histologic sections showed discrete areas of retinal and choroidal vascular thrombosis confined to the area of direct light exposure. Choroidal vascular thrombosis and outer retinal damage predominated in eyes treated at low light intensity. Thrombosis usually extended into the deep choroidal vessels in albino but not pigmented eyes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2071346

Wilson, C A; Hatchell, D L

1991-07-01

161

Photoacoustic removal of occlusions from blood vessels  

DOEpatents

Partial or total occlusions of fluid passages within the human body are removed by positioning an array of optical fibers in the passage and directing treatment radiation pulses along the fibers, one at a time, to generate a shock wave and hydrodynamics flows that strike and emulsify the occlusions. A preferred application is the removal of blood clots (thrombin and embolic) from small cerebral vessels to reverse the effects of an ischemic stroke. The operating parameters and techniques are chosen to minimize the amount of heating of the fragile cerebral vessel walls occurring during this photo acoustic treatment. One such technique is the optical monitoring of the existence of hydrodynamics flow generating vapor bubbles when they are expected to occur and stopping the heat generating pulses propagated along an optical fiber that is not generating such bubbles.

Visuri, Steven R. (Livermore, CA); Da Silva, Luiz B. (Danville, CA); Celliers, Peter M. (Berkeley, CA); London, Richard A. (Orinda, CA); Maitland, IV, Duncan J. (Lafayette, CA); Esch, Victor C. (San Francisco, CA)

2002-01-01

162

Successful therapy of transplant-associated veno-occlusive disease with a combination of tissue plasminogen activator and defibrotide  

Microsoft Academic Search

A 36-year-old man underwent matched unrelated donor bone marrow transplantation for chronic myeloid leukaemia. He developed\\u000a severe hepatic veno-occlusive disease as an early post-transplant complication. Tissue plasminogen activator was initially\\u000a felt to be contraindicated since the patient had concomitant pericarditis. Defibrotide was therefore commenced as treatment\\u000a for veno-occlusive disease. The pericarditis improved but the veno-occlusive disease continued to worsen (peak

MJ Jenner; INM Micallef; AZ Rohatiner; SM Kelsey; AC Newland; JD Cavenagh

2000-01-01

163

Retinal Artery Occlusion  

PubMed Central

Objective To investigate systematically the various associated systemic and ophthalmic abnormalities in different types of retinal artery occlusion (RAO). Design Cohort study. Participants 439 consecutive untreated patients (499 eyes) with RAO, first seen in our clinic from 1973 to 2000. Methods At first visit, all patients had a detailed ophthalmic and medical history, and comprehensive ophthalmic evaluation. Visual evaluation was done by recording visual acuity, using the Snellen visual acuity chart, and visual fields with a Goldmann perimeter. Initially they also had carotid Doppler/angiography and echocardiography. The same ophthalmic evaluation was performed at each follow-up visit. Main Outcome Measures Demographic features, associated systemic and ophthalmic abnormalities and sources of emboli in various types of RAO. Results RAO was classified into various types of central (CRAO) and branch (BRAO) artery occlusion. In both nonarteritic CRAO and BRAO the prevalence of diabetes mellitus, arterial hypertension, ischemic heart disease, and cerebrovascular accidents were significantly higher compared to the prevalence of these conditions in the matched US population (all p<0.0001). Smoking prevalence, compared to the US population, was significantly higher for males (p=0.001) with nonarteritic CRAO and for females with BRAO (p=0.02). Ipsilateral internal carotid artery had ?50% stenosis in 31% of nonarteritic CRAO patients and 30% of BRAO, and plaques in 71% of nonarteritic CRAO and 66% of BRAO. Abnormal echocardiogram with embolic source was seen in 52% of nonarteritic CRAO and 42% of BRAO. Neovascular glaucoma developed in only 2.5% of nonarteritic CRAO eyes. Conclusion This study showed that in CRAO as well as BRAO the prevalence of various cardiovascular diseases and smoking was significantly higher compared to the prevalence of these conditions in the matched US population. Embolism is the most common cause of CRAO and BRAO; plaque in the carotid artery is usually the source of embolism and less commonly the aortic and/or mitral valve. The presence of plaques in the carotid artery is generally of much greater importance than the degree of stenosis in the artery. Contrary to the prevalent misconception, there is no cause-and-effect relationship between CRAO and neovascular glaucoma.

Hayreh, Sohan Singh; Podhajsky, Patricia A.; Bridget Zimmerman, M.

2009-01-01

164

Toxicity assessment of total dissolved solids in effluent of Alaskan mines using 22-h chronic Microtox ® and Selenastrum capricornatum assays  

Microsoft Academic Search

In order to overcome limitations associated with the Daphnia assay, we have explored two alternative assays, the 22-h chronic Microtox® test and the 3-day S. capricornutum test, as substitutes. During this study, we compared the two assays using both a simple TDS standard solution and field water samples from two Alaskan mines. Using EC20 values, our results suggest that simple

Jane B LeBlond; Lawrence K Duffy

2001-01-01

165

The Outback Catheter: A New Device for True Lumen Re-entry After Dissection During Recanalization of Arterial Occlusions  

Microsoft Academic Search

To report the initial experience with a new catheter system (The Outback catheter) designed to allow fluoroscopically controlled re-entry of the true arterial lumen after subintimal guidewire passage during recanalization procedures of arterial occlusions. The catheter was used in 10 patients with intermittent claudication caused by chronic segmental occlusions of the superficial femoral or popliteal arteries. In all patients, conventional

Klaus A. Hausegger; Borjana Georgieva; Horst Portugaller; Josef Tauss; Gerhard Stark

2004-01-01

166

Learning to Find Occlusion Regions  

Microsoft Academic Search

For two consecutive frames in a video, we identify which pixels in the first frame become occluded in the second. Such general-purpose detection of occlusion regions is difficult and important because one-to-one correspondence of imaged scene points is needed for many tracking, video segmentation, and reconstruction algorithms. Our hypothesis is that an effective trained occlusion detector can be generated on

Ahmad Humayun; Oisin Mac Aodha; Gabriel J. Brostow

2011-01-01

167

Sequential bilateral retinal artery occlusion  

PubMed Central

An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic embolic event. Initially, she presented a superior branch retinal artery occlusion in her right eye followed by a central retinal artery occlusion with cilioretinal artery sparing in her left eye. Some conservative maneuvers performed did not improve visual acuity in the left eye. Supra-aortic Doppler ultrasonography revealed mild right internal carotid artery stenosis and moderate left internal carotid artery stenosis with a small, smooth, and homogeneous plaque. The transthoracic echocardiography showed a severe calcification of the mitral valve with a mild-moderate rim of stenosis. Central retinal artery occlusion and branch retinal artery occlusion are characterized by painless monocular loss of vision. Clinical approach and management attempt to treat the acute event, find the source of the vascular occlusion, and prevent further vascular events from occurring. Giant cell arteritis is a potentially treatable cause of central retinal artery occlusion and should be excluded in every single patient over 50 years old.

Padron-Perez, Noel; Arones, Janny Rosario; Munoz, Silvia; Arias-Barquet, Luis; Arruga, Jorge

2014-01-01

168

Effect of fibrin glue occlusion of the hepatobiliary tract on thioacetamide-induced liver failure  

Microsoft Academic Search

Background: Expression and activation of hepatocyte growth factor (HGF) is stimulated by a complex system of interacting proteins, with thrombin playing an initial role in this process. The impact of temporary occlusion of the hepatobiliary tract with fibrin glue (major component thrombin) on the HGF system in acute and chronic liver damage in a rat model was investigated.Methods: Chronic liver

Thomas C Schmandra; Holger Bauer; Henrik Petrowsky; Günther Herrmann; Albrecht Encke; Ernst Hanisch

2001-01-01

169

The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation  

NASA Technical Reports Server (NTRS)

OBJECTIVES: To inform the debate over whether human sleep can be chronically reduced without consequences, we conducted a dose-response chronic sleep restriction experiment in which waking neurobehavioral and sleep physiological functions were monitored and compared to those for total sleep deprivation. DESIGN: The chronic sleep restriction experiment involved randomization to one of three sleep doses (4 h, 6 h, or 8 h time in bed per night), which were maintained for 14 consecutive days. The total sleep deprivation experiment involved 3 nights without sleep (0 h time in bed). Each study also involved 3 baseline (pre-deprivation) days and 3 recovery days. SETTING: Both experiments were conducted under standardized laboratory conditions with continuous behavioral, physiological and medical monitoring. PARTICIPANTS: A total of n = 48 healthy adults (ages 21-38) participated in the experiments. INTERVENTIONS: Noctumal sleep periods were restricted to 8 h, 6 h or 4 h per day for 14 days, or to 0 h for 3 days. All other sleep was prohibited. RESULTS: Chronic restriction of sleep periods to 4 h or 6 h per night over 14 consecutive days resulted in significant cumulative, dose-dependent deficits in cognitive performance on all tasks. Subjective sleepiness ratings showed an acute response to sleep restriction but only small further increases on subsequent days, and did not significantly differentiate the 6 h and 4 h conditions. Polysomnographic variables and delta power in the non-REM sleep EEG-a putative marker of sleep homeostasis--displayed an acute response to sleep restriction with negligible further changes across the 14 restricted nights. Comparison of chronic sleep restriction to total sleep deprivation showed that the latter resulted in disproportionately large waking neurobehavioral and sleep delta power responses relative to how much sleep was lost. A statistical model revealed that, regardless of the mode of sleep deprivation, lapses in behavioral alertness were near-linearly related to the cumulative duration of wakefulness in excess of 15.84 h (s.e. 0.73 h). CONCLUSIONS: Since chronic restriction of sleep to 6 h or less per night produced cognitive performance deficits equivalent to up to 2 nights of total sleep deprivation, it appears that even relatively moderate sleep restriction can seriously impair waking neurobehavioral functions in healthy adults. Sleepiness ratings suggest that subjects were largely unaware of these increasing cognitive deficits, which may explain why the impact of chronic sleep restriction on waking cognitive functions is often assumed to be benign. Physiological sleep responses to chronic restriction did not mirror waking neurobehavioral responses, but cumulative wakefulness in excess of a 15.84 h predicted performance lapses across all four experimental conditions. This suggests that sleep debt is perhaps best understood as resulting in additional wakefulness that has a neurobiological "cost" which accumulates over time.

Van Dongen, Hans P A.; Maislin, Greg; Mullington, Janet M.; Dinges, David F.

2003-01-01

170

Treatment of iatrogenic IVC occlusion with implantation of a stent of a new shape dedicated to aortic aneurysms  

PubMed Central

Summary Background: Successful treatment of chronic occlusion of inferior vena cava (IVC) and iliocaval confluence with angioplasty and stent implantation is very rare. Case Report: We present a case of a 59-year-old patient with iatrogenic occlusion of IVC following L3/L4 discectomy. The wall of the ventral IVC was ruptured during the operation. Results: The torn wall was treated by patch angioplasty, resulting in a permanent IVC occlusion, as confirmed by angiography. Iatrogenic permanent occlusion of IVC was successfully treated with recanalization and implantation of a non-covered aortic stent.

Sieron, Dominik; Wiggermann, Phillip; Knap, Daniel; Platzek, Ivan; Wawrzynek, Wojciech; Stroszczynski, Christian

2013-01-01

171

Evaluation of body composition and nitrogen content of renal patients on chronic dialysis as determined by total body neutron activation  

SciTech Connect

Total body protein (nitrogen), body cell mass (potassium), fat, and water were measured in 15 renal patients on maintenance hemodialysis (MHD). Total body nitrogen was measured by means of prompt ..gamma.. neutron activation analysis; total body water was determined with tritium labeled water; total body potassium was measured by whole body counting. The extracellular water was determined by a technique utilizing the measurement of total body chloride and plasma chloride. When compared with corresponding values of a control group of the same age, sex, and height, the protein content, body cell mass, and total body fat of the MHD patients were within the normal range. The only significant change was an increase in the extracellular water/body cell mass ratio in the male MHD patients compared to the control. The lack of significant difference of the nitrogen values of the MHD patients compared to matched controls suggests that dialysis minimizes any residual effects of uremic toxicity or protein-calorie malnutrition. These findings further suggest that there is a need to reevaluate the traditional anthropometric and biochemical standards of nutritional status for MHD patients. It was concluded that it is particularly important to measure protein stores of MHD patients with low protein intake to ascertain nutritional status. Finally, in vivo measurement of total body nitrogen and potassium for determination of body composition provides a simple, direct, and accurate assessment of the nutritional status of MHD patients.

Cohn, S.H.; Brennan, B.L.; Yasumura, S.; Vartsky, D.; Vaswani, A.N.; Ellis, K.J.

1983-07-01

172

Naftidrofuryl in Chronic Arterial Disease. Results of a Controlled Multicenter Study  

Microsoft Academic Search

In a double blind, randomized multicenter study naftidrofuryl, a vasoactive substance, was compared with placebo in the treatment of 104 patients with chronic arterial occlusive disease. After a run-in period of four weeks the pa tients received either naftidrofuryl (600mg daily) or placebo over 12 weeks. The pain-free and the total walking distances improved significantly in both groups. However, the

G. Trübestein; H. Böhme; H. Heidrich; F. Heinrich; H. Hirche; U. Maass; H. Mörl; G. Rudofsky

1984-01-01

173

Guiding Intellect for Occlusal Errors  

PubMed Central

Purpose: The purpose of the study is to quantify occlusal errors seen, during the processing of complete denture. Material and Methods: Maxillary and mandibular complete dentures were fabricated for 30 subjects. Anterior and posterior markings were made on articulator and the distance was measured from these points before and after processing of complete dentures. Occlusal errors following processing of complete dentures was determined by subjecting the values obtained to statistical analysis using paired t-test. Results: The results indicated the existence of discrepant amount of occlusal errors following processing of complete denture and statistical test applied was paired t-test, p-values obtained are, p=0.00 anterior reference markings and p=0.006 for posterior reference markings (p ? 0.001 highly significant). Conclusion: The processing errors are inevitable. Hence for patient comfort, laboratory remounting is an important procedure that needs to be followed as a regular step after processing of each and every denture.

Patel, Mansi; A.A., Ponnanna; Tripathi, Gaurav

2013-01-01

174

Wound Management: The Occlusive Dressing  

PubMed Central

Superficial wounds resulting from athletic injury are common in sports medicine. Although such wounds can be quite painful, they are usually merely inconvenient to the athlete. If improperly managed, however, superficial wounds may heal slowly and cause unnecessary scar tissue proliferation at the wound site. Scar formation causes the wound to break open frequently and puts the athlete at risk of cross-contamination by pathogenic organisms. New advances in the science of wound management strongly favor the use of occlusive dressings to increase patient comfort, increase patient compliance, decrease the risk of infection, and decrease overall healing time. Occlusion has clearly been proven to aid in the healing of superficial wounds and should be considered as a treatment alternative for wounds in the sports medicine setting. In this paper, I discuss three of the most widely used types of occlusive dressings: 1) films, 2) hydrogels, and 3) hydrocolloids.

Rheinecker, Scot B.

1995-01-01

175

The relationship between maximum isometric strength and intramuscular circulatory occlusion  

Microsoft Academic Search

Twenty male college students served as subjects for lhe study which investigated the relationship between maximum isometric strength and the isometric tension necessary to produce total occlusion of intramuscular circulation. Subjects performed a scries of progressively increasing static contractions by squeezing a hand dynamometer and the subsequent blood flow responses were measured. Blood flow was occluded at a mean of

WILLIAM S. BARNES

1980-01-01

176

Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS.  

PubMed

We report on oxygenation changes noninvasively recorded by multichannel continuous-wave near infrared spectroscopy (CW-NIRS) during endovascular neuroradiologic interventions requiring temporary balloon occlusion of arteries supplying the cerebral circulation. Digital subtraction angiography (DSA) provides reference data on the site, timing, and effectiveness of the flow stagnation as well as on the amount and direction of collateral circulation. This setting allows us to relate CW-NIRS findings to brain specific perfusion changes. We focused our analysis on the transition from normal perfusion to vessel occlusion, i.e., before hypoxia becomes clinically apparent. The localization of the maximal response correlated either with the core (occlusion of the middle cerebral artery) or with the watershed areas (occlusion of the internal carotid artery) of the respective vascular territories. In one patient with clinically and angiographically confirmed insufficient collateral flow during carotid artery occlusion, the total hemoglobin concentration became significantly asymmetric, with decreased values in the ipsilateral watershed area and contralaterally increased values. Multichannel CW-NIRS monitoring might serve as an objective and early predictive marker of critical perfusion changes during interventions-to prevent hypoxic damage of the brain. It also might provide valuable human reference data on oxygenation changes as they typically occur during acute stroke. PMID:24301292

Rummel, Christian; Zubler, Christoph; Schroth, Gerhard; Gralla, Jan; Hsieh, Kety; Abela, Eugenio; Hauf, Martinus; Meier, Niklaus; Verma, Rajeev K; Andres, Robert H; Nirkko, Arto C; Wiest, Roland

2014-02-01

177

Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS  

PubMed Central

We report on oxygenation changes noninvasively recorded by multichannel continuous-wave near infrared spectroscopy (CW-NIRS) during endovascular neuroradiologic interventions requiring temporary balloon occlusion of arteries supplying the cerebral circulation. Digital subtraction angiography (DSA) provides reference data on the site, timing, and effectiveness of the flow stagnation as well as on the amount and direction of collateral circulation. This setting allows us to relate CW-NIRS findings to brain specific perfusion changes. We focused our analysis on the transition from normal perfusion to vessel occlusion, i.e., before hypoxia becomes clinically apparent. The localization of the maximal response correlated either with the core (occlusion of the middle cerebral artery) or with the watershed areas (occlusion of the internal carotid artery) of the respective vascular territories. In one patient with clinically and angiographically confirmed insufficient collateral flow during carotid artery occlusion, the total hemoglobin concentration became significantly asymmetric, with decreased values in the ipsilateral watershed area and contralaterally increased values. Multichannel CW-NIRS monitoring might serve as an objective and early predictive marker of critical perfusion changes during interventions—to prevent hypoxic damage of the brain. It also might provide valuable human reference data on oxygenation changes as they typically occur during acute stroke.

Rummel, Christian; Zubler, Christoph; Schroth, Gerhard; Gralla, Jan; Hsieh, Kety; Abela, Eugenio; Hauf, Martinus; Meier, Niklaus; Verma, Rajeev K; Andres, Robert H; Nirkko, Arto C; Wiest, Roland

2014-01-01

178

Effect of Induced Occlusal Disharmony on Stress.  

National Technical Information Service (NTIS)

This study was designed to ascertain whether or not a systemic stress reaction sufficient to elevate serum corticosteroid levels, in normal healthy adult males, would result from induced occlusal disharmony or interferences. Occlusal interferences were de...

M. D. Jendresen I. L. Shannon

1968-01-01

179

The depth discontinuity occlusion camera  

Microsoft Academic Search

Rendering a scene using a single depth image suffers from disocclusion errors as the view translates away from the reference view. We present the depth discontinuity occlusion camera (DDOC), a non-pinhole camera that samples surfaces which are hidden in the reference view, but are likely to become visible in nearby views. The DDOC reference image alleviates disocclusion errors; since it

Voicu Popescu; Daniel G. Aliaga

2006-01-01

180

Hemodilution therapy in central retinal vein occlusion  

Microsoft Academic Search

Systemic hemorheologic abnormalities may play a part in the pathogenesis of central retinal vein occlusions. A statistically significant elevation of plasma viscosity was found in patients with acute central retinal vein occlusion compared with control patients. Local retinal blood flow parameters including arteriovenous passage time and mean arterial dye bolus velocity were significantly altered in the central retinal vein occlusion

Sebastian Wolf; Oliver Arend; Bernd Bertram; Andreas Remky; Karin Schulte; Kenneth J. Wald; Martin Reim

1994-01-01

181

Common Carotid Artery Occlusion: A Case Series  

PubMed Central

Subjects and Methods. We analysed 5000 cerebrovascular ultrasound records. A total of 0.4% of the patients had common carotid artery occlusion (CCAO). Results. The mean age was 59.8 ± 14.2 years, and the male/female ratio was 2.33. The most frequent risk factors were hypertension, ischaemic heart disease, dyslipidemia, diabetes mellitus, and smoking. Right-sided and left-sided CCAO occurred in 65% and 30% of the cases, respectively, and bilateral occlusion was detected in one case (5%). Patent bifurcation was observed in 10 cases of CCAO in which the anterograde flow in the ICA was maintained from the external carotid artery with reversed flow. In two of the cases, the occluded CCA was hypoplastic. The aetiology of CCAO in the majority of cases was the atherosclerosis (15 cases). The male/female ratio was higher in the patients with occluded distal vessels, and the short-term outcome was poorer. Only two cases from this series underwent revascularisation surgery. Spontaneous recanalisation was observed in one case. Conclusions. The most frequent cause of CCAO was atherosclerosis. The outcome is improved in the cases with patent distal vessels, and spontaneous recanalisation is possible. Treatment methods have not been standardised. Surgical revascularisation is possible in cases of patent distal vessels, but the indications are debatable.

Bajko, Zoltan; Balasa, Rodica; Motataianu, Anca; Maier, Smaranda; Chebut, Octavia Claudia; Szatmari, Szabolcs

2013-01-01

182

5-hydroxytryptamine (5-HT) reduces total peripheral resistance during chronic infusion: direct arterial mesenteric relaxation is not involved  

PubMed Central

Serotonin (5-hydroxytryptamine; 5-HT) delivered over 1?week results in a sustained fall in blood pressure in the sham and deoxycorticosterone acetate (DOCA)-salt rat. We hypothesized 5-HT lowers blood pressure through direct receptor-mediated vascular relaxation. In vivo, 5-HT reduced mean arterial pressure (MAP), increased heart rate, stroke volume, cardiac index, and reduced total peripheral resistance during a 1?week infusion of 5-HT (25 µg/kg/min) in the normotensive Sprague Dawley rat. The mesenteric vasculature was chosen as an ideal candidate for the site of 5-HT receptor mediated vascular relaxation given the high percentage of cardiac output the site receives. Real-time RT-PCR demonstrated that mRNA transcripts for the 5-HT2B, 5-HT1B, and 5-HT7 receptors are present in sham and DOCA-salt superior mesenteric arteries. Immunohistochemistry and Western blot validated the presence of the 5-HT2B, 5- HT1B and 5-HT7 receptor protein in sham and DOCA-salt superior mesenteric artery. Isometric contractile force was measured in endothelium-intact superior mesenteric artery and mesenteric resistance arteries in which the contractile 5- HT2A receptor was antagonized. Maximum concentrations of BW-723C86 (5- HT2B agonist), CP 93129 (5-HT1B agonist) or LP-44 (5-HT7 agonist) did not relax the superior mesenteric artery from DOCA-salt rats vs. vehicle. Additionally, 5-HT (10–9?M to 10–5?M) did not cause relaxation in either contracted mesenteric resistance arteries or superior mesenteric arteries from normotensive Sprague- Dawley rats. Thus, although 5-HT receptors known to mediate vascular relaxation are present in the superior mesenteric artery, they are not functional, and are therefore not likely involved in a 5-HT-induced fall in total peripheral resistance and MAP.

2012-01-01

183

5-hydroxytryptamine (5-HT) reduces total peripheral resistance during chronic infusion: direct arterial mesenteric relaxation is not involved.  

PubMed

Serotonin (5-hydroxytryptamine; 5-HT) delivered over 1 week results in a sustained fall in blood pressure in the sham and deoxycorticosterone acetate (DOCA)-salt rat. We hypothesized 5-HT lowers blood pressure through direct receptor-mediated vascular relaxation. In vivo, 5-HT reduced mean arterial pressure (MAP), increased heart rate, stroke volume, cardiac index, and reduced total peripheral resistance during a 1 week infusion of 5-HT (25 µg/kg/min) in the normotensive Sprague Dawley rat. The mesenteric vasculature was chosen as an ideal candidate for the site of 5-HT receptor mediated vascular relaxation given the high percentage of cardiac output the site receives. Real-time RT-PCR demonstrated that mRNA transcripts for the 5-HT2B, 5-HT1B, and 5-HT7 receptors are present in sham and DOCA-salt superior mesenteric arteries. Immunohistochemistry and Western blot validated the presence of the 5-HT2B, 5- HT1B and 5-HT7 receptor protein in sham and DOCA-salt superior mesenteric artery. Isometric contractile force was measured in endothelium-intact superior mesenteric artery and mesenteric resistance arteries in which the contractile 5- HT2A receptor was antagonized. Maximum concentrations of BW-723C86 (5- HT2B agonist), CP 93129 (5-HT1B agonist) or LP-44 (5-HT7 agonist) did not relax the superior mesenteric artery from DOCA-salt rats vs. vehicle. Additionally, 5-HT (10-9 M to 10-5 M) did not cause relaxation in either contracted mesenteric resistance arteries or superior mesenteric arteries from normotensive Sprague- Dawley rats. Thus, although 5-HT receptors known to mediate vascular relaxation are present in the superior mesenteric artery, they are not functional, and are therefore not likely involved in a 5-HT-induced fall in total peripheral resistance and MAP. PMID:22559843

Davis, Robert Patrick; Pattison, Jill; Thompson, Janice M; Tiniakov, Ruslan; Scrogin, Karie E; Watts, Stephanie W

2012-01-01

184

Evaluation of Occlusal Contacts among Different Groups of Malocclusion using 3D Digital Models.  

PubMed

Objectives: (1) To evaluate the applicability of using 3D digital models in the assessment of the magnitude of occlusal contacts by measuring occlusal contact surface areas (OCSAs) and 3D mesh points in 'contact' (OCMPs) in a sample of orthodontic patients; (2) To detect any sex differences in the magnitude of occlusal contacts in all malocclusion groups; (3) To detect inter- group differences; (4) To assess possible correlations between occlusal contacts and other dental characteristics. Materials and methods: Study casts of 120 malocclusion patients were selected and divided into 4 groups (class I division 1, class II division 1, class II division 2, class III) with equal numbers for both sexes. 3D digital models were produced using O3DM™ technology. Occlusal contacts were quantifed using two methods of measuring. Results: (1) No signifcant sexual differences were detected for OCMPs (mesh points) and OCSAs (mm(2)) in all groups. (2) There were statistically signifcant differences among malocclusion groups for OCMPs and OCSAs (p < 0.001). Tukey's HSD post- hoc tests showed that class III patients had signifcantly less occlusal contacts than other malocclusion groups. (3) Stepwise multiple regression equations showed that overjet, lower arch width and overbite could explain approximately 19.5% of the total variance of OCSAs and OCMPs. Conclusion: Sexual differences in occlusal contacts were not detected. Class I division 1 patients had the highest amount of occlusal contacts among all groups of malocclusion. Overjet, overbite and lower dental arch width were best predictors of occlusal contacts in the current sample. Keywords: 3D digital models, Malocclusion, Occlusal contacts, 3D mesh points, Correlation, Stepwise regression analysis. How to cite this article: Al-Rayes NZ, Hajeer MY. Evaluation of Occlusal Contacts among Different Groups of Malocclusion using 3D Digital Models. J Contemp Dent Pract 2014;15(1): 46-55. Source of support: Nil Confict of interest: None declared. PMID:24939264

Al-Rayes, Naim Z; Hajeer, Mohammad Y

2014-01-01

185

Direct pressure monitoring accurately predicts pulmonary vein occlusion during cryoballoon ablation.  

PubMed

Cryoballoon ablation (CBA) is an established therapy for atrial fibrillation (AF). Pulmonary vein (PV) occlusion is essential for achieving antral contact and PV isolation and is typically assessed by contrast injection. We present a novel method of direct pressure monitoring for assessment of PV occlusion. Transcatheter pressure is monitored during balloon advancement to the PV antrum. Pressure is recorded via a single pressure transducer connected to the inner lumen of the cryoballoon. Pressure curve characteristics are used to assess occlusion in conjunction with fluoroscopic or intracardiac echocardiography (ICE) guidance. PV occlusion is confirmed when loss of typical left atrial (LA) pressure waveform is observed with recordings of PA pressure characteristics (no A wave and rapid V wave upstroke). Complete pulmonary vein occlusion as assessed with this technique has been confirmed with concurrent contrast utilization during the initial testing of the technique and has been shown to be highly accurate and readily reproducible. We evaluated the efficacy of this novel technique in 35 patients. A total of 128 veins were assessed for occlusion with the cryoballoon utilizing the pressure monitoring technique; occlusive pressure was demonstrated in 113 veins with resultant successful pulmonary vein isolation in 111 veins (98.2%). Occlusion was confirmed with subsequent contrast injection during the initial ten procedures, after which contrast utilization was rapidly reduced or eliminated given the highly accurate identification of occlusive pressure waveform with limited initial training. Verification of PV occlusive pressure during CBA is a novel approach to assessing effective PV occlusion and it accurately predicts electrical isolation. Utilization of this method results in significant decrease in fluoroscopy time and volume of contrast. PMID:23485956

Kosmidou, Ioanna; Wooden, Shannnon; Jones, Brian; Deering, Thomas; Wickliffe, Andrew; Dan, Dan

2013-01-01

186

Thermography in Occlusive Cerebrovascular Diseases  

PubMed Central

Cooling of the skin over the medial supraorbital region in 80% of patients who have an occlusion or severe stenosis of a carotid artery can be demonstrated by facial thermography. Minor stenotic lesions in the carotid arteries do not produce characteristic thermographic changes, while thermography is of no help in the diagnosis of vertebrobasilar arterial disease. Thermographic changes suggestive of carotid arterial lesions are found occasionally in patients whose angiograms are normal, owing to variations in the size of the frontal sinuses, or factors such as fever or inflammatory lesions. It is suggested that facial thermography is of value in the preliminary investigation of patients with occlusive cerebrovascular disease. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6

Mawdsley, C.; Samuel, E.; Sumerling, M. D.; Young, G. B.

1968-01-01

187

High frequency rotational ablation: an alternative in treating coronary artery stenoses and occlusions.  

PubMed Central

OBJECTIVE--To prove the safety and effectiveness of high frequency rotational ablation of coronary artery stenoses and occlusion in humans. SUBJECTS--106 patients with symptoms (91 men, 15 women) who had 67 significant stenoses, mainly types B and C, and 46-chronic occlusions. MAIN OUTCOME MEASURES--Mean change in diameter stenosis after rotational angioplasty alone and in combination with percutaneous transluminal coronary angioplasty immediately after treatment and 24 hours and six months later; restenosis rates at six months; complication of treatment. RESULTS--Rotational ablation could not be used in five stenoses and 16 chronic occlusions because of inability to reach or cross the lesion with the Rotablator guide wire. In four cases rotational ablation failed. Initial angiographic and clinical success by rotational ablation was achieved in 40 of the 67 stenoses (60%) and in 18 of the 46 chronic occlusions (39%). Additional balloon angioplasty was performed in 45 patients, increasing the success rates to 79% and 54%, respectively. In the 62 stenoses treated by rotational ablation the angiographic diameter stenoses were reduced from 76% (SD 14%) to 32% (14%) after Rotablator treatment alone and from 75% (11%) to 33% (17%) with additional balloon angioplasty. In the 30 chronic occlusions treated by rotational ablation the angiographic diameter stenoses were reduced to 38% (18%). At six months angiographic restenosis was evident in nine of the 25 (36%) stenoses treated with rotational ablation alone, in seven of the 22 (32%) stenoses treated with rotational and balloon angioplasty, and in 14 of the 24 (58%) chronic occlusions. There were no procedural deaths and two patients (2%) underwent emergency coronary artery bypass grafting. Although no transmural infarction occurred, there were five (6%) non-Q wave infarctions (two embolic side branch occlusions, two subacute occlusions, and one acute occlusion). Clinically insignificant slight increases in creatine kinase activity were seen in five patients (6%). Severe coronary artery spasm unresponsive to medical treatment was provoked in seven cases (8%). CONCLUSIONS--High frequency rotational ablation is a safe and effective method for treating type B and C coronary artery lesions with results comparable to percutaneous transluminal coronary balloon angioplasty. The combined use of rotational ablation and balloon angioplasty is feasible and is necessary in about half of all procedures, in most cases because the lumen created by the biggest burr is too small. Images

Dietz, U; Erbel, R; Rupprecht, H J; Weidmann, S; Meyer, J

1993-01-01

188

Persistent middle cerebral artery occlusion associated with lower body temperature on admission  

PubMed Central

Background Low body temperature is considered neuroprotective in ischemic stroke, yet some studies suggest that low body temperature may also inhibit clot lysis and recanalization. We hypothesized that low body temperature was associated with persistent proximal middle cerebral artery (MCA) occlusion in patients with acute ischemic stroke presenting with symptoms of proximal MCA occlusion, suggesting a possible detrimental effect of low body temperature on recanalization. Methods All patients with acute ischemic stroke admitted to our Stroke Unit between February 2006 and August 2012 were prospectively registered in a database. Computed tomography (CT) angiography was performed in patients admitted <6 hours after stroke onset. Based on presenting symptoms, patients were classified according to the Oxford Community Stroke Project classification (OCSP). Patients with symptomatic proximal MCA occlusion were compared to patients with total anterior circulation infarct (TACI) without MCA occlusion on CT angiography. Results During the study period, 384 patients with acute ischemic stroke were examined with CT angiography. A total of 79 patients had proximal MCA occlusion and 31 patients had TACI without MCA occlusion. Median admission body temperatures were lower in patients with MCA occlusion compared to patients without occlusion (36.3°C versus 36.7°C, P = 0.027). Admission body temperature <36.5°C was independently associated with persistent MCA occlusion when adjusted for confounders in multivariate analyses (odds ratio 3.7, P = 0.007). Conclusion Our study showed that low body temperature on admission was associated with persistent proximal MCA occlusion. These results may support a possible detrimental effect of low body temperature on clot lysis and recanalization.

Kvistad, Christopher Elnan; ?ygarden, Halvor; Thomassen, Lars; Waje-Andreassen, Ulrike; Naess, Halvor

2013-01-01

189

[Plain radiographic examination and abdominal echography in intestinal occlusion syndrome. Preliminary note].  

PubMed

Plain film of the abdomen is widely used in the diagnostic evaluation of intestinal occlusion. Even though this technique can yield a panoramic and high-resolution view of gas-filled intestinal loops, several factors, such as type and duration of occlusion, neurovascular status of the intestine and general patient condition, may reduce the diagnostic specificity of the plain film relative to the organic or functional nature of the occlusion. From 1987 to 1989, fifty-four patients with intestinal occlusion were studied combining plain abdominal film with abdominal ultrasound (US). This was done in order to evaluate whether the additional information obtained from US could be of value in better determining the nature of the ileus. US evaluation was guided by the information already obtained from plain film which better demonstrates gas-filled loops. The results show that in all 27 cases of dynamic ileus (intestinal ischemia, acute appendicitis, acute cholecystitis, acute pancreatitis or blunt abdominal trauma) US demonstrates: intestinal loops slightly increased in caliber, with liquid content, or loops containing rare hyperechoic particles, intestinal wall thickening and no peristalsis. In 27 cases of acute, chronic or complicated mechanical ileus (adhesions, internal hernia, intestinal neoplasm, peritoneal seedings) US shows: 1) in acute occlusion: hyperperistaltic intestinal loops containing inhomogeneous liquid; 2) in chronic occlusion: liquid content with a solid echogenic component; 3) in complicated occlusion: liquid stasis, frequent increase in wall thickness, moderate peritoneal effusion and inefficient peristalsis. In conclusion, based on the obtained data, the authors feel that the combination of plain abdominal film and abdominal US can be useful in the work-up of patient with intestinal occlusion. The information provided by US allows a better definition of the nature of the ileus. PMID:2014334

Amodio, C; Antico, E; Zaccarelli, A; Frassineti, A; Montesi, A

1991-03-01

190

De Novo Aneurysm Formation after Carotid Artery Occlusion for Cerebral Aneurysms  

PubMed Central

Therapeutic parent artery occlusion has been routinely utilized for management of some intracranial aneurysms. One possible long-term complication of this procedure is “de novo” formation of aneurysms. The purpose of this paper is to estimate the incidence of de novo aneurysm formation, the time period between occlusion and formation, and the most common sites of formation. A PubMed search was performed for all articles between 1970 and 2008 reporting cases of both therapeutic carotid occlusion and de novo cerebral aneurysms. The 20 papers reviewed reported 187 patients having undergone therapeutic carotid occlusion. Of the 163 patients reported in complete-case series, seven developed new aneurysms (4.3%). Thirty-six total new aneurysms were reported, ranging from 1 to 5 per patient. The average time period between occlusion and detection of de novo aneurysm was 9.1 years (range: 2 to 20 years). These aneurysms occurred mostly in the anterior circulation, predominately the anterior communicating artery and posterior communicating artery, and frequently occurred contralateral to the site of occlusion. Therapeutic parent artery occlusion is a likely risk factor for de novo aneurysm formation. Noninvasive follow-up studies should be performed, especially between 2 and 10 years after occlusion.

Arambepola, Priyangee K.; McEvoy, Sean D.; Bulsara, Ketan R.

2010-01-01

191

De novo aneurysm formation after carotid artery occlusion for cerebral aneurysms.  

PubMed

Therapeutic parent artery occlusion has been routinely utilized for management of some intracranial aneurysms. One possible long-term complication of this procedure is "de novo" formation of aneurysms. The purpose of this paper is to estimate the incidence of de novo aneurysm formation, the time period between occlusion and formation, and the most common sites of formation. A PubMed search was performed for all articles between 1970 and 2008 reporting cases of both therapeutic carotid occlusion and de novo cerebral aneurysms. The 20 papers reviewed reported 187 patients having undergone therapeutic carotid occlusion. Of the 163 patients reported in complete-case series, seven developed new aneurysms (4.3%). Thirty-six total new aneurysms were reported, ranging from 1 to 5 per patient. The average time period between occlusion and detection of de novo aneurysm was 9.1 years (range: 2 to 20 years). These aneurysms occurred mostly in the anterior circulation, predominately the anterior communicating artery and posterior communicating artery, and frequently occurred contralateral to the site of occlusion. Therapeutic parent artery occlusion is a likely risk factor for de novo aneurysm formation. Noninvasive follow-up studies should be performed, especially between 2 and 10 years after occlusion. PMID:21772796

Arambepola, Priyangee K; McEvoy, Sean D; Bulsara, Ketan R

2010-11-01

192

Adaptation of cardiovascular responses to repetitive umbilical cord occlusion in the late gestation ovine fetus  

PubMed Central

The impact of repeated umbilical cord occlusion on the normal maturation of fetal heart rate (FHR) and mean arterial pressure (MAP) and the cardiovascular responses to successive umbilical cord occlusion was investigated over a 21 day period in the latter part of gestation. Fifteen chronically instrumented sheep (control group n = 6; occlusion group n = 9) were studied for 21 days (113-133 days of gestation, term = 145 days) with umbilical cord occlusions (90 s duration) performed every 30 min for 1–4 h each day. On days 1, 9 and 18, FHR, FHR variation and MAP were monitored continuously and fetal arterial blood gases, pH and metabolites were measured at predetermined intervals. The baroreflex response to 75-100 ?g phenylephrine (i.v.) was tested on days 1 and 18. Basal FHR decreased (?FHR: control, 34.6 ± 3.6 beats min?1; occlusion, 36.9 ± 2.7 beats min?1) and MAP increased (?MAP: control, 3.1 ± 1.7 mmHg; occlusion, 5.2 ± 2.1 mmHg) to a similar extent in control and occlusion groups between days 1 and 21 of the study. There was a small decline in FHR variation over the 21 day study in occlusion, but not control, group fetuses. The magnitude of the fall in FHR decreased and the rise in MAP increased, despite similar changes in blood gases in response to umbilical cord occlusion, over the course of the 21 day study. Despite a significant decline in the ratio of ?FHR to ?MAP on days 9 and 18 compared to day 1, there was no difference between control and occlusion groups in baroreflex sensitivity. However ?FHR/?PO2, an index of chemoreceptor sensitivity, had decreased by day 9 and 18 compared to day 1. The cardiovascular responses to umbilical cord occlusion are altered with repetitive occlusions during the latter part of gestation, with a decrease in ?FHR/?MAP, which does not involve changes in baroreflex sensitivity, but may involve changes in chemoreceptor sensitivity. However, repeated umbilical cord occlusion appears to have no impact on baseline cardiovascular control since there was no change in the normal maturational decrease in FHR and rise in MAP.

Green, L R; Kawagoe, Y; Homan, J; White, S E; Richardson, B S

2001-01-01

193

Modified Total-Body Recumbent Stepper Exercise Test for Assessing Peak Oxygen Consumption in People With Chronic Stroke  

PubMed Central

Background: Assessment of peak oxygen consumption (V?o2peak) using traditional modes of testing such as treadmill or cycle ergometer can be difficult in individuals with stroke due to balance deficits, gait impairments, or decreased coordination. Objective: The purpose of this study was to quantitatively assess the validity and feasibility of a modified exercise test using a total-body recumbent stepper (mTBRS-XT) in individuals after stroke. Design: A within-subject design, with a sample of convenience, was used. Participants. Eleven participants (7 male, 4 female) with a mean of 40.1 months (SD=32.7) after stroke, a mean age of 60.9 years (SD=12.0), and mild to severe lower-extremity Fugl-Myer test scores (range=13–34) completed the study. Methods: Participants performed 2 maximal-effort graded exercise tests on separate days using the mTBRS-XT and a cycle ergometer exercise protocol to assess cardiorespiratory fitness. Measurements of V?o2peak and peak heart rate (peak HR) were obtained during both tests. Results: A strong relationship existed between the mTBRS-XT and the cycle ergometer exercise test for V?o2peak and peak HR (r=.91 and .89, respectively). Mean V?O2peak was significantly higher for the mTBRS-XT (16.6 mL×kg?1×min?1[SD=4.5]) compared with the cycle ergometer exercise protocol (15.4 mL×kg?1×min?1 [SD=4.5]). All participants performed the mTBRS-XT. One individual with severe stroke was unable to pedal the cycle ergometer. No significant adverse events occurred. Conclusion: The mTBRS-XT may be a safe, feasible, and valid exercise test to obtain measurements of V?o2peak in people with stroke. Health care professionals may use the mTBRS-XT to prescribe aerobic exercise based on V?o2peak values for individuals with mild to severe deficits after stroke.

Billinger, Sandra A; Tseng, Benjamin Y; Kluding, Patricia M

2008-01-01

194

Functional health and well-being in patients with severe atherosclerotic peripheral vascular occlusive disease  

Microsoft Academic Search

Functional health and sense of well-being are known to be adversely affected by chronic illness. The extent to which peripheral vascular occlusive disease (PVOD) alters these factors independent of other comorbid conditions is unknown. Sixty patients with PVOD severe enough to have required aortobifemoral bypass (AFB) between 1985 and 1990 were selected for evaluation. Although all were heavy smokers and

Joseph R. Schneider; Colleen A. McHorney; David J. Malenka; Martha D. McDaniel; Daniel B. Walsh; Jack L. Cronenwett

1993-01-01

195

Arterial Occlusive Disease Complicating Radiation Therapy of Cervical Cancer  

PubMed Central

Radiation-induced arterial disease is caused by significant atherosclerosis in the circumjacent vessels being irradiated. Even though this has been recognized as survival of cancer patients treated with radiotherapy improves, it is a problem that is often under-reported. We present a case of chronic thromboembolic occlusion of right common iliac artery in a 53-year-old woman who was treated with radiation therapy for cervical cancer 13 years ago. We initially performed percutaneous transluminal angioplasty with thrombolytic therapy, but had to cease thrombolytic therapy due to upper gastrointestinal bleeding of Dieulafoy's lesion, nevertheless, achieved good results after revascularization by Fogarty embolectomy.

Won, Ki-Bum; Kim, Byeong-Keuk; Ko, Young-Guk; Hong, Myeong-Ki; Jang, Yangsoo

2012-01-01

196

Endovascular recanalization techniques for popliteal arterial occlusive injury with limb-threatening ischemia secondary to trauma  

PubMed Central

To date, no ideal endovascular strategy has been established for traumatic arterial occlusion. Here, we report the outcomes of a combination of endovascular recanalization techniques applied in two patients with high risk of leg amputation. A 33-year-old man with popliteal artery occlusion due to blunt trauma was treated by balloon angioplasty with long inflation time and aspiration thrombectomy. A 74-year-old woman with popliteal artery occlusion after total knee replacement was treated by aspiration thrombectomy and stent placement. In both cases, we achieved satisfactory recanalization, and peripheral ischemia was absent even 1 year later.

Murata, Satoru; Yasui, Daisuke; Tajima, Hiroyuki; Kawamata, Hiroshi; Yokota, Hiroyuki; Kumita, Shin-ichiro

2014-01-01

197

Incidence of upper genital tract occlusion following microwave endometrial ablation (MEA).  

PubMed

The aim of the study was to determine the incidence of occlusion of the upper genital tract following microwave endometrial ablation (MEA) in women treated for therapy-resistant menorrhagia. A total of 35 women were recruited between January 1997 and January 2005, Royal United Hospital Bath, to have interval hysterosalpingogram (HSG) post-MEA. After a successful MEA, either with general or local anaesthesia, 35 HSGs were performed 3 or more months later. Complete occlusion of the upper genital tract was found in 30 women (85.7%) and incomplete occlusion with tubal patency persisted in 5 (14.3%). PMID:16827830

Tawfeek, S; Sholapurkar, S; Sharp, N

2006-08-01

198

ACUTE RETINAL ARTERIAL OCCLUSIVE DISORDERS  

PubMed Central

The initial section deals with basic sciences; among the various topics briefly discussed are the anatomical features of ophthalmic, central retinal and cilioretinal arteries which may play a role in acute retinal arterial ischemic disorders. Crucial information required in the management of central retinal artery occlusion (CRAO) is the length of time the retina can survive following that. An experimental study shows that CRAO for 97 minutes produces no detectable permanent retinal damage but there is a progressive ischemic damage thereafter, and by 4 hours the retina has suffered irreversible damage. In the clinical section, I discuss at length various controversies on acute retinal arterial ischemic disorders. Classification of acute retinal arterial ischemic disorders These are of 4 types: CRAO, branch retinal artery occlusion (BRAO), cotton wools spots and amaurosis fugax. Both CRAO and BRAO further comprise multiple clinical entities. Contrary to the universal belief, pathogenetically, clinically and for management, CRAO is not one clinical entity but 4 distinct clinical entities – non-arteritic CRAO, non-arteritic CRAO with cilioretinal artery sparing, arteritic CRAO associated with giant cell arteritis (GCA) and transient non-arteritic CRAO. Similarly, BRAO comprises permanent BRAO, transient BRAO and cilioretinal artery occlusion (CLRAO), and the latter further consists of 3 distinct clinical entities - non-arteritic CLRAO alone, non-arteritic CLRAO associated with central retinal vein occlusion and arteritic CLRAO associated with GCA. Understanding these classifications is essential to comprehend fully various aspects of these disorders. Central retinal artery occlusion The pathogeneses, clinical features and management of the various types of CRAO are discussed in detail. Contrary to the prevalent belief, spontaneous improvement in both visual acuity and visual fields does occur, mainly during the first 7 days. The incidence of spontaneous visual acuity improvement during the first 7 days differs significantly (p<0.001) among the 4 types of CRAO; among them, in eyes with initial visual acuity of counting finger or worse, visual acuity improved, remained stable or deteriorated in nonarteritic CRAO in 22%, 66% and 12% respectively; in nonarteritic CRAO with cilioretinal artery sparing in 67%, 33% and none respectively; and in transient nonarteritic CRAO in 82%, 18% and none respectively. Arteritic CRAO shows no change. Recent studies have shown that administration of local intra-arterial thrombolytic agent not only has no beneficial effect but also can be harmful. Prevalent multiple misconceptions on CRAO are discussed. Branch retinal artery occlusion Pathogeneses, clinical features and management of various types of BRAO are discussed at length. The natural history of visual acuity outcome shows a final visual acuity of 20/40 or better in 89% of permanent BRAO cases, 100% of transient BRAO and 100% of nonarteritic CLRAO alone. Cotton wools spots These are common, non-specific acute focal retinal ischemic lesions, seen in many retinopathies. Their pathogenesis and clinical features are discussed in detail. Amaurosis fugax Its pathogenesis, clinical features and management are described.

Hayreh, Sohan Singh

2011-01-01

199

Comorbidities in combined retinal artery and vein occlusions  

PubMed Central

Background Several general diseases cause blindness in patients with simultaneous combined retinal artery and vein occlusion. Methods/patients We examined 14 patients with acute unilateral visual loss due to combined retinal artery and venous occlusions. All 14 patients presented at the Polyclinic over a period of about 3 years. Fluorescein angiography was carried out in 12 patients to confirm the diagnosis. Ten patients underwent Doppler sonography and 11 echocardiography. Results Concerning systemic diseases, 11 of our 14 patients presented several cardiovascular risk factors, i.e., immunocytoma and arterial hypertension and hypercholesterolemia in one patient; another patient had chronic bronchitis, tachycardia and hypercholesterolemia. Six patients presented coagulation anomalies, and eight patients had arterial hypertension. Doppler sonography revealed normal carotid arteries in nine of ten patients. In 8 of 11 patients, echocardiography displayed no cardiac abnormalities. Ophthalmoscopy revealed no emboli in any of these patients. Conclusion Unilateral simultaneous combined incomplete retinal artery and venous occlusions should be considered as one entity. Eleven of our patients presented comorbidities reflecting several cardiovascular risk factors. Immunological diseases, malignancies and coagulopathies can cause this ocular disorder, resulting in blindness. No emboli were found in any of these patients. Patients suffering from acute visual loss must be examined for the presence of systemic diseases to enable therapy at an early stage.

2013-01-01

200

Composite occlusal surfaces for acrylic resin denture teeth  

Microsoft Academic Search

Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to a loss of chewing efficiency and a loss of vertical dimension of occlusion. The use of metal occlusal surfaces on the acrylic resin denture teeth will minimize occlusal wear. Several articles have described methods to construct metal occlusal surfaces; however, these methods are time-consuming, costly, and sometimes

Carlos Eduardo Vergani; Eunice Teresinha Giampaolo; Ana Lucia Machado Cucci

1997-01-01

201

Repair of right ventricle rupture caused by left coronary artery occlusion.  

PubMed

A 67-year-old man was admitted with right ventricular free wall rupture secondary to occlusion of the left anterior descending artery. Emergency coronary angiography showed total occlusion of the proximal left anterior descending artery and severe stenosis of the proximal right coronary artery. Echocardiography revealed acute cardiac tamponade, and free wall rupture of the heart was suspected. At surgery under cardiopulmonary bypass, closure was achieved using mattress sutures with pledgets. PMID:24570528

Tarui, Tatsuya; Ikeda, Masahiro

2013-08-01

202

Acute effects of granulocyte colony-stimulating factor on early ventricular arrhythmias after coronary occlusion in rats  

PubMed Central

Objectives: To evaluate the acute effects of colony-stimulating factor (G-CSF) on ventricular arrhythmias after coronary occlusion in rats. Materials and Methods: Male Wistar rats (10 weeks) received G-CSF (100 ?g.kg-1) or vehicle. Thirty minutes later, animals were infarcted by coronary occlusion under artificial respiration. Electrocardiogram was monitored for 30 min to evaluate ventricular arrhythmias. Results: G-CSF treatment reduced the number of premature ventricular beats and the number and duration of ventricular tachycardia. The incidence of ventricular fibrillation was significantly reduced by G-CSF (MI-Cont: 11.2 ± 2.4 vs. MI-GCSF: 5.4 ± 1 events; P < 0.05). However, total duration of ventricular fibrillation was not altered (MI-Cont: 84 ± 16 vs. MI-GCSF: 76 ± 13 sec). Conclusions: Acute administration of G-CSF before coronary ligature in rats reduces the incidence of ventricular premature beats and ventricular tachycardia, suggesting a possible direct electrophysiological effect of this cytokine independently of its genomic effects. However, the data suggest that G-CSF treatment may affect the spontaneous recovery from ventricular fibrillation. Acute G-CSF administration acts directly on cardiac electrophysiology, different from chronic treatment.

Baldo, Marcelo Perim; Rodrigues, Sergio Lamego; Mill, Jose Geraldo

2012-01-01

203

Longitudinal trajectory of sexual functioning after hematopoietic cell transplantation: impact of chronic graft-versus-host disease and total body irradiation.  

PubMed

This prospective study described the trajectory of sexual well-being from before hematopoietic cell transplantation (HCT) to 3 years after in 131 allogeneic and 146 autologous HCT recipients using Derogatis Interview for Sexual Function and Derogatis Global Sexual Satisfaction Index. Sixty-one percent of men and 37% of women were sexually active pre-HCT; the prevalence declined to 51% (P = .01) in men and increased to 48% (P = .02) in women at 3 years post-HCT. After HCT, sexual satisfaction declined in both sexes (P < .001). All sexual function domains were worse in women compared with men (P ? .001). Orgasm (P = .002) and drive/relationship (P < .001) declined in men, but sexual cognition/fantasy (P = .01) and sexual behavior/experience (P = .01) improved in women. Older age negatively impacted sexual function post-HCT in both sexes (P < .01). Chronic graft-versus-host disease was associated with lower sexual cognition/fantasy (P = .003) and orgasm (P = .006) in men and sexual arousal (P = .05) and sexual satisfaction (P = .005) in women. All male sexual function domains declined after total body irradiation (P < .05). This study identifies vulnerable subpopulations that could benefit from interventional strategies to improve sexual well-being. PMID:24159171

Wong, F Lennie; Francisco, Liton; Togawa, Kayo; Kim, Heeyoung; Bosworth, Alysia; Atencio, Liezl; Hanby, Cara; Grant, Marcia; Kandeel, Fouad; Forman, Stephen J; Bhatia, Smita

2013-12-01

204

Comparison of total body irradiation vs chlorambucil and prednisone for remission induction of active chronic lymphocytic leukemia: an ECOG study. Part I: total body irradiation-response and toxicity  

SciTech Connect

Twenty-six evaluable patients were entered into two fractionated total body irradiation (TBI) programs; 11 patients received a course of 150 rad TBI (x 3 if tolerated) and 15 patients received a lower dose course of 50 rad (x 3 if tolerated). Complete remissions (CR) were not produced by either course; however, the higher dose course (Plan I) yielded a partial response (PR) rate of 73%, while the lower dose course yielded a PR of 47%. Although fraction size seemed trivial in both TBI plans, an unexpected high degree of hematologic toxicity was encountered, and was parallel to the response rates: in Plan I 73% of patients experienced severe to life-threatening depression of platelets, or granulocytes, whereas in Plan II this rate was 47%. This was of short duration with rapid return of blood counts to normal levels. One death can be attributed to TBI. The chemotherapy arm of the study demonstrated superiority in terms of complete responses. Twenty-three percent of patients treated by cholrambucil and prednisone attained CR, in contrast to 0% of TBI patients. PR for chemotherapy was similar to that obtained with TBI. Chemotherapy also proved superior in terms of overall response rate, number of patients in remission, and in the median duration of response, but not in the median duration of survival. Fractional TBI techniques for active chronic lymphocytic leukemia (CLL) should be interrupted when the platelet count dips below 100,000 and the granulocyte count is lower than 2,000. Future studies should continue TBI radiation therapy and chemotherapy.

Rubin, P. (Univ. of Rochester, NY); Bennent, J.M.; Begg, C.; Bozdech, M.J.; Silber, R.

1981-12-01

205

Combined surface and volumetric occlusion shading  

Microsoft Academic Search

In this paper, a method for interactive direct volume rendering is proposed that computes ambient occlusion effects for visualizations that combine both volumetric and geometric primitives, specifically tube shaped geometric objects representing streamlines, magnetic field lines or DTI fiber tracts. The proposed algorithm extends the recently proposed Directional Occlusion Shading model to allow the rendering of those geometric shapes in

Mathias Schott; Tobias Martin; A. V. Pascal Grosset; Carson Brownlee; Thomas Hollt; Benjamin P. Brown; Sean T. Smith; Charles D. Hansen

2012-01-01

206

The effect of occlusal forces on restorations.  

PubMed

This review will focus on the effect occlusal forces, both normal masticatory force and paranormal bruxing and clenching force, have on various restorative materials and their interaction with the teeth through a variety of bonding mechanisms. Salient physical properties of each of the materials will be reviewed, as well as the effect occlusal force has on restoration durability. PMID:23346657

Larson, Thomas D

2012-01-01

207

Recognizing and managing retinal vein occlusion.  

PubMed

Retinal vein occlusion is the second most common retinal vascular disease after diabetic retinopathy and represents a significant cause of irreversible sight loss and disability in persons over the age of 50 years (The Branch Vein Occlusion Study Group, 1984). PMID:24402030

Arunakirinathan, Meena; Aj Ting, Michelle; Crawley, Laura

2014-01-01

208

Robust Multiple Car Tracking with Occlusion Reasoning  

Microsoft Academic Search

Abstract: In this work we address the problem of occlusion in tracking multiple 3D objects in a knownenvironment and propose a new approach for tracking vehicles in road traffic scenes using anexplicit occlusion reasoning step. We employ a contour tracker based on intensity and motionboundaries. The motion of the contour of the vehicles in the image is assumed to be

Dieter Koller; Joseph Weber; Jitendra Malik

1994-01-01

209

Nefiracetam Improves the Impairment of Local Cerebral Blood Flow and Glucose Utilization after Chronic Focal Cerebral Ischemia in Rats  

Microsoft Academic Search

In this study we investigated the effects of nefiracetam (DM-9384) on local cerebral blood flow (LCBF) and local cerebral glucose utilization (LCMRglc) in the chronic phase after middle cerebral artery (MCA) occlusion in rats. Nefiracetam (10 mg\\/kg) was administered orally once a day for 2 weeks from day 15 after MCA occlusion. On day 28 after MCA occlusion, LCBF and

Jingji Jin; Shigeo Watabe; Tsuneyuki Yamamoto

2002-01-01

210

The occlusion rate and patterns of saphenous vein after radiofrequency ablation  

PubMed Central

Purpose Radiofrequency ablation (RFA) is a widely accepted to treat the varicose vein. However, outcome studies for occlusion rate and patterns of the saphenous vein after RFA are scarce. The purpose of our study is to report the results of RFA in patients with varicose vein. Methods We retrospectively reviewed the clinical outcomes after RFA using ClosureFAST (Covidien) catheter. We evaluated the occlusion rate and patterns with duplex scanning after RFA. Results A total of 200 limbs (148 patients) underwent RFA. The truncal veins were ablated in 163 great saphenous veins (GSV) and 41 small saphenous veins (SSVs). The mean age was 52.1 ± 11.9 years and female to male ratio was 125 : 87. At the mean follow-up of 13.9 months, the CEAP score, VCSS, and QoL score were significantly improved 2.33 ± 0.78 to 1.29 ± 0.96 (P < 0.0001), 3.48 ± 0.98 to 0.63 ± 1.16 (P < 0.0001), and 6.91 ± 6.69 to 3.38 ± 4.74 (P < 0.0001), respectively. The occlusion rate was 94.6% (53/56) in GSV and 94.5% (17/18) in SSV. The most common occlusion pattern in GSV was total occlusion of main trunk with patent superficial inferior epigastric vein in 41.1%. And, the most common pattern in SSV was the total occlusion of SSV with stump in 66.7%. Conclusion RFA is an effective modality in the treatment of varicose vein. At the mean follow-up of 13.9 months, the occlusion rate was 94.6%in GSV and 94.5% in SSV. There are several patterns of saphenous occlusion after RFA.

Choi, Jung Hyun; Park, Ho-Chul

2013-01-01

211

Paeoniflorin attenuates chronic cerebral hypoperfusion-induced learning dysfunction and brain damage in rats  

Microsoft Academic Search

Chronic cerebral hypoperfusion, a mild ischemic condition, is associated with the cognitive deficits of AD. Paeoniflorin (PF), a major constituent of peony root, was proved to be neuroprotective in middle cerebral artery occlusion model. In this study, we investigated whether PF could attenuate chronic cerebral hypoperfusion-induced learning dysfunction and brain damage in rat. Seven weeks after permanent bilateral occlusion of

Jing Liu; Dao-Zhong Jin; Liang Xiao; Xing-Zu Zhu

2006-01-01

212

[Occlusal vertical dimension in removable complete dentures].  

PubMed

In removable complete dentures, the occlusal vertical dimension is an important factor for patients' satisfaction with aesthetics. An excessively reduced occlusal vertical dimension is especially likely to lead to complaints about aesthetics, whereas an increased occlusal vertical dimension may lead to discomfort and a decision not to wear the complete dentures. There are various methods for determining the occlusal vertical dimension in complete dentures, based on the vertical dimension in the rest position of the mandible or on phonetics. However, none of the methods have proven to be clearly superior, in terms of reliability, than the others. The assessment of the occlusal vertical dimension will become more reliable if several methods are used simultaneously. Moreover, knowledge of the characteristics of the ageing face is essential. PMID:22292357

den Haan, R; Witter, D J

2011-12-01

213

Special report: Occlusive cuff controller  

NASA Technical Reports Server (NTRS)

A mechanical occlusive cuff controller suitable for blood flow experiments in space shuttle flights is described. The device requires 115 volt ac power and a pressurized gas source. Two occluding cuff pressures (30 and 50 mmHg) are selectable by a switch on the front panel. A screw driver adjustment allows accurate cuff pressurization levels for under or oversized limbs. Two pressurization cycles (20 second and 2 minutes) can be selected by a front panel switch. Adjustment of the timing cycles is also available through the front panel. A pushbutton hand switch allows remote start of the cuff inflation cycle. A stop/reset switch permits early termination of the cycle and disabling of the controller to prevent inadvertent reactivation. Pressure in the cuff is monitored by a differential aneroid barometer. In addition, an electrocardiogram trigger circuit permits the initiation of the pressurization cycle by an externally supplied ECG cycle.

Baker, J. T.

1975-01-01

214

Behavioral and biochemical studies of total furocoumarins from seeds of Psoralea corylifolia in the chronic mild stress model of depression in mice.  

PubMed

Depression is related to alterations of the monoamine oxidase (MAO), hypothalamic-pituitary-adrenal (HPA) axis, and oxidative systems, and some antidepressants achieve their therapeutic effects through alteration of following biochemical markers of depression: MAO-A and MAO-B activities, cortisol levels, superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels. The seeds of Psoralea corylifolia, otherwise known as Buguzhi, have long been used for treatments of various symptoms associated with aging in China. Furocoumarins are the most widespread secondary metabolites in this species. The present study was designed to evaluate the potential antidepressant-like activity of total furocoumarins of P. corylifolia (TFPC) in the chronic mild stress (CMS) model of depression. Mice subjected to CMS exhibited a reduction in sucrose intake. Conversely, brain MAO-A and MAO-B activities, plasma cortisol levels, and liver SOD activity and MDA levels were increased following CMS exposures. The time-course for reversal of CMS-induced deficits in sucrose consumption by TFPC was dose-dependent. Thus, the statistically significant effect of the higher dose of TFPC (50 mg/kg body wt.) was observed after 3 days of treatment, while 6 days of treatment were required in the group receiving a lower dose (30 mg/kg body wt.) of TFPC. TFPC reversed these biochemical changes. These results suggest that TFPC may possess potent and rapid antidepressant properties that are mediated via MAO, the HPA axis and oxidative systems and these antidepressant actions could make TFPC a potentially valuable drug for the treatment of depression in the elderly. PMID:17085027

Chen, Y; Wang, H-D; Xia, X; Kung, H-F; Pan, Y; Kong, L-D

2007-08-01

215

Detecting natural occlusion boundaries using local cues.  

PubMed

Occlusion boundaries and junctions provide important cues for inferring three-dimensional scene organization from two-dimensional images. Although several investigators in machine vision have developed algorithms for detecting occlusions and other edges in natural images, relatively few psychophysics or neurophysiology studies have investigated what features are used by the visual system to detect natural occlusions. In this study, we addressed this question using a psychophysical experiment where subjects discriminated image patches containing occlusions from patches containing surfaces. Image patches were drawn from a novel occlusion database containing labeled occlusion boundaries and textured surfaces in a variety of natural scenes. Consistent with related previous work, we found that relatively large image patches were needed to attain reliable performance, suggesting that human subjects integrate complex information over a large spatial region to detect natural occlusions. By defining machine observers using a set of previously studied features measured from natural occlusions and surfaces, we demonstrate that simple features defined at the spatial scale of the image patch are insufficient to account for human performance in the task. To define machine observers using a more biologically plausible multiscale feature set, we trained standard linear and neural network classifiers on the rectified outputs of a Gabor filter bank applied to the image patches. We found that simple linear classifiers could not match human performance, while a neural network classifier combining filter information across location and spatial scale compared well. These results demonstrate the importance of combining a variety of cues defined at multiple spatial scales for detecting natural occlusions. PMID:23255731

DiMattina, Christopher; Fox, Sean A; Lewicki, Michael S

2012-01-01

216

Open-ended guidewire: new technique for balloon angioplasty of chronically occluded coronary arteries.  

PubMed

Chronic total coronary occlusion is a growing indication to percutaneous transluminal coronary angioplasty. Since primary success of balloon angioplasty in this condition is usually limited by the difficulty of crossing the occlusion, different techniques have been described for this purpose, such as use of stiff guidewires, coronary infusion catheters, guidewires with an olive-shaped tip, or new developing methods (atherectomy, laser), in association with balloon dilatation. Here, we describe our initial experience with a thick (0.035 in) and relatively stiff open-ended guidewire, which has an inner (0.018 in diameter) lumen provided with a core wire. Several advantages are considered. The core wire yields a perfect means of steerability of the whole system, while pushability of a thicker guidewire is much greater. Moreover, the core wire can be removed, and contrast injections beyond the occlusion through the inner lumen can assure proper intraluminal location. Finally, position across the occlusion can be kept easily, since an exchange wire for conventional balloon catheters can be inserted in the inner lumen of the open-ended guidewire. PMID:2527610

Vassanelli, C; Turri, M; Morando, G; Menegatti, G; Zardini, P

1989-08-01

217

[Systemic lysis therapy in retinal vascular occlusions].  

PubMed

In the management of acute major vessel occlusion, the use of fibrinolytic agents such as recombinant tissue plasminogen activator (rt-PA), urokinase or streptokinase is widely accepted. Today, the spectrum of indications for thrombolytic drugs comprises acute myocardial infarction, lung embolism, ischaemic stroke, deep vein thrombosis and acute arterial occlusions of the lower limbs. In view of the histopathological and clinical features of retinal vessel occlusion, fibrinolysis aimed at early restoration of blood flow appears to be a promising therapeutic approach. Basically, it is of some concern that the systemic administration of fibrinolytic agents is associated with a haemorrhagic risk. Since this includes cerebral haemorrhage or gastrointestinal bleeding, the choice of an appropriate intravenous thrombolytic therapy in a non-life threatening situation such as central retinal artery occlusion (CRAO) or central retinal vein occlusion (CRVO) should be based on minimising the risk of adverse events. Furthermore, the fibrinolytic treatment of choice should be able to produce rapid and complete restoration of retinal capillary and arterial or venous blood flow and maintain patency long enough for retinal salvage to take place. In this article, we review several studies of fibrinolytic therapy in patients with retinal vessel occlusion to determine whether this treatment is likely to improve major clinical outcomes. Moreover, we review the large scale trials of fibrinolysis in myocardial infarction and acute ischaemic stroke to evaluate safety and efficacy of various thrombolytic regimens. Furthermore, we report on our results of fibrinolytic therapy with low dose rt-PA in patients with retinal artery occlusion and ischaemic central retinal vein occlusion. In light of the fact that the occurrence of bleeding complications constitutes a dose dependent problem, we conclude that the use of low dose regimens should be the ideal approach to fibrinolysis in retinal vessel occlusion. Although the results of our pilot studies must be interpreted with caution, we believe that the administration of low-dose rt-PA (50 mg) in a frontloaded manner (= simultaneous administration of rt-PA and intravenous heparin) constitutes a reasonable treatment option in patients with central retinal artery occlusion (CRAO) or ischaemic retinal vein occlusion (RVO), recent onset of symptoms (CRAO < or = 12 h, RVO < or = 11 d) and severe visual loss (< or = 20/50). Because of these limitations and the numerous contraindications of fibrinolytic therapy, only a limited number of patients will be suitable for this treatment. In view of the poor visual and ocular prognosis in severe retinal vessel occlusion, controlled clinical trials are needed to determine the benefit of thrombolysis in the management of this disease. PMID:9782735

Hattenbach, L O

1998-08-01

218

Technique, Complication, and Long-Term Outcome for Endovascular Treatment of Iliac Artery Occlusion  

SciTech Connect

The aim of this study was to report technical details, procedure-related complications, and results of endovascular treatment in chronic iliac artery occlusion. Between 2001 and 2008, endovascular treatments of 127 chronic iliac artery occlusions in 118 patients (8 women and 110 men; mean age, 59 years) were retrospectively reviewed. The study was based on Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery Standards). All occlusions were treated with stent placement with or without preliminary balloon angioplasty. Kaplan-Meier estimators were used to determine patency rates. Univariate and multivariate analyses were performed to determine variables affecting successful recanalization, major complications, early stent thrombosis ({<=}30 days), and primary and secondary patency rates. Initial technical success was achieved in 117 (92%) procedures. Successful recanalization was obtained by antegrade approach in 69 of 77 (90%) procedures and by retrograde approach in 52 of 105 (50%) procedures (p < 0.001). Complications were encountered in 28 (24%) patients [minor in 7 patients (6%) and major in 22 patients (19%)]. One death occurred in the operative period secondary to iliac artery rupture. Early stent thrombosis was seen in eight (7%) patients. Presence of critical limb ischemia (p = 0.03), subintimal recanalization (p = 0.03), and major complication (p = 0.02) were the independent predictors of early stent thrombosis on multivariate analysis. Primary and secondary patency rates at 5 years were 63 and 93%, respectively. Presence of critical limb ischemia, TASC type C iliac lesions, combined occlusions of both common and external iliac arteries, and major complications were associated with decreased patency rates on univariate analysis, whereas these factors were not independent predictors of stent patency on multivariate analysis. In conclusion, endovascular treatment of iliac artery occlusion has a high technical success rate with favorable long-term patency rate. Success of recanalization increases with use of the antegrade approach and with the presence of a stump of artery before the occlusion.

Ozkan, Ugur, E-mail: radugur@yahoo.com; Oguzkurt, Levent; Tercan, Fahri [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)

2010-02-15

219

Thrombophilia and retinal vascular occlusion  

PubMed Central

Purpose The purpose of this research was to assess associations of thrombophilia with central retinal vein occlusion (CRVO), central retinal artery occlusion (CRAO), and amaurosis fugax (AF); to evaluate outcomes of normalizing high homocysteine; and to study CRVO, CRAO, and AF developing in estrogens/estrogen agonists in women subsequently shown to have thrombophilia. Methods Measures of thrombophilia–hypofibrinolysis were obtained in 132 CRVO cases, 15 CRAO cases, and 17 AF cases. Cases were compared to 105 healthy control subjects who did not differ by race or sex and were free of any ophthalmologic disorders. All cardiovascular disease (CVD) risk factors were compared to healthy general populations. Main outcome measures The main outcome measure of this study was thrombophilia. Results CRVO cases were more likely than controls to have high homocysteine (odds ratio [OR] 8.64, 95% confidence intervals [CI]: 1.96–38), high anticardiolipin immunoglobulin M (IgM; OR 6.26, 95% CI: 1.4–28.2), and high Factor VIII (OR 2.47, 95% CI: 1.31–7.9). CRAO-AF cases were more likely than controls to have high homocysteine (OR 14, 95% CI: 2.7–71.6) or the lupus anticoagulant (OR 4.1, 95% CI: 1.3–13.2). In four of 77 women with CRVO (two found to have high homocysteine, two with inherited high Factor XI), CRVO occurred after starting estrogen–progestins, estrogen–testosterone, or estrogen agonists. In one of eight women with CRAO found to have high anticardiolipin antibody IgG, CRAO occurred after starting conjugated estrogens, and AF occurred after starting conjugated estrogens in one of eleven women with AF (inherited protein S deficiency). Therapy for medians of 21 months (CRVO) and 6 months (CRAO-AF) was 5 mg folic acid, 100 mg B6, and 2000 mcg/day B12 normalized homocysteine in 13 of 16 (81%) CRVO cases and all five CRAO-AF cases with pretreatment hyperhomocysteinemia. The CRVO cases had an excess of hypertension; CRAO-AF cases had an excess of type 2 diabetes and hypertension. Conclusion Treatable thrombophilia, hyperhomocysteinemia in particular, is more common in RVO cases than in normal controls. RVO occurs after estrogens or estrogen agonists were administered in women subsequently shown to have thrombophilia.

Glueck, Charles J; Hutchins, Robert K; Jurantee, Joel; Khan, Zia; Wang, Ping

2012-01-01

220

Workflow Optimization in Vertebrobasilar Occlusion  

SciTech Connect

Objective: In vertebrobasilar occlusion, rapid recanalization is the only substantial means to improve the prognosis. We introduced a standard operating procedure (SOP) for interventional therapy to analyze the effects on interdisciplinary time management. Methods: Intrahospital time periods between hospital admission and neuroradiological intervention were retrospectively analyzed, together with the patients' outcome, before (n = 18) and after (n = 20) implementation of the SOP. Results: After implementation of the SOP, we observed statistically significant improvement of postinterventional patient neurological status (p = 0.017). In addition, we found a decrease of 5:33 h for the mean time period from hospital admission until neuroradiological intervention. The recanalization rate increased from 72.2% to 80% after implementation of the SOP. Conclusion: Our results underscore the relevance of SOP implementation and analysis of time management for clinical workflow optimization. Both may trigger awareness for the need of efficient interdisciplinary time management. This could be an explanation for the decreased time periods and improved postinterventional patient status after SOP implementation.

Kamper, Lars, E-mail: lars.kamper@helios-kliniken.de; Meyn, Hannes [University Hospital Witten/Herdecke, Department of Diagnostic and Interventional Radiology, HELIOS Klinikum Wuppertal (Germany); Rybacki, Konrad [University Hospital, Department of Diagnostic Radiology (Germany); Nordmeyer, Simone [St. Josef-Hospital Oberhausen, Department of Psychiatry and Psychotherapy (Germany); Kempkes, Udo; Piroth, Werner [University Hospital Witten/Herdecke, Department of Diagnostic and Interventional Radiology, HELIOS Klinikum Wuppertal (Germany); Isenmann, Stefan [University Hospital Witten/Herdecke, Department of Neurology, HELIOS Klinikum Wuppertal (Germany); Haage, Patrick [University Hospital Witten/Herdecke, Department of Diagnostic and Interventional Radiology, HELIOS Klinikum Wuppertal (Germany)

2012-06-15

221

Pentachlorophenol dermal absorption and disposition from soil in swine: effects of occlusion and skin microorganism inhibition.  

PubMed

Residue of the environmentally relevant biocide pentachlorophenol (PCP) is found mainly in soil, making dermal contact one of the primary routes for PCP exposure. To quantify exposure effects on dermal absorption and systemic disposition, [14C-UL]PCP was dosed nonocclusively or occlusively at 40 micrograms/cm2 in a soil-based mixture in an in vivo swine model. Additionally, antibiotics were also codosed with occlusive PCP in soil to examine the impacts of skin microbial PCP biodegradation on total dermal absorption. Under nonocclusive, occlusive, and occlusive-antibiotic conditions, total radiolabel absorption by 408 hr was 29.08, 100.72, and 86.21% dose, respectively. Tissue accumulation of PCP and its labeled metabolite(s) was very significant in swine since one-half to two-thirds of the absorbed dose was still present in tissues by 17 days after PCP dermal exposure. High 14C concentrations were found in liver, kidney, lung, ovary, and uterus. Urine and fecal routes were equally important for label excretion from the body. Occlusion enhanced total dermal absorption and changed the shape of the absorption profiles in the blood and plasma. Skin microorganism inhibition retarded 14C dermal absorption, altered local and systemic tissue distribution, and increased plasma/blood concentration ratios, suggesting skin microbial PCP degradation might play an important role in the altered absorption and disposition by occlusion. This study demonstrated significant dermal absorption and extensive tissue persistence of PCP after soil exposure. Occlusion and skin microflora growth may greatly impact dermal absorption, cutaneous disposition, and systemic toxic input. Therefore, exposure-specific PCP absorption and disposition profiles must be taken into consideration in risk analysis. PMID:9439719

Qiao, G L; Brooks, J D; Riviere, J E

1997-12-01

222

Traumatic middle cerebral artery occlusion from boxing  

Microsoft Academic Search

A case of a traumatic middle cerebral artery occlusion resulting from a boxing injury is presented. A 22-year-old man, an amateur boxer, was admitted because of difficulty in speaking, that had appeared a day after a sparring fight. A computed tomographic scan showed low-density areas in the left globus pallidus and corona radiata. A carotid angiogram indicated complete occlusion of

Satoshi Sawauchi; Tohru Terao; Satoshi Tani; Takeki Ogawa; Toshiaki Abe

1999-01-01

223

Stenting in Acute Lower Limb Arterial Occlusions  

SciTech Connect

Management of critical limb ischemia of acute onset includes surgical embolectomy, bypass grafting, aspiration thrombectomy, thrombolysis, and mechanical thrombectomy followed by treatment of the underlying cause. We present our experience with the use of stents to treat acute embolic/thrombotic occlusions in one iliac and three femoropopliteal arteries. Although this is a small case series, excellent immediate and midterm results suggest that stenting of acute occlusions of the iliac, superficial femoral, and popliteal arteries is a safe and effective treatment option.

Raja, Jowad; Munneke, Graham; Morgan, Robert; Belli, Anna-Maria, E-mail: anna.belli@stgeorges.nhs.u [St George's Hospital, Department of Radiology (United Kingdom)

2008-07-15

224

Pancreatic Remnant Occlusion after Whipple's Procedure: An Alternative Oncologically Safe Method  

PubMed Central

Introduction. To present our experience regarding the use of pancreatic stump occlusion technique as an alternative management of the pancreatic remnant after pancreatoduodenectomy (PD). Methods. Between 2002 and 2009, hospital records of 93 patients who had undergone a Whipple's procedure for either pancreatic-periampullary cancer or chronic pancreatitis were retrospectively studied. In 37 patients the pancreatic duct was occluded by stapling and running suture without anastomosis of the pancreatic remnant, whereas in 56 patients a pancreaticojejunostomy was performed. Operative data, postoperative complications, oncological parameters, and survival rates were recorded. Results. 2/37 patients of the occlusion group and 9/56 patients of the anastomosis group were treated for chronic pancreatitis, whereas 35/37 and 47/56 patients for periampullary malignancies. The duration of surgery for the anastomosis group was significantly longer (mean time 220 versus 180 minutes). Mean hospitalization time was 6 days for both groups. The occlusion group had a lower morbidity rate (24% versus 32%). With regard to postoperative complications, a slightly higher incidence of pancreatic fistulas was observed in the anastomosis group. Conclusions. Pancreatic remnant occlusion is a safe, technically feasible, and reducing postoperative complications alternative approach of the pancreatic stump during Whipple's procedure.

Theodosopoulos, Theodosios; Dellaportas, Dionysios; Yiallourou, Anneza I.; Gkiokas, George; Polymeneas, George; Fotopoulos, Alexios

2013-01-01

225

Evaluation of body composition and nitrogen content of renal patients on chronic dialysis as determined by total body neutron activation13  

Microsoft Academic Search

Total body protein (nitrogen), body cell mass (potassium), fat, and water were measured in 15 renal patients on maintenance hemodialysis (MHD). Total body nitrogen was measured by means of prompt y neutron activation analysis; total body water was determined with tritium labeled water; total body potassium was measured by whole body counting. The extracellular water was determined by a technique

Stanton H Cohn; B Lawrence Brennan; Seiichi Yasumura; David Vartsky; Ashok N Vaswani; Kenneth J Ellis

226

Clinicopathological observations in middle cerebral artery occlusion in the cat.  

PubMed

This study was designed to investigate the relationships among neurological deficits, changes in the electroencephalogram (EEG) and morphological damage over a one week period following temporary occlusion (2 h) of the middle cerebral artery (MCA) in the cat. The animals were grouped into mild, moderate, and severe stroke based on the EEG alterations produced 30 min after the MCA occlusion. All three grades of stroke showed a precipitous fall in mean EEG amplitude followed by a recovery during a 4 h recirculation period. Over the subsequent 7 days there was a gradual secondary depression in the EEG amplitude. Post-operatively, a secondary fall in EEG amplitude in the contralateral hemisphere was also noted in all stroke groups corresponding to the clinical phenomenon of 'diaschisis'. The overall neurological score differed significantly among the severe, moderate, and mild stroke groups. The neurological deficits on the 7th day were highly correlated with the degree of morphological damage. Additionally, the reduction of EEG was also well correlated with the pathological data. This stroke model in the cat has provided important data concerning the restitution of brain function following chronic focal ischaemia. PMID:7609848

Komatsumoto, S; Greenberg, J H; Hickey, W F; Reivich, M

1995-04-01

227

Theoretical estimation of retinal oxygenation during retinal artery occlusion.  

PubMed

The aim of the present work was to simulate the oxygenation of the whole retina under normal conditions as well as during retinal ischemia. A differential equation describing how oxygen is transported from blood to tissue, diffuses through the tissue and is consumed according to Michaelis-Menten kinetics was constructed. The outer retina was divided into three regions of which one was set to have consumption. The inner retina was considered as one uniform region with respect to maximal rate of oxygen consumption and blood flow. The results suggest that extreme hyperoxia would be needed to make the choroid capable of supplying the whole retina during total retinal artery occlusion and moreover confirm that light might to some extent be beneficial. As supplying 100% oxygen by nose cannula or common oxygen mask can hardly increase the arterial oxygen tension to the levels needed to rescue the whole retina, the effects of oxygen treatment of total retinal artery occlusion are expected to be modest, both in darkness and light, unless a non-rebreather face mask system is used. PMID:15712729

Roos, Magnus W

2004-12-01

228

Recurrent occlusion of laser iridotomy sites after posterior chamber phakic IOL implantation.  

PubMed

We report a case of recurrent occlusion of laser iridotomy (LI) sites after a Visian ICL (Implantable contact lens version 4, Staar Surgical AG, Nidau, Switzerland) implantation. A 45-year-old woman had bilateral ICL implantation after placement of two peripheral LI sites in each eye to prevent pupillary block. At one month after the operation, severe narrowing or occlusion of four LI sites occurred. After this, although she received four additional LIs at postoperative months 1, 6, 9 and 10 in both eyes, the narrowing or occlusion recurred. Mild chronic anterior chamber inflammation was observed intermittently throughout the follow-up period. We performed clear lens extraction in both eyes (at postoperative month 11 in the left eye and month 26 in the right eye) due to recurrent occlusion of the LI sites and excess trabecular meshwork pigment deposition presumably caused by the four repeated LIs. Recurrent obstruction of LI sites can occur after ICL implantation. These problems were unresolvable despite four repeated laser iridotomies. The risks associated with anterior uveitis must be considered when planning an ICL implantation. PMID:18612232

Park, In Ki; Lee, Je Myung; Chun, Yeoun Sook

2008-06-01

229

Recurrent Occlusion of Laser Iridotomy Sites After Posterior Chamber Phakic IOL Implantation  

PubMed Central

We report a case of recurrent occlusion of laser iridotomy (LI) sites after a Visian ICL (Implantable contact lens version 4, Staar Surgical AG, Nidau, Switzerland) implantation. A 45-year-old woman had bilateral ICL implantation after placement of two peripheral LI sites in each eye to prevent pupillary block. At one month after the operation, severe narrowing or occlusion of four LI sites occurred. After this, although she received four additional LIs at postoperative months 1, 6, 9 and 10 in both eyes, the narrowing or occlusion recurred. Mild chronic anterior chamber inflammation was observed intermittently throughout the follow-up period. We performed clear lens extraction in both eyes (at postoperative month 11 in the left eye and month 26 in the right eye) due to recurrent occlusion of the LI sites and excess trabecular meshwork pigment deposition presumably caused by the four repeated LIs. Recurrent obstruction of LI sites can occur after ICL implantation. These problems were unresolvable despite four repeated laser iridotomies. The risks associated with anterior uveitis must be considered when planning an ICL implantation.

Park, In Ki; Lee, Je Myung

2008-01-01

230

21 CFR 878.4020 - Occlusive wound dressing.  

Code of Federal Regulations, 2013 CFR

... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing. (a) Identification. An occlusive...

2013-04-01

231

[Arteriovenous dissection for branch retinal vein occlusion].  

PubMed

Arteriovenous dissection (AVD) is a surgical maneuver to separate the retinal artery and vein at the crossing site in patients with branch retinal vein occlusion (BRVO). The published studies showed an evidence level 3. AVD seems to be maintainable in patients with recent onset of BRVO and decimal visual acuity < or =0.4. PMID:18317778

Feltgen, N; Hattenbach, L-O; Mirshahi, A; Hansen, L

2008-04-01

232

Infant Defensive Reactions to Visual Occlusion.  

ERIC Educational Resources Information Center

This paper describes the initial organization of the infant's reaction to having his vision occluded by an opaque cloth; traces the development of this reaction over the first six months; and probes the role the occlusion of vision plays in provoking the reaction. Fifty videotaped sessions of infants during two conditions - eyes covered with an…

Adamson, Lauren; Tronick, Edward

233

Chimney grafts in aortic occlusive disease.  

PubMed

The aim of this article was to present juxtavisceral aortic occlusive disease with particular reference to a novel therapeutic approach, namely protected stenting by means of so called chimney grafts. The juxta renal aortic occlusion is the last aortoiliac occlusive lesion not to be stented routinely because of the risk for trash and/or need for overstenting of vital aortic side branches. The risk for trash also exists in open repair which makes it particularly challenging in this setting. The patients have advanced atherosclerosis and are poor risks for major surgery. A safe endovascular approach is therefore desirable. These lesions are either predominantly thrombotic or heavily calcified plaques. The thrombotic lesions can be stented under protection of the visceral branches by temporary occlusion balloons. The calcified lesions, on the other hand, require overstenting of the visceral vessels that then need to be preserved by chimney grafts. These endovascular procedures are complex and time consuming but they are associated with less surgical trauma and hence improved morbidity, mortality and recovery. The median term results of chimney grafts are encouraging, although more patients and longer follow-up are still needed. PMID:24796899

Malina, M; Sonesson, B; Bin Jabr, A

2014-04-01

234

Management of Central Retinal Vein Occlusion  

Microsoft Academic Search

The management of central retinal vein occlusion (CRVO) is discussed briefly. Since the prognosis, complications, visual outcome and management of nonischemic and ischemic CRVO are very different, the first essential step in the management of CRVO is to determine which type of CRVO one is dealing with. The various parameters which help to differentiate the two types reliably are described

Sohan Singh Hayreh

2003-01-01

235

Central retinal vein occlusion and thrombophilia  

Microsoft Academic Search

Central retinal vein occlusion is one of the commonest vascular diseases of the eye. The pathogenesis is multifactorial with both local factors and systemic diseases being aetiologically important. Many thrombophilic conditions have recently been identified and studies looking at their potential role in CRVO have been undertaken. The aim of this review is to critically appraise these studies as to

C D Fegan

2002-01-01

236

Optociliary veins and central retinal vein occlusion  

Microsoft Academic Search

In a follow up of 94 patients with central retinal vein occlusion (CRVO) whose onset had taken place less than 1 year earlier, optociliary veins (OCVs) were found in 7.4% at first examination. Among the 79 eyes in which the fundus of the eye was very visible after a follow up of more than 1 year OCVs were found in

G Giuffrè; C Palumbo; G Randazzo-Papa

1993-01-01

237

Central retinal vein occlusion in young people  

Microsoft Academic Search

In a study performed on 20 subjects with central retinal vein occlusion (CRVO) aged 40 years or less we found the ischemic form in 20%. Disc edema was a common finding at the onset, while macular edema was less frequently seen. Systemic or ocular disorders that could be related with the development of the CRVO were often found; a patient

Giuseppe Giuffré; Gaetano Randazzo-Papa; Carlo Palumbo

1992-01-01

238

Local intraarterial fibrinolysis in acute vertebrobasilar occlusion  

Microsoft Academic Search

Local intraarterial fibrinolytic therapy (LIF) in patients with acute vertebrobasilar occlusion (AVBO) is a rational and if successful a life saving treatment. The recent progress in this field is determined by the use of microcatheters for superselective basilar artery catheterisation and a “short time, highdose” regimen using 750.000 IU Urokinase in not more than two h. Two out of 7

H. Zeumer; H.-J. Freitag; U. Grzyska; H.-P. Neunzig

1989-01-01

239

Circumflex coronary artery occlusion after blunt chest trauma.  

PubMed

A 32-year-old white male police officer suffered blunt trauma to the anterior chest wall during a routine training session. This was accompanied by the precipitous onset of chest discomfort. There was no previous history of any cardiac risk factors. The diagnosis of an inferior wall myocardial infarction was made based on the electrocardiogram findings, at his local community hospital. The total creatine kinase, creatine kinase-MB, and troponin I were normal. The transesophageal echocardiogram performed at that time demonstrated no aortic or coronary dissection. He was transferred to our tertiary care center. Emergency cardiac catheterization demonstrated lateral wall hypokinesis with a left ventricular ejection fraction of 45% and a total occlusion of the left circumflex coronary artery in its proximal portion. This was successfully recannulized with angioplasty and stenting techniques. We believe this to be only the second reported case of circumflex coronary artery obstruction after blunt chest trauma. PMID:12783632

Naseer, Nauman; Aronow, Wilbert S; McClung, John A; Sanal, Shirin; Peterson, Stephen J; Weiss, Melvin B; Frishman, William H

2003-01-01

240

Bilateral central retinal artery occlusions in an infant with hyperhomocysteinemia.  

PubMed

A previously healthy 7-week-old boy developed bilateral central retinal artery occlusions in the presence of hyperhomocysteinemia and elevated serum methylmalonic acid and was found to have a transcobalamin receptor mutation. Retinal arterial occlusion is uncommon in young patients and typically prompts a systemic workup. In cases of atypical retinal arterial occlusion, hyperhomocysteinemia should be investigated. PMID:22819238

Karth, Peter; Singh, Ravi; Kim, Judy; Costakos, Deborah

2012-08-01

241

Systemic diseases associated with various types of retinal vein occlusion  

Microsoft Academic Search

PURPOSE: To investigate systemic diseases associated with various types of retinal vein occlusion.METHODS: We investigated prospectively in 1090 consecutive patients with retinal vein occlusion, almost all Caucasian (consistent with the racial pattern here), the prevalence of associated systemic disorders before or at the onset of various types of retinal vein occlusion. The patients were categorized into six types of retinal

Sohan Singh Hayreh; Bridget Zimmerman; Mark J. McCarthy; Patricia Podhajsky

2001-01-01

242

Cardiovascular and thrombophilic risk factors for central retinal vein occlusion  

Microsoft Academic Search

Retinal vein occlusion (RVO) is a relatively common disease that is often associated with a variety of systemic disorders including arterial hypertension, diabetes mellitus, dyslipidemia, and systemic vasculitis. There are various types of RVO, categorized on the basis of the site of occlusion and on the type of consequent vascular damage. Central retinal vein occlusion (CRVO) is the most frequently

Domenico Prisco; Rossella Marcucci; Laura Bertini; Anna Maria Gori

2002-01-01

243

Detailed cross-sectional study of 60 superficial femoral artery occlusions: morphological quantitative analysis can lead to a new classification  

PubMed Central

Objective Current clinical classification of superficial femoral artery (SFA) occlusions as defined by TASC II guidelines is limited to length and calcifications analysis on 2D angiograms, while state-of-the-art cross-sectional imaging like computed tomography angiography (CTA) and magnetic resonance angiography (MRA) provides much more detailed anatomical information than traditional invasive angiography: quantitative morphological analysis of these advanced imaging techniques could therefore be the basis of a refined classification. Methods and results Forty-six patients (65% men, 68±11.6 years) that underwent lower limb CTA were retrospectively included, totalizing 60 SFA occlusions. Lesions were classified as TASC II stage A in 3% of cases, stage B in 20%, stage C in 2% and stage D in 75%. For each pathological artery, curved multiplanar reconstructions following the occluded SFA course were used to measure the total length and the mean diameter of the occluded segment. Color-coded map provided an accurate estimation of calcifications’ volume. Thirty-nine percent of the occlusions were total. Mean occluded segment length was 219±107 mm (range, 14-530 mm); mean occluded segment diameter was 6.1±1.6 mm (range, 3.4-10 mm); mean calcifications’ volume in the occluded segment was 1,265±1,893 mm3 (range, 0-8,815 mm3), corresponding to a percentage of 17.4%±20% (range, 0-88.7%). Shrinked occluded occlusions were defined by a mean diameter under 5 mm and heavily calcified occlusions by a mean percentage of calcifications above 4%. Use of these thresholds allowed the distinction of four groups of patients: heavily calcified occlusions with preserved caliber (56%), non-calcified occlusions with preserved caliber (19%), non-calcified occlusions with small caliber (15%) and heavily calcified occlusions with small caliber (10%). Conclusions SFA occlusions are disparate: this simple morphological study points out TASC II classification weaknesses for SFA occlusions, as quantitative cross-sectional imaging analysis with measurement of mean occluded diameter and percentage of calcifications can refine it. This could be particularly useful in the management of TASC II type D lesions, for which new endovascular revascularization techniques are arising, and where a CTA or MRA-based morphological classification could provide support in choosing between them. Keywords Computer-assisted image processing; femoral artery; multidetector computed tomography; magnetic resonance angiography (MRA); peripheral arterial disease

El Ghannudi, Soraya; Girsowicz, Elie; Lejay, Anne; Georg, Yannick; Thaveau, Fabien; Chakfe, Nabil; Roy, Catherine

2014-01-01

244

Inhibition of vascular nitric oxide after rat chronic brain hypoperfusion: spatial memory and immunocytochemical changes  

Microsoft Academic Search

An aging rat model of chronic brain hypoperfusion (CBH) that mimics human mild cognitive impairment (MCI) was used to examine the role of nitric oxide synthase (NOS) isoforms on spatial memory function. Rats with CBH underwent bilateral common carotid artery occlusion (2-vessel occlusion (2-VO)) for either 26 or 8 weeks and were compared with nonoccluded sham controls (S-VO). The neuronal

Jack C de la Torre; Gjumrakch Aliev; JC de la Torre

2005-01-01

245

Celiac axis stenosis in pancreatic head resection for chronic pancreatitis  

Microsoft Academic Search

Background and aims. To determine the outcome of pancreatic head resection for chronic pancreatitis in the presence of celiac axis stenosis or occlusion we analyzed the blood supply of the upper abdominal organs in 11 patients before and after surgery. Patients and methods. Between March 1994 and April 2000 we performed 145 pancreatic head resections for chronic pancreatitis. Preoperatively 11

Jörn Pfeiffenberger; Ulrich Adam; Oliver Drognitz; Jens C. Kröger; Frank Makowiec; Wolfgang Schareck; Ulrich T. Hopt

2002-01-01

246

Osteochondroma of the mandibular condyle: surgical excision followed by occlusal stabilization.  

PubMed

Osteochondroma of the mandibular condyle in adults can be treated by surgical excision, condylectomy followed by costochondral graft or orthognathic surgery. Such complex treatment plan may not be appropriate for patients with old age, affected with chronic osteochondroma of the condyle. In this clinical report, we present a patient with osteochondroma of the condyle treated by surgical excision. The patient's postoperative occlusion was a contraindication for orthognathic surgery because of the severe abrasion of the teeth and the chronic compensation of the dentition to the deviated mandible. Surgical excision of the lesion was carried out under general anesthesia, and the remaining condylar head was salvaged as much as possible. No graft materials or posthodontic condyle reconstruction was carried out. Because there was no occlusal stop to secure the mandible in a centric relation position of the condyle, a stabilization splint was delivered to position the condyle in a relatively stable position. The stability of the condyle position was evaluated by follow-up cone beam computed tomographic scans of the pathologic and the contralateral condyle, along with clinical factors such as occlusal contact points and mandible movements assayed by ARCUSdigma (KaVo). After significant condylar position was achieved, full prosthodontic reconstruction was performed to both the patient's and the dentist's satisfaction. PMID:22421872

Yoo, Ji-Yeon; Choi, Byung-Joon; Kwon, Yong-Dae; Lee, Deok-Won; Ohe, Joo-Young; Suh, Joon-Ho

2012-03-01

247

Myocardial thallium-201 kinetics during coronary occlusion and reperfusion: influence of method of reflow and timing of thallium-201 administration  

SciTech Connect

Thallium-201 (201Tl) uptake and redistribution kinetics were examined in an open-chest canine preparation of occlusion and reperfusion. Seven dogs (group I) underwent 3 hr of sustained occlusion and received 1.5 mCi of 201Tl after 40 min of occlusion of the left anterior descending coronary artery (LAD). Group II (n = 18) underwent 60 min of LAD occlusion followed by sudden and total release of the ligature. Group IIa (n = 8) received intravenous 201Tl during occlusion of the LAD, whereas group IIb (n = 10) received intravenous 201Tl at the time of peak reflow. Group III dogs (n = 26) also underwent 60 min of LAD occlusion that was followed by gradual reflow through a residual critical stenosis. Animals in this group also received 201Tl either before (IIIa; n = 16) or after reflow was established (IIIb; n = 10). In group I, the relative 201Tl gradient (nonischemic minus ischemic activity) decreased from 88 +/- 8% (mean +/- SEM) to 59 +/- 6% during 3 hr of coronary occlusion (p = .034). After rapid and total reperfusion (group IIa), this gradient decreased from 71 +/- 6% during occlusion to 26 +/- 5% after reflow (p less than .001). After slow reperfusion through a residual stenosis (group IIIa), the gradient decreased from 81 +/- 5% to 31 +/- 5% (p less than .001) (p = .56 compared with group IIa). In rapidly reperfused dogs receiving intravenous thallium during peak reflow (IIb), initial 201Tl activity in the ischemic zone was 155 +/- 20% of initial normal activity and fell to 93 +/- 13% of normal after 2 hr of reperfusion. In dogs reperfused slowly through a critical stenosis (IIIb), which received 201Tl during reflow, 201Tl activity soon after reflow was 94 +/- 4% of initial normal and decreased to 80 +/- 6% at 2 hr of reperfusion (p = .10). There was histochemical evidence of necrosis in the biopsy region in 80% of the 20 dogs subjected to triphenyl tetrazolium chloride staining.

Granato, J.E.; Watson, D.D.; Flanagan, T.L.; Gascho, J.A.; Beller, G.A.

1986-01-01

248

A case of veno-occlusive disease following liver transplantation  

PubMed Central

The present case report describes the diagnosis and treatment of a patient with veno-occlusive disease (VOD) following liver transplantation. Combining the clinical data and relevant literature, the study aimed to consider the causes of VOD following liver transplantation, and the pathogenesis, clinical diagnosis and auxiliary examination features of VOD. A 42-year-old man who had a long history of taking traditional Chinese medicine (essential components unknown) underwent an orthotropic liver transplantation on January 14, 2011, due to small venous occlusion disease of the liver. The patient was treated with tacrolimus as an antirejection therapy following the surgery, and gradually developed right upper quadrant pain and fatigue. The examination results were consistent with the diagnostic standards for VOD. Following treatment with methylprednisolone, the patient was treated with alprostadil and Danhong injections. Forty days later, the patient’s total bilirubin (TBIL) level was observed to have decreased significantly, the liver function had returned to normal and the ascites had decreased, but had not completely disappeared. The patient then underwent a transjugular intrahepatic portosystemic shunt (TIPS) procedure, following which the ascites were shown to have completely disappeared.

CHEN, HONG; WANG, XU; FAN, TIEYAN; LI, JUN; WANG, LETIAN; SHEN, ZHONGYANG

2014-01-01

249

Occlusion handling in videos object tracking: A survey  

NASA Astrophysics Data System (ADS)

Object tracking in video has been an active research for decades. This interest is motivated by numerous applications, such as surveillance, human-computer interaction, and sports event monitoring. Many challenges regarding tracking objects remain, this can arise due to abrupt object motion, changing appearance patterns of objects and the scene, non-rigid object structures and most significancly occlusion of tracked object (be it object-to-object or object-to-scene occlusions). Generally, occlusion in object tracking occurs under three situations: self-occlusion, inter-object occlusion by background scene structure. Self-occlusion most frequently arises while tracking articulated objects when one part of the object occludes another. Inter-object occlusion occurs when two objects being tracked occlude each other whereas occlusion by the background occurs when a structure in the background occludes the tracked objects. Typically, tracking methods handle occlusion by modelling the object motion using linear and non-linear dynamic models. The derived models will be used to continuously predicting the object location when a tracked object is occluded until the object reappears. Examples of these methods are Kalman filtering and Particle filtering trackers. Researchers have also utilised other features to resolved occlusion, for example, silhouette projections, colour histogram and optical flow. We will present some results from a previously conducted experiment when tracking single object using Kalman filter, Particle filter and Mean Shift trackers under various occlusion situations. We will also review various other occlusion handling methods that involved using multiple cameras. In a nutshell, the goal of this paper is to discuss in detail the problem of occlusion in object tracking and review the state of the art occlusion handling methods, classify them into different categories, and identify new trends. Moreover, we discuss the important issues related to occlusion handling including the use of appropriate selection of motion models, image features and use of multiple cameras.

Lee, B. Y.; Liew, L. H.; Cheah, W. S.; Wang, Y. C.

2014-02-01

250

Occlusion Handling in Videos Object Tracking: A Survey  

NASA Astrophysics Data System (ADS)

Object tracking in video has been an active research since for decades. This interest is motivated by numerous applications, such as surveillance, human-computer interaction, and sports event monitoring. Many challenges related to tracking objects still remain, this can arise due to abrupt object motion, changing appearance patterns of objects and the scene, non-rigid object structures and most significant are occlusion of tracked object be it object-to-object or object-to-scene occlusions. Generally, occlusion in object tracking occur under three situations: self-occlusion, inter-object occlusion by background scene structure. Self-occlusion occurs most frequently while tracking articulated objects when one part of the object occludes another. Inter-object occlusion occurs when two objects being tracked occlude each other whereas occlusion by the background occurs when a structure in the background occludes the tracked objects. Typically, tracking methods handle occlusion by modelling the object motion using linear and non-linear dynamic models. The derived models will be used to continuously predicting the object location when a tracked object is occluded until the object reappears. Example of these method are Kalman filtering and Particle filtering trackers. Researchers have also utilised other features to resolved occlusion, for example, silhouette projections, colour histogram and optical flow. We will present some result from a previously conducted experiment when tracking single object using Kalman filter, Particle filter and Mean Shift trackers under various occlusion situation in this paper. We will also review various other occlusion handling methods that involved using multiple cameras. In a nutshell, the goal of this paper is to discuss in detail the problem of occlusion in object tracking and review the state of the art occlusion handling methods, classify them into different categories, and identify new trends. Moreover, we discuss the important issues related to occlusion handling including the use of appropriate selection of motion models, image features and use of multiple cameras.

Lee, B. Y.; Liew, L. H.; Cheah, W. S.; Wang, Y. C.

2014-02-01

251

Fludarabine Phosphate and Total-Body Irradiation Followed by Donor Peripheral Blood Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia or Chronic Myelogenous Leukemia That Has Responded to Treatment With Imatinib Mesylate, Dasatinib, or Nilotinib  

ClinicalTrials.gov

Adult Acute Lymphoblastic Leukemia in Remission; Blastic Phase Chronic Myelogenous Leukemia; Childhood Acute Lymphoblastic Leukemia in Remission; Chronic Myelogenous Leukemia, BCR-ABL1 Positive; Chronic Phase Chronic Myelogenous Leukemia; Philadelphia Chromosome Positive Adult Precursor Acute Lymphoblastic Leukemia; Philadelphia Chromosome Positive Childhood Precursor Acute Lymphoblastic Leukemia; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Relapsing Chronic Myelogenous Leukemia

2014-07-22

252

Surgical and endovascular treatment of occlusive aortic syndromes.  

PubMed

Aortic occlusive syndromes encompass a wide variety of aortic and aortoiliac conditions that present with devastating clinical sequale of hypertension coupled with visceral and lower limb ischemia. Clinical presentations, natural history, etio-pathology, diagnosis, management and outcomes of each of these disorders is unique. Risk factor management, endovascular intervention, and/or surgical revascularization compete and complement each other in an exciting manner to give best long-term outcomes. Common causes of aortic occlusion include: 1) atherosclerotic occlusive disease, including aortoiliac occlusive diseases (AIOD); acute aortic occlusion (embolic/thrombotic/dissection; 2) mid aortic syndrome: Takayasu arteritis; congenital aortic hypoplasia; fibromuscular dysplasia; neurofibromatosis; 3) coral reef aorta. PMID:23443590

Verma, H; Baliga, K; George, R K; Tripathi, R K

2013-02-01

253

Changes in systolic and postsystolic wall thickening during acute coronary occlusion and reperfusion in closed-chest pigs: Implications for the assessment of regional myocardial function  

Microsoft Academic Search

The aim of the study was to characterize the impact of short-lived total coronary occlusions in closed-chest pigs on radial wall thickening within the “at-risk” myocardial segment by using gray-scale M-mode echocardiography. Twelve pigs underwent a series of 20-second total circumflex coronary artery occlusions with an angioplasty balloon. Myocardial thickening\\/thinning indexes were continuously monitored before ischemia, during ischemia, and on

Fadi Jamal; Monika Szilard; Tomasz Kukulski; Xiao-Shun Liu; Bart Bijnens; Frank Rademakers; Liv Hatle; Ivan De Scheerder; George R. Sutherland

2001-01-01

254

Total body irradiation correlates with chronic graft versus host disease and affects prognosis of patients with acute lymphoblastic leukemia receiving an HLA identical allogeneic bone marrow transplant  

Microsoft Academic Search

Purpose: To investigate whether different procedure variables involved in the delivery of fractionated total body irradiation (TBI) impact on prognosis of patients affected by acute lymphoblastic leukemia (ALL) receiving allogeneic bone marrow transplant (BMT).Methods and Materials: Ninety-three consecutive patients with ALL receiving a human leukocyte antigen (HLA) identical allogeneic BMT between 1 August 1983 and 30 September 1995 were conditioned

Renzo Corvò; Gabriella Paoli; Salvina Barra; Almalina Bacigalupo; Maria Teresa Van Lint; Paola Franzone; Francesco Frassoni; Daniele Scarpati; Andrea Bacigalupo; Vito Vitale

1999-01-01

255

Restoration of posterior teeth using occlusal matrix technique.  

PubMed

This article describes a technique for duplicating occlusal surface anatomy using the Biteperf device. Duplication requires an intact occlusal enamel surface and is only indicated when caries lesions are hidden. The occlusal matrix technique allows for preservation of all anatomic details. When the last layer of composite has been placed, the occlusal matrix is forced into the uncured composite to replicate the original occlusal surface, instead of performing manual curing and shaping as in the standard approach. It is technically possible to achieve this effect with any material that is able to copy anatomic details. The main benefits of the occlusal matrix technique, more precisely the Biteperf, are the technical ease of use due to its simplicity and its high accuracy in reconstructing occlusal morphology. PMID:21187632

Martos, Josu; Silveira, Luiz Fernando M; Ferrer-Luque, Carmen M; Gonzalez-López, Santiago

2010-01-01

256

Evaluation of the effectiveness of a semi-finished occlusal appliance - a randomized, controlled clinical trial  

PubMed Central

Introduction Painful temporomandibular disorders (TMDs) are usually treated with physiotherapy, self-exercises, medication-based therapy and splint therapy. For splint therapy different types of splints are available. Therefore this randomized controlled study compared the effectiveness of a semi-finished occlusal appliance (SB) with a laboratory-made occlusal appliance (SS) in myofascial pain patients. Method The trial subjects allocated to the experimental groups with the (SB) occlusal appliance and those provided with a laboratory-made occlusal appliance (SS) did, in addition, receive conservative treatment (self-exercises, drug-based and manual therapy). The control group was given conservative therapy (CO) only. Overall, a total of 63 patients participated in the study with each group consisting of 21 subjects. Results When the first follow-up examination took place (14 days after splint insertion) mouth opening within the SB group was significantly enlarged. When the second examination was conducted (2.5 months after splint insertion) mouth opening was significantly enlarged in both splint groups when compared with the initial value. In the control group, no significant enlargement of mouth opening was detected. At no point there was a significant reduction in the number of pressure-sensitive areas of the TMJ. On palpation of the masticatory muscles however, a significant reduction in the number of pressure-sensitive areas could be observed within the CO group and the SS group after 2.5 months. When comparing pain reduction (muscle/joint pain) and mouth opening, no significant differences could be detected between the treatments. Conclusion The results suggest that TMD should be treated conservatively. In cases of restricted mouth opening, the additional use of occlusal appliances can eliminate the patient’s discomfort more quickly. In this context, the tested, semi-finished occlusal appliance appears to offer an immediately available, temporary alternative to laboratory-made splints.

2013-01-01

257

Local cerebral blood flow during and after bilateral carotid artery occlusion in unanesthetized gerbils.  

PubMed

Using [14C]iodoantipyrine autoradiography, we measured regional cerebral blood flow in unanesthetized gerbils subjected to 2 (n = 5) or 30 (n = 6) minutes of bilateral carotid artery occlusion or 5 (n = 6), 30 (n = 6), or 120 (n = 5) minutes of reflow after 30 minutes of occlusion. Blood pressure, respiratory rate, and blood gases were recorded, and these and other gerbils were evaluated with periodic neurologic examinations. Blood flow to structures above the level of the diencephalon ceased almost totally during occlusion. The lateral thalamus, the rostral three quarters of the hypothalamus, and the superior colliculi were also markedly ischemic. Blood flow to the brainstem and cerebellum was only slightly affected. After release of the occlusion, blood flow was restored in some of the affected areas but to levels somewhat below that in eight sham-operated gerbils. In several areas, principally column-shaped areas in the cortex as well as patchy areas in other structures, blood flow did not recover. This inhomogeneous blood flow distribution lasted at least 30 minutes after release of the occlusion. Thereafter, the inhomogeneity slowly disappeared in such a manner that blood flow to originally well reperfused areas appeared to decrease while that to poorly reperfused areas increased. During reflow, blood flow in the brainstem and cerebellum slowly and continuously decreased. We show that there is an early no-reflow phenomenon that is inhomogeneous and appears to be of vascular origin and lasts approximately 30 minutes after release of the occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2349594

Nadasy, G L; Greenberg, J H; Reivich, M; Kovach, A G

1990-06-01

258

Electroretinography in central retinal vein occlusion  

Microsoft Academic Search

In 149 eyes with central retinal vein occlusion (CRVO), we prospectively investigated the role of routine, clinical electroretinography (ERG) in differentiating ischemic (60 eyes) from nonischemic CRVO (89 eyes). Single-flash photopic and scotopic ERGs were recorded. Data for the amplitudes and implicit times of a- and b-waves and for the b-\\/a-wave amplitude ratio were analyzed in detail. The study revealed

Sohan Singh Hayreh; Marie R. Klugman; Patricia Podhajsky; Hansjoerg E. Kolder

1989-01-01

259

Interventional Treatment of Mesenteric Venous Occlusion  

PubMed Central

Summary Background Mesenteric venous thrombus may be an incidental finding during imaging studies and asymptomatic patients are treated conservatively or with anticoagulant therapy only. Patients with symptomatic acute thrombosis causing bowel ischemia require urgent treatment, which frequently includes extensive surgery. Interventional treatment may be an alternative. Purpose: To present results of interventional treatment in patients with symptomatic occlusion of the mesenteric veins. Material/Methods Eight patients, four men and four women aged 24–74 years (mean 53 years) were treated due to symptomatic portomesenteric venous occlusion of thrombotic origin. Transhepatic (n=5), trans-splenic (n=2), and transjugular (n=4) accesses were used. Patients were treated with mechanical thrombus fragmentation (n=4), pharmacological thrombolysis (n=3) and stent placement (n=8). Additional transjugular intrahepatic portosystemic shunt (TIPS) was created to facilitate the outflow from the treated veins (n=4). Results The majority of the patients required combination of different treatment methods. Resolution of symptoms with initial clinical success was achieved in seven of the eight patients, and one patient died the day after the procedure due to sepsis. Two other patients had procedure-related complications; one of them required embolization. Two patients had documented long-term clinical success with patent stents and no symptoms at one year following intervention. Conclusions Endovascular treatment of portomesenteric occlusion in patients with acute symptomatology showed good short-term clinical success rate.

Wichman, Heather J.; Cwikiel, Wojciech; Keussen, Inger

2014-01-01

260

A case of cilioretinal artery occlusion resembling hemicentral retinal artery occlusion  

PubMed Central

A 77-year-old man presented with an inferior hemivisual field defect in the left eye. Funduscopy revealed well demarcated retinal edema of the superior quadrant resembling hemicentral retinal artery occlusion. Further, the upper and inferior retinal arteries emerged separately from the optic disc. Fluorescein angiography demonstrated a marked filling delay of the upper retinal artery. We repeated fluorescein angiography, which showed that the involved upper retinal artery was a cilioretinal artery having an earlier dye appearance than the lower retinal artery. We suggest that when cases of hemicentral retinal artery occlusion are encountered, vascular architecture at the optic disc should be evaluated carefully.

Makino, Shinji; Ohkawara, Yuriko; Sato, Yukihiro

2012-01-01

261

TTC, Fluoro-Jade B and NeuN staining confirm evolving phases of infarction induced by middle cerebral artery occlusion  

Microsoft Academic Search

Considerable debate exists in the literature on how best to measure infarct damage and at what point after middle cerebral artery occlusion (MCAO) infarct is histologically complete. As many researchers are focusing on more chronic endpoints in neuroprotection studies it is important to evaluate histological damage at later time points to ensure that standard methods of tissue injury measurement are

Fudong Liu; Dorothy P. Schafer; Louise D. McCullough

2009-01-01

262

Investigation of Chlamydia pneumoniae DNA, chlamydial lipopolisaccharide antigens, and Helicobacter pylori DNA in atherosclerotic plaques of patients with aortoiliac occlusive disease  

Microsoft Academic Search

Background and IntroductionIt has been suggested that chronic infections may have a role in both the initiation and progression of atherosclerosis. While the majority of available data are focused on coronary artery disease, our aim was to investigate the presence of Chlamydia pneumoniae and Helicobacter pylori in samples from aortoiliac occlusive disease.

Islam Kaklikkaya; Nese Kaklikkaya; Kurtulu? Buruk; Zerrin Pulathan; Ismail Koramaz; Faruk Aydin; Ilknur Tosun; Ali Osman Kilic; Fahri Özcan

2006-01-01

263

Clinical Results of Percutaneous Transluminal Angioplasty and Stenting for Intracranial Vertebrobasilar Atherosclerotic Stenoses and Occlusions  

PubMed Central

Summary Eighteen patients with intracranial vertebrobasilar stenosis and occlusion were treated by PTA or stenting. In 11 of 18 cases, only PTA was performed and in seven of 18 cases, we used stents. The mean stenosis before and after PTA/stenting was 82.8% and 22.3%, respectively. In 11 cases of PTA only, the stenotic rate decreased from 81.8% to 29.6%, while 85.0% of the stenotic rate remarkably reduced to 6.0% in seven cases of stenting. The 30 days morbidity and 30 days mortality rate were 5.5% and 5.5%, respectively. There was only one haemorrhagic complication (cerebellar haemorrhage) in cases of stenting, and no ischemic events during or after the procedures. Restenosis (more than 50% stenosis) occurred in four of 18 cases(22.2%) during mean follow-up period of 12 months. Two patients with VA occlusion before treatment, developed restenosis and reocclusion. Complete total occlusion seems to be a high-risk lesion and strict follow-up is required. In this study, PTA/stenting for intracranial vertebrobasilar artery stenosis or occlusion is an effective treatment, but strict indications may be required because procedure-related 30 days morbidity rate was 5.5% in addition to unclear natural history.

Tsuura, M.; Terada, T.; Masuo, O.; Tsumoto, T.; Yamaga, H.; Itakura, T.; Matsumoto, H.; Hyoutani, G.; Hayashi, S.

2004-01-01

264

Japanese Registry of Neuroendovascular Therapy: extracranial steno-occlusive diseases except for internal carotid artery stenosis.  

PubMed

Although utilization of endovascular treatment of extracranial steno-occlusive lesions except for internal carotid artery stenosis continues to increase, there is no consensus regarding the natural course and standard treatment of these lesions. The aim of this study was to characterize the utility of endovascular treatment for extracranial steno-occlusive lesions except for internal carotid artery stenosis. A total of 1249 procedures for extracranial steno-occlusive lesions were identified from the Japanese Registry of Neuroendovascular Therapy (JR-NET) and JR-NET2. Excluding the cases of carotid lesions (290 cases), endovascular procedures were performed for 471 (37.7%) subclavian artery stenoses, 404 (32.3%) extracranial vertebral artery stenoses, and 38 (3.0%) innominate artery stenoses with a technical success rate of 97.2%. A stent was placed for 783 lesions and percutaneous transluminal angioplasty was performed for 183 lesions. Forty complications were reported in this cohort. Among these, ischemic complications were the most frequent (12 cases). Comparison between JR-NET1 and JR-NET2 demonstrated a marked increase in the number of procedures, a change in the utilization of antiplatelet therapy, and an increased rate of favorable outcome. We conclude that the endovascular treatment for extracranial steno-occlusive lesions is relatively safe. Continuous efforts should be made to reduce the complication rate, and further trials are needed to validate the beneficial effect of this procedure. PMID:24257542

Kikuchi, Takayuki; Ishii, Akira; Nakahara, Ichiro; Miyamoto, Susumu; Sakai, Nobuyuki

2014-01-01

265

Diazoxide and dimethyl sulphoxide prevent cerebral hypoperfusion-related learning dysfunction and brain damage after carotid artery occlusion  

Microsoft Academic Search

Chronic cerebral hypoperfusion, a mild ischemic condition is associated with advancing age and severity of dementia; however, no unanimous therapy has been established to alleviate related neurological symptoms. We imposed a permanent, bilateral occlusion of the common carotid arteries of rats (n=18) to create cerebral hypoperfusion. A mitochondrial ATP-sensitive K+ channel opener diazoxide (DZ, 5 mg\\/kg) or its solvent dimethyl

Eszter Farkas; Ádám Institóris; Ferenc Domoki; András Mihály; Paul G. M. Luiten; Ferenc Bari

2004-01-01

266

A prospective follow-up study of panretinal photocoagulation in preventing neovascular glaucoma following ischaemic central retinal vein occlusion  

Microsoft Academic Search

Fifteen consecutive eyes with central retinal vein occlusion (CRVO) and extensive capillary non-perfusion were treated by\\u000a panretinal photocoagulation using argon laser. Of these eyes six had chronic glaucoma and one had acute angle-closure glaucoma\\u000a when first seen. One developed neovascular glaucoma before treatment. After photocoagulation iris new vessels appeared in\\u000a two eyes with preexisting glaucoma. In one case the new

L. Laatikainen

1983-01-01

267

Methodological challenges in the study of dental occlusion.  

PubMed

This narrative review describes the methodological challenges in the study of dental occlusion. The reigning confusion about the scope of this topic is discussed, and a conceptual framework for understanding dental occlusion research is suggested. The characteristics of clinical studies used in the study of dental occlusion are presented within this proposed framework consisting of a triad comprising the relative positions of the teeth-mandible-maxilla, the oral functions and oral appearance. Challenges in the preparation for a clinical study of dental occlusion are reviewed, which include a discourse on the objectives of a clinical study and appropriateness of different study designs. Guidelines are provided for the conduct of studies with a central focus on dental occlusion and diagnostic tests, prognosis, therapy and aetiology, respectively. Summarising chapters present methodological challenges in designing a clinical study of dental occlusion and threats to the proper conduct of a clinical study. PMID:22435482

Jokstad, A

2012-07-01

268

Paraplegia after aortic and superior mesenteric artery stenting for occlusive disease.  

PubMed

Paraplegia after endovascular therapy for aortic and visceral artery occlusive disease is an extremely uncommon occurrence. Two cases of paraplegia after placement of an aortic covered stent for infrarenal aortic stenosis and a superior mesenteric artery stent for chronic visceral ischemia are presented. In both patients, embolization of the arterial supply to the spinal cord was the presumed cause. One patient had a slight recovery after intense physical therapy and rehabilitation. The second patient did not have any recovery from her paraplegia. PMID:24295883

Hans, Sachinder S; Ngo, William; McAllister, Michael

2014-02-01

269

Alt ekstremite gecikmi? tromboembolik arteriyel tikanmalarda ayni seansta embolektomi ve kapali fasiyotomi beraberli?i Accompanying embolectomy and closed fasciotomy in the same session for the delayed arterial thromboembolic occlusions in lower extremity  

Microsoft Academic Search

Objective: We aimed to compare the postoperative complications in patient with acute lower extremity arterial occlusion who admitted in the late period in whom accompanying embolectomy and fasciotomy in the same session and fasciotomy following embolectomy were applied, because of development of compartment syndrome. Methods: A total of 36 patients (13 female, 23 male) with acute lower extremity arterial occlusion,

Adem Güler; Mehmet Ali; Kubilay Karabacak; Harun Tatar

270

Formation of retinochoroidal collaterals in central retinal vein occlusion  

Microsoft Academic Search

Purpose: To demonstrate the drainage routes that compensate the venous congestion in central retinal vein occlusion.Methods: Indocyanine green angiography was performed in 13 eyes of 13 patients with central retinal vein occlusion at the involutional stage using a scanning laser ophthalmoscope. The interval between onset of central retinal vein occlusion and indocyanine green angiography ranged from 1.0 to 9.3 years

Kyoichi Takahashi; Kanemitsu Muraoka; Shoji Kishi; Koichi Shimizu

1998-01-01

271

The occlusal guard: a simplified technique for fabrication and equilibration.  

PubMed

Hard occlusal guards have been used effectively to treat myofacial pain originating from parafunctional activities. Also, they can protect the natural dentition when it opposes porcelain restorations, help to evaluate changes in occlusal vertical dimension during full mouth rehabilitation, minimize further tooth loss in patients with abfraction lesions, and redirect occlusal loads more favorably onto dental implant-supported prostheses. A simplified technique is described to fabricate a properly designed wax model of an occlusal guard that can be processed in acrylic in the same manner used to construct a complete denture. PMID:23649575

Antonelli, John; Hottel, Timothy L; Siegel, Sharon C; Brandt, Robert; Silva, Gladston

2013-01-01

272

Doppler diagnosis of intracranial artery occlusive disorders.  

PubMed Central

Pulsed wave 2 MHz Doppler with acoustical focusing was used to obtain blood flow velocity recordings through the intact cranium in 11 patients with occlusive disease of major intracranial arteries. Increased blood flow velocities were recorded from stenoses of the carotid siphon and of the middle cerebral, anterior cerebral and basilar arteries. A clear, inverse relationship existed between angiographical residual lumen diameter and flow velocity. The Kendall rank correlation coefficient (Tau) was -0.89 (p = 0.0001). Transcranial Doppler is a useful means for evaluating patients with this disorder. Images

Lindegaard, K F; Bakke, S J; Aaslid, R; Nornes, H

1986-01-01

273

Trigeminal trophic syndrome treated with thermoplastic occlusion.  

PubMed

A 72-year-old man with a history of thrombotic CVA causing lateral medullary infarction presented with non-healing ulcers of the right side of the face of 5 months' duration. After extensive investigations, a diagnosis of trigeminal trophic syndrome was made. The ulcers progressed relentlessly despite amitriptyline and gabapentin, and he was treated with a combination of carbamazepine and thermoplastic mask occlusion of the right side of his face. Over the next 10 weeks the shallower facial ulcers began to diminish in depth and diameter, and the deeper ulcers stopped progressing. Although the patient showed early signs of healing, he died because of complications from the CVA. PMID:21332680

Kurien, Anil M; Damian, Diona L; Moloney, Fergal J

2011-02-01

274

Clobetasol propionate 0.05% under occlusion in the treatment of alopecia totalis\\/universalis  

Microsoft Academic Search

Background: Efficacy of topical steroids in alopecia areata is still discussed. Objective: The purpose of this study was to evaluate the efficacy of clobetasol propionate 0.05% ointment under occlusion in 28 patients with alopecia areata totalis (AT) or AT\\/alopecia universalis. Methods: A total of 28 patients were instructed to apply 2.5 g of clobetasol propionate to the right side of

Antonella Tosti; Bianca Maria Piraccini; Massimiliano Pazzaglia; Colombina Vincenzi

2003-01-01

275

Occlusion Shadows: Using Projected Light to Generate Realistic Occlusion Effects for View-Dependent Optical See-Through Displays  

Microsoft Academic Search

This paper presents projector-based illumination techniques for creating correct occlusion effects for optical see-through setups. We project view-dependent occlusion shadows onto the real surfaces that are located behind virtual objects. This results in a perfect occlusion of real objects by virtual ones. We have implemented and tested our approach in the context of the Virtual Showcase display. We describe hardware

Oliver Bimber; Bernd Fröhlich

2002-01-01

276

Recanalization of Acute and Subacute Femoropopliteal Artery Occlusions with the Rotarex Catheter: One Year Follow-up, Single Center Experience  

SciTech Connect

Purpose:To assess the efficacy and safety of a new rotational catheter for percutaneous removal of fresh and organized thrombi in the femoropopliteal artery.Methods:Forty-one limbs in 38 patients (age 56-90 years, mean 75.6 years) with acute, subacute or chronic femoropopliteal occlusions of 1-180 days' duration (mean 31.6 days) were treated with the Rotarex device. The Fontaine stage was mainly IIB (Rutherford 2-3, 22 patients) or III (Rutherford 4, 14 patients). The length of occlusion varied from 2 to 35 cm (mean 13.1 cm). After recanalization percutaneous transluminal angioplasty (PTA) was performed if there was a residual stenosis of >25%. Patients were followed up with color Doppler ultrasound at 48 hr and clinically with Doppler pressures and oscillometry at 3, 6, and 12 months.Results:After an average of two passages with the Rotarex catheter all but two limbs required PTA for residual stenosis >25%. Five patients needed additional stenting. Major complications were one groin hematoma requiring blood transfusion and one arteriovenous fistula spontaneously thrombosing after unsuccessful primary prolonged balloon dilation. Distal embolizations occurred in 10 patients; 6 clinically relevant emboli were aspirated. All occlusions were technically successfully recanalised there were 2 early reocclusions after 1 day and two at 2 weeks. Brachial-ankle indices improved from an average of 0.41 before to 0.93 after recanalization. Primary and secondary patency rates were 62% / 84% after 6 months and 39% / 68% after 1 year. The amputation-free survival at 12 months was 100%.Conclusion:The Rotarex mechanical thrombectomy device is an efficient, quick, easy to handle, and safe tool for the treatment of acute, subacute or even chronic peripheral arterial thromboembolic occlusions. It can be used for short or long occlusions with equal success, provided the obstruction is not heavily calcified and has been safely passed with a guidewire first.

Duc, Sylvain R., E-mail: Sylvain.duc@balgrist.ch; Schoch, Eric [Kantonsspital Winterthur, Department of Radiology (Switzerland); Pfyffer, Markus; Jenelten, Regula [Section of Angiology, Kantonsspital Winterthur, Department of Internal Medicine (Switzerland); Zollikofer, Christoph L. [Kantonsspital Winterthur, Department of Radiology (Switzerland)

2005-06-15

277

Smile line and occlusion: An epidemiological study  

PubMed Central

Background: The purpose of the present study was to discuss some new concepts of the desirable characteristics of smile tooth display. Due to the increasing application of cosmetic dental treatments, there is an increasing need for better understanding of the esthetic principles. Materials and Methods: In the present descriptive study, with 212 participants, included were patients with no history of orthodontic treatment, loss or prosthetic replacement of anterior teeth, extracted teeth, lips with asymmetry or a history of trauma. Chi-square test was used to determine possible significances in the relation of smile line to Angle occlusion class, overbite and overjet and arch form. A P level of <0.05 was set as to be significant. Results: Chi-square test indicated that there was a significant difference between the smile design and overbite, overjet and gender but no statistically significant association was found between the smile design and crossbite, molar Angle classification and arch form. Conclusion: Within the limitations of such studies, it might be concluded that there is a significant and important relation between some occlusal parameters and smile design, which must be considered.

Harati, Mahsa; Mostofi, Shahbaz Naser; Jalalian, Ezzatollah; Rezvani, Gholamreza

2013-01-01

278

Regressing intracranial carotid occlusions in childhood.  

PubMed

Though detected with increasing frequency, intracranial carotid artery dissection remains less common in infancy. We report on 3 otherwise healthy children aged 8, 12 and 15 years who presented with focal headache and stroke secondary to intracranial carotid occlusive disease consistent with arterial dissection. In 2 cases this was precipitated by strenuous physical exertion. The protean angiographic configuration included long tapered narrowing with focal stenosis, beaded narrowing with Moya Moya vascular network and 'string sign'; occlusion of the anterior cerebral artery was always present. Control angiograms revealed complete or partial recanalization in all cases suggesting self-healing dissection. The clinical course was smooth in all patients, and at long-term follow-up (5, 3, and 2 years) they remain in good neurological condition. Although intracranial carotid dissection has a poor reputation, regression to normal and fair outcome may sometimes occur as in the extracranial counterpart, suggesting the existence of benign forms of the disease. Surgical procedures should be weighed against the spontaneous resolution of the lesion. PMID:7865410

Pozzati, E; Galassi, E; Godano, U; Cordella, L

1994-01-01

279

Numerical analysis of human dental occlusal contact  

NASA Astrophysics Data System (ADS)

The purpose of this study was to obtain real contact areas, forces, and pressures acting on human dental enamel as a function of the nominal pressure during dental occlusal contact. The described development consisted of three steps: characterization of the surface roughness by 3D contact profilometry test, finite element analysis of micro responses for each pair of main asperities in contact, and homogenization of macro responses using an assumed probability density function. The inelastic deformation of enamel was considered, adjusting the stress-strain relationship of sound enamel to that obtained from instrumented indentation tests conducted with spherical tip. A mechanical part of the static friction coefficient was estimated as the ratio between tangential and normal components of the overall resistive force, resulting in ?d = 0.057. Less than 1% of contact pairs reached the yield stress of enamel, indicating that the occlusal contact is essentially elastic. The micro-models indicated an average hardness of 6.25GPa, and the homogenized result for macroscopic interface was around 9GPa. Further refinements of the methodology and verification using experimental data can provide a better understanding of processes related to contact, friction and wear of human tooth enamel.

Bastos, F. S.; Las Casas, E. B.; Godoy, G. C. D.; Meireles, A. B.

2010-06-01

280

Parent Artery Occlusion for Intracranial Aneurysms  

PubMed Central

Summary Peripheral cerebral aneurysms are difficult to treat with preservation of the parent arteries. We report the clinical and angiographic outcome of 12 patients with cerebral aneurysms located peripherally. In the past five years, 12 patients, six females and six males, presented at our institution with intracranial aneurysms distal to the circle of Willis and were treated endovascularly. The age of our patients ranged from four to 58 years with a mean age of 37 years. Seven of the 12 patients had subarachnoid and/or intracerebral hemorrhage upon presentation. Two patients with P2 dissecting aneurysms presented with mild hemiparesis and hypoesthesia, one patient with a large dissecting aneurysm complained of headaches and two patients with M3 dissecting aneurysms had mild hemiparesis and hypoesthesia of the right arm. Locations of the aneurysms were as follows: posterior cerebral artery in seven patients, anterior inferior cerebellar artery in two, posterior inferior cerebellar artery in one, middle cerebral artery in two. Twelve patients with peripheral cerebral aneurysms underwent parent artery occlusion (PAO). PAO was performed with detachable coils. No patient developed neurologic deficits. Distally located cerebral aneurysms can be treated with parent artery occlusion when selective embolization of the aneurysmal sac with detachable platinum coils or surgical clipping cannot be achieved.

Cui, Lishan; Peng, Qiang; Ha, Wenbo; Zhou, Dexiang; Xu, Yang

2009-01-01

281

40 CFR 180.1148 - Occlusion Bodies of the Granulosis Virus of Cydia pomenella; tolerance exemption.  

Code of Federal Regulations, 2013 CFR

...false Occlusion Bodies of the Granulosis Virus of Cydia pomenella; tolerance exemption...1148 Occlusion Bodies of the Granulosis Virus of Cydia pomenella; tolerance exemption...agent Occlusion Bodies of the Granulosis Virus of Cydia pomonella (codling...

2013-07-01

282

Importance of occlusion aspects in the completion of orthodontic treatment.  

PubMed

The purpose of this study was to address the therapeutic goals regarding the static and functional occlusion in the completion of orthodontic treatment. For such purpose, a study population comprising 20 female treated Class II malocclusion subjects with an initial mean age of 11 years underwent a two-phase treatment (orthopedics and orthodontics). The patients were diagnosed in centric relation and were treated according to the six keys for normal occlusion and functional occlusal parameters (centric relation, vertical dimension, lateral and anterior guidances, occlusal contacts and direction of forces applied on the teeth). After removal of fixed mechanics, retainers were installed and maintained for two years. Five years after orthodontic completion, the occlusal stability of the patients was evaluated regarding molar relationship and overjet, measured in dental casts. All subjects maintained the normal molar relationship and correct overjet achieved at the end of treatment, indicating a fair level of occlusal stability. The importance of the criteria of the ideal functional occlusion to ensure a better stability after completion orthodontic treatment will be discussed in detail in this paper. In addition, some clinical situations in which localized adjustments are indicated for occlusal refinement will be described. PMID:17639207

Oltramari, Paula Vanessa Pedron; Conti, Ana Cláudia de Castro Ferreira; Navarro, Ricardo de Lima; Almeida, Márcio Rodrigues de; Almeida-Pedrin, Renata Rodrigues de; Ferreira, Fernando Pedrin Carvalho

2007-01-01

283

Effect of occlusion of a tracheotomy tube on aspiration  

Microsoft Academic Search

The purpose of the present study was to investigate the effect of occlusion of a tracheotomy tube on aspiration utilizing fluoroscopy. Twenty consecutive tracheotomized patients referred for a modified barium swallow were included. Selection criteria were ability to tolerate tracheotomy tube occlusion during the modified barium swallow procedure, no surgery of the upper aerodigestive tract except tracheotomy, and no history

Steven B. Leder; John M. Tarro; Morton I. Burrell

1996-01-01

284

Guide wire extension for shape memory polymer occlusion removal devices  

DOEpatents

A flexible extension for a shape memory polymer occlusion removal device. A shape memory polymer instrument is transported through a vessel via a catheter. A flexible elongated unit is operatively connected to the distal end of the shape memory polymer instrument to enhance maneuverability through tortuous paths en route to the occlusion.

Maitland, Duncan J. (Pleasant Hill, CA); Small, IV, Ward (Livermore, CA); Hartman, Jonathan (Sacramento, CA)

2009-11-03

285

Coronary artery spatial distribution of acute myocardial infarction occlusions  

Microsoft Academic Search

Study Question: Acute coronary occlusions leading to ST-segment elevation myocardial infarctions (STEMIs) are due primarily to rupture of atherosclerotic plaques. Present “vulnerable plaque” detection technology focuses on identifying individual plaques with no clear therapeutic plan beyond conventional risk-factor reduction. The investigators developed a spatial map of the distribution of acute coronary occlusions to test our hypothesis that plaque ruptures do

J. C. Wang; S. T. Normand; L. Mauri; R. E. Kuntz

2004-01-01

286

A multi-target tracking approach combined with occlusion segmentation  

Microsoft Academic Search

Multiple-target tracking in complex scenes is one of the most complicated problems in computer vision. Handling the occlusion between objects is the key issue in multiple target tracking. This paper presents an occlusion segmentation-based method to track multiple people in complex situations which are captured by static monocular cameras. In the proposed method, we calculate the probabilistic histogram of each

Huan Ding; Wensheng Zhang

2011-01-01

287

Graphical Model Approach to Iris Matching Under Deformation and Occlusion  

Microsoft Academic Search

Template matching of iris images for biometric recognition typically suffers from both local deformations between the template and query images and large occlusions from the eyelid. In this work, we model deformation and occlusion as a set of hidden variables for each iris comparison. We use afield of directional vectors to represent deformation and a field of binary variables to

Ryan Kerekes; Balakrishnan Narayanaswamy; Jason Thornton; Marios Savvides; B. V. K. Vijaya Kumar

2007-01-01

288

Traumatic carotid artery occlusion following blunt cervical injury  

Microsoft Academic Search

Two cases of overlooked, traumatic unilateral occlusion of the carotid artery are reported. Postmortem revealed occlusion of the internal carotid artery in one case and that of the common carotid artery in another. The progression of the morbid state, along with the management with emphasis on the significance of the carotid angiogram and follow-up repeated computed tomography are mentioned. Although

Arum Kumara Singh; Hiroshi Okudera; Shigeaki Kobayashi

1999-01-01

289

OCCLUSION-HANDLING FOR IMPROVED PARTICLE FILTERING-BASED TRACKING  

Microsoft Academic Search

One of the particle filtering uses is object tracking since this tech- nique permits to deal with uncertainty over time met in real time image sequences framework. This uncertainty is as m uch non- manageable that an object occlusion appears in imag es. In this paper, we propose an occlusion-handling scheme which signifi- cantly improves the tracking performance in presenc

Raphaël Canals; Ali Ganoun; Rémy Leconge

2009-01-01

290

Thrombotic Occlusion of Bjork-Shiley Prosthetic Aortic Valve  

Microsoft Academic Search

Thrombotic occlusion of a prosthetic Bjork-Shiley valve is a potentially fatal complication. We present the case of a male, 62 years of age, diagnosed with thrombotic occlusion of prosthetic Bjork-Shiley aortic valve approximately 17 years post implantation. A brief review of the literature focusing on potential risk factors associated with the development of this condition and currently available diagnostic modalities

Sumeesh Dhawan; Param Sharma

2003-01-01

291

Occlusion analysis: Learning and utilising depth maps in object tracking  

Microsoft Academic Search

Complex scenes such as underground stations and malls are composed of static occlusion structures such as walls, entrances, colu mns, turnstiles, bar- riers, etc. Unless this occlusion landscape is made explicit such structures can defeat the process of tracking individuals through the scene. This paper describes a method of generating the probability density functions (PDFs) for the depth of the

Darrel Greenhill; John-paul Renno; James Orwell; Graeme A. Jones

2008-01-01

292

Cilioretinal arterial circulation in central retinal vein occlusion  

Microsoft Academic Search

The hypothesis that an occlusion of the central retinal artery is an essential prerequisite for haemorrhage formation after central retinal vein obstruction has been investigated by examining the fundus changes in patients with a cilio-retinal arterial circulation; the findings are at variance with the 'combined occlusion hypothesis'. Comparisons were made between the pathological features in two retinal capillary beds with

D McLeod

1975-01-01

293

The relationship between anticardiolipin antibodies and vascular access occlusion in patients on hemodialysis.  

PubMed

Vascular access occlusion is frequently seen in some patients on hemodialysis. There are different opinions about pathogenesis of recurrent access thrombosis. Anticardiolipin (aCL) antibodies have been suggested to be involved in thrombosis and can be found in a high proportion of patients with chronic renal failure. We investigated the relationship between vascular access occlusion and the level of aCL antibodies in hemodialysis patients. We measured serum IgG and IgM aCL antibodies and protein C levels in 50 patients on hemodialysis having no fistule thrombosis (group 1), in 33 patients on hemodialysis with fistule thrombosis (group 2), and 20 nondialyzed patients with chronic renal failure (group 3). There were no differences in age and duration on hemodialysis (p > 0.05). No significant correlation was found between protein C and platelet counts in all groups (p > 0.05). In group 1, aCL IgG and IgM were 2%. In group 2, aCL IgG and IgM were 6.06% and 0%, respectively. In group 3, aCL IgG and IgM were negative. We did not find any significant difference between aCL IgG and IgM in all groups (p > 0.05). No association was found between aCL antibodies and vascular access thrombosis in our patients on hemodialysis. PMID:15839442

Gültekin, Füsun; Alagözlü, Hakan; Candan, Ferhan; Nadir, I?ilay; Bakici, Mustafa Zahir; Sezer, Hafize

2005-01-01

294

Punctal occlusion is safe and efficient for the treatment of keratoconjunctivitis sicca in patients with ocular GvHD.  

PubMed

The use of punctal plugs in the treatment of keratoconjunctivitis sicca (KCS) in inflammatory eye disease remains controversial because of the potentially increased retention time of tears enriched with inflammatory cytokines that may aggravate eye inflammation. We describe the safety and efficacy of punctal occlusion in a retrospective analysis of 19 patients (16 men) with KCS due to chronic GvHD (cGvHD). Efficacy and safety were assessed by subjective and objective criteria (symptoms, corneal fluorescein staining, tear film break-up time (BUT), Schirmer I test, Jones test and visual acuity). Follow-up was from plug insertion until maximum one year after punctal occlusion. After punctal occlusion, patients reported a significant increase in subjective comfort (1.10 vs 0.59 on a scale ranging from no symptoms (0) to severe impairment (2), P<0.001). Pathological corneal fluorescein staining decreased significantly (P<0.001) and tear film BUT remained unchanged (5.98 vs 4.0?s, P=0.79). Measurement of tear secretion or retention time showed a non-significant trend for improvement in the Schirmer I (3.0 vs 3.40?mm, P=0.08) and Jones (1.36 vs 2.8?mm, P=0.08) tests. The logMAR visual acuity remained unchanged. Punctal occlusion achieved a significant improvement in subjective symptoms and objective findings in ocular GvHD without increasing ocular inflammation. PMID:22041848

Sabti, S; Halter, J P; Braun Fränkl, B C; Goldblum, D

2012-07-01

295

Endovascular Treatment of Chronic Mesenteric Ischemia: Report of Five Cases  

SciTech Connect

Purpose: To evaluate the midterm results of percutaneous transluminal angioplasty (PTA) and stent placement in stenotic and occluded mesenteric arteries in five consecutive patients with chronic mesenteric ischemia. Methods: Five patients with 70%-100% obliterations of all mesenteric vessels resulting in chronic mesenteric ischemia (n= 4) and as a prophylactic measure prior to abdominal aortic aneurysm repair (n= 1) underwent PTA of celiac and/or superior mesenteric artery (SMA) stenoses (n= 2), primary stenting of ostial celiac occlusions (n= 2), and secondary stenting of a SMA occlusion (n= 1; recoil after initial PTA). All patients underwent duplex ultrasonography (US) (n= 3) and/or angiography (n= 5) during a median follow-up of 21 months (range 8-42 months). Results: Clinical success was obtained in all five patients. Asymptomatic significant late restenoses (n3) were successfully treated with repeat PTA (n= 2) and stenting of an SMA occlusion (n= 1; celiac stent restenosis). Recurrent pain in one patient was interpreted as secondary to postsurgical abdominal adhesions. Two puncture-site complications occurred requiring local surgical treatment. Conclusions: Endovascular techniques may be attempted prior to surgery in cases of stenotic or short occlusive lesions in patients with chronic mesenteric ischemia. Surgery may still be preferred in patients with long occlusions and a low operative risk.

Nyman, Ulf; Ivancev, Krasnodar; Lindh, Mats; Uher, Petr [Section of Vascular and Interventional Radiology, Department of Diagnostic Radiology, Malmoe University Hospital, University of Lund, S-205 02 Malmoe (Sweden)

1998-07-15

296

Iliocaval reconstruction in chronic deep vein thrombosis.  

PubMed

Chronic occlusion of the iliac veins and the inferior vena cava is a source of significant morbidity to often otherwise healthy patients, but it can be successfully managed with percutaneous recanalization and stenting. In this article, I summarize our current approach to patients with chronic occlusion of the iliac veins: patient selection, timing of intervention, commonly needed equipment, procedure, difficulties encountered, complications, clinical follow-up, and outcomes. An ideal patient is the one who is physically active (or was so before iliocaval occlusion), is at least 6 months past acute iliocaval thrombosis, has a patent common femoral vein and hepatic vein or caval confluence, and has no thrombophilic state. The duration of the occlusion has not affected our technical success of recanalization but may, by predisposing the patient to recurrent deep vein thrombosis, affect long-term patency by degrading the size and number of inflow vessels. Secondary patency rates at 4 years can be as high as 70%-90%. We anticipate that even higher success rates will follow with ongoing evolutions in device design (stents with appropriate diameter, length, radial conformity to conduits of varying diameter, and resistance to compression); better understanding of the biological interaction of the stent, the veins, and the coagulation system; and improved navigation systems to cross longer, occluded segments that are resistant to guidewire passage. PMID:24840966

Williams, David M

2014-06-01

297

[Experimental model of venous hemorrhagic infarction by cerebral sinus occlusion].  

PubMed

A new experimental model of the hemorrhagic infarction was devised to study the pathophysiology of the hemorrhagic infarction of the venous origin. To make a model of the hemorrhagic infarction by sinus occlusion, mixture of alpha-cyanoacrylate monomer and pantopaque was injected through a catheter introduced into the superior sagittal sinus in 15 dogs, using embolization technique. These dogs were divided into three groups according to the volume of the mixture injected into the sinus. In control groups (3 dogs), no mixture was injected. For partial sinus occlusion (5 dogs), 0.5-1.0 ml of mixture was injected into the sinus and 1.0-1.5 ml of mixture, for complete sinus occlusion (7 dogs). Changes of intracranial pressure (ICP), superior sagittal sinus pressure (SSSP), tissue pressure (TP) rCBF and histological changes were evaluated before and after sinus occlusion. The following results were obtained. (1) In control groups, ICP, SSSP and TP were 9 +/- 2.2 mmHg, 4 +/- 2.5 mmHg and 4-5 mmHg respectively, but in partial and complete sinus occlusion, SSSP and TP were higher than ICP. ICP, SSSP & TP were 32 +/- 5.4 mmHg, 35 +/- 6.5 mmHg and 37-42 mg, in partial sinus occlusion and 62 +/- 5.9 mmHg, 65 +/- 6.0 mmHg, 65-72 mmHg in complete sinus occlusion. (2) R-CBF in partial sinus occlusion showed no change even after sinus occlusion, but in complete sinus occlusion, decreased to 20% of that of the control group due to marked venous congestion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6504262

Fujita, K; Kojima, N; Matsumoto, S

1984-08-01

298

Clinical, electrocardiographic, and ventriculographic consequences of isolated occlusion of the right coronary artery.  

PubMed

The effects of total occlusion of the right coronary artery, a sole lesion, were evaluated in an unselected series of 45 patients. Findings ranged from no detectable consequences to massive post-infarction left ventricular scars. Patients were divided into three groups: Group I, those without clinical or ventriculographic evidence of myocardial infarction (10 patients); Group II, those with clinical or angiographic evidence of nontransmural myocardial infarction (eight patients); Group III, those with electrocardiographic evidence of transmural myocardial infarction (27 patients). The critical compensatory importance of collateral vessels was demonstrated (1) by the difference between the presence of adequate collaterals in Groups I and II (89 percent), versus 44.5 percent in Group III (p less than 0.005), and (2) by the fact that the three patients without demonstrable collaterals showed the most extensive wall motion abnormalities. Four patients in Group I had no clinical evidence of ischemic disease, occlusion being an incidental finding. It is concluded that the natural history of total occlusion of the right coronary artery depends largely upon the function of collateral vessels. PMID:3993655

Selzer, A; Rokeach, S

1985-05-01

299

Occlusion as a measure for visual workload: an overview of TNO occlusion research in car driving.  

PubMed

A process-oriented approach by systematically studying driver performance, distraction, and workload is the way to go for assessing safety effects of new telematics applications in vehicles. These systems may strive for drivers' attention and possibly lead to distraction from the primary task. Visual occlusion techniques appear to be an effective means of studying drivers' visual information processing performance. Studies to illustrate this include identifying the minimum visual information drivers need for driving (asking for visual information) and the evaluation of driver support systems such as heading control and adaptive cruise control with respect to visual workload. In other applications the occlusion technique is used to exclude 'visual array' information from the optic flow field. The temporary exclusion of part of the visual field of view was applied in evaluating the effects of different types of driver's side rearview mirrors. PMID:15145281

van der Horst, Richard

2004-05-01

300

Acute renal artery occlusion following infliximab infusion.  

PubMed

We report the case of a 44-year-old male patient who presented with acute renal artery occlusion, 3 d after first injection of infliximab for steroid refractory attack of ulcerative colitis. Extensive work-up provided no evidence of predisposing factors for arterial thrombosis. Infliximab was thus suspected in the genesis of thrombosis, based on both intrinsic and extrinsic criteria. At month 3 after thrombosis with ongoing anticoagulation, angio-tomodensitometry showed complete revascularization of the left renal artery with renal atrophy. Renal function remained normal and the patient was still in steroid free remission on mercaptopurin monotherapy at maximal follow-up. Few thromboembolic events have been described with anti- tumor necrosis factor (TNF) agents, but it is the first case reported of renal artery thrombosis after infliximab infusion. In addition, we review thrombosis associated with anti-TNF agents. PMID:24255891

Lemaitre, Caroline; Iwanicki-Caron, Isabelle; Vecchi, Clément De; Bertiaux-Vandaële, Nathalie; Savoye, Guillaume

2013-08-01

301

[Hemorheological changes in retinal vein occlusions].  

PubMed

Some hemorheological factors were studied in 34 patients affected by retinal vein occlusion (RVO) and in 25 healthy control subjects. Whole blood viscosity, plasma viscosity, fibrinogen and hematocrit were increased in RVO patients compared with controls. Erythrocyte filterability was reduced in RVO patients compared with controls. However, when evaluating the type of capillaropathy at fluorescein angiography, blood viscosity and plasma viscosity were altered both in patients with and without evidence of capillary non-perfusion. Reduction of red cell filterability showed statistical significance only in patients with capillary non-perfusion. This finding suggests that reduced erythrocyte filterability might be a causal factor in the development of capillary non-perfusion in RVO patients. PMID:4035223

Peduzzi, M; Debbia, A; Guerrieri, F; Zirilli, E; Bolzani, R; Barbieri, U

1985-01-01

302

Effects of occlusal load on cervical lesions.  

PubMed

Toothbrush abrasion has been considered to cause cervical lesions. However, some investigators have proposed that occlusal loading factors direct tensile stresses at the cervical area, resulting in wedge-shaped abfraction defects. The purpose of this study is to investigate the role of axial and non-axial load on the development of cervical lesions. Matched paired premolars, extracted for orthodontic purposes, were used in a custom-fabricated toothbrushing apparatus. A periodontal sulcus width of 0b1 mm with 1 mm gingival recession was simulated with denture base resin. In phase 1, eight matched premolar pairs were subjected to 80 h (1b4 million strokes) of brushing and 300 g of toothbrush force. Toothpaste slurry was applied continuously through the toothbrush. One specimen in each pair was subjected to 250 h and 45 kg of continuous axial load, while the other unloaded tooth served as a negative control. In phase 2, 10 matched premolar pairs were subjected to the same conditions; however, the experimental teeth were subjected to 250 h and 45 kg of intermittent non-axial load, directed at a 45 degrees angle to the buccal cusp. Rubber impressions were made of the cervical lesions, then trimmed, weighed, and compared to determine the amount of tooth material lost. When teeth were loaded axially, there was significantly less tooth material loss (P < 0b02); however, when teeth were loaded non-axially, there was no significant difference (P =0b80) when compared with controls. Optical and scanning electron microscopy did not reveal any significant differences in the morphology between pairs. Our data suggest that the application of occlusal load may not necessarily play a significant role in the progression of cervical tooth wear commonly referred to as abfraction. PMID:15025654

Litonjua, L A; Bush, P J; Andreana, S; Tobias, T S; Cohen, R E

2004-03-01

303

Occlusive and Non-Occlusive Application of Microemulsion for Transdermal Delivery of Progesterone: Mechanistic Studies  

PubMed Central

This work evaluated the occlusive versus non-occlusive application of microemulsion (ME) for the transdermal delivery of progesterone. The mechanisms of enhanced skin penetration were investigated. ME comprised of oleic acid, Tween 80, propylene glycol, and water, was used neat or with ethanol as a volatile cosurfactant. The ME formulations enhanced progesterone transdermal flux compared to the saturated drug solution in 14% aqueous propylene glycol (control). Ethanol-containing ME (EME) was better than the ethanol-free system (EFME). Open application of EFME produced a marginal reduction in flux compared to occlusive application. For EME, open application reduced the flux by 26–28% with the flux remaining significantly higher than that obtained with EFME. The mechanistic studies revealed synergism between ethanol and EFME with EME, producing greater flux than the sum of fluxes obtained from 40% ethanol in water and EFME. Penetration enhancement and supersaturation played a role in enhanced transdermal delivery, but other mechanisms were also possible. This study thus introduced EME as a transdermal delivery system for progesterone with good potential for open application as a spray.

El Maghraby, Gamal M.

2012-01-01

304

Use of a Hanging Weight System for Coronary Artery Occlusion in Mice  

PubMed Central

Murine studies of acute injury are an area of intense investigation, as knockout mice for different genes are becoming increasingly available 1-38. Cardioprotection by ischemic preconditioning (IP) remains an area of intense investigation. To further elucidate its molecular basis, the use of knockout mouse studies is particularly important 7, 14, 30, 39. Despite the fact that previous studies have already successfully performed cardiac ischemia and reperfusion in mice, this model is technically very challenging. Particularly, visual identification of the coronary artery, placement of the suture around the vessel and coronary occlusion by tying off the vessel with a supported knot is technically difficult. In addition, re-opening the knot for intermittent reperfusion of the coronary artery during IP without causing surgical trauma adds additional challenge. Moreover, if the knot is not tied down strong enough, inadvertent reperfusion due to imperfect occlusion of the coronary may affect the results. In fact, this can easily occur due to the movement of the beating heart. Based on potential problems associated with using a knotted coronary occlusion system, we adopted a previously published model of chronic cardiomyopathy based on a hanging weight system for intermittent coronary artery occlusion during IP 39. In fact, coronary artery occlusion can thus be achieved without having to occlude the coronary by a knot. Moreover, reperfusion of the vessel can be easily achieved by supporting the hanging weights which are in a remote localization from cardiac tissues. We tested this system systematically, including variation of ischemia and reperfusion times, preconditioning regiments, body temperature and genetic backgrounds39. In addition to infarct staining, we tested cardiac troponin I (cTnI) as a marker of myocardial infarction in this model. In fact, plasma levels of cTnI correlated with infarct sizes (R2=0.8). Finally, we could show in several studies that this technique yields highly reproducible infarct sizes during murine IP and myocardial infarction6, 8, 30, 40, 41. Therefore, this technique may be helpful for researchers who pursue molecular mechanisms involved in cardioprotection by IP using a genetic approach in mice with targeted gene deletion. Further studies on cardiac IP using transgenic mice may consider this technique.

Eckle, Tobias; Koeppen, Michael; Eltzschig, Holger

2011-01-01

305

Coil occlusion of the paient ductus arteriosus: lessons learned  

SciTech Connect

Purpose: To review the clinical outcomes of catheter-directed coil occlusion (coil occlusion) of persistently patent ductus arteriosus (PDA) at a pediatric tertiary care hospital.Methods: A retrospective review of all patients referred to the Cardiac Catheterization Laboratory for coil occlusion at our institution was performed. Twenty-one consecutive patients (12 female) underwent coil occlusion and follow-up between May 1995 and December 1997. We undertook PDA occlusion if: (a) the PDA narrowed to less than 4 mm on echocardiogram and (b) the minimum body weight was approximately 10 kg. Standard right and retrograde left heart catheterization was performed, followed by coil occlusion. Color-flow mapping (CFM) was used intra-procedurally to confirm occlusion of the PDA with a follow-up study several weeks later.Results: The median age and weight of the patients were 33 months and 13.2 kg, respectively. Fourteen patients received one coil, with six requiring a second coil and one requiring multiple coils. Initial follow-up was at a median of 2.4 months. At latest follow-up, 2 patients still have persistent How at the ductal level. The coils were deployed without complication or embolization.Conclusions: A review of our first 21 cases demonstrated three important lessons: (1) the maximum diameter of the PDA suitable for coil occlusion is approximately 3 mm; (2) CFM must show complete obliteration of flow in the catheterization lab in order to ensure occlusion of the PDA at follow-up; and (3) the Jackson detachable system allows for precise placement of the coil, often within another coil.

Sanatani, Shubhayan; Potts, James E.; Ryan, Angela; Sandor, George G. S.; Human, Derek G. [British Columbia's Children's Hospital, Division of Cardiology, Department of Pediatrics (Canada); Culham, J. A. Gordon [British Columbia's Children's Hospital, Department of Radiology (Canada)

2000-03-15

306

Coil Occlusion of the Patent Ductus Arteriosus: Lessons Learned  

SciTech Connect

Purpose: To review the clinical outcomes of catheter-directed coil occlusion (coil occlusion) of persistently patent ductus arteriosus (PDA) at a pediatric tertiary care hospital.Methods: A retrospective review of all patients referred to the Cardiac Catheterization Laboratory for coil occlusion at our institution was performed. Twenty-one consecutive patients (12 female) underwent coil occlusion and follow-up between May 1995 and December 1997. We undertook PDA occlusion if: (a) the PDA narrowed to less than 4 mm on echocardiogram and (b) the minimum body weight was approximately 10 kg. Standard right and retrograde left heart catheterization was performed, followed by coil occlusion. Color-flow mapping (CFM) was used intra-procedurally to confirm occlusion of the PDA with a follow-up study several weeks later.Results: The median age and weight of the patients were 33 months and 13.2 kg, respectively. Fourteen patients received one coil, with six requiring a second coil and one requiring multiple coils. Initial follow-up was at a median of 2.4 months. At latest follow-up, 2 patients still have persistent flow at the ductal level. The coils were deployed without complication or embolization.Conclusions: A review of our first 21 cases demonstrated three important lessons: (1) the maximum diameter of the PDA suitable for coil occlusion is approximately 3 mm; (2) CFM must show complete obliteration of flow in the catheterization lab in order to ensure occlusion of the PDA at follow-up; and (3) the Jackson detachable system allows for precise placement of the coil, often within another coil.

Sanatani, Shubhayan; Potts, James E.; Ryan, Angela; Sandor, George G.S.; Human, Derek G. [Division of Cardiology, Department of Pediatrics, British Columbia's Children's Hospital, 1F Clinic, 4480 Oak Street, Vancouver, BC, V6H 3V4 (Canada); Culham, J.A. Gordon [Department of Radiology, British Columbia's Children's Hospital, 1L56, 4480 Oak Street, Vancouver, BC, V6H 3V4 (Canada)

2000-03-15

307

Mitral Isthmus Ablation with and Without Temporary Spot Occlusion of the Coronary Sinus  

PubMed Central

Objective To evaluate the safety and outcomes of mitral isthmus (MI) linear ablation with temporary spot occlusion of the coronary sinus (CS). Background CS blood flow cools local tissue precluding transmurality and bidirectional block across MI lesion. Methods In a randomized, controlled trial (CS-occlusion = 20, Control = 22), MI ablation was performed during continuous CS pacing to monitor the moment of block. CS was occluded at the ablation site using 1 cm spherical balloon, Swan–Ganz catheter with angiographic confirmation. Ablation was started at posterior mitral annulus and continued up to left inferior pulmonary vein (LIPV) ostium using an irrigated-tip catheter. If block was achieved, balloon was deflated and linear block confirmed. If not, additional ablation was performed epicardially (power ?25 W). Ablation was abandoned after ~30 minutes, if block was not achieved. Results CS occlusion (mean duration –27 ± 9 minutes) was achieved in all cases. Complete MI block was achieved in 13/20 (65%) and 15/22 (68%) patients in the CS-occlusion and control arms, respectively, P = 0.76. Block was achieved with significantly small number (0.5 ± 0.8 vs 1.9 ± 1.1, P = 0.0008) and duration (1.2 ± 1.7 vs 4.2 ± 3.5 minutes, P = 0.009) of epicardial radiofrequency (RF) applications and significantly lower amount of epicardial energy (1.3 ± 2.4 vs 6.3 ± 5.7 kJ, P = 0.006) in the CS-occlusion versus control arm, respectively. There was no difference in total RF (22 ± 9 vs 23 ± 11 minutes, P = 0.76), procedural (36 ± 16 vs 39 ± 20 minutes, P = 0.57), and fluoroscopic (13 ± 7 vs 15 ± 10 minutes, P = 0.46) durations for MI ablation between the 2 arms. Clinically uneventful CS dissection occurred in 1 patient Conclusions Temporary spot occlusion of CS is safe and significantly reduces the requirement of epicardial ablation to achieve MI block. It does not improve overall procedural success rate and procedural duration. Tissue cooling by CS blood flow is just one of the several challenges in MI ablation.

HOCINI, MELEZE; SHAH, ASHOK J.; NAULT, ISABELLE; RIVARD, LENA; LINTON, NICK; NARAYAN, SANJIV; MIYAZAKI, SHINSUKE; JADIDI, AMIR S.; KNECHT, SEBASTIEN; SCHERR, DANIEL; WILTON, STEPHEN B.; ROTEN, LAURENT; PASCALE, PATRIZIO; PEDERSEN, MICHALA; DERVAL, NICOLAS; SACHER, FREDERIC; JAIS, PIERRE; CLEMENTY, JACQUES; HAISSAGUERRE, MICHEL

2012-01-01

308

Total protein  

MedlinePLUS

The total protein test measures the total amount of two classes of proteins found in the fluid portion of your blood. These are albumin and globulin. Proteins are important parts of all cells and tissues. ...

309

Basilar artery occlusion treated conventionally with good outcome.  

PubMed

It presents a case of a 39-year old woman with acute symptomatic occlusion of basilar artery proximal segment, which was manifested by severe neurological symptomatology and deficits. The patient was treated conventionally (anticoagulant, then antiplatelet agent therapy) with excellent short-term and long-term outcome. In spite of serious acute neurological symptomatology of basilar artery occlusion, proximal localization of the occlusion, fluctuating symptomatology flow, younger age and development of collateral circulation can suggest a good outcome in conventionally treated patients. PMID:21849958

Buljan, Krunoslav; Butkovi?-Soldo, Silva; Janculjak, Davor; Gmajni?, Rudika; Poljakovi?, Zdravka; Candrli?, Marija; Buljan, Vesna

2011-08-01

310

Arrangement of anatomic-type artificial teeth into balanced occlusion.  

PubMed

The mechanical factors which are involved in the arrangement of anatomic type artificial teeth into balanced occlusion have been described. Many of the mechanical problems encountered during artificial tooth arrangement have been listed, together with suggestions for their solution. Hanau's Laws of Articulation have been utilized in a practical manner in formulating some of the solutions to tooth arrangement problems when establishing balanced occlusion. Trial dentures which present ideal occlusions in the articulator may not always do so when examined in the patient's mouth. Possible reasons for these differences are listed, and methods for making the necessary corrections are described. PMID:349138

Jordan, L G

1978-05-01

311

The Outback Catheter: A New Device for True Lumen Re-entry After Dissection During Recanalization of Arterial Occlusions  

SciTech Connect

To report the initial experience with a new catheter system (The Outback catheter) designed to allow fluoroscopically controlled re-entry of the true arterial lumen after subintimal guidewire passage during recanalization procedures of arterial occlusions. The catheter was used in 10 patients with intermittent claudication caused by chronic segmental occlusions of the superficial femoral or popliteal arteries. In all patients, conventional guidewire recanalization had failed. In 8 patients, successful true lumen re-entry was achieved with the Outback catheter. Percutaneous transluminal angioplasty was successfully performed in these patients without complications. Two technical failures occurred in heavily calcified arteries. The Outback catheter was safe and effective when used in complicated recanalization procedures in the superficial femoral and popliteal artery and the tibial trunk.

Hausegger, Klaus A., E-mail: klaus.hausegger@lkh-klu.at; Georgieva, Borjana; Portugaller, Horst; Tauss, Josef [University Hospital Graz, Auenbruggerplatz 9, 8036 Graz, Department of Radiology (Austria); Stark, Gerhard [University Hospital Graz, Graz, Department of Internal Medicine, Angiology (Austria)

2004-01-15

312

Early onset hypercholesterolemia induced by the 2nd-generation tyrosine kinase inhibitor nilotinib in patients with chronic phase-chronic myeloid leukemia  

PubMed Central

Despite a well-recognized clinical benefit of the 2nd-generation tyrosine kinase inhibitor nilotinib in patients with imatinib-resistant/-intolerant or newly diagnosed chronic myeloid leukemia, recent evidence suggests that nilotinib has a propensity to increase the risk of occlusive arterial events, especially in patients with pre-existing cardiovascular risk factors. Given the key role of lipids in cardiovascular diseases, we studied the plasma lipid profile and global cardiovascular risk prior to and during nilotinib therapy in a series of 27 patients in the setting of a prospective single center study. Data from a minimum 1-year follow up showed that nilotinib significantly increased total, low- and high-density lipoprotein cholesterol within three months. Consequently, the proportion of patients with non-optimal low-density lipoprotein cholesterol increased from 48.1% to 88.9% by 12 months, leading to cholesterol-lowering drug intervention in 22.2% of patients. The proportion of patients with low levels of high-density lipoprotein cholesterol decreased from 40.7% to 7.4% by 12 months. In contrast, a significant decrease in triglycerides was observed. Global cardiovascular risk worsened in 11.1% of patients due to diabetes or occlusive arterial events. Whether hypercholesterolemia was the main driver of occlusive arterial events was uncertain: a longer follow up is necessary to ask whether nilotinib-induced hypercholesterolemia increases long-term risk of atherosclerotic diseases. Nevertheless, given key atherogenic properties of low-density lipoprotein cholesterol, we conclude that when prescribing nilotinib, commitment to detect lipid disorders at baseline and during follow up is mandatory given their frequency, requirement for changes in lifestyle or drug intervention, and potential for long-term cardiovascular complications.

Rea, Delphine; Mirault, Tristan; Cluzeau, Thomas; Gautier, Jean-Francois; Guilhot, Francois; Dombret, Herve; Messas, Emmanuel

2014-01-01

313

Early onset hypercholesterolemia induced by the 2nd-generation tyrosine kinase inhibitor nilotinib in patients with chronic phase-chronic myeloid leukemia.  

PubMed

Despite a well-recognized clinical benefit of the 2(nd)-generation tyrosine kinase inhibitor nilotinib in patients with imatinib-resistant/-intolerant or newly diagnosed chronic myeloid leukemia, recent evidence suggests that nilotinib has a propensity to increase the risk of occlusive arterial events, especially in patients with pre-existing cardiovascular risk factors. Given the key role of lipids in cardiovascular diseases, we studied the plasma lipid profile and global cardiovascular risk prior to and during nilotinib therapy in a series of 27 patients in the setting of a prospective single center study. Data from a minimum 1-year follow up showed that nilotinib significantly increased total, low- and high-density lipoprotein cholesterol within three months. Consequently, the proportion of patients with non-optimal low-density lipoprotein cholesterol increased from 48.1% to 88.9% by 12 months, leading to cholesterol-lowering drug intervention in 22.2% of patients. The proportion of patients with low levels of high-density lipoprotein cholesterol decreased from 40.7% to 7.4% by 12 months. In contrast, a significant decrease in triglycerides was observed. Global cardiovascular risk worsened in 11.1% of patients due to diabetes or occlusive arterial events. Whether hypercholesterolemia was the main driver of occlusive arterial events was uncertain: a longer follow up is necessary to ask whether nilotinib-induced hypercholesterolemia increases long-term risk of atherosclerotic diseases. Nevertheless, given key atherogenic properties of low-density lipoprotein cholesterol, we conclude that when prescribing nilotinib, commitment to detect lipid disorders at baseline and during follow up is mandatory given their frequency, requirement for changes in lifestyle or drug intervention, and potential for long-term cardiovascular complications. PMID:24658819

Rea, Delphine; Mirault, Tristan; Cluzeau, Thomas; Gautier, Jean-François; Guilhot, François; Dombret, Hervé; Messas, Emmanuel

2014-07-01

314

[Intestinal occlusion and abdominal compartment syndrome (ACS)].  

PubMed

Intestinal occlusion is defined as an independent predictive factor of intra-abdominal hypertension (IAH) which represents an independent predictor of mortality. Baggot in 1951 classified patients operated with intestinal occlusion as being at risk for IAH ("abdominal blow-out"), recommending them for open abdomen surgery proposed by Ogilvie. Abdominal surgery provokes IAH in 44.7% of cases with mortality which, in emergency, triples with respect to elective surgery (21.9% vs 6.8%). In particular, IAH is present in 61.2% of ileus and bowel distension and is responsible for 52% of mortality (54.8% in cases with intra-abdominal infection). These patients present with an increasing intra-abdominal pressure (IAP) which, over 20-25 mmHg, triggers an Abdominal Compartment Syndrome (ACS) with altered functions in some organs arriving at Multiple Organ Dysfunction Syndrome (MODS). The intestine normally covers 58% of abdominal volume but when there is ileus distension, intestinal pneumatosis develops (third space) which can occupy up to 90% of the entire cavity. At this moment, Gastro Intestinal Failure (GIF) can appear, which is a specific independent risk factor of mortality, motor of "Organ Failure". The pathophysiological evolution has many factors in 45% of cases: intestinal pneumatosis is associated with mucosal and serous edema, capillary leakage with an increase in extra-cellular volume and peritoneal fluid collections (fourth space). The successive loss of the mucous barrier permits a bacterial translocation which includes bacteria, toxins, pro-inflammatory factors and oxygen free radicals facilitating the passage from an intra-abdominal to inter-systemic vicious cyrcle. IAH provokes the raising of the diaphragm, and vascular and visceral compressions which induce hypertension in the various spaces with compartmental characteristics. These trigger hypertension in the renal, hepatic, pelvic, thoracic, cardiac, intracranial, orbital and lower extremity areas, giving a critical clinical condition of Polycompartment Syndrome. The monitoring of Abdominal Perfusion Pressure (APP) is more correct than the measurement of IAP because it reveals hydrodynamic alterations in the abdominal compartment. The APP (MAP-IAP) depends on arterial flow, venous outflow and capacity of the abdominal compartments response to increased internal volumes. The medical therapy used to decrease IAH and to contrast ACS is intestinal decompression with gastric and rectal tube; colonic endoscopic detention; correction of electrolytic abnormalities and prokinetic agents. Surgery, besides being decompressive and resolutive, must prevent a recurrence of ACS through the "tension-free closure" procedure. PMID:20476671

Stagnitti, Franco

2009-01-01

315

The clinical role of the cerebral collateral circulation in carotid occlusion.  

PubMed

The occurrence and severity of ischemic cerebral symptoms after carotid occlusion depends on the interdependency of cerebral collateral blood supply. Only those with the "fittest" collateral capacity survive this process of natural selection. Using the transcranial Doppler method in 55 patients with unilateral carotid occlusion, we tested the dependency of each cerebral hemisphere on the remaining patent carotid artery by digital carotid compression, and in 41 of these patients we also tested the carbon dioxide reactivity in each hemisphere. Both hemispheric dependency and carbon dioxide reactivity were compared to 15 healthy controls. Mean blood flow velocities in the middle cerebral artery were lower on the occluded side than on the patent side (p less than 0.003). When the patent carotid artery was compressed middle cerebral artery blood flow velocities on the occluded side were mainly independent of the patent carotid artery, but on the patent side there was a high degree of dependency (p less than 0.0001). Carbon dioxide reactivity did not differ between the hemispheres, but in hemispheres with total dependency, carbon dioxide reactivity was inversely proportional to the severity of stenosis (r = -0.63). Tests of cerebral collateral reserve in patients with unilateral carotid occlusion evaluated by carotid compression and cerebral carbon dioxide reactivity may discriminate between survivors and potential nonsurvivors before the patent carotid artery occludes. PMID:2116535

Norris, J W; Krajewski, A; Bornstein, N M

1990-08-01

316

Central Retinal and Posterior Ciliary Artery Occlusion After Intralesional Injection of Sclerosant to Glabellar Subcutaneous Hemangioma  

SciTech Connect

The aim of this study is to describe vision loss caused by central retinal artery and posterior ciliary artery occlusion as a consequence of sclerotherapy with a polidocanol injection to a glabellar hemangioma. An 18-year-old man underwent direct injection with a 23-gauge needle of 1 mL of a polidocanol-carbon dioxide emulsion into the glabellar subcutaneous hemangioma under ultrasound visualization of the needle tip by radiologists. He developed lid swelling the next day, and 3 days later at referral, the visual acuity in the left eye was no light perception. Funduscopy revealed central retinal artery occlusion and fluorescein angiography disclosed no perfusion at all in the left fundus, indicating concurrent posterior ciliary artery occlusion. The patient also showed mydriasis, blepharoptosis, and total external ophthalmoplegia on the left side. Magnetic resonance imaging demonstrated the swollen medial rectus muscle. In a month, blepharoptosis and ophthalmoplegia resolved but the visual acuity remained no light perception. Sclerosing therapy for facial hemangioma may develop a severe complication such as permanent visual loss.

Matsuo, Toshihiko, E-mail: matsuot@cc.okayama-u.ac.j [Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Department of Ophthalmology (Japan); Fujiwara, Hiroyasu; Gobara, Hideo; Mimura, Hidefumi; Kanazawa, Susumu [Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Department of Radiology (Japan)

2009-03-15

317

Synergistic white matter protection with acute-on-chronic endotoxin and subsequent asphyxia in preterm fetal sheep  

PubMed Central

Background Perinatal asphyxia and exposure to intrauterine infection are associated with impaired neurodevelopment in preterm infants. Acute exposure to non-injurious infection and/or inflammation can either protect or sensitize the brain to subsequent hypoxia-ischemia. However, the effects of subacute infection and/or inflammation are unclear. In this study we tested the hypothesis that acute-on-chronic exposure to lipopolysaccharide (LPS) would exacerbate white matter injury after subsequent asphyxia in preterm fetal sheep. Methods Fetal sheep at 0.7 gestational age received a continuous LPS infusion at 100 ng/kg for 24 hours, then 250 ng/kg/24 hours for 96 hours, plus 1 ?g boluses of LPS at 48, 72, and 96 hours or the same volume of saline. Four hours after the last bolus, complete umbilical cord occlusion or sham occlusion was induced for 15 minutes. Sheep were sacrificed 10 days after the start of infusions. Results LPS exposure was associated with induction of microglia and astrocytes and loss of total and immature and mature oligodendrocytes (n?=?9) compared to sham controls (n?=?9). Umbilical cord occlusion with saline infusions was associated with induction of microglia, astrogliosis, and loss of immature and mature oligodendrocytes (n?=?9). LPS exposure before asphyxia (n?=?8) was associated with significantly reduced microglial activation and astrogliosis and improved numbers of immature and mature oligodendrocytes compared to either LPS exposure or asphyxia alone. Conclusions Contrary to our initial hypothesis, the combination of acute-on-chronic LPS with subsequent asphyxia reduced neuroinflammation and white matter injury compared with either intervention alone.

2014-01-01

318

Aortoiliac Occlusive Disease Presenting as Sudden Onset Paraplegia.  

PubMed

Thromboembolism and atherosclerotic stenosis both can cause arterial occlusion. Aortoiliac occlusive disease involving bifurcation of the aortoiliac artery induces symptoms of ischemia such as claudication and pain of buttocks and thighs, decreased bilateral femoral pulses, and impotence. Here, we describe a 58-year-old woman with a past history of atrial fibrillation and lacuna stroke with minimal right side weakness. She presented to our emergency department with sudden onset bilateral pain in the legs and paraplegia. A comprehensive examination revealed paresthesia and decreasing bilateral distal pulses. Computed tomographic imaging showed filling defects over the low abdominal aorta just above the bifurcation of the common iliac artery and bilateral femoral arteries. Acute aortic embolic occlusion was suspected. Her symptoms were resolved after emergent thrombectomy for acute limb ischemia. Physicians need to be aware of aortoiliac embolic occlusive disease which may present as acute paraplegia. PMID:24509374

Lai, Chien-Hung; Wang, Cheng-Hsien; Wu, Shih-Yun; Shih, Hong-Mo

2014-07-01

319

Forearm muscle oxygenation responses during and following arterial occlusion in patients with mitochondrial myopathy.  

PubMed

The aim was to study whether mitochondrial myopathy induces different oxygenation (deoxy[Hb+Mb] and oxy[Hb+Mb]) responses during and following arterial occlusion. In 10 mitochondrial myopathy patients (MMpatients) (age: 29±7 years; body mass: 59.9±15.7kg; heigth: 166.2±11.4cm) and age- and gender-matched healthy subjects (age: 28±9 years; body mass: 72.7±16.9kg; height: 174.4±8.7cm) arterial occlusion was performed by inflating a cuff to 240mmHg. Deoxy[Hb+Mb] and oxy[Hb+Mb] were registered during (AOoxy and AOdeoxy) and following (POdeoxy and POoxy) arterial occlusion. Amplitude of AOdeoxy did not differ (p=0.47) between MMpatients (44.9±28.0?M) and healthy subjects (38.6±22.8?M), The time constant of the exponential model was greater in MMpatients (263.4±49.1s vs. 200.3±73.7s, p=0.03). Following cuff release, in both populations a transient increase in total[Hb+Mb] was observed induced by different kinetics of POoxy and POdeoxy. The increase in POoxy (TD=6.6±2.2s and 11.9±3.5s; ?=3.8±1.4s and 6.4±2.9s for MMpatients and healthy subjects, respectively) was faster (p<0.001 for TD and ?) compared to the decrease in POdeoxy (TD=13.2±3.6s and 26.5±4.6s; ?=-6.2±2.2s and -9.6±2.4s for MMpatients and healthy subjects, respectively). POoxy and POdeoxy showed faster kinetics (p<0.001 and p<0.01 for TD and ?, respectively) in MMpatients compared to healthy subjects. MMpatients display altered oxygenation responses during and following arterial occlusion reflecting pathology related changes in the relationship between muscle blood flow and oxygen uptake. PMID:24070894

Boone, Jan; Celie, Bert; Dumortier, Jasmien; Barstow, Thomas J; De Bleecker, Jan; Smet, Joel; Van Lander, Arnaud; Van Coster, Rudy; Bourgois, Jan

2014-01-01

320

Severity of Occlusal Disharmonies in Down Syndrome  

PubMed Central

Objective. To quantify the severity of malocclusion and dental esthetic problems in untreated Down syndrome (DS) and untreated non-Down syndrome children age 8–14 years old using the PAR and ICON Indices. Materials and Methods. This retrospective study evaluated pretreatment study models, intraoral photographs, and panoramic radiographs of 30 Down syndrome and two groups of 30 non-Down syndrome patients (private practice and university clinic) age 8–14 years. The models were scored via PAR and ICON Indices, and descriptive characteristics such as Angle classification, missing or impacted teeth, crossbites, open bites, and other dental anomalies were recorded. Results. The DS group had significantly greater PAR and ICON scores, as well as 10 times more missing teeth than the non-DS group. The DS group possessed predominantly Class III malocclusions, with the presence of both anterior and posterior crossbites in a majority of the patients. The non-DS group had mostly Class I or II malocclusion with markedly fewer missing teeth and crossbites. The DS group also had more severe malocclusions based upon occlusal traits such as open bite and type of malocclusion. Conclusion. The DS group had very severe malocclusions, while the control group from the university clinic had more severe malocclusions than a control group from a private practice.

Bauer, Danielle; Evans, Carla A.; BeGole, Ellen A.; Salzmann, Larry

2012-01-01

321

Surgical embolus removal in retinal artery occlusion  

PubMed Central

Aims To evaluate the anatomical outcomes, safety and functional effectiveness of surgical embolus removal in retinal artery occlusion (RAO). Methods Prospective study of seven patients with RAO of <36?h duration. All eyes underwent pars plana vitrectomy and a longitudinal incision of the anterior wall of the occluded arteriole in an attempt to remove the embolus. Outcome measures included visual acuity and arteriolar reperfusion, as evaluated with fluorescein angiography. Results Surgical removal of the embolus was achieved in six of the seven (87.5%) patients, visual acuity improved from a median of 20/400 (range: hand movements 20/25) to 20/40 (range: hand movements 20/25), and reperfusion of the occluded vessel was angiographically confirmed in four of the six patients in whom the embolus was successfully removed. Conclusion Surgical removal of retinal arterial emboli seems to be an effective and safe treatment for RAO, but a randomised and controlled clinical trial will be necessary to establish an evidence base for the role, if any, of this intervention.

Garcia-Arumi, J; Martinez-Castillo, V; Boixadera, A; Fonollosa, A; Corcostegui, B

2006-01-01

322

Local histograms and image occlusion models.  

PubMed

The local histogram transform of an image is a data cube that consists of the histograms of the pixel values that lie within a fixed neighborhood of any given pixel location. Such transforms are useful in image processing applications such as classification and segmentation, especially when dealing with textures that can be distinguished by the distributions of their pixel intensities and colors. We, in particular, use them to identify and delineate biological tissues found in histology images obtained via digital microscopy. In this paper, we introduce a mathematical formalism that rigorously justifies the use of local histograms for such purposes. We begin by discussing how local histograms can be computed as systems of convolutions. We then introduce probabilistic image models that can emulate textures one routinely encounters in histology images. These models are rooted in the concept of image occlusion. A simple model may, for example, generate textures by randomly speckling opaque blobs of one color on top of blobs of another. Under certain conditions, we show that, on average, the local histograms of such model-generated-textures are convex combinations of more basic distributions. We further provide several methods for creating models that meet these conditions; the textures generated by some of these models resemble those found in histology images. Taken together, these results suggest that histology textures can be analyzed by decomposing their local histograms into more basic components. We conclude with a proof-of-concept segmentation-and-classification algorithm based on these ideas, supported by numerical experimentation. PMID:23543920

Massar, Melody L; Bhagavatula, Ramamurthy; Fickus, Matthew; Kova?evi?, Jelena

2013-05-01

323

Occlusion between removable dentures and natural teeth.  

PubMed

Study casts on thirty-five partially edentulous patients were analysed at their arch level and at the interarch levels. At the arch level the crest of the residual ridge is located lingually to the position of the remaining teeth in the maxilla as well as in the mandible. The spatial interarch relationship between the residual edentulous ridge and the antagonist natural teeth in the buccolingual plane indicated that the crest of the residual ridge is lingual to the occlusal surfaces of the antagonist teeth. In the maxilla the positioning of the artificial teeth in the area previously occupied by the natural extracted teeth will place the denture teeth far buccal as well as away from the crest of the residual ridge. Other possibilities are to place the artificial teeth in a cross bite relation or to eliminate the buccal cusps of the replacement teeth. In the mandible the denture teeth can be placed at the position occupied formerly by the natural teeth. PMID:268416

Pietrokovski, J; Mejias, J E

1977-07-01

324

Local histograms and image occlusion models  

PubMed Central

The local histogram transform of an image is a data cube that consists of the histograms of the pixel values that lie within a fixed neighborhood of any given pixel location. Such transforms are useful in image processing applications such as classification and segmentation, especially when dealing with textures that can be distinguished by the distributions of their pixel intensities and colors. We, in particular, use them to identify and delineate biological tissues found in histology images obtained via digital microscopy. In this paper, we introduce a mathematical formalism that rigorously justifies the use of local histograms for such purposes. We begin by discussing how local histograms can be computed as systems of convolutions. We then introduce probabilistic image models that can emulate textures one routinely encounters in histology images. These models are rooted in the concept of image occlusion. A simple model may, for example, generate textures by randomly speckling opaque blobs of one color on top of blobs of another. Under certain conditions, we show that, on average, the local histograms of such model-generated-textures are convex combinations of more basic distributions. We further provide several methods for creating models that meet these conditions; the textures generated by some of these models resemble those found in histology images. Taken together, these results suggest that histology textures can be analyzed by decomposing their local histograms into more basic components. We conclude with a proof-of-concept segmentation-and-classification algorithm based on these ideas, supported by numerical experimentation.

Massar, Melody L.; Bhagavatula, Ramamurthy; Fickus, Matthew; Kovacevic, Jelena

2012-01-01

325

Dynamic occlusion in the perception of rotation in depth  

Microsoft Academic Search

Occlusion of more distant texture elements by nearer elements can provide relative distance information in parallel projections\\u000a of rotating objects, according to Braunstein, Andersen, and Riefer (1982). In that study, occlusion was present in static\\u000a views in the form of contour interruptions or interposition. In the present study, all visible contours were eliminated. Dots\\u000a were located within implicit pentagonal texture

George J. Andersen; Myron L. Braunstein

1983-01-01

326

Nontraumatic vascular emergencies: imaging and intervention in acute venous occlusion  

Microsoft Academic Search

.   Risk factors for acute venous occlusion range from prolonged immobilization to hypercoagulability syndromes, trauma, and\\u000a malignancy. The aim of this review article is to illustrate the different imaging options for the diagnosis of acute venous\\u000a occlusion and to assess the value of interventional strategies for venous thrombosis treatment in an emergency setting.\\u000a \\u000a First, diagnosis and treatment of the most

Patrick Haage; Timo Krings; Thomas Schmitz-Rode

2002-01-01

327

Kernel-Based Robust Tracking for Objects Undergoing Occlusion  

Microsoft Academic Search

\\u000a Visual tracking has been a challenging problem in computer vision over the decades. The applications of Visual Tracking are\\u000a far-reaching, ranging from surveillance and monitoring to smart rooms. Occlusion is one of the major challenges that needs\\u000a to be handled in tracking. In this work, we propose a new method to track objects undergoing occlusion using both sum-of-squared\\u000a differences (SSD)

R. Venkatesh Babu; Patrick Pérez; Patrick Bouthemy

2006-01-01

328

Thrombotic occlusion of Bjork-Shiley prosthetic aortic valve.  

PubMed

Thrombotic occlusion of a prosthetic Bjork-Shiley valve is a potentially fatal complication. We present the case of a male, 62 years of age, diagnosed with thrombotic occlusion of prosthetic Bjork-Shiley aortic valve approximately 17 years post implantation. A brief review of the literature focusing on potential risk factors associated with the development of this condition and currently available diagnostic modalities used for evaluation and treatment are presented. PMID:15931324

Dhawan, Sumeesh; Sharma, Param; Tak, Tahir

2003-10-01

329

Hyperhomocysteinemia: a risk factor for central retinal vein occlusion  

Microsoft Academic Search

PURPOSE:Previous studies have documented that elevated plasma homocysteine level is a risk factor for vascular disease. This study was performed to determine whether hyperhomocysteinemia is a risk factor for central retinal vein occlusion.METHODS:In a case-control study, data from 74 patients with documented central retinal vein occlusion were reassessed. Control subjects consisted of individuals referred to the same clinic for assessment

Andrew K Vine

2000-01-01

330

Occlusal concepts application in resolving implant prosthetic failure: case report.  

PubMed

The prosthetic management of a poor implant treatment is presented in this case report. The recommended occlusion concepts for implant-supported prostheses were applied for the resolution of the case. The rehabilitation of the posterior segments provided a mutually protected occlusion with adequate distribution of the axial and lateral bite forces with stable posterior occlusion. The clinical exam indicated the need for modification in the vertical dimension of occlusion. Sufficient interocclusal rest space was present to test the alteration in the vertical dimension. The aim was to achieve an occlusion scheme that followed four specific criteria: (1) centric contacts and centric relation of the jaw-to-jaw position; (2) anterior guidance only; (3) shallow anterior angle of tooth contact; and (4) vertical dimension of occlusion with acceptable tooth form and guidance. The success of an oral rehabilitation relies in following the aforementioned criteria, appropriate interaction between the dental laboratory technician and the clinician, careful elaboration of the provisional rehabilitation with all the desired details to be reproduced in the final prosthetic restoration and sufficient follow-up time of the provisional prostheses before placing the final restoration. PMID:22251257

Jamcoski, Vanessa Helena; Faot, Fernanda; de Mattias Sartori, Ivete Aparecida; Vieira, Rogéria Acedo; Tiossi, Rodrigo

2014-04-01

331

Vitrectomy prevents retinal hypoxia in branch retinal vein occlusion.  

PubMed

Vitrectomy has been shown to halt diabetic retinal neovascularization, but the mechanism of this process is unknown. We propose that vitrectomy improves the oxygen supply to ischemic inner retina by way of fluid currents in the vitreous cavity. In order to test this hypothesis, we induced branch retinal vein occlusion in cats and measured preretinal oxygen tension before and after branch retinal vein occlusion in ten nonvitrectomized and five vitrectomized eyes. Branch retinal vein occlusion caused a significant decrease in preretinal oxygen tension in nonvitrectomized eyes, in which the oxygen tension fell from 20 +/- 7 to 6 +/- 5 mmHg (P = 0.001). Conversely, in vitrectomized eyes the oxygen tension was not significantly reduced after branch retinal vein occlusion. The data demonstrate that branch retinal vein occlusion causes retinal hypoxia in nonvitrectomized eyes, whereas after vitrectomy the hypoxic effect of branch retinal vein occlusion is reduced. The relief of retinal hypoxia that follows vitrectomy may be responsible for halting retinal neovascularization after vitrectomy in diabetic patients. PMID:2303330

Stefánsson, E; Novack, R L; Hatchell, D L

1990-02-01

332

Aortic Bifurcation Reconstruction: Use of the Memotherm Self-Expanding Nitinol Stent for Stenoses and Occlusions  

SciTech Connect

Purpose: To assess the technical success, initial clinical outcome, and intermediate follow-up of the Memotherm nitinol self-expanding stent in aortic bifurcation reconstruction. Methods: Thirty-three patients (13 male, 20 female), mean age 64 years, were treated, who had symptoms classified by the Surgical Vascular Society/International Society of Cardiovascular Surgery (SVS/ICVS) classification as grade 2 in 11 (33%), grade 3 in 19 (58%) and grade 4 in 3 (9%) patients. Lesions were classified according to severity and type. Indications for placement of a Memotherm nitinol self-expanding stent were failed angioplasty in 14 (42%), chronic occlusions in 12 (37%), and complex stenoses in seven (21%) patients. Results: Sixty-seven stents were technically successfully placed in 66 aorto-iliac segments in 33 patients, with one major complication. Initial clinical outcome was improvement in 25 (81%), no change in four (13%), and a worsening in two (6%) patients by Rutherford criteria. Mean early ankle/brachial pressure index (ABI) gain was 0.27 for occlusions and 0.05 for stenoses. Clinical follow-up was obtained in all patients, with retrospective angiographic follow-up in 28 (85%) at a mean of 16 months (range 12-26 months). The decrease in ABI and the decrease in angiographic luminal diameter at follow-up was determined as the 'late loss.' The mean ABI late losses were -0.06, 0.00, and 0.09, and the mean angiographic late losses were 6.7%, 10% and 14% for occlusions, stenoses, and normal segments respectively. Primary clinical patency was 96%, primary angiographic patency was 89%, and secondary angiographic patency was 93%. Conclusion: The high technical success of stent placement, the low complication rates for aortic bifurcation reconstruction using the Memotherm self-expanding stent, and high clinical and angiographic patency maintained at intermediate follow-up support their use in aortic bifurcation reconstruction.

Houston, J. Graeme [Directorate of Clinical Radiology, Dundee Teaching Hospitals NHS Trust, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland (United Kingdom); McCollum, Peter T.; Stonebridge, Peter A.; Raza, Zahid [Department of Vascular Surgery, Dundee Teaching Hospitals NHS Trust, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland (United Kingdom); Shaw, J. William [Directorate of Clinical Radiology, Dundee Teaching Hospitals NHS Trust, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland (United Kingdom)

1999-03-15

333

Hyperhomocystinemia in patients with nonarteritic anterior ischemic optic neuropathy, central retinal artery occlusion, and central retinal vein occlusion 1 1 Received October 23, 1999. Accepted March 28, 2000  

Microsoft Academic Search

ObjectiveThis study aimed to determine the prevalence of hyperhomocystinemia among patients with nonarteritic anterior ischemic optic neuropathy (NAION), central retinal artery occlusion (CRAO), or central retinal vein occlusion (CRVO).

Pazit Pianka; Yehoshua Almog; Oran Man; Michaela Goldstein; Ben-Ami Sela; Anat Loewenstein

2000-01-01

334

Totally James  

ERIC Educational Resources Information Center

This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

Owens, Tom

2006-01-01

335

Neovascular Glaucoma Due to Branch Retinal Vein Occlusion Combined with Branch Retinal Artery Occlusion  

PubMed Central

Branch retinal artery occlusion (BRAO) and branch retinal vein occlusion (BRVO) rarely cause neovascular glaucoma (NVG). A 58-year-old woman with hypertension and type 2 diabetic mellitus complained of progressive visual loss in her right eye for the previous 3 months. At initial examination, visual acuity was 20 / 63 in the right eye. Angle neovascularization was observed and the intraocular pressure (IOP) was 30 mmHg in her right eye. Fundus examination and fluorescein angiography showed BRAO combined with BRVO. We immediately injected intravitreal and intracameral bevacizumab in her right eye. The next day, we performed scatter photocoagulation in the nonperfusion area. One month later, visual acuity was 20 / 20 in her right eye and the IOP was 17 mmHg with one topical antiglaucoma agent. The neovascularization had regressed completely. We report a case of unilateral NVG which was caused by BRAO with concomitant BRVO and advise close ophthalmic examination of the iris and angle in BRVO with BRAO.

An, Tae-Su

2013-01-01

336

Neovascular glaucoma due to branch retinal vein occlusion combined with branch retinal artery occlusion.  

PubMed

Branch retinal artery occlusion (BRAO) and branch retinal vein occlusion (BRVO) rarely cause neovascular glaucoma (NVG). A 58-year-old woman with hypertension and type 2 diabetic mellitus complained of progressive visual loss in her right eye for the previous 3 months. At initial examination, visual acuity was 20 / 63 in the right eye. Angle neovascularization was observed and the intraocular pressure (IOP) was 30 mmHg in her right eye. Fundus examination and fluorescein angiography showed BRAO combined with BRVO. We immediately injected intravitreal and intracameral bevacizumab in her right eye. The next day, we performed scatter photocoagulation in the nonperfusion area. One month later, visual acuity was 20 / 20 in her right eye and the IOP was 17 mmHg with one topical antiglaucoma agent. The neovascularization had regressed completely. We report a case of unilateral NVG which was caused by BRAO with concomitant BRVO and advise close ophthalmic examination of the iris and angle in BRVO with BRAO. PMID:23372385

An, Tae-Su; Kwon, Soon-Il

2013-02-01

337

[Severe occlusive bilateral retinal vasculitis within the scope of seronegative systemic lupus erythematosus].  

PubMed

Retinal vascular manifestation is the most common form of ophthalmic involvement in patients with systemic lupus erythematosus (SLE). Most frequently these consist of cotton-wool spots with or without intraretinal hemorrhages. Although rare, a more severe retinal vaso-occlusive disease, termed retinal vasculitis, has been described. We report on a 37-year-old white female with a 13-year follow-up of chronic discoid lupus erythematosus, which suffered massive bilateral visual loss coincident with the systemic exacerbation of her disease (proteinuria, pneumonia, serositis, leucopenia). The diagnosis of SLE was established with reference to the revised ARA-criteria (American Rheumatism Association). Ophthalmoscopy and fluorescein angiography revealed the typical aspect of a SLE-associated vaso-occlusive retinopathy on both eyes with marked ischemia of the macula. Immediate maximal immuno-suppressive therapy, early performed panretinal photocoagulation and subsequent cryoretinopexy did not stop the progression of the disease. Six months after the initial event vascularisations of the disc and rubeosis iridis occurred, but no secondary glaucoma up to date. In this patient, the almost complete absence of characteristic autoantibodies and immunological markers was striking. The correlation with other lupus manifestations, different therapeutic concepts and prognostic factors in SLE-associated retinal vasculitis are discussed. PMID:1479791

Koch, J W; al Nawaiseh, I; Koch, F H

1992-11-01

338

[Selected cases of prosthetic treatment in patients with lowered height of the occlusion].  

PubMed

In the paper three selected cases that illustrate comprehensive prosthetic treatment in which modern methods and prosthetic materials have been used non-conventional composed bridges with partial crowns on abutment teeth sealed with composites in patients with deep bite are reported. For facing the crowns and bridges such materials as Izosit, porcelain, acryl-derived material--Colorstat which is superior to acrylate considering its physicochemical properties have been used. For the reconstruction of the patients, own teeth Izofil adhesive material has been used for capping the teeth partly or totally establishing a new occlusal situation in anterior and lateral segments. PMID:3270923

Tejchman, H; Pro?ba-Mackiewicz, M; Bereznowski, Z; Majda?ska, Z; Koza, J

1988-01-01

339

Use of PTFE Stent Grafts for Hemodialysis-related Central Venous Occlusions: Intermediate-Term Results  

Microsoft Academic Search

Purpose  To assess the safety and effectiveness of a polytetrafluoroethylene (PTFE) encapsulated nitinol stents (Bard Peripheral Vascular,\\u000a Tempe, AZ) for treatment of hemodialysis-related central venous occlusions.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods  Study design was a single-center nonrandomized retrospective cohort of patients from May 2004 to August 2009 for a total of\\u000a 64 months. There were 14 patients (mean age 60 years, range 50–83 years;

Sanjoy Kundu; Milad Modabber; John M. You; Paul Tam; Gordon Nagai; Robert Ting

340

Rescue microsurgery in coil herniation causing thromboembolic occlusion of parent artery  

Microsoft Academic Search

Background  Malpositioned coils can provoke abrupt occlusion of the parent vessels and\\/or neighboring branches causing stroke during coil\\u000a embolization (CE) of intracranial aneurysms. The authors describe a series of cases in which urgent surgical recanalization\\u000a of the vessels clogged with herniated or migrated coils rescued the patients.\\u000a \\u000a \\u000a \\u000a Methods  A total of six patients with aneurysms who underwent surgical management for parent artery

Yong Bae Kim; Kyu Chang Lee; Jae Whan Lee; Seung Kon Huh; Pyeong Ho Yoon; Dong Ik Kim

2009-01-01

341

Chronic wounds.  

PubMed

Chronic wounds are a challenge to treat for the clinician. We present a current overview of intrinsic and extrinsic factors in the development chronic nonhealing wounds. Solutions to some of these difficult problems are presented. PMID:15814118

Izadi, Kouros; Ganchi, Parham

2005-04-01

342

Differences in molar relationships and occlusal contact areas evaluated from the buccal and lingual aspects using 3-dimensional digital models  

PubMed Central

Objective The aims of this study were to use a 3-dimensional (3D) system to compare molar relationship assessments performed from the buccal and lingual aspects, and to measure differences in occlusal contact areas between Class II and Class I molar relationships. Methods Study casts (232 pairs from 232 subjects, yielding a total of 380 sides) were evaluated from both the buccal and lingual aspects, so that molar relationships could be classified according to the scheme devised by Liu and Melsen. Occlusal contact areas were quantified using 3D digital models, which were generated through surface scanning of the study casts. Results A cusp-to-central fossa relationship was observed from the lingual aspect in the majority of cases classified from the buccal aspect as Class I (89.6%) or mild Class II (86.7%). However, severe Class II cases had lingual cusp-to-mesial triangular fossa or marginal ridge relationships. Mean occlusal contact areas were similar in the Class I and mild Class II groups, while the severe Class II group had significantly lower values than either of the other 2 groups (p < 0.05). Conclusions Buccal and lingual assessments of molar relationships were not always consistent. Occlusal contact areas were lowest for the Class II-severe group, which seems to have the worst molar relationships - especially as seen from the lingual aspect.

Jang, Sook-Yoon; Kim, Minji

2012-01-01

343

Spontaneous Massive Necrosis of Hepatocellular Carcinoma with Narrowing and Occlusion of the Arteries and Portal Veins  

PubMed Central

We herein present the case of a 77-year-old man who had fever and right hypochondriac pain. He visited his doctor and underwent contrast computed tomography (CT), and he was suspected to have a liver abscess. He received an antibiotic treatment and his symptoms soon disappeared, but the tumor did not get smaller and its density on contrast CT image got stronger. He underwent biopsy and moderately differentiated hepatocellular carcinoma (HCC) was found. Extended left hepatic and caudate lobectomy was performed. Histological examination showed moderately differentiated HCC with narrowing and occlusion both in the arteries and portal veins associated with mild chronic inflammation. The mechanisms of spontaneous regression of HCC, such as immunological reactions and tumor hypoxia, have been proposed. In our case, histological examination showed the same findings. However, the mechanism is complex, and therefore further investigations are essential to elucidate it.

Tomino, Takahiro; Yamashita, Yo-ichi; Iguchi, Tomohiro; Itoh, Shinji; Ninomiya, Mizuki; Ikegami, Toru; Yoshizumi, Tomoharu; Soejima, Yuji; Kawanaka, Hirofumi; Ikeda, Tetsuo; Aishima, Shinichi; Shirabe, Ken; Maehara, Yoshihiko

2014-01-01

344

[Case of cerebellar and spinal cord infarction presenting with acute brachial diplegia due to right vertebral artery occlusion].  

PubMed

A 73-year-old man was admitted for evaluation of sudden onset of dizziness, bilateral shoulder pain, and brachial diplegia. Neurological examination revealed severe bilateral weakness of the triceps brachii, wrist flexor, and wrist extensor muscles. There was no paresis of the lower limbs. His gait was ataxic. Pinprick and temperature sensations were diminished at the bilateral C6-C8 dermatomes. Vibration and position senses were intact. An MRI of the head revealed a right cerebellar infarction and occlusion of the right vertebral artery. An MRI of the cervical spine on T? weighted imaging (T?WI) showed cord compression at the C3/4-C5/6 level secondary to spondylotic degeneration without any intramedullary signal changes of the cord. On the following day, however, high-signal lesions on T?WI appeared in the C5-C6 spinal cord, suggesting cord infarction. Unilateral vertebral artery occlusion does not usually result in cervical cord infarction because of anastomosis of arteries. Because of the long-term mechanical compression in our case, it was likely that cervical cord ischemia was present before the onset of symptoms. On the basis of chronic cord compression, our case suggests that occlusion of a unilateral vertebral artery could cause cervical cord infarction. PMID:22790805

Fujii, Takayuki; Santa, Yo; Akutagawa, Noriko; Nagano, Sukehisa; Yoshimura, Takeo

2012-01-01

345

Does Maturity Affect Cephalic Perfusion and T/QRS Ratio during Prolonged Umbilical Cord Occlusion in Fetal Sheep?  

PubMed Central

T/QRS ratio monitoring is used to help identify fetal asphyxia. However, immature animals have greater capacity to maintain blood pressure during severe asphyxia, raising the possibility that they may show an attenuated T/QRS increase during asphyxia. Chronically instrumented fetal sheep at 0.6 of gestation (0.6?GA; n = 12), 0.7?GA (n = 12), and 0.8?GA (n = 8) underwent complete umbilical cord occlusion for 30?min, 25?min, or 15?min, respectively. Cord occlusion was associated with progressive metabolic acidosis and initial hypertension followed by severe hypotension, with a more rapid fall in mean arterial blood pressure (MAP) and carotid blood flow (CaBF) with advancing gestation. T/QRS ratio rose after occlusion more rapidly at 0.8?GA than in immature fetuses, to a similar final peak at all ages, followed by a progressive fall that was slower at 0.8?GA than in the immature fetuses. The increase in T/QRS ratio correlated with initial hypertension at 0.8?GA (P < 0.05, R2 = 0.38), and conversely, its fall correlated closely with falling MAP in all gestational groups (P < 0.01, R2 = 0.67). In conclusion, elevation of the T/QRS ratio is an index of onset of severe asphyxia in the last third of gestation, but not of fetal compromise.

Drury, Paul P.; Gunn, Eleanor R.; Bennet, Laura; Gunn, Alistair J.

2014-01-01

346

Effects of different beta adrenoceptor ligands in mice with permanent occlusion of the left anterior descending coronary artery  

PubMed Central

We have studied the effects of three ?AR ligands (carvedilol, alprenolol, and ICI-118,551) with different pharmacological profiles and negative efficacy at the ?2AR on cardiac in vivo, in vitro, biochemical and gene expression parameters in mice with permanent occlusion of the left anterior descending coronary artery. Cardiac in vivo parameters were determined using Doppler studies. Mitral-wave E peak velocity (EPV) and aortic peak velocity (AoPV) decreased in the first 2 weeks postocclusion. After 3 weeks of drug treatment, EPV was improved in the carvedilol group to preocclusion values; however, a further reduction in EPV in the alprenolol and control permanent occlusion group was measured and there was no change after ICI-118,551 treatment. AoPV was unchanged between weeks 2 and 5 in all groups. The left atria were isolated to record isometric tension responses to isoprenaline. Permanent occlusion significantly reduced the maximum isoprenaline response to 30% of control and carvedilol increased the maximum response to isoprenaline significantly to 60%. The biochemical and gene expression studies revealed different effects of the three ?AR ligands. Most notably, carvedilol reduced gene expression of myosin heavy chain ?. These results indicate that chronic treatment with carvedilol is beneficial in a mouse model of myocardial damage resulting from ischaemia. We hypothesise that these beneficial effects of the drug may be because of the negative efficacy at the ?2AR, combined with ?1AR antagonism.

Callaerts-Vegh, Zsuzsanna; Evans, Kenda L J; Shipley, Gregory L; Davies, Peter J A; Cuba, Donald L; Gurji, Hunaid A; Giles, Heather; Bond, Richard A

2003-01-01

347

Induction of hepatic veno-occlusive disease in dogs.  

PubMed Central

The authors attempted to induce hepatic veno-occlusive disease (VOD) in 64 dogs. Preparative treatments included combinations of total-body irradiation (TBI) or localized hepatic irradiation (LI) or both and chemotherapy consisting of dimethylbusulfan (DMB), L-phenylalanine mustard (L-PAM), methotrexate, or monocrotaline. VOD occurred infrequently in those dogs given 9.2 Gy TBI and DMB (1/10), TBI and/or LI (9.2-27 Gy) with L-PAM (2/36) or high dose methotrexate and LI (0/2). Specifically, VOD occurred in the dogs with a shorter interval between TBI and DMB or in the dog that received the glutathione reductase inhibitor, buthionine sulfoximide (BSO) before L-PAM. In contrast, among 17 dogs given monocrotaline, 8 developed VOD, particularly when used with L-PAM +/- irradiation (7/13). The major cause of death, early gastrointestinal toxicity, was further augmented by higher doses of irradiation, by shortening the interval between LI and L-PAM administration to less than 4 weeks, and administering BSO or monocrotaline before L-PAM. Gastrointestinal toxicity was lessened by giving low dose cyclophosphamide given before L-PAM. VOD can be produced in dogs especially with monocrotaline or BSO given before and L-PAM +/- irradiation. However, gastrointestinal toxicity renders the study of VOD beyond the acute phase difficult. Nevertheless, this approach appears useful for the study of VOD in other animals and for developing agents aimed at preventing VOD. Images Figure 1 p[117]-b Figure 2 Figure 3

Shulman, H. M.; Luk, K.; Deeg, H. J.; Shuman, W. B.; Storb, R.

1987-01-01

348

Visual Tracking in Occlusion Environments by Autonomous Switching of Targets  

NASA Astrophysics Data System (ADS)

Visual tracking is required by many vision applications such as human-computer interfaces and human-robot interactions. However, in daily living spaces where such applications are assumed to be used, stable tracking is often difficult because there are many objects which can cause the visual occlusion. While conventional tracking techniques can handle, to some extent, partial and short-term occlusion, they fail when presented with complete occlusion over long periods. They also cannot handle the case that an occluder such as a box and a bag contains and carries the tracking target inside itself, that is, the case that the target invisibly moves while being contained by the occluder. In this paper, to handle this occlusion problem, we propose a method for visual tracking by a particle filter, which switches tracking targets autonomously. In our method, if occlusion occurs during tracking, a model of the occluder is dynamically created and the tracking target is switched to this model. Thus, our method enables the tracker to indirectly track the “invisible target” by switching its target to the occluder effectively. Experimental results show the effectiveness of our method.

Imai, Jun-Ichi; Kaneko, Masahide

349

Patterns of recurrent disease after recanalization of femoropopliteal artery occlusions  

SciTech Connect

Purpose. In this prospective study we investigated the site, occurrence, and development of stenoses and occlusions following recanalization of superficial femoral artery occlusions. Methods. Recanalization of an occluded femoropopliteal artery was attempted in 62 patients. Follow-up examinations included clinical examination and color-flow duplex scanning at regular intervals. Arteriography was used to determine the localization of the recurrent disease relative to the initially occluded segment. Results. During a mean follow-up of 23 months (range 0-69 months) 14 high-grade restenoses, indicated by a peak systolic velocity ratio {>=}3.0, were detected by color-flow duplex scanning. Occlusion of the treated segment occurred in 11 patients. The cumulative 3-year primary patency rate for high-grade restenoses and occlusions combined was 44% (SE 9%). By arteriographic examination the site of restenosis was localized in the distal half of the treated vessel segment in 16 of 21 cases. Conclusion. Most restenoses and occlusions occurred during the first year and most disease developed at the previous intervention site. The site of restenosis is more frequently in the distal part of the initially treated segment, a finding that may have therapeutic implications.

Vroegindeweij, Dammis; Tielbeek, Alexander V. [Catharina Hospital, Department of Radiology (Netherlands); Buth, Jaap [Catharina Hospital, Department of Vascular Surgery (Netherlands); Vos, Louwerens D.; Bosch, Harrie C. M. van den [Catharina Hospital, Department of Radiology (Netherlands)

1997-07-15

350

Monitoring carotid test occlusions with continuous EEG and clinical examination.  

PubMed

We routinely monitor invasive neuroradiologic carotid balloon test occlusions with continuous polygraph and quantitative EEG along with repeated detailed clinical examinations. Four of 17 consecutive cases showed changes during carotid occlusion. In one instance, an immediate delta increase was accompanied by slurred speech and aphasia. Another showed alpha attenuation without clinical change. A third patient had significant clinical change without EEG change. Nine of the 17 cases underwent permanent therapeutic carotid occlusion as treatment of an intracerebral vascular abnormality. Seven of these nine had no EEG or clinical changes during monitoring and have had no functional abnormalities on follow-up. The patient with focal alpha attenuation had an accidental balloon detachment but has had no functional or structural neurologic abnormalities. The patient with minor regional increased delta received a permanent carotid occlusion and went on to develop clinical signs 24 h later. We believe that continuous EEG monitoring and repeated clinical examinations provide useful ways of evaluating cerebral circulation during carotid test occlusions. PMID:8408601

Cloughesy, T F; Nuwer, M R; Hoch, D; Vinuela, F; Duckwiler, G; Martin, N

1993-07-01

351

The muscle engram: the reflex that limits conventional occlusal treatment.  

PubMed

The engram (the masticatory "muscle memory") is shown to be a conditionable reflex whose muscle conditioning lasts less than two minutes, far shorter than previously thought. This reflex, reinforced and stored in the masticatory muscles at every swallow, adjusts masticatory muscle activity to guide the lower arch unerringly into its ICP. These muscle adjustments compensate for the continually changing intemal and external factors that affect the mandible's entry into the ICP. A simple quick experiment described in this article isolates the engram, enabling the reader to see its action clearly for the first time. It is urged that every reader perform this experiment. This experiment shows how the engram, by hiding the masticatory muscles' reaction (the hit-and-slide), limits the success of the therapist in achieving occlusion-muscle compatibility. This finding has major clinical implications. It means that, as regards the muscle aspect of treating occlusion, the dentist treating occlusion conventionally is working blind, a situation the neuromuscular school of occlusal thought seeks to correct. The controversy over occlusion continues. PMID:22128670

Lerman, Martin D

2011-10-01

352

In vitro evaluation of the occlusive properties of latex-covered amplatzer vascular plugs for transrenal ureteral occlusion.  

PubMed

Abstract Purpose: To evaluate the occlusive properties of latex-covered Amplatzer Vascular Plugs (AVPs) for transrenal ureteral occlusion in vitro. Materials and Methods: Latex-covered AVPs type I and II (diameter 8, 10, 12, 14, and 16?mm) were used as occlusive devices. Radial force of an AVP was measured using simulated ureteral diameters of 4 to 12?mm. Occlusive properties were examined in a silicone tube (inner diameter 6?mm) with measurement of drainage time of a 40?cm water column. In complete occlusion, the maximum pressure that the plug was able to withstand was determined at different temperature levels. Statistical analysis of drainage time was performed in a general linear model (GLM) and using correlation analyses. Explanted porcine ureters were used to simulate physiologic conditions. Pressure measurements were performed until leakage, plug dislocation, or rupture of the ureter occurred. Results: Radial force depended on AVP type, size, ureteral diameter, and temperature. The 16-mm AVP II showed the highest radial force of more than 5?N (ureteral diameter 4?mm, body temperature). All AVP I showed water leakage and plug dislocation. Drainage time of the AVP II depended significantly on plug size and temperature and correlated with radial force (r=0.731, P<0.001). In complete occlusion, water leakage occurred at 500 to 1000?cm H2O and dislocation between 500 to more than 2000?cm H2O. In porcine ureters, leakage occurred at room temperature between 19 to 93?cm H2O. At body temperature, all AVP II occluded the ureter completely. Conclusion: Latex-covered AVP II (diameter 8-16?mm) can effectively occlude the ureter, especially considering remodeling of the nitinol at body temperature. Large plug diameters can exert enough radial force even in dilated ureters to allow for successful occlusion. Because deployment of a 16-mm latex-covered AVP II can be technically difficult, we advocate the use of 12- or 14-mm AVP II for transrenal ureteral occlusion. AVP Is are not suitable for ureteral occlusion. PMID:24564487

Pieper, Claus Christian; Schild, Hans Heinz

2014-06-01

353

Hemi-central retinal artery occlusion in young adults  

PubMed Central

Amongst the clinical presentations of retinal artery occlusion, hemi-central retinal artery occlusion (Hemi-CRAO) is rarely described. This case series of four adults aged between 22 and 36 years attempts to describe the clinical profile, etiology and management of Hemi-CRAO. Case 1 had an artificial mitral valve implant. Polycythemia and malignant hypertension were noted in Case 2. The third patient had Leiden mutation while the fourth patient had Eisenmenger’s syndrome. Clinical examination and fundus fluorescein angiography revealed a bifurcated central retinal artery at emergence from the optic nerve head, in all cases. Color Doppler examination of the central retinal artery confirmed branching of the artery behind the lamina cribrosa. It is hypothesized that bifurcation of central retinal artery behind the lamina cribrosa may predispose these hemi-trunks to develop an acute occlusion if associated with underlying risk factors. The prognosis depends upon arterial recanalisation and etiology of the thromboembolic event.

Rishi, Pukhraj; Rishi, Ekta; Sharma, Tarun; Mahajan, Sheshadri

2010-01-01

354

Radiation-induced large intracranial vessel occlusive vasculopathy  

SciTech Connect

Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The clinical, angiographic, and histologic features of these two cases are discussed and previously reported cases are reviewed.

Brant-Zawadzki, M.; Anderson, M.; DeArmond, S.J.; conley, F.K.; Jahnke, R.W.

1980-01-01

355

[Ophthalmologic diagnostic procedures and imaging of retinal vein occlusions].  

PubMed

Retinal vein occlusions are a common vascular disease of the eye. Ophthalmological diagnostic procedures and imaging are important for the prognosis of the disease, as are the systemic work-up and therapy. Besides routine ophthalmic tests (visual acuity, slit lamp examination, funduscopy) a work-up for glaucoma such as intraocular pressure, visual field or 24 h IOP profile is useful as a diagnostic procedure. Furthermore, new diagnostic and imaging tests such as central corneal thickness and optic nerve head imaging by Heidelberg retina tomography or optical coherence tomography (OCT) should be considered for glaucoma evaluation. Optical coherence tomography also plays a major role in treatment monitoring of macular edema secondary to retinal vein occlusions. Fluorescein angiography is well established and can provide information with regard to size and extent of the occlusion, degree of ischemia, areas of non-perfusion and neovascularization, as well as macular edema. PMID:21331683

Mirshahi, A; Lorenz, K; Kramann, C; Stoffelns, B; Hattenbach, L-O

2011-02-01

356

Ambient Occlusion Effects for Combined Volumes and Tubular Geometry  

PubMed Central

This paper details a method for interactive direct volume rendering that computes ambient occlusion effects for visualizations that combine both volumetric and geometric primitives, specifically tube-shaped geometric objects representing streamlines, magnetic field lines or DTI fiber tracts. The algorithm extends the recently presented the directional occlusion shading model to allow the rendering of those geometric shapes in combination with a context providing 3D volume, considering mutual occlusion between structures represented by a volume or geometry. Stream tube geometries are computed using an effective spline-based interpolation and approximation scheme that avoids self-intersection and maintains coherent orientation of the stream tube segments to avoid surface deforming twists. Furthermore, strategies to reduce the geometric and specular aliasing of the stream tubes are discussed.

Schott, Mathias; Martin, Tobias; Grosset, A.V. Pascal; Smith, Sean T.; Hansen, Charles D.

2013-01-01

357

MPEG-7 based shape retrieval with robustness against partial occlusion  

NASA Astrophysics Data System (ADS)

Object shape features are powerful when used in similarity search-&-retrieval and object recognition because object shape is usually strongly linked to object functionality and identity. Many applications, including those concerned with visual objects retrieval or indexing, are likely to use shape features. Those systems have to cope with scaling, rotation, deformation and partial occlusion of the objects to be described. The ISO standard MPEG-7 contains different shape descriptors, where we focus especially on the region-shape descriptor. Since we found, that the region-shape descriptor is not very robust against partial occlusion, we propose a slightly changed feature extraction method, which is based on central-moments. Further, we compare our method with the original region-shape implementation and show that, applying the proposed changes, the robustness of the region-shape descriptor against partial occlusions can be significantly increased.

Hoeynck, Michael; Ohm, Jens-Rainer

2003-01-01

358

Using computerized cephalometrics to analyze the vertical dimension of occlusion.  

PubMed

A computer program that uses cephalometric analyses for determining the patient's occlusal vertical dimension has recently been introduced. Data generated from this computer implies changes in incisal-pin position for articulated casts. This study evaluated the accuracy of this vertical-dimension program using 24 completely dentate, white male subjects with clinically acceptable occlusal vertical dimensions. A cephalometric radiograph was made, and measurements from the tracing were entered into the computer for analysis. Recommended incisal-pin changes ranged from -11 to +25.3 mm, with a mean change of 8.4 mm for all methods tested. These results showed a low correlation with each subject's clinically determined occlusal vertical dimension. PMID:8240648

Edwards, C L; Richards, M W; Billy, E J; Neilans, L C

1993-01-01

359

Development of 'De novo' Aneurysm after Therapeutic Carotid Occlusion  

PubMed Central

Carotid occlusion is an inevitable therapeutic modality for the treatment of complex aneurysms such as giant, traumatic, and intracavernous aneurysms. Late complications of carotid occlusion include 'de novo' aneurysm formation at a distant site because of hemodynamic changes in the circle of Willis. We report a case of de novo aneurysm in a vessel that appeared to be normal on initial angiography. The patient developed an anterior communicating artery aneurysm and marked growth of a basilar bifurcation aneurysm 9 years after trapping of the left internal carotid artery for the treatment of a ruptured large saccular aneurysm involving ophthalmic and cavernous segments. We propose that patients who undergo therapeutic carotid occlusion should be periodically followed by magnetic resonance angiography or computed tomographic angiography to evaluate the possibility of de novo aneurysm formation; this advice is in line with previous reports.

Jin, Sung-Chul; Choi, Choong-Gon

2009-01-01

360

Development of 'De novo' Aneurysm after Therapeutic Carotid Occlusion.  

PubMed

Carotid occlusion is an inevitable therapeutic modality for the treatment of complex aneurysms such as giant, traumatic, and intracavernous aneurysms. Late complications of carotid occlusion include 'de novo' aneurysm formation at a distant site because of hemodynamic changes in the circle of Willis. We report a case of de novo aneurysm in a vessel that appeared to be normal on initial angiography. The patient developed an anterior communicating artery aneurysm and marked growth of a basilar bifurcation aneurysm 9 years after trapping of the left internal carotid artery for the treatment of a ruptured large saccular aneurysm involving ophthalmic and cavernous segments. We propose that patients who undergo therapeutic carotid occlusion should be periodically followed by magnetic resonance angiography or computed tomographic angiography to evaluate the possibility of de novo aneurysm formation; this advice is in line with previous reports. PMID:19444350

Jin, Sung-Chul; Choi, Choong-Gon; Kwon, Do-Hoon

2009-04-01

361

Proximal Arterial Occlusion in Acute Ischemic Stroke with Low NIHSS Scores Should Not Be Considered as Mild Stroke  

PubMed Central

Background Untreated acute mild stroke patients have substantial 90-day disability rates and worse outcomes than those who are treated with thrombolysis. There is little information regarding which patients with acute mild stroke will benefit from thrombolysis. We sought to investigate factors that are associated with early neurological deterioration (END) and poor prognosis in patients with acute mild stroke. Methods This was a retrospective study of consecutively registered patients with acute mild stroke (NIHSS ?3) at our tertiary stroke center between October 2008 and December 2011. END was defined as an increase in NIHSS ?2 points between hospital days 0 and 5. Modified Rankin Scale (mRS) scores of 0–1 at 90 days post-stroke were defined as favorable outcomes. Results A total of 378 (mean age, 65.9±13.0 years) patients were included in this study. END occurred in 55 patients (14.6%). IV-thrombolysis was performed in only 9 patients. Symptomatic arterial occlusion on the initial MRA was independently associated with END (OR, 2.206; 95% CI, 1.219–3.994; p?=?0.009) by multivariate logistic regression. Of the 119 patients with symptomatic arterial occlusion, ICA occlusion was independently associated with END (OR, 8.606; 95% CI, 2.312–32.043; p?=?0.001). Conclusions This study demonstrates that symptomatic arterial occlusion may be an important predictor of END in patients with acute mild stroke. It may therefore be important to consider that acute ischemic stroke with symptomatic arterial occlusion and low NIHSS scores may not represent mild stroke in acute periods.

Kim, Joon-Tae; Park, Man-Seok; Chang, Jane; Lee, Ji Sung; Choi, Kang-Ho; Cho, Ki-Hyun

2013-01-01

362

Functional dental occlusion: an anthropological perspective and implications for practice.  

PubMed

Physiologic changes occur in dental occlusion throughout life, resulting from the interplay between functional demands and reciprocating adaptive responses. These changes have been reported in the anthropological literature and they reflect evolutionary changes in the human stomatognathic system during the Paleolithic, hunter-gatherer period. Specific occlusal changes occur in response to different environments, leading to extensive variation within and between extinct and extant human populations. For example, functional demands can cause occlusal and interproximal tooth wear, resulting in shortening of the dental arch, continual tooth eruption and changes in masticatory patterns. Since the advent of farming through to our current industrialized culture, functional demands on the human masticatory system, and its adaptive responses to these demands, have been reduced considerably. Indeed, it is only occasionally that functional demands are severe enough to lead to obvious pathology in the modern human dentition. In contrast to normal masticatory activity, 'modern-day conditions' such as dental caries, periodontal disease and erosion, can lead to significant changes in dental occlusion that are pathological and need to be treated. The masticatory system is a dynamic, functional unit that displays considerable change over a lifetime. In this concept paper, it is proposed that modern human populations living in industrialized environments display dental occlusions that can be considered to be 'neotenous'; that is, our dentitions tend to reflect an unworn stage of our ancestors that was only seen in infants, juveniles and young adults. Clinicians can draw on both phylogenetic and ontogenetic perspectives of 'functional dental occlusion' to differentiate continual physiological changes occurring over time that require ongoing review, from pathological responses that require intervention. PMID:24444303

Kaidonis, Ja; Ranjitkar, S; Lekkas, D; Brook, Ah; Townsend, Gc

2014-06-01

363

Occlus-o-Guide® versus Andresen activator appliance: neuromuscular evaluation  

PubMed Central

Background The aim of the present study was to assess the muscular variations at the electromyography (EMG) level for the anterior temporalis muscles and masseter muscles during treatment with Occlus-o-Guide® and Andresen activator appliances. Methods Eighty-two patients (35 males and 47 females) aged between 8 and 12 years (mean age, 10.5?±?0.8 years) participated in the study. Fifty patients underwent treatment with an Occlus-o-Guide® and 32 patients with an Andresen activator. All patients underwent EMG examination using a Freely EMG (De Gotzen, Legnano, Italy) and surface bipolar electrodes when the appliances were worn for the first time (T0), and after 6 months (T1) and after 12 months (T2) of appliance use. Results Statistical analysis showed that both at T0 and T2, the percent overlapping coefficient (POC) of the anterior temporalis muscles was not statistically different between the appliance groups. At T0, the POC of the masseter muscles was significantly lower for the Andresen appliance as compared to the Occlus-o-Guide® (p?=?0.02), while at T2 this significance was lost. Conclusions At insertion of an appliance, all patients show neuromuscular balance that does not correspond to orthognathic occlusion. Both appliances work by creating muscular imbalance. With the appliances in situ, EMG responses were generally analogous for the Occlus-o-Guide® and the Andresen activator; however, the imbalance was greater and the recovery of the orthological muscular balance was slower in patients under treatment with the Andresen activator as compared to those with the Occlus-o-Guide®.

2013-01-01

364

The effects of naris occlusion on mouse nasal turbinate development.  

PubMed

Unilateral naris occlusion, a standard method for causing odor deprivation, also alters airflow on both sides of the nasal cavity. We reasoned that manipulating airflow by occlusion could affect nasal turbinate development given the ubiquitous role of environmental stimuli in ontogenesis. To test this hypothesis, newborn mice received unilateral occlusion or sham surgery and were allowed to reach adulthood. Morphological measurements were then made of paraffin sections of the whole nasal cavity. Occlusion significantly affected the size, shape and position of turbinates. In particular, the nasoturbinate, the focus of our quantitative analysis, had a more delicate appearance on the occluded side relative to the open side. Occlusion also caused an increase in the width of the dorsal meatus within the non-occluded and occluded nasal fossae, compared with controls, and the position of most turbinates was altered. These results suggest that a mechanical stimulus from respiratory airflow is necessary for the normal morphological development of turbinates. To explore this idea, we estimated the mechanical forces on turbinates caused by airflow during normal respiration that would be absent as a result of occlusion. Magnetic resonance imaging scans were used to construct a three-dimensional model of the mouse nasal cavity that provided the input for a computational fluid dynamics simulation of nasal airflow. The simulation revealed maximum shear stress values for the walls of turbinates in the 1 Pa range, a magnitude that causes remodeling in other biological tissues. These observations raise the intriguing possibility that nasal turbinates develop partly under the control of respiratory mechanical forces. PMID:24311813

Coppola, David M; Craven, Brent A; Seeger, Johannes; Weiler, Elke

2014-06-15

365

A Case of Branch Retinal Artery Occlusion following Uneventful Phacoemulsification  

PubMed Central

We would like to present a case of branch retinal artery occlusion following uneventful phacoemulsification, possibly caused by sub-Tenon's anaesthesia. There were no predisposing general health problems. There are two possible mechanisms: (1) mechanical effect of the bolus anaesthetic; (2) pharmacologically mediated changes in the vascular calibre. The latter mechanism is much more probable, because of the vasoconstrictive properties of both medications used. This is the first reported case of branch retinal artery occlusion after sub-Tenon's anaesthesia with preservative-free medications.

Dragnev, Daniel; Barr, Dai; Kulshrestha, Manoj; Shanmugalingam, Sinnathamboo

2013-01-01

366

Permanent Preoperative Carotid Artery Occlusion and Carotid Body Tumor Surgery  

PubMed Central

Precise angiographic evaluation of the cerebrovascular system and radiographically controlled balloon occlusion of the internal carotid artery have considerably changed the risk involved with carotid surgery at the skull base. Preoperative permanent balloon occlusion of the internal carotid artery was used in three patients with infiltrative carotid body tumors. Embolization and definitive preoperative control of the carotid artery provided ideal conditions for focusing the surgeon's attention on radical removal of tumor with maximal functional preservation of the adjacent cranial nerves. ImagesFigure 1p23-bFigure 1Figure 2Figure 3Figure 4

Palaskas, Constantine W.; Fisch, Ugo; Valavanis, Anton; Pfaltz, Madeleine

1993-01-01

367

Hepatic veno-occlusive disease originating in Ecuador.  

PubMed

A case of hepatic veno-occlusive disease manifested by massive ascites is described in a 35-year-old female. She had consumed an herbal tea containing a Crotalaria plant species for 6 months prior to evaluation. Inferior vena cava and hepatic veins were patent by angiography. Liver biopsy showed histological changes typical of hepatic veno-occlusive disease, consisting of centrilobular congestion and sublobular hepatic vein obstruction. Complete clinical, biochemical, and histological recovery was documented 1 year after ingestion of the brew was discontinued. This is the first case known to be reported from Ecuador and the first to be diagnosed in the United States. PMID:1245269

Lyford, C L; Vergara, G G; Moeller, D D

1976-01-01

368

Giant Serpentine Internal Carotid Artery Aneurysm: Endovascular Parent Artery Occlusion  

PubMed Central

Summary We report on a case of a 14-year-old boy with a giant serpentine aneurysm of the left internal carotid artery cavernous segment with symptoms of acute mass-effect cranial nerve dysfunction. After a balloon occlusion test of the collateral circulation, the patient underwent parent artery occlusion with platinum Guglielmi detachable coils and fibered coils. An optimal angiographic result and successful clinical outcome were achieved with resolution of IIIrd, IVth and Vlth cranial nerve ischemic symptoms. CT angiography and 3D-XRA rotational angiography reconstructions gave sufficient inclusion information on the giant serpentine aneurysm angioarchitechture.

Prochazka, V.; Chmelova, J.; Cizek, V.; Skoloudik, D.; Hrbac, T.

2007-01-01

369

A diagnostic craniometric method for determining occlusal vertical dimension.  

PubMed

There is no precise scientific method for determining the correct edentulous occlusal vertical dimension. This study established the proportion between the ear-eye to chin-nose distance for determining reasonable occlusal vertical dimension. Two hundred white and 400 Asian men and women participated in this study. The ear-eye and chin-nose distances were measured with a modified craniometer. The results revealed that left ear-eye distance can be used to predict chin-nose distance with reasonable accuracy. However, the algorithm for making this prediction is not the same for combinations of sex and ethnic origin. PMID:8040818

Chou, T M; Moore, D J; Young, L; Glaros, A G

1994-06-01

370

Subclavian artery occlusion after radiotherapy for carcinoma of the breast  

SciTech Connect

Disturbance of the arterial circulation in the ipsilateral upper limb following mastectomy is a rare sequel attributed to adjuvant radiotherapy. A review of the literature revealed 20 such cases, and two more are presented. Different mechanisms of injury leading to arterial occlusion have been proposed. This is a late complication with a considerable time lag between irradiation and onset of symptoms. The symptoms vary in type and severity, but are consistent with peripheral occlusive arterial disease. To alleviate symptoms and prevent limb loss, reconstructive vascular surgery is advocated, and was successfully performed in one of our patients. 18 references.

Hashmonai, M.; Elami, A.; Kuten, A.; Lichtig, C.; Torem, S.

1988-05-15

371

The 15Year Cumulative Incidence of Retinal Vein Occlusion  

Microsoft Academic Search

Results: The 15-year cumulative incidences of branch retinal vein occlusion and central retinal vein occlusion were 1.8% and 0.5%, respectively. Using a generalized estimating equation model, incident retinal vein occlu- sion was related to baseline age (odds ratio (OR) per 10 years,1.70;95%confidenceinterval(CI),1.36-2.12),his- tory of barbiturate use (OR, 5.30; 95% CI, 2.28-12.31), focalretinalarteriolarnarrowing(OR,2.45;95%CI,1.29- 4.66), glaucoma (OR, 3.17; 95% CI, 1.50-6.69), serum

Ronald Klein; Scot E. Moss; Stacy M. Meuer; Barbara E. K. Klein

2008-01-01

372

Pulmonary veno-occlusive disease in a female gardener.  

PubMed

Pulmonary veno-occlusive disease (PVOD) is a subgroup of pulmonary arterial hypertension with a poor prognosis. The diagnosis is usually delayed and treatment options other than lung transplantation are unfortunately limited. We report the case of 51-year-old female gardener diagnosed with PVOD by open lung biopsy before her death. Although there are many reported cases of hepatic veno-occlusive disease due to toxic agents present in nature, such as pyrrolizidine alkaloid exposure, to date this has not been linked to PVOD. PMID:23886653

Rodríguez Rodríguez, Paula; Pedraza Serrano, Fernando; Morán Caicedo, Liliana Patricia; Rodríguez de Guzmán, Maria Carmen; Cebollero Presmanes, María; de Miguel Díez, Javier

2014-01-01

373

Inadvertent Occlusion of the Anterior Choroidal Artery Explains Infarct Variability in the Middle Cerebral Artery Thread Occlusion Stroke Model  

PubMed Central

Intraluminal occlusion of the middle cerebral artery (MCAo) in rodents is perhaps the most widely used model of stroke, however variability of infarct volume and the ramifications of this on sample sizes remains a problem, particularly for preclinical testing of potential therapeutics. Our data and that of others, has shown a dichotomous distribution of infarct volumes for which there had previously been no clear explanation. When studying perfusion computed tomography cerebral blood volume (CBV) maps obtained during intraluminal MCAo in rats, we observed inadvertent occlusion of the anterior choroidal artery (AChAo) in a subset of animals. We hypothesized that the combined occlusion of the MCA and AChA may be a predictor of larger infarct volume following stroke. Thus, we aimed to determine the correlation between AChAo and final infarct volume in rats with either temporary or permanent MCA occlusion (1 h, 2 h, or permanent MCAo). Outbred Wistar rats (n?=?28) were imaged prior to and immediately following temporary or permanent middle cerebral artery occlusion. Presence of AChAo on CBV maps was shown to be a strong independent predictor of 24 h infarct volume (??=?0.732, p <0.001). This provides an explanation for the previously observed dichotomous distribution of infarct volumes. Interestingly, cortical infarct volumes were also larger in rats with AChAo, although the artery does not supply cortex. This suggests an important role for perfusion of the MCA territory beyond the proximal occlusion through AChA-MCA anastomotic collateral vessels in animals with a patent AChAo. Identification of combined MCAo and AChAo will allow other investigators to tailor their stroke model to reduce variability in infarct volumes, improve statistical power and reduce sample sizes in preclinical stroke research.

McLeod, Damian D.; Beard, Daniel J.; Parsons, Mark W.; Levi, Christopher R.; Calford, Mike B.; Spratt, Neil J.

2013-01-01

374

Near-infrared spectroscopic assessment of oxygen delivery to free flaps on monkeys following vascular occlusions and inhalation of pure oxygen  

NASA Astrophysics Data System (ADS)

In recent studies, near-infrared spectroscopy (NIRS) has been considered as a potentially ideal noninvasive technique for the postoperative monitoring of plastic surgery. In this study, free flaps were raised on rhesus monkeys' forearms and oxygen delivery to these flaps was monitored following vascular occlusions and inhalation of pure oxygen. Optical fibers were adopted in the probe of the oximeter so that the detection could be performed in reflectance mode. The distance between emitter and detector can be adjusted easily to achieve the best efficacy. Different and repeatable patterns of changes were measured following vascular occlusions (arterial occlusion, venous occlusion and total occlusion) on flaps. It is clear that the near-infrared spectroscopy is capable of postoperatively monitoring vascular problems in flaps. NIRS showed high sensitivity to detect the dynamic changes in flaps induced by inhalation of pure oxygen in this study. The experimental results indicated that it was potential to assess tissue viability utilizing the dynamic changes induced by a noninvasive stimulation. It may be a new assessing method that is rapid, little influenced by other factors and brings less discomfort to patients.

Tian, Fenghua; Ding, Haishu; Cai, Zhigang; Wang, Guangzhi; Zhao, Fuyun

2002-04-01

375

Standard Care vs. COrticosteroid for REtinal Vein Occlusion (SCORE) Study: FPRC Imaging Procedures.  

National Technical Information Service (NTIS)

This document describes a randomized efficacy and safety of intravitreal injection(s) of triamcinoline acetonide with standard care to treat macular edema associated with central retinal vein occlusion amd branch retinal vein occlusion.

2005-01-01

376

Standard Care vs. COrticosteroid for REtinal Vein Occlusion (SCORE) Study, Version 6.0.  

National Technical Information Service (NTIS)

Macular edema is a major cause of vision loss in patients with central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). Currently, there is no effective treatment for macular edema associated with CRVO. For macular edema associated ...

2007-01-01

377

Balloon-Assisted Occlusion of the Internal Iliac Arteries in Patients with Placenta Accreta/Percreta  

SciTech Connect

Background. Placenta accreta/percreta is a leading cause of third trimester hemorrhage and postpartum maternal death. The current treatment for third trimester hemorrhage due to placenta accreta/percreta is cesarean hysterectomy, which may be complicated by large volume blood loss. Purpose. To determine what role, if any, prophylactic temporary balloon occlusion and transcatheter embolization of the anterior division of the internal iliac arteries plays in the management of patients with placenta accreta/percreta. Methods. The records of 28 consecutive patients with a diagnosis of placenta accreta/percreta were retrospectively reviewed. Patients were divided into two groups. Six patients underwent prophylactic temporary balloon occlusion, followed by cesarean section, transcatheter embolization of the anterior division of the internal iliac arteries and cesarean hysterectomy (n = 5) or uterine curettage (n = 1). Twenty-two patients underwent cesarean hysterectomy without endovascular intervention. The following parameters were compared in the two groups: patient age, gravidity, parity, gestational age at delivery, days in the intensive care unit after delivery, total hospital days, volume of transfused blood products, volume of fluid replacement intraoperatively, operating room time, estimated blood loss, and postoperative morbidity and mortality. Results. Patients in the embolization group had more frequent episodes of third trimester bleeding requiring admission and bedrest prior to delivery (16.7 days vs. 2.9 days), resulting in significantly more hospitalization time in the embolization group (23 days vs. 8.8 days) and delivery at an earlier gestational age than in those in the surgical group (32.5 weeks). There was no statistical difference in mean estimated blood loss, volume of replaced blood products, fluid replacement needs, operating room time or postoperative recovery time. Conclusion. Our findings do not support the contention that in patients with placenta accreta/percreta, prophylactic temporary balloon occlusion and embolization prior to hysterectomy diminishes intraoperative blood loss.

Bodner, Leonard J.; Nosher, John L. [UMDNJ-Robert Wood Johnson Medical School, Department of Radiology (United States)], E-mail: nosher@umdnj.edu; Gribbin, Christopher [St. Peter's University Hospital, Department of Radiology (United States); Siegel, Randall L.; Beale, Stephanie [UMDNJ-Robert Wood Johnson Medical School, Department of Radiology (United States); Scorza, William [Saint Peter's University Hospital, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine (United States)

2006-06-15

378

Evaluation of the effect of two different occlusal splints on maximum occlusal force in patients with sleep bruxism: a pilot study  

PubMed Central

PURPOSE The occlusal splint has been used for many years as an effective treatment of sleep bruxism. Several methods have been used to evaluate efficiency of the occlusal splints. However, the effect of the occlusal splints on occlusal force has not been clarified sufficiently. The purpose of this study was to evaluate the effect of occlusal splints on maximum occlusal force in patients with sleep bruxism and compare two type of splints that are Bruxogard-soft splint and canine protected hard stabilization splint. MATERIALS AND METHODS Twelve students with sleep bruxism were participated in the present study. All participants used two different occlusal splints during sleep for 6 weeks. Maximum occlusal force was measured with two miniature strain-gage transducers before, 3 and 6 weeks after insertion of occlusal splints. Clinical examination of temporomandibular disorders was performed for all individuals according to the Craniomandibular Index (CMI) before and 6 weeks after the insertion of splints. The changes in mean occlusal force before, 3 and 6 weeks after insertion of both splints were analysed with paired sample t-test. The Wilcoxon test was used for the comparison of the CMI values before and 6 weeks after the insertion of splints. RESULTS Participants using stabilization splints showed no statistically significant changes in occlusal force before, 3, and 6 weeks after insertion of splint (P>.05) and participants using Bruxogard-soft splint had statistically significant decreased occlusal force 6 weeks after insertion of splint (P<.05). There was statistically significant improvement in the CMI value of the participants in both of the splint groups (P<.05). CONCLUSION Participants who used Bruxogard-soft splint showed decreases in occlusal force 6 weeks after insertion of splint. The use of both splints led to a significant reduction in the clinical symptoms.

Dogan, Arife; Bek, Bulent

2014-01-01

379

Acute Inferior Wall Myocardial Infarction due to Occlusion of the Wrapped Left Anterior Descending Coronary Artery  

PubMed Central

Acute occlusion of the left anterior descending coronary artery (LAD) generally results in ST segment elevations in precordial leads and reciprocal ST segment depression in inferior leads. The occurrence of isolated inferior myocardial infarction due to occlusion of LAD is very rare. We describe an isolated acute inferior myocardial infarction due to occlusion of a wrapped LAD at the apex which continues as the large posterior descending coronary artery (PDA) beyond the occlusion.

Sunil Roy, Thottuvelil Narayanan; Nagham, Jafar Saeed; Anil Kumar, Rajappan

2013-01-01

380

Design for functional occlusal surface of CAD/CAM crown using VR articulator.  

PubMed

In this present study, we introduce an approach that utilizes the VR articulator to mimic lateral excursions and design a functional occlusal surface. We then take the resultant occlusal surface from this approach and compare it with a conventional method. As a result, we developed a novel CAD/CAM system which can render a functional occlusal surface, via a VR articulator. The marginal fit and occlusion in our CAD/CAM crown was sufficient to apply to the clinic. PMID:21335796

Ikawa, Tomoko; Ogawa, Takumi; Shigeta, Yuko; Kasama, Shintaro; Hirabayashi, Rio; Fukushima, Shunji; Hattori, Asaki; Suzuki, Naoki

2011-01-01

381

Learning about Occlusion: Initial Assumptions and Rapid Adjustments  

ERIC Educational Resources Information Center

We examined 6-month-olds' abilities to represent occluded objects, using a corneal-reflection eye-tracking technique. Experiment 1 compared infants' ability to extrapolate the current pre-occlusion trajectory with their ability to base predictions on recent experiences of novel object motions. In the first condition infants performed at asymptote…

Kochukhova, Olga; Gredeback, Gustaf

2007-01-01

382

Occlusion training increases muscular strength in division IA football players.  

PubMed

The purpose of this study was to investigate the effectiveness of 4 weeks of low-intensity resistance training with blood-flow occlusion on upper and lower body muscular hypertrophy and muscular strength in National Collegiate Athletic Association Division IA football players. There were 32 subjects (average age 19.2 ± 1.8 years) who were randomized to an occlusion group or control group. The athletes performed 4 sets of bench press and squat in the following manner with or without occlusion: 30 repetitions of 20% predetermined 1 repetition maximum (1RM), followed by 3 sets of 20 repetitions at 20% 1RM. Each set was separated by 45 seconds. The training duration was 3 times per week, after the completion of regular off-season strength training. Data collected included health history, resting blood pressure, pretraining and posttraining bench press and squat 1RM, upper and lower chest girths, upper and lower arm girths, thigh girth, height, and body mass. The increases in bench press and squat 1RM (7.0 and 8.0%, respectively), upper and lower chest girths (3 and 3%, respectively), and left upper arm girth were significantly greater in the experiment group (p < 0.05). Occlusion training could provide additional benefits to traditional strength training to improve muscular hypertrophy and muscular strength in collegiate athletes. PMID:22105051

Yamanaka, Tetsuo; Farley, Richard S; Caputo, Jennifer L

2012-09-01

383

Importance of occlusion aspects in the completion of orthodontic treatment  

Microsoft Academic Search

The purpose of this study was to address the therapeutic goals regarding the static and functional occlusion in the completion of orthodontic treatment. For such purpose, a study population comprising 20 female treated Class II malocclusion subjects with an initial mean age of 11 years underwent a two-phase treatment (orthopedics and orthodontics). The patients were diagnosed in centric relation and

Paula Vanessa; Pedron OLTRAMARI; Ana Cláudia de Castro; Ferreira CONTI; Ricardo de Lima NAVARRO; Márcio Rodrigues de ALMEIDA

2007-01-01

384

Support Vector Machines in face recognition with occlusions  

Microsoft Academic Search

Support Vector Machines (SVM) are one of the most use- ful techniques in classification problems. One clear exam- ple is face recognition. However, SVM cannot be applied when the feature vectors defining our samples have missing entries. This is clearly the case in face recognition when occlusions are present in the training and\\/or testing sets. When k features are missing

Hongjun Jia; Aleix M. Martínez

2009-01-01

385

Support Vector Machines in face recognition with occlusions  

Microsoft Academic Search

Support vector machines (SVM) are one of the most useful techniques in classification problems. One clear example is face recognition. However, SVM cannot be applied when the feature vectors defining our samples have missing entries. This is clearly the case in face recognition when occlusions are present in the training and\\/or testing sets. When k features are missing in a

Hongjun Jia; Aleix M. Martinez

2009-01-01

386

Osteochondroma of C1 causing vertebral artery occlusion.  

PubMed

Spinal osteochondromas constitute a small percentage of all intraspinal tumours, and are a rare cause of neurological symptoms. We describe a patient with a vertebral artery occlusion secondary to an osteochondroma of the C1 vertebra presenting with symptoms of cerebral ischaemia. This case is reported because of its extreme rarity. PMID:22844969

Altaf, Farhaan; Movlik, Harvard; Brew, Stefan; Rezajooi, Kia; Casey, Adrian

2013-02-01

387

Lung Growth and Maturation after Tracheal Occlusion in Diaphragmatic Hernia  

Microsoft Academic Search

Tracheal occlusion (TO) was performed at 120 d of gestation by noninvasive endoscopic technique using a releasable latex balloon, in fetal lambs with diaphragmatic hernia (DH) established at 85 d. The lungs were studied at 139 d in five fetuses with DH 1 TO, five fetuses with DH only, and six con- trol fetuses. Fluid retention consecutive to TO allowed

ALEXANDRA BENACHI; BERNADETTE CHAILLEY-HEU; ANNE-LISE DELEZOIDE; MARC DOMMERGUES; FRANCIS BRUNELLE; YVES DUMEZ; JACQUES R. BOURBON

1998-01-01

388

Pancreatoduodenectomy with occlusion of the residual stump by Neoprene ® injection  

Microsoft Academic Search

Pancreatojejunal anastomosis disruption still represents the main postoperative complication after pancreatoduodenectomy. In this study, a technique of occlusion of the residual pancreatic stump instead of pancreatojejunal anastomosis is proposed. Between March, 1981 and August, 1987, we performed 51 pancreatoduodenectomies, using Neoprene®injection in the Wirsung duct, for carcinoma of the pancreatic head (28 cases), ampullary carcinoma (12 cases), islet cell carcinoma

Valerio Di Carlo; Roberto Chiesa; Antonio E. Pontiroli; Michele Carlucci; Carlo Staudacher; Alessandro Zerbi; Marco Cristallo; Marco Braga; Guido Pozza

1989-01-01

389

Course of disturbance of EOG in retinal vessel occlusions  

Microsoft Academic Search

More than 60 patients with retinal vessel occlusions were examined using the electro-oculogram (EOG) ramp test. In the course of the disease a systematic disturbance of the slow oscillation of the corneoretinal potential occurred. First, the latency of the light peak increased. Then the peak decreased and was reached up to 5 min later than in the healthy eye. In

R. Tfiumer; N. Rohde; J. Wollensak

1982-01-01

390

Gradient recalled echo MR imaging of superior sagittal sinus occlusion  

Microsoft Academic Search

With T1-weighted gradient recalled echo (GRE) MR images and flow compensation, we studied the superior sagittal sinus in 3 normal volunteers and 3 patients with sinus occlusion. In these images, sites of patency of the superior sagittal sinus were identified due to the high signal intensity of the normal sinus. Tumor invading the sinus was nearly isointense with cerebral gray

D. L. Daniels; L. F. Czervionke; L. E. Hendrix; L. P. Mark; D. F. Smith; G. A. Meyer; D. J. Maiman; V. M. Haughton; A. L. Williams

1989-01-01

391

Optically induced occlusion of single blood vessels in rodent neocortex.  

PubMed

The ability to form targeted vascular occlusions in small vessels of the brain is an important technique for studying the microscopic basis of cerebral ischemia. We describe two complementary methods that enable targeted occlusion of any single blood vessel within the upper 500 µm of adult rodent neocortex. Our goal is to generate highly localized regions of ischemia by blocking penetrating arterioles and ascending venules, which are bottlenecks of flow in the cortical angioarchitecture. One method, termed photothrombosis, makes use of linear optical absorption by a photosensitizer, transiently circulated in the blood stream, to induce a clot in a surface or near-surface segment of a vessel. The second method, termed plasma-mediated ablation, makes use of nonlinear optical interactions, without the need to introduce an exogenous absorber, to induce clots in subsurface segments of penetrating vessels, as well as subsurface microvessels and capillaries. The choice of the method for occlusion of individual vessels depends on the location of the vessels being studied and the objectives of the study. Here we describe concurrent high resolution in vivo imaging and auxiliary laser setups, occlusion protocols, and post hoc histological procedures. PMID:24298038

Shih, Andy Y; Nishimura, Nozomi; Nguyen, John; Friedman, Beth; Lyden, Patrick D; Schaffer, Chris B; Kleinfeld, David

2013-12-01

392

Occlusion of modified Blalock-Taussig shunt after clopidogrel cessation.  

PubMed

It has been suggested previously that rebound hypercoagulability may be responsible for morbidity and mortality following clopidogrel cessation in adults with acute coronary syndrome. We report a case of acute occlusion of a modified Blalock-Taussig shunt in an infant after clopidogrel discontinuation. PMID:22269735

Avlonitis, Vassilios Spiridon; Planas, Silvia; Hayes, Alison M; Parry, Andrew

2012-02-01

393

Rescue from hemodialysis by late recanalization of renal artery occlusion  

PubMed Central

We report on a patient with terminal renal insufficiency undergoing hemodialysis since four months. Imaging studies showed complete renal artery occlusion of a single kidney with collateral perfusion. Interventional recanalization of the renal artery was successful with a drop of serum creatinine from 1138 to 163 mol/l sparing the patient from further hemodialysis.

Ringe, Kristina Imeen; Galanski, Michael; Rosenthal, Herbert

2011-01-01

394

Role of Thrombophilic Gene Polymorphisms in Branch Retinal Vein Occlusion  

Microsoft Academic Search

Objective: Branch retinal vein occlusion (BRVO) is a common cause of severe visual loss. Numerous risk factors, including arterial hypertension, diabetes mellitus, and arteriosclerosis, have been identified. Gene polymorphisms affecting hemostasis may also play a role in the pathogenesis of BRVO. The present study was therefore done to determine the prevalence of genetic polymorphisms in factors implicated in hypercoagulability among

Martin Weger; Wilfried Renner; Iris Steinbrugger; Lisa Cichocki; Werner Temmel; Olaf Stanger; Yosuf El-Shabrawi; Helga Lechner; Otto Schmut; Anton Haas

2005-01-01

395

A segmentation-aware object detection model with occlusion handling  

Microsoft Academic Search

The bounding box representation employed by many popular object detection models [3, 6] implicitly assumes a ll pixels inside the box belong to the object. This assumption makes this representation less robust to the object with occlusion [16]. In this paper, we augment the bounding box w ith a set of binary variables each of which corresponds to a cell

Tianshi Gao; Benjamin Packer; Daphne Koller

2011-01-01

396

Effectiveness and Complications Associated With 2 Vasectomy Occlusion Techniques  

Microsoft Academic Search

Purpose: We compared the effectiveness and complications associated with 2 common vasec- tomy occlusion techniques, namely clipping and excision of a small vas segment and thermal cautery with fascial interposition and an open testicular end. Materials and Methods: We retrospectively reviewed the computerized records of 3,761 men who underwent initial vasectomy at a single university hospital family planning clinic and

MICHEL LABRECQUE; HANIF NAZERALI; MYRTO MONDOR; VINCENT FORTIN; MARLINA NASUTION

2002-01-01

397

Absence of Hypoglycemia in Canine Splanchnic Arterial Occlusion (SAO) Shock.  

National Technical Information Service (NTIS)

The primary purpose of the present study was to determine the role of glucose in splanchnic arterial occlusion (SAO) shock. The three major arteries to the splanchnic region: celiac, superior, and inferior mesenteric of dogs were occluded for a 90 to 120 ...

L. T. Archer M. R. Black M. M. Lane L. B. Hinshaw

1975-01-01

398

Occlusion of pores of polymeric membranes with colloidal silica  

Microsoft Academic Search

The concept of surface pore modification using colloidal silica was extended to polymeric membranes. Occlusion of surface pores of commercially available polysulfone, and polyvinylidene fluoride membranes were examined using silica particles suspended in a variety of dispersing media. Impregnation techniques previously proven effective with aluminum oxide membranes did not result in uniform and defect-free impregnation of the pores of the

Maryam Moaddeb; William J. Koros

1997-01-01

399

An occlusion-aware feature for range images  

Microsoft Academic Search

This paper presents a novel local feature for 3D range image data called ‘the line image’. It is designed to be highly viewpoint invariant by exploiting the range image to efficiently detect 3D occupancy, producing a representation of the surface, occlusions and empty spaces. We also propose a strategy for defining keypoints with stable orientations which define regions of interest

A. Quadros; J. P. Underwood; B. Douillard

2012-01-01

400

Comparison of the sideris and Amplatzer septal occlusion devices  

Microsoft Academic Search

The results of transcatheter atrial septal defect (ASD) occlusion with 2 different devices (Sideris adjustable buttoned device vs Amplatzer Septal Occluder) were compared in 2 consecutive series of patients. Comparative outcomes were assessed by whether a device was implanted or not, by complications and fluoroscopy time of implantation, and by the incidence of residual shunting on transthoracic echocardiography at follow-up.

Kevin P Walsh; Magdi Tofeig; Denise J Kitchiner; Ian Peart; Robert Arnold

1999-01-01

401

Occlusal force pattern during rhythmic human tapping movement.  

PubMed

The dynamic occlusal force patterns associated with the performance of rhythmic tapping movement were analysed in normal subjects, who were instructed to make tapping movements at four frequencies, 2, 2.5, 3.3 and 5 Hz, with as constant a magnitude of force as possible. The occlusal force recorded by an intra-oral customized device showed a triphasic pattern which could be divided into two components, and this pattern was more clearly defined during slower tapping movements. Of the two components, the first was relatively stable, regardless of changes in tapping frequency, while the second was highly dependent on the tapping cycle duration, and its duration was shortened with increases in tapping frequency. Furthermore, there was a significant correlation between the changes in the occlusal power phase and those in the burst duration of the masseter EMG simultaneously recorded by a pair of surface electrodes. On the basis of these findings, it is suggested that the tapping rhythm is modulated by the duration of the occlusal power phase and the associated jaw elevator muscle activity. PMID:1856779

Munakata, Y; Tsuji, M; Kasai, S

1991-05-01

402

Argon laser panretinal photocoagulation in ischemic central retinal vein occlusion  

Microsoft Academic Search

We conducted a prospective, planned study of argon laser panretinal photocoagulation (PRP) in ischemic central retinal vein occlusion (CRVO) over a 10-year period in 123 eyes. On comparing the lasered eyes versus the nonlasered eyes, there was no statistically significant difference between the two groups in the incidence of development of angle neovascularization (NV), neovascular glaucoma (NVG), retinal and\\/or optic

Sohan Singh Hayreh; Marie R. Klugman; Patricia Podhajsky; Gary E. Servais; Edward S. Perkins

1990-01-01

403