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[Chronic total occlusions].  


Many studies showed that successful recanalization of chronic total occlusion (CTO) provides an improvement of long-term outcome and left ventricular ejection fraction, electrical stability of the myocardium, increased tolerance to future coronary events, and last but not least an improvement in quality of life. Because of the perceived procedural complexity of percutaneous coronary interventions (PCI), patients with CTO are usually referred to coronary artery bypass surgery or medical therapy. Recent advances in PCI materials, devices, approaches, and techniques have allowed expert operators to tackle successfully with complex cases of CTO that many years ago would have sent patients to surgery. This has also been motivated by the long-term patency and freedom from restenosis obtained by drug-eluting stent implantation. Each strategy and device has advantages and disadvantages, even though percutaneous treatment of CTO needs a higher operator's skill with respect to other non-occlusive lesions as well as an appropriate training period. In order to avoid complications and to achieve CTO recanalization in more than 70% of cases, it is advisable to understand the principles of each strategy, to plan the proper strategy and choose the appropriate materials, to take time, to be zen and aware when to stop. PMID:18942554

Galassi, Alfredo R; Tomasello, Salvatore D; Costanzo, Luca; Tamburino, Corrado



Current status of percutaneous coronary intervention of chronic total occlusion.  


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. PMID:22843178

Ge, Jun-bo



Endovascular recanalization for chronic symptomatic middle cerebral artery total occlusion  

PubMed Central

The optimal treatment of chronic middle cerebral artery (MCA) occlusion is unclear. Angioplasty and stenting may be an alternative treatment for patients with recurrent ischemic symptoms despite medical therapy. Two patients with chronic right MCA occlusion successfully treated with stenting are reported, together with their long term follow-up to illustrate the feasibility of endovascular recanalization. One patient remained asymptomatic at the 29-month follow-up. Another patient developed symptomatic in-stent restenosis at 12?months which resolved after repeat angioplasty. Further larger scale pilot studies are needed to determine the efficacy and long term outcome of this treatment.

Ma, Ning; Mo, Da-Peng; Gao, Feng



Predictors of success in percutaneous transluminal coronary angioplasty of chronic total occlusions.  


Earlier studies have indicated that percutaneous transluminal coronary angioplasty (PTCA) of chronic total occlusions has a low success rate. To determine success rate and assess clinical and angiographic variables associated with success and complications, 57 total occlusions in 56 patients undergoing PTCA were analyzed. The clinical duration of occlusion was 51 +/- 86 days. Success (less than 50% residual stenosis) was achieved at 40 of 57 (70%) dilatation sites. Of these 57 total occlusions, 5 were attempted within 24 hours of acute myocardial infarction, 35 between 1 day and 8 weeks of clinical occlusion, 13 greater than 8 weeks and 4 were of unknown duration. Success rates were 4 of 5, 25 of 35, 9 of 13 and 2 of 4, respectively, in each group (difference not significant, comparison of all time groups). Of the 9 narrowings with a successful PTCA for an occlusion greater than 8 weeks, the mean duration of occlusion was 93 +/- 41 days (range 60 to 180). None of the attempted dilatations of occlusions with a clinical duration of greater than 180 days (n = 3) was successful. None of the clinical or angiographic variables (including tortuosity, length of occlusion gap, distance of the occlusion from the vessel origin, thrombus, lesion calcium, collaterals, prior myocardial infarction, vessel dilated or diffuse disease) impacted on success rate (difference not significant for all). No patient died, had a Q-wave infarction, required emergency coronary artery bypass grafting or underwent repeat PTCA within 7 days of the procedure. Non-Q-wave infarction occurred in 2 of 56 patients (4%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2589190

LaVeau, P J; Remetz, M S; Cabin, H S; Hennecken, J F; McConnell, S H; Rosen, R E; Cleman, M W



ST-elevation myocardial infarction as a complication of retrograde chronic total occlusion recanalization.  


With the advent of new tools and techniques including the retrograde approach, success rates for recanalization of chronic total occlusion (CTO) have improved. Numerous cardiac and extracardiac complications during retrograde CTO recanalization have been described. To date the development of ST-segment elevation myocardial infarction (STEMI) with retrograde recanalization as a result of atheroembolization has not been reported. We report such a case following retrograde recanalization of a totally occluded right coronary artery. PMID:21805592

Prayaga, Sastry; Uretsky, Barry F; Sachdeva, Rajesh



Transvenous IVUS-guided percutaneous coronary intervention for chronic total occlusion: a novel strategy.  


The major obstacle to successful recanalization of a chronic total occlusion (CTO) is difficulty in passing the guidewire through the occlusion. We report successful transvenous intravascular ultrasound (IVUS)-guided percutaneous coronary intervention for CTO of the coronary artery in two patients, one with CTO of the left circumflex artery and the other with CTO of the left anterior descending artery. The procedure involved the passage of a guidewire through the CTO lesion under fluoroscopic guidance and insertion of an IVUS catheter into the cardiac vein parallel to the target artery. Angiography after 8 months revealed no restenosis in either patient. PMID:23813072

Takahashi, Yasuhiro; Okazaki, Hirotake; Mizuno, Kyoichi



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



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


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



Pioneer re-entry device for iliac chronic total occlusion: Truly a Paradigm shift.  


The number of percutaneous revascularization procedures performed for symptomatic peripheral arterial disease has significantly increased over the past several years. Traditionally, the use of percutaneous techniques were limited to certain anatomic subsets, such as stenosis or focal occlusions, with surgical treatment preferred for more extensive disease. More recently, endovascular specialists are facing the challenge of peripheral chronic total occlusions. Furthermore, unlike the coronary circulation, these occlusions are often very long and associated with other features of complexity such as severe calcifications. One of the primary issues concerning these lesions is the ability to safely achieve initial angiographic success. This article focus indeed on the Pioneer catheter, a new lumen re-entry device exploiting intravascular ultrasound imaging that was used in a case of totally occluded left common iliac artery with favorable results. The details of this technique, and how this catheter helped in re-entering the true lumen at the aortic bifurcation after subintimal dissection, are thoroughly discussed. © 2013 Wiley Periodicals, Inc. PMID:21542103

Rezq, Ahmed; Aprile, Alessandro; Sangiorgi, Giuseppe



Stingray balloon used in slender percutaneous coronary intervention for chronic total occlusion.  


Slender chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using 5 Fr radial Ikari catheter is possible in simple CTO cases. We report a case where we initially thought the LAD CTO was short and easy, but we found that the CTO had a considerable amount of calcium and also some tortuosity, making simple wire crossing impossible. We used a Stingray balloon to perform re-entry by tracking the balloon over an Ultimate Bros 3 gram wire using an extension wire. We successfully punctured into true lumen and completed stenting through a slender 5 Fr system. This case demonstrates the beauty of combining the advances in CTO PCI from the East and the West together and also demonstrates the possibility of using the Stingray system in a 5 Fr guiding catheter. PMID:23813075

Wu, Eugene B; Ikari, Yuji



Transradial percutaneous coronary intervention for chronic total occlusion using sheathless technique and retrograde approach.  


The use of 5 or 6 Fr sheath in transradial (TR) approach is often required due to the relative small radial artery size. A sheathless approach may overcome the limitation of small radial size which limits the TR approach. Our case showed successful angioplasty of the right coronary artery chronic total occlusion (CTO) by bilateral TR approaches, utilizing a 7-Fr guide (7 Fr BL 3.5, 85 cm) for a retrograde sheathless approach, and a 6-Fr Ikari 3.5 guide catheter for an antegrade approach. The sheathless TR technique can minimize vascular trauma and increase back-up support for successful coronary intervention in CTO.© 2013 Wiley Periodicals, Inc. PMID:23172759

Lin, Cheng-Jui; Fang, Hsiu-Yu; Chen, Tien-Hsing; Wu, Chiung-Jen



Percutaneous recanalization of chronic total occlusions: wherein lies the body of proof?  


Although interventional technology and skills have markedly advanced, percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) lesions remains challenging. Indeed, CTO PCI is technically complex, carries the potential for a relatively high likelihood of failure and acute complications, and requires specifically skilled operators and a demanding use of resources. In addition, controversy persists surrounding appropriate indications for attempting CTO revascularization. Finally, there is a wide uncertainty on the actual benefits achieved with successful CTO recanalization. A growing number of studies have reported procedural results and/or assessed functional effects and long-term clinical outcomes of CTO PCI. We therefore sought to review and critically appraise the evidence base for procedural outcomes and potential clinical benefits of CTO PCI. PMID:23351815

Tamburino, Corrado; Capranzano, Piera; Capodanno, Davide; Dangas, George; Zimarino, Marco; Bass, Theodore A; Mehran, Roxana; Antoniucci, David; Colombo, Antonio; La Manna, Alessio; Di Salvo, Maria E; Stone, Gregg W



Results of percutaneous coronary intervention for chronic total occlusions of coronary arteries: a single center report.  


Objectives: Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) is associated with lower rates of procedural success and higher complication rates compared with PCIs in non-CTO lesions. The purpose of this study was to analyze the relationship between lesion characteristics and procedural success rates and in-hospital outcomes after PCI for CTO with novel equipment. Study design: We evaluated the prospectively entered data of 63 consecutive patients undergoing PCI for CTO at our institute between August 2009 and June 2012. Results: A total of 63 patients (mean age: 64±11, 71% male) with one CTO lesion each underwent PCI. There were 46 patients (mean age: 63±10, 70% male) in the CTO success group and 17 patients (mean age: 65±13, 76.5% male) in the CTO failure group. Successful revascularization was achieved in 73% of patients. We used antegrade approach in 61 cases and retrograde approach in 2 cases. Our predominant strategy was single-wire technique, which was used in 54 cases (85.7%), followed by parallel-wire technique in 7 cases (11.1%). Moderate-to-severe tortuosity (odds ratio [OR]: 9.732, 95% confidence interval [CI]: 1.783-53.115, p=0.009) and occlusion duration (OR: 1.536, 95% CI: 1.178-2.001, p=0.002) were independent predictors of procedural failure in the multivariate analysis. No in-hospital major cardiac events occurred. Conclusion: We have reported a study with a relatively high success rate of PCI with very low procedural and in-hospital complications. Moderate-to-severe tortuosity was observed as the most challenging problem despite the utilisation of novel equipment and techniques for CTO recanalization. PMID:24104975

Cetin, Mustafa; Karaman, Kay?han; Zencir, Cemil; Oztürk, Unal; Y?ld?z, Emrah; Ozgül, Sami



Dorsal-plantar loop technique using chronic total occlusion devices via anterior tibial artery.  


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. PMID:23364993

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



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



Novel devices and specialized techniques in recanalization of peripheral artery chronic total occlusions (CTOs)--a literature review.  


Currently, recanalization of chronic total occlusions (CTOs) in peripheral arteries remains a challenging obstacle encountered by clinical practitioners. Percutaneous CTO interventions are associated with low rates of procedural success using standard guidewires and catheters. When guidewires cannot cross the occluded segment or fail to reenter the true lumen after subintimal crossing of the occlusion, successful recanalization may be unachievable. In the last few years, the emergence of novel devices and new techniques has dramatically improved the success rates of the revascularization for CTOs. This paper reviews the published data of current devices and specialized techniques of percutaneous intervention to relieve CTOs. PMID:22459363

Liang, Gang Zhu; Zhang, Fu Xian



Immediate outcome of chronic total occlusion opening in post-angioplasty patients.  


The study sought to compare procedural outcomes for patients undergoing percutaneous coronary intervention (PCI) of a chronic total coronary artery occlusion (CTO) with a matched non-CTO cohort. Percutaneous coronary intervention of a CTO is a common occurrence, and the outcome for patients with successful PCI of a CTO has not been clearly defined. Between November 2006 and December 2010, a total of 2,000 consecutive patients consecutively underwent PCI for a CTO. Utilizing propensity scoring methods, a matched non-CTO cohort of 2,000 patients was identified and compared to the CTO group. The cohorts were stratified as successful and failed procedures in United Hospital Limited Dhaka. The in-hospital major adverse cardiac event (MACE) rate was 3.8% in the CTO cohort. Technical success has improved over the last 10 years (overall 74.4%, slope 1.0%/year, p=0.02, R²=49.9%) as did procedural success (overall 69.9%, slope 1.2%/year, p=0.02, R²=51.5%) without a concomitant increase in in-hospital MACE rates (slope 0.1%/year, p=0.7). There was a distinct advantage for successful CTO treatment compared with failed CTO treatment (73.5% vs. 65.1%, p=0.001). The CTO versus non-CTO survival was the same (71.2% vs. 71.4%, p=0.9). Diabetics in the CTO cohort had a lower survival compared with non-diabetics (58.3% vs. 74.3%, p=0.0001). These data represent outcome of PCI for a CTO. The 10-year survival rates for matched non-CTO and the CTO cohorts were similar. Success rates have continued to improve without an accompanying increase in MACE rates. A successfully revascularized CTO confers a significant survival advantage compared with failed revascularization. PMID:23982538

Khan, K N; Khan, M H; Haque, M Z



Optical frequency domain imaging for guidance of optimal stenting in the setting of recanalization of chronic total occlusion.  


We present an interesting case illustrating how coronary optical frequency domain imaging (OFDI) examination can be used to guide revascularization of a complex chronic total occlusion (CTO) in a patient presenting to our hospital with a 2-year history of angina, dyspnea, and a positive treadmill test. This case demonstrates the potential clinical role of high-resolution OFDI to optimize coronary stent implantation. OFDI may help to limit the coronary area covered by stents to the true coronary lesion. PMID:23813069

Jaguszewski, Milosz; Guagliumi, Giulio; Landmesser, Ulf



A Case of Intra- and Extra-Mural Hematomas During Recanalization for Chronic Total Occlusion  

PubMed Central

An intramural hematoma is an accumulation of blood between the internal and external elastic membranes within the medial space, whereas an extramural hematoma is a dilution and/or dissemination of blood throughout the adventitia. Intra- and extra-hematomas are observed by intravascular ultrasound during percutaneous coronary intervention (PCI). The patient described herein presented with angina pectoris. Her coronary angiogram showed diffuse narrowing of the mid-left anterior descending artery and total occlusion of the distal right coronary artery (RCA). Intra- and extra-mural hematomas developed during PCI of the RCA; however, the lesions were covered successfully using long drug-eluting stents.

Kang, Sun-Young; Choi, Hyun-Chul; Kim, Gyu-Soo; Cho, Yun-Kyeong; Han, Chun-Duk; Park, Hyoung-Seob; Yoon, Hyuck-Jun; Kim, Hyungseop; Nam, Chang-Wook; Kim, Yoon-Nyun; Kim, Kwon-Bae



True lumen re-entry after extravascular recanalization of a superficial femoral artery chronic total occlusion.  


A 66-year-old man was treated for disabling right leg calf claudication with angioplasty and stenting of a chronically occluded superficial femoral artery. During attempted subintimal passage, the guidewire tracked extralumenally, which was not recognized, but it was successfully redirected into the true lumen distal to the occlusion with the use of the Outback (Cordis Endovascular, Miami Lakes, Fla) re-entry device. A bare metal nitinol stent was initially deployed extralumenally in the perivascular soft tissue. The patient returned for reintervention 9 days later complaining of pain and discoloration of the popliteal space. Duplex evaluation of the superficial femoral artery revealed a pseudoaneurysm, and Viabahn stent grafts (W. L. Gore & Assoc, Flagstaff, Ariz) were successfully deployed to produce an endovascular percutaneous prosthetic bypass. PMID:20434294

Wagner, Jason K; Chaer, Rabih A; Rhee, Robert Y; Marone, Luke K



A New Parameter Predicting Chronic Total Occlusion of Coronary Arteries: Platelet Distribution Width.  


Platelet distribution width (PDW) measures the variability in platelet size and is a marker of platelet activation. We investigated whether PDW is associated with the extent of coronary artery disease (CAD) and coronary total occlusions (CTOs). We studied 162 patients: 108 had a coronary lesion with a diameter stenosis of ?50%, the CAD(+) group, and 54 patients had normal coronary anatomy, the CAD(-) group. The CAD(+) group was subdivided into CAD(+) CTO(+) and CAD(+) CTO(-) groups. Among patients with CAD, the CTO(+) group had a significantly greater PDW (%) than the CTO(-) group (16.9 ± 2.8, 15.4 ± 3.0, and 15.4 ± 1.9, respectively; P = .008). In a receiver-operating characteristic analysis, a PDW cut point of 15.7% was identified in patients with CTO(+) (area under curve = 0.64, 95% confidence interval 0.54-0.75). A PDW value of more than 15.7% demonstrated a sensitivity of 64% and a specificity of 66%. The PDW is a simple platelet index that may predict the presence of CTO. PMID:23636855

Vatankulu, Mehmet Akif; Sonmez, Osman; Ertas, Gokhan; Bacaksiz, Ahmet; Turfan, Murat; Erdogan, Ercan; Tasal, Abdurrahman; Kul, Seref; Uyarel, Huseyin; Goktekin, Omer



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


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. PMID:23656802

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



"Head-to-toe" kissing balloon angioplasty during PCI of right coronary artery chronic total occlusion.  


New techniques involving the use of retrograde channels have enabled successful revascularization of chronically occluded arteries previously not amenable to standard strategies. We describe the use of a simultaneous antegrade and retrograde approach to perform bifurcation kissing balloon angioplasty which was not possible using a standard antegrade approach. As the balloons are oriented in opposite rather than identical directions, we have named this technique "Head-to-Toe Kissing." © 2013 Wiley Periodicals, Inc. PMID:23553919

Al Aloul, Basel; Guigari, Pavel; Nicholas Burke, M



Multimodality Imaging Evaluation of Functional and Clinical Benefits of Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion Lesion  

PubMed Central

Aims: To determine the effects of percutaneous coronary intervention (PCI) on cardiac perfusion, cardiac function, and quality of life in patients with chronic total occlusion (CTO) lesion in left anterior descending (LAD) coronary artery. Methods and Results: Patients (n=99) with CTO lesion in the LAD coronary artery who had successfully undergone PCI were divided into three groups based on the SPECT/CTCA fusion imaging: (a) no severe cardiac perfusion defects (n=9); (b) reversible cardiac perfusion defects (n=40); or (c) fixed cardiac perfusion defects (n=50). No statistical difference of perfusion abnormality was observed at 6 months and 1 year after PCI in group (a). In group (b), SPECT/CTCA fusion imaging demonstrated that cardiac perfusion abnormality was significantly decreased 6 month and 1 year after PCI. Left ventricular ejection fraction (LVEF) increased significantly at 6 months and 1 year follow up. Quality of life improved at 6 months and 1 year after PCI procedure. Moreover, patients in group (c) also benefited from PCI therapy: a decrease in cardiac perfusion abnormality, an increase in LVEF, and an improvement in quality of life. PCI of coronary arteries in addition to LAD did not significantly affect cardiac function and quality of life improvement in each group. Conclusions: PCI exerts functional and clinical benefits in patients with CTO lesion in LAD coronary artery, particularly in patients with reversible cardiac perfusion defects. SPECT/CTCA fusion imaging may serve as a useful tool to evaluate the outcomes of patients with CTO lesion in LAD coronary artery.

Sun, Dongdong; Wang, Jing; Tian, Yue; Narsinh, Kazim; Wang, Haichang; Li, Chengxiang; Ma, Xiaowei; Wang, Yabing; Wang, Dongjuan; Li, Chunhong; Wu, Joseph C; Tian, Jie; Cao, Feng



A case of successful angioplasty by the "double retrograde" approach for chronic total occlusion in the left circumflex artery.  


Currently introduced retrograde approach may increase the success rate of percutaneous coronary interventions on chronic total occlusion (CTO) lesion. This article describes a case of CTO in the left circumflex artery (LCX), which did not allow the regular retrograde approach to deliver a guide wire. At first, a guide wire was attempted to advance from the apical collateral channel, which supplied the distal LCX. However, wiring was extremely difficult because the collateral channel was headed reversely against the direction that the wire was going. Different angle angiogram revealed the existence of another collateral artery, which supplied the distal RCA (posterior descending branch). A guide wire was successfully advanced from the distal RCA, through apical collateral channel, and reached the distal LCX. After the wire was retrieved from the guiding catheter engaged in the left main trunk, antegrade access for balloon and stent delivery was obtained. This method, a sort of "double retrograde" approach, would be worthy to consider when recanalization is failed by other approaches. PMID:21812091

Hoshiyama, Koki; Nakamura, Sunao



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



A case of successful use of microsnare to hold and pull the retrograde guidewire for the intervention to peripheral chronic total occlusion.  


A basket-shaped microsnare has various uses such as the pull through technique during coronary intervention to chronic total occlusion (CTO). A 79-year-old man underwent angioplasty for the femoral artery occlusion. We performed a controlled antegrade and retrograde tracking (CART) with dilatation of a balloon on the antegrade guidewire. The retrograde guidewire partly ran in the true lumen but could not pass through the CTO lesion because of inadequate CART. Eventually, we successfully gripped the top of the retrograde guidewire in the CTO lesion using the basket-shaped microsnare (Soutenir(®)). The microsnare may be useful for bidirectional approach in peripheral CTO lesions. PMID:23338676

Hara, Tomoya; Wakatsuki, Tetsuzo; Taketani, Yoshio; Yamaguchi, Koji; Iwase, Takashi; Sata, Masataka



Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention  

PubMed Central

Background The prognosis of elderly patients with chronic total occlusion (CTO) and diabetes mellitus (DM) treated with percutaneous coronary intervention (PCI) is not known. Objective To investigate the effect of diabetes on long-term follow-up of CTO after PCI in elderly patients. Methods A total of 153 elderly patients (age > 65 years old) with CTO lesions which were successfully treated with PCI were enrolled. Fifty one patients with diabetes and 102 without diabetes were compared for long-term outcomes (mean follow up: 36 ± 12 months). Major adverse cardiac events (MACE) which include death, myocardial infarction or target lesion revascularization (TLR) were considered as a combined endpoint. Results The combined endpoint occurred in 29.4% of diabetes patients, and 11.3% of the patients without diabetes (P < 0.05). The Cox proportional hazards model identified: drug eluting stent (DES) or bare metal stent (BMS) (HR: 0.13, 95% confidence interval (95% CI): 0.03–0.62, P = 0.004), DM (HR: 6.69, 95% CI: 1.62–15.81, P = 0.01) and final minimal lumen diameter (MLD) (HR: 0.37, 95% CI: 0.13–0.90, P = 0.03 ) as independent predictors of MACE, DM with renal impairment (HR: 6.64, 95% CI: 1.32–33.36, P = 0.02), HBA1C on admission (HR: 1.79, 95% CI: 1.09–2.94, P = 0.02), as independent predictors of MACE at long term follow-up. Conclusions The study demonstrates that DM is a predictive factor for MACE in elderly CTO patients treated with PCI, type of stent, final minimal lumen diameter and DM with renal impairment, and HBA1C level on admission are predictors of MACE.

Liu, Wei; Wagatsuma, Kenji; Nii, Hideo; Toda, Mikihito; Amano, Hideo; Uchida, Yasuto



Clinical and angiographic outcomes after percutaneous recanalization of chronic total saphenous vein graft occlusion using modern techniques.  


Poor long-term outcomes after percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) of saphenous vein grafts (SVGs) have been reported. However, limited data are available evaluating the use of modern techniques in this group. The aim of the present study was to assess the efficacy and long-term outcomes of PCI in SVG CTO with the routine use of embolic protection devices and drug-eluting stents. A retrospective cohort analysis was conducted of all consecutive patients undergoing PCI to SVG CTO from May 2002 to July 2009 at 2 centers. The indication for PCI was the presence of angina or silent ischemia with evidence of inducible ischemia after functional testing in the territory supplied by the SVG, despite optimal medical therapy. We identified 34 patients with SVG CTO. Of the 34 patients, 23 (68%) underwent successful SVG recanalization with stent implantation. An embolic protection device was used in 78% and 95% of stents implanted were drug-eluting stents. No in-hospital major adverse cardiac events occurred in the successful PCI group; one myocardial infarction occurred in the unsuccessful group. At follow-up (median 18.0 months, interquartile range 10.4 to 48.3), 1 case of myocardial infarction had occurred in the successful group. The in-stent restenosis rate was 68% (n = 13), of which 77% were focal, with target vessel revascularization in 61%. In conclusion, despite the relatively low procedural success rates, the clinical outcomes after successful PCI to SVG CTO with modern techniques were favorable. The repeat revascularization rates were high; however, graft patency was achievable in most after reintervention. PMID:21126616

Al-Lamee, Rasha; Ielasi, Alfonso; Latib, Azeem; Godino, Cosmo; Ferraro, Massimo; Arioli, Francesco; Mussardo, Marco; Piraino, Daniela; Figini, Filippo; Carlino, Mauro; Montorfano, Matteo; Chieffo, Alaide; Colombo, Antonio



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


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 and 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. PMID:23969577

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



Long-term outcomes after percutaneous coronary intervention for chronic total occlusion (from the CREDO-Kyoto registry cohort-2).  


Despite improving success rate of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions, the clinical benefit of recanalization of CTO is still a matter of debate. Of 13,087 patients who underwent PCI in the CREDO-Kyoto registry cohort-2, 1,524 patients received PCI for CTO (CTO-PCI). Clinical outcomes were compared between 1,192 patients with successful CTO-PCI and 332 patients with failed CTO-PCI. In-hospital death tended to occur less frequently in the successful CTO-PCI group than in the failed CTO-PCI group (1.4% vs 3.0%, p = 0.053). Through 3-year follow-up, the cumulative incidence of all-cause death was not significantly different between the successful and failed CTO-PCI groups (9.0% vs 13.1%, p = 0.18), whereas the cumulative incidence of cardiac death was significantly less in the successful CTO-PCI group than in the failed CTO-PCI group (4.5% vs 8.4%, p = 0.03). However, after adjusting confounders, successful CTO-PCI was associated with lesser risk for neither all-cause death (hazard ratio 0.93, 95% confidence interval 0.64 to 1.37, p = 0.69) nor cardiac death (hazard ratio 0.71, 95% confidence interval 0.44 to 1.16, p = 0.16). The cumulative incidence of coronary artery bypass grafting (CABG) was remarkably less in patients with successful PCI compared with those with failed PCI (1.8% vs 19.6%, p <0.0001). In conclusion, successful CTO-PCI compared with failed PCI was not associated with lesser risk for 3-year mortality. However, successful CTO-PCI was associated with significantly less subsequent CABG. PMID:23735646

Yamamoto, Erika; Natsuaki, Masahiro; Morimoto, Takeshi; Furukawa, Yutaka; Nakagawa, Yoshihisa; Ono, Koh; Mitsudo, Kazuaki; Nobuyoshi, Masakiyo; Doi, Osamu; Tamura, Takashi; Tanaka, Masaru; Kimura, Takeshi



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



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

PubMed Central

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 a chronic total occlusion between 1981 and 1992. RESULTS--Procedural success was achieved in 191 lesions (61.2%). A major complication occurred in six patients (1.9%). Multiple stepwise logistic regression analysis identified the presence of bridging collaterals (p < 0.001), the absence of a tapered entry configuration (p < 0.001), estimated duration of occlusion of greater than three months (p = 0.001), and a vessel diameter of less than 3 mm (p = 0.003) as independent predictors of procedural failure. The logistic regression model was used to classify patients into groups of high, intermediate, and low probability of procedural success with cut off points of 70% and 30%. The predictive value for procedural success (probability > or = 70%) was 91% (95% confidence intervals (95% CI) 83% to 96%) and predictive value for procedural failure (probability < 30%) was 81% (95% CI 64% to 92%). CONCLUSIONS--Percutaneous transluminal coronary angioplasty of chronic total occlusions is associated with a low risk of acute complication. Procedural success is influenced by easily identifiable clinical and angiographic features and the multiple regression model described may help to improve selection of patients.

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



Functional assessment of the collateral-dependent circulation in chronic total coronary occlusion using transthoracic Doppler ultrasound and venous adenosine infusion.  


The measurement of collateral flow reserve (CFR; the hyperemic/baseline collateral flow velocity ratio) in patients with chronic total coronary occlusion requires invasive and expensive techniques. Noninvasive transthoracic coronary Doppler echocardiography may be an alternative option. Fifty-one patients with chronic total coronary occlusion were evaluated by transthoracic coronary Doppler echocardiography and venous adenosine infusion to measure CFR in occluded coronary arteries (the left anterior descending artery in 44 patients and the artery supplying the posterior descending artery in 7 patients). CFR data were plotted against 3 angiographic parameters: (1) grade of the epicardial filling of the occluded artery (1=absent, 2=partial, 3=complete), (2) stenosis of the donor artery, and (3) the extent of coronary artery disease (vessels with >or=70% stenosis). Collateral flow was maintained at stress in 34 patients (CFR>or=1, range 1.0 to 2.2) but was withdrawn in 17 patients (CFR<1, range 0.25 to 0.90). CFR increased with the degree of angiographic collateral flow (grade 1: 0.73+/-0.29; grade 2: 1.16+/-0.31; grade 3: 1.34+/-0.49; F=5.31, p=0.008). A multivariate model of CFR prediction showed a direct relation with angiographic collateral grade and the number of diseased vessels and an inverse relation with stenosis of the donor artery. In conclusion, CFR measurement is feasible by transthoracic coronary Doppler echocardiography. One third of the patients with chronic total coronary occlusion had collateral flow withdrawal at stress, which occurs when collateral circulation is poor and when the donor artery is stenotic. CFR correlates with angiographic collateral grade and with the extent of coronary artery disease. PMID:16828592

Pizzuto, Francesco; Voci, Paolo; Puddu, Paolo Emilio; Chiricolo, Gaetano; Borzi, Mauro; Romeo, Francesco



Serum erythropoietin: a useful biomarker for coronary collateral development and potential target for therapeutic angiogenesis among the patients with coronary chronic total occlusion.  


The study was to investigate the association of endogenous erythropoietin (EPO) and coronary collateral development. Forty-nine patients (31 with chronic total occlusion (CTO), 18 with normal coronary artery) were consecutively enrolled. The serum EPO was positively related with Rentrop class. Increased serum EPO was one of the independent predictors of good collateral development (odds ratio 1.31; p?=?0.025). A significantly positive correlation was seen between serum EPO and vascular endothelial growth factor (VEGF) levels (r?=?0.96, p?

Xu, Weixian; Guo, Zhiguo; Mi, Lin; Wang, Guisong



Chronic retinal vein occlusion in glaucoma  

Microsoft Academic Search

Asymptomatic chronic retinal vein occlusion that occurs in chronic simple glaucoma is described. The condition is characterized by marked elevation of retinal vein pressure with collateral vessels and vein loops at the optic disc in cases of central vein occlusion, or retinal veno-venous anastomoses along a horizontal line temporal and nasal to the disc in hemisphere vein occlusion. No patient

R A Hitchings; G L Spaeth



Interaction of chronic total occlusion and chronic kidney disease in patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction.  


Chronic total occlusion (CTO) in a non-infarct-related artery and chronic kidney failure (CKD) are associated with worse outcomes after primary percutaneous coronary intervention (PCI). The aim of this study was to investigate the interaction of CTO and CKD in patients who underwent primary PCI for acute ST-segment elevation myocardial infarction (STEMI). Patients with STEMIs with or without CKD, defined as an estimated glomerular filtration rate <60 ml/min/1.73 m(2), were categorized into those with single-vessel disease and those with multivessel disease with or without CTO. The primary outcomes were the incidence of 30-day and 1-year mortality. Among 1,873 consecutive patients with STEMIs included between 2006 and 2011, 336 (18%) had CKD. The prevalence of CTO in a non-infarct-related artery was 13% in patients with CKD compared with 7% in those without CKD (p = 0.0003). There was a significant interaction between CKD and CTO on 30-day mortality (p = 0.018) and 1-year mortality (p = 0.013). Independent predictors of late mortality in patients with CKD were previous myocardial infarction (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.01 to 2.79), age >75 years (HR 1.86, 95% CI 1.19 to 2.95), a left ventricular ejection fraction after primary PCI <40% (HR 2.20, 95% CI 1.36 to 3.63), left main culprit artery (HR 4.46, 95% CI 1.64 to 10.25), and shock (HR 7.44, 95% CI 4.56 to 12.31), but multivessel disease with CTO was not a predictor. In contrast, multivessel disease with CTO was an independent predictor of mortality in patients without CKD (HR 3.30, 95% CI 1.70 to 6.17). In conclusion, in patients with STEMIs who underwent primary PCI, with preexisting CKD, the prevalence of CTO in a non-infarct-related artery was twice as great. In these patients, the clinical impact of CTO seems to be overshadowed by the presence of CKD. PMID:23601580

Bataille, Yoann; Plourde, Guillaume; Machaalany, Jimmy; Abdelaal, Eltigani; Déry, Jean-Pierre; Larose, Eric; Déry, Ugo; Noël, Bernard; Barbeau, Gérald; Roy, Louis; Costerousse, Olivier; Bertrand, Olivier F



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 NTR1108.



Successful bypass restenting across the struts of an occluded subintimal stent in chronic total occlusion using a retrograde approach.  


Recently, subintimal angioplasty has been introduced as a bailout strategy to improve the success rate of PCI for vessels with CTO. However, the long-term outcome of subintimal angioplasty has not been determined, and a limitation of subintimal angioplasty is the uncertainty in making the re-entry point. We report two cases, where occlusive in-stent restenosis occurred in a stent implanted in the subintimal space of the RCA that had CTO. These two cases were successfully treated with bypass restenting across the struts of an occluded subintimal stent using a retrograde approach. A retrograde wire crossed the occluded segment through the lumen along the outside of the stent and reentered the inside of the stent across the stent struts. The reverse CART technique followed by multiple restenting across the stent struts restored antegrade flow. Follow-up angiography demonstrated the patency of the RCA. © 2013 Wiley Periodicals, Inc. PMID:23704039

Ohya, Hidefumi; Kyo, Eisho; Katoh, Osamu



Segmental pancreatic autotransplantation with pancreatic ductal occlusion after near total or total pancreatic resection for chronic pancreatitis. Results at 5- to 54-month follow-up evaluation.  

PubMed Central

Reported are eight patients with idiopathic chronic pancreatitis and two patients with alcoholic pancreatitis who had near total distal pancreatectomy for disabling pain and underwent simultaneous segmental pancreatic autotransplantation of the body and tail of the gland to the femoral area in an attempt to prevent or delay the onset of diabetes. The median follow-up period was 31 months, and follow-up study in nine patients ranged from 24 to 54 months. Patency of the grafts was determined by angiography and selected percutaneous venous assays for insulin. Islet cell function was determined by oral glucose tolerance tests, intravenous (I.V.) glucose tolerance tests, and I.V. glucagon stimulation studies. Segmental autotransplantation was technically successful in eight patients, only one of whom required insulin (at 2 years after grafting). The other seven patients with technically successful grafts have remained insulin independent, including two patients who later underwent pyloric preserving pancreatoduodenectomy for completion pancreatectomy. Variable pain relief was observed in patients who underwent near total pancreatectomy, but pain was unrelieved in those patients who underwent limited distal resection. Patients with idiopathic pancreatitis appear to have better pain relief and preservation of endocrine function than alcoholic patients. Segmental pancreatic autotransplantation prevents or delays the onset of diabetes mellitus and should be considered as an alternative for those patients who require extensive pancreatic resection for chronic pancreatitis.

Rossi, R L; Soeldner, J S; Braasch, J W; Heiss, F W; Shea, J A; Nugent, F W; Watkins, E; Silverman, M L; Bolton, J



Clinical outcomes of endovascular treatments for critical limb ischemia with chronic total occlusive lesions limited to below-the-knee arteries.  


BackgroundDiabetes mellitus tends to have the greatest impact on the smaller vessels and contributes significantly to occlusive disease from the popliteal artery distally.PurposeTo evaluate the clinical outcomes after a balloon angioplasty with or without stent placement in diabetic patients with critical limb ischemia (CLI) by chronic total occlusion (CTO) limited to below-the-knee (BTK) arteries.Material and MethodsFrom August 2005, patients who presented CLI and CTO limited to the BTK arteries, and who underwent endovascular treatment, were included in this study. The primary endpoints evaluated were technical success, limb salvage, and primary patency. The secondary endpoints evaluated were 30-day access site, intervention site, and systemic complications. Patency and limb salvage were evaluated using the Kaplan-Meier method and compared using Fisher's exact test.ResultsThe BTK endovascular treatment (EVT) was performed on 64 limbs. Technical success rate was 93.8% and limb salvage rate was 90.6%. Three of four limbs with technical failure and three of 60 limbs with technical success underwent BTK amputation and the comparison of these rates were significantly different (75% vs. 5%, P = 0.002). Primary patency rates for the limbs were 75% and 59.1% at 6-month and 12-month follow-up, respectively. Minor complications disappeared through the follow-up periods and there was no 30-day complication or systemic adverse events for the treated vessel.ConclusionEven though EVT for CLI in patients with diabetes and CTO in isolated BTK arteries does not have comparable primary patency, it can lead to a very high rate of limb salvage. This result can accentuate the importance of more blood flow to the foot by means of successful revascularization using EVT rather than long-term patency in CTO of isolated BTK arteries. PMID:23091234

Park, Sang Woo; Kim, Jun Seok; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Chee, Hyun Keun; Chang, Seong-Hwan; Shin, Dong Hyeok; Jung, Hong Geun; Chang, Il Soo



Absence of robust ischemic preconditioning by five 1-minute total umbilical cord occlusions in fetal sheep  

Microsoft Academic Search

OBJECTIVE: To determine to what extent a series of five 1-minute total umbilical cord occlusions, intended to induce ischemic preconditioning (IP), affects the physiologic responses to a 10-minute total umbilical cord occlusion (damaging insult [DI]) 1 hour later and provides cardio- and neuroprotection. METHODS: In 14 chronically catheterized late gestation fetal sheep (127-131 days' gestation), we performed a 10-minute total

F. K. Lotgering; J. M. Bishai; P. C. Struijk; A. B. Blood; C. J. Hunter; K. C. Oberg; G. G. Power; L. D. Longo



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.



Left atrial inflow and outflow obstruction as a complication of retrograde approach for chronic total occlusion: Report of a case and literature review of left atrial hematoma after percutaneous coronary intervention.  


Retrograde recanalization of a chronic coronary total occlusion has become an increasingly utilized method to increase success from percutaneous coronary intervention (PCI). Retrograde wire passage using a septal collateral is the preferred route as the consequences of vessel perforation are more benign than epicardial collateral perforation which may produce cardiac tamponade. Tamponade risk is thought to be lessened by previous coronary bypass surgery due to adhesions preventing free flow of blood throughout the pericardial space. We report the first case of the retrograde approach producing epicardial collateral perforation resulting in a localized epicardial hematoma, which in turn, produced left atrial (LA) inflow and outflow obstruction, with the former producing localized pulmonary edema and pleural effusion. We review reported cases of LA hematoma as a consequence of the antegrade PCI approach and describe a unified explanation for the development of this phenomenon. © 2012 Wiley Periodicals, Inc. PMID:23239608

Aggarwal, Chhaya; Varghese, Joji; Uretsky, Barry F



Sharp Recanalization for Chronic Left Iliac Vein Occlusion  

SciTech Connect

Endovascular treatment has emerged as a first-line treatment for venous occlusions, but is sometimes challenging with conventional approaches. This article describes a helpful technique using a Roesch-Uchida needle to cross a chronic occlusion of the iliac vein when conventional techniques have failed.

Ito, Nobutake, E-mail:; Isfort, Peter; Penzkofer, Tobias [RWTH Aachen University, Department of Diagnostic and Interventional Radiology, University Hospital (Germany); Grommes, Jochen; Greiner, Andreas [RWTH Aachen University, Department of Vascular Surgery, University Hospital (Germany); Mahnken, Andreas [RWTH Aachen University, Department of Diagnostic and Interventional Radiology, University Hospital (Germany)



Tracking of Moving Objects Under Severe and Total Occlusions.  

National Technical Information Service (NTIS)

We present an algorithm for tracking moving objects using intrinsic minimal surfaces which handles particularly well the presence of severe and total occlusions even in the presence of weak object boundaries. We adopt an edge based approach and find the s...

A. Bartesaghi G. Sapiro



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



Total pancreatectomy for chronic pancreatitis.  


Ten instances of total pancreatectomy performed for chronic alcohol induced pancreatitis are reported. There was no hospital mortality, and all of the patients were free of pain. The most difficult problem was labile insulin sensitive diabetes in these patients who were chronic alcoholics. In addition, steatorrhea with weight loss, bleeding marginal ulcers and general weakness diminished working ability. The present data suggest that this procedure should be considered as the last resort in the treatment of severe instances of chronic pancreatitis. PMID:3883550

Kiviluoto, T; Schröder, T; Lempinen, M



Angioplasty of total coronary occlusions using combination of intracoronary Probing Catheter and balloon on wire Probe.  


We describe our experience with a technique for PTCA of total coronary occlusions using the ultra low profile balloon on wire Probe. An intracoronary Probing Catheter was used to facilitate crossing the stenosis with a guide wire. This was followed by exchanging the guide wire for the Probe into the obstruction for balloon dilatation. This technique was used in 22 consecutive patients undergoing PTCA for chronic total occlusion. The total obstruction could be crossed by guide wire (0.014 flex or 0.016 standard) passed through Probing Catheter in 19 patients (86%). The obstruction could be successfully dilated by the Probe, delivered through the probing catheter, in 17 of these patients. Of the remaining 2 patients, one could be dilated by sequential dilatation using over the wire low profile balloon system and the other one by dilatation with the Probe, respectively. The Probing Catheter technique offers a new method to apply balloon on wire technology to the dilatation of chronic total coronary occlusions with very promising results. PMID:1398688

Kaul, U; Bahl, V K; Dev, V; Rajani, M; Wasir, H S


Sustained benefit of stenting chronic coronary occlusion: long-term clinical follow-up of the Stenting in Chronic Coronary Occlusion (SICCO) study  

Microsoft Academic Search

Objectives. This study assessed the long-term clinical outcome of stenting chronic occlusions.Background. In the Stenting in Chronic Coronary Occlusion (SICCO) study, patients were randomized to additional stent implantation (n = 58) or not (n = 59) after successful recanalization and dilation of a chronic coronary occlusion. Palmaz-Schatz stents were used with full anticoagulation. The previously published 6-month angiographic follow-up results

Knut Endresen; John Kjekshus; Yngvar Myreng; Per Mølstad; Per Albertsson; Arild Mangschau



Late Spontaneous Recanalization of Chronic Middle Cerebral Artery Occlusion  

PubMed Central

Early spontaneous recanalization of the middle cerebral artery in acute ischemic phase artery is not uncommon, whereas the late spontaneous recanalization of chronic occluded artery is a very rare phenomenon and exact incidence and the timing of this event have not been quantified. We present a case in which late spontaneous recanalization of long-lasting middle cerebral artery occlusion occurred in the absence of surgical, endovascular and thrombolytic treatments.

Ryu, Chang-Woo; Koh, Jun-Seok; Kim, Gook Ki



Re-Entry Devices in the Treatment of Peripheral Chronic Occlusions  

PubMed Central

Chronic occlusions are present in up to 40% of patients who undergo treatment for symptomatic peripheral arterial disease. The primary difficulty encountered during the treatment of chronic occlusions is inability to re-enter the true lumen after subintimal crossing of the occlusion. Two devices have been designed to mitigate this limitation via controlled re-entry. Herein, we report our experience with the Outback LTD catheter and the Pioneer Plus Catheter PPlus 120 in re-entering the true arterial lumen during percutaneous intentional extraluminal revascularization for peripheral chronic occlusions involving the superficial femoral artery. In reviewing our peripheral interventions performed from February 2006 through February 2009, we evaluated angiograms, patients' characteristics, presentations, types of lesions, procedural successes, complications, and symptom-free intervals. The total study population consisted of 23 patients. The Outback catheter was used in 15 patients and the Pioneer catheter in 8 patients. The procedure was successful in all 8 Pioneer cases (100%) and in 13 of the 15 Outback cases (87%). All 8 (100%) of the patients in the Pioneer group and 12 of the 14 patients in the Outback group (86%) remained asymptomatic at an average of 12 months. Overall, there were no procedural complications, amputations, or deaths. This single-center experience demonstrates that the Outback and Pioneer re-entry catheters are safe and effective in managing peripheral chronic occlusions, with an average symptom-free interval of 12 months. This management strategy proves to be reasonable when standard techniques fail to achieve true lumen re-entry.

Smith, Marcus; Pappy, Reji; Hennebry, Thomas A.



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:; 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)



Mild chronic hypoxia modifies the fetal sheep neural and cardiovascular responses to repeated umbilical cord occlusion  

PubMed Central

We have shown that five days of mild hypoxia has significant effects on fetal ECoG activity, heart rate and blood pressure. We now studied if mild prolonged hypoxemia had an adverse effect on the fetal cardiovascular and neural responses to repeated cord occlusion and on the magnitude of neuronal damage. Fetal and maternal catheters were placed at 120 days’ gestation and animals allocated at random to receive intratracheal maternal administration of nitrogen (n=8) or compressed air in controls (n=7). Five days after surgery, nitrogen infusion was adjusted to reduce fetal brachial artery pO2 by 25%. After 5 days of chronic hypoxemia the umbilical cord was completely occluded for 5 minutes every 30 minutes for a total of four occlusions. Data are presented as mean ± SEM and were analyzed by Two Way ANOVA or two sample t test. Nitrogen infusion decreased fetal pO2 by 26% (20.5±1.7 vs. 14.3±0.8 mmHg) without changing fetal pCO2 or pH. Pre-existing hypoxia fetuses had a greater terminal fall in heart rate in occlusions II, III and IV, and also had a more severe terminal hypotension in the final occlusion. Pre-existing hypoxia was associated with a greater fall in spectral edge frequency during occlussions from 14.4±0.9 Hz to 6.9±0.4 Hz vs. 13.6±1.64 Hz to 10.6±0.77 Hz in controls, p<0.05. In addition, during the three-day post-occlusion period the contribution of theta and alpha band frequencies to total ECoG activity was significantly lower in the pre-existing hypoxia fetuses (p<0.05). These effects were associated with increased neuronal loss in the striatum (p<0.05). In summary, the cardiovascular and neural response indicate a detrimental effect of pre-existing mild hypoxia on fetal outcome following repeated umbilical cord occlusions.

Pulgar, Victor M.; Zhang, Jie; Massmann, G. Angela; Figueroa, Jorge P.



Effect of Dalteparin on Healing of Chronic Foot Ulcers in Diabetic Patients With Peripheral Arterial Occlusive Disease: A prospective, randomized, double-blind, placebo-controlled study  

Microsoft Academic Search

OBJECTIVE — Chronic foot ulcers are a common, severe, and expensive complication threatening life and limb in patients with diabetes. The aim of the present study was to investigate the effect of dalteparin on ulcer outcome in patients with diabetes, peripheral arterial occlusive disease, and chronic foot ulcers. RESEARCH DESIGN AND METHODS — A total of 87 patients were investigated




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



Total body irradiation in chronic myeloid leukemia  

SciTech Connect

Total body irradiation (TBI), given as 10 rad daily for five days a week for a total dose of 150 rad has been used in an attempt to control the chronic phase of chronic myeloid leukemia (CML). Thirteen patients with CML received fractionated TBI leading to rapid and good control of WBC count without any adverse reaction. The chronic phase of CML could also be controlled with TBI, even in three patients who were resistant to busulfan. Following TBI, WBC count remained under control for a period of 32 weeks as compared to 40 weeks following vusulfan alone. Repeat TBI was also well tolerated with good response. It appears that TBI is an effective and safe therapy for controlling the chronic phase of CML.

Advani, S.H.; Dinshaw, K.A.; Nair, C.N.; Ramakrishnan, G.



Vasomotor Function of Pig Coronary Arteries after Chronic Coronary Occlusion  

Microsoft Academic Search

Placement of an ameroid constrictor in large-conduit pig coronary arteries causes progressive stenosis and distal myo- cardial ischemia. Blood perfusion in the ischemic region is partly dependent on vasomotor responses to neural and humoral factors distal to the occlusion site. To ascertain the degree of impairment of vascular function in pigs, the authors induced myocardial is- chemia by placing an

Jinsheng Li; Hector De Leon; Takafumi Ueno; Jianhua Cui; Patrick K. Coussement; Spencer B. King; Nicolas A. F. Chronos; Keith A. Robinson


Optical-coherence-reflectometry (OCR)-guided rf ablation guide wire for total occlusions  

NASA Astrophysics Data System (ADS)

One of the last remaining frontiers in angioplasty interventions is successfully recanalizing arteries containing total occlusions. The primary limitation is the inability to pass a guide wire safely across the total occlusion to facilitate therapeutic interventions, such as balloon angioplasty. The Optical Coherence Reflectometry (OCR) guide wire system has demonstrated clinical potential for navigating through total occlusions, but often these lesions are refractory to passage of the guide wire by mechanical force alone. The OCR guide wire has been coupled with low frequency (250-500 kHz), short duration (100 millisecond pulses) radio frequency energy to facilitate guided ablation through the total occlusion. 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. Coupled with the OCR guidance system, the RF ablation allows passage through highly resistant lesions that would not normally be transversed with conventional guide wires. The OCR guided RF guide wire system has been successfully tested in porcine models with cadaveric atherosclerotic diseased arterial grafts.

Neet, John M.; Winston, Thomas R.; Siglinger, Marlin R.; Janssen, Michael; Balaster, Ammon N.



Elective surgical treatment of symptomatic chronic mesenteric occlusive disease: Early results and late outcomes  

Microsoft Academic Search

Purpose: The purpose of this study was to determine the safety and efficacy of the elective surgical treatment of symptomatic chronic mesenteric occlusive disease (SCMOD) and to identify the factors that influence the results of this procedure. Methods: From 1977 to 1997, 85 patients (mean age, 62 years) underwent elective surgical treatment of SCMOD. The presenting symptoms were abdominal pain

Romeo B. Mateo; Patrick J. O'Hara; Norman R. Hertzer; Edward J. Mascha; Edwin G. Beven; Leonard P. Krajewski



Revascularization of vertebrobasilar artery occlusion at the chronic stage.  


We describe a patient who underwent intracranial angioplasty and Solitaire stent placement for recanalization of a vertebrobasilar artery occlusion 2 months after symptom onset. Computed tomography angiography and digital subtraction angiography showed that both vertebral arteries and the proximal basilar artery were occluded. Balloon angioplasty was performed on a segment of the occluded left vertebral artery and basilar artery, followed by successful detachment of one Solitaire stent. Repeat angiography showed near normal patency of the left vertebrobasilar artery. The patient`s symptoms improved significantly, and postoperative transcranial Doppler sonography 3 months later showed no evidence of in-stent restenosis. PMID:23887219

Liu, Xun-Can; Chen, Chen; Shi, Ming-Chao; Wang, Shou-Chun



Mid-term clinical outcome following endovascular therapy in patients with chronic aortic occlusion.  


Although endovascular therapy (EVT) has been widely used for iliac lesions due to acceptable patency with stenting, EVT has not been established as primary treatment for aortic occlusion, partly because of uncertainty regarding long-term results. The purpose of this study was to investigate outcomes following EVT with stenting for chronic aortic occlusion. This study was a single-center retrospective analysis of a prospectively maintained database. Between September 2005 and May 2012, twenty-four lesions from 25 patients with a clinical diagnosis of chronic aortic occlusion (mean age, 71 years; 80 % male) were treated with EVT with stenting. Kaplan-Meier estimators were used to determine the patency rates according to Society for Vascular Surgery criteria. In results, lesion type was Trans Atlantic Inter-Society Consensus D in all patients. Mean lesion length was 145 mm. Initial success rate and procedural complication rate were 96 % (24/25) and 8 % (2/25), respectively. At 36 months, primary and secondary patency rates were 76 and 94 %, respectively. Restenosis was observed in 5 patients, all of whom underwent reintervention (four successful, one failure and intensity of medical treatment). EVT can be safely done in patients with chronic aortic occlusion. Procedural morbidity and mid-term durability were comparable to those of bypass surgery up to 3 years. PMID:23539356

Dohi, Tomoharu; Iida, Osamu; Okamoto, Shin; Nanto, Kiyonori; Nanto, Shinsuke; Uematsu, Masaaki



Development of a total atherosclerotic occlusion with cell-mediated calcium deposits in a rabbit femoral artery using tissue-engineering scaffolds.  


This study sought to establish a chronic total occlusion (CTO) model with cell-mediated calcium deposits in rabbit femoral arteries. CTO is the most severe case in atherosclerosis and contains calcium deposits. Previous animal models of CTO do not mimic the gradual occlusion of arteries or have calcium in physiological form. In the present study we tested the strategy of placing tissue-engineering scaffolds preloaded with cells in arteries to develop a novel CTO model. Primary human osteoblasts (HOBs) were first cultured in vitro on polycaprolactone (PCL) scaffolds with 5 ng TGF?1 loading for 28 days for precalcification. The HOB-PCL construct was then implanted into a rabbit femoral artery for an additional 3, 10 or 28 days. At the time of sacrifice, angiograms and gross histology of arteries were captured to examine the occlusion of arteries. Fluorescent staining of calcium and EDS detection of calcium were used to evaluate the presence and distribution of calcium inside arteries. Rabbit femoral arteries were totally occluded over 28 days. Calcium was presented at CTO sites at 3, 10 and 28 days, with the day 10 specimens showing the maximum calcium. Chronic inflammatory response and recanalization were observed in day 28 CTO sites. A novel CTO model with cell-mediated calcium has been successfully established in a rabbit femoral artery. This model can be used to develop new devices and therapies to treat severe atherosclerotic occlusion. PMID:21400666

Zhu, Beili; Bailey, Steven R; Elliott, James; Li, Xiankai; Escobar, G Patricia; Rodriguez, Eva M; Agrawal, C Mauli



Late total occlusion after intracoronary brachytherapy for patients with in-stent restenosis  

Microsoft Academic Search

OBJECTIVESThe study sought to determine the incidence and predictors of late total occlusion (LTO, >30 days) in-patients with in-stent restenosis who were treated with intracoronary radiation.BACKGROUNDIntracoronary radiation both with beta and gamma emitters has been shown to reduce recurrent in-stent restenosis.METHODSWe reviewed the records of 473 patients who presented with in-stent restenosis and who were enrolled in various radiation protocols,

Ron Waksman; Balram Bhargava; Gary S Mintz; Roxana Mehran; Alexandra J Lansky; Lowell F Satler; Augusto D Pichard; Kenneth M Kent; Martin B Leon



The chronic vascular and haemodynamic response after permanent bilateral common carotid occlusion in newborn and adult rats  

Microsoft Academic Search

Vascular growth and redistribution of flow can compensate for arterial occlusion and possibly reduce the effects of hypoperfusion. As yet there is limited information on the age-dependent nature of vasculature remodelling. In this study, we have monitored the vascular and morphologic changes using magnetic resonance imaging and histology in a chronic bilateral common carotid artery occlusion (BCCAO) model in both

ManKin Choy; Vijeya Ganesan; David L Thomas; John S Thornton; Edward Proctor; Martin D King; Louise van der Weerd; David G Gadian; Mark F Lythgoe



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:; Habib, Said [Nottingham University Hospitals NHS Trust, Department of Radiology, Queens Medical Centre (United Kingdom)], E-mail:



Moderate loss of cerebellar Purkinje cells after chronic bilateral common carotid artery occlusion in rats  

Microsoft Academic Search

Pathological effects of moderate ischemia (oligemia, hypoperfusion) are relevant in relation to vascular factors in dementia.\\u000a Chronic bilateral common carotid artery occlusion (BCCAO) in adult Wistar rats induces oligemia and leads to acute changes\\u000a in gene expression, subacute changes in cortical astrocytes and prolonged changes in white matter tracts, while largely sparing\\u000a neurons in the forebrain areas. Dilation and remodeling

Orsolya Kántor; Christoph Schmitz; Judith Feiser; Ivona Brasnjevic; Hubert Korr; Raul Busto; Myron D. Ginsberg; Rainald Schmidt-Kastner



Mouth occlusion pressure, CO 2 response and hypercapnia in severe chronic obstructive pulmonary disease  

Microsoft Academic Search

The resting mouth occlusion pressure 0.1 s after onset of inspiration (P0.1) and minute ventilation (V 'E) and their response to CO2 in patients with chronic obstructive pulmonary disease (COPD) remain controversial. The ventilatory drive and the factors that predict resting arterial CO2 tension (Pa,CO2) were studied in 19 eucapnic and 14 hypercapnic severe COPD patients, and 20 controls. The

M. Montes de Oca; B. R. Celli



Percutaneous laser-assisted recanalization of long chronic iliac artery occlusions: primary and mid-term results  

Microsoft Academic Search

We report the primary and mid-term outcome of patients with long chronic iliac artery occlusions after percutaneous excimer-laser-assisted interventional recanalization. Between 2000 and 2001, 43 patients with 46 chronic occlusions of either the common iliac artery (n=27), the external iliac artery ( n=13) or both (n=3) underwent laser-assisted percutaneous transluminal angioplasty and implantation of stents. The average length of the

Jörn O. Balzer; Verena Gastinger; Axel Thalhammer; Ralf G. Ritter; Edelgard Lindhoff-Last; Thomas Schmitz-Rixen; Thomas J. Vogl



Stenting in chronic coronary occlusion (SICCO): A randomized, controlled trial of adding stent implantation after successful angioplasty  

Microsoft Academic Search

Objectives. This study investigated whether stenting improves long-term results after recanalization of chronic coronary occlusions.Background. Restenosis is common after percutaneous transluminal coronary angioplasty (PTCA) of chronic coronary occlusions. Stenting has been suggested as a means of improving results, but its use has not previously been investigated in a randomized trial.Methods. We randomly assigned 119 patients with a satisfactory result after

Per Anton Sirnes; Svein Gold; Yngvar Myreng; Per Mølstad; Håkean Emanuelsson; Per Albertsson; Magne Brekke; Arild Mangschau; Knut Endresen; John Kjekshus



Lamellar macular hole formation in chronic cystoid macular edema associated with retinal vein occlusion  

Microsoft Academic Search

Purpose  To report the formation of a lamellar macular hole (LMH) in four eyes with chronic cystoid macular edema (CME) associated\\u000a with retinal vein occlusion (RVO).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We reviewed retrospectively the medical records of four patients with chronic CME associated with RVO, in whom LMH formation\\u000a was observed by a series of examinations with optical coherence tomography.\\u000a \\u000a \\u000a \\u000a \\u000a Results  All eyes showed a large

Kayoko TsukadaAkitaka Tsujikawa; Akitaka Tsujikawa; Tomoaki Murakami; Ken Ogino; Nagahisa Yoshimura


Pancreatic islet autotransplantation with total pancreatectomy for chronic pancreatitis.  


Achieving pain relief and improving the quality of life are the main targets of treatment for patients with chronic pancreatitis. The use of total pancreatectomy to treat chronic pancreatitis is a radical and in some ways ideal strategy. However, total pancreatectomy is associated with severe diabetic control problems. Total pancreatectomy with islet autotransplantation can relieve severe pain and prevent the development of postsurgical diabetes. With islet autotransplantation, patients with chronic pancreatitis receive their own islet cells and therefore do not require immunosuppressive therapy. In the future, total pancreatectomy with islet autotransplantation may be considered a treatment option for chronic pancreatitis patients. PMID:23073847

Kuroki, Tamotsu; Adachi, Tomohiko; Ono, Shinichiro; Tanaka, Takayuki; Kitasato, Amane; Eguchi, Susumu



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



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


Astrocytes react to oligemia in the forebrain induced by chronic bilateral common carotid artery occlusion in rats  

Microsoft Academic Search

The effects of oligemia (moderate ischemia) on the brain need to be explored because of the potential role of subtle microvascular changes in vascular cognitive impairment and dementia. Chronic bilateral common carotid artery occlusion (BCCAO) in adult rats has been used to study effects of oligemia (hypoperfusion) using neuropathological and neurochemical analysis as well as behavioral tests. In this study,

Rainald Schmidt-Kastner; Cristina Aguirre-Chen; Isabel Saul; Linda Yick; Duco Hamasaki; Raul Busto; Myron D. Ginsberg



Assessment of Captopril and Nicardipine Effects on Chronic Occlusive Arterial Disease of the Lower Extremity Using Doppler Ultrasound  

Microsoft Academic Search

The effects of two potent vasodilating drugs, captopril (C) (25 mg tid), nicar dipine (N) (20 mg tid), and placebo (P) were evaluated and compared, in 10 men (mean age of sixty-five years) with intermittent claudication from moderate to severe multilevel chronic occlusive arterial disease (COAD) of the lower extrem ity, by use of the Doppler ultrasonic method, at rest

Daniele Bernardi; Paolo Bartoli; Andrea Ferreri; Antonio Brandinelli Geri; Aldo Ieri



Chronic mild stress exacerbates the effects of permanent bilateral common carotid artery occlusion on CA1 neurons  

Microsoft Academic Search

The effect of chronic mild stress (CMStress) was examined in an animal model of chronic cerebral hypoperfusion. Eight-month-old male Sprague–Dawley rats underwent permanent bilateral occlusion of the carotid arteries (2VO) or sham surgery. At 7 days postsurgery, animals from these groups were randomly assigned to undergo CMStress consisting of relatively mild stressor exposure 6 days a week for 6 weeks

Lesley J Ritchie; Maxine De Butte; Bruce A Pappas



Evaluation of a new hydrocolloid occlusive dressing for central catheters used in total parenteral nutrition.  


Catheter-related sepsis still remains one of the most frequent and serious complication of total parenteral nutrition. Strategies for preventing contamination of central venous lines have focused on decreasing the number of micro-organisms around the exit site and inhibiting their entry into the catheter wound. This prospective study compares a new occlusive hydrocolloid dressing (Visiband; Convatec Squibb) with that of a polyurethane film dressing for nutritional catheters. Dressings were changed either on day 3 or day 5 after application. Swab smears of the catheter exit site at each dressing change were stained by Gram's method before inoculation onto a blood agar plate, a chocolate agar plate and a MacConkey agar plate. Significantly less colonisation occurred under the former dressing at day 3 and day 5 dressing changes. In addition, the polyurethane film dressing was associated with a significant increase in skin colonisation (P = 0.04) and the number of positive Gram-stain microbes if left unchanged for 5 days (P = 0.0018). Staphylococcus aureus catheter-related sepsis occurred in 1 patient on day 18 in the polyurethane film dressing group. In addition, Candida albicans colonisation was confined to patients with the polyurethane film dressing. While the type of dressing applied to the catheter exit site may influence the incidence of catheter colonisation and infection, it must be emphasised that strict adherence to aseptic technique during catheter insertion and manipulation of the dressing is vital in the prevention of catheter-related sepsis during total parenteral nutrition. PMID:1763392

Haffejee, A A; Moodley, J; Pillay, K; Singh, B; Thomson, S; Bhamjee, A



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


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



Percutaneous Intraluminal Recanalization of Long, Chronic Superficial Femoral and Popliteal Occlusions Using the Frontrunner XP CTO Device: A Single-Center Experience  

SciTech Connect

The purpose of this study was to examine the safety and efficacy of the Frontrunner XP CTO (chronic total occlusion) Catheter (Cordis) for recanalization of long femoropopliteal artery occlusions. A Frontrunner catheter was used to treat 26 CTOs in SFA after guidewire failure (68.3 {+-} 8.8 years). Sixty-seven percent of patients had severe claudication. Critical lower limb ischemia with rest pain or minor tissue loss was present in three and eight patients, respectively. All the lesions were considered complex (TASC B, C, and D); 68% of the lesions were heavily calcified. The mean lesion length was 17.6 cm (range, 10-42 cm). The initial attempt to cross the occlusion with the CTO guidewire V18 was unsuccessful in 26 of 76 limbs (34.26%). A secondary attempt using the Frontrunner catheter (crossover approach, 27%; antegrade, 73%) performed in all 26 failed cases was successful in 17 limbs (65.38%), increasing the technical success rate to 88.12%. The main reasons for failure with the Frontrunner were inability to cross the lesion due to heavy calcification (six of nine) and inability to re-enter the true lumen after subintimal passage of the occluded segment (three of nine). The mean fluoroscopy time was 22.9 min. Minor complications included one distal extension of the dissection with involvement of the first popliteal segment and one perforation in the occluded segment. No major complications were seen. In conclusion, recanalization with the Frontrunner CTO catheter is a simple and safe method with a high technical success rate in the endovascular treatment of long superficial femoral artery occlusions and should be an alternative method after guidewire failure.

Charalambous, Nikolas, E-mail:; Schaefer, Philipp J.; Trentmann, Jens; Huemme, Tim. H.; Stoehring, Christine [University Hospital of Schleswig-Holstein, Department of Diagnostic Radiology (Germany); Mueller-Huelsbeck, Stefan [Academic Hospitals Flensburg, Department of Radiology (Germany); Heller, Martin; Jahnke, Thomas [University Hospital of Schleswig-Holstein, Department of Diagnostic Radiology (Germany)



Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis  

PubMed Central

Background The ergotamine tartrate associated with certain categories of drugs can lead to critical ischemia of the extremities. Discontinuation of taking ergotamine is usually sufficient for the total regression of ischemia, but in some cases it could be necessary thrombolytic and anticoagulant therapy to avoid amputation. Case report A woman of 62 years presented with a severe pain left forearm appeared 10 days ago, with a worsening trend. The same symptoms appeared after 5 days also in the right forearm. Physical examination showed the right arm slightly hypothermic, with radial reduced pulse in presence of reduced sensitivity. The left arm was frankly hypothermic, pulse less on radial and with an ulnar humeral reduced pulse, associated to a decreased sensitivity and motility. Clinical history shows a chronic headache for which the patient took a daily basis for years Cafergot suppository (equivalent to 3.2 mg of ergotamine). From about ten days had begun therapy with itraconazole for vaginal candidiasis. The Color-Doppler ultrasound shown arterial thrombosis of the upper limbs (humeral and radial bilateral), with minimal residual flow to the right and no signal on the humeral and radial left artery. Results Angiography revealed progressive reduction in size of the axillary artery and right humeral artery stenosis with right segmental occlusions and multiple hypertrophic collateral circulations at the elbow joint. At the level of the right forearm was recognizable only the radial artery, decreased in size. Does not recognize the ulnar, interosseous artery was thin. To the left showed progressive reduction in size of the distal subclavian and humeral artery, determined by multiple segmental steno-occlusion with collateral vessels serving only a thin hypotrophic interosseous artery. Arteriographic findings were compatible with systemic drug-induced disease. The immediate implementation of thrombolysis, continued for 26 hours, with heparin in continuous intravenous infusion and subsequent anticoagulant therapy allowed the gradual disappearance of the symptoms with the reappearance of peripheral pulses. Conclusion Angiography showed regression of vasospasm and the resumption of flow in distal vessels. The patient had regained sensitivity and motility in the upper limbs and bilaterally radial and ulnar were present.



Occlusion resistant object tracking  

Microsoft Academic Search

Object tracking with occlusion prediction using multiple feature correspondences is proposed. The tracking region is defined by a set of point features, tracked using Kanade-Lucas-Tomasi (1991) algorithm. During total occlusion the region position is estimated using motion prediction based on a Kalman filtering scheme applied to the motion model prior to occlusion. During partial occlusion the displacements of the occluded

Evangelos Loutas; Ioannis Pitas; Konstantinos I. Diamantaras



Multimodal therapy for acute and chronic venous thrombotic and occlusive disease.  


Critical deep venous thrombosis and occlusion constitutes a small percentage of patients with venous disease. However, these patients exhibit severe symptomatology including pain and extensive edema that may progress to limb- or life-threatening complications such as phlegmasia cerulea dolens and superior vena cava syndrome. This paper reviews the different multimodal percutaneous interventions currently available for the treatment of complex critical venous thrombotic and occlusive disease. PMID:16193209

Chaer, Rabih A; Dayal, Rajeev; Lin, Stephanie C; Trocciola, Susan; Morrissey, Nicholas J; McKinsey, James; Kent, K Craig; Faries, Peter L


Total Occlusion of the Abdominal Aorta Caused by Detachment of Cardiac Myxoma  

PubMed Central

Abdominal aortic occlusion (AAO) caused by detachment of cardiac myxoma (CM) is a very rare complication in patients with CM. Although the nature of CMs has been well established, detachment of CM may cause unexpected serious complications such as vicious embolic events. Actually, in several cases of AAO caused by detachment of CM, it has been reported that CM fragments easily migrated to the brain, heart, and lungs, and caused lifelong neurological complications despite appropriate surgical therapy. Herein, we report a case of a patient with AAO caused by detachment of CM who underwent CM excision and abdominal aortic thromboembolectomy. Additionally, we have presented the preoperative and postoperative images using 64-multidetector computed tomography.

Hong, Sungyong; Choe, Hyunmin



Rheological and Anticoagulant Therapy of Patients with Chronic Peripheral Occlusive Arterial Disease (COAD)  

Microsoft Academic Search

In the course of a six-month study, a three-subgroup cohort of 113 patients (103 m, 10 f, mean age 58±8 years) with angiographically proven occlusive peripheral arterial disease (COAD) Fontaine stage II was analyzed regarding the therapeutic (improvement of walking performance) and prophylactic (prevention of new vascular events) effects of oral treatment with three different drug regimens. Group A (38

A. Deutschinoff; L. Grozdinsky



Chronic bilateral common carotid artery occlusion: a model for ocular ischemic syndrome in the rat  

Microsoft Academic Search

Background  Ocular ischemic syndrome is a devastating eye disease caused by severe carotid artery stenosis. The reduction of blood flow\\u000a produced by bilateral common carotid artery occlusion (BCCAO) of rats for 7 days induces events related to gliosis with no\\u000a evident histological damage. However, retinal degeneration and cellular death occur after 90 days of BCCAO. Our purpose has\\u000a been to investigate

Daniel Lavinsky; Nice Sarmento Arterni; Matilde Achaval; Carlos Alexandre Netto



Difference in Hepatic Tissue Oxygenation between Total Vascular Exclusion and Inflow Occlusion of the Liver and the Possible Role of Hepatic Venous Blood under Liver Ischemia  

Microsoft Academic Search

The difference between total vascular exclusion (TVE) and inflow occlusion (IO) of the liver was assessed by the extent of DNA injury in rats and by hepatic tissue oxygen saturation (SahtO2) in pigs. Moreover, the role of hepatic venous blood under liver ischemia was discussed. Seventy percent of the rat livers were exposed to complete IO (hepatic artery + portal

Tsutomu Sato; Yoshihiro Asanuma; Tomoyuki Kusano; Noriaki Sasaki; Yoshiaki Shindo; Kenji Koyama



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.



Permanent, bilateral common carotid artery occlusion in the rat: a model for chronic cerebral hypoperfusion-related neurodegenerative diseases.  


Chronic cerebral hypoperfusion has been associated with cognitive decline in aging and Alzheimer's disease. Moreover, the pattern of cerebral blood flow in mild cognitive impairment has emerged as a predictive marker for the progression into Alzheimer's disease. The reconstruction of a pathological condition in animal models is a suitable approach to the unraveling of causal relationships. For this reason, permanent, bilateral occlusion of the common carotid arteries (2VO) in rats has been established as a procedure to investigate the effects of chronic cerebral hypoperfusion on cognitive dysfunction and neurodegenerative processes. Over the years, the 2VO model has generated a large amount of data, revealing the 2VO-related pattern of cerebral hypoperfusion and metabolic changes, learning and memory disturbances, failure of neuronal signaling, and the neuropathological changes in the hippocampus. In addition, the model has been introduced in research into ischemic white matter injury and ischemic eye disease. The present survey sets out to provide a comprehensive summary of the achievements made with the 2VO model, and a critical evaluation and integration of the various results, and to relate the experimental data to human diseases. The data that have accumulated from use of the 2VO model in the rat permit an understanding of the causative role played by cerebral hypoperfusion in neurodegenerative diseases. Thorough characterization of the model suggests that 2VO in the rat is suitable for the development of potentially neuroprotective strategies in neurodegenerative diseases. PMID:17296232

Farkas, Eszter; Luiten, Paul G M; Bari, Ferenc



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



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



[Evaluation of cerebral metabolism by multi-voxel proton magnetic resonance spectroscopy imaging in chronic unilateral internal carotid artery occlusion].  


Proton magnetic resonance spectroscopy(1H-MRS) has less been used to analyze cerebral metabolism in ischemic lesions compared to single photon emission computed tomography or positron emission computed tomography. Recent advances in magnetic resonance imaging apparatus and the related software have made possible obtaining multi-voxel 1H-MRS in a single study. We examined multi-voxel 1H-MRS in patients with unilateral internal carotid artery(ICA) occlusion to study the relationship between cerebral metabolism and cerebral blood flow. Fifteen patients(male 11; female 4, 47-76; average 67.1 year-old) with chronic unilateral ICA occlusion and without any marked infarction were studied. 1H-MRS was obtained using a 1.5 T Siemens Magnetom Vision scanner. Multi-voxel spectra were recorded using a SE-2 D-CSI sequence(TR/TE = 1500/135 ms). The volume of interest was 90 x 90 x 20 mm3, placed axially above the lateral ventricle. The single voxel size was 10 x 10 x 20 mm3. N-acetyl aspartate/creatine ratios(NAA/Cr) were calculated on each voxel and were averaged in view of the cortex and the white matter. The regional cerebral blood flow(CBF) was measured by Xenon-CT method. Eight patients were also examined by acetazolamide challenge to evaluate the cerebrovascular reserve capacity. NAA/Cr ratios in normal subjects were 1.905 +/- 0.090(mean +/- standard deviation) in the cortex and 2.183 +/- 0.258 in the white matter in 40's(n = 6), 2.046 +/- 0.166 in the cortex and 2.039 +/- 0.288 in the white matter in 60's(n = 5). The study revealed 7 patients with normal NAA/Cr ratio and CBF, 5 with reduced NAA/Cr ratio and normal CBF, and 3 with reduced NAA/Cr ratio and CBF in the affected cortex. A low correlation coefficient of 0.46 was noted between NAA/Cr ratio and the cerebrovascular reserve capacity calculated by acetazolamide challenge in the affected cortex. In the range of less than +10%(lower limit) in percentile change of regional CBF after acetazolamide injection, NAA/Cr ratio was distributed between 1.600 and 2.044, which were normal or slightly under the lower limit(mean-2 x standard deviation). Multi-voxel 1H-MRS is useful for the evaluation of cerebral metabolism, because it enables to quantify different chemicals in many fields at one time and to compare its distribution with regional CBF. In patients with unilateral ICA occlusion, NAA/Cr ratio of the affected cortex varies depending on the collateral circulation and the contralateral ICA lesions. The Extracranial-Intracranial Bypass should be considered if the case with unilateral ICA occlusion reveals reduced CBF and normal or slightly decreased NAA/Cr ratio in the affected cortex. PMID:10793417

Takayama, H; Suga, S; Kobayashi, M; Sadanaga, F; Hozumi, A; Kanai, Y; Okamura, M; Mihara, B



Complex left profunda femoris vein to renal vein bypass for the management of progressive chronic iliofemoral occlusion.  


Chronic occlusions of the inferior vena cava (IVC) and iliofemoral veins are long-term sequelae of deep venous thrombosis (DVT) that can lead to postthrombotic syndrome (PTS). Patients may present with a wide spectrum of signs and symptoms, ranging from mild discomfort and swelling to severe venous hypertension and ulcerations. We report a 68-year-old man who had a history of left lower extremity DVT after a laminectomy and who developed PTS with nonhealing ulcers. The patient underwent a cross-pubic femorofemoral venous bypass that failed to improve his clinical status. After unsuccessful endovascular attempts for recanalization of the iliofemoral segment, a profunda femoris to IVC bypass was performed. The symptoms recurred 2 years later. Venography revealed restenosis at the caval anastomosis that did not resolve by endovascular means. A surgical revision was performed, and given the quality of the IVC, a jump bypass was created to the left renal vein. The swelling improved and the ulcers healed completely. Twenty-eight months after the complex reconstructions, he remains ulcer-free with mild edema controlled with stockings. Venous reconstructions remain a viable option for patients with symptomatic and recalcitrant nonmalignant obstruction of the large veins. PMID:23122979

Anaya-Ayala, Javier E; Adams, Matthew K; Telich-Tarriba, Jose E; Dresser, Kelly L; Ismail, Nyla; Peden, Eric K



Totally implantable robot to treat chronic atrial fibrillation.  


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



Total burden of chronic diseases among older cancer patients  

Microsoft Academic Search

Introduction: Both chronic diseases and cancer are associated with ageing. As the population ages, also the number of older cancer patients with comorbidity will increase dramatically. In the future, general practitioners will be confronted with older patients with cancer and two, three or more concomitant diseases. Aim: We aim to assess the occurrence of comorbidity among older cancer patients as

L. D. Deckx; M. A. van der Akker; S. B. Bartholomeeusen; J. M. Metsemakers; A. K. Knottnerus; F. G. Schellevis; F. B. Buntinx



Successful coronary sinus lead replacement despite total venous occlusion using femoral pull through, two operator counter-traction and subclavian venoplasty.  


The majority of patients presenting for lead extraction have indications for a replacement lead. Venous stenosis is common in recipients of pacing leads and can impede ipsilateral lead replacement. Recanalization through an existing tract after lead extraction allows successful lead placement but may require complex hybrid lead extraction and revascularization techniques. We present a case in which a combination of femoral lead extraction with complete guidewire pull-through, two operator external counter-traction and subclavian venoplasty was used to successfully replace a coronary sinus lead in a patient with total subclavian venous occlusion. PMID:17605092

Rogers, Dominic P S; Lambiase, Pier D; Chow, Anthony W C



Aborted sudden cardiac death due to radiofrequency ablation within the coronary sinus and subsequent total occlusion of the circumflex artery.  


We report a case of aborted sudden cardiac death and subsequent development of malignant drug-refractory incessant ventricular tachycardia/fibrillation in a patient with acute coronary artery occlusion following radiofrequency ablation within the CS. Catheter ablation is a well-established therapy for treatment of atrial fibrillation (AF). In patients with longstanding persistent AF extensive left atrial ablation and ablation inside the coronary sinus (CS) is frequently performed. Perimitral flutter following AF ablation is the most common form of left atrial macroreentry, especially in patients with previous ablation of complex fractionated electrograms and incomplete linear lesion sets within the left atrium. Successful ablation of this type of tachycardia is generally difficult and in about 60-70% patients requires additional ablation within the CS to achieve termination of tachycardia or/and left atrial isthmus (LAI) block. A limited number of case reports have been published describing acute coronary artery occlusion during or immediately after LAI ablation within the CS. This case exhibits a potential lethal risk of radiofrequency ablation within the CS. PMID:23362986

Makimoto, Hisaki; Zhang, Qingyong; Tilz, Roland Richard; Wissner, Erik; Cuneo, Alessandro; Kuck, Karl-Heinz; Ouyang, Feifan



Theoretical study of the flow rate toward the right heart territory in case of total occlusion of the right coronary artery.  


In this work, patients with severe coronary disease and chronic occlusion of the right coronary artery (RCA) are studied. In this clinical situation, the collateral circulation is an important factor in the preservation of the myocardium until reperfusion of the area at risk. An accurate estimation of collateral flow is crucial in surgical bypass planning as it can influence the outcome of a given treatment for a given patient. The evaluation of collateral flow is frequently achieved using an index (CFI, Collateral Flow Index) based on pressure measurements. Using a model of the coronary circulation based on hydraulic/electric analogy, we demonstrate, through theoretical simulations, that a wide range of fractional collateral flow values can be obtained for any given distal pressure difference depending on the values of the capillary and collateral resistances. PMID:22584016

Maasrani, Mahmoud; Drochon, Agnès; Harmouche, Majid; Corbineau, Hervé; Verhoye, Jean-Philippe



[Occlusal splint: state of the art].  


Occlusal splint are defined as intra-oral devices mostly indicated to modify the occlusal relationship between maxillar and mandibular dental arches. Among the different shapes of occlusal splint, an updating seemed necessary to the authors. The main indications for occlusal splint are represented by temporomandibular disorders and teeth protection. Occlusal splints are usually made of hard resin and are, generally, carried on the mandibular jaw. Total occlusal splint are preferable to partial occlusal splint, except in some emergent cases. The smooth occlusal splints are needed for musculo-articular disorders when the indentated splints are reserved for mandibular repositioning in articular temporomandibular joint disorders. PMID:19409587

Ré, J-P; Chossegros, C; El Zoghby, A; Carlier, J-F; Orthlieb, J-D



Transient changes of brain-derived neurotrophic factor (BDNF) mRNA expression in hippocampus during moderate ischemia induced by chronic bilateral common carotid artery occlusions in the rat  

Microsoft Academic Search

Chronic bilateral common carotid artery occlusion (BCCAO) induces moderate ischemia (oligemia) in the rat forebrain in the absence of overt neuronal damage. In situ hybridization for brain-derived neurotrophic factor (BDNF) mRNA was used to search for a molecular response to moderate ischemia. BDNF mRNA was significantly increased in the hippocampal granule cells at 6 h of occlusion (ANOVA, Tukey test

Rainald Schmidt-Kastner; Jessie Truettner; Baowan Lin; Weizhao Zhao; Isabel Saul; Raul Busto; Myron D. Ginsberg



Adherence to the Overall Nutritional Quality Index and Risk of Total Chronic Disease  

PubMed Central

Background: The Overall Nutritional Quality Index (ONQI) algorithm is a nutrient profiling scheme that incorporates over 30 dietary components, and aims to rank foods by relative healthfulness. Purpose: To assess whether diets with a higher ONQI score predict lower risk of major chronic disease risk. Methods: A total of 62,284 healthy women from the Nurses’ Health Study and 42,382 healthy men from Health Professionals Follow-Up Study were followed from 1986 to 2006. Dietary data were collected from questionnaires at baseline. Each food was scored by the ONQI algorithm and the average ONQI score for the diet consumed by each participant was computed. Total chronic disease was defined as cardiovascular disease (CVD), cancer, diabetes and nontrauma death. Data analysis was conducted in 2010. Results: A total of 20,004 and 13,520 chronic disease events were documented in women and men, respectively. The ONQI score was inversely associated with risk of total chronic disease, CVD, diabetes and all-cause mortality (p-trend?0.01), but not cancer, in both cohorts. Women in the highest compared to lowest quintile of the ONQI score had a relative risk (95% CI) of 0.91 (0.87, 0.95) for chronic disease, 0.79 (0.71, 0.88) for CVD, 0.86 (0.78, 0.96) for diabetes and 0.90 (0.84, 0.97) for all-cause mortality. Men in the highest compared to lowest quintile of the ONQI score had a relative risk of 0.88 (0.83, 0.93) for chronic disease, 0.77 (0.70, 0.85) for CVD, 0.84 (0.73, 0.96) for diabetes and 0.89 (0.83, 0.97) for all-cause mortality. Conclusions: The ONQI scoring system was associated with modestly lower risk of chronic disease and all-cause mortality.

Chiuve, Stephanie E.; Sampson, Laura; Willett, Walter C.



Total and caspase-cleaved cytokeratin 18 in chronic cholecystitis: A prospective study  

PubMed Central

Background Cell death mode has been studied in cancer, autoimmune, and neurodegenerative diseases. In this study, apoptosis and necrosis are investigated for the first time in patients with chronic calculous cholecystitis. Methods and materials Thirty five (35) patients (27 women and 8 men, aged 55.65 ± 13.48 years) with symptomatic chronic calculous cholecystitis underwent laparoscopic cholecystectomy. The early specific apoptotic tendency (caspase-cleaved cytokeratin 18) was studied in these patients with M30 Apoptosense ELISA and the total cytokerarin 18 (both derived from apoptosis and necrosis) with M65 ELISA. The ratio M30/M65 (caspase-cleaved to total cytokeratin 18) was also computed. According to the histopathological examination, the patients were divided in two groups: group A included patients with chronic inactive cholecystitis (n = 10), and group B those with chronic active cholecystitis (n = 25). Results The concentrations of caspase-cleaved cytokerarin 18 (CK18), and especially those of total CK18, were higher in bile samples than in serum samples. In group B, there were significant differences between serum and bile samples regarding both caspase-cleaved CK18 and total CK18. Cells staining positive for caspase-cleaved CK18 were present in the epithelial cells of the mucosa of the gallbladder. Conclusion CK18 is expressed in the gallbladder epithelial cells. The concentrations of both caspase-cleaved CK18 and total CK18 were higher in bile samples than in serum samples. The levels of total CK18, as well as caspase-cleaved CK18, do not seem to differ between active and inactive chronic cholecystitis.

Simopoulos, Constantinos; Tsaroucha, Alexandra K; Asimakopoulos, Byron; Giatromanolaki, Alexandra; Gavriilidis, Paschalis; Polychronidis, Alexandros; Karayiannakis, Anastasios



Results of partial and total pancreaticoduodenectomy in 117 patients with chronic pancreatitis  

Microsoft Academic Search

This is a report of 117 pancreaticoduodenectomies performed for chronic pancreatitis, of which 49 were partial and 68 were total. The operative mortality rate of partial pancreaticoduodenectomy was 8.2% and of total pancreatectomy was 20.6%. During a follow-up period of 6 1\\/2 years, 76% and 63% of the surgical patients, respectively, continued to drink alcohol as heavily as before. Prior

F. P. Gall; E. Mühe; C. Gebhardt



Total daily energy expenditure in wasted chronic obstructive pulmonary disease patients  

Microsoft Academic Search

Objectives: To investigate total daily energy expenditure in chronic obstructive pulmonary disease (COPD) patients during a rehabilitation programme.Design: Observational study involving a case and a control group.Subjects: Ten COPD patients (six with body mass index (BMI) 18.5 kg\\/m2) were evaluated for their energy expenditure profile. Four additional healthy age-matched volunteers were also included for methodology evaluation.Interventions: Measurements of total daily

NLS Tang; ML Chung; M Elia; E Hui; CM Lum; JKH Luk; MG Jones; J Woo



Recanalization of a chronic totally occluded left anterior descending artery after enhanced external counterpulsation therapy.  


We present a case of a 52 y/o male with history of hypertension and high cholesterol who suffered an acute myocardial infarction. His catheterization revealed severe 3-vessel coronary artery disease with total occlusion of left anterior descending (LAD) artery at the mid segment with anterior and apical wall dyskinesia and estimated ejection fraction of 30%. After 3 years of medical therapy the patient had NYHA class II heart failure symptoms without angina. Enhanced external counterpulsation (EECP) therapy was offered as adjunctive therapy. After completing therapy patient started to develop angina and a new catheterization showed recanalization of LAD with TIMI I flow and normal ejection fraction without wall motion abnormalities. Patient underwent successful coronary artery bypass graft. PMID:19610581

Salgado, Víctor; Salgado, Carlos; Medina, Arturo


Total body potassium depletion and severe myopathy due to chronic liquorice ingestion.  

PubMed Central

A 33-year-old patient with hypokalaemia associated with severe myopathy following liquorice ingestion is described. Potassium depletion was confirmed by total body potassium measurements and myopathy was established by electromyography and enzyme studies. The potential hazard of chronic liquorice consumption even as a sweet is illustrated by this case.

Sundaram, M. B.; Swaminathan, R.



Chronic Iliac Vein Occlusion and Painful Nonhealing Ulcer Induced by High Venous Pressures from an Arteriovenous Malformation  

PubMed Central

Chronic femoral vein compression (May-Thurner Syndrome) is a known rare cause of deep venous thrombosis. Subsequent angiogenesis and the development of arteriovenous malformation (AVM) in the setting of chronic venous thrombosis is by itself a rare and poorly understood phenomenon. We report a case in which elevated venous pressures resulting from such compression appear to have resulted in the development of a pelvic arteriovenous malformation, which was further complicated by chronic, nonhealing painful lower extremity ulcers, and the development of extensive subcutaneous venous collaterals. Following successful embolization of the pelvic AVM and ablation of veins under the ulcers with laser and sclerotherapy, the patient's ulcers healed and she became pain-free.

Link, Daniel P.; Granchi, Phillip J.



Sonographic Evaluation of Experimental Acute Renal Arterial Occlusion in Dogs  

Microsoft Academic Search

Eleven segmental and eight total renal artery occlusions were evaluated by sonog- raphy in transplanted kidneys of 19 adult mongrel dogs. The segmental occlusions were serially scanned daily or every other day for up to 35 days. The total occlusions were scanned daily for up to 10 days. Each occlusion was confirmed angiographically, and kidneys were examined pathologically. Acute segmental

James B. Spies; Hedvig Hricak; Thomas M. Slemmer; Salim Zeineh; Charles E. Alpers; Pierre Zayat; Tom F. Lue; Robert K. Kerlan; Beatrice L. Madrazo; Michael A. SandIer


Permanent, bilateral common carotid artery occlusion in the rat: A model for chronic cerebral hypoperfusion-related neurodegenerative diseases  

Microsoft Academic Search

Chronic cerebral hypoperfusion has been associated with cognitive decline in aging and Alzheimer's disease. Moreover, the pattern of cerebral blood flow in mild cognitive impairment has emerged as a predictive marker for the progression into Alzheimer's disease. The reconstruction of a pathological condition in animal models is a suitable approach to the unraveling of causal relationships. For this reason, permanent,

Eszter Farkas; Paul G. M. Luiten; Ferenc Bari



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))



Intrarenal Hemodynamic Changes Following Acute Partial Renal Arterial Occlusion.  

National Technical Information Service (NTIS)

Both an increase and a decrease in total renal vascular resistance, following a period of total renal artery occlusion, were previously reported. The duration of the occlusive period and the height of the perfusion pressure were found to prescribe consist...

C. M. Brake D. Reins L. E. Wittmers L. B. Hinshaw



Uncemented total hip arthroplasty in young patients with juvenile chronic arthritis.  

PubMed Central

The hip joint is commonly affected in juvenile chronic arthritis (JCA) and involvement is usually bilateral. It is well established that the involvement of the hip in JCA is the most important reason that the patient will lose independence and mobility. The positive gains, both in terms of hip function and the overall functional capability, of the patients of JCA after hip replacement have been shown by several studies. There have been many reports regarding cemented total hip replacement in young patients with JCA. The short-term results have been excellent, but failure rates were considerably higher with further follow-up. To our knowledge there have been no other reports to date of the results of cementless arthroplasty of the hip in this condition. We reviewed the results of 25 primary uncemented total hip replacements (THR) in 16 patients with JCA. The mean postoperative follow-up time was 4.5 years (range 1-19 years). The clinical results were evaluated using the modified Harris hip score. The functional outcome was assessed by a scoring system described by Witt et al. The most significant long-term problem was acetabular loosening (12%) in our series. Images Figure 1 Figure 2

Kumar, M. N.; Swann, M.



Completely laparoscopic total colectomy for chronic constipation: report of a case.  


Laparoscopic surgery has had a remarkable impact on the practice of colorectal surgery. However, most operations are performed using a technique of laparoscopic assistance, whereby extracorporeal bowel division and anastomosis are made following laparoscopic mobilization of the bowel. To our knowledge, this is the first report to describe a case of chronic constipation managed by total colectomy with ileorectal anastomosis, performed completely laparoscopically. The diagnosis of slow transit constipation was made by a transit time study. After dissection of the entire colon, the colon to be resected was delivered through the open rectal stump and brought out transanally. The anvil of an intraluminal circular stapler was passed through the rectum into the peritoneal cavity and the end of the open distal rectum was closed with a linear cutting stapler. The anvil of the circular stapler was inserted into the end of the open terminal ileum and fixed with an Endo-Loop, following which an intracorporeal double-stapling anastomosis was performed. By 3 months following surgery, the patient was passing 3-4 stools a day. Thus, we highly recommend this technique as it eliminates the need for a small incision to deliver the resected colon, thereby minimizing the operative time and risk of wound infection. PMID:12107785

Inoue, Yoshifumi; Noro, Hiroshi; Komoda, Hiroshi; Kimura, Toshihiro; Mizushima, Tsunekazu; Taniguchi, Eiji; Yumiba, Takeyoshi; Itoh, Toshinori; Ohashi, Shuichi; Matsuda, Hikaru



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




Treatment of chronic lymphocytic leukemia by total body irradiation alone and combined with chemotherapy. [Efficacy and complications  

Microsoft Academic Search

Total body irradiation (TBI) offers a new dimension in the treatment of chronic lymphocytic leukemia (CLL), a disease heretofore refractory to effective management. Excellent responses were observed in 50\\/57 (88%) consecutive patients with active CLL treated since 1964, and complete remissions were achieved in 22\\/57 (39%). Toxicity was acceptable and was minimized by combining TBI and chemotherapy in attenuated doses




Management of chronic lateral instability due to lateral collateral ligament deficiency after total knee arthroplasty: a case report  

Microsoft Academic Search

INTRODUCTION: Lateral instability following total knee arthroplasty (TKA) is a rare condition with limited report of treatment options. The objective of this case presentation is to demonstrate the outcomes of different surgical procedures performed in a single patient with lateral collateral ligament (LCL) deficiency. CASE PRESENTATION: We present a case of chronic lateral instability due to LCL deficiency after primary

Aasis Unnanuntana; James E Murphy; William J Petersilge



Restoration of occlusal vertical dimension in dental erosion caused by gastroesophageal reflux: case report.  


The authors describe a minimally invasive procedure for occlusal rehabilitation in a young patient presenting with mild mandibular prognathism and loss of occlusal vertical dimension caused by dental erosion from chronic gastroesophageal reflux. PMID:20166420

Reston, Eduardo Galia; Closs, Luciane Quadrado; Busato, Adair Luiz Stefanello; Broliato, Gustavo André; Tessarollo, Fábio Rafael


[Pure motor hemiparesis secondary to chronic subdural hematoma with total recovery through medical treatment].  


We discuss in this paper the cases of two patients with pure motor hemiparesis which were secondary to chronic subdural hematoma who evolved satisfactorily only with medical treatment. Of 1,000 consecutive patients with cerebro-vascular pathology admitted in our Neurology Department in the last 5 years, said two patients were the only ones (0.2%) in whom the lacunar syndrome "pure motor hemiparesis" was secondary to a chronic subdural hematoma. Such cases show that a subdural hematoma can manifest itself as a lacunar syndrome and that in selected cases the medical treatment of chronic subdural hematoma can yield goods results. PMID:8516509

Arboix, A; Massons, J; Oliveres, M; Titus, F



Acute pain after total hip arthroplasty does not predict the development of chronic postsurgical pain 6 months later  

Microsoft Academic Search

Purpose  Much remains unknown about the relationship between acute postoperative pain and the development of pathologic chronic postsurgical\\u000a pain (CPSP). The purpose of this project was to identify the extent to which maximum pain scores on movement over the first\\u000a two days after total hip arthroplasty predicted the presence of chronic pain 6 months later after controlling for potentially\\u000a important covariates.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The sample

Hance Clarke; Joseph Kay; Nicholas Mitsakakis; Joel Katz



Placement of a port catheter through collateral veins in a patient with central venous occlusion.  


Long-term utilization of central venous catheters (CVCs) for parenteral nutrition has a high incidence of central venous complications including infections, occlusions, and stenosis. We report the case of a 31-year-old woman presenting with a malabsorption caused by short gut syndrome due to congenital aganglionic megacolon. The patient developed a chronic occlusion of all central neck and femoral veins due to long-term use of multiple CVCs over more than 20 years. In patients with central venous occlusion and venous transformation, the implantation of a totally implanted port system by accessing collateral veins is an option to continue long-term parenteral nutrition when required. A 0.014-in. Whisper guidewire (Terumo, Tokyo) with high flexibility and steerability was chosen to maneuver and pass through the collateral veins. We suggest this approach to avoid unfavorable translumbar or transhepatic central venous access and to conserve the anatomically limited number of percutaneous access sites. PMID:19504152

Teichgräber, Ulf Karl-Martin; Streitparth, Florian; Gebauer, Bernhard; Benter, Thomas



Early Results with the Use of Heparin-bonded Stent Graft to Rescue Failed Angioplasty of Chronic Femoropopliteal Occlusive Lesions: TASC D Lesions Have a Poor Outcome  

SciTech Connect

Purpose: To evaluate early patency rate of the heparin-bonded stent grafts in atherosclerotic long femoropopliteal occlusive disease, and to identify factors that affect outcome. Methods: Heparin-bonded Viabahn stent grafts were placed in 33 limbs in 33 patients during 2009-2010. The stents were deployed to rescue failed conventional balloon angioplasty. Mean age was 69 (range 44-88) years, and 67 % (22 of 33) were men. Most procedures (21 of 33, 64 %) were performed for critical limb ischemia (33 % for rest pain, 30 % tissue loss). Kaplan-Meier plots and Cox regression analysis were used to identify significant risk factors. Results: The average length of lesions treated was 25 {+-} 10 cm, and they were predominantly TASC (Transatlantic Intersociety Consensus) D (n = 13) and C (n = 17) lesions. The median primary patency was 5.0 months (95 % confidence interval 1.22-8.77). The mean secondary patency was 8.6 months (95 % confidence interval 6.82-10.42). Subsequently, 4 patients underwent bypass surgery and 5 patients underwent major amputation. One patient died. There were 5 in-stent or edge-stent stenoses. Cox multivariate regression analysis identified TASC D lesions to be a significant risk factor for early occlusion (p = 0.035). Conclusion: TASC D lesions of femoropopliteal occlusions have poor patency rates with the use of heparin-bonded stent grafts after failed conventional angioplasty. Alternative options should be considered for these patients.

Kuhan, Ganesh, E-mail:; Abisi, Said; Braithwaite, Bruce D.; MacSweeney, Shane T. R. [Nottingham University Hospitals, Vascular and Endovascular Unit, Queens Medical Centre (United Kingdom); Whitaker, Simon C.; Habib, Said B. [Nottingham University Hospitals, Department of Radiology, Queen's Medical Centre (United Kingdom)



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



Total Pancreatectomy (TP) and Islet Autotransplantation (IAT) for Chronic Pancreatitis (CP)  

PubMed Central

Background Total-pancreatectomy (TP) with intraportal-islet-auto-transplantation (IAT) can relieve pain and preserve beta-cell-mass in patients with chronic-pancreatitis (CP) when other-therapies fail. Reported is a >30-year-single-center-series. Study Design 409 patients (53 children, 5–18 yrs) with CP underwent TP-IAT from Feb/1977–Sept/2011; (etiology idiopathic-41%; SOD/biliary-9%; genetic-14%; divisum-17%; alcohol-7%; other-12%); mean age-35.3 yrs,); 74% female; prior-surgeries 21%--Puestow procedure 9%, Whipple 6%, distal pancreatectomy 7%; other 2%). Islet-function was classified as insulin-independent for those on no insulin; partial if known C-peptide positive or euglycemic on once-daily-insulin; and insulin-dependent if on standard basal–bolus diabetic regimen. An SF-36-survey for Quality-of-Life (QOL)) was completed before and in serial follow-up by patients done since 2007 with an integrated-survey that added in 2008. Results Actuarial-patient-survival post-TP-IAT was 96% in adults and 98% in children (1-year) and; 89% and 98% (5-years). Complications requiring relaparotomy occurred in 15.9%, bleeding (9.5%) being most common. IAT-function is achieved in 90% (C-peptide >0.6 ng/ml). At 3 years, 30% were insulin-independent (25% in adults, 55% in children) and 33% had partial-function. Mean HbA1C was <7.0% in 82%. Prior pancreas surgery lowered islet-yield (2712vs4077/kg, p=.003). Islet yield [<2500/kg (36%); 2501–5000/kg (39%); >5000/kg (24%)] correlated with degree of function with insulin-independent rates at 3 yrs of 12, 22 and 72%, partial function 33, 62 and 24%. All patients had pain before TP-IAT and nearly all were on daily-narcotics. After TP-IAT, 85% had pain-improvement. By two years 59% had ceased-narcotics. All children were on narcotics before, 39% at follow-up; pain improved in 94%; 67% became pain-free. In the SF-36 survey, there was significant improvement from baseline in all dimensions including the Physical and Mental Component Summaries (P<0.01), whether on narcotics or not. Conclusions TP can ameliorate pain and improve QOL in otherwise-refractory-CP-patients, even if narcotic-withdrawal is delayed or incomplete because of prior long-term use. IAT preserves meaningful islet function in most patients and substantial islet function in >2/3 of patients with insulin-independence occurring in one-quarter of adults and half the children.

Sutherland, David E.R.; Radosevich, David M.; Bellin, Melena D.; Hering, Bernard J.; Beilman, Gregory J.; Dunn, Ty B.; Chinnakotla, Srinath; Vickers, Selwyn M.; Bland, Barbara; Balamurugan, A.N.; Freeman, Martin L.; Pruett, Timothy L.



An unusual case of bilateral subclavian-carotid artery graft occlusion with coronary steal syndrome managed in the cath lab.  


A 65-year-old man, s/p coronary bypass surgery (CABG) with left internal mammary artery (LIMA) to the left anterior descending (LAD) artery 12 years previously, presented to his local hospital with left upper extremity pain, dizziness, falls, and chest pain. At the outside hospital, a proximal total left subclavian occlusion was found and the patient underwent left subclavian artery to common carotid artery (SCA-CCA) bypass surgery. Shortly thereafter, the patient developed right subclavian thrombosis, and underwent right SCA-CCA bypass surgery. Twenty days later, coronary steal symptoms recurred; troponin levels were elevated and ultrasound exam revealed bilateral SCA-CCA graft occlusion. The patient was then transferred to a tertiary care facility with a diagnosis of non-ST elevation myocardial infarct (NSTEMI). A successful endovascular procedure was performed in the cardiac catheterization laboratory with the use of coronary chronic total occlusion (CTO) devices, to treat the coronary steal syndrome. PMID:23293182

Wisneski, Andrew D; Beyer, Anna T; Shunk, Kendrick A



Pulmonary veno-occlusive disease in myeloproliferative disorder.  


The present study reports a case of biopsy-proven pulmonary veno-occlusive disease as a cause of severe pulmonary hypertension in a patient suffering from a chronic myeloproliferative disorder. The pulmonary disease evolved favourably under treatment with defibrotide, a pro-fibrinolytic medication used in hepatic veno-occlusive disease. PMID:19118232

Willems, E; Canivet, J-L; Ghaye, B; de Leval, L; Radermecker, M; Preiser, J-C; Beguin, Y



Dental occlusion and postural control in adults.  


We studied the influence of a dental occlusion perturbation on postural control. The tests were performed in three dental occlusion conditions: (Rest Position: no dental contact, Maximal Intercuspal Occlusion: maximal dental contact, and Thwarted Laterality Occlusion: simulation of a dental malocclusion) and four postural conditions: static (stable platform) and dynamic (unstable platform), with eyes open and eyes closed. A decay of postural control was noted between the Rest Position and Thwarted Laterality Occlusion conditions with regard to average speed and power indexes in dynamic conditions and with eyes closed. However, the head position and stabilization were not different from those in the other experimental conditions, which means that the same functional goal was reached with an increase in the total energetic cost. This work shows that dental occlusion differently affects postural control, depending on the static or dynamic conditions. Indeed, dental occlusion impaired postural control only in dynamic postural conditions and in absence of visual cues. The sensory information linked to the dental occlusion comes into effect only during difficult postural tasks and its importance grows as the other sensory cues become scarce. PMID:19070652

Tardieu, Corinne; Dumitrescu, Michel; Giraudeau, Anne; Blanc, Jean-Luc; Cheynet, François; Borel, Liliane



Parasympathetic Denervation of Rat Pial Vessels Significantly Increases Infarction Volume Following Middle Cerebral Artery Occlusion  

Microsoft Academic Search

Summary: Studies were undertaken in Long Evans rats to examine the hypothesis that chronic unilateral sectioning of vasodilating nerve fibers (parasympathetic and\\/or sensory) innervating the circle of Willis increases infarction volume following unilateral branch occlusion of the middle cerebral artery (MCA) combined with temporary (45 min) bilateral common carotid occlusion. Infarct size was measured 24 h after surgical occlusion from

Michihisa Kano; Michael A. Moskowitz; Masayuki Yokota



Unified Mathematical Model to Quantify Performance Impairment for Both Chronic Sleep Restriction and Total Sleep Deprivation.  

National Technical Information Service (NTIS)

Performance prediction models based on the classical two-process model of sleep regulation are reasonably effective at predicting alertness and neurocognitive performance during total sleep deprivation /201TSD/202. However, during sleep restriction/201par...

D. Thorsley N. J. Wesensten P. Rajdev S. Rajaraman T. L. Rupp



Chronic asymptomatic dislocation of a total hip replacement: a case report  

Microsoft Academic Search

INTRODUCTION: Dislocation of a prosthetic hip is the second most common complication after thromboembolic disease in patients undergoing total hip arthroplasty, with an incidence reported as 0.5 to 20%. Although the period of greatest risk for dislocation has been reported to be within the first few months after surgery, late dislocation occurs more commonly then previously thought. CASE PRESENTATION: A

Surjit Lidder; Vijai S Ranawat; Nitran S Ranawat; Tudor L Thomas



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.



Early recovery of wall motion abnormalities after recanalization of chronic totally occluded coronary arteries: A dobutamine echocardiographic, prospective, single-center experience  

Microsoft Academic Search

Background Patients with symptomatic myocardial ischemia from a chronic totally occluded coronary (TOC) artery are usually referred for coronary artery bypass surgery. Because guide wire technology has improved considerably in recent years, percutaneous coronary angioplasty has become a useful technique in opening chronic TOC arteries. We evaluated the early functional results of successful percutaneous recanalization by performing dobutamine stress echocardiography

Riccardo Rambaldi; Jaap N. Hamburger; Marcel L. Geleijnse; Don Poldermans; Geert J. Kimman; Aric A. Aiazian; Paolo M. Fioretti; Folkert J. Ten Cate; Jos R. T. C. Roelandt; Patrick W. Serruys



Total knee arthroplasty combined with medial patellofemoral ligament reconstruction for osteoarthritic knee with preoperative valgus deformity and chronic patellar dislocation.  


We report a challenging case of a 44-year-old woman who had osteoarthritis in the lateral compartment of her right knee with severe valgus deformity and chronic lateral patellar dislocation. Total knee arthroplasty was performed for the knee. However, persistent patellar dislocation remained during the surgery; and therefore, medial patellofemoral ligament (MPFL) reconstruction was additionally performed at the time of the surgery. Stable patellar tracking was obtained after the MFPL reconstruction; and during the 2-year follow-up, her knee functioned well, and no recurrent patellar dislocation was observed. This clinical case indicates the usefulness of MPFL reconstruction for obtaining stable patellar tracking during total knee arthroplasty when a tendency for lateral patellar dislocation remains. PMID:20347256

Matsushita, Takehiko; Kuroda, Ryosuke; Kubo, Seiji; Mizuno, Kiyonori; Matsumoto, Tomoyuki; Kurosaka, Masahiro



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



Chronic Parasympathetic Sectioning Decreases Regional Cerebral Blood Flow During Hemorrhagic Hypotension and Increases Infarct Size After Middle Cerebral Artery Occlusion in Spontaneously Hypertensive Rats  

Microsoft Academic Search

Summary: Regional cerebral blood flow (rCBF) during controlled hemorrhagic hypotension (140-20 mm Hg) was assessed 10-14 days after chronic unilateral sectioning of parasympathetic and\\/or sensory fibers innervating pial vessels in spontaneously hypertensive rats (SHR). rCBF was measured in the cortical barrel fields bilaterally by laser Doppler blood flowmetry. Immunohistochemistry of middle cerebral artery (MCA) whole mount preparations was used to

Naoki Koketsu; Michael A. Moskowitz; Hermes A. Kontos; Masayuki Yokota; Takeo Shimizu



Stereoscopic occlusion junctions.  


Portions of surfaces in a binocularly viewed scene may be 'half occluded', that is, visible in only one eye. The human visual system uses zones of half occlusion to help segment the visual scene and infer figure-ground relationships at object boundaries. We developed a quantitative model of the depth-discontinuity cue provided by half occlusion. Half occlusions are revealed by two-dimensional interocular displacements of binocularly viewed occlusion junctions, such as T junctions. We derived a formula relating this two-dimensional displacement, or 'pseudodisparity', to binocular disparities and orientations of occluding and occluded contours. In human psychophysical experiments, perceived depth and contour orientation quantitatively depended on pseudodisparity, as predicted by our model, implying that the visual system senses quantitative variations in interocular junction position to reconstruct occlusion geometry. PMID:10461224

Malik, J; Anderson, B L; Charowhas, C E



Intramedullary rod and cement static spacer construct in chronically infected total knee arthroplasty.  


Two-stage reimplantation, with interval antibiotic-impregnated cement spacer, is the preferred treatment of prosthetic knee joint infections. In medically compromised hosts with prior failed surgeries, the outcomes are poor. Articulating spacers in such patients render the knee unstable; static spacers have risks of dislocation and extensor mechanism injury. We examined 58 infected total knee arthroplasties with extensive bone and soft tissue loss, treated with resection arthroplasty and intramedullary tibiofemoral rod and antibiotic-laden cement spacer. Thirty-seven patients underwent delayed reimplantation. Most patients (83.8%) were free from recurrent infection at mean follow-up of 29.4 months. Reinfection occurred in 16.2%, which required debridement. Twenty-one patients with poor operative risks remained with the spacer for 11.4 months. All patients, during spacer phase, had brace-free ambulation with simulated tibiofemoral fusion, without bone loss or loss of limb length. PMID:21783338

Kotwal, Suhel Y; Farid, Yasser R; Patil, Suresh S; Alden, Kris J; Finn, Henry A



Systemic factors contributory to retinal vein occlusion.  


This study was undertaken in 79 patients with retinal vein occlusion to assess the different systemic mechanisms contributing to the occlusion, namely, intrinsic vessel disease and abnormalities of the blood constituents and blood viscosity. In 55 patients older than 50 years of age, important associations were hypertension, abnormal results on glucose tolerance test, hyperlipidemia, chronic lung disease, and elevated serum IgA levels. In the 24 patients younger than 50 years of age, male incidence was high and important associations were head injuries, hyperlipidemia, and the use of estrogen-containing preparations. Hyperviscosity and cryofibrinogenemia were prominent in both groups. The pathogenesis of retinal venous occlusion is complex involving interaction between the vessel wall and blood constituents. PMID:626551

McGrath, M A; Wechsler, F; Hunyor, A B; Penny, R



Thermolabile MTHFR genotype and retinal vascular occlusive disease  

Microsoft Academic Search

BACKGROUNDRaised levels of total plasma homocysteine (tHcy) are associated with an increased risk of retinal vascular occlusive disease. A thermolabile form of a pivotal enzyme in homocysteine metabolism, methylenetetrahydrofolate reductase (MTHFR), has been associated with vascular occlusive disease and raised tHcy levels. The relation between thermolabile MTHFR genotype, tHcy, and retinal vascular occlusive disease has not been determined.METHODSA retrospective case-control

M Cahill; M Karabatzaki; C Donoghue; R Meleady; L A Mynett-Johnson; D Mooney; I M Graham; A S Whitehead; D C Shields



Laparoscopic management of totally intra-thoracic stomach with chronic volvulus  

PubMed Central

AIM: To evaluate the outcomes of patients who underwent laparoscopic repair of intra-thoracic gastric volvulus (IGV) and to assess the preoperative work-up. METHODS: A retrospective review of a prospectively collected database of patient medical records identified 14 patients who underwent a laparoscopic repair of IGV. The procedure included reduction of the stomach into the abdomen, total sac excision, reinforced hiatoplasty with mesh and construction of a partial fundoplication. All perioperative data, operative details and complications were recorded. All patients had at least 6 mo of follow-up. RESULTS: There were 4 male and 10 female patients. The mean age and the mean body mass index were 66 years and 28.7 kg/m2, respectively. All patients presented with epigastric discomfort and early satiety. There was no mortality, and none of the cases were converted to an open procedure. The mean operative time was 235 min, and the mean length of hospitalization was 2 d. There were no intraoperative complications. Four minor complications occurred in 3 patients including pleural effusion, subcutaneous emphysema, dysphagia and delayed gastric emptying. All minor complications resolved spontaneously without any intervention. During the mean follow-up of 29 mo, one patient had a radiological wrap herniation without volvulus. She remains symptom free with daily medication. CONCLUSION: The laparoscopic management of IGV is a safe but technically demanding procedure. The best outcomes can be achieved in centers with extensive experience in minimally invasive esophageal surgery.

Toydemir, Toygar; Cipe, Gokhan; Karatepe, Oguzhan; Yerdel, Mehmet Ali



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.



Full occlusal protection—theory and practice of occlusal therapy  

Microsoft Academic Search

In this review the full occlusal protection theory is proposed and its clinical practice demonstrated for varying Angle's malocclusions. The concept of developing restorative anatomical shapes or bio-designing occlusal schemes of crowns to compensate for poor intra-arch tooth positioning is proposed and demonstrated. Clinical parameters for full occlusal protection in occlusal therapy are presented.

Michael Darveniza



OcclusionGood occlusal practice in children's dentistry  

Microsoft Academic Search

The difference between paediatric dentistry and most other branches of dentistry is that in the child the occlusion is changing. Consequently 'Good Occlusal Practice' in children is a matter of making the right clinical decisions for the future occlusion. The clinician needs to be able to predict the influence that different treatment options will have on the occlusion when the

R J M Gray; I C Mackie; S J Davies



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



Salvage of elbow function in chronic complex elbow fracture dislocation with total elbow arthroplasty: a case report.  


In patients with an elbow fracture dislocation the incidence of radial head fracture is 36%, where as coronoid process fractures occur in 13%, and olecranon fractures in 4% of patients. Combination of all these fractures with a 'terrible triad' is rarely reported in the literature. We describe a 40 year old lady involved in a polytrauma who had head injury, pnuemothorax and an open fracture dislocation of the left elbow. The Injury Severity Score initially on admission was 44. She presented with chronic elbow instability with pain 1 year later. A semi constrained total elbow arthroplasty (TEA) with a Coonrad-Morrey prosthesis was performed in this complex injury involving fractures of the coronoid, olecranon, proximal third of the ulna and radial head malunion with heterotrophic ossification around the elbow joint. Although the survivorship of total elbow replacements has improved, it is still a procedure reserved to older patients with low functional demand. At 1-year follow-up, the patient had full range in flexion and extension. The Mayo Elbow Performance Score (MEPS) was 100. TEA is a procedure which gains function and stability in a terrible triad elbow. PMID:24145266

Ramesh, M; Agus Iwan, F; Anuar, A; Benard, D



Occlusion-aware interfaces  

Microsoft Academic Search

We define occlusion-aware interfaces as interaction techniques which know what area of the display is currently occluded, and use this knowledge to counteract potential problems and\\/or utilize the hidden area. As a case study, we describe the Occlusion-Aware Viewer, which identifies important regions hidden beneath the hand and displays them in a non-occluded area using a bubble-like callout. To determine

Daniel Vogel; Ravin Balakrishnan



Basilar artery occlusion  

Microsoft Academic Search

Basilar artery occlusion is assumed to carry a grave prognosis, with mortality rates of up to 90%. Diagnosis is often delayed,\\u000a or even missed, as a result of the variety of clinical presentations seen with this condition. The pathogenesis of occlusion\\u000a can be secondary to both local atherothrombosis or cardioembolism. The use of noninvasive imaging such as magnetic resonance\\u000a imaging

Tracey A. Baird; Keith W. Muir; Ian Bone



[Vascular interventions and reconstructive plastic surgery. Optimizing the treatment of chronic wounds].  


Despite the high prevalence of arterial occlusive disease, only a few studies have investigated the benefit of interventions to recanalize extremity arteries prior to plastic operations to close chronic wounds. The purpose of this study was to investigate the correlation of simple clinical examinations and apparative diagnostics of arterial occlusive disease of the lower extremity in patients with chronic wounds and to evaluate the benefit of vascular procedures to optimize wound perfusion before surgical closure. A total of 150 individuals with chronic wounds were included in this retrospective study. All patients underwent palpation of their foot pulses, Doppler sonography, and measurement of occlusive pressure. Positive results were tested by angiography. All patients with peripheral extremity vessel occlusion underwent vascular interventions prior to plastic operations for definitive wound closure. In all 34 patients with missing foot pulses, the clinical diagnosis of arterial occlusion could be confirmed by angiography. Peripheral recanalization and improved wound perfusion could be achieved in all patients. Arterial insufficiency could be diagnosed rapidly and safely using simple clinical examination such as palpation of foot pulses or measurement of occlusive pressures combined with Doppler sonography. Thus this simple and straightforward algorithm helped to secure the success of surgical therapy by shortening the time until wound-healing and reducing the psychosocial burden on the patient and financial costs to the health care system. PMID:17440701

Aust, M C; Spies, M; Kall, S; Gohritz, A; Rosenthal, H; Pichlmaier, M; Oehlert, G; Vogt, P M



Total body irradiation and cyclophosphamide is a conditioning regimen for unrelated bone marrow transplantation in a patient with chronic myelogenous leukemia and renal failure on hemodialysis  

Microsoft Academic Search

Five years after the diagnosis of Ph chromosome-positive chronic myeloid leukemia (CML) a 31-year-old patient developed malignant nephrosclerosis with renal failure. He then underwent an allogeneic unrelated BMT in first chronic phase CML. The preparative regimen consisted of fractionated total body irradiation (TBI) and cyclophosphamide (CY). We studied the pharmacokinetics of cyclophosphamide on hemodialysis and compared clinical parameters including time

ME Bischoff; W Blau; T Wagner; W Wagenmann; O Dörner; N Basara; AA Fauser



Homocystinuria presenting as fatal common carotid artery occlusion  

Microsoft Academic Search

A patient with homocystinuria presenting with fatal cerebral infarction that resulted from left common carotid artery occlusion is reported. This 13-year-old, healthy and intelligent girl presented with progressive cerebral infarction. Angiography revealed total occlusion of the left common carotid artery and stenosis of the right common carotid artery. Distal stenosis of bilateral vertebral arteries was also observed. Initially Takayasu arteritis

Chun-Yi Lu; Jia-Woei Hou; Pen-Jung Wang; Hsiu-Hui Chiu; Tso-Ren Wang



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:; Oguzkurt, Levent, E-mail:; Tercan, Fahri, E-mail:; Gumus, Burcak, E-mail: [Baskent University Faculty of Medicine, Department of Radiology (Turkey)



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.



Myocardial Perfusion Grade (MPG) After Late Infarct Artery Recanalization is Associated With Global and Regional LV Function at One Year; Analysis From the Total Occlusion Study of Canada-2  

PubMed Central

Background Whether myocardial perfusion grade (MPG) following late recanalization of infarct-related arteries (IRA) predicts left ventricular (LV) function recovery beyond the acute phase of myocardial infarction (MI) is unknown. Methods and Results The Total Occlusion Study of Canada-2 (TOSCA-2) enrolled stable patients with persistently occluded IRA beyond 24 h and up to 28 days post-MI. We studied the relationship between the initial MPG and changes in LV function and volume, and the change in MPG from immediate post-PCI to one year in 139 PCI patients with TIMI 3 epicardial flow post PCI and with paired values, grouped into impaired or good MPG groups (MPG 0/1 or MPG 2/3). MPG 0/1 patients were more likely to have received thrombolytic therapy and to have a LAD IRA. They had lower blood pressure and LV ejection fraction (LVEF), and a higher heart rate and systolic sphericity index at baseline. Changes in the MPG 0/1 and MPG 2/3 groups from baseline to 1 year were: LVEF 3.3±9.0 and 4.8±8.9 percent (p=0.42), LV end-systolic volume index (LVESVI) -1.1±9.2 and -4.7±12.3 ml/m2 (p=0.25), LV end-diastolic volume index (LVEDVI) 0.08±19.1 and -2.4±22.2 ml/m2 (p=0.67), and standard deviations /chord for infarct zone wall motion index (WMI)) 0.38±0.70 and 0.84±1.11 (p=0.01). By covariate-adjusted analysis, post-PCI MPG 0/1 predicted lower WMI (p<0.001), lower LVEF (p<0.001) and higher LVESVI (p<0.01), but not LVEDVI at one year. Of the MPG 0/1 patients, 60% were MPG 2 or 3 at one year. Conclusions Preserved MPG is present in a high proportion of patients following late PCI of occluded IRAs post-MI. Poor MPG post-PCI frequently improves MPG over 1 year. MPG graded after IRA recanalization undertaken days to weeks post MI is associated with LV recovery indicating that MPG determined in the subacute post-MI period remains a marker of viability.

Steigen, Terje K.; Buller, Christopher E.; John Mancini, G. B.; Jorapur, Vinod; Cantor, Warren J.; Rankin, James M.; Thomas, Boban; Webb, John G.; Kronsberg, Shari S.; Atchison, Deborah J.; Lamas, Gervasio A.; Hochman, Judith S.; Dzavik, Vladimir



Total diet study on pesticide residues in France: levels in food as consumed and chronic dietary risk to consumers.  


Chronic dietary exposure to pesticide residues was assessed for the French population using a total diet study (TDS) to take into account realistic levels in foods as consumed at home (table-ready). Three hundred and twenty-five pesticides and their transformation products, grouped into 283 pesticides according to their residue definition, were sought in 1235 composite samples corresponding to 194 individual food items that cover 90% of the adult and child diet. To make up the composite samples, about 19,000 food products were bought during different seasons from 2007 to 2009 in 36 French cities and prepared according to the food preparation practices recorded in the individual and national consumption survey (INCA2). The results showed that 37% of the samples contained one or more residues. Seventy-three pesticides were detected and 55 quantified at levels ranging from 0.003 to 8.7mg/kg. The most frequently detected pesticides, identified as monitoring priorities in 2006, were the post-harvest insecticides pirimiphos-methyl and chlorpyrifos-methyl-particularly in wheat-based products-together with chlorpyrifos, iprodione, carbendazim and imazalil, mainly in fruit and fruit juices. Dietary intakes were estimated for each subject of INCA2 survey, under two contamination scenarios to handle left-censored data: lower-bound scenario (LB) where undetected results were set to zero, and upper-bound (UB) scenario where undetected results were set to the detection limit. For 90% of the pesticides, exposure levels were below the acceptable daily intake (ADI) under the two scenarios. Under the LB scenario, which tends to underestimate exposure levels, only dimethoate intakes exceeded the ADI for high level consumers of cherry (0.6% of children and 0.4% of adults). This pesticide, authorised in Europe, and its metabolite were detected in both cherries and endives. Under the UB scenario, that overestimates exposure, a chronic risk could not be excluded for nine other pesticides (dithiocarbamates, ethoprophos, carbofuran, diazinon, methamidophos, disulfoton, dieldrin, endrin and heptachlor). For these pesticides, more sensitive analyses of the main food contributors are needed in order to refine exposure assessment. PMID:22595191

Nougadère, Alexandre; Sirot, Véronique; Kadar, Ali; Fastier, Antony; Truchot, Eric; Vergnet, Claude; Hommet, Frédéric; Baylé, Joëlle; Gros, Philippe; Leblanc, Jean-Charles



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: [Dicle University School of Medicine, Department of Radiology (Turkey); Oguzkurt, Levent, E-mail:; Gur, Serkan, E-mail: [Baskent University School of Medicine, Department of Interventional Radiology, Adana Hospital (Turkey); Onder, Hakan, E-mail: [Dicle University School of Medicine, Department of Radiology (Turkey); Andic, Cagatay, E-mail: [Baskent University School of Medicine, Department of Interventional Radiology, Adana Hospital (Turkey)



Pulmonary veno-occlusive disease  


Pulmonary vaso-occlusive disease ... In most cases, the cause of pulmonary veno-occlusive disease is unknown. The high blood pressure occurs in the pulmonary arteries, which are the lung arteries directly connected to ...


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:; 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)



Occlusion, TMDs, and dental education  

Microsoft Academic Search

The paradigmatic shift to evidence-based dentistry (EBD) that relates to occlusal therapy, selective occlusal adjustment (OA) and stabilization splints therapy (SS) for TMDs has had an unfavourable impact on the teaching of many of the important aspects of occlusion needed in dental practice. The teaching of OA systematically in dental schools has been nearly abandoned because of the belief that

Major M Ash Jr



Portal venous occlusion  

Microsoft Academic Search

Summary Morbidly obese patients are significantly more susceptible to clotting phenomena, including recurrent deep venous thrombosis, pulmonary emboli, inferior vena caval thrombosis, and renal vein thrombosis. The patient described in this report developed the sudden onset of massive ascites two years following jejunoileal bypass for morbid obesity. Occlusion of the portal vein and its tributaries was demonstrated. Our experience and

Richard Metz; Robert Gray; Leonard Goldstein



Retinal Vein Occlusions  

Microsoft Academic Search

Retinal vein occlusion (RVO) is a common cause of vision loss in elderly people. The complex pathogenesis of central RVO (CRVO), hemi-RVO (HRVO) and branch RVO (BRVO) makes it an interdisciplinary task. Treatment of RVO should aim at eliminating the complications and vision-disturbing effects of RVO but also include prophylactic measures in order to avoid recurrence of the disease. Problems

Wolf Buehl; Stefan Sacu; Ursula Schmidt-Erfurth



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

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 ..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

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



Female sterilization occlusion techniques.  


There are several different female sterilization occlusion techniques. Tubes can be tied, blocked with mechanical devices such as clips or rings, or scarred closed with electric current. In partial salpingectomy, the most common occlusion technique, the fallopian tubes are cut and tied with a suture material. This approach is safe, effective, easy to learn, and does not require any special equipment. Titanium or plastic clips block the fallopian tubes by clamping down and cutting off the blood supply to a portion of the tubes, causing sufficient scarring or fibrosis to prevent fertilization. Silicone rings also are used to block the tubes mechanically. A small loop of tube is pulled through the stretched ring and the resultant scarring blocks passage of the sperm or egg. Finally, electrocoagulation uses electric current to coagulate a small portion of each fallopian tube. This technique is rarely used, however, because of the risk of organ injury. PMID:12321060

Keller, S



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


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


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



Laparoscopic Uterine Artery Occlusion Combined with Myomectomy for Uterine Myomas  

Microsoft Academic Search

We sought to evaluate the clinical feasibility and mid- to long-term effects of laparoscopic uterine artery occlusion before myomectomy in the treatment of uterine myomas. A total of 566 patients with uterine myoma were treated by laparoscopic uterine artery occlusion before myomectomy from October 2001 through July 2007. Mean blood loss was 88.2 ± 52.7 mL (95% CI 82.7–93.8). The

Zhongping Cheng; Weihong Yang; Hong Dai; Liping Hu; Xiaoyan Qu; Le Kang



Chronic nitrogen additions reduce total soil respiration and microbial respiration in temperate forest soils at the Harvard Forest  

Microsoft Academic Search

At the Harvard Forest Long-term Ecological Research Site Chronic Nitrogen Amendment Study, a red pine and a mixed deciduous stand showed immediate changes in soil respiration following nitrogen additions (low N: 5gNm?2 per year; high N: 15gNm?2 per year) during the initial year (1988) of the study. In the hardwood stand, soil respiration rates increased after N additions in the

Richard D Bowden; Eric Davidson; Kathleen Savage; Chris Arabia; Paul Steudler



Chronic nitrogen additions reduce total soil respiration and microbial respiration in temperate forest soils at the Harvard Forest  

Microsoft Academic Search

Abstract At the Harvard Forest Long-term Ecological Research Site Chronic Nitrogen Amendment Study, a red pine and a mixed deciduous stand showed,immediate,changes in soil respiration following nitrogen additions (low N: 5 g N m, 2 per year), with further reductions in the second year. Weekly measures of soil respiration during summer 2001 showed that after 13 years of continuous nitrogen

Richard D. Bowden; Eric Davidson; Kathleen Savage; Chris Arabia; Paul Steudler



Butadiene cancer exposure-response modeling: based on workers in the styrene-butadiene-rubber industry: total leukemia, acute myelogenous leukemia, chronic lymphocytic leukemia, and chronic myelogenous leukemia.  


Cox regression is used to estimate exposure-response models (with cumulative 1,3-butadiene (BD) ppm-years as the exposure metric) based on the most recent data and validated exposure estimates from UAB's study of North American workers in the styrene-butadiene-rubber industry. These data are substantially updated from those in USEPA's 2002 risk assessment. The slope for cumulative BD ppm-years is not statistically significantly different than zero for CML, AML, or, when any one of eight exposure covariates is added to the model, for all leukemias combined (total leukemia). For total leukemia, the EC(1/100,000) is approximately 0.15 BD environmental ppm and the corresponding unit risk factor is approximately 0.00007 per BD environmental ppm. The excess risk for CML is approximately 15-fold less than for total leukemia. The maximum likelihood estimates suggest that there is no excess risk for AML from cumulative BD ppm-years. For CLL, the slope is statistically significantly different than zero. The excess risk for CLL is approximately 2.5-fold less than for total leukemia. For both total leukemia and CLL, the slope is not statistically significantly different than zero when the exposure-response modeling is based on the person-years with cumulative BD ppm-years less than or equal to 300 ppm-years. PMID:21600953

Sielken, Robert L; Valdez-Flores, Ciriaco



Lateral occlusion schemes in natural and minimally restored permanent dentition: a systematic review.  


Clinicians commonly encounter the dilemma of which lateral occlusion schemes is most suitable for a specific patient. The aim of this review is to evaluate the prevalence of the lateral occlusion schemes that exist naturally. An electronic search was completed through PubMed (MEDLINE), Google Scholar and Cochrane Library. The search was confined to peer-reviewed studies published in English, up to April 2013. The literature search was supplemented by manual searching through the bibliography lists of the selected studies. The initial search retrieved a total of 575 studies. After applying the selection criteria, only 12 studies were suitable for inclusion. The Critical Appraisal Skills Programme (CASP) tools were utilised to appraise the quality of the studies. The prevalence of canine-guided, group function and balanced occlusions was reported. Overall, there was a clear variability between the studies. The prevalence of the lateral occlusion schemes appears to be influenced by the following factors: (i) the magnitude of excursion, (ii) an individual's age and (iii) the static occlusal relationship. During complete excursion, the canine-guided occlusion tends to be more frequently observed. After partial excursion, the most prevalent lateral occlusion schemes was group function occlusion. With ageing, the prevalence of canine-guided occlusion tends to be reduced and the prevalence of group function occlusion is increased. Dentition that is closer to Class II occlusion exhibits mainly canine-guided occlusion, while for Class III occlusion, group function occlusion is more prevalent. The studies revealed no relationship between the lateral occlusion schemes and TMD development. PMID:23981045

Abduo, J; Tennant, M; McGeachie, J



Part-time occlusion therapy for amblyopia in older children  

PubMed Central

Aim: To compare the efficacy of part-time versus full-time occlusion for treatment of amblyopia in children aged 7-12 years. Materials and Methods: Prospective interventional case series. One hundred children between 7-12 years of age with anisometropic (57), strabismic (25) and mixed (18) unilateral amblyopia were randomized (simple randomization) into four groups (25 each) to receive two hours, four hours, six hours or full-time occlusion therapy. Children were regularly followed up at six-weekly intervals for a minimum of three visits. Statistical Analysis: Intragroup visual improvement was analyzed using paired t-test while intergroup comparisons were done using ANOVA and unpaired t-test. Results: All four groups showed significant visual improvement after 18 weeks of occlusion therapy (P<0.001). Seventy-three (73%) of the total 100 eyes responded to amblyopia therapy with 11 eyes (44%), 17 eyes (68%), 22 eyes (88%) and 23 eyes (92%) being amblyopia responders in the four groups respectively, with the least number of responders in the two hours group. In mild to moderate amblyopia (vision 20/30 to 20/80), there was no significant difference in visual outcome among the four groups (P=0.083). However, in severe amblyopia (vision 20/100 or worse), six hours (P=0.048) and full-time occlusion (P=0.027) treatment were significantly more effective than two hours occlusion. Conclusion: All grades of part-time occlusion are comparable to full-time occlusion in effectiveness of treatment for mild to moderate amblyopia in children between 7-12 years of age unlike in severe amblyopia, where six hours and full-time occlusion were more effective than two hours occlusion therapy.

Singh, Inderpreet; Sachdev, Nishant; Kaushik, Sushmita



Percutaneous retrograde revascularization of the occluded celiac artery for chronic mesenteric ischemia using intravascular ultrasound guidance.  


A 47-year-old male presented with a triad of postprandial abdominal pain, food fear and significant weight loss since 1 year suggestive of chronic mesenteric ischemia. CT angiogram revealed chronic total occlusion of the celiac artery (CA), inferior mesenteric artery and 80-90 % stenosis of the proximal superior mesenteric artery (SMA). After SMA stenting, successful retrograde recanalisation of chronically occluded CA through pancreatico-duodenal arcade using intravascular ultrasound (IVUS) guidance was done when standard tools failed. The role of IVUS in such challenging lesions is described in the following case report. PMID:23526494

Jain, Gagan; Pandit, Bhagya Narayan; Goyal, Mayank; Trehan, Vijaya Kumar



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



[Occlusive pancreatojejunoanastomosis in pancreatoduodenal resection].  


A technique for creation of occlusive pancreatojejunoanastomosis (OPJA) in pancreatoduodenal resection was used in 7 patients. Uncomplicated course of the postoperative period was noted in 6 of them. The indications for formation of the OPJA are substantiated by the experience with 32 pancreatoduodenal resections with pancreatojejunoanastomosis formation, and 47--with occlusion of the pancreatic stump. PMID:2696807

Danilov, M V; Pomelov, V S; Buriev, I M; Za?denberg, M A



Photoacoustic removal of occlusions from blood vessels  


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)



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



The influence of stoma occlusion on aspects of tracheoesophageal voice.  


In this study, speech of 21 laryngectomized patients is investigated under 2 different stoma occlusion conditions, i.e. direct digital occlusion of the stoma (by thumb or finger), and digital occlusion (by finger) via a special heat and moisture exchanger with speech valve (Provox Stomafilter). For both conditions, acoustical analyses of voice quality (various pitch, amplitude, tremor and harmonicity measures) were performed on a sustained /a/, the mean maximum phonation time was calculated, and a phonetogram was made. Acoustical analysis was possible in 13 of the 21 voices (for the other voices, the pitch was too low or the voice was too aperiodic), but no statistical significant differences were found for any of the acoustical parameters studied. However, the maximum phonation time was significantly longer, and the dynamic range significantly larger, under the Stomafilter occlusion condition. The maximum phonation time showed a relevant improvement in 57% of the patients, while the dynamic range showed a relevant improvement in 35% of the patients. In total, 75% of the patients experience an improvement in one or both of these speech characteristics when using the Stomafilter occlusion. It can be concluded that optimal stoma occlusion by means of a specialized device has a positive influence on two relevant parameters of prosthetic voice production: maximum phonation time and dynamic loudness range. PMID:9840514

van As, C J; Hilgers, F J; Koopmans-van Beinum, F J; Ackerstaff, A H



Dental occlusion and postural control in adults  

Microsoft Academic Search

We studied the influence of a dental occlusion perturbation on postural control. The tests were performed in three dental occlusion conditions: (Rest Position: no dental contact, Maximal Intercuspal Occlusion: maximal dental contact, and Thwarted Laterality Occlusion: simulation of a dental malocclusion) and four postural conditions: static (stable platform) and dynamic (unstable platform), with eyes open and eyes closed. A decay

Corinne Tardieu; Michel Dumitrescu; Anne Giraudeau; Jean-Luc Blanc; François Cheynet; Liliane Borel



Inflammation in Retinal Vein Occlusion  

PubMed Central

Retinal vein occlusion is a common, vision-threatening vascular disorder. The role of inflammation in the pathogenesis and clinical consequences of retinal vein occlusion is a topic of growing interest. It has long been recognized that systemic inflammatory disorders, such as autoimmune disease, are a significant risk factor for this condition. A number of more recent laboratory and clinical studies have begun to elucidate the role inflammation may play in the molecular pathways responsible for the vision-impairing consequences of retinal vein occlusion, such as macular edema. This improved understanding of the role of inflammation in retinal vein occlusion has allowed the development of new treatments for the disorder, with additional therapeutic targets and strategies to be identified as our understanding of the topic increases.

Deobhakta, Avnish; Chang, Louis K.



Comparison of Optical Coherence Tomography Findings in a Patient with Central Retinal Artery Occlusion in One Eye and End-stage Glaucoma in the Fellow Eye  

PubMed Central

This case describes a patient with chronic central retinal artery occlusion in one eye and end-stage traumatic glaucoma in the fellow eye. Optical coherence tomography (OCT) of the macula of the chronic phase of central retinal artery occlusion of the right eye indicated loss of the normal foveal depression, extensive inner retinal atrophy, and marked retinal thinning. In contrast, scans of the left eye with end-stage glaucoma demonstrated an intact foveal depression and limited retinal thinning. The pattern of macular OCT findings in this patient illustrates distinguishing features between chronic central retinal artery occlusion and chronic optic neuropathy due to end-stage glaucoma.

Greene, Daniel P.; Richards, Charles P.; Ghazi, Nicola G.



Lesions of the ventral ascending noradrenergic bundles decrease the stress response to occlusal disharmony in rats.  


Occlusal disharmony induced by placing an acryl cap on the lower incisors of rats is perceived as chronic stress. This chronic stress activates corticotropin-releasing hormone (CRH) neurons in the hypothalamic paraventricular nucleus (PVN), resulting in stimulation of the hypothalamic-pituitary-adrenal (HPA) axis. The ventral ascending noradrenergic bundles (V-NAB) from the brainstem innervate the PVN. To investigate the relationship between the response of the HPA axis and the V-NAB, we examined changes in extracellular noradrenaline (NA) in the PVN and plasma corticosterone, the final output of the HPA axis, following occlusal disharmony in rats injected with 6-hydroxydopamine (6-OHDA), a specific catecholamine neurotoxin. 6-OHDA microinjection into the V-NAB reduced the magnitude of the responses of extracellular NA in the PVN and the plasma corticosterone to occlusal disharmony. Our results suggest that V-NAB to the PVN are involved in occlusal disharmony-induced activation of the HPA axis. PMID:21864649

Yoshihara, Toshihiro; Yawaka, Yasutaka



Placement of a Port Catheter Through Collateral Veins in a Patient with Central Venous Occlusion  

Microsoft Academic Search

Long-term utilization of central venous catheters (CVCs) for parenteral nutrition has a high incidence of central venous complications including infections, occlusions, and stenosis. We report the case of a 31-year-old woman presenting with a malabsorption caused by short gut syndrome due to congenital aganglionic megacolon. The patient developed a chronic occlusion of all central neck and femoral veins due to

Ulf Karl-Martin Teichgraeber; Florian Streitparth; Bernhard Gebauer; Thomas Benter



Placement of a Port Catheter Through Collateral Veins in a Patient with Central Venous Occlusion  

Microsoft Academic Search

Long-term utilization of central venous catheters (CVCs) for parenteral nutrition has a high incidence of central venous complications\\u000a including infections, occlusions, and stenosis. We report the case of a 31-year-old woman presenting with a malabsorption\\u000a caused by short gut syndrome due to congenital aganglionic megacolon. The patient developed a chronic occlusion of all central\\u000a neck and femoral veins due to

Ulf Karl-Martin Teichgräber; Florian Streitparth; Bernhard Gebauer; Thomas Benter



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



Intensive occlusion therapy for amblyopia  

PubMed Central

AIM—To study the effects of supervised inpatient occlusion treatment for amblyopia in children who had failed to respond to outpatient treatment.?METHODS—A retrospective study of 39 children admitted to a paediatric ophthalmic ward for 5 days of supervised intensive occlusion therapy having previously failed to respond to outpatient occlusion. Visual acuity of amblyopic and fellow eyes was recorded at each clinic visit before admission, daily during admission, and at each outpatient visit after discharge.?RESULTS—There was no significant overall improvement in visual acuity during a mean of 9 months of attempted outpatient occlusion before admission. During the 5 days of admission 26 children (67%) gained at least one line of acuity in their amblyopic eye and five (13%) gained three or more lines (mean gain 1.03 Snellen lines). The acuities of both the amblyopic and fellow eyes subsequently improved with continuing part time patching as an outpatient, including in nine of the children who did not respond during admission. At the last recorded visit, at a median time of 14 months after discharge, 13 (33%) of the patients had an acuity of at least 6/12 in their amblyopic eye.?CONCLUSIONS—The acuity of amblyopic eyes did not improve without effective treatment. Subsequent supervised inpatient occlusion therapy was effective in the majority of the children.??

Dorey, S.; Adams, G.; Lee, J.; Sloper, J.



Occlusion for fixed prosthodontics: a historical perspective of the gnathological influence.  


This article addresses the historical perspective of the gnathological influence upon the concepts of occlusion for fixed prosthodontics. A critical assessment and subsequent scientific validation of occlusal theories require an understanding of their evolution in the formative years and the subsequent development of effective models for clinical practice. While gnathological concepts offer a structured methodology for prosthodontic procedures, further research is needed to corroborate current occlusal treatment approaches. This review focuses on the "classic" fixed prosthodontic literature and the currently available scientific literature involving fixed prosthodontic dentate occlusion and gnathology. A MEDLINE search was performed to identify English-language peer-reviewed publications spanning the last 56 years, along with an extensive hand search for years prior. Electronic searches of the literature were performed in MEDLINE using the key words: case series, clinical trials, cohort studies, fixed partial denture occlusion, dental occlusion, dental occlusion research, centric relation, incisal guidance, maximal intercuspation, occlusal vertical dimension, and occlusion, in various combinations to obtain potential references for review. A total of 10,382 English-language nonduplicate titles were obtained for 1950-2006 for the key words "dental occlusion." Other key word searches produced smaller numbers of articles, many of which were duplicates due to multiple searches and were subsequently eliminated. Manual hand searching of the MEDLINE reference list and other journals of interest was performed to identify any articles missed in the original search. Articles were included for review if they contained emerging occlusal theories, new technologies, or occlusal studies that included multiple subjects in contrast to case reports. PMID:18395541

Pokorny, Paul H; Wiens, Jonathan P; Litvak, Harold



Occlusion constraints and stereoscopic slant.  


In binocular vision horizontal magnification of one retinal image leads to a percept of three-dimensional slant around a vertical axis. It is demonstrated that the perception of slant is diminished when an occlusion interpretation is possible. A frontoparallel plane located in the immediate vicinity of a slanted surface in a location which allows a perception of occlusion reduces the magnitude of perceived slant significantly. When the same plane is placed on the other side, the slant perception is normal because there is no alternative occlusion interpretation. The results indicate that a common border between the occluder and a slanted surface is not a necessary condition for the reduction effect. If the edges are displaced and the edge of the slanted surface is placed in a location in which it could be occluded, the effect still appears. PMID:9196688

Häkkinen, J; Nyman, G



Vertebral Artery Dissection Complicated by Basilar Artery Occlusion.  


Acute basilar artery occlusion (ABAO) is an infrequent but potentially fatal complication that can cause strokes in both adults and children. Traumatic vertebral artery dissection (VAD) is one of the most common causes of ABAO in young patients. We present a case of an 11-year-old boy with VAD complicated by basilar artery occlusion 2 days after a fight with classmates that caused severe neurological deficits. He did not have any direct head trauma or concomitant risk factors. Clinical symptoms included nausea, vomiting, and rapid alteration of consciousness. Magnetic resonance imaging showed total occlusion of the basilar artery, and angiography confirmed VAD from the third to the fourth segments. A history of such subtle precipitating events should be noted when diagnosing young patients with brainstem strokes. A delay in the diagnosis of ABAO is frequently due to misleading symptoms and signs and the lack of awareness of this rare condition. PMID:23597537

Kuan, Chia-Yin; Hung, Kun-Long




PubMed Central

Purpose The purpose of this study was to assess the risk factors for central retinal vein occlusion and associated morbidity and mortality in a Chinese population. Methods The participants included patients with central retinal vein occlusion 40 years old and younger. Predisposing factors, mortality, and systemic complications were examined in this group. Results Unilateral (n = 19) and bilateral (n = 3) central retinal vein occlusions were identified in a total of 22 patients (25 eyes), with a mean follow-up time of 37 months. Hypercholesterolemia (65%), hypertriglyceridemia (64%), and hyperhomocysteinemia (42%) were all identified as risk factors. Three patients (14%) developed stroke and 1 (5%) developed transient ischemic attacks during follow-up. Renal failure and pulmonary hypertension resulted in the death of two patients. The mean initial and final visual acuities (±standard deviation) were 20/400 (±20/250) and 20/500 (±20/320), respectively, and treatments did not result in vision improvement (P = 0.57). The poor visual prognosis was likely due to macular edema in 7 eyes (28%), optic atrophy in 4 eyes (16%), and secondary glaucoma in 3 eyes (12%). Conclusion Morbidity and mortality are high in young Chinese patients with central retinal vein occlusion who may have associated serious complications including stroke, blindness, and death. Central retinal vein occlusion may serve as an initial clinical presentation of serious systemic diseases.

Kuo, Jane Zea-Chin; Lai, Chi-Chun; Ong, Frank Shih-Chang; Shih, Chia-Pang; Yeung, Ling; Chen, Tun-Lu; Chen, Kuan-Jen; Wu, Wei-Chi



[Collateral compensation of blood flow and hemodynamics of the lower extremities in atherosclerotic occlusion of abdominal aorta].  


Results of investigation of collateral blood flow in 159 patients with atherosclerotic occlusion of abdominal aorta of various kinds were presented. There was shown, that a. mesenterica superior constitutes the main visceral branch, securing the blood circulation compensation in total, high and middle occlusion of abdominal aorta and in low occlusion--a. mesenterica inferior. The change of direction and enhancement of blood flow along a. epigastric inferior was noted in all the patients. In spite of identity of total volumetric blood flow along the collateral branches, the volumetric blood flow velocity along the lower extremities arteries is determined by the level and spread of aortal occlusion. PMID:11944263

Sukharev, I I; Guch, A A; Novosad, E M; Vla?kov, G G



Probabilistic People Tracking for Occlusion Handling  

Microsoft Academic Search

This work presents a novel people tracking approach, able to cope with frequent shape changes and large occlusions. In particular, the tracks are described by means of probabilistic masks and appearance models. Occlusions due to other tracks or due to background objects and false occlusions are discriminated. The tracking system is general enough to be applied with any motion segmentation

Rita Cucchiara; Costantino Grana; Giovanni Tardini; Roberto Vezzani



Symmetric Stereo Matching for Occlusion Handling  

Microsoft Academic Search

In this paper, we propose a symmetric stereo model to han- dle occlusion in dense two-frame stereo. Our occlusion reasoning is directly based on the visibility constraint that is more general than both ordering and uniqueness con- straints used in previous work. The visibility constraint requires occlusion in one image and disparity in the other to be consistent. We embed

Jian Sun; Yin Li; Sing Bing Kang; Heung-Yeung Shum



New éndings on object permanence: A developmental difference between two types of occlusion  

Microsoft Academic Search

Manual search for totally occluded objects was investigated in 10-, 12- and 14-month- old infants. Infants responded to two types of total hiding in different ways, supporting the inference that object permanence is not a once-and-for-all attainment. Occlusion of an object by movement of a screen over it was solved at an earlier age than occlusion in which an object

M. Keith Moore; Andrew N. Meltzoff


Retinal Vein Occlusion: Current Treatment  

Microsoft Academic Search

Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is

Rosangela Lattanzio; Ana Torres Gimeno; Maurizio Battaglia Parodi; Francesco Bandello



Images from self-occlusion  

Microsoft Academic Search

We propose a complete system for designing, simulating, and fabricating surfaces with shading due to self-occlusion that induce desired input images. Our work is based on a simple observation. Consider a cylindrical hole (a pit) in a planar surface. As the depth of the hole increases, the radiance emitted from the surface patch that contains the hole decreases. This is

Marc Alexa; Wojciech Matusik



Tracking facial features with occlusions  

Microsoft Academic Search

Facial expression recognition consists of determining what kind of emotional content is presented in a human face. The problem presents a complex area for exploration, since it encompasses face acquisition, facial feature tracking, facial ex- pression classification. Facial feature tracking is of the most interest. Active Appearance Model (AAM) enables accurate tracking of facial features in real-time, but lacks occlusions




Etiology and Management of Branch Retinal Vein Occlusion  

Microsoft Academic Search

Retinal vein occlusion is one of the vascular disorders affecting vision. Branch retinal vein occlusion and central retinal vein occlusion are the two basic types of vein occlusion. Branch retinal vein occlusion is three times more common than central retinal vein occlusion and is second only to diabetic retinopathy as the most common retinal vascular cause of visual impairment. The

Sadaf Hamid; Sajid Ali Mirza; Ishrat Shokh


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.



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



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



Complex neurodegeneration in retina following moderate ischemia induced by bilateral common carotid artery occlusion in Wistar rats  

Microsoft Academic Search

Bilateral common carotid artery occlusion (BCCAO) produces moderate levels of ischemia in the retina of rats, which may simulate the inflow disturbances in severe carotid artery disease. ERG changes following acute BCCAO have been well described, but the effects of chronic BCCAO on the histopathology of the retina remain to be characterized in a reproducible model. Chronic BCCAO was induced

Hideo Yamamoto; Rainald Schmidt-Kastner; Duco I. Hamasaki; Hiroko Yamamoto; Jean-Marie Parel



Serum hepatitis B surface antigen is correlated with intrahepatic total HBV DNA and cccDNA in treatment-naïve patients with chronic hepatitis B but not in patients with HBV related hepatocellular carcinoma.  


The aim of the study was to investigate correlations between intrahepatic hepatitis B virus total DNA, covalently closed circular DNA (cccDNA), and serum HBsAg in treatment-naïve chronic hepatitis B and HBV related hepatocellular carcinoma (HCC). Liver tissues were taken from 42 HBV related HCC and 36 patients with chronic hepatitis B. A fraction of DNA extracted from liver tissue was digested with a plasmid-safe ATP-dependent DNase and used for HBV cccDNA detection. The remaining DNA was used for the detection of HBV total DNA and ?-globin, the latter of which is a housekeeping gene and quantified for normalization by real-time PCR. Quantitation of serum HBsAg was performed by a chemiluminescence assay. Serum HBsAg had positive correlations with serum HBV DNA (r?=?0.636, P?total DNA (r?=?0.519, P?=?0.001) and cccDNA (r?=?0.733, P?chronic hepatitis B, while HBsAg correlated poorly with DNA (r?=?0.224, P?=?0.210), intrahepatic total DNA and cccDNA in the tumor (r?=?0.351, P?=?0.031; r?=?0.164, P?=?0.324, respectively) and non-tumor (r?=?0.237, P?=?0.152; r?=?0.072, P?=?0.667, respectively) liver tissues of 42 HCC. HBV cccDNA and total DNA were significantly higher in liver tissue from chronic hepatitis B than in tumor and non-tumor of HCC (P?chronic hepatitis B than in HCC (P?total DNA were significantly higher in chronic hepatitis B than in HCC, and significant correlations among them were observed in treatment-naïve chronic hepatitis B but not in HCC. PMID:23168998

Wang, Meirong; Qiu, Ning; Lu, Shichun; Xiu, Dianrong; Yu, Jianguo; Wang, Xing Tai; Lu, Fengmin; Li, Tong; Liu, Xueen; Zhuang, Hui



The Range of Adaptation by Collateral Vessels After Femoral Artery Occlusion  

Microsoft Academic Search

Natural adaptation to femoral artery occlusion in animals by collateral artery growth restores only 35% of adenosine-recruitable maximal conductance (Cmax) probably because initially elevated fluid shear stress (FSS) quickly normalizes. We tested the hypothesis whether this deficit can be mended by artificially increasing FSS or whether anatomical restraints prevent complete restitution. We chronically increased FSS by draining the collateral flow

Inka Eitenmuller; Oscar Volger; Alexander Kluge; Kerstin Troidl; Miroslav Barancik; Wei-Jun Cai; Matthias Heil; Frederic Pipp; Silvia Fischer; Anton J. G. Horrevoets; Thomas Schmitz-Rixen; Wolfgang Schaper



The range of adaptation by collateral vessels after femoral artery occlusion  

Microsoft Academic Search

Natural adaptation to femoral artery occlusion in animals by collateral artery growth restores only approximate to 35% of adenosine-recruitable maximal conductance (C-max) probably because initially elevated fluid shear stress (FSS) quickly normalizes. We tested the hypothesis whether this deficit can be mended by artificially increasing FSS or whether anatomical restraints prevent complete restitution. We chronically increased FSS by draining the

I. Eitenmueller; O. Volger; A. Kluge; K. Troidl; M. Barancik; W. J. Cai; M. Heil; F. Pipp; S. Fischer; A. J. G. Horrevoets; T. Schmitz-Rixen; W. Schaper



Emergency Endovascular Treatment of a Superior Mesenteric Artery Occlusion  

SciTech Connect

Endovascular treatment of acute mesenteric ischemia is rarely reported. We report a patient with a 1-year history of chronic mesenteric ischemia who presented with acute worsening of his symptoms and peritoneal signs. Aortography depicted an occlusion of the superior mesenteric artery, which was successfully managed with immediate percutaneous angioplasty (PTA) and stent placement. The patient's clinical condition improved markedly and an exploratory laparotomy performed the following day confirmed the viability of the intestine. He remains symptom-free 12 months after the procedure, and color Doppler follow-up showed that the stent is patent.

Brountzos, Elias N. [Second Department of Radiology, Medical School, Athens University Eugenidion Hospital, 20 Papadiamantopoulou Street, G-11528, Athens (Greece); Critselis, Antonios; Magoulas, Dimitrios; Kagianni, Eleni [Departments of Radiology and Surgery, Metaxa Cancer Hospital, Botassi 51, Piraeus (Greece); Kelekis, Dimitrios A. [Second Department of Radiology, Medical School, Athens University Eugenidion Hospital, 20 Papadiamantopoulou Street, G-11528, Athens (Greece)



Retinal and choroidal vascular occlusion secondary to corticosteroid embolisation.  

PubMed Central

We report a case of visual loss following intranasal injection of triamcinolone acetonide and phenylephrine hydrochloride in a 22-year-old female with chronic sinusitis. Clinical examination and fluorescein angiography revealed vascular occlusions which involved multiple small branches of both the choroidal and retinal circulations. The mechanism of such a complication probably involves inadvertent intra-arterial injection into the anterior or the posterior ethmoidal artery, with retrograde flow into the opthalmic arterial system. Precautions can be taken to avoid such complications. Images

Wilkinson, W S; Morgan, C M; Baruh, E; Gitter, K A



Comparison of the effects of semi-occlusive polyurethane dressings and hydrocolloid dressings on dermal repair: 1. Cellular changes.  


The effects on dermal repair of two wound dressings, one the semi-occlusive polyurethane sheet Opsite, the other the hydrocolloid Granuflex, were compared in full-thickness excised lesions on porcine skin during the period from 5 d to 6 months after injury. Quantitative studies were made of changes in the populations of polymorphonuclear leucocytes, macrophages, fibroblasts, and endothelial cells. The progress of repair in the wounds covered with the semi-occlusive dressing showed a decrease in the number of inflammatory cells (polymorphonuclear leukocytes and macrophages) from 5 to 60 d, whereas the number of proliferative phase cells (fibroblasts and endothelial cells) increased from 5 to 7 d. The total cellularity per unit area showed an increase between 5 and 7 d, that is, during the proliferative phase of repair, and then progressively decreased as the proliferative phase was succeeded by the remodeling phase. In contrast, the repair process in the hydrocolloid-dressed wounds was more complex. The number of inflammatory cells remained relatively high throughout and there were consistently fewer endothelial cells present throughout. Fibroblast number showed an initial fall from 5 to 14 d but then started to increase in number from 21 to 60 d. This chronic inflammatory reaction appeared to be in response to particulate matter that had been incorporated into the wound bed and hypodermis, and was still apparent 6 months after injury, when hydrocolloid particles were detectable microscopically in the hypodermis. PMID:1823536

Young, S R; Dyson, M; Hickman, R; Lang, S; Osborn, C




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



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


21 CFR 880.5950 - Umbilical occlusion device.  

Code of Federal Regulations, 2010 CFR

... 2010-04-01 false Umbilical occlusion device. 880.5950 Section 880...Therapeutic Devices § 880.5950 Umbilical occlusion device. (a) Identification. An umbilical occlusion device is a clip, tie, tape,...



21 CFR 870.2890 - Vessel occlusion transducer.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Vessel occlusion transducer. 870.2890 Section 870...Monitoring Devices § 870.2890 Vessel occlusion transducer. (a) Identification. A vessel occlusion transducer is a device used to...



21 CFR 870.2890 - Vessel occlusion transducer.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 2009-04-01 false Vessel occlusion transducer. 870.2890 Section 870...Monitoring Devices § 870.2890 Vessel occlusion transducer. (a) Identification. A vessel occlusion transducer is a device used to...



21 CFR 880.5950 - Umbilical occlusion device.  

Code of Federal Regulations, 2010 CFR

... 2009-04-01 false Umbilical occlusion device. 880.5950 Section 880...Therapeutic Devices § 880.5950 Umbilical occlusion device. (a) Identification. An umbilical occlusion device is a clip, tie, tape,...



Towards Adaptive Occlusion Culling Using Camera Coherence  

Microsoft Academic Search

Occlusion culling proves to be useful for the interactive visualization of environments that are not densely occluded. Those which are built up by dense geometric sets like aerospace engines composed of thousands of components and millions of polygons. In first place the convenience of using occlusion culling is studied with a simple scheme. Then improvements are analyzed. The key points

Ignacio Mansa; Aiert Amundarain; E. Elizalde; Alejandro M. García-alonso; Luis M. Matey



Branch Retinal Vein Occlusion: Classification and Treatment  

Microsoft Academic Search

Branch retinal vein occlusion (BRVO) refers to a heterogeneous group of disorders with different clinical aspects, courses, and probably therapy. Depending on the site of the arteriovenous crossing, we can roughly divide BRVO into 3 main groups: major BRVO, hemispheric retinal vein occlusion, and macular BRVO. Main treatment options include laser treatment, corticosteroid administration, anti-VEGF drugs, and sheathotomy with or

Maurizio Battaglia Parodi; Francesco Bandello



Vascular Occlusion Techniques during Liver Resection  

Microsoft Academic Search

Control of bleeding from the transected liver basically consists of vascular inflow occlusion and control of hepatic venous backflow from the caval vein. Central venous pressure determines the pressure in the hepatic veins and is an extremely important factor in controlling blood loss through venous backflow. Vascular inflow occlusion (Pringle maneuver) involves clamping of the portal vein and the hepatic

Thomas M. van Gulik; Wilmar de Graaf; Sander Dinant; Olivier R. C. Busch; Dirk J. Gouma



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



The effect of occlusal forces on restorations.  


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


Computerized analysis of occlusal contacts in bruxism patients treated with occlusal splint therapy  

PubMed Central

PURPOSE Occlusal splints are commonly used to prevent tooth wear caused by bruxism. However, the effects of splints on occlusion are still unclear. Although it is rarely alluded in literature, splints can provoke severe occlusal alterations and other complications. This study was aimed to identify differences in the responses of individuals with bruxism and healthy individuals to a full-arch maxillary stabilization splint in terms of occlusal changes. MATERIALS AND METHODS Occlusal contacts in 20 (5 male, 15 female) bruxism patients and 20 (5 male, 15 female) controls with normal occlusion were evaluated before and after occlusal splint therapy. T-Scan III, a computerized occlusal analysis system, was used to simultaneously measure occlusion and disclusion times as well as left-right and anterior-posterior contact distributions before splint therapy and 3 months after therapy. Wilcoxon and Mann-Whitney U tests were used for statistical analyses (?=.05). RESULTS No differences were found in the posterior contact of bruxism patients before and after stabilization splint treatment. However, differences in posterior contact were observed between bruxists and normal individuals prior to treatment, and this difference disappeared following treatment. CONCLUSION The results of this study showed the use of a stabilization splint may not have an effect on occlusion. However, the area of posterior occlusal contact among bruxists was found to be greater than that of normal individuals. According to this study, the clinical use of splints may be harmless.

K?l?nc, Halil Ibrahim; Tuna, Suleyman Hakan; Ozcan, Nihal



[Occlusal vertical dimension in removable complete dentures].  


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



Bilateral mechanical rotational vertebral artery occlusion.  


Rotational vertebral artery occlusion, or bow hunter's stroke, is reversible, positional symptomatic vertebrobasilar ischemia. The typical mechanism of action is obstruction of a dominant vertebral artery with contralateral head rotation in the setting of baseline ipsilateral vertebral artery stenosis or occlusion. Here we present a rare case of mechanical occlusion of bilateral patent vertebral arteries manifesting as near syncope with rightward head rotation. Diagnostic cerebral angiography showed dynamic right C5 vertebral occlusion and left C2 vertebral occlusion. The patient underwent right C4/5 transverse process decompression. Postoperative angiogram showed patent flow through the right vertebral artery in neutral position and with head turn with resultant resolution of symptoms. PMID:23465174

Dargon, Phong T; Liang, Conrad W; Kohal, Anmol; Dogan, Aclan; Barnwell, Stanley L; Landry, Gregory J



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:; Oguzkurt, Levent; Tercan, Fahri [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)



Ten year outcomes after bypass surgery in aortoiliac occlusive disease  

PubMed Central

Purpose Most outcome studies of bypass surgery are limited to five years of follow-up. However, as human life expectancy has increased, analyses of more long-term outcomes are needed. The aim of this study is to evaluate 10-year outcomes of anatomical bypasses in aortoiliac occlusive disease. Methods From 1996 to 2009, 92 patients (82 males and 10 females) underwent aortic anatomical bypasses to treat aortoiliac occlusive disease at Samsung Medical Center. The patients were reviewed retrospectively. Kaplan-Meier survival analyses were performed using PASW ver. 18.0 (IBM Co). Results A total of 72 patients (78.3%) underwent aorto-femoral bypasses (uni- or bi-femoral), 15 patients (16.3%) underwent aorto-iliac bypasses (uni- or bi-iliac), and 5 patients (5.4%) underwent aorto-iliac and aorto-femoral bypasses. The overall primary patency rates of the 92 patients were 86.2% over 5 years and 77.6% over 10 years. The 10-year limb salvage rate and overall survival rate were 97.7% and 91.7%, respectively. Conclusion The overall patency rates of bypass graft and limb salvage rates decreased as time passed. The analysis of results after bypass surgery to treat arterial occlusive disease will be needed to extend for 10 years of follow-up.

Lee, Gwan-Chul; Yang, Shin-Seok; Park, Keun-Myoung; Park, Yangjin; Kim, Young-Wook; Park, Kwang Bo; Park, Hong Suk; Do, Young-Soo



Hand occlusion on a multi-touch tabletop  

Microsoft Academic Search

We examine the shape of hand and forearm occlusion on a multi-touch table for different touch contact types and tasks. Individuals have characteristic occlusion shapes, but with commonalities across tasks, postures, and handedness. Based on this, we create templates for designers to justify occlusion-related decisions and we propose geometric models capturing the shape of occlusion. A model using diffused illumination

Daniel Vogel; Géry Casiez



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



3D silhouette tracking with occlusion inference  

NASA Astrophysics Data System (ADS)

It is a challenging problem to robustly track moving objects from image sequences because of occlusions. Previous methods did not exploit depth information sufficiently. Based on multiple camera scenes, we propose a 3D silhouette tracking framework to resolve occlusions and recover the appearances in 3D space, which enhances tracking effectiveness. In the framework, 2D object silhouettes are initially gained by Snake. Then a Voxel Space Carving procedure is introduced to simultaneously generate the occlusion model and visual hull of objects. Next, we adopt Particle Filter to select the valuable parts of occlusion model and combine them with the initial object silhouettes to generate the updated visual hull. Finally, updated visual hull of the objects are re-projected to each view to obtain their final contours. The experiments under the public LAB and SCULPTURE datasets validate the feasibility and effectiveness of our framework.

Li, Wenkai; Yao, Hongxun; Ji, Rongrong; Liu, Tianqiang; Zhao, Debin



Transcatheter occlusion of large pulmonary arteriovenous fistula.  


We describe the compound transcatheter occlusion of a large and symptomatic pulmonary arteriovenous malformation in a 58-yr-old man. Pre- and postintervention clinical and laboratory data support the impression of an excellent outcome. PMID:11025582

Berman, W; Fripp, R R; Raisher, B D; Yabek, S M



Acute aortic occlusion – Factors that influence outcome  

Microsoft Academic Search

Purpose: The purpose of this study was to report our experience in the management of acute aortic occlusion and to analyze factors that influenced the outcome.Methods: This was a retrospective analysis of 48 patients with acute aortic occlusion treated over a 19-year period. Presentation included limb ischemia in 34, acute abdomen in four, spinal cord compression-like symptoms in eight, and

Sateesh C. Babu; Pravin M. Shah; Jim Nitahara



Dynamic Occlusion Analysis in Optical Flow Fields  

Microsoft Academic Search

Optical flow can be used to locate dynamic occlusion boundaries in an image sequence. We derive an edge detection algorithm sensitive to changes in flow fields likely to be associated with occlusion. The algorithm is patterned after the Marr-Hildreth zero-crossing detectors currently used to locate boundaries in scalar fields. Zero-crossing detectors are extended to identify changes in direction and\\/or magnitude

William B. Thompson; Kathleen M. Mutch; Valdis A. Berzins



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:; 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)



Occlusion of a large coronary-cameral fistula using the Amplatzer vascular plug in a 2-year old.  


A 2-year-old girl underwent transcatheter occlusion of a fistula. The fistula originated from the right coronary artery and drained into the right atrium. Three interlocking Gianturco coils were initially placed in the distal portion of the fistula resulting in near-total occlusion of blood flow. Placing a 12-mm Amplatzer vascular plug obliterated the proximal, dilated portion of the fistula. Complete occlusion with accurate placement was achieved. Advantages and technical implications of the Amplatzer vascular plug in this clinical setting are discussed. PMID:16649238

Balaguru, Duraisamy; Joseph, Annette; Kimmelstiel, Carey



Magnetic resonance angiography of carotid and cerebral arterial occlusion in rats using a clinical scanner  

Microsoft Academic Search

In rat models to induce both focal cerebral ischemia and chronic cerebral hypoperfusion, it is highly desirable to verify the success of vessel occlusion and reopening with non-invasive method. The contrast-agent free 3D time-of-flight magnetic resonance angiography (TOF-MRA), diffusion-weighted imaging (DWI) and T2-weighted imaging by 3.0-T MR clinical scanner were applied when unilateral middle cerebral artery (MCA) was occluded and

Yan Mei Yang; XiaoYuan Feng; Zhen Wei Yao; Wei Jun Tang; Han Qiu Liu; Li Zhang



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



Bilateral common carotid artery occlusion — A case report and literature review  

Microsoft Academic Search

Although unilateral common carotid artery (CCA) occlusion and bilateral internal carotid artery (ICA) occlusion have been reported in the past, bilateral CCA occlusion is rare. The management and mechanism of unilateral CCA occlusion and bilateral ICA occlusion are debatable, but those of bilateral CCA occlusion are largely unknown. Herein, we present a case of bilateral CCA occlusion that had an

Shiao-Lin Lai; Yi-Chun Chen; Hsu-Huei Weng; Sien-Tsong Chen; Shih-Pin Hsu; Tsong-Hai Lee



Unilateral branch retinal arterial occlusion following administration of bevacizumab for branch retinal vein occlusion.  


Intravitreal bevacizumab has been adopted as a well-established treatment modality for the treatment of macular edema associated with branch retinal vein occlusion. It is considered a safe and efficacious option for improving visual acuity. We present an interesting case of unilateral superotemporal branch retinal vein occlusion in a 55-year-old man who received two doses of intravitreal bevacizumab one month apart. Laboratory tests including complete hypercoagulability and thrombotic work-up were completed but the patient successively developed branch retinal artery occlusion. We reviewed cases in literature and combined possible etiologies. We report a previously unpublished case of retinal artery occlusion following the use of intravitreal bevacizumab. Several studies have shown evidence of systemic thromboembolic events after the use of intravenous and systemic bevacizumab; however, to the best of our knowledge, no case has been reported of retinal artery occlusion immediately after administration of intravitreal bevacizumab. PMID:23179231

Kaur, Savleen; Sachdev, Nishant



Chronic venous insufficiency.  


Like the noninvasive assessment of arterial occlusive disease, the various methods for evaluation of chronic venous insufficiency (CVI) can be divided into those that provide hemodynamic information and those that provide anatomic detail. The majority of noninvasive methods for evaluation of CVI are directed toward assessing hemodynamic events in large vessels by detecting abnormally directed blood flow, elevated venous pressure, increased limb-volume changes, or valvular reflux. B-mode ultrasound, the principal non-invasive method for anatomic assessment of CVI, defines either valvular incompetence, obstruction, or recanalization changes. PMID:2406965

O'Donnell, T F; McEnroe, C S; Heggerick, P



Pelvic venoablation with ethanol for the treatment of erectile dysfunction due to veno-occlusive dysfunction  

Microsoft Academic Search

Objectives. To perform pelvic venoablation with ethanol injection into the deep dorsal vein for the treatment of 10 patients with venogenic erectile dysfunction. This procedure was easily performed without any selective embolization technique. The efficacy and safety of this technique are discussed.Methods. A total of 10 patients with veno-occlusive dysfunction, severe enough to make vaginal insertion impossible, underwent pelvic venoablation

Yoshiji Miwa; Rikiya Shioyama; Yasuhiko Itou; Hiroshi Kanamaru; Kenichiro Okada



Occlusion issues in early Renaissance art  

PubMed Central

Early Renaissance painters innovatively attempted to depict realistic three-dimensional scenes. A major problem was to produce the impression of overlap for surfaces that occlude one another in the scene but are adjoined in the picture plane. Much has been written about perspective in art but little about occlusion. Here I examine some of the strategies for depicting occlusion used by early Renaissance painters in relation to ecological considerations and perceptual research. Perceived surface overlap is often achieved by implementing the principle that an occluding surface occludes anything behind it, so that occlusion perception is enhanced by a lack of relationship of occluding contour to occluded contours. Some well-known figure-ground principles are also commonly used to stratify adjoined figures. Global factors that assist this stratification include the placement of figures on a ground plane, a high viewpoint, and figure grouping. Artists of this period seem to have differed on whether to occlude faces and heads, often carefully avoiding doing so. Halos were either eliminated selectively or placed oddly to avoid such occlusions. Finally, I argue that the marked intransitivity in occlusion by architecture in the paintings of Duccio can be related to the issue of perceptual versus cognitive influences on the visual impact of paintings.

Gillam, Barbara



Primary Stenting in Infrarenal Aortic Occlusive Disease  

SciTech Connect

Purpose: To evaluate the results of primary stenting in aortic occlusive disease.Methods: Thirty patients underwent primary stenting of focal concentric (n = 2) and complex aortic stenoses (n = 19), and aortic or aorto-iliac occlusions (n = 9). Sixteen patients underwent endovascular outflow procedures, three of whom also had distal open surgical reconstructions. Median follow-up was 16 months (range 1-60 months).Results: Guidewire crossing of two aorto-biiliac occlusions failed, resulting in a 93% (28/30) technical success. Major complications included one access hematoma, one myocardial infarction, one death (recurrent thromboembolism) in a patient with widespread malignancy, and one fatal hemorrhage during thrombolysis of distal emboli from a recanalized occluded iliac artery. One patient did not improve his symptoms, resulting in a 1-month clinical success of 83% (25/30). Following restenting the 26 stented survivors changed their clinical limb status to +3 (n = 17) and +2 (n = 9). During follow-up one symptomatic aortic restenosis occurred and was successfully restented.Conclusions: Primary stenting of complex aortic stenoses and short occlusions is an attractive alternative to conventional surgery. Larger studies with longer follow-up and stratification of lesion morphology are warranted to define its role relative to balloon angioplasty. Stenting of aorto-biiliac occlusions is feasible but its role relative to bypass grafting remains to be defined.

Nyman, Ulf; Uher, Petr; Lindh, Mats [Department of Radiology, Malmoe University Hospital, University of Lund, S-205 02 Malmoe (Sweden); Lindblad, Bengt [Department of Vascular and Renal Diseases, Malmoe University Hospital, University of Lund, S-205 02 Malmoe (Sweden); Ivancev, Krasnodar [Department of Radiology, Malmoe University Hospital, University of Lund, S-205 02 Malmoe (Sweden)



Occlusion issues in early Renaissance art.  


Early Renaissance painters innovatively attempted to depict realistic three-dimensional scenes. A major problem was to produce the impression of overlap for surfaces that occlude one another in the scene but are adjoined in the picture plane. Much has been written about perspective in art but little about occlusion. Here I examine some of the strategies for depicting occlusion used by early Renaissance painters in relation to ecological considerations and perceptual research. Perceived surface overlap is often achieved by implementing the principle that an occluding surface occludes anything behind it, so that occlusion perception is enhanced by a lack of relationship of occluding contour to occluded contours. Some well-known figure-ground principles are also commonly used to stratify adjoined figures. Global factors that assist this stratification include the placement of figures on a ground plane, a high viewpoint, and figure grouping. Artists of this period seem to have differed on whether to occlude faces and heads, often carefully avoiding doing so. Halos were either eliminated selectively or placed oddly to avoid such occlusions. Finally, I argue that the marked intransitivity in occlusion by architecture in the paintings of Duccio can be related to the issue of perceptual versus cognitive influences on the visual impact of paintings. PMID:23145262

Gillam, Barbara



Successful IVUS-guided reentry from iatrogenic coronary arteriovenous fistula related to wire perforation following wiring of a totally occluded vessel.  


We experienced a rare case in which a guidewire was advanced into a coronary vein through an arteriovenous fistula caused by wire perforation. The patient, who had chronic total occlusion (CTO) of the left circumflex coronary artery, was treated successfully with a procedure guided by intravascular ultrasound (IVUS). The IVUS-guided parallel-wire technique allowed recrossing of the guidewire into the distal true lumen of the CTO by identifying the anatomy of the occluded segment and the appropriate re-entry point. Angiography demonstrated that the fistula was completely sealed after stent deployment, and there was no extravasation. PMID:23813071

Ohya, Hidefumi; Kyo, Eisho; Katoh, Osamu



Predicting curvilinear target motion through an occlusion.  


When a tracked target is occluded transiently, extraretinal signals are known to maintain smooth pursuit, albeit with a reduced gain. The extent to which extraretinal signals incorporate predictions of time-varying behavior, such as gradual changes in target direction, is not known. Three experiments were conducted to examine this question. In the experiments, subjects tracked a target that initially moved along a straight path, then (briefly) followed the arc of a circle, before it disappeared behind a visible occlusion. In the first experiment, the target did not emerge from the occlusion and subjects were asked to point to the location where they thought the target would have emerged. Gaze and pointing behaviors demonstrated that most of the subjects predicted that the target would follow a linear path through the occlusion. The direction of this extrapolated path was the same as the final visible target direction. In the second set of experiments, the target did emerge after following a curvilinear path through the occlusion, and subjects were asked to track the target with their eyes. Gaze behaviors indicated that, in this experimental condition, the subjects predicted curvilinear target motion while the target was occluded. Saccades were directed to the unseen curvilinear path and pursuit continued to follow this same path at a reduced speed in the occlusion. Importantly, the direction of smooth pursuit continued to change throughout the occlusion. Smooth pursuit angular velocity was maintained for approximately 200 ms following target disappearance. The results of the experiments indicate that extraretinal signals indeed incorporate cognitive expectations about the time-varying behavior of target motion. PMID:17053910

Mrotek, Leigh A; Soechting, John F



Interventional occlusion of congenital vascular malformations  

Microsoft Academic Search

Background  New materials and devices have been used in the management of cardiac malformations. In this paper, we present our experience\\u000a with interventional occlusion of congenital vascular malformations.\\u000a \\u000a \\u000a \\u000a Methods  Between January 1997 and December 2005, 139 patients with congenital vascular malformations who had undergone interventional\\u000a occlusion in the Children’s Hospital, Zhejiang University School of Medicine were studied. The clinical data of the

Chun-Hong Xie; Cheng-Sen Xia; Fang-Qi Gong; Yin-Bao Zhou; Wei-Hua Zhu



Abdominal aortic occlusion of young adults  

PubMed Central

The occlusion of the infrarenal aorta is a rare event, which is potentially life threatening. We present the case of a heavy smoking, 35-year-old woman who was referred to the emergency department of our hospital because of sudden abdominal pain and urinary incontinence. She also complained of a two-year history of bilateral intermittent claudication. A computerized tomography revealed the thrombosis of the abdominal aorta and of both iliac arteries. Treatment consists of an aortoiliac thromboendarterectomy (AITE). For young patients with atheromatous occlusive disease of the infrarenal aorta, AITE is an attractive alternative to bypass grafting.

Bucci, Federico; Fiengo, Leslie; Hamati, Samer; Plagnol, Philippe



Iliopsoas bursitis following total hip replacement  

Microsoft Academic Search

We report the imaging features of a 52-year-old man presenting with a groin mass and gross lower limb oedema secondary to venous occlusion by massive cystic enlargement of the iliopsoas bursa 4 years after uncemented primary total hip replacement. Ultrasonography of the groin mass demonstrated a large cystic lesion extending into the pelvis. CT showed displacement of the external iliac vessels

Y. M. Cheung; C. M. Gupte; M. J. Beverly



Meta-analysis of plasma homocysteine, serum folate, serum vitamin B 12, and thermolabile MTHFR genotype as risk factors for retinal vascular occlusive disease  

Microsoft Academic Search

PurposeTo assess the role of plasma total homocysteine (tHcy) levels, serum folate and vitamin B12levels, and homozygosity for the thermolabile methylenetetrahydrofolate reductase genotype (TT) as risk factors for retinal vascular occlusive disease.

Mark T Cahill; Sandra S Stinnett; Sharon Fekrat



Role of occlusion in endodontic management: report of two cases.  


The two clinical cases reported demonstrate that traumatic occlusion can play a role in the initiation and progression of pulp and periradicular inflammation. The symptom of persistent pain did not subside after the commencement of endodontic treatment. Traumatic occlusion was identified in both cases to be the main cause and hence occlusal adjustment was performed. This resulted in the gradual resolution of the symptoms. The findings suggest that occlusal trauma is often overlooked in the diagnosis and management of endodontic diseases. PMID:15633800

Yu, Christine Y



Medical conditions underlying recurrence of retinal vein occlusion  

Microsoft Academic Search

Seventeen patients with recurrent retinal vein occlusion were investigated for underlying medical conditions and compared with 61 patients with single retinal vein occlusion (26 with central, 35 with branch vein occlusion). The two study groups were comparable for age, sex, and weight. Patients with recurrence had a significantly increased prevalence rate of hypertension (88% versus 48%: p less than 0.01),

P M Dodson; A J Kubicki; K G Taylor; E E Kritzinger



Surgical embolus removal in retinal artery occlusion  

Microsoft Academic Search

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

J Garci?a-Arumi?; V Martinez-Castillo; A Boixadera; A Fonollosa; B Corcostegui



Traumatic occlusion of both internal carotid arteries  

Microsoft Academic Search

Two cases of bilateral occlusion of the extracranial internal carotid artery after blunt trauma to the head and neck are presented. Sixteen similar cases have been reported in the literature, and at least 150 case reports exist on unilateral blunt trauma of carotid arteries. The 25-day post-traumatic latent interval in one of our cases is the longest to date. The

U. Schultz; M. Kiitemeyer; A. Kern; W. Hepp



Supernumerary occlusal cusps on permanent human teeth  

Microsoft Academic Search

Supernumerary (central) cusps that appear on the occlusal surface of the teeth have already been grouped by many authors. The most comprehensive grouping of central cusps on the premolars is that by Schulze (1987). However, different central cusp forms may occur on the molar teeth, and cusp-like protrusions may also develop on the incisors and the canines. In the present

Gábor S Kocsis; Antónia Marcsik; Erzsébet L Kókai; Katalin S Kocsis


Dental occlusion and posture: an overview  

Microsoft Academic Search

ObjectivesIn recent decades, it has been suggested that disorders of the masticatory system such as malocclusions, can influence whole body posture. A growing number of patients are seeking concomitant treatment for dental malocclusions and postural disorders. The aim of this overview is to critically analyze the relationship between dental occlusion and posture.

Ambra Michelotti; Gerarda Buonocore; Paolo Manzo; Gioacchino Pellegrino; Mauro Farella



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



Management of Retinal Vein Occlusion – Consensus Document  

Microsoft Academic Search

Retinal vein occlusion (RVO) can have severe consequences for the people affected by the disease, including visual loss with costly social repercussions. Currently, there is no European consensus with regard to the management of RVO. Following a careful review of the medical literature as well as the data from several clinical trials, a collaborative group of retina specialists put forth

Gabriel Coscas; Anat Loewenstein; Albert Augustin; Francesco Bandello; Maurizio Battaglia Parodi; Paolo Lanzetta; Jordi Monés; Marc de Smet; Gisèle Soubrane; Giovanni Staurenghi



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



Balloon occlusion scintigraphy of aortopulmonary collaterals  

Microsoft Academic Search

We evaluated two children with pulmonary atresia for coil embolization of aortopulmonary collateral vessels after placement of palliative aortopulmonary shunts. To determine vessel distribution and lung perfusion prior to collateral embolization, perfusion scintigraphy with technetium 99m-labeled macroaggregated albumin assessed pulmonary blood flow before and after balloon wedge catheter occlusion of the collaterals. In the first patient we found no perfusion

C. Hardy; J. Wong; J. N. Young; J. McCray



[Arteriovenous dissection for branch retinal vein occlusion].  


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



Towards sutureless non-occlusive cerebral revascularization.  


Sutureless vascular anastomoses have been the subject of extensive research for decades. In neurosurgery the need for a safe and fast technique is high, because temporary occlusion of cerebral arteries may rapidly lead to brain ischemia. Conventional sutured anastomoses have always been the golden standard. Limited working space and difficult suturing techniques were reasons to find alternatives. Many artificial devices to create anastomoses have been engineered over the years like tissue sealants, clips and automated suturing sets with variable success. For all previous options, temporary occlusion of the recipient artery was necessary. The Excimer Laser Assisted Non-Occlusive Anastomosis (ELANA) technique™ facilitates the construction of an end-to-side anastomosis without temporary occlusion of the recipient artery using a platinum ring and a laser. However, the technical challenge of intracranial micro-sutures remained. Experiments using less sutures eventually resulted in a sutureless ELANA (SELANA) anastomosis. After in vitro and in vivo experiments, the SELANA slide was considered feasible for intracranial use although some concrete improvements, like the inclusion of a clip at the back of the device, were needed. Therefore, the development of an ideal sutureless anastomosis is still ongoing. This process is an evolution rather than a revolution. PMID:21623324

De Boer, B; Van Doormaal, T P; Van Der Zwan, A; Tulleken, C A; Regli, L



[Mechanisms and theory of occlusal wear].  


The various mechanisms which cause wear of occlusal surfaces of the teeth, erosion as caused by the food, direct contact wear, and surface fatigue are discussed from their theoretical bases. Special attention is paid to the implications for the oral environment. The ACTA wear machine, designed to simulate these mechanisms, as well as some of its results, are briefly discussed. PMID:11921989

Pallav, P; de Gee, A J



IV Thrombolysis-Bridging and Endovascular Treatment for Occlusive Internal Carotid Artery Dissection with Tandem Occlusion  

PubMed Central

Compared to other etiologies of ischemic stroke, occlusive internal carotid artery dissection responds worse to intravenous (IV) thrombolysis. Intracranial tandem occlusion is a predictor of poor outcome. A direct endovascular approach has been proposed as a safe and probably superior alternative to IV thrombolysis. However, it may lead to considerable treatment delays. We used rapidly initiated IV thrombolysis-bridging and subsequent endovascular treatment in two patients with severe hemispheric ischemia due to occlusive internal carotid artery dissection with tandem occlusion and achieved good outcomes. Minimizing recanalization times likely improves patient outcome and IV thrombolysis-bridging may be a reasonable strategy to achieve this. The positive initial results obtained with endovascular approaches and IV thrombolysis-bridging in this patient group deserve further scientific exploration.

Scheperjans, Filip; Pekkola, Johanna; Mustanoja, Satu; Putaala, Jukka; Tiainen, Marjaana; Ollila, Leena; Paananen, Tapio; Lappalainen, Kimmo



An appraisal on increasing the occlusal vertical dimension in full occlusal rehabilitation and its outcome.  


Increasing the occlusal vertical dimension for gaining sufficient restoration space in the management of severely worn dentition is being practiced. This contentious belief has lead to challenging thoughts regarding its effects on the Odonto-stomatognathic system. There are basic uncertainties and existing erroneous thoughts regarding the perception of increasing the occlusal vertical dimension. This manuscript will review the bite raising concepts and its outcome on the stomatognathic system. PMID:22654346

Gopi Chander, N; Venkat, R



Bilateral Ophthalmic Artery Occlusion in Rhino-Orbito-Cerebral Mucormycosis  

PubMed Central

Purpose To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. Methods Reviewed clinical charts, photographs, and fluorescein angiography. Results An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. Conclusions Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.

Song, Yoo-Mi



Acute on chronic exposure to endotoxin is associated with enhanced chemoreflex responses in preterm fetal sheep.  


There is increasing evidence that exposure to infection can sensitize the fetus to subsequent hypoxic injury. However, it is unclear whether this involves compromise of the fetal cardiovascular adaptation to acute asphyxia. Chronically instrumented 103-day-old (0.7 gestational age, term is 147 days) fetal sheep in utero were randomized to receive either gram-negative lipopolysaccharide (LPS) as a continuous low-dose infusion for 120 h plus boluses of 1 ?g LPS at 48, 72, and 96 h with asphyxia at 102 h (i.e., 6 h after the final LPS bolus) induced by umbilical cord occlusion for 15 min (LPS treated, n = 8), or the same volume of saline plus occlusion (saline treated, n = 7). Fetuses were killed 5 days after occlusion. LPS was associated with a more rapid fall in fetal heart rate at the onset of occlusion (P < 0.05) and with minimally lower values during occlusion (P < 0.05). The LPS-treated fetuses had lower fetal mean arterial blood pressure (BP) and greater carotid artery blood flow (CaBF) before occlusion (P < 0.05) but showed an increase in BP and fall in CaBF to similar values as saline controls during occlusion. There were no differences between the groups in femoral blood flow before or during occlusion. Contrary to our initial hypothesis, acute on chronic exposure to LPS was associated with more rapid cardiovascular adaptation to umbilical cord occlusion. PMID:23485869

Booth, Lindsea C; Drury, Paul P; Muir, Cameron; Jensen, Ellen C; Gunn, Alistair J; Bennet, Laura



Intravascular balloon to minimize blood loss during total hip replacement in a Jehovah's Witness.  


Intermittent intravascular occlusive balloons are commonly used to minimize bleeding in cases where massive blood loss is anticipated. However, the efficiency and safety of balloon occlusion remains unclear for elective procedures, and several cases of distal thrombosis have been reported. A case of intra-arterial occlusive balloon that was selectively placed preoperatively to minimize bleeding in a patient during total hip replacement is presented. Use of an external tourniquet was not feasible for this patient. The balloon was inflated to a minimum volume to achieve intravascular occlusion and was periodically deflated to minimize the risk of postoperative complications. A surgical field with minimal blood loss was created. PMID:21296252

Mangar, Devanand; Shube, Sam; Omar, Hesham; Kolla, Jaya; Karlnoski, Rachel A; Camporesi, Enrico M



Occlusion effect of earmolds with different venting systems.  


In this study the occlusion effect was quantified for five types of earmolds with different venting. Nine normal-hearing listeners and ten experienced hearing aid users were provided with conventional earmolds with 1.6 and 2.4 mm circular venting, shell type earmolds with a novel vent design with equivalent cross-sectional vent areas, and nonoccluding soft silicone eartips of a commercial hearing instrument. For all venting systems, the occlusion effect was measured using a probe microphone system and subjectively rated in test and retest sessions. The results for both normal-hearing subjects and hearing aid users showed that the novel vents caused significantly less occlusion than the traditional vents. Occlusion effect associated with the soft silicone eartip was comparable to the nonoccluded ear. Test-retest reproducibility was higher for the subjective occlusion rating than for the objectively measured occlusion. Perceived occlusion revealed a closer relationship to measured occlusion in the ear in which the measured occlusion effect was higher ("high OE" ear) than in the "low OE" ear. As our results suggest that subjective judgment of occlusion is directly related to the acoustic mass of the air column in the vent, the amount of perceived occlusion may be predicted by the vent dimensions. PMID:16050334

Kiessling, Jürgen; Brenner, Barbara; Jespersen, Charlotte Thunberg; Groth, Jennifer; Jensen, Ole Dyrlund



Achieving harmony with oneself: life with a chronic illness.  


This paper presents partial findings of a larger research project focusing on what it means to live with a chronic illness. Getting in harmony with oneself is a movement towards, and a form of, acceptance of the chronic suffering and disease. Some patients achieve this level of acceptance, while for others the obstacles of everyday life make this movement towards acceptance difficult. Achieving harmony with oneself is conditioned by the existence of hope and spirit of life/life courage and by the pressure of doubts on this hope. Doubts can shake this hope so that instead of moving towards acceptance, the patient drifts towards hopelessness and despair. The research design is qualitative and uses a phenomenological-hermeneutic approach. A total of 18 patients were interviewed, divided into three groups of six patients diagnosed with 'type I' diabetes, colitis ulcerosa and patients with coronary occlusion in the rehabilitation phase. The goal of the research was to derive patterns/themes common to the three diagnosed groups regarding the patients' view of health and disease in connection with chronic illness and to elucidate the significance of this view for how the patients coped with everyday life. The research method is inspired by Paul Ricoeur. PMID:16101848

Delmar, Charlotte; Bøje, Trine; Dylmer, Dorrit; Forup, Lisbeth; Jakobsen, Christina; Møller, Majbritt; Sønder, Hanne; Pedersen, Birthe D



Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement  

SciTech Connect

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine catheter dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices.Patients with longer catheter dwell time were more likely to develop central vein abnormalities. In order to preserve vascular access for dialysis fistulae and grafts and adhere to Dialysis Outcomes Quality Initiative guidelines, alternative venous access sites should be considered for patients with chronic renal insufficiency and end-stage renal disease.

Gonsalves, Carin F., E-mail:; Eschelman, David J.; Sullivan, Kevin L.; DuBois, Nancy; Bonn, Joseph [Jefferson MedicalCollege/Thomas Jefferson University Hospital, Suite 4200 GibbonBuilding, 111 South 11th Street, Philadelphia, PA 19107, Department of Radiology (United States)



Chronic pulmonary emboli and radiologic mimics on CT pulmonary angiography: a diagnostic challenge.  


Chronic pulmonary thromboembolism (CPE) is a challenging diagnosis for clinicians. It is an often-forgotten diagnosis and can be difficult to detect and easily misdiagnosed. The radiologic features on CT pulmonary angiography are subtle and can be further compounded by pathologic mimics and unusual findings observed with disease progression. Diagnosis is important because CPE can lead to progressive pulmonary hypertension, morbidity, and mortality. Moreover, chronic thromboembolic pulmonary hypertension is the only category of pulmonary hypertension with an effective curative treatment in the form of pulmonary endarterectomy. Therefore, CPE must be considered and recognized early. The features of chronic pulmonary emboli on CT scans can be categorized into vascular or parenchymal findings. Endoluminal signs include totally or partially occlusive thrombi and webs and bands. Parenchymal features such as mosaic attenuation and pulmonary infarction are also noted, in addition to features of pulmonary artery hypertension. Additional findings have been noted, including cavitation of infarcts, microbial colonization of cavities, and bronchopleural fistulae. As CPE can be diagnosed at different stages of its disease pathway, such findings may not necessarily arouse suspicion toward a causative diagnosis of chronic embolism. To aid diagnosis for clinicians, this article describes the characteristic vascular and parenchymal CT scan features of chronic emboli, as well as important ancillary findings. We also provide an illustrative case series focusing on CT pulmonary angiography specifically as an imaging modality to highlight the progressive nature of CPE and its sequelae, as well as important radiologic mimics to consider in the differential diagnosis. PMID:23648910

Wijesuriya, Shalini; Chandratreya, Ladli; Medford, Andrew R



Effects of increased occlusal vertical dimension on daily activity and myosin heavy chain composition in rat jaw muscle.  


Mammalian skeletal muscles change their contractile-protein phenotype in response to mechanical loading and/or chronic electrical stimulation, implying that the phenotypic changes in masticatory muscles might result from new masticatory-loading conditions. To analyze the effects of increased occlusal vertical dimension (OVD) on daily activities and fibre-type compositions in jaw muscles, we measured the total duration of daily activity (duty time) and the myosin heavy chain (MyHC) compositions in the masseter and digastric muscles of freely moving control and bite-opened rats. In the control state, the duty time of the digastric muscle was higher than that of the masseter muscle at activity levels exceeding 5 and 20% of the day's peak activity. The opposite was true at activity levels exceeding 50 and 80% of the day's peak activity. The MyHCs consisted of a mixture of fast and slow types in the digastric muscle. The masseter consisted of mostly fast-type MyHC. The increment of OVD increased not only the duty time at activity levels exceeding 5, 20, 50 and 80% of the day' peak activity in both muscles but also the proportion of MyHC IIa in the masseter muscle and MyHC I in the digastric muscle at the expense of that of MyHC IIb. These results suggest that the increment of OVD changes masseter and digastric muscles towards slower phenotypes by an increase in their daily activities. PMID:19524215

Ohnuki, Yoshiki; Kawai, Nobuhiko; Tanaka, Eiji; Langenbach, Geerling E J; Tanne, Kazuo; Saeki, Yasutake



Meningovascular syphilis with fatal vertebrobasilar occlusion.  


We report the case of a young patient with meningovascular syphilis who suffered fatal vertebrobasilar occlusion despite thrombolytic treatment and endovascular interventions. A 35-year-old man without any known medical history presented with an acute ischemic stroke and was initially treated with intravenous tissue plasminogen activator. He was then transferred to the stroke center, where he underwent endovascular recanalization of his occluded vertebrobasilar system. Despite initial successful recanalization, he suffered recurrent vertebrobasilar occlusion, and a second endovascular treatment attempt was unsuccessful. He subsequently developed a pontine hemorrhage and acute hydrocephalus and died secondary to transtentorial herniation. Laboratory findings were suggestive of prior spirochetal infection, and autopsy revealed necrotizing vasculitis and extensive adventitial inflammation involving the basilar and vertebral arteries, supporting the diagnosis of meningovascular syphilis. PMID:19680027

Feng, Wuwei; Caplan, Michael; Matheus, Maria G; Papamitsakis, Nikolaos I H



Stroke attributable to acute basilar occlusion  

Microsoft Academic Search

Opinion statement  Acute basilar artery occlusion carries a high risk of disabling stroke or death. Fast recanalization of the vessel is the\\u000a mainstay of the therapy. Recanalization may be achieved by intravenous or intra-arterial administration of thrombolytics.\\u000a These procedures are currently used as life-saving interventions, despite the low level of evidence supporting their efficacy,\\u000a because of the bad prognosis of the

Mauro Bergui; Paolo Cerrato; Gianni Boris Bradac



Psychic and occlusal factors in bruxers  

Microsoft Academic Search

Background: The aim of this study was to investigate the existence of associations between bruxism and psychic and occlusal factors. Methods: Participants in this study (n=85) were recruited from the Section of Odontostomatology, Department of Neuroscience, University of Pisa, Italy. They were split into two groups, bruxers (n=34) and non-bruxers (n=51), on the basis of the presence of both clinical

D. Manfredini; N. Landi; M. Romagnoli; M. Bosco



Time Management in Acute Vertebrobasilar Occlusion  

Microsoft Academic Search

Acute vertebrobasilar occlusion (VBO) is associated with a high risk of stroke and death. Although local thrombolysis may\\u000a achieve recanalization and improve outcome, mortality is still between 35% and 75%. However, without recanalization the chance\\u000a of a good outcome is extremely poor, with mortality rates of 80–90%. Early treatment is a fundamental factor, but detailed\\u000a studies of the exact time

Lars Kamper; Konrad Rybacki; Michael Mansour; Sven B. Winkler; Udo Kempkes; Patrick Haage



Association between jaw fatigue and occlusion  

Microsoft Academic Search

We investigated the association between jaw fatigue and occlusion via an initial questionnaire. The subjects were divided into six groups based on overbite of the anterior teeth and the anteroposterior skeletal relationship between the maxilla and mandible: Open bite+skeletal Class I group (O-I group), Open bite+skeletal Class II group (O-II group), Open bite+skeletal Class III group (O-III group), Deep bite+skeletal

Ayumi Okayama; Mariko Horiuchi; Kunimichi Soma



Is there a relationship between the acoustic occlusion effect and the sensation of occlusion?  


The objective of the present investigation was to examine the relationship between the acoustic occlusion effect and the subjective occlusion sensation when using ear moulds. The material comprises 45 subjects (19M and 26F, at a median age of 76 years, range 38-88 years) subgrouped according to the classification of their hearing disorder into two group: N = 22 subjects with conductive hearing loss (1); N = 21 subjects with sensorineural hearing loss (2). The side effects caused by an ear mould were evaluated at an interview, based on a structured questionnaire, two months after the hearing aid fitting. The comparative investigation showed that when the outer ear canal was occluded with an ear mould there were no significant differences between the two groups of subjects in the frequency of sensation of occlusion, in the sound quality of environmental sound or own voice, in hearing problems when chewing, or in ventilation problems. Neither were significant differences in the magnitude of the acoustic occlusion effect present between those answering yes and those answering yes and those answering no to a change in the sound quality of own voice in the group with sensorineural hearing loss. Although the number of subjects is limited, it is concluded that no relationship exists between the acoustic occlusion effect and the perceived sound quality, thus leaving no physical basis for the claim that this side effect is caused by an ear mould. PMID:8085110

Biering-Sørensen, M; Pedersen, F; Parving, A



The endovascular occlusion system for safe and immediate peripheral vessel occlusion during vascular interventions.  


Endovascular occlusion of blood vessels is an important part of interventional therapy concepts. Here, we evaluate the feasibility, procedural safety and efficacy of the novel endovascular occlusion system (EOS) in the arterial system in a porcine model. Thirteen devices were deployed in the iliac and femoral arteries (diameter: 4-5 mm) of five adult swine. Post-deployment angiography was performed at 1, 5 and 10 min and 6 h. All devices (n = 13) could be successfully delivered without any complications, such as dissection, perforation or rupture. The devices could be easily advanced to the target vessel segment, deployed at the intended target location and produced immediate and complete vessel occlusion which was confirmed to be maintained after 6 h. No leaks, recanalization or device migration was observed. In this pilot study, we demonstrate the feasibility, safety and efficacy of immediate vessel occlusion with the EOS device in the peripheral arterial system in a porcine animal model. Our data indicate that this novel device allows precise delivery without the occurrence of cardiovascular complications. Owing to its long-term safety and efficacy the EOS may represent a promising and effective alternative to currently available devices for vessel occlusion during vascular interventions. PMID:23868605

Emmert, Maximilian Y; Venbrux, Anthony; Rudakov, Leon; Cesarovic, Nikola; Radvany, Martin G; Gailloud, Philippe; Falk, Volkmar; Plass, Andre



A multiparametric analysis of occlusal and periodontal jaw reflex characteristics in young adults with normal occlusion.  


Periodontal jaw reflex, duration of percussion sounds, tooth mobility, and time-moment analysis of occlusal contacts by the T-scan system was recorded in nine periodontally healthy volunteers. The results showed that (i) reflex responses to the pressure applied to the uppercentageral incisors in the lingolabial direction varied, depending on the background jaw-clenching force (BCF) of the same-sided first molars. The BCF levels to elicit excitatory reflexes were 6-8 Kgf, and inhibitory reflexes were clearly elicited with a BCF of 10 Kgf and beyond. (ii) Duration of percussion sounds via an occlusal sound analyser (4.73-4.84 mS: upper first molars, 4.89-5.00 mS: uppercentageral incisors) and tooth mobility using a 'Periotest' (3.3-3.5: upper first molars, 5.5-5.6: uppercentageral incisors) showed a normal value. (iii) The time moments of occlusal contacts were symmetrical toward the midsagittal axis of the occlusal plane. The centre of the anteroposterior occlusal contacts was located in the first molar regions. PMID:9291255

Suda, S; Matsugishi, K; Seki, Y; Sakurai, K; Suzuki, T; Morita, S; Hanada, K; Hara, K



Acute occlusion of the abdominal aorta with concomitant internal iliac artery occlusion.  


Acute aortic occlusion is a rare but catastrophic pathology with high mortality even after revascularization. We describe four patients who underwent thrombectomy or bypass surgery for acute aortic occlusion with concomitant internal iliac artery occlusion. Two patients (82- and 75-year-old men), who had insufficient reperfusion of bilateral internal iliac arteries after treatment (thrombectomy alone and axillobifemoral bypass, respectively), died on postoperative day three of uncontrollable hyperkalemia and multiple organ failure, respectively (mortality: 50%). The third patient (74-year-old man), in whom the left internal iliac artery was reperfused after an axillobifemoral bypass, underwent right lower limb amputation but survived. The fourth patient (63-year-old man) with sufficient internal iliac artery reperfusion bilaterally after aortobifemoral and right internal iliac artery reconstruction, had an uneventful postoperative course. Elevated creatine phosphokinase and myoglobinuria levels were observed in all four patients but were notably higher in the two patients with no reperfusion in either of the internal iliac arteries. Our results suggest that reperfusion of one or more internal iliac arteries may be a crucial factor in reducing mortality in revascularization treatment of acute aortic occlusion with concomitant internal iliac artery occlusion. PMID:21881336

Yamamoto, Hiroshi; Yamamoto, Fumio; Tanaka, Fuminobu; Motokawa, Mamika; Shiroto, Keisuke; Yamaura, Gembu; Ishibashi, Kazuyuki



Structured sparse error coding for face recognition with occlusion.  


Face recognition with occlusion is common in the real world. Inspired by the works of structured sparse representation, we try to explore the structure of the error incurred by occlusion from two aspects: the error morphology and the error distribution. Since human beings recognize the occlusion mainly according to its region shape or profile without knowing accurately what the occlusion is, we argue that the shape of the occlusion is also an important feature. We propose a morphological graph model to describe the morphological structure of the error. Due to the uncertainty of the occlusion, the distribution of the error incurred by occlusion is also uncertain. However, we observe that the unoccluded part and the occluded part of the error measured by the correntropy induced metric follow the exponential distribution, respectively. Incorporating the two aspects of the error structure, we propose the structured sparse error coding for face recognition with occlusion. Our extensive experiments demonstrate that the proposed method is more stable and has higher breakdown point in dealing with the occlusion problems in face recognition as compared to the related state-of-the-art methods, especially for the extreme situation, such as the high level occlusion and the low feature dimension. PMID:23303693

Li, Xiao-Xin; Dai, Dao-Qing; Zhang, Xiao-Fei; Ren, Chuan-Xian



Nimodipine attenuates biochemical, behavioral and histopathological alterations induced by acute transient and long-term bilateral common carotid occlusion in rats  

Microsoft Academic Search

Restoration of blood flow to an ischemic brain region is associated with generation of reactive oxygen species with consequent reperfusion injury. Chronic cerebral hypoperfusion induced by permanent occlusion of bilateral common carotid arteries in rats is associated with behavioral and histopathological alterations. Nimodipine, a dihydropyridine calcium channel antagonist, has potent vasodilatory effect on cerebral vessels and increases cerebral blood flow.

S. U Yanpallewar; Debashish Hota; Sunita Rai; Mohan Kumar; S. B Acharya



Research report 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; Adam Institoris; Ferenc Domoki; Andras Mihaly; Paul G. M. Luiten; Ferenc Bari


Persistent impairment of gait performances and working memory after bilateral common carotid artery occlusion in the adult Wistar rat  

Microsoft Academic Search

Background: The clinical and pathophysiological effects of a chronic reduction of cerebral blood flow in humans are not completely known. We investigated whether rats subjected to bilateral common carotid artery occlusion (bCCA-o) developed focal neurological deficits, gait dysfunction, and working memory alterations. Methods: Eighteen male Wistar rats were subjected to bCCA-o, 13 were sham-operated. We assessed sensorimotor functions, gait on

Cristina Sarti; Leonardo Pantoni; Luciano Bartolini; Domenico Inzitari



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



Increase in receptor binding affinity for nimodipine in the rat brain with permanent occlusion of bilateral carotid arteries  

Microsoft Academic Search

The permanent occlusion of bilateral common carotid arteries (2VO) in rats has been shown to cause progressive and long-lasting cognitive deficits which may be due to impairment of memory retention and\\/or memory recall process. To clarify the function of voltage dependent calcium channels and the receptor binding of nimodipine by chronic cerebral ischemia, we examined specific (+)-[3H]PN 200-110 binding and

Shizuo Yamada; Shinya Uchida; Takafumi Naito; Akihiko Urayama; Ryohei Kimura; Yukihisa Murakami; Kinzo Matsumoto; Hiroshi Watanabe



Latent Development of Occlusive Coronary Atherosclerosis as a Cause of Decompensation of NonIschemic Dilated Cardiomyopathy  

Microsoft Academic Search

Four patients with chronically well-compensated, non-ischemic dilated cardiomyopathy (NIDC) presented with occlusive atherosclerotic coronary artery disease as the cause of subacute decompensation (FC III–IV heart failure) 8–13 years following the diagnosis of NIDC. In addition to the atherogenic condition of heart failure, 3 of the patients acquired major atherosclerotic risk factors (dyslipidemia, diabetes mellitus) during the interval between the diagnoses

Bryan M. White; Rohit Mehta; Philip F. Binkley; Carl V. Leier



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

SciTech Connect

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

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



[Mandibular movement and electromyogram investigation of normal occlusion and reversed occlusion before and after correction of over jet].  


The purpose of this investigation was to understand how the mandibular movement and myofunction in reversed occlusion, approach to normal occlusion after the correction of over jet. The experiment was carried out in 30 normal and 26 reversed occlusion school children patients who were classified into 3 groups by morphological analysis. A K6 diagnostic system was used. It recorded muscle activity of maximum clenching, free way space, path of closure, and the maximum velocity of opening and closing mandibular. And recorded a condylar test at the same time. Reversed occlusion classified 3 groups: upper and lower incisor had improper inclinations (D group, 19%), construction bite possible but recognized back and forth discrepancy between maxilla and mandibular (FS group, 50%), discrepancy larger than FS group and construction bite not possible (S group, 31%). Toward upper forth group indicated 77% and toward upper back group indicated 23% in normal occlusion. As for reversed occlusion the former indicated 92% and the latter indicated 8%. Differences in connection with orthodontic appliance and period of treatment were not so large. Back and forth mandibular movement, as measured by a condylar test, was greater for reversed occlusion than for normal occlusion, but this value tended to decrease after orthodontic treatment. In reversed occlusion, maximum opening, free way space, maximum velocity of opening and closing and muscle activity of rest position didn't show significant difference (p less than 0.05) among each group before and after the correction of over jet. Temporalis and masseter activity of maximum clenching, except temporalis among the D group, approached the values for normal occlusion. In the S group, muscle activity of maximum clenching with a cotton-roll, was lower before treatment, but approached to data in normal occlusion. These results prove that improvement of over jet in reversed occlusion, by ordinary orthodontal diagnosis and treatment plan, quasi-normalizes mandibular movement and muscle activity in reversed occlusion. PMID:2637253

Maeda, T



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,…

Owens, Tom



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



Postural Effects on Brain Hemodynamics in Unilateral Cerebral Artery Occlusive Disease: A Positron Emission Tomography Study  

Microsoft Academic Search

To investigate effect of assuming of upright posture on brain hemodynamics in patients with unilateral internal carotid or middle cerebral artery occlusion (MCAO), local tissue oxygen extraction fraction (OEF), and postural changes in regional cerebral blood flow (rCBF) during supine and sitting conditions were examined using positron emission tomography (PET) with 15O-gas steady-state method and H215O autoradiographic method. A total

Yasuomi Ouchi; Shuji Nobezawa; Etsuji Yoshikawa; Masami Futatsubashi; Toshihiko Kanno; Hiroyuki Okada; Tatsuo Torizuka; Teiji Nakayama; Keisei Tanaka



Intravitreal triamcinolone acetonide vs bevacizumab for treatment of macular oedema secondary to branch retinal vein occlusion  

Microsoft Academic Search

PurposeTo compare the short-term visual and morphological results of intravitreal triamcinolone acetonide vsintravitreal bevacizumab for eyes with macular oedema secondary to branch retinal vein occlusion (BRVO).DesignRetrospective interventional consecutive case series.MethodsWe reviewed the clinical records of 29 patients (29 eyes) who had macular oedema due to BRVO with minimum follow-up of 6 months. A total of 16 patients were treated with

K-C Cheng; W-C Wu; K-J Chen



Fissure Removal and Needle Scraping for Evaluation of the Bacteria in Occlusal Fissures of Human Teeth  

Microsoft Academic Search

The bacterial counts obtained with a needle-scrape method for collecting plaque samples from human occlusal fissures with incipient caries were compared with the microflora remaining in the fissures as determined with a fissure removal method. Scraping of six fissures with a sterile needle recovered only 18.2% of the total recovered fissure flora. The needle-scrape method failed to detect specific cariogenic

J. C. Meiers; C. F. Schachtele



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



Hepatic veno-occlusive disease after tandem autologous stem cell transplantation conditioned by melphalan.  


We report the case of a 58-year-old man with multiple myeloma stage III A who received tandem autologous stem cell transplantation after induction by two courses of VAD and three cycles of bortezomib-dexamethasone, due to progression under chemotherapy. The second transplantation was complicated by severe hepatic veno-occlusive disease (HVOD). The patient received defibrotide with total recovery. The occurence of HVOD after conditioning by melphalan is uncommon and the role of bortezomib was questioned. PMID:18696182

Labidi, Sana Intidhar; Sebban, Catherine; Ghesquières, Hervé; Nicolas, Emmanuele Virelizier; Biron, Pierre



Worsened Outcome from Middle Cerebral Artery Occlusion in Aged Rats Receiving 17?-Estradiol  

PubMed Central

Although estrogens are neuroprotective in young adult animal models of stroke, clinical trials demonstrate that estrogens increase the incidence and severity of stroke in aged women. We have previously shown that experimental stroke pathophysiology differs between young adult and aged rats. The aim of this study was to determine the effects of 17?-estradiol after middle cerebral artery occlusion and reperfusion in young adult and aged female rats. Focal embolic stroke was performed by middle cerebral artery occlusion with fibrin clot followed by reperfusion with iv human recombinant tissue plasminogen activator. Histological and functional outcomes were measured at 24 h after middle cerebral artery occlusion with fibrin clot. Aged rats treated with 17?-estradiol had significantly increased infarct volumes compared with placebo-treated aged rats. Young adult rats treated with 17?-estradiol had significantly decreased infarct volumes and improved functional outcome compared with ovariectomized young adult rats. Our results suggest that 17?-estradiol may act in an age-dependent manner in the postischemic rat brain. In young adult rats, it is neuroprotective; chronic treatment with 17?-estradiol during aging leads to worsened ischemic brain injury in aged female rats.

Leon, Rachel L.; Li, Xinlan; Huber, Jason D.



Transcatheter vessel occlusion: Selection of methods and materials  

Microsoft Academic Search

Transcatheter vessel occlusion (TCVO) is increasingly used for control of hemorrhage, palliative and preoperative tumor embolization,\\u000a organ function ablation, and obliteration of arteriovenous fistulae and malformations. Methods for TCVO include transcather\\u000a electrocoagulation, “staining” with contrast, the use of balloon-tipped catheters, and embolization. The choice of method\\u000a and material depends on whether proximal occlusion of feeding vessels or arteriocapillary occlusion is

Alan J. Greenfield



Retinal vein occlusions: a review for the internist  

Microsoft Academic Search

Retinal vein occlusion (RVO) is a disease that is often associated with a variety of systemic disorders including arterial\\u000a hypertension, diabetes mellitus, dyslipidemia and systemic vasculitis. There are various types of RVO, categorized on the\\u000a basis of the site of occlusion and on the type of consequent vascular damage. Central retinal vein occlusion (CRVO) is the\\u000a most clinically relevant type

Rossella Marcucci; Francesco Sofi; Elisa Grifoni; Andrea Sodi; Domenico Prisco


Bilateral vertebral artery balloon occlusion for giant vertebrobasilar aneurysms  

Microsoft Academic Search

We describe the clinical presentation, radiological and clinical results in six consecutive patients with a giant vertebrobasilar\\u000a aneurysm treated by bilateral vertebral artery balloon occlusion. Five patients presented with headache and signs of brain-stem\\u000a compression and one with subarachnoid haemorrhage. In all patients vertebral artery balloon occlusion was performed. In four,\\u000a this followed successful test occlusion. In one patient, who

M. Sluzewski; E. H. Brilstra; W. J. van Rooij; D. Wijnalda; C. A. F. Tulleken; G. J. E. Rinkel



Retinal venous occlusions: diagnosis and choice of treatments.  


Retinal vascular occlusive disorders constitute one of the major causes of blindness and impaired vision. There is marked controversy on their pathogeneses, clinical features and particularly their management. Recently, advances in clinical research added antivascular endothelial growth factor, corticosteroids and sustained-release implants to our armamentarium in the management of retinal vein occlusions. The purpose of our paper is to provide an update and a brief review on the current treatment options of retinal vein occlusions. PMID:23406678

Querques, Giuseppe; Triolo, Giacinto; Casalino, Giuseppe; García-Arumí, José; Badal, Josep; Zapata, Miguel; Boixadera, Ana; Castillo, Vicente Martinez; Bandello, Francesco



[Occlusal reconstruction of a patient with hypohidrotic ectodermal dysplasia].  


Prosthodontic treatment for patient with hypohidrotic ectodermal dysplasia (HED) is difficult to manage because of the loss of occlusal vertical dimension, abnormal alveolar ridge and anodontia A 20-year-old case with HED was reported. The patient was treated with occlusal reconstruction by a maxillary fixed prosthesis and mandibular telescopic prosthesis. At one-year's follow-up, dentures were well used and occlusal function of the patient returned to normal. PMID:23484313

Zeng, Yongfei; Shi, Lianshui; Zhang, Fubao; Zhang, Lin



A Robust Multiple Object Tracking Algorithm under Highly Occlusion  

Microsoft Academic Search

We describe a real-time multiple face-tracking algorithm under highly occlusion. In order to resolve the occlusion and temporal lost problem, a robust data association + filtering procedure is proposed. The mechanism combines the census transform based block-by-block strategy to infer the occlusion state via concerning observation changes of two faces. And a robust and straightforward filtering approach is provided to

Dang Xiaoyan; Zhang Ya; Wang Wei; Wang Zhuo; Wang Zhihua



Changing concepts. The effects of occlusion on periodontitis.  


Despite volumes of publications on the theory of occlusion, occlusal design, and equilibration techniques, there have been few well-designed human studies directed at answering the question does occlusal trauma modify the progression of attachment loss in periodontitis. The articles reviewed indicate that occlusal forces can cause changes in the alveolar bone and periodontal connective tissue both in the presence and in the absence of periodontitis. These changes can affect tooth mobility and clinical probing depth. Although occlusal forces do not initiate periodontitis, results are inconclusive as to if or how these forces affect attachment loss owing to plaque-induced inflammatory periodontal disease. Although some studies reported a relationship between increased attachment loss and tooth mobility, others found no relationship between attachment loss and abnormal occlusal contacts. Tooth mobility results from a variety of factors, including alveolar bone loss, attachment loss, disruption of the periodontal tissues by inflammation, widening of the PDL in response to occlusal forces (physiologic adaptation), PDL atrophy from disuse, and other processes that effect the periodontium. Therefore, any relationship found between tooth mobility and progressing periodontitis does not necessarily implicate or defend occlusion as a cofactor in the progression of inflammatory periodontal disease. Periodontitis can be treated and periodontal health maintained without occlusal adjustment and in the presence of traumatic occlusal forces. Statistically greater gains in clinical periodontal attachment level have been reported, however, when occlusal adjustment was included as a component of periodontal therapy. The extent to which this is clinically meaningful is unclear. Once periodontal health is established, occlusal therapy can be used to reduce mobility, to regain bone lost owing to traumatic occlusal forces, and to treat a variety of clinical problems related to occlusal instability and restorative needs. The clinician's decision whether or not to use occlusal adjustment as a component of periodontal therapy should be related to an evaluation of clinical factors involving the patient's comfort and function and not based on the assumption that occlusal adjustment is necessary to stop the progression of periodontitis. PMID:9597338

Gher, M E



Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale.  


Due to lack of the periodontal ligament, osseointegrated implants, unlike natural teeth, react biomechanically in a different fashion to occlusal force. It is therefore believed that dental implants may be more prone to occlusal overloading, which is often regarded as one of the potential causes for peri-implant bone loss and failure of the implant/implant prosthesis. Overloading factors that may negatively influence on implant longevity include large cantilevers, parafunctions, improper occlusal designs, and premature contacts. Hence, it is important to control implant occlusion within physiologic limit and thus provide optimal implant load to ensure a long-term implant success. The purposes of this paper are to discuss the importance of implant occlusion for implant longevity and to provide clinical guidelines of optimal implant occlusion and possible solutions managing complications related to implant occlusion. It must be emphasized that currently there is no evidence-based, implant-specific concept of occlusion. Future studies in this area are needed to clarify the relationship between occlusion and implant success. PMID:15642028

Kim, Yongsik; Oh, Tae-Ju; Misch, Carl E; Wang, Hom-Lay



Meningioma and occlusive vasculopathy: coexisting complications of past extracranial radiation  

SciTech Connect

Two cases are reported in which a meningioma and occlusion of the internal carotid artery with development of transdural collateral circulation coexisted following extracranial radiation in childhood.

Montanera, W.; Chui, M.; Hudson, A.



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)



Stent-assisted recanalization in acute basilar artery occlusion.  


Lock-in syndrome is a tragedy due to the occlusion of the vertebrobasilar artery. Intravenous thrombolysis with rTPA was the only approved medicine using in mild to moderate (NIHSS 4-25) acute ischemic stroke happened within 3 hours. Patients with lock-in syndrome often belonged to severe stroke, and are excluded by traditional intra-venous thrombolysis. Intra-arterial thrombolysis is flexible to extend the therapeutic window up to 12 hours in posterior circulation, and with a higher recanalization rate. Stent-assisted recanalization is a life saving procedure for patient with acute basilar artery occlusion(1). A 53-year-old man suffered from sudden onset of dizziness and hemiparesis of right side extremities on 08:15am during work. He was brought to our emergency department on 09:10am and brain computer tomography (CT) was performed on 09:31am. Neurologist evaluated the patient on 10:00am with initial NIHSS 29 and brain stem stroke was impressed. Intubation was performed on 10:20am due to conscious deterioration. We performed intra-arterial thrombolysis with partially recanalization but had a complete recover of neurological deficits on 13:30pm. However, conscious deteriorate was noted again and brain CT perfusion defect at posterior circulation (Figure 1) was noted on 15:41pm. Emergent angioplasty and totally four consecutive balloon-expandable stents (Medtronic Driver 3.0-24mm, 3.5-18mm, 3.5-24mm, 4.0-18mm) were deployed retrograde from the basilar tip to distal portion of left vertebral artery with complete revascularization of basilar artery (Figure 2) and perfusion (Figure 1). Patient was discharged smoothly one month later with mild right arm weakness (mRS 1). PMID:24030044

Chan, Lung; Li, Ai-Hsian; Lai, Yen-Jun; Liu, Hon-Mon



Subintimal Angioplasty for Peripheral Arterial Occlusive Disease: A Systematic Review  

SciTech Connect

The objective of this study was to summarize outcomes of subintimal angioplasty (SA) for peripheral arterial occlusive disease. The Cochrane Library, Medline and Embase databases were searched to perform a systematic review of the literature from 1966 through May 2007 on outcomes of SA for peripheral arterial occlusive disease of the infrainguinal vessels. The keywords 'percutaneous intentional extraluminal revascularization,' 'subintimal angioplasty,' 'peripheral arterial disease,' 'femoral artery,' 'popliteal artery,' and 'tibial artery' were used. Assessment of study quality was done using a form based on a checklist of the Dutch Cochrane Centre. The recorded outcomes were technical and clinical success, primary (assisted) patency, limb salvage, complications, and survival, in relation to the clinical grade of disease (intermittent claudication or critical limb ischemia [CLI] or mixed) and location of lesion (femoropopliteal, crural, or mixed). Twenty-three cohort studies including a total of 1549 patients (range, 27 to 148) were included in this review. Methodological and reporting quality were moderate, e.g., there was selection bias and reporting was not done according to the reporting standards. These and significant clinical heterogeneity obstructed a meta-analysis. Reports about length of the lesion and TASC classification were too various to summarize or were not mentioned at all. The technical success rates varied between 80% and 90%, with lower rates for crural lesions compared with femoral lesions. Complication rates ranged between 8% and 17% and most complications were minor. After 1 year, clinical success was between 50% and 70%, primary patency was around 50% and limb salvage varied from 80% to 90%. In conclusion, taking into account the methodological shortcomings of the included studies, SA can play an important role in the treatment of peripheral arterial disease, especially in the case of critical limb ischemia. Despite the moderate patency rates after one year, SA may serve as a 'temporary bypass' to provide wound healing and limb salvage.

Met, Rosemarie, E-mail:; Lienden, Krijn P. Van, E-mail: k.p.vanlienden@amc.n [Academic Medical Center, Department of Radiology (Netherlands); Koelemay, Mark J. W., E-mail: m.j.koelemaij@amc.n [Academic Medical Center, Department of Vascular Surgery (Netherlands); Bipat, Shandra, E-mail: s.bipat@amc.n [Academic Medical Center, Department of Radiology (Netherlands); Legemate, Dink A., E-mail: d.a.legemate@amc.n [Academic Medical Center, Department of Vascular Surgery (Netherlands); Reekers, Jim A., E-mail: j.a.reekers@amc.uva.n [Academic Medical Center, Department of Radiology (Netherlands)



Dual-Energy CT Angiography in Peripheral Arterial Occlusive Disease  

SciTech Connect

We sought to study the accuracy of dual-energy computed tomographic angiography (DE-CTA) for the assessment of symptomatic peripheral arterial occlusive disease of the lower extremity by using the dual-energy bone removal technique compared with a commercially available conventional bone removal tool. Twenty patients underwent selective digital subtraction angiography and DE-CTA of the pelvis and lower extremities. CTA data were postprocessed with two different applications: conventional bone removal and dual-energy bone removal. All data were reconstructed and evaluated as 3D maximum-intensity projections. Time requirements for reconstruction were documented. Sensitivity, specificity, accuracy, and concordance of DE-CTA regarding degree of stenosis and vessel wall calcification were calculated. A total of 359 vascular segments were analyzed. Compared with digital subtraction angiography, sensitivity, specificity, and accuracy, respectively, of CTA was 97.2%, 94.1%, and 94.7% by the dual-energy bone removal technique. The conventional bone removal tool delivered a sensitivity of 77.1%, a specificity of 70.7%, and an accuracy of 72.0%. Best results for both postprocessing methods were achieved in the vascular segments of the upper leg. In severely calcified segments, sensitivity, specificity, and accuracy stayed above 90% by the dual-energy bone removal technique, whereas the conventional bone removal technique showed a substantial decrease of sensitivity, specificity, and accuracy. DE-CTA is a feasible and accurate diagnostic method in the assessment of symptomatic peripheral arterial occlusive disease. Results obtained by DE-CTA are superior to the conventional bone removal technique and less dependent on vessel wall calcifications.

Brockmann, Carolin, E-mail:; Jochum, Susanne; Sadick, Maliha [University of Heidelberg, Department of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim (Germany); Huck, Kurt [University of Heidelberg, I. Medical Clinic, Medical Faculty Mannheim (Germany); Ziegler, Peter [University of Heidelberg, Department of Surgery, Medical Faculty Mannheim (Germany); Fink, Christian; Schoenberg, Stefan O.; Diehl, Steffen J. [University of Heidelberg, Department of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim (Germany)



Measurement of forearm blood flow by venous occlusion plethysmography: Influence of hand blood flow during sustained and intermittent isometric exercise  

Microsoft Academic Search

Summary  The requirement for using an arterial occlusion cuff at the wrist when measuring forearm blood flows by plethysmography was tested on a total of 8 subjects at rest and during and after sustained and intermittent isometric exercise. The contribution of the venous effluent from the hand to the forearm flow during exercise was challenged by immersing the arm in water

Carole A. Williams; Alexander R. Lind



A reassessment of carotid endarterectomy in the face of contralateral carotid occlusion: Surgical results in symptomatic and asymptomatic patients  

Microsoft Academic Search

Objective: Total occlusion of the contralateral internal carotid artery has often been considered to be a predictor of poor outcome after carotid endarterectomy (CEA) of ipsilateral carotid stenosis. Data from both the North American Symptomatic Carotid Endarterectomy Trial and the Asymptomatic Carotid Atherosclerosis Study have suggested this to be true. However, each of these trials had relatively few patients with

Caron B. Rockman; William Su; Patrick J. Lamparello; Mark A. Adelman; Glenn R. Jacobowitz; Paul J. Gagne; Ronnie Landis; Thomas S. Riles



Endovascular treatment of carotid occlusive disease.  


Carotid occlusive disease is one of several etiologic factors for stroke. Of all strokes, an estimated 88% are ischemic in nature. Less than 20% of these are caused by atheroma in the carotid bifurcation. Traditionally, carotid artery stenosis has been treated with carotid endarterectomy (CEA); however, carotid artery balloon angioplasty and stent placement has enjoyed significant technological advances over the last decade and can now offer a comparable treatment alternative to CEA. In this review, the authors concentrate their discussion on the treatment of carotid atherosclerotic disease with particular attention on the endovascular treatment. PMID:24156855

Stetler, William; Gemmete, Joseph J; Pandey, Aditya S; Chaudhary, Neeraj



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



Sheathotomy without Separation of Venule Overlying Arteriole at Occlusion Site in Uncommon Branch Retinal Vein Occlusion  

Microsoft Academic Search

Two cases of uncommon branch retinal vein occlusion (BRVO) with vein overlying artery at occlu- sion site that can be found in less than 1 % who underwent retinal venule sheathotomy without separation of retinal vessel for decompression of BRVO were reported. Both patients had macular hemorrhage, edema, and area of macular capillary nonperfusion. Visual acuity (VA) worsened to 6\\/60

Nuttawut Rodanant; Somanus Thoongsuwan



Symptomatic subclavian vein stenosis and occlusion in hemodialysis patients with transvenous pacemakers.  


The objective of this study was to determine the incidence and timing of complications associated with ipsilateral transvenous pacemakers and hemodialysis access, including subclavian vein stenosis and occlusion, and assess their impact on dialysis access patency. All patients who had pacemakers placed at St. Francis Medical Center were reviewed during the 10-year period from 1988 to 1998. Patients requiring chronic hemodialysis were identified and their demographic data, the presence of arm swelling, and fistula patency were noted. Development of subclavian vein stenosis and occlusion was documented by venography in symptomatic patients. The ultimate outcome of dialysis access was recorded. During the 10-year period 495 patients had transvenous pacemakers placed. Twenty patients were identified with renal failure requiring hemodialysis and 14 had hemodialysis access in the extremity ipsilateral to the pacemaker. Ten (10/14, 71%) patients developed symptoms of subclavian stenosis, including venous hypertension, high recirculation rate, arm swelling, pain, and neurologic symptoms. Eighty percent (8/10) of symptomatic patients had subclavian vein occlusion. All 10 symptomatic patients required ligation of the hemodialysis access to control symptoms. The four asymptomatic patients expired within 6 months of placement of the pacemaker or hemodialysis access from unrelated causes. There is a high incidence of complications in patients who have ipsilateral pacemakers and hemodialysis access. The presence of pacemaker electrodes in the subclavian vein and the flow associated with hemodialysis may accelerate the occurrence of subclavian venous stenosis and occlusion. Patients who did not develop symptoms may have expired before venous outflow obstruction could develop. Vascular surgeons and cardiac surgeons/cardiologists need to coordinate their procedures to avoid ipsilateral transvenous pacemakers and hemodialysis access. PMID:12958674

Teruya, Theodore H; Abou-Zamzam, Ahmed M; Limm, Whitney; Wong, Linda; Wong, Livingston



Veno occlusive disease: update on clinical management.  


Hepatic veno-occlusive disease is a clinical syndrome characterized by hepatomegaly, ascites, weight gain and jaundice, due to sinusoidal congestion which can be caused by alkaloid ingestion, but the most frequent cause is haematopoietic stem cell transplantation (STC) and is also seen after solid organ transplantation. The incidence of veno occlusive disease (VOD) after STC ranges from 0 to 70%, but is decreasing. Survival is good when VOD is a mild form, but when it is severe and associated with an increase of hepatic venous pressure gradient > 20 mmHg, and mortality is about 90%. Prevention remains the best therapeutic strategy, by using non-myeloablative conditioning regimens before STC. Prophylactic administration of ursodeoxycholic acid, being an antioxidant and antiapoptotic agent, can have some benefit in reducing overall mortality. Defibrotide, which has pro-fibrinolytic and antithrombotic properties, is the most effective therapy; decompression of the sinusoids by a transjugular intrahepatic portosystemic shunt (TIPS) can be tried, especially to treat VOD after liver transplantation and when multiorgan failure (MOF) is not present. Liver transplantation can be the last option, but can not be considered a standard rescue therapy, because usually the concomitant presence of multiorgan failure contraindicates this procedure. PMID:17663504

Senzolo, M; Germani, G; Cholongitas, E; Burra, P; Burroughs, A-K



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...



21 CFR 884.5380 - Contraceptive tubal occlusion device (TOD) and introducer.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Contraceptive tubal occlusion device (TOD) and introducer. 884... § 884.5380 Contraceptive tubal occlusion device (TOD) and introducer. (a) Identification. A contraceptive tubal occlusion device (TOD) and introducer...



21 CFR 884.5380 - Contraceptive tubal occlusion device (TOD) and introducer.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 false Contraceptive tubal occlusion device (TOD) and introducer. 884... § 884.5380 Contraceptive tubal occlusion device (TOD) and introducer. (a) Identification. A contraceptive tubal occlusion device (TOD) and introducer...



Carotid artery stenting using the proximal or dual protection method for near occlusion of the cervical internal carotid artery.  


The treatment for patients with near occlusion of the cervical internal carotid artery (ICA) is controversial. The aim of this study was to examine the results of carotid artery stenting (CAS) as a surgical treatment for ICA near occlusion. Between April 2008 and September 2012, 14 patients (all men; mean age, 75.4 years) with ICA near occlusion were treated with CAS. This represents 5.2 % of a total of 267 patients treated with CAS during the study period. All patients were treated with CAS using an embolic protection device. The proximal balloon protection method was performed in five patients, and the dual protection method using a proximal balloon and distal filter protection was used in nine patients. We examined the change of stenotic lesion, hyperintensity spot in diffusion-weighted imaging (DWI), and perioperative complications after CAS. All near occlusions were successfully dilated. Among 2 of 14 patients, DWI showed 1 and 4 hyperintensity spots. Transient and persistent complications, including neurological deficits, did not occur in any patients. In this small number of cases, CAS using the proximal or dual embolic protection method seems to be a safe and beneficial treatment for ICA near occlusion. PMID:23793616

Sakamoto, Shigeyuki; Kiura, Yoshihiro; Kajihara, Yosuke; Shibukawa, Masaaki; Okazaki, Takahito; Matsushige, Toshinori; Shinagawa, Katsuhiro; Mukada, Kazutoshi; Kurisu, Kaoru



Virtual restoration of anatomic jaw relationship to obtain a precise 3D model for total joint prosthesis construction for treatment of TMJ ankylosis with open bite  

Microsoft Academic Search

Temporomandibular joint (TMJ) reconstruction with a TMJ Concepts total joint prosthesis (TMJ Concepts, Ventura, USA) requires a precise 3D model of the jaws in centric occlusion. The authors present a virtual procedure for repositioning the lower jaw in centric occlusion to obtain a precise stereolithographic model for TMJ reconstruction using a custom-made total joint prosthesis in a case of TMJ

C. Zizelmann; P. Bucher; D. Rohner; N.-C. Gellrich; H. Kokemueller; B. Hammer



The Effect of Occlusion on Motion Integration in Infants  

ERIC Educational Resources Information Center

|Previous psychophysical studies have shown that the adult human visual system makes use of form information such as occlusion to determine whether to integrate or segregate local motion signals (J. McDermott, Y. Weiss, & E. H. Adelson, 2001). Using the displays developed by McDermott et al., these experiments examined whether occlusion and amodal…

Otsuka, Yumiko; Konishi, Yukuo; Kanazawa, So; Yamaguchi, Masami K.



Dental appliances with inadequate occlusal coverage: a case report  

Microsoft Academic Search

A case is presented which illustrates the occlusal problems that can develop when a dental appliance such as a temporomandibular splint with incomplete occlusal cover is worn for a reasonable length of time. As in this case, the selective over-eruption of posterior teeth not incorporated in the appliance can lead to the development of an anterior open bite and an

D. T. Falconer; R. A. C. Chate



A novel experimental design model for increasing occlusal vertical dimension.  


This study aimed to establish a rat model of increasing occlusal vertical dimension (iOVD) using a prosthodontic approach. The OVD was increased by bonding a maxillary, bilateral, posterior dental splint with a bearing ball while the occlusal stops that were made on the stone casts adjusted the occlusion and bonded in the mouths of adult Wistar rats (iOVD group); the controls did not receive a splint. Both groups were subdivided after splint insertion: 3 days and 1, 2, 3, or 4 weeks (n = 6/subgroup). The effects of iOVD were evaluated by radiographs, body weight, and histologic diagnosis of tooth and temporomandibular joints. There were no differences in body weights between the 2 groups; occlusal asymmetric dentition abrasions did not occur in the iOVD rats. The occlusal splints caused the remodeling of the periodontal tissue and condylar cartilage. Overall, an iOVD rat model can be constructed using prosthodontic techniques ensuring a balance of bilateral occlusal height.Abbreviations: OVD, occlusal vertical dimension; iOVD, increasing occlusal vertical dimension; TMJ, temporomandibular joint; TMD, temporomandibular disorders. PMID:20489449

Li, Yan; Zhang, Zhiguang; Wu, Shuyi; Qiao, Yonggang



Bilateral internal carotid artery occlusion: natural history and surgical alternatives  

Microsoft Academic Search

Purpose and background: Bilateral internal carotid artery occlusion is an extremely rare entity, therefore, studies of the natural history of this disease are lacking in the English literature. The purpose of this study is to analyze the natural history and surgical alternatives for patients with bilateral internal carotid artery occlusion. Patient population and methods: Twenty-one patients with bilateral internal carotid

A. F AbuRahma; S. E Copeland



Assessing Temporal Coherence for Posture Classification with Large Occlusions  

Microsoft Academic Search

In this paper we present a people posture classification approach especially devoted to cope with occlusions. In particular, the approach aims at assessing temporal coherence of visual data over probabilistic models. A mixed predictive and probabilistic tracking is proposed: a probabilistic tracking maintains along time the actual appearance of detected people and evaluates the occlusion probability; an additional tracking with

Rita Cucchiara; Roberto Vezzani



Dental occlusion modifies gaze and posture stabilization in human subjects  

Microsoft Academic Search

Repercussion of dental occlusion was tested upon postural and gaze stabilization, the latter with a visuo-motor task evaluated by shooting performances. Eighteen permit holders shooters and 18 controls were enrolled in this study. Postural control was evaluated in both groups according to four mandibular positions imposed by interocclusal splints: (i) intercuspal occlusion (IO), (ii) centric relation (CR), (iii) physiological side

Pierre Gangloff; Jean-Paul Louis; Philippe P Perrin



Endovascular therapy for acute thrombotic occlusion of the intracranial artery  

Microsoft Academic Search

The goal of this study was to evaluate the efficacy of endovascular therapy for acute thrombotic occlusion. Six patients with acute thrombotic occlusion in the middle cerebral or basilar arteries underwent treatment with intra-arterial thrombolysis, followed by assessment of residual stenosis. If residual stenosis was greater than 70%, percutaneous transluminal angioplasty (PTA) was performed in the same session; otherwise, patients

Tomoyuki Tsumoto; Tomoaki Terada; Mitsuharu Tsuura; Yukiaki Ryujin; Hiroyuki Matsumoto; Osamu Masuo; Hiroo Yamaga; Toru Itakura



Role of protein C in childhood cerebrovascular occlusive accidents  

Microsoft Academic Search

A group of 23 children with cerebrovascular occlusion of unknown oetiology were re-evaluated 6 months-2 years later. Plasma protein C levels were determined with the coagulation method and were low in 10 cases. The role of this deficiency and the necessity of this test in cerebrovascular occlusion is discussed.

S. Uysal; B. Anlar; C. Altay; S. Kirazli



Subintimal Angioplasty for Peripheral Arterial Occlusive Disease: A Systematic Review  

Microsoft Academic Search

The objective of this study was to summarize outcomes of subintimal angioplasty (SA) for peripheral arterial occlusive disease. The Cochrane Library, Medline and Embase databases were searched to perform a systematic review of the literature from 1966 through May 2007 on outcomes of SA for peripheral arterial occlusive disease of the infrainguinal vessels. The keywords 'percutaneous intentional extraluminal revascularization,' 'subintimal

Rosemarie Met; Krijn P. Van Lienden; Mark J. W. Koelemay; Shandra Bipat; Dink A. Legemate; Jim A. Reekers



Outcome after Thrombolysis for Acute Isolated Posterior Cerebral Artery Occlusion  

Microsoft Academic Search

Background: To date, there is limited data on intra-arterial thrombolysis (IAT) and intravenous thrombolysis (IVT) for isolated posterior cerebral artery (PCA) occlusion. We aimed to evaluate recanalization, outcome and quality of life in patients who undergo thrombolysis for isolated PCA occlusion. Methods: Analysis of 9 patients treated with IAT and 9 patients treated with IVT with short-term (3 months) outcome

Niklaus Meier; Urs Fischer; Gerhard Schroth; Oliver Findling; Caspar Brekenfeld; Marwan El-Koussy; Gian Marco De Marchis; Marie-Luise Mono; Simon Jung; Jan Gralla; Krassen Nedeltchev; Heinrich P. Mattle; Marcel Arnold



Retinal vein occlusion during flare of multicentric Castleman's disease  

PubMed Central

We report a case of successive bilateral retinal vein occlusion in a human immunodeficiency virus (HIV)-positive male with multicentric Castleman’s disease treated successfully with a single injection of intravitreal bevacizumab. Castleman’s disease should be a differential diagnosis of occlusive retinovascular disease and, occasionally, ocular manifestation can lead to systemic diagnosis.

Kozak, Igor; Reid, Erin G



Radiation-induced large intracranial vessel occlusive vasculopathy  

Microsoft Academic Search

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

Michael Brant-Zawadzki; Mark Anderson; Stephen J. DeArmond; Frances K. Conley; Robert W. Jahnke



Effect of Cotton-Tipped Swab Use on Earwax Occlusion  

Microsoft Academic Search

We studied parents' and patients' approach to earwax (cerumen) removal, patients' level of cerumen occlusion, and the association between the use of cotton-tipped swabs (CTS) and cerumen occlusion. Six hundred fifty-one consecutive patients from the general pediatric practice of the Cleveland Clinic aged 2 weeks to 20 years (57% males) answered a questionnaire with their parents' help. Of the 651,

Michael L. Macknin; Haitham Talo; Sharon VanderBrug Medendorp



Myocardial Infarction and Other Arterial Occlusions in Hemophilia A Patients  

Microsoft Academic Search

Myocardial infarction and other arterial occlusions are considered to be rare in hemophilia A. However, a systematic study of the subject has never been attempted. All case reports of myocardial infarction or other arterial occlusions have been now gathered and properly evaluated from a cardiological point of view. Thirty-six patients with myocardial infarction and 6 patients with documented cerebrovascular event

A. Girolami; E. Ruzzon; F. Fabris; C. Varvarikis; R. Sartori; B. Girolami



Management of macular edema secondary to central retinal vein occlusion: an evidence-based  

Microsoft Academic Search

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity.\\u000a Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO),\\u000a or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. Decreased vision in patients afflicted with CRVO\\u000a may result from retinal ischemia and\\/or the accumulation of fluid

Ahmad A. Aref; Ingrid U. Scott



Management of macular edema secondary to branch retinal vein occlusion: an evidence-based update  

Microsoft Academic Search

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity.\\u000a Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO),\\u000a or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. The most common cause of decreased vision in patients\\u000a afflicted with BRVO is the accumulation of fluid

Ahmad A. Aref; Ingrid U. Scott



Grid photocoagulation combined with intravitreal bevacizumab for recurrent macular edema associated with retinal vein occlusion  

PubMed Central

Purpose: To report the efficacy of grid photocoagulation combined with intravitreal bevacizumab (IVB) for macular edema recurring after previous IVBs associated with retinal vein occlusion (RVO). Methods: This retrospective study consisted of 19 eyes with branch retinal vein occlusion (BRVO) and nine eyes with central retinal vein occlusion (CRVO), which were treated with grid photocoagulation combined with IVB for recurrent macular edema after previous IVBs. The mean duration of total follow-up was 29.3 ± 5.8 months. Results: After this combination therapy, foveal thickness was reduced, significant with slight improvement in visual acuity (VA). At 1 month after treatment, although 25 of the 28 eyes showed complete resolution of the cystoid space, the macular edema recurred to some extent in 19 eyes. Compared with initial values, final foveal thickness was reduced significantly in both BRVO and CRVO groups (P < 0.001), but improvement in VA was significant only for eyes with BRVO (P = 0.012). The total number of IVB was 2.8 ± 0.7 for eyes with either BRVO or CRVO. Conclusion: Grid photocoagulation combined with IVB has a substantial effect on reducing recurrent macular edema associated with RVO, but the effect on visual acuity is limited.

Ogino, Ken; Tsujikawa, Akitaka; Murakami, Tomoaki; Muraoka, Yuki; Kurashige, Yumiko; Yoshimura, Nagahisa



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


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



Occlusion of the anterior cerebral artery after head trauma  

PubMed Central

Intracranial arterial occlusion is rarely encountered in association with head injury. Only six cases of traumatic occlusion of the anterior cerebral artery (ACA) have previously been reported. In this paper, the authors describe a case of a posttraumatic occlusion of ACA. A 35-year-old male presented to the emergency room with severe head injury. Computed tomography (CT) scan displayed diffuse brain swelling with multiple skull fractures. Follow up CT scan showed extensive cerebral infarction in the territory of ACA. The patient underwent CT angiography that demonstrated occlusion of the ACA by a fracture of the anterior fossa. He died after 3 d. ACA traumatic occlusion is a rare condition, with poor prognosis. In this case, fracture was responsible for dissection and direct obstruction of the artery.

Paiva, Wellingson Silva; de Andrade, Almir Ferreira; Soares, Matheus Schmidt; Amorim, Robson Luis; Figueiredo, Eberval Gadelha; Teixeira, Manoel Jacobsen



Mechanical occlusions: diagnostic traps and key points of the report.  


Management of mechanical occlusion, particularly of the small intestine, has altered considerably over recent years, with a change of paradigm and the indication for surgery depending on the cause of the occlusion and any signs of entrapment or strangulation. It is therefore important today to make a positive diagnosis of mechanical occlusion, to assess its degree, its location and its cause, and to look for signs of entrapment and strangulation. Only computer tomography can provide the answers to these different questions. The aim of this paper is to provide a reminder of the CT signs that enable us to confirm diagnosis of the various aspects of mechanical occlusion of the stomach and duodenum, small intestine or colon, to emphasize and illustrate the diagnostic traps in CT and to set out the key points of a CT report of mechanical occlusion. PMID:23773530

Taourel, P; Alili, C; Pages, E; Curros Doyon, F; Millet, I



Clinical features associated with internal carotid artery occlusion do not correlate with MRA cerebropetal flow measurements  

PubMed Central

OBJECTIVES—The aetiology of clinical symptoms in patients with severe internal carotid artery (ICA) lesions may be thromboembolic or haemodynamic. The purpose was to assess whether changes in cerebropetal blood flow caused by an ICA occlusion have an effect on clinical symptoms and cerebral metabolism.?METHODS—Forty three patients with an ICA occlusion who had hemispheric ischaemia (transient ischaemic attack or stroke), retinal ischaemia, or without symptoms, and 34 patients without significant ICA lesions with either hemispheric ischaemia or no symptoms were studied. Magnetic resonance angiography (MRA) was used to investigate total cerebropetal flow (flow in the ICAs plus basilar artery) and the flow in the middle cerebral arteries. Cerebral metabolic changes in the flow territory of the middle cerebral artery were determined with proton MR spectroscopy.?RESULTS—Low total cerebropetal flow (r=?0.15, p<0.05) and low middle cerebral artery flow (r=?0.31, p<0.001) were found in patients with an ICA occlusion, but did not correlate with the clinical syndrome. By contrast, patients with prior symptoms of hemispheric ischaemia had decreased cerebral N-acetylaspartate/choline ratios (r=?0.35, p<0.001). However, the presence of an ICA occlusion (and subsequent low flow) did not correlate with low N-acetylaspartate/choline ratios.?CONCLUSION—Neurological deficit caused by (transient) hemispheric ischaemia is associated with low N-acetylaspartate/choline ratios, whereas prior clinical features are not associated with low cerebropetal blood flow, as measured with MR angiography. As a result, differences in cerebropetal flow cannot explain why patients with similar carotid artery disease experience different neurological features.??

van Everdingen, K J; Kappelle, L; Klijn, C; Mali, W; van der Grond, J



Total glossectomy.  


Forty-five patients had a "total" glossectomy for initial advanced tongue carcinoma or for recurrent carcinoma. Forty percent of the patients (18) had a total laryngectomy at the time of glossectomy. Forty-nine percent of the patients (22) had either a lateral or anterior mandibulectomy at the time of glossectomy. Seventy-one percent of the patients (15 of 21) who had an intact larynx and 12.5 percent who had laryngectomy (3 of 24) had some degree of useful speech. Thirty-one percent of the patients (14 of 45) had no problems in deglutition whereas 53 percent of the patients (24) needed a nasogastric tube, 4 patients inserted the feeding tube themselves, 2 had a cervical esophagostomy, and 1 had a special prosthesis for feeding purposes. Thirty-seven percent of the patients (10 of 27) had considerable aspiration problems. Twenty-two percent (6 patients) needed a laryngectomy, and 7.5 percent (2 patients) needed a cervical esophagostomy to prevent further problems. Seven and one-half percent of the patients (2) succumbed to serious pulmonary infection. In this study, total glossectomy had a salvage rate of 65 percent at 6 months postoperatively, 27.5 percent at 1 year, 25 percent at 2 years, 25 percent at 3 years, 20 percent at 5 years, and 10 percent at 10 years. PMID:6625097

Razack, M S; Sako, K; Bakamjian, V Y; Shedd, D P



Occlusal traits in developmental dyslexia: a preliminary study  

PubMed Central

Aim The objective of the study reported here was to assess the orthodontic features in children affected by developmental dyslexia (DD). Patients and methods A total of 28 children affected by DD (22 boys, six girls; mean age: 9.78 ± 1.69 years) were compared with 51 healthy children (38 boys, 13 girls; mean age 9.41 ± 1.48; range 7–10 years). Reading and writing skills were evaluated along with orthodontic features. Results The DD and control groups were not significantly different in terms of total intelligence quotient (P = 0.441) and writing skills (P = 0.805 and P = 0.240, respectively), whereas significant differences were observed between the DD group and control group in both word reading (2.018 ± 1.714 vs 0.917 ± 0.563; P = 0.000) and non-word reading (2.537 ± 1.543 vs 0.862 ± 0.244; P = 0.000). Moreover, for many orthodontic features, there was no significant difference between the two groups; only in prevalence of diastemas (57.14%, P = 0.006), midline diastemas (46.42%, P = 0.007), overbite > 4 mm (71.42%, P = 0.006) and overjet > 4 mm (53.57%, P = 0.001), was there a statistically significant difference. According to univariate logistic regression analysis, the presence of diastemas (odds ratio [OR] 4.33; 95% confidence interval [CI] 1.61–11.65), midline diastemas (OR 4.68; 95% CI 1.61–13.43), an overbite >4 mm (OR 1.75; 95% CI 0.64–4.71), or an overjet >4 mm (OR 2.76; 95% CI 1.06–7.20) seems to play a role in the relationship between occlusal abnormalities and DD in children. Conclusion Children with DD tend to present with altered dental features, particularly in the area of the incisors, suggesting that a persistently different tongue kinematic profile may thus affect both the developmental variability of the tongue and lip and the occlusion.

Perillo, Letizia; Esposito, Maria; Contiello, Mariarosaria; Lucchese, Alessandra; Santini, Annamaria Chiara; Carotenuto, Marco



Current treatment of basilar artery occlusion.  


Basilar artery occlusion (BAO) is associated with high mortality (85-95%) if recanalization does not occur. Evidence of the efficacy of different therapy protocols of intravenous thrombolysis (IVT) or intraarterial thrombolysis (IAT) and/or mechanical endovascular treatment is based on retrospective or prospective patient cohorts, since randomized controlled trials (RCTs) do not exist. Roughly a third of BAO patients reach independent outcome following thrombolysis. From those in whom recanalization occurs, about half will reach independence. In noninvasive and endovascular protocols, recanalization of BAO is reached in 60-85% of the patients. While invasive endovascular approaches afford greater recanalization rates, they have not been proven superior to IVT in terms of functional outcome. Meaningful survival after BAO requires rapid access to thrombolysis. "Bridging" protocols have been introduced where rescue therapies such as endovascular thrombolysis and on-demand mechanical thrombectomy or angioplasty are used. Multimodal imaging techniques should be used to choose the best therapeutic option individually. PMID:22994219

Lindsberg, Perttu J; Sairanen, Tiina; Strbian, Daniel; Kaste, Markku



Coil occlusion of a subclavian mycotic aneurysm.  


We report the first successful application of nonferromagnetic embolization coils for endovascular exclusion of a mycotic right subclavian artery aneurysm. A 58-year-old woman presented with acute cervical pain and a pulsatile mass in the right supraclavicular fossa under antibiotic medication for subacute infectious endocarditis. Diagnostic work-up including duplex sonography, digital subtraction angiography, and magnetic resonance imaging demonstrated a saccular aneurysm of the extrathoracic right subclavian artery. As an alternative to open surgery or stent-graft repair, this pathology was electively treated by transcatheter coil embolization. No neurological deficit or ischemic symptoms were noted during 9 months clinical follow-up. Multislice computed tomography scan revealed complete occlusion of the mycotic aneurysm 6 months after the interventional procedure. Transcatheter closure with Inconel embolization coils is a cost-effective and safe therapeutic option in patients with mycotic aneurysm originating from the subclavian artery. PMID:20146324

Kische, Stephan; Ince, Hüseyin; Peuster, Matthias



Local Oxygen Content in the Skin Is Increased in Chronic Venous Incompetence  

Microsoft Academic Search

In skin lesions of chronic venous incompetence (CVI) transcutaneous oxygen pressure (tcpO2) at the ankle is often reduced. However, in some CVI patients the tcpO2 during suprasystolic occlusion remains significantly higher than in healthy subjects. The aim of the present study was to investigate which kind of CVI patients develop this phenomenon and whether the higher tcpO2 during occlusion is

Markus Stücker; Martin Falkenberg; Tilmann Reuther; Peter Altmeyer; Dietrich W. Lübbers



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.




[Specific features of circulation in aorto-iliac arterial occlusion].  


On occlusion of aorto-iliac segment arteries the collateral circulation ensures an effective compensation of circulation in lower extremities and pelvic organs. The Doppler characteristics of the circulation in visceral and collateral ways of circulation are the subject of the study. The power of ultrasound duplex scanning to evaluate the regional hemodynamics on atherosclerotic occlusion of aorto-iliac segment vessels has been proved. The Doppler parameters of circulation in upper (UMA) and lower (LMA) mesenteric arteries and internal iliac artery (IIA) on high, moderate an low occlusion of abdominal part of aorta (APA) and on unilateral occlusion of iliac arteries have studied. Depending on the level and grade of extension of occlusion of main arteries the collateral circulation may increase in two or three times. Comparing volumetric velocity of circulation (VVC) in UMA and LMA in control group and in patients with low occlusion of APA an increase of VVC in the artery that has an opening situated directly near the proximal site of occlusion were revealed. These results are the evidence of functional remodelling of regional hemodynamics and of the presence of resources of collateral circulation on occlusional and stenothic lesion of aorto-iliac segment arteries. PMID:14610791

Novosad, Ie M



The effect of bilateral lingual nerve anesthesia and increased occlusal vertical dimension on the onset of swallowing in adult males.  


The present study attempts to determine whether the onset of swallowing is affected by bilateral lingual and inferior alveolar nerve anesthesia and by raising the occlusal vertical dimension by wearing an occlusal bite plate. Twenty young male volunteers were selected and asked to chew and swallow corned beef and a corned beef and liquid mixture in their usual manner before and after modifications were made. Oral and pharyngeal swallowing was investigated using videofluoroscopic examination in the lateral plane. Eight objective indicators, including oral containment time, swallowing threshold, and pharynx-to-swallow intervals were estimated. Oral containment time, total sequence duration, total number of chews, and total number of swallows of the two test foods were significantly different before and after the modifications. Individual pharynx-to-swallow intervals also varied. The results indicate that modification of the masticatory condition affects the onset of swallowing and that changes in the onset varied among the participants. PMID:15727320

Tei, Kanchu; Yamazaki, Yutaka; Ono, Mitunobu; Totsuka, Yasunori



Limb salvage after delayed diagnosis for blunt traumatic infrapopliteal occlusion.  


Infrapopliteal occlusion is uncommon after blunt trauma, and limb salvage after delayed diagnosis is even rarer. We present the case of a 56-year-old man who had complex lower leg orthopedic fractures along with a reportedly normal pulse examination with an 11-day diagnostic delay of limb-threatening ischemia requiring distal revascularization. This case illustrates an incidence of delayed infrapopliteal three-vessel occlusion with successful revascularization and subsequent endovascular management to maintain patency. We describe the workup and treatment of delayed infrapopliteal occlusion and a review of the current literature on this topic. PMID:20570464

Causey, Marlin Wayne; Oguntoye, Morohunranti O; Miller, Seth; Andersen, Charles; Singh, Niten



Chronic Pain  


... cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis Pain from nerve damage Chronic pain usually cannot be cured. But treatments can help. They include medicines, acupuncture, electrical stimulation and surgery. Other treatments include psychotherapy, ...


Evaluation of the correlation between dental occlusion and posture using a force platform  

PubMed Central

OBJECTIVES: Force platforms are widely used to evaluate the relationship between posture and dental occlusion. This study evaluated whether force platforms are able to detect eventual postural modifications resulting from dental occlusion. METHOD: A total of 44 healthy volunteers who were given no information on the aim of the study underwent six postural stabilometric exams under different mandibular and visual conditions. Four parameters were considered: sway area, sway velocity, X axis displacement of the center of the foot pressure and Y axis displacement of the center of the foot pressure. RESULTS: An analysis of variance (ANOVA) revealed the relative influence of each factor; specifically, the ocular afference significantly influenced the sway area and sway velocity parameters, and the mandibular position had only a weak influence on the sway area parameter. CONCLUSIONS: Vision was shown to influence body posture, and a weak correlation was observed between mandibular position and body posture in healthy subjects. However, the force platform is most likely not able to clearly detect this relationship. Gnathologists must use caution when using force platform analysis to modify a therapeutic plan. The sway area seems to be the most sensitive parameter for evaluating the effect of occlusion on body posture.

Baldini, Alberto; Nota, Alessandro; Tripodi, Domenico; Longoni, Salvatore; Cozza, Paola



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: [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)



Impact of excessive occlusal load on successfully-osseointegrated dental implants: a literature review.  


The aim of the present study was to review the available evidence on the response of the peri-implant bone when subjected to excessive occlusal forces. The search strategy included papers published in English in the Medline database and the Wiley Online Library from January 1991 to December 2011. Experimental or review papers reporting the conditions of the peri-implant bone of dental implants submitted to excessive occlusal loading in the presence of a controlled oral hygiene regime were eligible for inclusion. The knowledge regarding the response of the peri-implant bone when the dental implant is excessively loaded is limited, and the level of evidence is poor. With animal experimental studies showing conflicting results, it is unclear whether occlusal overload might cause marginal bone loss or total loss of osseointegration to already osseointegrated dental implants when the applied load exceeds the biologically-acceptable limit. This biological limit is also unknown. Furthermore, higher remodeling activity of the peri-implant bone is found around implants subjected to high loading forces. PMID:23918506

Chang, Michael; Chronopoulos, Vasileios; Mattheos, Nikos



Percutaneous Treatment in Iliac Artery Occlusion: Long-Term Results  

SciTech Connect

We evaluated the long-term results of recanalization with primary stenting for patients with long and complex iliac artery occlusions. This was a retrospective nonrandomised study. Between 1995 and 1999, 138 patients underwent recanalization of an occluded iliac artery with subsequent stenting. Patency results were calculated using Kaplan-Meier analysis. The mean length of follow-up was 108 months. Variables affecting primary stent patency such as patient age; stent type and diameter; lesion site, shape, and length; Society of Cardiovascular and Interventional Radiology classification; total runoff score; Fontaine classification; and cardiovascular risk factors were analysed using Breslow test. These variables were then evaluated for their relation to stent patency using Cox proportional hazards test. Technical success was 99%. Primary patency rates were 90% (SE .024), 85% (SE .029), 80% (SE .034), and 68% (SE .052) at 3, 5, 7, and 10 years, respectively. Lesion site (p = 0.022) and stent diameter (p = 0.028) were shown to have a statistically significant influence on primary stent patency. Long-term results of iliac recanalization and stent placement were excellent, without major complications, even in highly complex vascular obstructions. A primary endovascular approach appears to be justified in the majority of patients as a less invasive alternative treatment to surgery. In any case, a first-line interventional approach should be considered in elderly patients or in patients with severe comorbidities.

Gandini, Roberto; Fabiano, Sebastiano; Chiocchi, Marcello; Chiappa, Roberto, E-mail:; Simonetti, Giovanni [University of Rome Tor Vergata, Departments of Diagnostic Imaging, Interventional Radiology, Molecular Imaging, and Radiotherapy (Italy)



Integrating global and local aspects of visual occlusion.  


The phenomenon of visual occlusion has frequently been studied by means of two-dimensional line drawings. These drawings may elicit various interpretations. Sometimes a mosaic of shapes is seen, sometimes a shape that partly occludes another shape. In the latter case, observers often have a clear idea about the form of the partly occluded shape. Local and global pattern aspects both seem to be decisive with respect to the preferred interpretation. An attempt is made to integrate these aspects by applying the global-minimum principle to the perceptual complexity of three distinct components of those pattern interpretations: (i) The internal structure, dealing with each of the shapes separately, (ii) the external structure, dealing with the positional relation between these shapes, and (iii) the virtual structure, dealing with the occluded parts of the shapes. The perceptual complexity of each of these three components can be expressed in terms of structural information. The hypothesis that the perceptually preferred interpretation is the one for which the total information load is minimal is tested on many patterns stemming from different studies on pattern completion. PMID:7870565

van Lier, R; van der Helm, P; Leeuwenberg, E



Simultaneous Total Aortic Replacement from Arch to Bifurcation: Experience with Six Cases  

PubMed Central

Simultaneous total aortic replacement, including the arch and extending to bifurcation, has been performed in six cases at our institution. The cases presented were (1) acute dissection, including the intimal tear in the arch (one case); (2) chronic Type-I dissection, with both visceral and inferior limb ischemia (three cases); and (3) multiple aneurysms (two cases). The broad outline of the surgical technique employed consists of inducing general hypothermia with extracorporeal circulation. At core temperature of 20° C, circulation is stopped and the aortic arch is replaced. Afterward, cerebral perfusion and total body perfusion are resumed at low flow, keeping body temperature between 20 and 24° C. The intercostal orifices are attached to the side of the aortic graft, and the spinal cord is reperfused. Finally, during a period of hypothermic abdominal ischemia, the abdominal aorta is replaced, and subsequently, rewarming is started. This result is achieved by instituting extracorporeal circulation with two arterial return cannulae (in the ascending aorta and in a femoral artery), making it possible to continue the perfusion of both the upper and lower body during the stages of aortic occlusion. Two patients died from bleeding 3 to 6 hours after operation, and medullary injury was not ascertained; one patient died after 1 month without neurologic disturbances; three patients are alive and in good functional condition 6 to 27 months after operation. We believe that total simultaneous aortic replacement is feasible with the hypothermic technique. Images

Massimo, Carlo G.; Poma, Alberto G.; Viligiardi, Riccardo R.; Duranti, Alberto; Colucci, Michele; Favi, Piero P.



Temporary Fibrin Glue Occlusion of the Main Pancreatic Duct in the Prevention of Intra-Abdominal Complications After Pancreatic Resection  

PubMed Central

Objective To determine whether temporary occlusion of the main pancreatic duct with human fibrin glue decreases the incidence of intra-abdominal complications after pancreatoduodenectomy (PD) or distal pancreatectomy (DP). Summary Background Data To the authors’ knowledge, there are no randomized studies comparing outcomes after pancreatic resection with or without main pancreatic duct occlusion by injection of fibrin glue. Of three nonrandomized studies, two reported no fistulas after intracanal injection and ductal occlusion with fibrin glue after PD with immediate pancreatodigestive anastomosis, while another study reported no protective effect of glue injection. Methods This prospective, randomized, single-blinded, multicenter study, conducted between January 1995 and January 1999, included 182 consecutive patients undergoing PD followed by immediate pancreatic anastomosis or DP, whether for benign or malignant tumor or for chronic pancreatitis. One hundred two underwent pancreatic resection followed by ductal occlusion with fibrin glue (made slowly resorbable by the addition of aprotinin); 80 underwent resection without ductal occlusion. The main end point was the number of patients with one or more of the following intra-abdominal complications: pancreatic or other digestive tract fistula, intra-abdominal collections (infected or not), acute pancreatitis, or intra-abdominal or digestive tract hemorrhage. Severity factors included postoperative mortality, repeat operations, and length of hospital stay. Results The two groups were similar in pre- and intraoperative characteristics except that there were significantly more patients in the ductal occlusion group who were receiving octreotide, who had reinforcement of their anastomosis by fibrin glue, and who had fibrotic pancreatic stumps. However, the rate of patients with one or more intra-abdominal complications, and notably with pancreatic fistula, did not differ significantly between the two groups. There was still no significant difference found after statistical adjustment for these patient characteristic discrepancies, confirming the inefficacy of fibrin glue. The rate of intra-abdominal complications was significantly higher in the presence of a normal, nonfibrotic pancreatic stump and main pancreatic duct diameter less than 3 mm, whereas reinforcement of the anastomosis with fibrin glue or use of octreotide did not influence outcome. In multivariate analysis, however, normal pancreatic parenchyma was the only independent risk factor for intra-abdominal complications. No significant differences were found in the severity of complications between the two groups. Conclusions Ductal occlusion by intracanal injection of fibrin glue decreases neither the rate nor the severity of intra-abdominal complications after pancreatic resection.

Suc, Bertrand; Msika, Simon; Fingerhut, Abe; Fourtanier, Gilles; Hay, Jean-Marie; Holmieres, Franck; Sastre, Bernard; Fagniez, Pierre-Louis



Preprosthetic therapy utilizing a temporary occlusal acrylic splint: a case report.  


This case report describes the complex occlusal rehabilitation of a patient with signs and symptoms of temporomandibular disorders with utilization of an occlusal acrylic splint as a means of initial treatment for neuromuscular reprogramming and repositioning of the condyle within the mandibular fossa for occlusal stability, thus allowing adaptation to a new occlusal vertical dimension. PMID:15130082

Badel, Tomislav; Kraljeviç, Sonja; Panduriç, Josip; Marotti, Miljenko



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

SciTech Connect

Purpose: To assess the safety and effectiveness of a polytetrafluoroethylene (PTFE) encapsulated nitinol stents (Bard Peripheral Vascular, Tempe, AZ) for treatment of hemodialysis-related central venous occlusions. Materials and Methods: Study design was a single-center nonrandomized retrospective cohort of patients from May 2004 to August 2009 for a total of 64 months. There were 14 patients (mean age 60 years, range 50-83 years; 13 male, 1 female). All patients had autogenous fistulas. All 14 patients had central venous occlusions and presented with clinical symptoms of the following: extremity swelling (14%, 2 of 14), extremity and face swelling (72%, 10 of 14), and face swelling/edema (14%, 2 of 14). There was evidence of access dysfunction with decreased access flow in 36% (5 of 14) patients. There were prior interventions or previous line placement at the site of the central venous lesion in all 14 patients. Results were assessed by recurrence of clinical symptoms and function of the access circuit (National Kidney Foundation recommended criteria). Results: Sixteen consecutive straight stent grafts were implanted in 14 patients. Average treated lesion length was 5.0 cm (range, 0.9-7 cm). All 14 patients had complete central venous occlusion (100% stenosis). The central venous occlusions were located as follows: right subclavian and brachiocephalic vein (21%, 3 of 14), right brachiocephalic vein (36%, 5 of 14), left brachiocephalic vein (36%, 5 of 14), and bilateral brachiocephalic vein (7%, 1 of 14). A total of 16 PTFE stent grafts were placed. Ten- or 12-mm-diameter PTFE stent grafts were placed. The average stent length was 6.1 cm (range, 4-8 cm). Technical (deployment), anatomic (<30% residual stenosis), clinical (resolution of symptoms), and hemodynamic (resolution of access dysfunction) success were 100%. At 3, 6, and 9 months, primary patency of the treated area and access circuit were 100% (14 of 14). Conclusions: This PTFE encapsulated stent graft demonstrates encouraging intermediate-term patency results for central vein occlusions. Further prospective studies with long-term assessment and larger patient populations will be required.

Kundu, Sanjoy, E-mail:; Modabber, Milad [Scarborough General Hospital-General Division, Department of Medical Imaging (Canada); You, John M. [Scarborough General Hospital-General Division, Department of Vascular Surgery (Canada); Tam, Paul; Nagai, Gordon; Ting, Robert [Scarborough General Hospital-General Division, Department of Nephrology (Canada)



21 CFR 880.5950 - Umbilical occlusion device.  

Code of Federal Regulations, 2013 CFR

...umbilical occlusion device is a clip, tie, tape, or other article used to close the blood vessels in the umbilical cord of a newborn infant. (b) Classification. Class I (general controls). The device is exempt from the premarket notification...



Digital intravenous angiography in the diagnosis of renal artery occlusion  

SciTech Connect

Digital intravenous angiography (DIVA) proved to be highly accurate and sensitive in the diagnosis of six cases of renal artery occlusion. The impact of this new modality on the diagnosis and management of such patients is considered.

Beinart, C.; Saddekni, S.; Sos, T.A.; Sniderman, K.W.; Weiner, M.A.



Hepatic veno-occlusive disease associated with comfrey ingestion.  


A 23 year old man presented with hepatic veno-occlusive disease and severe portal hypertension and subsequently died from liver failure. Light microscopy and hepatic angiography showed occlusion of sublobular veins and small venous radicles of the liver, associated with widespread haemorrhagic necrosis of hepatocytes. The patient had been on a predominantly vegetarian diet and, prior to his illness, took comfrey leaves which are known to contain hepatotoxic pyrrolizidine alkaloids. Comfrey is widely used as a herbal remedy, but so far has only been implicated in two other documented cases of human hepatic veno-occlusive disease. A possible causal association of comfrey and this patient's veno-occlusive disease is suggested by the temporal relationship of the ingestion of comfrey to his presentation, the histological changes in the liver and the exclusion of other known causes of the disease. PMID:2103401

Yeong, M L; Swinburn, B; Kennedy, M; Nicholson, G


The Bacterial Flora of Incipient Occlusal Lesions in Naval Recruits.  

National Technical Information Service (NTIS)

The bacterial contents of occlusal surface pit and fissure incipient dental caries was studied, following excavation of the fissures in naval recruits. Streptococcus mutans was recovered from all carious fissures and in significantly greater numbers in th...

J. C. Meiers M. R. Wirthlin I. L. Shklair



21 CFR 878.4020 - Occlusive wound dressing.  

Code of Federal Regulations, 2013 CFR




Pancreaticoduodenal artery aneurysms associated with celiac axis occlusion.  


True aneurysms of the pancreaticoduodenal artery associated with celiac axis occlusion are very rare; only 38 cases have been reported, according to our literature review. We present three consecutive cases with different options of surgical treatment. PMID:15981115

Bellosta, Raffaello; Luzzani, Luca; Carugati, Claudio; Melloni, Claudia; Sarcina, Antonio



Evidence Relating Subjective Contours and Interpretations Involving Occlusion.  

National Technical Information Service (NTIS)

Subjective contours, according to one theory, outline surfaces that are apparently interposed between the viewer and background (because of the disruption of background figures, sudden termination of lines, and other occlusion 'cues') but are not explicit...

K. A. Stevens



Retroperitoneal Approach via Paramedian Incision for Aortoiliac Occlusive Disease  

PubMed Central

Aortoiliac occlusive disease is a frequently encountered occlusive arterial disease. Different surgical approaches to the infrarenal abdominal aorta have been reported. We retrospectively studied the postoperative outcomes of patients who were treated for aortoiliac occlusive disease via a retroperitoneal versus a transperitoneal surgical approach. From January 2005 through May 2009, 47 patients underwent surgery at our hospital for the correction of aortoiliac occlusive disease: 30 via a paramedian incision and retroperitoneal approach, and 17 via a midline sternotomy and transperitoneal approach. In the retroperitoneal group, the surgical procedures involved iliofemoral bypass in 15 patients, aortofemoral bypass in 12, aortoiliac bypass in 2, and aortobifemoral bypass in 1. All 17 patients in the transperitoneal group underwent aortobifemoral bypass. The preoperative characteristics and perioperative data of the patients were analyzed. We believe that the retroperitoneal aortoiliac approach with a paramedian incision may be considered as a surgical option for aortoiliac revascularization.

Emrecan, Bilgin; Onem, Gokhan; Ocak, Erkin; Arslan, Murat; Yagci, Baki; Baltalarli, Ahmet; Akdag, Beyza



Occlusion pressure analysis role in partitioning of pulmonary vascular resistance in CTEPH.  


Flow-directed pulmonary artery occlusion is posited to enable partitioning of vascular resistance into small and large vessels. As such it may have a role in assessment for pulmonary endarterectomy. To test if the occlusion technique distinguished small from large vessel disease we studied 59 subjects with chronic thromboembolic pulmonary hypertension (CTEPH), idiopathic pulmonary arterial hypertension (IPAH), and connective tissue disease (CTD)-associated PAH. At right heart catheterisation, occlusion pressures were recorded. With fitting of the pressure decay curve, pulmonary vascular resistance was partitioned into downstream (small vessels) and upstream (large vessels, Rup). 47 patients completed the study; 14 operable CTEPH, 15 inoperable CTEPH, 13 idiopathic or CTD-PAH and five post-operative CTEPH. There was a significant difference in mean Rup in the proximal operable CTEPH group 87.3 (95% CI 84.1-90.5); inoperable CTEPH mean 75.8 (95% CI 66.76-84.73), p=0.048; and IPAH/CTD, mean 77.1 (95% CI 71.86-82.33), p=0.003. Receiver operating characteristic curves to distinguish operable from inoperable CTEPH demonstrated an area under the curve of 0.75, p=0.0001. A cut-off of 79.3 gave 100% sensitivity (95% CI 73.5-100%) but 57.1% specificity (95% CI 28.9-82.3%). In a subgroup analysis of multiple lobar sampling there was demonstrable heterogeneity. Rup is significantly increased in operable proximal CTEPH compared with non-operable distal CTEPH and IPAH/CTD-PAH. Rup variability in patients with CTEPH and PAH is suggestive of pathophysiological heterogeneity. PMID:22362857

Toshner, Mark; Suntharalingam, Jay; Fesler, Pierre; Soon, Elaine; Sheares, Karen K; Jenkins, David; White, Paul; Morrell, Nicholas W; Naeije, Robert; Pepke-Zaba, Joanna



Pathophysiological aspects of sickle cell vaso-occlusion  

SciTech Connect

This book contains over 30 selections. Some of the titles are: An Animal Model for Sickle Cell Vaso-Occlusion: A Study Using NMR and Technetium Imaging; Sickle-Cell Vaso-Occlusion in an Animal Model: Intravital Microscopy and Radionuclide Imaging of Selective Sequestration of Dense Cells; Magnetic Resonance Imaging, Percentage of Dense Cells, and Serum Prostanoids as Tools for Objective Assessment of Pain Crisis: A Preliminary Report; and Painful Crisis and Dense Echinocytes: Effects of Hydration and Vasodilators.

Nagel, R.L.



Dental occlusion and body posture: No detectable correlation  

Microsoft Academic Search

The present study was designed to determine if a correlation could be found between dental occlusion and body posture through posturography. Twenty-six healthy subjects (mean age 26.8±5.3 years) were monitored under opposing visual (eyes open\\/closed) and dental occlusion (mandibular rest\\/intercuspidation positions) conditions. The spatial (absolute displacement of centre of pressure from the theoretical point; ACOPD) and dynamic (sway area, length

Giuseppe Perinetti



Human body modeling with partial self occlusion from monocular camera  

Microsoft Academic Search

Automated human body modeling from monocular video sequences is a challenging task because humans may possess very sophisticated postures with various types of motions. The self-occlusion problem often makes body parts invisible in a period of time. In this paper, we propose an automated contour-based 2D human modeling system which is able to deal with partial self-occlusion problem. The 2D

Chih-Chang Yu; Hsu-Yung Cheng; Jenq-Neng Hwang; Kuo-Chin Fan



Occlusal Caries Depth Measurements Obtained by Five Different Imaging Modalities  

Microsoft Academic Search

The study aimed to assess the accuracy and reproducibility of occlusal caries depth measurements obtained from different imaging\\u000a modalities. The study comprised 21 human mandibular molar teeth with occlusal caries. Teeth were imaged using film, CCD, two\\u000a different cone-beam computerized tomography (CBCT) units and a microcomputer tomography (micro-CT). Thereafter, each tooth\\u000a was serially sectioned, and the section with the deepest

K?vanç Kamburo?lu; Hakan Kurt; Eray Kolsuz; Bengi Özta?; ?lkan Tatar; Hakan Hamdi Çelik


Branch retinal vein occlusion associated with quetiapine fumarate  

PubMed Central

Background To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate. Case Presentation A 29 years old gentleman who was taking quetiapine fumarate for 3 years for bipolar mood disorder, presented with sudden vision loss. He was found to have a superior temporal branch retinal vein occlusion associated with hypercholesterolemia. Conclusion Atypical antipsychotic drugs have metabolic side effects which require regular monitoring and prompt treatment.



Early thrombolysis in stroke due to basilar artery occlusion  

Microsoft Academic Search

.   Basilar artery occlusion is usually associated with a poor prognosis. Nevertheless, intra-arterial thrombolysis has been\\u000a shown to improve clinical outcome in selected cases. We report the case of a 29-year-old patient who suffered a severe ischemic\\u000a stroke due to basilar artery occlusion and who was treated with intra-arterial thrombolysis within 3 h of symptoms onset;\\u000a treatment was followed by

G. Orlandi; G. Moscato; R. Padolecchia; F. Sartucci



Stent-based mechanical thrombectomy in acute basilar artery occlusion  

Microsoft Academic Search

Stent-based mechanical thrombectomy was recently proposed as an effective alternative to other mechanical techniques to achieve recanalization of large-vessel embolic occlusions in the anterior circulation. To our knowledge, there are no reports of the use of this technique in acute basilar artery occlusion (ABAO). We present a patient with complete endovascular recanalization of ABAO using a stent-based thrombectomy technique. Advantages

José E. Cohen; Ronen R. Leker; Samuel Moscovici; Moshe Attia; Eyal Itshayek


Endovascular treatment of basilar artery occlusion by manual aspiration thrombectomy  

Microsoft Academic Search

Background and purposeBasilar artery occlusion remains one of the most devastating subtypes of stroke. Intravenous and intra-arterial therapy have altered the natural history of this disease; however, clinical results remain poor. Therefore, exploring more aggressive and innovative management is warranted.MethodsSix consecutive patients presenting with a basilar artery occlusion were treated with the same general algorithm of intra-arterial tissue plasminogen activator

Brian T Jankowitz; Aitziber Aleu; Ridwan Lin; Mouhammad Jumaa; Hilal Kanaan; Dean Kostov; Maxim Hammer; Ken Uchino; Larry R Wechsler; Michael Horowitz; Tudor G Jovin



Subintimal Angioplasty for Peripheral Arterial Occlusive Disease: A Systematic Review  

Microsoft Academic Search

The objective of this study was to summarize outcomes of subintimal angioplasty (SA) for peripheral arterial occlusive disease.\\u000a The Cochrane Library, Medline and Embase databases were searched to perform a systematic review of the literature from 1966\\u000a through May 2007 on outcomes of SA for peripheral arterial occlusive disease of the infrainguinal vessels. The keywords “percutaneous\\u000a intentional extraluminal revascularization,” “subintimal

Rosemarie Met; Krijn P. Van Lienden; Mark J. W. Koelemay; Shandra Bipat; Dink A. Legemate; Jim A. Reekers



Extrapolation of vertical target motion through a brief visual occlusion  

Microsoft Academic Search

It is known that arbitrary target accelerations along the horizontal generally are extrapolated much less accurately than\\u000a target speed through a visual occlusion. The extent to which vertical accelerations can be extrapolated through an occlusion\\u000a is much less understood. Here, we presented a virtual target rapidly descending on a blank screen with different motion laws.\\u000a The target accelerated under gravity

Myrka Zago; Marco Iosa; Vincenzo Maffei; Francesco Lacquaniti



Region Covariance Matrix-Based Object Tracking with Occlusions Handling  

Microsoft Academic Search

\\u000a This work proposes an optical-flow based feature tracking that is combined with region covariance matrix for dealing with\\u000a tracking of an object undergoing considerable occlusions. The object is tracked using a set of key-points. The key-points\\u000a are tracked via a computationally inexpensive optical flow algorithm. If the occlusion of the feature is detected the algorithm\\u000a calculates the covariance matrix inside

Ivar Austvoll; Bogdan Kwolek



Compliance in amblyopia therapy: objective monitoring of occlusion.  

PubMed Central

AIM/BACKGROUND--This study aimed to determine the feasibility of objective compliance monitoring of amblyopia therapy in clinical research. Occlusion has been the mainstay of amblyopia therapy for over 250 years, yet it has never been subjected to rigorous evaluation. Treatment regimens range arbitrarily from a few minutes to most of the waking hours of the day. Compliance is problematic and as, hitherto, accurate objective monitoring has been impossible it is not known how much occlusion is required to effect an improvement in vision. METHODS--An occlusion dose monitor (ODM) has been developed. The ODM consists of a modified occlusion patch and a miniature battery driven datalogger which periodically monitors patch skin contact. The patch is a standard disposable item with two miniature electrocardiogram electrodes attached to its undersurface. The datalogger comprises a high speed static RAM and a clock driven address counter. Data are retrieved using an IBM PC/AT computer. Fifteen child amblyopes were randomly allocated unilateral occlusion of 1, 4, or 8 hours per day for 4 weeks. Owing to data loss, presumed because of accumulation and discharge of static electricity, an additional child was included in the 8 hour group. Outcome measures were objective (ODM) and subjective (diary) compliance with treatment, logMAR visual acuity, and contrast sensitivity. RESULTS--Objective monitoring of occlusion is technically feasible and clinically informative. CONCLUSION--Objective monitoring of occlusion has opened up new research opportunities which, it is hoped, will enable the dose-effect relation of occlusion therapy in the various types of amblyopia to be investigated objectively, and facilitate the design of effective therapeutic regimens. Images

Fielder, A R; Irwin, M; Auld, R; Cocker, K D; Jones, H S; Moseley, M J



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



Severity of occlusal disharmonies in down syndrome.  


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. PMID:22934114

Bauer, Danielle; Evans, Carla A; Begole, Ellen A; Salzmann, Larry



Tracking with occlusions via graph cuts.  


This work presents a new method for tracking and segmenting along time-interacting objects within an image sequence. One major contribution of the paper is the formalization of the notion of visible and occluded parts. For each object, we aim at tracking these two parts. Assuming that the velocity of each object is driven by a dynamical law, predictions can be used to guide the successive estimations. Separating these predicted areas into good and bad parts with respect to the final segmentation and representing the objects with their visible and occluded parts permit handling partial and complete occlusions. To achieve this tracking, a label is assigned to each object and an energy function representing the multilabel problem is minimized via a graph cuts optimization. This energy contains terms based on image intensities which enable segmenting and regularizing the visible parts of the objects. It also includes terms dedicated to the management of the occluded and disappearing areas, which are defined on the areas of prediction of the objects. The results on several challenging sequences prove the strength of the proposed approach. PMID:21088324

Papadakis, Nicolas; Bugeau, Aurélie



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



Extravasal occlusion of large vessels with titanic clips: efficiency, indications, and contraindications.  


The mechanism of extravasal occlusion of blood vessels with titanic clips "Atrauclip" and "Ligaclip extra" was studied in order to reveal indications and contraindications to their use. Occlusion with the clips of both types was ineffective in vessels with a diameter of >7.0 mm. Arteritis or the presence of an intravascular occlusion facility in the vessel were also the contraindications for clip occlusion. In overcases the procedure of occlusion with titanic clips was efficient and atraumatic. PMID:12802466

Vasilenko, Yu V; Kim, A I; Kotov, S A



The occlusion effect in unilateral versus bilateral hearing aids.  


The benefit of bilateral hearing aids is well documented, but many hearing-aid users still wear only one aid. It is plausible that the occlusion effect is part of the reason for some hearing-aid users not wearing both hearing aids. In this study we quantified the subjective occlusion effect by asking ten experienced users of bilateral hearing aids and a reference group of ten normal-hearing individuals to rate the naturalness of their own voice while reading a text sample aloud. The subjective occlusion effect was evaluated in the unilateral versus bilateral condition for a variety of vent designs in earmolds and in a custom hearing aid. The subjective occlusion effect was significantly higher for bilateral hearing aids with all vent designs with the exception of a non-occluding eartip option. The subjective occlusion effect was reduced with the more open vent designs in both the unilateral and bilateral conditions. Assuming that the occlusion effect is a barrier to bilateral hearing aid use, these results indicate that open-hearing-aid fittings can help promote the use of two aids. PMID:17153723

Jespersen, Charlotte Thunberg; Groth, Jennifer; Kiessling, Jürgen; Brenner, Barbara; Jensen, Ole Dyrlund


Velocity, occlusion, and sex of subjects in coincidence of anticipation.  


The purpose of this study was to assess effects of velocity, occlusion distance, and sex on coincidence of anticipation. The Bassin anticipation timer was used to test 25 men and 25 women when velocity was .69 m/sec. and 1.38 m/sec. or "slow" and "fast", and occlusion distances of zero, 1.06 m and 2.12 m were "zero," "small," and "large" on a 4.25-m length of track. There were six test conditions. Analysis showed that increased occlusion distances produced increased absolute, constant, and variable error scores. A significant interaction of velocity and occlusion appeared for all error measures. With an increase in occlusion distance at the slow velocity constant error increased in the positive direction or early response while at the fast velocity a similar increase in constant errors was seen but in the negative direction or late response. Under zero occlusion the expectation that performance at the fast velocity would be more accurate and show less variability than at the slow velocity was not supported. Also, sex did not significantly affect anticipation time in any condition or on any error measures. PMID:12081297

Harrold, Darin; Kozar, Bill



Stimulated intrauterine insemination in women with unilateral tubal occlusion  

PubMed Central

Objective To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. Methods Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. Results The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. Conclusion Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.

Yi, Gwang; Suh, Chang Suk; Kim, Seok Hyun



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



Sex Differences During Visual Scanning of Occlusion Events in Infants  

PubMed Central

A growing number of sex differences in infant behavior have been reported over the last 10 years. One task on which sex differences have been observed reliably is the event-mapping task. In this task, infants view an occlusion event involving 1 or 2 objects, the occluder is removed, and then infants see 1 object sitting on the platform. When the occlusion sequence is complex (i.e., involves paths of motion that change direction when occluded), boys are more likely than girls to detect an inconsistency between a 2-object occlusion event and a 1-object display. The current research used eye-tracking technology to investigate the specific cognitive processes that underlie these sex differences. Three experiments were conducted with 2 age groups of infants with mean ages of 9 months and 4 months. Infants saw a ball–box (2-object) or ball–ball (1-object) occlusion event followed by a 1-ball display; visual scanning of the occlusion event and the 1-ball display was recorded. In the older age group, boys were more likely than girls to visually track the objects through occlusion; they were also more likely to detect an inconsistency between the ball–box event and the 1-ball display (i.e., they visually searched for the missing box). In addition, tracking of the objects through occlusion was related to infants' scanning of the 1-ball display. In the younger age group, both boys and girls failed to track the objects through occlusion and to detect an inconsistency between the ball–box event and the 1–ball display. These results suggest that infants' capacity to track objects through occlusion facilitates extraction of the structure of the initial event (i.e., the number of distinct objects involved), that infants can map onto the final display, and that sex differences in this ability emerge between 4 and 9 months. Possible explanations for how the structure of an occlusion event is extracted and mapped onto a subsequent nonocclusion display are considered.

Wilcox, Teresa; Alexander, Gerianne M.; Wheeler, Lesley; Norvell, Jennifer M.



Failure of the hypotensive provocative test during temporary balloon test occlusion of the internal carotid artery to predict delayed hemodynamic ischemia after therapeutic carotid occlusion  

Microsoft Academic Search

BACKGROUND Extensive experience and critical evaluation of the efficacy of a pharmacologic hypotensive challenge during conventional balloon test occlusion (BTO) of the internal carotid artery (ICA) is lacking. This prompted us to review our institution’s most recent experience with this adjunctive provocative test before planned therapeutic balloon occlusion of the ICA.METHODS Twenty consecutive cases of endovascular therapeutic balloon occlusion of

Amos O Dare; John C Chaloupka; Christopher M Putman; Pierre B Fayad; Issam A Awad



[A new device for measuring occlusion pressure].  


Mouth pressure in the first 100 ms of inspiration with the airway occluded (P0.1) is an indirect measure of central airways activity. Few adequately validated devices are available on the market for measuring this variable automatically, impeding wider use of this measurement. Our aim was to determine the validity and precision of a new automatized manometer for measuring P0.1 and compare the device to the apparatus normally used in our laboratory. The newly manufactured device consisted of a semiconductor type pressure transduce connected to an analog-to-digital converter. The usual apparatus used was constructed in our laboratory from a Honewell transducer, an analog-to-digital card (Data Translation DT2801) for an IBM-compatible PC and a standard spread sheet program. Both devices recorded a continuous signal at a sample frequency of 100 Hz. To determine linearity, accuracy, sensitivity and precision, two columns of 5 and 25 cmH2O were used. For clinical assessment, 33 patients scheduled for lung function analysis were tested. Five measurements of P0.1 were performed on each. The sensitivity of the new device was 0.1 cmH2O; precision expressed as a variation coefficient was 0%, and linearity expressed as a correlation coefficient was r = 0.999 between the two columns. The mean difference between the two devices was 0.11 (0.46) cmH2O (p < 0.0001). Analysis of concordance confirmed a reading bias for the new device in comparison with the usual one, although the difference was not clinically significant (0.08 to 0.14 cmH2O). We conclude that the new device gives good results and its availability on the market may allow more frequent clinical application of occlusion pressure measurement. PMID:8983569

Belda, J; Giner, J; Casán, P; Sanchis, J



Time Management in Acute Vertebrobasilar Occlusion  

SciTech Connect

Acute vertebrobasilar occlusion (VBO) is associated with a high risk of stroke and death. Although local thrombolysis may achieve recanalization and improve outcome, mortality is still between 35% and 75%. However, without recanalization the chance of a good outcome is extremely poor, with mortality rates of 80-90%. Early treatment is a fundamental factor, but detailed studies of the exact time management of the diagnostic and interventional workflow are still lacking. Data on 18 patients were retrospectively evaluated. Time periods between symptom onset, admission to hospital, time of diagnosis, and beginning of intervention were correlated with postinterventional neurological status. The Glasgow Coma Scale and National Institute of Health Stroke Scale (NIHSS) were used to examine patients before and after local thrombolysis. Additionally, multivariate statistics were applied to reveal similarities between patients with neurological improvement. Primary recanalization was achieved in 77% of patients. The overall mortality was 55%. Major complications were intracranial hemorrhage and peripheral embolism. The time period from symptom onset to intervention showed a strong correlation with the postinterventional NIHSS as well as the patient's age, with the best results in a 4-h interval. Multivariate statistics revealed similarities among the patients. Evaluation of time management in acute VBO by multivariate statistics is a helpful tool for definition of similarities in this patient group. Similarly to the door-to-balloon time for acute coronary interventions, the chances for a good outcome depend on a short time interval between symptom onset and intervention. While the only manipulable time period starts with hospital admission, our results emphasize the necessity of efficient intrahospital workflow.

Kamper, Lars, E-mail: lars.kamper@helios-kliniken.d [University Hospital Witten/Herdecke, Department of Diagnostic and Interventional Radiology, HELIOS Klinikum Wuppertal (Germany); Rybacki, Konrad [University Hospital, Department of Diagnostic Radiology (Germany); Mansour, Michael; Winkler, Sven B.; Kempkes, Udo; Haage, Patrick [University Hospital Witten/Herdecke, Department of Diagnostic and Interventional Radiology, HELIOS Klinikum Wuppertal (Germany)



[Excimer laser angioplasty. II: Initial clinical experience with peripheral arterial occlusive diseases].  


First clinical experiences in the treatment of chronically occluded arteries with 7F-multi-fiber catheter systems transmitting pulsed laser light are presented. 16 patients (7 stadium IIb, 4 stadium III, 5 stadium IVa Fontain) underwent the procedure. 14 of 16 lesions (distance: 0.5-10 cm), most of them with visible calcification, could be recanalized successfully. After the catheter had passed lesions several times, remaining stenoses of 48% (mean value) could be reduced by balloon angioplasty. By moving the catheter with less speed than the experimentally determined speed of laser light ablation and by guiding it over a safety wire, perforation and embolization could be avoided. In one case, occlusion material was pressed into collateral vessels and in two cases groin hematomas had to be observed. PMID:2157246

Huppert, P E; Duda, S H; Haase, K K; Karsch, K R; Claussen, C D



Comparison of retinal thickness values and segmentation performance of different OCT devices in acute branch retinal vein occlusion  

Microsoft Academic Search

PurposeTo compare retinal thickness (RT) measurement and segmentation performance of time domain (TD, Stratus) and spectral domain (SD) optical coherence tomography (OCT) devices (Cirrus, Spectralis) for imaging macular oedema (ME) secondary to branch retinal vein occlusion (BRVO).MethodsIn this study, 20 eyes of 20 consecutive patients with acute BRVO were included. A total of 18 unaffected fellow eyes served as control

G Matt; S Sacu; W Buehl; C Ahlers; R Dunavoelgyi; C Pruente; U Schmidt-Erfurth



Percutaneous retrograde recanalization of the celiac artery by way of the superior mesenteric artery for chronic mesenteric ischemia.  


A 52-year-old man presented with recurrent postprandial abdominal pain, sitophobia, and progressive weight loss. Chronic mesenteric ischemia (CMI) due to subtotal occlusion of the superior mesenteric artery (SMA) and flush occlusion of the celiac artery (CA) was diagnosed. Retrograde recanalization of the CA by way of a collateral channel from the SMA was performed using contemporary recanalization equipment. The CA and SMA were then stented, resulting in sustained resolution of CMI-related symptoms. PMID:22526103

Joseph, George; Chacko, Sujith Thomas



Expandable metal stents in chronic pancreatitis  

PubMed Central

Background Biliary obstruction in chronic pancreatitis may be relieved by the insertion of a biliary endoprosthesis. Stenting is usually achieved with a plastic device, but self-expandable metal stents may also be used. Case outlines Two patients are described with severe chronic pancreatitis complicated by biliary obstruction and portal vein thrombosis, who underwent insertion of metallic biliary endoprostheses. In both patients the endoprostheses became occluded, at 12 and 7 months respectively, which necessitated open operation. Both patients experienced surgical complications and one patient died postoperatively. Discussion The use of metal endoprostheses in chronic pancreatitis may result in occlusion, necessitating open operation. Such stents should be used with caution in these patients, who are likely to be high-risk surgical candidates.

Charnley, RM



Cerebral blood flow and CO/sub 2/ reactivity in transient ischemic attacks: comparison between TIAs due to the ICA occlusion and ICA mild stenosis  

SciTech Connect

Hemispheric mean cerebral blood flow (CBF), together with its CO2 reactivity in response to hyperventilation, was investigated in 18 patients with transient ischemic attacks (TIAs) by intraarterial 133Xe injection method in a subacute-chronic stage of the clinical course. In 8 patients, the lesion responsible for symptoms was regarded as unilateral internal carotid artery (ICA) occlusion, and in 10 patients, it was regarded as unilateral ICA mild stenosis (less than 50% stenosis in diameter). Resting flow values were significantly decreased in the affected hemisphere of TIA due to the ICA occlusion as compared with the unaffected hemisphere of the same patient, regarded as the relative control. It was not decreased in the affected hemisphere of TIA due to the ICA mild stenosis as compared with the control. With respect to the responsiveness of CBF to changes in PaCO2, it was preserved in both TIAs, due to the ICA occlusion and ICA mild stenosis. Vasoparalysis was not observed in either types of TIAs in the subacute-chronic stage. However, in the relationship of blood pressure and CO2 reactivity, expressed as delta CBF(%)/delta PaCO2, pressure-dependent CO2 reactivity as a group was observed with significance in 8 cases of TIA due to the ICA occlusion, while no such relationship was noted in 10 cases of TIA due to the ICA mild stenosis. Moreover, clinical features were different between TIAs due to the ICA occlusion and ICA mild stenosis, i.e., more typical, repeatable TIA (6.3 +/- 3.7 times) with shorter duration (less than 30 minutes) was observed in TIAs due to the ICA mild stenosis, while more prolonged, less repeatable TIA (2.4 +/- 1.4 times) was observed in TIAs due to fixed obstruction of the ICA. From these observations, two different possible mechanisms as to the pathogenesis of TIA might be expected.

Tsuda, Y.; Kimura, K.; Yoneda, S.; Etani, H.; Asai, T.; Nakamura, M.; Abe, H.



Retrospective Nationwide Survey of Acute Stroke due to Large Vessel Occlusion in Japan: A Review of 1,963 Patients and the Impact of Endovascular Treatment  

Microsoft Academic Search

Background: The purpose of this study was to clarify the clinical impact of endovascular treatment (EVT) on acute cerebral large vessel occlusion using a nationwide survey of Japan conducted in 2009. Methods: Patients admitted within 24 h after stroke onset were registered retrospectively. Treatment selection, methods, and clinical results were analyzed. Results: A total of 1,963 patients (855 women, 1,108

Shinichi Yoshimura; Yusuke Egashira; Nobuyuki Sakai; Naoya Kuwayama



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)



Sealing occlusal caries lesions in adults referred for restorative treatment: 2-3 years of follow-up.  


The aim of this study was to assess the possibility to arrest occlusal caries lesions in adults by sealant as well as to assess the presence of radiographic progression, arrest, and regression of the sealed lesions. Seventy-two occlusal caries lesions in 52 adult patients referred to restorative treatment by senior lecturers at School of Dentistry, Copenhagen, Denmark were included. In case the patient had more than one occlusal caries lesion, randomization between sealing and restoration was made; otherwise, the lesion was sealed. In total, 60 resin sealants and 12 composite restorations were made. Follow-up period was 25-38 months (mean?=?33 months). Data were analyzed using non-parametric statistics including kappa statistics. After 2-3 years, the dropout rate was 15%; two patients did not show up for control and nine previously sealed lesions were restored by the patients' general practitioners. All 12 restorations and 39 of the remaining 49 sealants were well functioning, seven (14%) sealants were repaired/replaced due to failure, and three (6%) sealed lesions were restored due to caries progression (p?>?0.05). The radiographic assessment showed caries progression beneath five (10%) sealants, caries regression beneath one (2%) sealant, and unchanged depth beneath 43 (88%) sealants and all restorations (p?>?0.05). The majority of the referred lesions were successfully arrested by sealants, indicating the possibility for extending the criteria for sealing occlusal caries lesions in adults. However, a longer observation period is needed for final conclusion. Extending the criteria of therapeutic sealing of occlusal caries lesions in adults will lead to increased dental health. PMID:21479565

Bakhshandeh, Azam; Qvist, Vibeke; Ekstrand, Kim R



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



[Occlusal reduction. A new approach using a particular rotary instrument].  


In this paper the occlusal reduction for a single crown is studied. After a brief description of the classical techniques and usual instruments, an analysis of the different malocclusions demonstrates that the reduction has to be made in accordance with each individual case. Afterwards, the author presents a new diamond with an original profile which shows a concave working side limited by two spherical parts. With this profile an ideal prepared occlusal surface can be obtained with only one passage of the bur. The preparation of the occlusal surface with this instrument is then analysed step by step, showing how a real sculpture of this surface can be achieved rapidly and with ease. A clinical case demonstrates the results. PMID:1657324

Truche, F



Treatment of macular edema due to retinal vein occlusions  

PubMed Central

Retinal vein occlusion (RVO) is a prevalent retinal vascular disease, second only to diabetic retinopathy. Previously there was no treatment for central retinal vein occlusion (CRVO) and patients were simply observed for the development of severe complications, generally resulting in poor visual outcomes. The only treatment for branch vein occlusion (BRVO) was grid laser photocoagulation, which reduces edema very slowly and provides benefit in some, but not all patients. Within the past year, clinical trials have demonstrated the effects of three new pharmacologic treatments, ranibizumab, triamcinolone acetonide, and dexamethasone implants. The benefit/risk ratio is best for intraocular injections of ranibizumab, making this first-line therapy for most patients with CRVO or BRVO, while intraocular steroids are likely to play adjunctive roles. Standard care for patients with RVO has changed and will continue to evolve as results with other new agents are revealed.

Channa, Roomasa; Smith, Michael; Campochiaro, Peter A



Treatment of macular edema due to retinal vein occlusions.  


Retinal vein occlusion (RVO) is a prevalent retinal vascular disease, second only to diabetic retinopathy. Previously there was no treatment for central retinal vein occlusion (CRVO) and patients were simply observed for the development of severe complications, generally resulting in poor visual outcomes. The only treatment for branch vein occlusion (BRVO) was grid laser photocoagulation, which reduces edema very slowly and provides benefit in some, but not all patients. Within the past year, clinical trials have demonstrated the effects of three new pharmacologic treatments, ranibizumab, triamcinolone acetonide, and dexamethasone implants. The benefit/risk ratio is best for intraocular injections of ranibizumab, making this first-line therapy for most patients with CRVO or BRVO, while intraocular steroids are likely to play adjunctive roles. Standard care for patients with RVO has changed and will continue to evolve as results with other new agents are revealed. PMID:21629578

Channa, Roomasa; Smith, Michael; Campochiaro, Peter A



Segmentation and tracking multiple objects under occlusion from multiview video.  


In this paper, we present a multiview approach to segment the foreground objects consisting of a group of people into individual human objects and track them across the video sequence. Depth and occlusion information recovered from multiple views of the scene is integrated into the object detection, segmentation, and tracking processes. Adaptive background penalty with occlusion reasoning is proposed to separate the foreground regions from the background in the initial frame. Multiple cues are employed to segment individual human objects from the group. To propagate the segmentation through video, each object region is independently tracked by motion compensation and uncertainty refinement, and the motion occlusion is tackled as layer transition. The experimental results implemented on both our sequences and other's sequence have demonstrated the algorithm's efficiency in terms of subjective performance. Objective comparison with a state-of-the-art algorithm validates the superior performance of our method quantitatively. PMID:21659028

Zhang, Qian; Ngan, King Ngi



[Ophthalmologic diagnostic procedures and imaging of retinal vein occlusions].  


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



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.



Ambient occlusion effects for combined volumes and tubular geometry.  


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. PMID:23559506

Schott, Mathias; Martin, Tobias; Grosset, A V Pascal; Smith, Sean T; Hansen, Charles D



[Prevention and treatment of hepatic veno-occlusive disease].  


Hematopoietic stem cell transplantation is currently the main cause of hepatic veno-occlusive disease, which is the early complication of this procedure with the highest short-term morbidity and mortality. Given that mortality from severe hepatic veno-occlusive disease can be nearly 100%, the search for measures to prevent of treat this complication is essential. Several risk factors for this complication have been identified and the triggering event that leads to sinusoidal obstruction has been shown to be sinusoidal endothelial cell injury. The present review analyzes measures to avoid or modify the casual risk factors for this complication, as well as the pharmacological agents that can prevent or modify the initial endothelial dysfunction or the resulting sinusoidal occlusion. PMID:21571396

Carreras, Enric



[Branch retinal vein occlusion: high time for cardiovascular risk management].  


Cardiovascular risk management is common in patients suffering from manifest cardiovascular disease, hypertension, hyperlipidaemia and diabetes mellitus. It is generally accepted that medication is the most effective treatment for reducing cardiovascular morbidity and mortality in these patients. Remarkably, cardiovascular risk management is rare in patients suffering from branch retinal vein occlusion. This common retinal vascular disorder in middle aged and elderly people occurs where a thickened retinal artery compresses the affected vein. Although thrombosis is involved, procoagulant disorders are only present in selected cases. On the other hand, prior diabetes, hypertension, and peripheral artery disease are associated with an increased risk of developing branch retinal vein occlusion up to a decade later, and retinal vascular disorder is associated with an increased risk of subsequently developing hypertension, diabetes, congestive heart failure, and cerebrovascular disease later on. Therefore, branch retinal vein occlusion is a marker of developing cardiovascular disease and warrants adequate cardiovascular risk management. PMID:23693011

Bredie, Sebastian J H



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



Should TGV be measured from end-inspiratory occlusions rather than end-expiratory occlusions in wheezy infants?  


It has been suggested that thoracic gas volume (TGV) measured in infants in a plethysmograph most accurately represents true lung volume when calculated from end-inspiratory airway occlusions. The rationale proposed is that pressure measured at the mouth underestimates alveolar pressure more at end-expiration than at end-inspiration, presumably due to small airway closure, and this results in greater overestimation of TGV. To investigate this possibility we calculated TGV in 40 wheezy infants from occlusions at both end-inspiration (TGVei) and end-expiration (TGVee) using a 60 L whole body plethysmograph. TGV was corrected for equipment dead space and tidal volume. When a significant change in TGV was defined as lying outside the 95% confidence interval of the TGVee measurements, 8 of the 40 infants tested had significantly higher TGV values measured from occlusions made at end-expiration, while two infants had significantly lower TGV values measured from occlusions made at end-expiration. This trend was not more common in infants with "concave" flow-volume curves. Although it is technically easier to make occlusions at end-expiration, occluding at end-inspiration may minimize errors of TGV measures in a few individuals due to small airway closure at low lung volumes. PMID:2259553

Lanteri, C J; Raven, J M; Sly, P D



Intracranial endovascular balloon test occlusion: indications, methods, and predictive value.  


Abrupt interruption of the internal carotid artery without a balloon test occlusion (BTO) carries a 26% risk of cerebral infarction. BTO is a test used to decrease this risk by evaluating the efficacy of the collateral circulation. Clinical tolerance of parent vessel occlusion can be assessed by a BTO with several variables, including the clinical examination, angiographic assessment, stump pressure, induced hypotension, perfusion scanning, transcranial Doppler ultrasonography, and neurophysiologic monitoring. This review discusses the indications, methods, predictive value, and complications of BTO. PMID:24156859

Elias, Augusto E; Chaudhary, Neeraj; Pandey, Aditya S; Gemmete, Joseph J



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



Evaluation of retinal functional loss in branch retinal vein occlusion  

Microsoft Academic Search

  \\u000a \\u000a Purpose: Branch retinal vein occlusion (BRVO) induces variable functional deficits depending on the grade of vascular occlusion and\\u000a its localisation. Theses deficiences are not easily defined by visual acuity measurements. However, microperimetry offers\\u000a topical mapping of retinal function, allowing precise documentation of the intensity and dimension of retinal functional loss\\u000a in BRVO.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: Retinal sensitivity was examined using a

Irene A. Barbazetto; Ursula M. Schmidt-Erfurth



Stent-based mechanical thrombectomy in acute basilar artery occlusion.  


Stent-based mechanical thrombectomy was recently proposed as an effective alternative to other mechanical techniques to achieve recanalization of large-vessel embolic occlusions in the anterior circulation. To our knowledge, there are no reports of the use of this technique in acute basilar artery occlusion (ABAO). We present a patient with complete endovascular recanalization of ABAO using a stent-based thrombectomy technique. Advantages and limitations of this technique in the management of ABAO are discussed. The stent-thrombectomy technique is promising, and will need further evaluation in posterior circulation stroke. PMID:22001243

Cohen, José E; Leker, Ronen R; Moscovici, Samuel; Attia, Moshe; Itshayek, Eyal



[Basilar artery occlusion--a diagnostic and therapeutic challenge].  


Acute basilar artery occlusion is a neurological emergency that almost invariably leads to death or severe disability if not recanalized. Therapeutic recanalization is attempted using thrombolytic therapy either intravenously alone or by bridging it to on-demand, endovascular procedures. Due to often demanding differential diagnosis, angiographic evidence of basilar artery occlusion is necessary before treatment decisions. The etiology is often cardioembolism or vertebrobasilar thromboembolism due to atherothrombotic disease, or vertebral artery dissection in less than one in ten cases. Different therapeutic approaches have not been compared in randomized controlled trials. The selection of recanalization therapies thus builds on empirical knowledge and availability of vascular interventional services in the local setting. PMID:23786108

Sairanen, Tiina; Strbian, Daniel; Lindsberg, Perttu J



[Non occlusive mesenteric ischemia: a late complication of cardiogenic shock].  


The case of a diabetic 62-year-old man with a past history of myocardial infarction, developing a cardial arrest followed by successful cardiopulmonary resuscitation, is reported. In the late clinical course, the patient displayed abdominal signs related to mesenteric ischaemia. The pathophysiology of non-occlusive mesenteric ischaemia is discussed. Risk factors such as diabetes, cardiovascular disease, hemodialysis, the use of digoxine or alpha-adrenergic drugs are listed. Non-occlusive mesenteric ischaemia is not an infrequent complication of cardiac failure in high risk patients. PMID:7733601

Soravia, C; Höhn, L; Mentha, G; Chevrolet, J C; Suter, P; Rohner, A



Fingertip injuries management with semi-occlusive dressing.  


We have developed a simple, cheap and efficient method of management of fingertip injury using a semi-occlusive dressing ("Opsite"--Smith and Nephew). The fingertip is covered with the "Opsite" once a week only. The dressing provides a temporary "skin", making the finger painless. This semi-occlusive "skin" allows the healing environment to reach an optimal milieu (e.g. pH, oxygen, tension, immunoagents) actively promoting granulation tissue formation and epithelialization. The result of 200 fingertip injuries treated with this method proves the development of a near normal pulp shape and useful epithelium within an average of 20 days. PMID:8409649

Mennen, U; Wiese, A



Tracheal Occlusion Conditioning in Conscious Rats Modulates Gene Expression Profile of Medial Thalamus  

PubMed Central

The thalamus may be the critical brain area involved in sensory gating and the relay of respiratory mechanical information to the cerebral cortex for the conscious awareness of breathing. We hypothesized that respiratory mechanical stimuli in the form of tracheal occlusions would modulate the gene expression profile of the thalamus. Specifically, it was reasoned that conditioning to the respiratory loading would induce a state change in the medial thalamus consistent with a change in sensory gating and the activation of molecular pathways associated with learning and memory. In addition, respiratory loading is stressful and thus should elicit changes in gene expressions related to stress, anxiety, and depression. Rats were instrumented with inflatable tracheal cuffs. Following surgical recovery, they underwent 10?days (5?days/week) of transient tracheal occlusion conditioning. On day 10, the animals were sacrificed and the brains removed. The medial thalamus was dissected and microarray analysis of gene expression performed. Tracheal obstruction conditioning modulated a total of 661 genes (p?occlusions.

Bernhardt, Vipa; Hotchkiss, Mark T.; Garcia-Reyero, Natalia; Escalon, B. Lynn; Denslow, Nancy; Davenport, Paul W.



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 ...



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.



Positional occlusion of the vertebral artery: A rare cause of embolic stroke  

Microsoft Academic Search

A young, previously healthy patient developed embolic occlusions of the posterior cerebral, superior cerebellar, and posterior inferior cerebellar arteries. This patient also demonstrated positional occlusion of the left vertebral artery which may have been the etiology for his embolic stroke.

R. I. Grossmann; K. R. Davis



Isolated cilioretinal artery occlusion as an initial manifestation of polycythemia vera.  


Isolated cilioretinal artery occlusion is a rarely reported initial manifestation of polycythemia vera. In this study, we reported a case of a 65-year-old man with polycythemia vera with cilioretinal artery occlusion as an initial manifestation. PMID:20844687

Elasri, Fouad; Souhail, H; Reda, K; Iferkhass, S; Idrissi, A; Naoumi, A; Oubaaz, A



Isolated Cilioretinal Artery Occlusion as an Initial Manifestation of Polycythemia Vera  

PubMed Central

Isolated cilioretinal artery occlusion is a rarely reported initial manifestation of polycythemia vera. In this study, we reported a case of a 65-year-old man with polycythemia vera with cilioretinal artery occlusion as an initial manifestation.

Elasri, Fouad; Souhail, H.; Reda, K.; Iferkhass, S.; Idrissi, A.; Naoumi, A.; Oubaaz, A.



Inadvertent occlusion of the anterior choroidal artery explains infarct variability in the middle cerebral artery thread occlusion stroke model.  


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. PMID:24069448

McLeod, Damian D; Beard, Daniel J; Parsons, Mark W; Levi, Christopher R; Calford, Mike B; Spratt, Neil J



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.



Total body water and total body potassium in anorexia nervosa  

SciTech Connect

In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.



Chronic Illness  


... giving up cherished activities, adapting to new physical limitations and special needs, and paying for what can ... as long as eight years after diagnosis. Physical limitations imposed by heart disease and other chronic illnesses ...


Chronic Pericarditis  


... unknown. However, it may be caused by cancer, tuberculosis, or an underactive thyroid gland (hypothyroidism). Usually, the ... injury, heart surgery, or a bacterial infection. Previously, tuberculosis was the most common cause of chronic pericarditis ...


Retinal vein occlusions: The potential impact of a dysregulation of the retinal veins  

Microsoft Academic Search

A retinal vein occlusion (RVO) is a sight threatening disease. It can be divided into central vein occlusion and branch retinal\\u000a vein occlusion. The pathogenesis of the condition remains to be solved. Mechanical compression of the vessel wall or thrombotic\\u000a occlusion of the vessel lumen, sometimes combined with rheological disorders, are often assumed pathomechanisms. Accordingly,\\u000a the therapy relies either on

Stephan A. Fraenkl; Maneli Mozaffarieh; Josef Flammer



Occlusion potential of zeolites for mixed and non-nitrate salts  

Microsoft Academic Search

Occluded salts in the form of salt complexes exhibit the interesting properties unattainable in bulk state. In this study, occlusion of non-nitrate salts and co-occlusion of mixed nitrate salts were attempted to further expand occlusion potential of zeolites. The non-nitrate salts such as KClO3 and KH2PO4 were occluded by mordenite, although they do not establish stable molten state. Their occlusions

Man Park; Choong Lyeal Choi; Jong Soo Kim; Dong Hoon Lee; Kwang Seop Kim; Nam Ho Heo; Jyung Choi



Ear infection - chronic  


Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... Chole RA, Sudhoff HH. Chronic otitis media, mastoiditis, and ... eds. Otolaryngology: Head & Neck Surgery . 5th ed. Philadelphia, ...


Transconjunctival 25-gauge pars plana vitrectomy and internal limiting membrane peeling for chronic macular edema  

PubMed Central

Background The purpose of this study was to investigate the visual and anatomic outcomes in patients with chronic macular edema who underwent 25-gauge pars plana vitrectomy with internal limiting membrane peeling. Methods This study was a retrospective chart review of 24 eyes from 21 patients who underwent 25-gauge pars plana vitrectomy and indocyanine green-assisted internal limiting membrane peeling for chronic macular edema. Preoperative and postoperative spectral-domain optical coherence tomography (OCT) was examined for macular thickness and macular volume. Outcomes and variables were analyzed using the two-tailed t-test and Spearman’s rank correlation coefficient. Results Twenty-four eyes from 11 men and 10 women of mean age 69 (range 55–84) years were included. Four patients (17%) had chronic macular edema from uveitis, four (17%) from retinal vein occlusion, and 16 (67%) from diabetes. Mean visual acuity was 20/103 preoperatively and 20/87 postoperatively (P = 0.55). Sixty-three percent of the eyes had improved vision (47% better than 20/40), 21% maintained the same vision, and 17% had worse vision. Forty-seven percent of improved eyes and 30% of total eyes gained more than two lines of visual acuity (range ?9 to +7 lines). Mean macular thickness was 455 ?m preoperatively and 396 ?m postoperatively (P = 0.29). Mean macular volume was 7.9 mm3 preoperatively and 7.5 mm3 postoperatively (P = 0.51). The strongest predictor of postoperative visual acuity was initial visual acuity (r = 0.673, P = 0.0003). Conclusion Even though a majority of patients had improved vision and decreased macular thickening after 25-gauge pars plana vitrectomy with internal limiting membrane peeling for chronic macular edema of various etiologies, the difference in visual acuity or macular thickening did not reach statistical significance.

Cho, Minhee; D'Amico, Donald J



Low-Dose Total Body Irradiation and Donor Peripheral Blood Stem Cell Transplant Followed By Donor Lymphocyte Infusion in Treating Patients With Non-Hodgkin Lymphoma, Chronic Lymphocytic Leukemia, or Multiple Myeloma

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage II Multiple Myeloma; Stage III Multiple Myeloma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia



Evaluation of the occlusal contact of crowns fabricated with the bite impression method.  


In prosthodontic treatment, reconstruction of a proper occlusal contact relationship is very important as well as reconstruction of a proper interproximal relationship and marginal fitness. Unfortunately, occlusal relationships are sometimes lost in the process of occlusal adjustment of crowns. The purpose of this study was to compare the occlusal contacts of single crown fabricated by two different types of impression techniques. Nine subjects, whose molars required treatment with crown restoration, were enrolled in this study. Full cast crowns were fabricated using two types of impression techniques: the conventional impression method (CIM) and the bite impression method (BIM). The occlusal contacts of crowns were precisely evaluated at the following stages: after occlusal adjustment on the articulator (Step 0), before occlusal adjustment in the mouth (Step 1), after occlusal adjustment at the intercuspal position (Step 2), and after occlusal adjustment during lateral and protrusive excursions (Step 3). The number of occlusal contacts of the crowns on the functional cusps fabricated with BIM was significantly greater than that with CIM after occlusal adjustment. For this reason, the crowns fabricated with BIM might have a more functionally desirable occlusal surface compared to the crowns fabricated with CIM. PMID:24146169

Makino, Sachi; Okada, Daizo; Shin, Chiharu; Ogura, Reiko; Ikeda, Masaomi; Miura, Hiroyuki



Treatment of Branch Retinal Vein Occlusion induced Macular Edema with Bevacizumab  

Microsoft Academic Search

BACKGROUND: Branch retinal vein occlusion is a frequent cause of visual loss with currently insufficient treatment options. We evaluate the effect of Bevacizumab (Avastin®) treatment in patients with macular edema induced by branch retinal vein occlusion. METHODS: Retrospective analysis of 32 eyes in 32 patients with fluorescein angiography proven branch retinal vein occlusion, macular edema and Bevacizumab treatment. Outcome measures

Mathias Abegg; Christoph Tappeiner; Ute Wolf-Schnurrbusch;