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The management of chronic total coronary occlusions  

Microsoft Academic Search

Although recent consensus has clearly defined chronic total occlusions (CTO), attempted per- cutaneous coronary intervention (PCI) remains low. Histopathologically, CTOs are characterized by fibrous caps, varying degrees of plaques, and neovascularization, with both increasing with the age of the CTO. Multiple registries and studies show that successful PCI of CTOs can improve symptoms, left ventric- ular function, and mortality. There




The management of chronic total coronary occlusions.  


Although recent consensus has clearly defined chronic total occlusions (CTO), attempted percutaneous coronary intervention (PCI) remains low. Histopathologically, CTOs are characterized by fibrous caps, varying degrees of plaques, and neovascularization, with both increasing with the age of the CTO. Multiple registries and studies show that successful PCI of CTOs can improve symptoms, left ventricular function, and mortality. There is overwhelming evidence that very low restenosis and reocclusion rates can be obtained with drug eluting stents after recanalization of CTOs. PCI should be considered the preferred initial revascularization modality in patients in whom a high procedural success rate may be anticipated. Novel techniques have greatly enhanced procedural success, and include ''parallel'' and ''seesaw'' wire techniques, balloon anchoring, subintimal tracking and reentry (STAR), retrograde approach, contralateral injection, and intravascular ultrasound (IVUS) guidance. Improvements in wire technology have largely been responsible for improved procedural success in PCI of CTO, while application of new technologies hold promise to significantly better outcomes. Magnetic resonance imaging (MRI) and multislice computed tomography (CT) are already employed in formulating treatment strategies and their role in the treatment of CTOs is likely to increase. PMID:18813187

Cuneo, A; Tebbe, U



Endovascular Recanalization for Chronic Symptomatic Intracranial Vertebral Artery Total Occlusion  

PubMed Central

Purpose. The outcome of recanalization in patients with chronic symptomatic intracranial vertebral artery (ICVA) total occlusion is poor. This paper reports the technical feasibility and long-term outcome of ICVA stenting in patients with chronic symptomatic total occlusion. Methods. Retrospective review of our prospectively maintained intracranial intervention database to identify patients with symptomatic total occlusion of ICVA with revascularization attempted >1 month after index ischemic event. Results. Eight patients (mean age 58 years) were identified. One had stroke and 7 had recurrent transient ischemic attacks. Four had bilateral ICVA total occlusion and 4 had unilateral ICVA total occlusion with severe stenosis contralaterally. Seven of 8 patients underwent endovascular recanalization, which was achieved in 6. Periprocedural complications included cerebellum hemorrhage, arterial dissection, perforation, and subacute in-stent thrombosis which occurred in 3 patients. One patient died of cerebellum hemorrhage. The other patients improved clinically after endovascular therapy. Conclusions. Stent-supported recanalization of ICVA total occlusion is technically feasible, and may become a viable treatment option in selected patients. PMID:25276423

Xu, Ziqi; Ma, Ning; Mo, Dapeng; Wong, Edward Ho chung; Gao, Feng; Jiao, Liqun; Miao, Zhongrong



Thrombotic Occlusion during Intravascular Ultrasonography-Guided Percutaneous Coronary Intervention of Stumpless Chronic Total Occlusion  

PubMed Central

Percutaneous coronary intervention (PCI) of stumpless chronic total occlusion (CTO) lesions with a side branch stemming from the occlusion have a significantly lower treatment success rate because physicians cannot identify an accurate entry point with only conventional angiographic images. An intravascular ultrasonography (IVUS)-guided wiring technique might be useful for the penetration of stumpless CTO. We recently experienced thrombotic occlusion during an IVUS-guided stumpless CTO procedure. The cause of the thrombosis is not completely understood; the thrombosis may have been associated with the long use of the IVUS catheter. Special precautions should be taken to prevent thrombus in such cases. PMID:25568847

Lee, Un Joo; Kim, Hyun Soo; Lee, Cheolhyun; Kim, Kwang-yeol



Optical coherence tomography for imaging of chronic total occlusions  

NASA Astrophysics Data System (ADS)

Chronic total occlusions (CTOs) are defined as complete occlusions of an artery older than one month. Minimally invasive catheter-based interventions commonly employed for partial occlusions (e.g., balloon angioplasty followed by stenting) are problematic in CTOs because of the phycisian's inability to pass the device through the occlusion without a significant risk of arterial wall perforations. Furthermore, successfully treated CTOs exhibit a high re-occlusion rate. As a result, these cases are mostly sent to bypass surgery. With the advent of drug-eluting stents that reduce the incidence of re-occlusion, and thus, eliminating the second problem, new devices have begun to emerge that aim to recanalize CTOs without the cost and trauma of bypass surgery. These devices, however, need effective image guidance methods to ensure successful crossing of the CTOs. Optical coherence tomography (OCT) is being evaluated as an intravascular imaging modality for guiding catheter-based interventions of CTOs. Occluded ex vivo human arterial samples were used to produce longitudinal cross-sections using an OCT system. These OCT images were compared with histology to assess OCT's ability to identify different components of the occluded artery, evaluate the imaging depth, and determine the ability to detect the underlying vessel wall. Given the inherent difficulties of creating a mechanically scanning OCT probe in the distal tip of a catheter for use in a stenotic artery, we directed our initial efforts towards developing a "motionless" fiber based OCT system using a single mode fiber array. We discuss design considerations for implementing a forward viewing intravascular OCT probe.

Munce, Nigel R.; Yang, Victor X. D.; Qiang, Beiping; Courtney, Brian K.; Brzozowski, Lukasz; Bakueva, Ludmilla; Mao, Linda Y.; Standish, Beau; Butany, Jagdish; Dick, Alexander J.; Strauss, Bradley H.; Wright, Graham A.; Vitkin, Alex



Dedicated devices and techniques – a cornerstone in recanalisation of chronic total occlusions of coronary arteries  

PubMed Central

Recanalisation of chronic total occlusion (CTO) is still a challenge in invasive cardiology, requiring operator experience, equipment, and techniques dedicated to CTO. Due to difficulties in crossing the lesion by wire and by balloon (both responsible for 98% of the procedure's failures), many helpful techniques have been described. We report the case of both Tornus system and anchor technique in successful recanalisation of a right coronary artery. PMID:25489310

Bryniarski, Leszek; Surowiec, S?awomir; Dudek, Dariusz; Czarnecka, Danuta



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

PubMed Central

Recanalization of chronic total occlusion (CTO) located in the ostium may require the operator's ability to use the retrograde approach. We present a case of opening a chronically occluded right coronary artery (RCA) by the retrograde approach after an unsuccessful attempt of recanalization by classic antegrade technique. PMID:24570749

Kameczura, Tomasz; Surowiec, S?awomir; Janu?, Bogdan; Derlaga, Bogus?aw; Dudek, Dariusz; Czarnecka, Danuta



Chronic total occlusion percutaneous coronary intervention case selection and techniques for the antegrade-only operator.  


Coronary chronic total occlusions (CTO) remain a difficult lesion subset to treat. Although CTOs are present at coronary angiography in 15-20% of patients, only a small fraction of eligible patients will be offered percutaneous treatment. Recent publications from centers with dedicated CTO programs using the full range of antegrade and retrograde techniques suggest success rates in the range of 90% even when little anatomic exclusion are used. However, many patients with clinically appropriate CTO targets have simpler anatomy that can predictably be managed without the selected skills and equipment. The purpose of this review is to provide skilled percutaneous coronary intervention operators who have not specialized in complex retrograde CTO techniques, an algorithm for the selection and antegrade management of appropriate CTO cases. Core equipment and techniques are discussed. © 2014 Wiley Periodicals, Inc. PMID:25044668

Rinfret, Stéphane; Joyal, Dominique; Spratt, James C; Buller, Christopher E



Percutaneous Recanalization of Coronary Chronic Total Occlusions: Current Devices and Specialized Wire Crossing Techniques  

PubMed Central

Treatment of coronary chronic total occlusions (CTOs) remains a challenging obstacle, posing a considerable barrier to achieving successful complete revascularization. By nature of their complexity, percutaneous CTO interventions are associated with lower rates of procedural success, higher complication rates, greater radiation exposure and longer procedure times compared with non-CTO interventions. In the last few years, development in guidewires, devices and the emergence of new techniques from Japanese centers resulted in higher success rates in the hands of experienced operators. The impact of drug eluting stents on restenosis has improved long-term outcomes after successful recanalization. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. This paper reviews the current devices and specialized crossing techniques of percutaneous intervention to relieve CTOs. PMID:20514329



Percutaneous Coronary Intervention to Treat Chronic Total Occlusion: Predictors of Technical Success and One-Year Clinical Outcome  

PubMed Central

We investigated the overall success rate of percutaneous coronary intervention (PCI) as a treatment for coronary chronic total occlusion and sought to determine the predictive factors of technical success and of one-year major adverse cardiac events (MACE). These factors have not been conclusively defined. Using data from our single-center PCI registry, we enrolled 269 consecutive patients (mean age, 56.13 ± 10.72 yr; 66.2% men) who underwent first-time PCI for chronic total occlusion (duration, ?3 mo) from March 2006 through September 2010. We divided them into 2 groups: procedural success and procedural failure. We compared occurrences of in-hospital sequelae and one-year MACE between the groups, using multivariate models to determine predictors of technical failure and one-year clinical outcome. Successful revascularization was achieved in 221 patients (82.2%). One-year MACE occurred in 13 patients (4.8%), with a predominance of target-vessel revascularization (3.7%). The prevalence of MACE was significantly lower in the procedural-success group (1.8% vs 18.8%; P <0.001). In the multivariate model, technical failure was the only predictor of one-year MACE. The predictors of failed procedures were lesion location, multivessel disease, the occurrence of dissection, a Thrombolysis In Myocardial Infarction flow grade of 0 before PCI, the absence of tapered-stump arterial structure, and an increase in serum creatinine level or lesion length. In our retrospective, observational study, PCI was successful in a high percentage of chronic total occlusion patients and had a low prevalence of complications. This suggests its safety and effectiveness as a therapeutic option. PMID:24512398

Salarifar, Mojtaba; Saroukhani, Sepideh; Nematipour, Ebrahim; Kassaian, Seyed Ebrahim; Alidoosti, Mohammad; Poorhosseini, Hamid-Reza; Haji-Zeinali, Ali-Mohammad; Nozari, Younes; Hosseini, Kianoush; Jalali, Arash



Chronic total coronary occlusions in patients with stable angina pectoris: impact on therapy and outcome in present day clinical practice  

Microsoft Academic Search

Background  Chronic total coronary occlusions (CTOs) represent a subgroup of coronary lesions with a low procedural success and high recurrence\\u000a rate. However, there is evidence for a prognostic benefit of revascularizing a CTO.\\u000a \\u000a \\u000a \\u000a Objective  This study assessed the prevalence of CTOs among patients with stable angina pectoris and its impact on therapeutic strategies.\\u000a \\u000a \\u000a \\u000a Methods  Between 2001 and 2003, a survey was conducted in

Gerald S. Werner; Anselm K. Gitt; Uwe Zeymer; Claus Juenger; Frank Towae; Harm Wienbergen; Jochen Senges



Computed tomography angiography-guided recanalization of saphenous vein graft chronic total occlusion  

PubMed Central

Computed tomography (CT) angiography can augment conventional coronary angiography relative to length of vessel occlusion and quality of distal run-off. In this case report we describe the significance of CT angiography in the revascularization decision-making process of a patient following occlusion of both coronary artery bypass grafts. PMID:22291813

Hajek, Petr; Adla, Theodor; Taborska, Katerina; Veselka, Josef



Elective versus deferred stenting following subintimal recanalization of coronary chronic total occlusions.  


Subintimal tracking and re-entry (STAR) technique has been described as a bailout strategy for coronary total occlusion (CTO) recanalization. However, the length of the dissected segment represents a major concern. The aim of this study is, to evaluate whether "deferred" stent implantation may limit the total stent length following STAR recanalization of CTO. All consecutive patients with CTO in a native coronary artery treated by successful STAR technique in our institution were included. In the first period (March 2004-December 2009) all procedures were completed with stent implantation (Elective Stent Group; n?=?60). Thereafter (January 2010-June 2012) stent implantation was postponed until a scheduled (within 3 months) angiographic follow-up (Deferred Stent Group; n?=?69). The dissection length was 75?±?37 mm in the Elective Stent Group and 83?±?31 mm in the Deferred Stent Group (P?=?0.22). In the Deferred Stent Group, at the angiographic follow-up, the dissection length was significantly shorter than at the index procedure (40?±?35 mm versus 83?±?31 mm, P <0.001). The total stent length was significantly shorter in the Deferred Stent Group versus the Elective Stent Group (22?±?33 mm versus 56?±?28 mm; P?

Visconti, Gabriella; Focaccio, Amelia; Donahue, Michael; Briguori, Carlo



Fundamental wire technique and current standard strategy of percutaneous intervention for chronic total occlusion with histopathological insights.  


Currently, successful treatment of chronic total occlusion (CTO) seems markedly improved, due to several new techniques and dedicated device developments. However, this improved success rate is often limited to procedures performed by skilled, highly experienced operators. To improve the overall success rate of percutaneous coronary intervention of CTO from a worldwide perspective, a deeper understanding of CTO histopathology might offer insights into the development of new techniques and procedural strategies. In this review, CTO histopathology and wire techniques are discussed on the basis of the fundamental concepts of antegrade and retrograde approaches. Although details pertaining to wire manipulation are very difficult to explain objectively, we tried to describe this as best as possible in this article. Finally, a systematic review of the current standard CTO strategy is provided. Hopefully, this article will enhance the understanding of this complex procedure and, consequently, promote safe and effective CTO-percutaneous coronary intervention for patients who present with this challenging lesion subset. PMID:21939933

Sumitsuji, Satoru; Inoue, Katsumi; Ochiai, Masahiko; Tsuchikane, Etsuo; Ikeno, Fumiaki



Dissection and re-entry techniques and longer-term outcomes following successful percutaneous coronary intervention of chronic total occlusion.  


New techniques involving dissection of the subintimal space and re-entry into the true lumen increase success rates in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). However, their long-term safety and efficacy were unknown. This study included a series of consecutive patients who underwent CTO PCI. All patients who did not present events were contacted 12 to 18 months after their PCI. The combined incidence of cardiac death, myocardial infarction, ischemia-driven target-vessel revascularization (TVR), or reocclusion was assessed as our primary outcome. From January 2010 to January 2013, of 212 CTOs treated in our CTO program, 192 (91%) were successfully opened (in 179 patients). Follow-up data were available for 187 CTOs (97.4%), with 82 (44%) that were opened with dissection re-entry and 105 (56%) with conventional wire escalation techniques. At a median follow-up of 398 days, the primary outcome occurred in 18 of 179 CTOs treated (10.7%), driven by TVR. No patient died from cardiac causes. Eleven CTOs (15.2%) treated with dissection re-entry versus 7 CTOs (7.3%) treated with wire escalation presented with the primary outcome (p = 0.17). With multivariate adjustment, dissection re-entry techniques had no significant impact on outcomes. However, treatment of an in-stent occlusion was independently associated with TVR (hazards ratio >6.0, p <0.001). In conclusion, dissection re-entry techniques have minimal impact on long-term outcomes after CTO PCI, which are favorable in most patients. However, treatment of an in-stent occlusion and use of sirolimus-eluting stent were predictors of subsequent adverse outcomes. PMID:25242364

Rinfret, Stéphane; Ribeiro, Henrique Barbosa; Nguyen, Can Manh; Nombela-Franco, Luis; Ureña, Marina; Rodés-Cabau, Josep



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

PubMed Central

Objectives To demonstrate the feasibility of magnetic resonance imaging (MRI) to x-ray fluoroscopy (XRF) image fusion to guide peripheral artery chronic total occlusion (CTO) recanalization. Background Endovascular peripheral artery CTO revascularization is minimally invasive, but challenging, because the occlusion is poorly visualized under XRF. Devices may steer out of the artery which can lead to severe perforation. Merging pre-acquired MRI of the CTO to the live XRF display may permit upfront use of aggressive devices and improve procedural outcomes. Methods Swine carotid artery CTO’s were created using a balloon injury model. Up to 8 weeks later, MRI of the carotid arteries was acquired and segmented to create 3D surface models, which were then registered onto live XRF. CTO recanalization was performed using incrementally aggressive CTO devices (Group A) or an upfront aggressive directed laser approach (Group B). Procedural success was defined as luminal or sub-intimal device position without severe perforation. Results In this swine model, MRI to XRF fusion guidance resulted in a procedural success of 57% in Group A and 100% in Group B, which compared favorably to 33% using XRF alone. Fluoroscopy time was significantly less for Group B (8.5 min ± 2.6 min) compared to Group A (48.7 min ± 23.9 min), p value<0.01. Contrast dose used was similar between Groups A and B. Conclusions MRI to XRF fusion guided peripheral artery CTO recanalization is feasible. Multi-modality image fusion may permit upfront use of aggressive CTO devices with improved procedural outcomes compared to XRF guided procedures. PMID:23097307

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



Subintimal Angioplasty of Long Chronic Total Femoropopliteal Occlusions: Long-Term Outcomes, Predictors of Angiographic Restenosis, and Role of Stenting  

SciTech Connect

Purpose: The purpose of this article is to report the results of a prospective single-center study analyzing the long-term clinical and angiographic outcomes of subintimal angioplasty (SIA) for the treatment of chronic total occlusions (CTOs) of the femoropopliteal artery. Materials and Methods: Patients with severe intermittent claudication or critical limb ischemia (CLI) were enrolled in the study. All lesions were treated with SIA and provisional stenting. Primary end points were technical success, patient survival, limb salvage, lesion primary patency, angiographic binary restenosis (>50%), and target lesion revascularization (TLR). Regular clinical and angiographic follow-up was set at 6 and 12 months and yearly thereafter. Study end points were calculated with life-table survival analysis. Proportional-hazards regression analysis with a Cox-model was applied to adjust for confounding factors of heterogeneity. Results: Between May 2004 and July 2009, 98 patients (105 limbs, patient age 69.3 {+-} 9.9 years) were included in the study. Technical success rate was 91.4% with a lesion length of 121 {+-} 77 mm. Limb-salvage and survival rates were 88.7% and 84.1% at 3 years, respectively. After 12, 24, and 36 months, primary patency was 80.1%, 42.3%, and 29.0%, angiographic binary restenosis was 37.2%, 68.6%, and 80.0%, and TLR was 84.8%, 73.0%, and 64.5%, respectively. CLI was the only adverse predictor for decreased primary patency (hazard ratio [HR] 0.36; 95% confidence interval [CI] 0.16-0.80, p = 0.012), whereas significantly less restenosis was detected after spot stenting of the entry and/or re-entry site (HR 0.31; 95% CI 0.10-0.89, p = 0.01 and HR 0.20; 95% CI 0.07-0.56, p = 0.002, respectively). Conclusions: Subintimal angioplasty is a safe and effective revascularization technique for the treatment of CTOs of the femoropopliteal artery. Provisional stenting may have a role at the subintimal entry or true lumen re-entry site.

Siablis, Dimitris, E-mail:; Diamantopoulos, Athanasios; Katsanos, Konstantinos; Spiliopoulos, Stavros [Patras University Hospital, Department of Radiology, Angiography Suite (Greece); Kagadis, George C. [Patras School of Medicine, Department of Medical Physics (Greece); Papadoulas, Spyros [Patras University Hospital, Department of Vascular Surgery (Greece); Karnabatidis, Dimitris [Patras University Hospital, Department of Radiology, Angiography Suite (Greece)



Association of increased serum glycated albumin levels with low coronary collateralization in type 2 diabetic patients with stable angina and chronic total occlusion  

PubMed Central

Background We investigated whether serum glycated albumin (GA) levels are related to coronary collateralization in type 2 diabetic patients with chronic total occlusion. Methods Blood levels of GA and glycosylated hemoglobin (HbA1c) were determined in 317 diabetic and 117 non-diabetic patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as low (Rentrop score of 0 or 1) or high collateralization (Rentrop score of 2 or 3). Results For diabetic patients, GA (21.2?±?6.5% vs. 18.7?±?5.6%, P??65 years, smoke, non-hypertension, duration of diabetes?>?10 years, metabolic syndrome, eGFR??18.3% were independently determinants for low collateralization in diabetic patients. Conclusions Increased GA levels in serum are associated with impaired collateral growth in type 2 diabetic patients with stable angina and chronic total occlusion. PMID:24209601



The innovation of composite core dual coil coronary guide-wire technology: A didactic coronary chronic total occlusion revascularization case report  

PubMed Central

The treatment of coronary chronic total occlusions (CTO) continues to solicit technical innovations. As success primarily depends on crossing the lesion with a wire, all aspects regarding tip shape retention, torque precision, and penetration ability of the guide-wire have greatly influenced new techniques and strategies. The world of interventional cardiology has to look carefully at these developments, and to use them accordingly to improve the success rate in ordinary percutaneous coronary interventions. We present a didactical case report of a CTO revascularization treated with a new ‘dual core’ technology guide-wire. PMID:25278725

Tomasello, Salvatore Davide; Giudice, Pietro; Attisano, Tiziana; Boukhris, Marouane; Galassi, Alfredo R.



The role for adjunctive image in pre-procedural assessment and peri-procedural management in chronic total occlusion recanalisation.  


Non invasive coronary angiography with multislice computed tomography has exquisite sensitivity to detect calcium and even the faintest late contrast filling of the distal vessel. Calcium burden and occlusion length are still valuable markers of duration, complexity and success of the recanalisation procedure. The ability to visualise the vessel also in the occluded segment, especially if calcified, can also help the operator to understand where to pierce the proximal cap in stumpless occlusions and to predict unusual courses, especially in very tortuous arteries. Imaging side by side CT images and angiography during the recanalisation procedure is an established practice in many active CTO laboratories and algorithms for co-registration are designed to overcome the challenges of systo-diastolic and respiratory motion. Intravascular ultrasound is used in almost all cases by the experienced Japanese CTO operators but most of the times its main use is a better identification of the diseased segment after predilatation to ensure complete stent cover and appropriate stent expansion, an application similar to other complex non occlusive lesions. The specificity of IVUS during CTO recanalisation is the identification of the vessel path in stumpless occlusions and the guidance of wire reentry especially during reverse Controlled Retrograde Anterograde Tracking. Optical coherence tomography has limitations in the setting of CTO recanalisation because of the need of forceful contrast flushing to clear blood, contraindicated in the presence of anterograde dissections, and the limited penetration. The variability in the use of both non-invasive and invasive imaging during CTO recanalisation is immense, going from more than 90% in Japan to less than 20% in Europe and intermediate penetration in the USA. Probably the explanation is almost only in availability and cost because all countries see a progressive increase of use suggesting that these methods are becoming an established tool for guidance of CTO recanalisation. PMID:24694101

Estevez-Loureiro, Rodrigo; Ghione, Matteo; Kilickesmez, Kadriye; Agudo, Pilar; Lindsay, Alistair; Di Mario, Carlo



Two-staged stent-assisted angioplasty treatment strategy for severe left main coronary distal bifurcation stenosis associated with the right coronary chronic total occlusion  

PubMed Central

A 63-year-old female patient, with history of 8-year hypertension and 10-year hyperlipidemia, presented with severe left main coronary bifurcation stenosis (LMCS) associated with the right coronary artery chronic total occlusion (CTO-RCA). On the day of admission, she received drug treatment with aspirin, clopidogrel, heparin, statins, angiotensin converting enzyme inhibitors and ?-blocker. On the next day, she underwent CTO recanalization with 6F guiding-catheter and two rapamycin-eluting stents, and showed no postoperative discomfort after interventional treatment. Considering having hypertensive nephropathy and chronic renal insufficiency, the patient then received intravenous saline full hydration therapy. Two weeks after successful completion of the RCA revascularization, the original collateral circulation in the blood flow from the LMC to RCA became two-way flow. Under the safe and reliable protective condition, staged percutaneous coronary intervention (PCI) with 6F XB3.0 guiding catheter and rapamycin-eluting stents was applied to treat the LMCL. 9-month postoperative follow-up with coronary computed tomographic imaging showed no restenosis inside the original stent, without any myocardial ischemic event. Our successful approach to turn the original unprotected LMCS combined with CTO-RCA into a protective one reduces the interventional risk and provides additional option besides coronary artery bypass graft surgery to treat such complex coronary artery disease (CAD). PMID:25550977

Yang, Yong-Yao; Wu, Qiang



Worsening late-acquired incomplete stent apposition after sirolimus-eluting stent implantation for a chronic total occlusion lesion.  


A 70-year-old man underwent percutaneous coronary intervention (PCI) using sirolimus-eluting stent (SES) at the just proximal site of left anterior descending coronary artery. Six months after SES implantation, he suffered from late stent thrombosis. Intravascular ultrasound (IVUS) images demonstrated positive remodeling of the vessel, indicating late-acquired incomplete stent apposition (ISA). An angioplasty with a bigger balloon was performed to obtain sufficient stent struts apposition. Twenty-six months after the second PCI, he developed ST-elevation myocardial infarction and his CAG showed re-occlusion of the SES. Optical coherence tomography showed ISA and IVUS revealed further enlargement of the coronary artery around the SES. PMID:24595874

Nakazato, Kazuhiko; Misaka, Tomofumi; Sakamoto, Nobuo; Kunii, Hiroyuki; Saitoh, Shu-Ichi; Takeishi, Yasuchika



The age, creatinine, and ejection fraction score to risk stratify patients who underwent percutaneous coronary intervention of coronary chronic total occlusion.  


Age, creatinine, and ejection fraction (ACEF) score predict clinical outcomes in patients who underwent elective percutaneous coronary intervention (PCI) of nonocclusive coronary stenoses. We aimed at assessing the prognostic value of the ACEF score in patients who underwent successful PCI of chronic total occlusion (CTO). ACEF score was calculated in 587 patients treated with PCI of CTO: successful in 433 (74%; success group) and failed in 154 patients (26%; failure group). Patients were divided in ACEF tertiles: first <0.950, second from 0.950 to 1.207, and third ACEF tertile >1.207. Major adverse cardiac events (MACE = overall death + nonfatal myocardial infarction + clinically driven target vessel revascularization) were assessed in 558 patients (95%) up to 24 months (8 to 24 months). In success group, higher MACE rate was significantly associated with increasing ACEF tertile (first = 7%, second = 13%, third ACEF = 18%, p = 0.02). MACE-free survival was significantly decreased with increasing ACEF tertile (log-rank 5.58, p = 0.018). In the failure group, lower MACE rate was significantly associated with increasing ACEF tertile (p = 0.041). This was mainly driven by significant decreasing rate of target vessel revascularization along the tertiles (first = 34%, second = 19%, third ACEF = 10%, p = 0.007). Compared with success group, in failure group, MACE rate was significantly higher in the first tertile (p <0.001) and similar in the third tertile (p = 0.59). In conclusion, ACEF score represents a simple tool in the prognostication of patients successfully treated with PCI of CTO and identifies those patients who would not derive any significant clinical harm despite failed percutaneous revascularization of the CTO. PMID:25152423

Di Serafino, Luigi; Borgia, Francesco; Maeremans, Joren; Pyxaras, Stylianos A; De Bruyne, Bernard; Wijns, William; Heyndrickx, Guy; Dens, Jo; Di Mario, Carlo; Barbato, Emanuele



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)



Thrombolysis and angioplasty of chronic iliac artery occlusions.  


The role of percutaneous angioplasty in the management of chronic iliac artery occlusions is controversial. This article reviews 7 years of experience in treating patients with complete chronic iliac artery occlusions (n = 99) by using thrombolysis and angioplasty. Patients were not excluded due to age or length of the lesion, or severity of underlying peripheral vascular disease. Thrombolysis was conducted with infusion of urokinase at a rate of 60,000-80,000 IU/h for 24 hours. Angioplasty was then performed irrespective of the results of thrombolysis. Seventy-nine percent of patients responded to urokinase, with complete lysis achieved in 55%. Angioplasty was successful in all patients with complete thrombolysis and in 88% of those with partial thrombolysis. The overall success rate was 86%, and more than 80% of surviving patients were symptom free at 5 years. There were seven complications, and the 30-day mortality rate was 2%. Our present results confirm the efficacy of thrombolysis/angioplasty for chronic arterial occlusions. PMID:8770845

Motarjeme, A; Gordon, G I; Bodenhagen, K



New approaches to total occlusions: the guiding light  

NASA Astrophysics Data System (ADS)

There have been many innovations and technological advancements in balloon angioplasty since its introduction in the late 1970"s, but percutaneous intervention on a totally occluded artery is still a challenge to the vascular interventionalist. Catheter-based intervention that avoids an invasive surgical procedure is a clear and desired advantage for the patient. A total occlusion challenges the interventionalist because the path of the artery can not be seen in the occluded vessel since the flow of the radiopaque contrast media is blocked. Optical coherence reflectometry techniques have been shown to be able to differentiate between artery wall and occlusive materials allowing the lumen of the blocked artery to be seen inside the occlusion. During this past year, a guide wire that uses OCR for forward-looking guidance has received FDA 510(k) clearance and future generation devices that add radio frequency ablation capabilities are in clinical trials. Clinical results show that these new tools are addressing this subset of patients with percutaneous interventions with safety and effectiveness.

Neet, John M.; Wong, P. H.; Bonnier, J. J. R. M.



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

Microsoft Academic Search

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

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



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)



Furosemide does not facilitate pulmonary vasodilation in broilers during chronic or acute unilateral pulmonary arterial occlusion.  


Furosemide (FURO) is a diuretic and a putative pulmonary vasodilator that, when added to broiler diets, previously has been shown to reduce the cumulative pulmonary hypertension syndrome (PHS) mortality induced by cold temperatures. The objective of the present study was to evaluate the influence of dietary FURO on the pulmonary vasculature in broilers undergoing chronic or acute unilateral pulmonary arterial occlusion. Broilers were fed a standard ration throughout the entire experiment (Control group) or the same ration supplemented with 0.015% (wt/wt) FURO from Day 14 to 42 (FURO group). In the present study chicks were chosen at random at 16 to 18 d of age to undergo sham surgery or a chronic unilateral pulmonary artery clamp (PAC) procedure. Diet and surgical treatments resulted in Control-Sham, FURO-Sham, Control-PAC, and FURO-PAC groups. The Control-PAC and FURO-PAC groups did not differ in body weight or right:total ventricular weight ratios (RV:TV). The postsurgical mortality, ascites mortality, and mortality due to other causes did not differ between the Control-PAC and FURO-PAC groups. Plasma Na+ (P < or = 0.05) was lower in the FURO-Sham group than in the Control-Sham group. Broilers from the same hatch were fed Control or FURO diets and surgically prepared for acute unilateral pulmonary arterial occlusion by using a snare. Tightening of the snare triggered characteristic increases in pulmonary blood flow, pulmonary arterial pressure, and pulmonary vascular resistance. Across all of these variables, the Control and FURO groups did not differ during any sample interval. Dietary FURO did not affect body weight, hematocrit, or RV:TV. Dietary FURO at 0.015% (wt/wt) does not appear to influence the pulmonary vasculature in broilers, but it may prolong the survival of broilers during the pathophysiological progression of PHS. PMID:11469658

Forman, M F; Wideman, R F



A new understanding of chronic total occlusion from a novel PCI technique that involves a retrograde approach to the right coronary artery via a septal branch and passing of the guidewire to a guiding catheter on the other side of the lesion.  


Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) by the antegrade approach is sometimes difficult, especially in the right coronary artery (RCA). We performed successful PCls following a retrograde approach via a septal branch in 2 patients with CTO in RCA. The method involves leading the retrograde guidewire outside the body through an opposite guiding catheter after the wire crosses the target lesion. A balloon or stent could then be delivered retrogradely or antegradely. Even a soft retrograde wire always crosses the lesion through the true lumen, as confirmed by IVUS. Selecting a suitable collateral, a straighter rather than a larger one, is crucial. Our results do not support the current concept regarding CTOs. Probably, the distal fibrous cap is soft and the proximal one has a thin point that soft wires, even blunt ones, can penetrate easily. The distal penetration point appears to connect to the proximal uncalcified thin point. Many channels seem to spread out from the proximal side, tree-like, within the lesion. In the retrograde approach, the wire is unlikely to enter these branch channels. The results suggest that PCI by the retrograde approach may be effective for treating CTOs of RCA. PMID:17086535

Ozawa, Noriyuki



Stent Recanalization of Chronic Portal Vein Occlusion in a Child  

SciTech Connect

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

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



Tracking in Presence of Total Occlusion and Size Variation using Mean Shift and Kalman Filter  

E-print Network

Tracking in Presence of Total Occlusion and Size Variation using Mean Shift and Kalman Filter Oscar using mean shift and the Kalman filter, which was added to the traditional algorithm as a predictor when mean shift Kalman filter algorithm improves the tracking performance of the classical algorithms

Paris-Sud XI, Université de


Surgical femorocaval bypass for treating chronic iliac vein occlusion: a case report  

PubMed Central

Chronic inferior vena cava and iliac vein occlusion, caused by long-term of deep venous thrombosis, will lead to swelling of the limbs, venous claudication and intractable ulcer. However, conservative treatment is often ineffective for vein occlusion. With the development of interventional techniques, endovascular therapy has become the first choice for the treatment of vein occlusion with higher success rate and lower trauma. However, for cases those fail endovascular therapy or for segmental veno-occlusive diseases with low long-term patency rate, venous bypass might be the only option. And, design of anastomotic stoma and orificium fistulae design is crucial to the success of operation. A case of long term deep venous thrombosis patient with occlusion in bilateral iliac vein and distal inferior vena cava was admitted and treated with interventional therapy. Unfortunately, this method failed. Then, we selected reasonable anastomotic stoma and orificium fistulae and performed femorocaval bypass. The 12 month follow-up results showed that the swelling was successively relieved and the ulcer healed. This indicated that rational anastomotic stoma and orificium fistulae could guarantee the exact clinical efficacy of venous bypass and higher long-term patency rate. PMID:25419436

Hao, Qingzhi; Ma, Ruiping; Kang, Yanmeng; Chen, Bainan; Wang, Bin; Zheng, Yuehong



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

PubMed Central

Clefts are common birth defects. They are accompanied by various malformations, including disturbances in facial look as well as skeletal disorders that include malocclusions, most frequently crossbites and class III anomalies. The aim of the study was to present the commonest malocclusions in patients with total cleft of the lip, alveolar bone and palate (n = 154) and compare the results to the healthy on-cleft patients (n = 151). Normal occlusion, characteristic for I angle class, was observed in 50% of the control group and 30% of the examined. In the examined patients with clefts, most frequently crossbite and open bite on the cleft side was observed. In patients with clefts, only 2 out of 154 patients presented isolated dental anomalies. In healthy individuals the commonest occlusal disorder was distal occlusion and dental anomalies. The commonest malocclusions among patients with clefts are crossbites and class III malocclusions. PMID:24982898

Paradowska-Stolarz, Anna



Transhepatic Guidance of Translumbar Hemodialysis Catheter Placement in the Setting of Chronic Infrarenal IVC Occlusion  

SciTech Connect

When patients with end-stage renal disease have exhausted both conventional and unconventional venous access options, creative solutions must be sought for hemodialysis catheter placement in order to ensure survival. This case describes a patient in urgent need of a dialysis catheter despite total occlusion of the jugular, subclavian, and femoral veins. Occlusion of the inferior vena cava (IVC) and right renal vein resulted in failed attempts at translumbar catheter placement. A gooseneck snare was temporarily advanced through the liver to the IVC for use as a fluoroscopic target to facilitate successful single-puncture, translumbar catheterization.

Lorenz, Jonathan M., E-mail:; Regalado, Sidney; Navuluri, Rakesh, E-mail:; Zangan, Steven; Thuong Van Ha; Funaki, Brian [University of Chicago Hospitals, Department of Radiology, Section of Interventional Radiology (United States)



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

SciTech Connect

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

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



Detection of total occlusion, string sign, and preocclusive stenosis of the internal carotid artery by color-flow duplex scanning  

Microsoft Academic Search

Background: Stroke prevention depends on the accurate differentiation of surgically treatable preocclusive lesions from total occlusions of the internal carotid artery. This prospective study was undertaken to review the accuracy of color-flow duplex scanning for identifying carotid string signs, focal preocclusive lesions (95% to 99% stenoses), and total occlusion of the internal carotid artery.Materials and methods: Over an 18-month period,

M. Ashraf Mansour; Mark A. Mattos; Douglas B. Hood; Kim J. Hodgson; Lynne D. Barkmeier; Don E. Ramsey; David S. Sumner



Chronic unilateral occlusion of an extrapulmonary primary bronchus induces pulmonary hypertension syndrome (ascites) in male and female broilers.  


Previously, it was demonstrated that acute (4 min) and chronic (12 d) occlusion of an extrapulmonary primary bronchus triggers pulmonary hypertension but not pulmonary hypertension syndrome (PHS, ascites) in broilers. The present study was conducted to determine whether a more prolonged period of bronchus occlusion causes PHS similar to that induced by clamping one pulmonary artery. Male and female broiler chicks, 14 to 18 d old, were anesthetized, the thoracic inlet was opened, and a silver clip was positioned to fully obstruct the left extrapulmonary primary bronchus (BRONCHUS CLAMP group) or the left pulmonary artery (PA-CLAMP group). Sham-operated chicks were anesthetized and the thoracic inlet was opened; however, neither the pulmonary artery nor the bronchus was clamped (SHAM group). An electrocardiogram (ECG) was obtained whenever clinical ascites became apparent in individual broilers, or prior to the final necropsy for broilers surviving to the end (Day 36) of the experiment. The right:total ventricular weight ratio (RV:TV) was evaluated as an index of pulmonary arterial pressure. Early post-surgical mortality (up to 21 d of age) was higher in the PA-CLAMP group (27% for males and females combined) than in the BRONCHUS CLAMP (10%) and SHAM (2%) groups. Cumulative ascites mortality (Days 22 to 36) also was higher in the PA-CLAMP group (86% for males, 77% for females) than in the BRONCHUS CLAMP (69% for males, 41% for females) and SHAM (23% for males, 0% for females) groups. Ascitic birds in all treatment groups had higher RV:TV ratios and more negative ECG Lead II S-wave amplitudes than nonascitic birds, reflecting the right ventricular hypertrophy and generalized ventricular dilation typically associated with PHS. These results demonstrate that unilateral bronchus occlusion is an effective experimental model for triggering ascites at a lower incidence than that obtained by occluding one pulmonary artery. Following the onset of pulmonary hypertension, the pathophysiological progression leading to ascites appears to be similar for broilers with either unilateral bronchus or pulmonary artery occlusion. PMID:9057225

Wideman, R F; Kirby, Y K; Owen, R L; French, H



[Options and Limitations in Endovascular Therapy for Acute and Chronic Mesenteric Arterial Occlusions.  


Background: The significance of endovascular therapy for mesenteric ischaemia (MI) is being debated. Despite initially lower mortality and morbidity, inconsistent early and late results led to questions concerning indications and technical applications of the procedure. Methods: 91 patients with MI underwent endovascular treatment in a period of 11 years. In 78 (85.7?%) patients a stent was deployed and in 13 (14.3?%) an angioplasty was performed, principally of the superior mesenteric artery (n?=?81/91, 89?%). Follow-up consisted of a clinical and an ultrasound examination in all cases. Mean follow-up was 4.2 years. Our results were compared to those in the literature. Results: Endovascular treatment of the intestinal arteries accounted for 0.6?% of all vascular procedures. Seven of 91 patients (7.7?%) died after an initial PTA/stenting. The overall peri-interventional morbidity was 6.6?% (n?=?6/91). Medium- to long-term complications were encountered in 20 patients (22?%), primarily during the first year (85?%). Six of 91 patients developed an in-stent stenosis (6.6?%) and 14/91 patients (15.4?%) stent occlusion. Additionally 2 dislocated stents (2.2?%) and an arterial perforation with bleeding into the mesentery (1.1?%) were seen. Although 3 of these 20 patients were successfully treated with an additional PTA or stenting (15.0?%; n?=?3/91, 3.3?%), surgical conversion was necessary in 9 (n?=?9/20, 45?%; n?=?9/91, 9.9?%). The postoperative mortality was respectively 22.2?% (n?=?2/9; n?=?2/91, 2.2?%). In the case of acute MI, endovascular procedures are only indicated for patients without peritonitis. In chronic MI, the indication for endovascular treatment depends on the type of occlusion and the vascular anatomy. Despite favourable early results, the outcome of endovascular treatment deteriorates with time reaching a 1-year patency rate of 63?% in a multicentre analysis. This leads to secondary procedures in 30?%. A surgical conversion carries a high mortality. Conclusion: The endovascular treatment of intestinal artery disease cannot be considered the treatment of choice, it is rather an alternative method in patients with functional or local contraindications to surgery. Life-long follow-up is necessary to prevent stent complications with fatal consequences. A prospective randomised study concerning the evaluation of the advantages and disadvantages of surgical and endovascular therapy of intestinal artery occlusive disease is required. PMID:25401371

Luther, B; Meyer, F; Mamopoulos, A; Zapenko, A; Doerbecker, R; Wullstein, C; Kroeger, K; Katoh, M



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


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

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



Direct photocoagulation to leakage points to treat chronic macular edema associated with branch retinal vein occlusion: a pilot study  

PubMed Central

Summary statement Direct photocoagulation reduces the central foveal thickness (CFT) in cases with chronic branch retinal vein occlusion (BRVO) of longer than 12 months duration. Photo-coagulation might be effective for chronic macular edema due to branch retinal vein occlusion. Background The aim was to investigate the effect of direct photocoagulation for treating chronic macular edema associated with BRVO. Methods This study was a noncomparative, pilot interventional case series. We examined the CFT and best-corrected visual acuity over 6 months in patients with BRVO treated with direct photocoagulation. Results Sixteen eyes of 16 patients had been treated with direct photocoagulation (mean follow-up period, 20.5 months). The mean CFT decreased significantly (P<0.001) between the baseline (465 ?m) and the final visit (304 ?m). The mean (logarithm of the minimum angle of resolution equivalent) best-corrected visual acuity at the baseline was 0.39 and improved significantly (P<0.001) to 0.20 at the final visit. Conclusion Direct photocoagulation to leakage points is beneficial for treating chronic macular edema associated with chronic BRVO of longer than 12 months duration. PMID:25336905

Sakimoto, Susumu; Kamei, Motohiro; Sakaguchi, Hirokazu; Suzuki, Mihoko; Matsumura, Nagakazu; Nishida, Kentaro; Nishida, Kohji



Broiler Breeder Survivors of Chronic Unilateral Pulmonary Artery Occlusion Produce Progeny Resistant to Pulmonary Hypertension Syndrome (Ascites) Induced by Cool Temperatures  

Microsoft Academic Search

Chronic occlusion of one pulmonary artery triggers a high incidence of pulmonary hyperten- sion syndrome (PHS, ascites) in broilers. In the present study, the left pulmonary artery was chronically oc- cluded in 295 male and 255 female chicks pedigreed from 18 sire families, leading to PHS in 74% of the males and 45% of the females. Survivors were reared to



Chronic intestinal ischaemia: measurement of the total splanchnic blood flow.  


A redundant collateral network between the intestinal arteries is present at all times. In case of ischaemia in the gastrointestinal tract, the collateral blood supply can develop further, thus accommodating the demand for oxygen even in the presence of significant stenosis or occlusion of the intestinal arteries without clinical symptoms of intestinal ischaemia. Symptoms of ischemia develop when the genuine and collateral blood supply no longer can accommodate the need for oxygen. Atherosclerosis is the most common cause of obliteration in the intestinal arteries. In chronic intestinal ischaemia (CII), the fasting splanchnic blood flow (SBF) is sufficient, but the postprandial increase in SBF is inadequate and abdominal pain will therefore develop in relation to food intake causing the patient to eat smaller meals at larger intervals with a resulting weight loss. Traditionally, the CII-diagnosis has exclusively been based upon morphology (angiography) of the intestinal arteries; however, substantial discrepancies between CII-symptoms and the presence of atherosclerosis/stenosis in the intestinal arteries have been described repeatedly in the literature impeding the diagnosis of CII. This PhD thesis explores a method to determine the total SBF and its potential use as a diagnostic tool in patients suspected to suffer from CII. The SBF can be measured using a continuous infusion of a tracer and catheterisation of a hepatic vein and an artery. By measuring the SBF before and after a standard meal it is possible to assess the ability or inability to enhance the SBF and thereby diagnosing CII. In Study I, measurement of SBF was tested against angiography in a group of patients suspected to suffer from CII due to pain and weight loss. A very good agreement between the postprandial increase in SBF and angiography was found. The method was validated against a well-established method independent of the hepatic extraction of tracer using pAH in a porcine model (study II). An excellent agreement was found between the two methods for the measurement of SBF. In the same set-up metabolism and recirculation in the intestines of the 99mTechnetium labelled tracer was rejected based on the consistency between the portal and arterial contents of tracer. Based on this study we concluded that an arterial blood sample can be used instead of a portal blood sample, making the method applicable to patients. In study III, 20 healthy volunteers and 29 patients with weight loss and abdominal pain but normal morphology of the intestinal arteries were investigated. A reference value for the meal induced SBF-increase and the relation to bodyweight was established designating that bodyweight should be taken into account when diagnosing CII based on measurement of SBF. The clinical method for measuring the SBF based on hepatic 99mTc-MBF extraction is a robust method. It allows determination of the postprandial increase in SBF providing knowledge about the circulatory physiology in intestines in patients with weight loss and abdominal pain with or without intestinal arterial stenosis. Future studies within this field could include measurement of the SBF before and after revascularisation in order to quantify the effect of revascularisation or investigate whether arterial blood sampling could be avoided or the amount of blood samples (and thus the time spend) could be reduced. The three studies were presented at eleven national and international congresses and Helle Damgaard Zacho has been awarded three prizes for the presentations. PMID:23651725

Zacho, Helle D



Electromyographic and patient-reported outcomes of a computer-guided occlusal adjustment performed on patients suffering from chronic myofascial pain.  


Objectives: Muscular hyperactivity is a potential source of symptoms in patients with temporal-mandibular disorders. An adequate occlusal adjustment may relieve such symptoms. This study aims to measure the effect of shortening the protrusive disclusion time (DT) and balancing the center of occlusal forces (COF) on the EMG recordings and assess the pain reported by chronic patients one month after the computer-guided occlusal adjustment. Study Design: The sample studied comprised 34 patients suffering from chronic facial pain in which the EMG activity of both masseters was recorded by electromyography. By selective grinding we alleviated all the occlusal interferences during the mandibular protrusion from the habitual closure position in order to establish an immediate posterior disclusion and an equilibration of the COF. Results: At follow-up 76.5% of the patients reported no facial pain. Moreover, the EMG activity and protrusive DT were significantly reduced, and occlusal and muscular function were significantly more symmetric than at baseline. Conclusions: According to this EMG study, this computer-guided occlusal adjustment is able to reduce the activity of the masseters and the self-reported muscular pain of patients one-month after treatment. PMID:25475783

Dib, A; Montero, J; Sanchez, J-M; López-Valverde, A



Myosin phosphatase isoforms and related transcripts in the pig coronary circulation and effects of exercise and chronic occlusion.  


Myosin phosphatase (MP) is a key target of signaling pathways that regulate smooth muscle tone and blood flow. Alternative splicing of MP targeting subunit (MYPT1) exon 24 (E24) generates isoforms with variable presence of a C-terminal leucine zipper (LZ) required for activation of MP by NO/cGMP. Here we examined the expression of MP and associated genes in a disease model in the coronary circulation. Female Yucatan miniature swine remained sedentary or were exercise-trained beginning eight weeks after placement of an ameroid constrictor around the left circumflex (LCX) artery. Fourteen weeks later epicardial arteries (~1mm) and resistance arterioles (~125?m) were harvested and assayed for gene expression. MYPT1 isoforms were distinct in the epicardial arteries (E24-/LZ+) and resistance arterioles (E24+/LZ-) and unchanged by exercise training or coronary occlusion. MYPT1, CPI-17 and PDE5 mRNA levels were not different between arteries and arterioles while Kir2.1 and eNOS were 6.6-fold and 3.9-fold higher in the arterioles. There were no significant changes in transcript abundance in epicardial arteries of the collateralized (LCX) vs. non-occluded left anterior descending (LAD) territories, or in exercise-trained vs. sedentary pigs. There was a significant 1.2 fold increase in CPI-17 in collateral-dependent arterioles, independent of exercise, and a significant 1.7 fold increase in PDE5 in arterioles from exercise-trained pigs, independent of occlusion. We conclude that differences in MYPT1 E24 (LZ) isoforms, eNOS, and Kir2.1 distinguish epicardial arteries and resistance coronary arterioles. Up-regulation of coronary arteriolar PDE5 by exercise and CPI-17 by chronic occlusion could contribute to altered vasomotor responses and requires further study. PMID:24534069

Zheng, Xiaoxu; Heaps, Cristine L; Fisher, Steven A



PON1 status evaluation in patients with chronic arterial occlusion of lower limbs due to atherosclerosis obliterans  

PubMed Central

Introduction Human paraoxonase (PON1) is a calcium-dependent enzyme physically associated with HDL, and it is believed to contribute to the atheroprotective effect of HDL. The aim of the study was to evaluate PON1 status in patients with atherosclerosis obliterans as an effect of ischemia regarding its activity and phenotype distribution. Material and methods The study group consisted of patients with chronic arterial occlusion of the lower limbs due to atherosclerosis obliterans (AO). The patients were divided into two groups according to the degree of ischemia: moderate (MI), and critical (CI). The ratio of the hydrolysis of salt-stimulated PON1 activity to the hydrolysis of phenylacetate was used to assign individuals to one of three possible phenotypes (low activity – A, medium activity – AB, high activity – B). It was observed that PON1 arylesterase activity was affected by ischemia of the lower limbs depending on its degree. Results The odds ratio and the relative risk analysis showed that the patients with moderate ischemia are much more often characterized by phenotype A than by phenotype B. The low activity phenotype A occurs over twice as often in patients with chronic ischemia of the lower limbs as in individuals from the control group (OR = 2.125; 1.96 to 3.776, p = 0.0143). Conclusions This study presents the low activity phenotype A in relation to the risk of ischemia of the lower limbs due to atherosclerosis and shows the potentially important role of PON1 in conclusion of the process leading to intensification of ischemia degree.

Iskra, Maria; Majewski, Wac?aw; Budzy?-Napiera?a, Magdalena; Gryszczy?ska, Bogna; Strzy?ewski, Krzysztof; Kasprzak, Jakub



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

PubMed Central

1 Effect of 0.25 mg brotizolam on patients with chronic obstructive lung disease of moderate to severe degree was studied. 2 There was no difference between the slopes of ventilation vs alveolar CO2 for brotizolam and placebo as compared with base line values. Mouth-occlusion pressures did not change under the influence of drug or placebo. 3 Brotizolam (0.25 mg) is without adverse side-effects on respiratory centre output or on mechanics of ventilation. PMID:6661387

Sybrecht, G. W.



The Use of Below-Knee Percutaneous Transluminal Angioplasty in Arterial Occlusive Disease Causing Chronic Critical Limb Ischemia  

SciTech Connect

Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n= 39) or in combination with PTA of the superficial and/or popliteal artery (n= 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs.Results: A technically successful PTA with at least one crural level was achieved in 88% of cases (n= 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. Conclusion: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions.

Loefberg, Ann-Marie; Loerelius, Lars-Erik [Department of Diagnostic Radiology, University Hospital, S-75185 Uppsala (Sweden); Karacagil, Sadettin; Westman, Bo; Almgren, Bo; Berqgvist, David [Department of Surgery, University Hospital, S-75185 Uppsala (Sweden)



Broiler breeder survivors of chronic unilateral pulmonary artery occlusion produce progeny resistant to pulmonary hypertension syndrome (ascites) induced by cool temperatures.  


Chronic occlusion of one pulmonary artery triggers a high incidence of pulmonary hypertension syndrome (PHS, ascites) in broilers. In the present study, the left pulmonary artery was chronically occluded in 295 male and 255 female chicks pedigreed from 18 sire families, leading to PHS in 74% of the males and 45% of the females. Survivors were reared to breeding age and served as parents for the resulting PHS-resistant chicks (Resistant), whereas control chicks were produced from the base population for this line (Base). In two experiments, male and female Resistant and Base chicks were reared separately by sex but mixed by group within environmental chambers, where they were exposed to cool (14 C) temperatures. In both experiments, the incidence of PHS was at least 50% lower in the Resistant males and females than in the Base males and females, respectively. When compared within a sex, the Base and Resistant broilers surviving to the end of both experiments did not differ in final body weight or body weight gain, nor did their right:total ventricular weight (RV:TV) ratios differ. These results demonstrate that broiler breeders capable of thriving after having their entire cardiac output forced to flow through one lung, subsequently produced male and female progeny with substantially improved resistance to the onset of PHS induced by fast growth and exposure to cool environmental temperatures. Fast growth and cool temperatures are primary triggers for PHS under most conditions of commercial broiler growout. In both experiments, final necropsies revealed higher RV:TV ratios in ascitic than in nonascitic broilers, whereas normalizing the left ventricle plus septum weight for differences in body weight generated similar values for ascitic and nonascitic males or females, respectively. These results support a primary role for pulmonary hypertension but not cardiomyopathy in the pathogenesis of ascites triggered by cool temperatures in both the Base and Resistant populations. PMID:10090268

Wideman, R F; French, H



Coronary arteriovenous fistula secondary to percutaneous coronary intervention of chronic total occlusion.  


This is a case report of a 61-year-old female presenting with ongoing chest pain in the setting of an NSTEMI with lateral ST-T changes. On attempting to open the left circumflex (LCX), it resulted in a proximal LCX dissection. The patient remained stable with no further chest pain. She was treated with IV Eptifibatide for 48 hours and restudied in 72 hours. Repeat coronary angiography showed a marginally improved proximal dissection plane with a coronary AV fistula. She was managed conservatively and discharged with a non-invasive assessment in 8 weeks. The patient had a negative stress echocardiogram and was managed with maximal medical therapy. PMID:23864982

Narasimhan, Seshasayee



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


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

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



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



473?Evaluating Total Serum IgE Levels in Patients with Chronic Hepatitis B and C  

PubMed Central

Background Liver disease has been considered a prominent cause of IgE elevation. Significant differences may be observed depending on the cause of liver damage. For viral hepatitis, increased IgE concentrations have been observed during acute hepatitis A and B. Chronic hepatitis B carriers may also have high IgE levels. But no data on serum IgE levels in chronic hepatitis C and hepatitis B patients have been reported. The aim of the study was to evaluate serum IgE levels in patients with chronic hepatitis C and hepatitis B and to corelate with atopic patients. Methods Serum IgE levels were determined in 568 adult patients with chronic hepatitis B, in 47 patients with chronic hepatitis C, and 311 patients with atopic diseases. Results The averages of serum IgE levels were 103,9 IU/mL in chronic hepatitis C, 95,1 IU/mL in hepatits B patients, and 126,6 IU/mL in atopic patients. There was no statistically significant difference between hepatits B and hepatits C patients. Total serum IgE levels were lower in patients with either chronic hepatitis C or hepatitis B than the atopic group. Conclusions According to the results presented, chronic hepatitis C and hepatitis B are not prominent causes of increased serum IgE values. Further studies are needed to clarify the differences and significance of IgE levels between hepatitis and atopic patients.

Köse, Sükran; Senger, Süheyla Serin; Yalcin, Arzu Didem; Cavdar, Gülsün; Atalay, Sabri; Ersan, Gürsel



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))



Examining the feasibility of radiofrequency treatment for chronic knee pain after total knee arthroplasty.  


Recently, investigators began using radiofrequency to manage knee osteoarthritis pain in patients at high risk who cannot undergo surgical intervention. To our knowledge, no study has investigated the use of radiofrequency ablation of the genicular nerves to alleviate chronic knee pain after total knee replacement. A single case is presented here in which genicular nerve ablation successfully improved pain and restored function. We believe that these preliminary results could be used in the development of future prospective cohort studies and randomized controlled trials that focus on the use of radiofrequency ablation to treat persistent knee pain after total knee replacement. PMID:24373908

Protzman, Nicole M; Gyi, Jennifer; Malhotra, Amit D; Kooch, Jason E



Total pancreatectomy with islet autologous transplantation: the cure for chronic pancreatitis?  


Chronic pancreatitis (CP) is a debilitating disease that leads to varying degrees of pancreatic endocrine and exocrine dysfunction. One of the most difficult symptoms of CP is severe abdominal pain, which is often challenging to control with available analgesics and therapies. In the last decade, total pancreatectomy with autologous islet cell transplantation has emerged as a promising treatment for the refractory pain of CP and is currently performed at approximately a dozen centers in the United States. While total pancreatectomy is not a new procedure, the endocrine function-preserving autologous islet cell isolation and re-implantation have made the prospect of total pancreatectomy more acceptable to patients and clinicians. This review will focus on the current status of total pancreatectomy with autologous islet cell transplant including patient selection, technical considerations, and outcomes. As the procedure is performed at an increasing number of centers, this review will highlight opportunities for quality improvement and outcome optimization. PMID:25630865

Kesseli, Samuel J; Smith, Kerrington A; Gardner, Timothy B



Exchangeable and Total Body Potassium in Patients with Chronic Renal Failure  

PubMed Central

Total body potassium determined by whole-body monitoring and exchangeable body potassium estimated with 43K were measured simultaneously in 12 patients with stable chronic renal failure. Values for the exchangeable potassium were obtained after equilibration periods of 24, 48, and 64 hours. The exchangeable body potassium, expressed as a percentage of the total body potassium (mean ± S.E. of mean), gave values of 60·7 ± 3·3%, 83·6 ± 2·7%, and 85·9 ± 2·7% at 24, 48, and 64 hours respectively. It seems that the equilibration between radioactive and native potassium is incomplete after 24 hours; and that exchangeable potassium measured at this time is not an accurate index of the status of total body potassium in such patients. Furthermore, the finding that the value at 64 hours is significantly less than found in healthy subjects suggests that the exchangeable potassium is a smaller fraction of the total body potassium in patients with chronic renal failure. PMID:4621439

Boddy, Keith; King, Priscilla C.; Lindsay, R. M.; Winchester, J.; Kennedy, A. C.



Estimation of Levels of Salivary Mucin, Amylase and Total Protein in Gingivitis and Chronic Periodontitis Patients  

PubMed Central

Background: Periodontal diseases are a group of inflammatory conditions resulting from interaction between a pathogenic bacterial biofilm and susceptible host’s inflammatory response eventually leading to the destruction of periodontal structures and subsequent tooth loss. Hence, investigation of salivary proteins in individuals with periodontal diseases may be useful to enhance the knowledge of their roles in these diseases. Materials and Methods: This case-control study was conducted at A.B. Shetty Memorial Institute of Dental Sciences, Mangalore. The study comprised of 90 patients of age between 25-60 years who were clinically examined and divided into three groups of 30 each: namely clinically healthy, gingivitis and chronic periodontitis. These were classified according to the values of gingival index score, clinical attachment loss and probing pocket depth. Unstimulated saliva was collected and salivary mucin, amylase and total protein levels were determined. Statistical analysis: Results obtained were tabulated and statistically analyzed using ANOVA test and Karl pearson’s correlation test. Results: The results of the study showed an increased concentration of salivary mucin, amylase and total protein in gingivitis patients and increased levels of amylase and total protein in saliva of chronic periodontitis patients compared to healthy individuals which were statistically significant. A decrease in mucin concentration was observed in the periodontitis group compared to gingivitis group. A positive correlation was present between salivary mucin, amylase and total protein levels in the three groups. Conclusion: Salivary mucin, amylase and total protein may serve as an important biochemical parameter of inflammation of the periodontium. Also, it can be hypothesized that various enzyme inhibitors might be useful as a part of host modulation therapy in the treatment of periodontal diseases. PMID:25478449

Bhandary, Rahul; Thomas, Biju; Kumari, Suchetha



Endovascular Treatment of Totally Occluded Superior Mesenteric Artery by Retrograde Crossing via the Villemin Arcade  

SciTech Connect

Chronic mesenteric ischemia (CMI) is a rare disorder that is commonly caused by progressive atherosclerotic stenosis or occlusion of one or more mesenteric arteries. Endovascular treatment for symptomatic CMI represents a viable option, especially in high-operative risk patients. We report a case of acute symptomatic CMI with chronic totally occlusion of the superior mesenteric artery (SMA) associated with significant stenosis of celiac trunk (CT) and inferior mesenteric artery (IMA) that underwent endovascular treatment of all the three mesenteric arteries: stenting of CT and IMA stenosis, and recanalization of the SMA occlusion by retrograde crossing via the Villemin arcade.

Ferro, Carlo; Rossi, Umberto G., E-mail:; Seitun, Sara; Bovio, Giulio [IRCCS San Martino University Hospital-IST-National Institute for Cancer Research, Department of Radiology and Interventional Radiology (Italy); Fornaro, Rosario [IRCCS San Martino University Hospital-IST-National Institute for Cancer Research, Department of Surgery (Italy)



Pain catastrophizing as a risk factor for chronic pain after total knee arthroplasty: a systematic review  

PubMed Central

Background Total knee arthroplasty (TKA) is a common and costly surgical procedure. Despite high success rates, many TKA patients develop chronic pain in the months and years following surgery, constituting a public health burden. Pain catastrophizing is a construct that reflects anxious preoccupation with pain, inability to inhibit pain-related fears, amplification of the significance of pain vis-à-vis health implications, and a sense of helplessness regarding pain. Recent research suggests that it may be an important risk factor for untoward TKA outcomes. To clarify this impact, we systematically reviewed the literature to date on pain catastrophizing as a prospective predictor of chronic pain following TKA. Methods We searched MEDLINE, EMBASE, and PsycINFO databases to identify articles related to pain catastrophizing, TKA, risk models, and chronic pain. We reviewed titles and abstracts to identify original research articles that met our specified inclusion criteria. Included articles were then rated for methodological quality. including methodological quality. Due to heterogeneity in follow-up, analyses, and outcomes reported across studies, a quantitative meta-analysis could not be performed. Results We identified six prospective longitudinal studies with small-to-mid-sized samples that met the inclusion criteria. Despite considerable variability in reported pain outcomes, pain catastrophizing was identified as a significant predictor of chronic pain persisting ?3 months following TKA in five of the studies assessed. Limitations of studies included lack of large-scale data, absence of standardized pain measurements, inadequate multivariate adjustment, such as failure to control for analgesic use and other relevant covariates, and failure to report non-significant parameter estimates. Conclusion This study provides moderate-level evidence for pain catastrophizing as an independent predictor of chronic pain post-TKA. Directions for future research include larger, well-controlled studies with standard pain outcomes, identification of clinically-relevant catastrophizing cut-offs that predict pain outcomes, investigation of other psychosocial risk factors, and assessment of interventions aimed to reduce pain catastrophizing on chronic pain outcomes following TKA surgery. PMID:25609995

Burns, Lindsay C; Ritvo, Sarah E; Ferguson, Meaghan K; Clarke, Hance; Seltzer, Ze’ev; Katz, Joel



Total Pancreatectomy and Islet Autotransplantation in Chronic Pancreatitis: Recommendations from PancreasFest  

PubMed Central

Description Total pancreatectomy with islet autotransplantation (TPIAT) is a surgical procedure used to treat severe complications of chronic pancreatitis or very high risk of pancreatic cancer while reducing the risk of severe diabetes mellitus. However, clear guidance on indications, contraindications, evaluation, timing, and follow-up are lacking. Methods A working group reviewed the medical, psychological, and surgical options and supporting literature related to TPIAT for a consensus meeting during PancreasFest. Results Five major areas requiring clinical evaluation and management were addressed: These included: 1) indications for TPIAT; 2) contraindications for TPIAT; 3) optimal timing of the procedure; 4) need for a multi-disciplinary team and the roles of the members; 5) life-long management issues following TPIAP including diabetes monitoring and nutrition evaluation. Conclusions TPIAT is an effective method of managing the disabling complications of chronic pancreatitis and risk of pancreatic cancer in very high risk patients. Careful evaluation and long-term management of candidate patients by qualified multidisciplinary teams is required. Multiple recommendations for further research were also identified. PMID:24555976

Bellin, Melena D.; Freeman, Martin L.; Gelrud, Andres; Slivka, Adam; Clavel, Alfred; Humar, Abhinav; Schwarzenberg, Sarah J.; Lowe, Mark E.; Rickels, Michael R.; Whitcomb, David C; Matthews, Jeffrey B.



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)



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

SciTech Connect

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.

Teichgraeber, Ulf Karl-Martin, E-mail:; Streitparth, Florian, E-mail: florian.streitparth@charite.d [Charite Universitaetsmedizin Berlin, Institut fuer Diagnostische und Interventionelle Radiologie (Germany); Gebauer, Bernhard, E-mail: bernhard.gebauer@charite.d [Charite Universitaetsmedizin Berlin, Klinik fuer Strahlenheilkunde (Germany); Benter, Thomas, E-mail: Thomas.Benter@klinikum-rg.d [Elblandkliniken Riesa-Grossenhain gGmbH, Klinik fuer Innere Medizin II Haematologie/Onkologie und Gastroenterologie (Germany)



Isthmic tubal occlusion: etiology and histology.  


Twenty five patients were operated on for isthmic tubal occlusion. In 15 cases (60%) the etiology of this lesion was salpingitis isthmica nodosa. Of the other 10 cases, three showed tubal endometriosis and another three isthmic fibrosis. In two patients the histologic examination showed chronic inflammation. In one case etiology was tubal tuberculosis and in one case a cyst of calcified Gartner 's duct was seen. Inflammatory etiology seems to be important in isthmic tubal occlusion. In many cases chlamydial infection may be the chronic irritant which also cause the muscular hypertrophy leading to salpingitis isthmica nodosa. PMID:6730864

Punnonen, R; Söderström, K O; Alanen, A



Total pancreatectomy for the treatment of chronic pancreatitis: indications, outcomes, and recommendations.  


Total pancreatectomy (TP) for chronic pancreatitis (CP) has not gained widespread acceptance because of concerns regarding technical complexity, diabetic complications, and uncertainty with respect to long-term pain relief. Records of patients having TP from 1997 to 2005 were reviewed. Patient presentation, etiology of disease, and the indication for TP were examined. Operative results were analyzed. Long-term results were critically assessed, including narcotic usage and the need for re-admission. Postoperative quality of life (QOL) was assessed by the SF-36 health survey. During the study period, 7 patients with CP had TP, and 28 had other operations. The etiology of CP was alcohol in four and hereditary pancreatitis in three. The indication for surgery was pain and weight loss. Preoperatively, all patients used narcotics chronically and two had insulin-dependent diabetes. Four had TP after failed previous surgical procedures. Endoscopic retrograde cholangiopancreatography and computed tomography demonstrated small ducts and atrophic calcified glands. The mean length of the operation was 468 minutes, and only two patients required transfusion. There were no biliary anastomotic complications. The mean length of stay was 14 days. Major morbidity was limited to a single patient with a leak from the gastrojejunal anastomosis. Thirty-day mortality was zero, with one late death unrelated to the surgical procedure or diabetes. The mean length of follow-up was 46 months. All patients remained alcohol and narcotic free. No patient was readmitted with a diabetic complication. When compared with the general population, QOL scores were diminished but reasonable. We conclude that TP is indicated in hereditary pancreatitis and in those with an atrophic, calcified pancreas with small duct disease; that TP is technically arduous but can be completed with very low morbidity and mortality; and that on long-term follow-up, pain relief and abstinence from alcohol and narcotics was excellent with an acceptable QOL. PMID:16676850

Behrman, Stephen W; Mulloy, Matthew



Alteration of the mu opioid receptor: Ca2+ channel signaling pathway in a subset of rat sensory neurons following chronic femoral artery occlusion.  


The exercise pressor reflex, a crucial component of the cardiovascular response under physiological and pathophysiological states, is activated via metabolic and mechanical mediators that originate from contracting muscles and stimulate group III and IV afferents. We reported previously that stimulation of mu opioid receptors (MOR), expressed in both afferents, led to a significant attenuation of the reflex in rats whose femoral arteries had been occluded for 72 h. The present study examined the effect of arterial occlusion on the signaling components involved in the opioid-mediated modulation of Ca(2+) channels in rat dorsal root ganglion neurons innervating the triceps surae muscles. We focused on neurons that were transfected with cDNA coding for enhanced green fluorescent protein whose expression is driven by the voltage-gated Na(+) channel 1.8 (NaV1.8) promoter region, a channel expressed primarily in nociceptive neurons. With the use of a small interference RNA approach, our results show that the pertussis toxin-sensitive G?i3 subunit couples MOR with Ca(2+) channels. We observed a significant leftward shift of the MOR agonist [d-Ala2-N-Me-Phe4-Glycol5]-enkephalin concentration-response relationship in neurons isolated from rats with occluded arteries compared with those that were perfused freely. Femoral occlusion did not affect Ca(2+) channel density or the fraction of the main Ca(2+) channel subtype. Furthermore, Western blotting analysis indicated that the leftward shift did not result from either increased G?i3 or MOR expression. Finally, all neurons from both groups exhibited an inward current following exposure of the transient potential receptor vanilloid 1 (TRPV1) agonist, 8-methyl-N-vanillyl-6-nonenamide. These findings suggest that sensory neurons mediating the exercise pressor reflex express NaV1.8 and TRPV1 channels, and femoral occlusion alters the MOR pharmacological profile. PMID:25231620

Hassan, Bassil; Kim, Joyce S; Farrag, Mohamed; Kaufman, Marc P; Ruiz-Velasco, Victor



Total Body Potassium in Non-Dialysed and Dialysed Patients with Chronic Renal Failure  

PubMed Central

Total body potassium was studied in 33 patients with chronic renal failure, 18 of whom had been receiving regular dialysis therapy for 1 to 48 months. In nondialysed patients body potassium was not significantly different from normal in the group as a whole, but was significantly greater than normal in three patients, and significantly less than normal in two patients. In 14 of the dialysed patients, both as individuals and as a group, body potassium was not significantly different from normal but in the remaining four it was less than normal. Potassium transfer during dialysis was studied in two patients. Uptake by these two patients of 43K added to the dialysate (1 mEq K/litre) was measured by whole-body monitoring. Transfer of administered 43K from the patients to the dialysate was measured by whole-body monitoring and by radioactive and chemical assay of the dialysate. A negative balance due to twice-weekly dialysis of 178 and 244 mEq K/week was found, which with weekly faecal and urine losses of 20-30 mEq K approximately equals the dietary intake of 210-315 mEq K. PMID:4622493

Boddy, Keith; King, Priscilla C.; Lindsay, Robert M.; Briggs, James D.; Winchester, James F.; Kennedy, Arthur C.



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



Percutaneous ureteral occlusion with use of Gianturco coils and gelatin sponge. Part I. Swine model.  


An animal model was developed to study ureteral occlusion produced by steel coils and gelatin sponge. A coil nest was formed in the ureter, and in all but one pig, gelatin sponge pledgets were incorporated in the coil nest. Animals were killed at 2 hours, 1 week, 1 month, and 2 months. High-grade obstruction was present immediately following the procedure in all animals and was documented to be persistent by means of antegrade nephrostograms obtained just prior to death. At gross examination after death, ureteral thickening and strictures were evident. Histologic studies helped confirm the presence of acute and chronic inflammatory changes. In the in vivo model, gelatin sponge was not found necessary for acute ureteral occlusion. However, in an ancillary in vitro study in which a rigid plastic tube was used, gelatin sponge was necessary in addition to coil occlusion to provide acute total obstruction. The authors' findings suggest that in a compliant ureter, coil occlusion alone produces sufficient mechanical occlusion. Long-term obstruction is probably due to mechanical obstruction and stricture formation. PMID:1627879

Bing, K T; Hicks, M E; Figenshau, R S; Wick, M; Picus, D; Darcy, M D; Clayman, R V



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



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

PubMed Central

Our previous studies have demonstrated that the total flavonoids (XBXT-2) isolated from the extract of Xiaobuxin-Tang (XBXT), a traditional Chinese herbal decoction, ameliorated behavioral alterations and hippocampal dysfunctions in chronically stressed rats. Studies over the last decades have suggested that the hyperactivity of hypothalamic-pituitary-adrenal (HPA) axis is one of the most consistent findings in stress-related depression. Herein, we used the same chronic mild stress model of rats as before to further investigate the effect of XBXT-2 on the hyperactivity of HPA axis, including the stress hormones levels and glucocorticoid receptors (GRs) expression. Our ELISA results showed that chronic administration of XBXT-2 (25, 50?mg?kg?1, p.o., 28 days, the effective doses for behavioral responses) significantly decreased serum corticosterone level and its upstream stress hormone adrenocorticotropic hormone (ACTH) level in chronically stressed rats. Furthermore, western blotting result demonstrated XBXT-2 treatment ameliorated stress-induced decrease of GRs expression in hippocampus, an important target involved in the hyperactivity of HPA axis. These results were similar to that of classic antidepressant imipramine treatment (10?mg?kg?1, p.o.). In conclusion, the modulation of HPA axis produced by XBXT-2, including the inhibition of stress hormones levels and up-regulation of hippocampal GRs expression, may be an important mechanism underlying its antidepressant-like effect in chronically stressed rats. PMID:20028718

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



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



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. PMID:22397977

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.



Islet autotransplantation to preserve beta cell mass in selected patients with chronic pancreatitis and diabetes mellitus undergoing total pancreatectomy  

PubMed Central

Objectives Islet autotransplant (IAT) is performed in non-diabetic patients with chronic pancreatitis at the time of total pancreatectomy (TP) to minimize risk of post-operative diabetes. The role of TPIAT in patients with chronic pancreatitis and C-peptide positive diabetes is not established. We postulate that IAT can preserve beta cell mass and thereby benefit patients with pre-existing diabetes undergoing TP. Methods Preoperative metabolic testing, islet isolation outcomes, and subsequent islet graft function were reviewed for 27 patients with diabetes mellitus and chronic pancreatitis undergoing TPIAT. The relationship between the results of preoperative metabolic testing and islet isolation outcomes were explored using regression analysis. Results Mean islet yield was 2,060 ± 2,408 IEQ/kg. Peak C-peptide (from mixed meal tolerance testing) was the strongest predictor of islet yield, with higher stimulated C-peptide levels associated with greater islet mass. Half of the patients who had C-peptide levels measured post-transplant demonstrated C-peptide production at a level that conveys protective benefit in type 1 diabetes (?0.6 ng/mL). Conclusions These findings provide proof-of-concept that significant islet mass can be isolated in patients with chronic pancreatitis and C-peptide positive diabetes mellitus undergoing TPIAT. Stimulated C-peptide may be a useful marker of islet mass pre-transplant in these patients. PMID:23146918

Bellin, Melena D.; Beilman, Gregory J.; Dunn, Ty; Pruett, Timothy; Chinnakotla, Srinath; Ngo, Anh; Radosevich, David M.; Freeman, Martin L.; Schwarzenberg, Sarah J.; Balamurugan, A.N.; Hering, Bernhard J.; Sutherland, David E.R.



Computerized occlusal analysis as an alternative occlusal indicator.  


Background: All disciplines of dentistry require that clinicians assess the articulation of the teeth/prosthesis with respect to simultaneous contacts, bite force and timing. Aims: This article intends to describe the advantages and limitations of the data acquired when using a computerized occlusal analysis as a dynamic occlusal indicator. Methodology: A search of the literature was completed (Medline, PubMed) using the keywords occlusion, occlusal registration, computerized occlusal analysis and T-Scan for dental. Results: According to the evidence available, the computerized occlusal analysis system is the only occlusal indicator that demonstrates the ability to provide quantifiable force and time variance in a real-time window from the initial tooth contact into maximum intercuspation. Conclusion: The reported advantages to accurately indicate occlusal contacts make the computerized occlusal analysis system a better occlusal indicator when compared with other non-digital convention indicator materials available. PMID:25323220

Afrashtehfar, Kelvin I; Qadeer, Sarah



Acute arterial occlusion - kidney  


Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidneys need a good blood supply. The main artery to the kidney is called the renal artery. ...


Rare Case of “Wandering Artery of Drummond” As a Result of Chronic Triple Mesenteric Vessel Occlusion Treated by Isolated Angioplasty and Stenting of the Inferior Mesenteric Artery  

PubMed Central

We report a rare clinical scenario of chronic mesenteric ischemia (CMI) patient with obstruction of all the three major gut vessels including celiac, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA) with a sole artery supplying the collaterals through marginal artery of left colon (the “wandering artery of Drummond”). A 70-year-old man was presented to hospital with acute onset of dyspnea, diaphoresis, severe epigastric pain, nausea, and vomiting that started after lunch. Initially, patient was diagnosed and treated for non-ST elevation myocardial infarction (NSTEMI). Furthermore, work-up, including computed tomographic scan of abdomen followed by angiogram, revealed 100% obstruction of celiac and SMA, whereas inferior IMA had 90% ostial lesion with poststenotic dilatation and collaterals supplying to entire colon. Subsequently, IMA ostial lesion was stented through percutaneous intervention and patient noted significantly improved symptoms and quality of life. To conclude, percutaneous endovascular treatments confer favorable strategy for CMI, and it may either be curative or allow nutritional optimization before definitive surgery. PMID:24436621

Shah, Tejaskumar; Singh, Mukesh; Bhuriya, Rohit; Kovacs, Daniela; Khosla, Sandeep



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.



Strategies Aimed at Preventing Chronic Post-surgical Pain: Comprehensive Perioperative Pain Management after Total Joint Replacement Surgery  

PubMed Central

ABSTRACT Purpose: Chronic post-surgical pain (CPSP) is a frequent outcome of musculoskeletal surgery. Physiotherapists often treat patients with pain before and after musculoskeletal surgery. The purposes of this paper are (1) to raise awareness of the nature, mechanisms, and significance of CPSP; and (2) to highlight the necessity for an inter-professional team to understand and address its complexity. Using total joint replacement surgeries as a model, we provide a review of pain mechanisms and pain management strategies. Summary of Key Points: By understanding the mechanisms by which pain alters the body's normal physiological responses to surgery, clinicians selectively target pain in post-surgical patients through the use of multi-modal management strategies. Clinicians should not assume that patients receiving multiple medications have a problem with pain. Rather, the modern-day approach is to manage pain using preventive strategies, with the aims of reducing the intensity of acute postoperative pain and minimizing the development of CPSP. Conclusions: The roles of biological, surgical, psychosocial, and patient-related risk factors in the transition to pain chronicity require further investigation if we are to better understand their relationships with pain. Measuring pain intensity and analgesic use is not sufficient. Proper evaluation and management of risk factors for CPSP require inter-professional teams to characterize a patient's experience of postoperative pain and to examine pain arising during functional activities. PMID:22654235

Woodhouse, Linda J.; Kennedy, Deborah; Stratford, Paul; Katz, Joel



Laboratory Measurement of Urine Albumin and Urine Total Protein in Screening for Proteinuria in Chronic Kidney Disease  

PubMed Central

Laboratory measurement of urine total protein has been important for the diagnosis and monitoring of renal disease for decades, and since the late 1990s, urine albumin has been measured to determine whether a diabetic patient has incipient nephropathy. Evolving understanding of chronic kidney disease (CKD) and, in particular, the cardiovascular risks that CKD confers, demands more sensitive detection of protein in urine. As well, evidence is now emerging that cardiovascular and all-cause mortality risks are increased at levels within the current ‘normal’ range for urine albumin. Standardisation is essential to permit valid application of universal decision points, and a National Kidney Disease Education Program/International Federation of Clinical Chemistry and Laboratory Medicine (NKDEP/IFCC) Working Party is making progress towards a reference system for urine albumin. In the meantime, available data suggest that Australasian laboratory performance is adequate in terms of precision and accuracy above current decision limits for urine albumin. In contrast, the complexity of proteins in urine makes standardisation of urine total protein measurement impossible. As well, urine total protein measurement is insufficiently sensitive to detect clinically important concentrations of urine albumin. An Australasian Expert Group, the Proteinuria Albuminuria Working Group (PAWG) has proposed that urine albumin/creatinine ratio is measured in a fresh, first morning, spot sample to screen for proteinuria in CKD. Both NKDEP/IFCC and PAWG emphasise the need for standardisation of sample collection and handling. PMID:21611083

Martin, Helen



Laboratory measurement of urine albumin and urine total protein in screening for proteinuria in chronic kidney disease.  


Laboratory measurement of urine total protein has been important for the diagnosis and monitoring of renal disease for decades, and since the late 1990s, urine albumin has been measured to determine whether a diabetic patient has incipient nephropathy. Evolving understanding of chronic kidney disease (CKD) and, in particular, the cardiovascular risks that CKD confers, demands more sensitive detection of protein in urine. As well, evidence is now emerging that cardiovascular and all-cause mortality risks are increased at levels within the current 'normal' range for urine albumin. Standardisation is essential to permit valid application of universal decision points, and a National Kidney Disease Education Program/International Federation of Clinical Chemistry and Laboratory Medicine (NKDEP/IFCC) Working Party is making progress towards a reference system for urine albumin. In the meantime, available data suggest that Australasian laboratory performance is adequate in terms of precision and accuracy above current decision limits for urine albumin. In contrast, the complexity of proteins in urine makes standardisation of urine total protein measurement impossible. As well, urine total protein measurement is insufficiently sensitive to detect clinically important concentrations of urine albumin. An Australasian Expert Group, the Proteinuria Albuminuria Working Group (PAWG) has proposed that urine albumin/creatinine ratio is measured in a fresh, first morning, spot sample to screen for proteinuria in CKD. Both NKDEP/IFCC and PAWG emphasise the need for standardisation of sample collection and handling. PMID:21611083

Martin, Helen



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 the right side ...


Occlusions veineuses rétiniennes  

Microsoft Academic Search

Retinal vein occlusion (RVO) may affect the central vein (CRVO) or a branch, and occurs in healthy patients or in patients having an arterial risk profile rather than a venous one. Its prevalence is above 1% in subjects older than 40 years. RVO is a cause of painless unilateral vision loss of variable degree. Significant residual visual loss is frequent:

E. Héron



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. PMID:24124329

Toydemir, Toygar; Çipe, Gökhan; Karatepe, O?uzhan; Yerdel, Mehmet Ali



Renin-angiotensin-aldosterone system related gene polymorphisms and urinary total arsenic is related to chronic kidney disease.  


A recent study demonstrated that an increased risk of chronic kidney disease (CKD) was associated with high urinary total arsenic levels. However, whether genomic instability is related to CKD remains unclear. An association between CKD and genetic polymorphisms of regulation enzymes of the renin-angiotensin-aldosterone system (RAAS), such as angiotensin-converting enzyme (ACE), angiotensinogen (AGT), angiotensin II type I receptor (AT1R), and aldosterone synthase (CYP11B2) has not been shown. The aim of the present study was to investigate the relationship between arsenic, genetic polymorphisms of RAAS enzymes and CKD. A total of 233 patients and 449 age- and gender-matched controls were recruited from the Taipei Medical University Hospital, Taipei Municipal Wan Fang Hospital and the Shin Kong Wu Ho-Su Memorial Hospital. Concentrations of urinary arsenic were determined by a high-performance liquid chromatography-linked hydride generator, and atomic absorption spectrometry. Polymorphisms of ACE(I/D), AGT(A[-20]C), (T174M), (M235T), AT1R(A1166C) and CYP11B2(C[-344]T) were examined by polymerase chain reaction and restriction fragment length polymorphism. Subjects carrying the CYP11B2 TT genotype had a higher odds ratio (OR), 1.39 (0.96-2.01), of CKD; while those with the AGT(A[-20]C) CC genotype had an inverse OR of CKD (0.20 (0.05-0.81)), and a high-risk genotype was defined as A/A+A/C for AGT(A[-20C]) and T/T for CYP11B2(C[-344]T). The trend test showed a higher OR for CKD in patients who had either high urinary total arsenic levels or carried the high-risk genotype, or both, compared to patients with low urinary total arsenic levels, who carried the low-risk genotype, and could also be affected by the hypertension or diabetes status. PMID:24907556

Chen, Wei-Jen; Huang, Ya-Li; Shiue, Horng-Sheng; Chen, Tzen-Wen; Lin, Yuh-Feng; Huang, Chao-Yuan; Lin, Ying-Chin; Han, Bor-Cheng; Hsueh, Yu-Mei



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


There are limited data on total dose infusion (TDI) using iron dextran in geriatric chronic kidney disease (CKD) patients with iron-deficiency anemia (IDA). Our goal was to evaluate the safety of TDI in this setting. We conducted a retrospective chart review spanning a 5 year period (2002-2007), including all patients with CKD and IDA who were treated with iron dextran TDI. Patient demographics were noted, and laboratory values for creatinine, hemoglobin and iron stores were recorded pre- and post-dose. TDI diluted in normal saline was administered intravenously over 4-6 hours after an initial test dose. One hundred fifty-three patients received a total of 250 doses of TDI (mean ± SD=971 ± 175 mg); age was 69 ± 12 years and creatinine 3.3 ± 1.9 mg/dL. All stages of CKD were represented (stage 4 commonest). Hemoglobin and iron stores improved post-TDI (P<0.001). None of the patients experienced an anaphylactic reaction or death. Adverse events (AEs) were noted in 8 out of 250 administered doses (3.2%). The most common AEs were itching, chills and back pain. One hundred and ten doses of high molecular weight (HMW) iron dextran produced 6 AEs (5.45%), whereas 140 doses of low molecular weight (LMW) iron dextran produced 2 AEs (1.43%), a non-significant trend (P=0.1433 by Fishers Exact Test). Iron dextran TDI is relatively safe and effective in correcting IDA in geriatric CKD patients. Fewer AEs were noted with the LMW compared to the HMW product. LMW iron dextran given as TDI can save both cost and time, helping to alleviate issues of non-compliance and patient scheduling. PMID:24845687

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



Does total body irradiation conditioning improve outcomes of myeloablative human leukocyte antigen-identical sibling transplantations for chronic lymphocytic leukemia?  


An allogeneic hematopoietic cell transplantation from an HLA-identical donor after high-dose (myeloablative) pretransplantation conditioning is an effective therapy for some people with chronic lymphocytic leukemia (CLL). Because CLL is a highly radiosensitive cancer, we hypothesized that total body irradiation (TBI) conditioning regimens may be associated with better outcomes than those without TBI. To answer this, we analyzed data from 180 subjects with CLL receiving myeloablative doses of TBI (n = 126) or not (n = 54), who received transplants from an HLA-identical sibling donor between 1995 and 2007 and reported to the Center for International Blood & Marrow Transplant Research. At 5 years, treatment-related mortality was 48% (95% confidence interval [CI], 39% to 57%) versus 50% (95% CI, 36% to 64%); P = NS. Relapse rates were 17% (95% CI, 11% to 25%) versus 22% (95% CI, 11% to 35%); P = NS. Five-year progression-free survival and overall survival were 34% (95% CI, 26% to 43%) versus 28% (95% CI, 15% to 42%); P = NS and 42% (95% CI, 33% to 51%) versus 33% (95% CI, 19% to 48%); P = NS, respectively. The single most common cause of death in both cohorts was recurrent/progressive CLL. No variable tested in the multivariate analysis was found to significantly affect these outcomes, including having failed fludarabine. Within the limitations of this study, we found no difference in HLA-identical sibling transplantation outcomes between myeloablative TBI and chemotherapy pretransplantation conditioning in persons with CLL. PMID:24321745

Sabloff, Mitchell; Sobecks, Ronald M; Ahn, Kwang Woo; Zhu, Xiaochun; de Lima, Marcos; Brown, Jennifer R; Inamoto, Yoshihiro; Holland, H Kent; Aljurf, Mahmoud D; Laughlin, Mary J; Kamble, Rammurti T; Hsu, Jack W; Wirk, Baldeep M; Seftel, Matthew; Lewis, Ian D; Arora, Mukta; Alyea, Edwin P; Kalaycio, Matt E; Cortes, Jorge; Maziarz, Richard T; Gale, Robert Peter; Saber, Wael



Treatment of psoriasis with triamcinolone acetonide 0.1% under occlusion: a comparison of two hydrocolloid dressings.  


A clinical, randomized, parallel study was undertaken to compare the efficacy of a widely known steroid preparation, triamcinolone acetonide 0.1% cream, in occlusion with two different hydrocolloid dressings, namely Duoderm and Actiderm, in the treatment of chronic plaques of psoriasis. A total of 23 patients with psoriasis were entered in the study. Two similar psoriatic plaques were identified in each patient, triamcinolone acetonide cream was applied, and a randomized table assigned the sides of the body to which each dressing was to be used for each patient. Changing of the dressing, with reapplication of the cream was done every 48 hours on each side until the lesions cleared or for a maximum of three weeks. At the end of the three weeks-therapy, period, 12 lesions had totally cleared with Duoderm and 13 with Actiderm. Seven lesions had achieved either marked or moderate improvement with duoderm and the same results were observed with Actiderm. Only three of 22 had mild improvement with Duoderm and two of 22 with Actiderm. No side effect were noted and none of the patients became worse during this treatment. This study demonstrated the beneficial effects of triamcinolone acetonide 0.1% cream under occlusion with two different hydrocolloid dressings in the treatment of chronic resistant plaques of psoriasis. The use of a hydrocolloid dressing in combination with steroid adds another therapeutic option for the treatment of chronic localized psoriatic lesions. PMID:2261015

González, J R; Cabán, F




Technology Transfer Automated Retrieval System (TEKTRAN)

Induction of Class 1 ADH occurs in rats fed alcohol chronically, and we have reported that C/EBPs and SREBP-1 are important signaling factors in this process. Chronic alcohol intake in humans can result in alcohol-induced diabetes. We have studied insulin signaling pathways in adult male Sprague-D...


Vertebral artery occlusion by a cervical `hour-glass' neurofibroma  

PubMed Central

A case of total vertebral artery occlusion by a cervical `hour-glass' or `dumb-bell' neurofibroma is reported. To the author's knowledge this is the first reported case in the English literature. A causal relationship between the arterial occlusion and the patient's symptoms has been postulated. The angiographic study of these patients is further emphasized to enhance safer and more effectual removal of these lesions. Images PMID:4647861

Geissinger, James D.; Gruner, George; Ruge, Daniel



Thrombolytic therapy for central venous catheter occlusion  

PubMed Central

Background Long-term central venous catheters have improved the quality of care for patients with chronic illnesses, but are complicated by obstructions which can result in delay of treatment or catheter removal. Design and Methods This paper reviews thrombolytic treatment for catheter obstruction. Literature from Medline searches using the terms “central venous catheter”, “central venous access device” OR “central venous line” associated with the terms “obstruction”, “occlusion” OR “thrombolytic” was reviewed. Efficacy of thrombolytic therapy, central venous catheter clearance rates and time to clearance were assessed. Results Alteplase, one of the current therapies, clears 52% of obstructed catheters within 30 min with 86% overall clearance (after 2 doses, when necessary). However, newer medications may have higher efficacy or shorter time to clearance. Reteplase cleared 67–74% within 30–40 min and 95% of catheters overall. Occlusions were resolved in 70 and 83% of patients with one and 2 doses of tenecteplase, respectively. Recombinant urokinase cleared 60% of catheters at 30 min and 73% overall. Alfimeprase demonstrated rapid catheter clearance with resolution in 40% of subjects within 5 min, 60% within 30 min, and 80% within 2 h. Additionally, urokinase prophylaxis decreased the incidence of catheter occlusions from 16–68% in the control group to 4–23% in the treatment group; in some studies, rates of catheter infections were also decreased in the urokinase group. Conclusions Thrombolytic agents successfully clear central venous catheter occlusions in most cases. Newer agents may act more rapidly and effectively than currently utilized therapies, but randomized studies with direct comparisons of these agents are needed to determine optimal management for catheter obstruction. PMID:22180420

Baskin, Jacquelyn L.; Reiss, Ulrike; Wilimas, Judith A.; Metzger, Monika L.; Ribeiro, Raul C.; Pui, Ching-Hon; Howard, Scott C.



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)



Occlusive arteriopathy and brain tumor.  


Four cases with the association of occlusive arteriopathy and brain tumor are presented. A clinical analysis of these cases and cases reported in the literature revealed that occlusive arteriopathy at the base of the brain was often associated with a slowly growing basal tumor in children. Possible causes of occlusive arteriopathy in these cases were compression of the circle of Willis by a slowly growing basal tumor, secondary artial occlusive changes by radiation therapy for a basal tumor, or vasculopathy associated with neurocutaneous syndrome. Symptoms of sudden onset or episodic nature suggest the presence of occlusive arteriopathy rather than the mass effect of a tumor. Cerebral angiography is mandatory whenever computerized tomography (CT), performed to rule out recurrence of a basal tumor, shows an ischemic lesion with low-density areas without any evidence of mass effect of the tumor. Cerebral angiography is also necessary when a basal tumor is suspected in children, particularly in cases associated with neurocutaneous syndrome and a basal tumor. Care should be taken not to scarify the abnormal vascular network at the base of the brain at the time of operation, because it is considered to be functioning as collateral circulation. The potential hazards of radiotherapy to radiation-induced occlusive changes of the circle of Willis must be considered in treating a benign basal brain tumor in children. Even in adults, repeated large doses of irradiation could cause occlusive arteriopathy. PMID:660265

Mori, K; Takeuchi, J; Ishikawa, M; Handa, H; Toyama, M; Yamaki, T



Retinal Artery Occlusion  

PubMed Central

Objective To investigate systematically the various associated systemic and ophthalmic abnormalities in different types of retinal artery occlusion (RAO). Design Cohort study. Participants 439 consecutive untreated patients (499 eyes) with RAO, first seen in our clinic from 1973 to 2000. Methods At first visit, all patients had a detailed ophthalmic and medical history, and comprehensive ophthalmic evaluation. Visual evaluation was done by recording visual acuity, using the Snellen visual acuity chart, and visual fields with a Goldmann perimeter. Initially they also had carotid Doppler/angiography and echocardiography. The same ophthalmic evaluation was performed at each follow-up visit. Main Outcome Measures Demographic features, associated systemic and ophthalmic abnormalities and sources of emboli in various types of RAO. Results RAO was classified into various types of central (CRAO) and branch (BRAO) artery occlusion. In both nonarteritic CRAO and BRAO the prevalence of diabetes mellitus, arterial hypertension, ischemic heart disease, and cerebrovascular accidents were significantly higher compared to the prevalence of these conditions in the matched US population (all p<0.0001). Smoking prevalence, compared to the US population, was significantly higher for males (p=0.001) with nonarteritic CRAO and for females with BRAO (p=0.02). Ipsilateral internal carotid artery had ?50% stenosis in 31% of nonarteritic CRAO patients and 30% of BRAO, and plaques in 71% of nonarteritic CRAO and 66% of BRAO. Abnormal echocardiogram with embolic source was seen in 52% of nonarteritic CRAO and 42% of BRAO. Neovascular glaucoma developed in only 2.5% of nonarteritic CRAO eyes. Conclusion This study showed that in CRAO as well as BRAO the prevalence of various cardiovascular diseases and smoking was significantly higher compared to the prevalence of these conditions in the matched US population. Embolism is the most common cause of CRAO and BRAO; plaque in the carotid artery is usually the source of embolism and less commonly the aortic and/or mitral valve. The presence of plaques in the carotid artery is generally of much greater importance than the degree of stenosis in the artery. Contrary to the prevalent misconception, there is no cause-and-effect relationship between CRAO and neovascular glaucoma. PMID:19577305

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



Impact of a multidisciplinary pain program for the management of chronic low back pain in patients undergoing spine surgery and primary total hip replacement: a retrospective cohort study  

PubMed Central

Background Low back pain is a very common disorder. In this field chronic low back pain represents a special challenge. The management of chronic low back pain consists of a range of different intervention strategies. Usually operative intervention should be avoided if possible. However, there are constellations were surgical therapy in patients with chronic low back pain seems to be meaningful. The aim of this study was to investigate the clinical outcomes after spine surgery and hip replacement in patients with chronic low back pain after undergoing a structured rehabilitation program including cognitive – behavioral therapy. Methods From January 1, 2007 to January 1, 2010 patients were indicated for total hip replacement (THA) or spine surgery after receiving inpatient multidisciplinary pain programs including cognitive – behavioral therapy at our orthopedic institute with a specialized unit for the rehabilitation of chronic pain patients. Indications for surgery were based on the synopsis of clinical and imaging findings and on positive effects after local injections during the multidisciplinary pain program. The tools for assessment included follow-up at 6 and 12 months and analyses of pain, chronicity, physical functioning and depression. Results Of the 256 patients admitted for multidisciplinary pain program, fifteen were indicated to benefit from a surgical intervention during multidisciplinary pain program. Ten patients received spine surgery. THA was indicated in five patients. In all cases, the peri- and postoperative clinical courses were uneventful. Only two of the patients subjected to spine surgery and three patients who had THA were improved after 12 months. One patient reported a worsened condition. All patients presented with good functional outcomes and normal radiological findings. Conclusions The indication for surgical intervention in patients with chronic low back pain and degenerative diseases must be critically assessed. THA in this cohort should focus on functional aspects, such as the improvement of range of motion, rather than the reduction of pain. Spine surgery in chronic low back pain patients after multidisciplinary pain program including cognitive – behavioral therapy cannot be recommended due to its questionable success. PMID:25473419



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

NASA Technical Reports Server (NTRS)

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

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



Sequential bilateral retinal artery occlusion  

PubMed Central

An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic embolic event. Initially, she presented a superior branch retinal artery occlusion in her right eye followed by a central retinal artery occlusion with cilioretinal artery sparing in her left eye. Some conservative maneuvers performed did not improve visual acuity in the left eye. Supra-aortic Doppler ultrasonography revealed mild right internal carotid artery stenosis and moderate left internal carotid artery stenosis with a small, smooth, and homogeneous plaque. The transthoracic echocardiography showed a severe calcification of the mitral valve with a mild-moderate rim of stenosis. Central retinal artery occlusion and branch retinal artery occlusion are characterized by painless monocular loss of vision. Clinical approach and management attempt to treat the acute event, find the source of the vascular occlusion, and prevent further vascular events from occurring. Giant cell arteritis is a potentially treatable cause of central retinal artery occlusion and should be excluded in every single patient over 50 years old. PMID:24748768

Padrón-Pérez, Noel; Aronés, Janny Rosario; Muñoz, Silvia; Arias-Barquet, Luis; Arruga, Jorge



Fludarabine Phosphate and Total-Body Irradiation Before Donor Peripheral Blood Stem Cell Transplant in Treating Patients With Chronic Lymphocytic Leukemia or Small Lymphocytic Leukemia

B-cell Chronic Lymphocytic Leukemia; Contiguous Stage II Small Lymphocytic Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Prolymphocytic Leukemia; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Stage I Chronic Lymphocytic Leukemia; Stage I Small Lymphocytic Lymphoma; Stage II Chronic Lymphocytic Leukemia; Stage III Chronic Lymphocytic Leukemia; Stage III Small Lymphocytic Lymphoma; Stage IV Chronic Lymphocytic Leukemia; Stage IV Small Lymphocytic Lymphoma



Complications related to radial artery occlusion, radial artery harvest, and arterial lines.  


Recent publications have suggested that there may be an important role for the radial artery regarding long-term perfusion of the hand. The increasing popularity of the radial artery as an access site for cardiac catheterization has also resulted in the recognition of acute and chronic radial artery occlusion, and cardiologists have placed renewed emphasis on preserving the patency of this artery for future interventional procedures. This article reviews the present literature on radial artery harvest and occlusion. Also discussed are the complications associated with radial artery occlusion and treatment options to prevent such complications. PMID:25455360

Chim, Harvey; Bakri, Karim; Moran, Steven L



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

SciTech Connect

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

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



Transdermal CO2 Application in Chronic Wounds  

Microsoft Academic Search

Chronic wounds are a challenge to treatment. In this retrospective study, the effect of transdermal CO2 application on wound healing in chronic ulcers was investigated and compared to the effect of CO2 on acute surgical wounds.Eightysix patients (52 females and 34 males) with chronic wounds of different origin except arterial occlusive disease were included. In addition, 17 patients (5 females,

U. Wollina; Birgit Heinig; Christine Uhlemann



Comparison of outcomes of allogeneic transplantation for chronic myeloid leukemia with cyclophosphamide in combination with intravenous busulfan, oral busulfan, or total body irradiation.  


Cyclophosphamide (Cy) in combination with busulfan (Bu) or total body irradiation (TBI) is the most commonly used myeloablative conditioning regimen in patients with chronic myeloid leukemia (CML). We used data from the Center for International Bone Marrow Transplantation Research to compare outcomes in adults who underwent hematopoietic cell transplantation for CML in first chronic phase after myeloablative conditioning with Cy in combination with TBI, oral Bu, or intravenous (i.v.) Bu. Four hundred thirty-eight adults received human leukocyte antigen (HLA)-matched sibling grafts and 235 received well-matched grafts from unrelated donors (URD) from 2000 through 2006. Important differences existed between the groups in distribution of donor relation, exposure to tyrosine kinase inhibitors, and year of transplantation. In multivariate analysis, relapse occurred less frequently among patients receiving i.v. Bu compared with TBI (relative risk [RR], .36; P = .022) or oral Bu (RR, .39; P = .028), but nonrelapse mortality and survival were similar. A significant interaction was detected between donor relation and the main effect in leukemia-free survival (LFS). Among recipients of HLA-identical sibling grafts, but not URD grafts, LFS was better in patients receiving i.v. Bu (RR, .53; P = .025) or oral Bu (RR, .64; P = .017) compared with TBI. In CML in first chronic phase, Cy in combination with i.v. Bu was associated with less relapse than TBI or oral Bu. LFS was better after i.v. or oral Bu compared with TBI. PMID:25528388

Copelan, Edward A; Avalos, Belinda R; Ahn, Kwang Woo; Zhu, Xiaochun; Gale, Robert Peter; Grunwald, Michael R; Hamadani, Mehdi; Hamilton, Betty K; Hale, Gregory A; Marks, David I; Waller, Edmund K; Savani, Bipin N; Costa, Luciano J; Ramanathan, Muthalagu; Cahn, Jean-Yves; Khoury, H Jean; Weisdorf, Daniel J; Inamoto, Yoshihiro; Kamble, Rammurti T; Schouten, Harry C; Wirk, Baldeep; Litzow, Mark R; Aljurf, Mahmoud D; van Besien, Koen W; Ustun, Celalettin; Bolwell, Brian J; Bredeson, Christopher N; Fasan, Omotayo; Ghosh, Nilanjan; Horowitz, Mary M; Arora, Mukta; Szer, Jeffrey; Loren, Alison W; Alyea, Edwin P; Cortes, Jorge; Maziarz, Richard T; Kalaycio, Matt E; Saber, Wael



The relationship between maximum isometric strength and intramuscular circulatory occlusion  

Microsoft Academic Search

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




Guiding Intellect for Occlusal Errors  

PubMed Central

Purpose: The purpose of the study is to quantify occlusal errors seen, during the processing of complete denture. Material and Methods: Maxillary and mandibular complete dentures were fabricated for 30 subjects. Anterior and posterior markings were made on articulator and the distance was measured from these points before and after processing of complete dentures. Occlusal errors following processing of complete dentures was determined by subjecting the values obtained to statistical analysis using paired t-test. Results: The results indicated the existence of discrepant amount of occlusal errors following processing of complete denture and statistical test applied was paired t-test, p-values obtained are, p=0.00 anterior reference markings and p=0.006 for posterior reference markings (p ? 0.001 highly significant). Conclusion: The processing errors are inevitable. Hence for patient comfort, laboratory remounting is an important procedure that needs to be followed as a regular step after processing of each and every denture. PMID:24392422

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



Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS.  


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

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



Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS  

PubMed Central

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

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




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. PMID:20010454

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



Superior Mesenteric Vein Thrombosis in a Patient with Chronic Inhalation Exposure to Stearic Acid  

PubMed Central

A previously healthy 36-year-old man admitted via emergency room with complaint of progressive chronic abdominal pain for 2 weeks. An enhanced computed tomography (CT) scan revealed a total occlusion of the superior mesenteric vein with thrombus and partial thrombosis of main portal vein. However, CT scan did not show any evidence of infectious or inflammatory foci in the abdominal cavity. He did not have any family history of coagulation disorder. He neither had any detectable coagulation disorder to induce thrombosis. The only possible risk factor for the superior venous thrombus is chronic inhalation exposure to stearic acid. PMID:23555339



Modulation of total ceramide and constituent ceramide species in the acutely and chronically hypoxic mouse heart at different ages  

Microsoft Academic Search

Ceramide has been implicated in regulatory processes vital for cell survival under different stressors, most notably hypoxia. Little has been done to investigate the contributions of the different ceramide species to the regulation of cell survival. This study aims to highlight the patterns of variation in total ceramide and its species in the growing and hypoxic mouse heart. Mus musculus

Lama Noureddine; Raed Azzam; Georges Nemer; Jacek Bielawski; Michel Nasser; Fadi Bitar; Ghassan S. Dbaibo



Visibility Culling Using Hierarchical Occlusion Maps  

Microsoft Academic Search

We present hierarchical occlusion maps (HOM) for visibility culling on complex models with high depth complexity. The culling algorithm uses an object space bounding volume hier- archy and a hierarchy of image space occlusion maps. Occlusion maps represent the aggregate of projections of the occluders onto the image plane. For each frame, the algorithm selects a small set of objects

Hansong Zhang; Dinesh Manocha; Thomas Hudson; Kenneth E. Hoff III



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. PMID:24167740

Bajkó, Zoltán; B?la?a, Rodica; Mo????ianu, Anca; Maier, Smaranda; Chebu?, Octavia Claudia; Szatmári, Szabolcs



Lacrimal occlusion therapy for the treatment of superior limbic keratoconjunctivitis.  


Superior limbic keratoconjunctivitis (SLK) is a chronic and recalcitrant disease of the superior bulbar and tarsal conjunctiva, as well as the superior limbic aspect of the cornea. Both the etiology and the pathogenesis of this condition are poorly understood. Many treatment options have been advocated in the management of SLK, including: topical antibiotics, topical anti-inflammatory agents, topical vitamin A solutions, chemical cautery, thermal cautery, and surgical resection. Most recently, studies have suggested that lacrimal occlusion therapy may be beneficial in the treatment of SLK. A case is presented in which this method of treatment was used, with excellent results. The implications of this report suggest that the use of lacrimal occlusion in the management of SLK may be a viable treatment option before considering more radical and invasive therapy. In addition, this case helps to illustrate the significant link between SLK and thyroid disease. PMID:9798210

Kabat, A G



Pulmonary veno-occlusive disease  

PubMed Central

Two distinct pathological entities may be associated with the clinical picture of `primary pulmonary hypertension'. In the classical form the brunt of the pathology falls upon the pulmonary arteries with the characteristic development of dilatation lesions and necrotizing arteritis. In the second rarer type the pulmonary veins appear to be primarily involved. This paper describes the clinical and pathological features of such a case of `pulmonary veno-occlusive disease' occurring in a young girl. Images PMID:4111463

Heath, Donald; Scott, Olive; Lynch, James



Med. Sci. Res., 1995; 23, 671-673 671 Combination of occlusive dressings and electrical stimulation  

E-print Network

- nologies facilitated the production of a new generation of wound dressings, was it employed in routine with an almost ten year old vision by Turner [5]. He foresaw the evolution of chronic wound dressings in three stages: traditional "passive" wound dressings have been overtaken by "interactive" occlusive dressings

Ljubljana, University of


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

Microsoft Academic Search

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

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



Treatment of chronic unstable angina pectoris: use of a totally implantable programmable device for continuous intrathecal infusion of opiates: case report.  


We report the case of a 70-year-old man with a 17-year history of angina pectoris, who had previously suffered two documented myocardial infarctions and undergone multiple diagnostic cardiac catheterizations, two coronary artery bypass operations, and several percutaneous transluminal coronary angioplasty procedures. The patient had experienced unstable angina for the past 3 years refractory to maximal medical therapy and was unsuitable for further attempts at revascularization. After a successful trial of epidural infusion of morphine, a totally implantable programmable continuous-infusion device with an intrathecal catheter was implanted in the patient on August 18, 1993, resulting in maintained pain resolution. His gardening, carpentry, and other activities of daily living were limited only by shortness of breath. Six months later, the pump treatment did not mask the development of a myocardial infarction. To the best of our knowledge, this is the first report of the use of continuous intrathecal infusion of morphine or the use of a totally implantable programmable infusion device for angina pectoris. We propose that in carefully selected patients with chronic unstable angina, continuous intrathecal infusion of morphine may relieve effort-induced pain without resulting in myocardial infarction. PMID:8869068

Segal, R; Murali, S; Tipton, K



Report of a patient with a Class II occlusion using the Begg technique to move the first molars distally.  


A 14-year-old female with a Class II occlusion and an increased overbite was treated using a Begg appliance and a modified Henrikson's arch. The treatment resulted in a Class I occlusion and ideal overjet, overbite, and incisor angulation. Class I occlusion was achieved after 6 months, and total treatment time was 1 year 6 months. The Begg technique with intermaxillary traction to move posterior teeth distally is an effective method to correct a Class II occlusion with minimum mandibular crowding. PMID:19885429

Uslu, Ozge; Erdem, Dilek



Visceral branch occlusion following aneurysm repair using multibranched thoracoabdominal stent-grafts.  


Purpose : To identify risk factors for late-occurring branch occlusion following multibranched endovascular repair of thoracoabdominal and pararenal aortic aneurysm. Method : Out of 120 patients who underwent multibranched endovascular aneurysm repair between September 2005 and May 2013, 100 (78 men; mean age 72.4±7.4 years) met the criteria for inclusion in the current retrospective analysis. Demographic data were gleaned from a prospectively maintained database. Mean aneurysm diameter was 66.7±11.7 mm. Multiplanar reconstructions of postoperative computed tomographic angiography were used to measure 6 parameters of renal branch morphology. Results : All 100 patients had undergone successful placement of multibranched aortic stent-grafts with a total of 95 celiac branches, 100 superior mesenteric artery (SMA) branches, and 187 renal branches. During a mean follow-up of 25.6 months, there were no stent fractures or stent separations, no SMA occlusions, and only 2 (2.1%) celiac artery occlusions, neither of which required reintervention. In contrast, there were 18 (9.6%) renal branch occlusions in 16 patients, all men (p=0.02). Patients with renal branch occlusions were significantly more likely to have a history of myocardial infarction (p=0.004). The mean renal artery length was significantly greater in the occlusion group compared to the non-occlusion group (47.5±13.6 vs. 39.4±14.2, p=0.03). No other aspect of branch morphology was significantly different between the occlusion and non-occlusion groups. Conclusion : Renal branch occlusion was by far the commonest late failure mode after multibranched endovascular aneurysm repair. The current study provides no basis for a change in patient selection or stent-graft design, only a change in the components used to construct renal branches. It is too early to tell the effect this will have. PMID:25453879

Premprabha, Dhanakom; Sobel, Julia; Pua, Chris; Chong, Karen; Reilly, Linda M; Chuter, Timothy A M; Hiramoto, Jade S



Facial height in Japanese-Brazilian descendants with normal occlusion  

PubMed Central

OBJECTIVE: The aim of this study was to determine the standards of facial height in 30 young (14-year-old) Japanese-Brazilian descendants with normal occlusion, and assess whether sexual dimorphism is evident. METHODS: The cephalometric measurements used followed the analyses by Wylie-Johnson, Siriwat-Jarabak, Gebeck, Merrifield and Horn. RESULTS: Results showed dimorphism for total anterior facial height (TAFH), lower anterior facial height (LAFH), anterior facial height (AFH), total posterior facial height (TPFH) and upper posterior facial height (UPFH) measurements. CONCLUSIONS: The standards of facial heights in young Japanese-Brazilian descendants with normal occlusion were observed. Sexual dimorphism was identified in five out of thirteen evaluated variables at this age range.

Vieira, Fabiano Paiva; Pinzan, Arnaldo; Janson, Guilherme; Fernandes, Thais Maria Freire; Sathler, Renata Carvalho; Henriques, Rafael Pinelli



Comorbidities in combined retinal artery and vein occlusions  

PubMed Central

Background Several general diseases cause blindness in patients with simultaneous combined retinal artery and vein occlusion. Methods/patients We examined 14 patients with acute unilateral visual loss due to combined retinal artery and venous occlusions. All 14 patients presented at the Polyclinic over a period of about 3 years. Fluorescein angiography was carried out in 12 patients to confirm the diagnosis. Ten patients underwent Doppler sonography and 11 echocardiography. Results Concerning systemic diseases, 11 of our 14 patients presented several cardiovascular risk factors, i.e., immunocytoma and arterial hypertension and hypercholesterolemia in one patient; another patient had chronic bronchitis, tachycardia and hypercholesterolemia. Six patients presented coagulation anomalies, and eight patients had arterial hypertension. Doppler sonography revealed normal carotid arteries in nine of ten patients. In 8 of 11 patients, echocardiography displayed no cardiac abnormalities. Ophthalmoscopy revealed no emboli in any of these patients. Conclusion Unilateral simultaneous combined incomplete retinal artery and venous occlusions should be considered as one entity. Eleven of our patients presented comorbidities reflecting several cardiovascular risk factors. Immunological diseases, malignancies and coagulopathies can cause this ocular disorder, resulting in blindness. No emboli were found in any of these patients. Patients suffering from acute visual loss must be examined for the presence of systemic diseases to enable therapy at an early stage. PMID:23947749




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. PMID:21620994

Hayreh, Sohan Singh



The Carotid Occlusion Surgery Study.  


The St. Louis Carotid Occlusion Study demonstrated that ipsilateral increased O2 extraction fraction (OEF) (Stage II hemodynamic failure) measured by positron emission tomography (PET) is a powerful independent risk factor for subsequent stroke in patients with symptomatic complete carotid artery (CA) occlusion. The ipsilateral ischemic stroke rate at 2 years has been shown to be 5.3% in 42 patients with normal OEF and 26.5% in 39 patients with increased OEF (p = 0.004). In patients in whom hemispheric symptoms developed within 120 days, the 2-year ipsilateral stroke rates were 12% in 27 patients with normal OEF and 50% in 18 patients with increased OEF. Previous PET studies have demonstrated that anastomosis of the superficial temporal artery (STA) to a middle cerebral artery (MCA) cortical branch can restore OEF to normal. The authors discuss the undertaking of a study that will test the hypothesis that STA-MCA anastomosis, when combined with the best medical therapy, can reduce ipsilateral ischemic stroke by 40% at 2 years in patients with symptomatic internal CA occlusion and Stage II hemodynamic failure occurring within 120 days after surgery. Only patients with increased OEF distal to a symptomatic occluded CA will be randomized to surgery or medical treatment. The primary endpoint will be all strokes and death occurring between randomization and the 30-day postoperative cut off (with an equivalent period in the nonsurgical group), as well as subsequent ipsilateral ischemic stroke developing within 2 years. It is estimated that 186 patients will be required in each group. Assuming that 40% of PET scans will demonstrate increased OEF, this will require enrolling 930 clinically eligible individuals. PMID:15709726

Grubb, Robert L; Powers, William J; Derdeyn, Colin P; Adams, Harold P; Clarke, William R



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

PubMed Central

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

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



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



Occlusion on oral implants: current clinical guidelines.  


Proper implant occlusion is essential for adequate oral function and the prevention of adverse consequences, such as implant overloading. Dental implants are thought to be more prone to occlusal overloading than natural teeth because of the loss of the periodontal ligament, which provides shock absorption and periodontal mechanoreceptors, which provide tactile sensitivity and proprioceptive motion feedback. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Thus, we performed a narrative literature review to ascertain the influence of implant occlusion on the occurrence of complications of implant treatment and discuss the clinical considerations focused on the overloading factors at present. The search terms were 'dental implant', 'dental implantation', 'dental occlusion' and 'dental prosthesis'. The inclusion criteria were literature published in English up to September 2013. Randomised controlled trials (RCTs), prospective cohort studies and case-control studies with at least 20 cases and 12 months follow-up interval were included. Based on the selected literature, this review explores factors related to the implant prosthesis (cantilever, crown/implant ratio, premature contact, occlusal scheme, implant-abutment connection, splinting implants and tooth-implant connection) and other considerations, such as the number, diameter, length and angulation of implants. Over 700 abstracts were reviewed, from which more than 30 manuscripts were included. We found insufficient evidence to establish firm clinical guidelines for implant occlusion. To discuss the ideal occlusion for implants, further well-designed RCTs are required in the future. PMID:25284468

Koyano, K; Esaki, D



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



Combining Serum Cystatin C with Total Bilirubin Improves Short-Term Mortality Prediction in Patients with HBV-Related Acute-On-Chronic Liver Failure  

PubMed Central

Background & Aims HBV-related acute-on-chronic liver failure (HBV-ACLF) is a severe liver disease which results in a high mortality in China. To early predict the prognosis of the patients may prevent the complications and improve the survival. This study was aimed to develop a new prognostic index to estimate the survival related to HBV-ACLF. Methods Consecutive patients with HBV-ACLF were included in a prospective observational study. Serum Cystatin C concentrations were measured by using the particle-enhanced immunonephelometry assay. All of the patients were followed for at least 3 months. Cox regression analysis was carried out to identify which factors were predictive of mortality. The area under the receiver operating characteristic curve (AUC) was used to evaluate the efficacy of the variates for early predicting mortality. Results Seventy-two patients with HBV-ACLF were recruited between January 2012 and January 2013. Thirty patients died (41.7%) during 3-months followed up. Cox multivariate regression analysis identified serum cystatin C (CysC) and total bilirubin (TBil) were independent factors significantly (P < 0.01) associated with survival. Our results further showed that new prognostic index (PI) combining serum CysC with TBil was a good indicator for predicting the mortality of patients with HBV-ACLF. Specifically, the PI had a higher accuracy than the CTP, MELD, or MELD-Na scoring for early prediction short-term survival of HBV-ACLF patients with normal levels of serum creatinine (Cr). The survival rate in low risk group (PI < 3.91) was 94.3%, which was markedly higher than those in the high-risk group (PI ? 3.91) (17.4%, P < 0.001). Conclusion We developed a new prognostic index combining serum CysC with TBil which early predicted the short-term mortality of HBV-ACLF patients. PMID:25629773

Wan, Zhihong; Wu, Yichen; Yi, Jing; You, Shaoli; Liu, Hongling; Sun, Zhiqiang; Zhu, Bing; Zang, Hong; Li, Chen; Liu, Fangfang; Li, Dongze; Mao, Yuanli; Xin, Shaojie



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)



Non-invasive diagnosis of portal vein occlusion by radionuclide angiography.  

PubMed Central

The accuracy of non-invasive radionuclide angiography in detecting portal vein occlusion was assessed in 61 patients--10 with portal vein occlusion confirmed by conventional portography, 25 with chronic liver disease and a patent portal vein (mild = 12, severe = 13), and 26 with normal liver function, who served as controls. The median percentage portal venous flow for the portal vein occlusion group was 8% (range 1-30) (consistent with negligible flow) compared with 78% (52-87) for control subjects (p < 0.005) and 68% (61-80) and 49% (23-59) respectively for patients with mild and severe liver disease (p < 0.001 and p < 0.005). At a portal venous inflow of < 20%, the procedure had a specificity of 100% and sensitivity of 90% in diagnosing portal vein occlusion. Non-invasive radionuclide angiography provides a safe and accurate screening method for evaluating portal vein patency or occlusion in the investigation of portal hypertension or before liver transplantation. PMID:1487169

MacMathuna, P; O'Connor, M K; Weir, D G; Keeling, P W



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. PMID:22708098

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



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. PMID:22969282

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



The biological effects of occlusal trauma on the stomatognathic system - a focus on animal studies.  


The aim of this review of the literature was to assess the biological effects of occlusal trauma on the stomatognathic system focusing on animal studies. However, there are no conclusive explanations on the association between occlusal trauma and disease of the stomatognathic system. A literature survey was performed using the Medline database, covering the period from 1967 to 2012. Over 300 abstracts were reviewed, and 70 manuscripts were selected. Additional references from citations within the articles were obtained, and current textbooks were also used. This review does not include the effects of occlusal trauma on dental implants or dental prostheses/appliances. A total of 70 full articles were included for the final analysis. The selected 70 articles were classified into the following five categories, including the effects of occlusal trauma on the pulp tissues, periodontal tissues, masticatory muscle, temporomandibular joint (TMJ) and central nervous system (CNS). It was demonstrated that occlusal trauma caused a variety of harmful biological effects on stomatognathic system. Additionally, occlusal trauma could lead to some pain substance changes in the pulp, periodontal tissues, masticatory muscle, TMJ and CNS, which was possibly related to the peripheral and the central neuronal sensitisation. However, these findings demonstrate that there are remaining disagreements by various authors. More randomised trials are needed to validate these effects. PMID:23211044

Liu, H; Jiang, H; Wang, Y



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)



Stenting in Acute Lower Limb Arterial Occlusions  

SciTech Connect

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

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



Acute non-occlusive mesenteric ischemia of the small bowel in a patient started on hemodialysis: a case report  

Microsoft Academic Search

BACKGROUND: Non-occlusive mesenteric ischemia is not uncommon in chronic hemodialysis patients and is the major cause of an acute abdomen in this population. Intensive ultrafiltration and intradialytic hypotension are usually the precipitation factors. A definite diagnosis is usually late and associated with high mortality. We present a rare case of a patient who developed abdominal symptoms during his first week

Zachary Z Brener; Michael Bergman; Hyunsook K Ohm; James F Winchester



Experience with the Use of an Iron Polymaltose (Dextrin) Complex Given by Single Total Dose Infusion to Stable Chronic Haemodialysis Patients  

Microsoft Academic Search

Background: Many studies of anaemia in patients on chronic haemodialysis have noted a high prevalence of iron deficiency despite oral iron supplementation. Our study examined the effect of intravenous iron given as bolus replacement. As the majority of these patients were not receiving concurrent recombinant human erythropoietin (rhEPO) it allowed an analysis of the safety and efficacy of intravenous iron

Roal van Zyl-Smit; Janet A. Halkett



Waxing techniques to develop proper occlusal morphology in different occlusal schemes.  


Static and dynamic occlusal interferences frequently need to be corrected by selective grinding of the occlusal surface of conventional cast, porcelain fused to metal and all-ceramic restorations. Proper dimensional contours and occlusal morphologies of these restorations is an important consideration in overall success of the case. Various types of occlusal morphologies and contact relationships of posterior reconstructions are dependent on the occlusal schemes (Cusp-fossa or Cusp-marginal ridge) and the requirements of the patient's masticatory system. While much has been said and deliberated about the occlusal schemes, little is spoken about its development using intricate waxing techniques. There are various waxing techniques described in the literature which give a detailed description of the steps, methodology and instrumentation used for waxing of occlusal forms. The role of using such intricate waxing techniques cannot be overemphasized. Discussed in this article are the different techniques to be used in developing appropriate occlusal morphology and is supported by suitable case presentations. PMID:23204728

Gauri, Mulay; Ramandeep, Dugal



Endovascular Treatment of Urgent Carotid Occlusion  

PubMed Central

Summary Emergency revascularization of acute carotid artery occlusion is still controversial. We treated 15 patients (13 men and two women, mean age of 67.3 years) with acute atherosclerotic carotid occlusion by endovascular procedures and evaluated the usefulness of this treatment. All of the patients were evaluated with emergency MRI and MRA before treatment. Intracranial tandem arterial occlusion due to distal embolism was observed in nine patients, and contralateral carotid stenosis (>70%) was observed in seven. The mean NIHSS score of the patients was 15.4±7.4 (mean±SD) before treatment. Treatment modality included local intraarterial fibrinolysis (LIF), percutaneous transluminal angioplasty (PTA), and carotid artery stenting (CAS). A protective balloon was successfully placed in the distal carotid artery through the plaque before recanalization in seven patients. Three patients were treated with LIF+PTA, five with PTA+CAS, six with LIF+PTA+CAS, and one with PTA only. Successful recanalization of the carotid artery was obtained in 14 of the 15 patients, and distal tandem middle cerebral artery occlusion was also successfully recanalized in eight of the nine patients. GOS was four or five in eight patients (good outcome group) and 1-3 in seven patients (poor outcome group). Mean NIHSS score of the 15 patients was (6.9±7.4) after treatment. Preoperative NIHSS score (10.3 ±7.4) in the good outcome group was significantly lower than that (21.3 ±5.4) in the poor outcome group. The protective balloon technique, PTA with stenting, seems to be useful for acute revascularization of urgent carotid occlusion. Simultaneous treatment of the intracranial tandem occlusive lesion is essential to achieve good clini-cal results. Patients with acute carotid occlusion with NIHSS scores of less than 16 could be good candidates for this advanced treatment. PMID:20569639

Tsumura, K.; Kuwayama, N.; Iwai, R.; Kanbayashi, T.; Satoh, H.; Kubo, M.; Endo, S.



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



Retinal vein occlusion in high altitude.  


Staying at high altitude has been reported to be associated with thrombosis in lowlanders. We report 3 cases of retinal vein occlusion in high altitude. Two were males 31 and 37 years of age, who developed nonischemic central retinal vein occlusion while staying at high altitude. The former developed central retinal vein occlusion after 90 days at 6309 m, while the latter was affected at an altitude of 3353 m where he had been for the past 1 year and had recurrence of central retinal vein occlusion in the other eye on re-entry to the same altitude. The third case is that of a 40-year-old female who developed inferotemporal branch retinal vein occlusion on the second day after entry into high altitude (3353 m) by air, while ascending further in a vehicle at an altitude of approximately 4572 m. All three did not have any systemic disease and showed complete recovery on descent to a lower altitude. PMID:22206565

Gupta, Atul; Singh, Surinderpal; Ahluwalia, Tejinder Singh; Khanna, Anurag



[Occlusion of the aorta and iliac arteries].  


Occlusion of the aorta and the iliac arteries leads to an insufficient perfusion of the legs and the genital and gluteal region. The occurring symptoms may be variable, mainly depending on the collateralization network of the internal iliac artery (IIA) circulation. Various differential diagnoses need to be excluded. Invasive therapy is almost always inevitable if an aortoiliac stenosis is established. With good patency rates and low mortality rates the indications for reconstructive procedures are liberally interpreted; therefore, invasive therapy can be performed in the early stages of claudication in certain situations. Due to lower invasiveness and therefore lower risk of complications while showing comparable long-term patency rates, endovascular treatment is the preferred first line therapy for the majority of occlusions. Because aortoiliac occlusion processes also affect patients who are actively involved in a professional career, the indications for invasive therapy can be attained even in Fontaine stage IIa. PMID:25182006

Kosan, J; Riess, H; Atlihan, G; Diener, H; Kölbel, T; Debus, E S



Primary stenting in infrarenal aortic occlusive disease  

Microsoft Academic Search

Purpose: To evaluate the results of primary stenting in aortic occlusive disease.\\u000a \\u000a \\u000a 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.\\u000a Median follow-up was 16 months (range 1–60 months).\\u000a \\u000a \\u000a \\u000a \\u000a Results: Guidewire crossing of

Ulf Nyman; Petr Uher; Mats Lindh; Bengt Lindblad; Krasnodar Ivancev



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


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

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



The Effect of Bangerter Occlusion Foils on Blepharospasm and Hemifacial Spasm in Occlusion-Positive and Occlusion-Negative Patients  

PubMed Central

Objective: To test the hypothesis that occlusion-positive (OP) patients with blepharospasm (BEB) or hemifacial spasm (HFS) will benefit from a Bangerter occlusion foil (BOF), compared to occlusion-negative (ON) patients. OP/ON was based on immediate improvement in spasm with placement of a hand in front of either eye. Design: Prospective non-randomised single-centre pilot study. Participants: Fifteen-patients (6 BEB, 9 HFS). Methods: Patients were identified as OP or ON and wore highest-density BOF tolerable over one spectacle lens for 1 month. Outcomes were assessed at 1 month. Main Outcome Measures: Validated quality-of-life questionnaire (CDQ-24), scores of blink-rate and spasm severity assessed by two observers from video-recordings. Results: OP group had mean improvement in all scores. There was no change or worsening of scores in the ON group. In both BEB and HFS, more OP patients reported subjective benefit from wearing a foil (2 of 4 BEB, and 2 of 2 HFS) compared to the ON group (0 of 2 BEB, and 1 of 7 HFS). Conclusion: OP patients with BEB and HFS are more likely to experience improvement in spasms from wearing a BOF compared to ON patients. The occlusion test should be considered on all patients with BEB or HFS. PMID:20148097

Malhotra, Raman; Then, Siew-Yin; Richards, Alison; Cheek, Elizabeth



Hyperhomocysteinemia, a risk factor for atherosclerosis in chronic uremic patients.  


Hyperhomocysteinemia has been shown to constitute an independent risk factor for premature occlusive arterial disease (N Engl J Med 324:1149), a frequent complication in chronic uremic patients in whom homocysteine (Hcy) accumulation has been reported to occur. We prospectively determined fasting plasma level of total, protein-bound Hcy in 118 adult chronic uremic patients, either dialyzed or not. In 79 non-dialyzed patients (47 male) with various degrees of chronic renal failure (RF) assessed by creatinine clearance (CCr), none receiving folate, B6 or B12 vitamin supplementation, mean (+/- 1 SD) plasma Hcy level was 16.2 +/- 8.1 mumol/liter in 28 patients with mild RF (CCr 30 to 75 ml/min), 23.3 +/- 14.7 in 29 patients with moderate RF (CCr 10 to 29.9), and 29.5 +/- 14.4 in 22 patients with advanced RF (CCr < 10), a significant difference (P < 0.01 for all groups) compared to 45 healthy controls (8.2 +/- 2.2 mumol/liter). Linear regression analysis showed a significant correlation between plasma creatinine and Hcy concentrations (r = 0.49, P < 0.0001). Hcy was significantly higher in 20 patients (16 males) who had past histories of occlusive arterial disease than in the 59 (31 males) who did not (30.9 +/- 19.1 vs. 19.6 +/- 9.7 mumol/liter, P < 0.001) and all of the former had Hcy level > 14.1 mumol/liter (the upper limit in healthy controls) versus 35 of 59 in the latter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8320950

Chauveau, P; Chadefaux, B; Coudé, M; Aupetit, J; Hannedouche, T; Kamoun, P; Jungers, P



21 CFR 878.4020 - Occlusive wound dressing.  




21 CFR 878.4020 - Occlusive wound dressing.  

Code of Federal Regulations, 2013 CFR




21 CFR 878.4020 - Occlusive wound dressing.  

Code of Federal Regulations, 2012 CFR




21 CFR 878.4020 - Occlusive wound dressing.  

Code of Federal Regulations, 2011 CFR




21 CFR 878.4020 - Occlusive wound dressing.  

Code of Federal Regulations, 2010 CFR




Relation of dietary preference to bite force and occlusal contact area in Japanese children.  


The purpose of this study was to examine the relationship of dietary preference to bite force and occlusal contact area in Japanese elementary school children. A total of 348 children, aged 7-12 years, from two public elementary schools located in Okayama Prefecture, Japan, participated in the study. Clinical examination included decayed, missing and filled teeth (dmft and DMFT), and total numbers of deciduous and permanent teeth. Bite force and occlusal contact area were measured using a pressure-detecting sheet. Dietary preference was assessed using a questionnaire in which the answers were given in like/dislike form. Mann-Whitney U-test and multiple logistic regression analysis were applied to analyse the data. In multiple logistic regression analysis after adjustment for age, gender and total number of teeth present, children who liked cabbage and celery showed significantly higher bite force (P = 0.05 and P < 0.01, respectively) than those who disliked these. Children who liked cabbage and celery also showed higher occlusal contact area (P < 0.05 and P < 0.01, respectively) than those who disliked these. The Japanese elementary school children who liked hard foods such as cabbage and celery showed higher bite force and higher occlusal contact area than those who disliked these foods. A positive attitude towards harder food items might contribute to healthy development of the masticatory apparatus. PMID:19548957

Yamanaka, R; Akther, R; Furuta, M; Koyama, R; Tomofuji, T; Ekuni, D; Tamaki, N; Azuma, T; Yamamoto, T; Kishimoto, E




E-print Network

' & $ % OCCLUSION REASONING FOR MULTIPLE OBJECT VISUAL TRACKING ZHENG WU Dissertation submitted OBJECT VISUAL TRACKING by ZHENG WU B.S., Zhejiang University, China, 2003 M.S., Zhejiang University been very patient to instruct me with every piece of my work in the past six years, providing extremely

Wu, Zheng


The Depth Discontinuity Occlusion Camera Voicu Popescu*  

E-print Network

on the observation that the samples needed are close to the discontinuities in the depth map of the reference viewThe Depth Discontinuity Occlusion Camera Voicu Popescu* Daniel Aliaga Purdue University Purdue University Figure 1 Depth image, DDOC reference image, and corresponding pair of frames. The DDOC reference

Aliaga, Daniel G.


Detecting Occlusion and Camouflage during Visual T. Chandesa  

E-print Network

Detecting Occlusion and Camouflage during Visual Tracking T. Chandesa School of Computer Science algorithms exist, occlusion and camouflage remain a common problem. These can cause a tracker to become on the detection of occlusion and camouflage during particle filter-based tracking. We use a Gaussian Mixture Model

Bargiela, Andrzej


Occlusion Analysis: Learning and Utilising Depth Maps in Object Tracking  

E-print Network

Occlusion Analysis: Learning and Utilising Depth Maps in Object Tracking D. Greenhill, J. Renno. J discontinuities. After regularisation, the depth map will support reasoning about static occlusions. As an object there has been significant occlusion of the observation. The depth map allows the visibility of the object

Jones, Graeme A.


Occlusion Analysis: Learning and Utilising Depth Maps in Object Tracking  

E-print Network

Occlusion Analysis: Learning and Utilising Depth Maps in Object Tracking D. Greenhill, J. Renno, S. In particular, the occlusion surfaces will appear as depth discontinuities. After regularisation, the depth map model - becomes problematic where there has been significant occlusion of the observation. The depth map

Jones, Graeme A.


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

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



PS-OCT of occlusal and interproximal caries lesions viewed from occlusal surfaces  

NASA Astrophysics Data System (ADS)

Previous studies have demonstrated that Polarization Sensitive Optical Coherence Tomography (PS-OCT) can be used to image early dental caries. The primary objective of this study was to compare the measured reflectivity of natural occlusal caries lesions with the relative mineral loss measured using digital microradiography. There was excellent agreement between the increase in the integrated reflectivity in the perpendicular polarization axis of the PS-OCT system and the increase in the integrated mineral loss or lesion severity for occlusal lesions. Therefore, PS-OCT is ideally suited to image natural caries lesions in the important occlusal surfaces for the assessment of the lesion severity and activity. A secondary objective was to compare the performance of a new autocorrelator-based PS-OCT system employing a novel polarization-switching probe with our polarization-maintaining fiber based PS-OCT system, both operating at 1310-nm. The new PS-OCT system produced clean images with no artifacts and achieved high penetration depth. Yet a third objective was to determine if interproximal lesions can be imaged from the occlusal surface (from above) since interproximal lesions may only be accessible in vivo from buccal or lingual surfaces or from the occlusal surface. Simulated and natural interproximal caries lesions were imaged from the occlusal surfaces as long as there was no intervening dentin.

Ngaotheppitak, Patara; Darling, Cynthia L.; Fried, Daniel; Bush, Jeff; Bell, Steve



Distribution of sagittal occlusal relationships in different stages of dentition.  


The aim of this study was to assess the distribution of sagittal occlusal relationships in different dentition periods in a Turkish sample group. In total, 1,110 patients (561 females, 549 males) aged 4.6-23 years were randomly chosen after intraoral clinical examination. The subjects were classified according to their sagittal occlusal relationships and four dentition stages -deciduous, early mixed, late mixed, and permanent dentition. The statistical significance of the occurrence of malocclusion types in dentition stages was evaluated by Chi-square and Fischer's exact tests. Class I malocclusion was observed at the highest rate in all dentition stages. Class III malocclusion was observed at the highest rate in the permanent dentition, whereas Class II malocclusion was observed at the highest rate in the late mixed dentition. The rates of Class I, II, and III malocclusions were similar in males and females. Our study reveals that the prevalence of malocclusion and need for orthodontic treatment has increased in the population towards the permanent dentition. PMID:25590502

Emine, Kaygisiz; Lale, Taner; Kahraman, Gungor



Occlusion handling in videos object tracking: A survey  

NASA Astrophysics Data System (ADS)

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

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



Occlusion Handling in Videos Object Tracking: A Survey  

NASA Astrophysics Data System (ADS)

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

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



The Use of Skeletal Muscle Near Infrared Spectroscopy and a Vascular Occlusion Test at High Altitude  

PubMed Central

Abstract Martin, Daniel, Denny Levett, Rick Bezemer, Hugh Montgomery, and Mike Grocott. The use of skeletal muscle near infrared spectroscopy and a vascular occlusion test at high altitude. High Alt Med Biol 14:256–262, 2013.—Microcirculatory function, central to tissue regulation of oxygen flux, may be altered by the chronic hypoxemia experienced at high altitude. We hypothesized that at high altitude, adaptations within skeletal muscle would result in reduced oxygen consumption and reduced microcirculatory responsiveness, detectable by near infrared spectroscopy (NIRS) during a vascular occlusion test (VOT). The VOT comprised 3?min of noninvasive arterial occlusion; thenar eminence tissue oxygenation (Sto2) was measured by NIRS during the VOT at sea level, 4900?m and 5600?m (after 7 and 17 days at altitude, respectively) in 12 healthy volunteers. Data were derived from Sto2 time-curves using specifically designed computer software. Mean (±SD) resting Sto2 was reduced at 4900?m and 5600?m (69.3 (±8.2)% (p=0.001) and 64.2 (±6.1)% (p<0.001) respectively) when compared to sea level (84.4 (±6.0)%. The rate of Sto2 recovery after vascular occlusion (Sto2 upslope) was significantly reduced at 4900?m (2.4 (±0.4)%/sec) and 5600?m (2.4 (±0.8)%/sec) compared to sea level (3.7 (±1.3)%/sec) (p=0.021 and p=0.032, respectively). There was no change from sea level in the rate of desaturation during occlusion (Sto2 downslope) at either altitude. The findings suggest that in resting skeletal muscle of acclimatizing healthy volunteers at high altitude, microvascular reactivity is reduced (Sto2 upslope after a short period of ischemia) but that oxygen consumption remains unchanged (Sto2 downslope). PMID:24067186

Levett, Denny Z.H.; Bezemer, Rick; Montgomery, Hugh E.; Grocott, Mike P.W.



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



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

PubMed Central

Introduction Painful temporomandibular disorders (TMDs) are usually treated with physiotherapy, self-exercises, medication-based therapy and splint therapy. For splint therapy different types of splints are available. Therefore this randomized controlled study compared the effectiveness of a semi-finished occlusal appliance (SB) with a laboratory-made occlusal appliance (SS) in myofascial pain patients. Method The trial subjects allocated to the experimental groups with the (SB) occlusal appliance and those provided with a laboratory-made occlusal appliance (SS) did, in addition, receive conservative treatment (self-exercises, drug-based and manual therapy). The control group was given conservative therapy (CO) only. Overall, a total of 63 patients participated in the study with each group consisting of 21 subjects. Results When the first follow-up examination took place (14 days after splint insertion) mouth opening within the SB group was significantly enlarged. When the second examination was conducted (2.5 months after splint insertion) mouth opening was significantly enlarged in both splint groups when compared with the initial value. In the control group, no significant enlargement of mouth opening was detected. At no point there was a significant reduction in the number of pressure-sensitive areas of the TMJ. On palpation of the masticatory muscles however, a significant reduction in the number of pressure-sensitive areas could be observed within the CO group and the SS group after 2.5 months. When comparing pain reduction (muscle/joint pain) and mouth opening, no significant differences could be detected between the treatments. Conclusion The results suggest that TMD should be treated conservatively. In cases of restricted mouth opening, the additional use of occlusal appliances can eliminate the patient’s discomfort more quickly. In this context, the tested, semi-finished occlusal appliance appears to offer an immediately available, temporary alternative to laboratory-made splints. PMID:23351923



Branch Retinal Artery Occlusion following Dental Extraction  

PubMed Central

Aim. To describe a case of branch retinal artery occlusion following dental extraction and to point out the ophthalmic complications of dental procedures to ophthalmologists and dentists. Case. A 51-year-old woman was referred to our clinic with painless sudden visual loss in her left eye after tooth extraction two days ago. In her left eye the best corrected visual acuity was 6/30 and fundus examination revealed peripapillary flame-shaped hemorrhages and pale retina in the upper temporal arcuate. The right eye examination was unremarkable. Conclusion. Dental procedures can lead to miscellaneous ophthalmic complications possibly due to the close proximity of the anatomic structures. Retinal arterial occlusion is a rare but serious cause of permanent visual loss among these dental procedures where the exact pathologic mechanism is still obscure. PMID:25580327

O?urel, Tevfik; Onaran, Zafer; O?urel, Reyhan; Örnek, Nurgül; Büyüktortop Gökç?nar, Nesrin; Örnek, Kemal



[TMJ morphological changes in abnormal occlusion].  


TMJ dysfunction is one of the most common diseases among all disorders of the maxillofacial region. Any abnormality in synchrony or amplitude of motion of the TMJ results in the malposition of the articular disc. Researchers and clinicians were always interested in topographic anatomy of the TMJ. There is currently no consensus on matters relating to changes in anatomical features of the TMJ by occlusal disturbances. PMID:23715443

Volkov, S I; Bazhenov, D V; Semkin, V A; Bogdanov, A O



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



Interventional Treatment of Mesenteric Venous Occlusion  

PubMed Central

Summary Background Mesenteric venous thrombus may be an incidental finding during imaging studies and asymptomatic patients are treated conservatively or with anticoagulant therapy only. Patients with symptomatic acute thrombosis causing bowel ischemia require urgent treatment, which frequently includes extensive surgery. Interventional treatment may be an alternative. Purpose: To present results of interventional treatment in patients with symptomatic occlusion of the mesenteric veins. Material/Methods Eight patients, four men and four women aged 24–74 years (mean 53 years) were treated due to symptomatic portomesenteric venous occlusion of thrombotic origin. Transhepatic (n=5), trans-splenic (n=2), and transjugular (n=4) accesses were used. Patients were treated with mechanical thrombus fragmentation (n=4), pharmacological thrombolysis (n=3) and stent placement (n=8). Additional transjugular intrahepatic portosystemic shunt (TIPS) was created to facilitate the outflow from the treated veins (n=4). Results The majority of the patients required combination of different treatment methods. Resolution of symptoms with initial clinical success was achieved in seven of the eight patients, and one patient died the day after the procedure due to sepsis. Two other patients had procedure-related complications; one of them required embolization. Two patients had documented long-term clinical success with patent stents and no symptoms at one year following intervention. Conclusions Endovascular treatment of portomesenteric occlusion in patients with acute symptomatology showed good short-term clinical success rate. PMID:25089163

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



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:



Renal artery occlusion model in dogs for the evaluation of thrombolytic agents.  


The purpose of this study was to develop a model of renal artery occlusion and to investigate the effects of various thrombolytic agents on an acute occlusion of the renal artery with respect to ischemic tolerance of renal parenchyma. In order to do this, a thrombosis model in dogs (n = 36) was established and a total of 72 dorsal renal arteries occluded using autologous clot material. For the in vitro preparing of a clot, autologous blood (20 mL) was withdrawn and 100 U thrombin immediately added. Then 1 mL of the clot material was injected into the dorsal branch of the exposed renal artery. The dogs were divided into 8 groups (2 control groups, 6 therapy groups with local and systemic thrombolytic therapy). Thrombolysis was performed using urokinase, single-chain urokinase, and recombinant tissue-plasminogen activator. In all cases the clot preparation technique allowed complete and stable occlusion of the renal arteries. Local and systemic application of the thrombolytic agents, however, resulted in complete recanalization of the clot material in all study groups. Recombinant tissue-plasminogen activator turned out to be the most effective agent in terms of recanalization time. The technique described allowed effective and reproducible artery occlusion for in vivo experimental work to study comparatively thrombolytic agents with respect to fibrin specificity, lytic efficacy, and side effects. PMID:9284002

Haberstroh, J; Wagner, G; Kiefer, T; Blum, U; von Specht, B U



Coil occlusion of the large patent ductus arteriosus.  


While coil occlusion is well accepted for the small patent ductus arteriosus (PDA), occlusive devices are preferred for the larger (> 3 mm) ducts by most institutions. Because of costs concerns, occlusive devices are not always realistic in many countries. The technique of simultaneous delivery of multiple coils with bioptome assistance works well for relatively larger ducts. This technique requires careful case selection through echocardiography. The duct anatomy plays a crucial part in determining the suitability for coil occlusion. Coil occlusion has a specific advantage for relatively larger ducts in selected small children and in preterm infants because it is possible to accomplish delivery of multiple coils through relatively small introducer sheaths. In addition, aortic narrowing is less likely because coils compact in the ampulla. This review describes case selection strategies and techniques of coil occlusion of the large PDA. Relevant illustrative images are shown. PMID:22368542

Kumar, Rk; Nair, Ac



Model for intravital microscopic evaluation of the effects of arterial occlusion-caused ischemia in bone.  


An in vivo model has been developed for chronic observation of the effects of ischemia on cortical bone remodeling and perfused vascularity. Diaphragm occluders were implanted around the right common iliac artery of four rabbits and inflated to produce 10 h of ischemia to the limb. Microcirculation was monitored with intravital microscopy of injected fluorescent microspheres and FITC-Dextran 70 through a bone window, the tibial bone chamber implant (BCI). Bone resorption and apposition in the BCI were indicated with mineralization dyes. Between 2 and 12 h following release of the occluder, secondary ischemia/no-reflow and other evidence of reperfusion injury were observed. Vessel damage was suggested by abnormally high leakage of FITC-D70 from the few vessels perfused during secondary ischemia. In the weeks following occluder release perfused vasculature increased beyond pre-occlusion levels. Net bone resorption reached a maximum when vascularity passed normal levels. In order to further validate the arterial occlusion model for osteonecrosis, techniques for (1) confirming bone death and (2) detecting increased leukocyte adherence to endothelial cells were added. The dead cell stain Ethidium homodimer-1 was used to tag dead osteocytes immediately after occlusion and produced a measure designated "osteonecrosis index." To detect leukocytes adhering to vessel walls, carboxyfluorescein diacetate, succinimidyl ester was injected at occluder release. An increase in the number of adherent leukocytes was detected. PMID:10468235

Hsieh, A S; Winet, H; Bao, J Y; Stevanovic, M



Elevated total iron-binding capacity as a predictor of response to deferasirox therapy in the setting of chronic iron overload.  


It is difficult to predict the efficacy of deferasirox (DFX) as its pharmacokinetics varies among patients. The area under the curve (AUC) is reportedly useful for determining adequate DFX dosage; however, serum concentration measurements are often challenging. Effective DFX dosage is thus defined by assessing the efficacy of this agent in clinical practice. To analyze a predictive response marker to DFX therapy for use in adjusting the effective dosage during the early treatment phase, we retrospectively evaluated 39 DFX-treated patients. We defined response as a >40 % decrease in serum ferritin concentration from the pretreatment level. A maximum elevation of the total iron-binding capacity (TIBC) correlated with response in a multivariate analysis of iron metabolic markers (R (2) = 0.37, p < 0.001). A receiver operating characteristic curve analysis revealed that TIBC elevation had an AUC of 0.85 (p < 0.001) and the optimal cut-off value of TIBC elevation was 150 µg/dl. TIBC elevation of >150 µg/dl is a favorable predictor of effective ferritin reduction in DFX therapy (hazard ratio 29.6, 95 % confidence interval 4.8-183.6; p < 0.001). DFX therapy with TIBC monitoring may enable the determination of the minimum effective DFX dosage. PMID:24986748

Watanabe, Junichi; Sato, Ken; Horiuchi, Toshikatsu; Kato, Shoichiro; Hikota, Reina; Maekawa, Takaaki; Yamamura, Takeshi; Kobayashi, Ayako; Osawa, Yukiko; Kobayashi, Shinichi; Kimura, Fumihiko



Follow-up of coil occlusion of patent ductus arteriosus  

Microsoft Academic Search

Objective. We sought to determine the prevalence and fate of residual ductal shunting following coil occlusion of patent ductus arteriosus.Background. Although transcatheter coil occlusion of patent ductus arteriosus has gained popularity, few follow-up data have been reported.Methods. A review of 75 patients who underwent coil occlusion was performed. Residual shunting was investigated by Doppler echocardiography in follow-up. Angiograms were reviewed

David Shim; Raymond T. Fedderly; Robert H. Beekman; Achi Ludomirsky; Mary L. Young; M. Anthony Schork; Thomas R. Lloyd



Formation of retinochoroidal collaterals in central retinal vein occlusion  

Microsoft Academic Search

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

Kyoichi Takahashi; Kanemitsu Muraoka; Shoji Kishi; Koichi Shimizu



Natural history of carotid artery occlusion.  


Carotid artery occlusion (CAO) is a risk factor for stroke ipsilateral to the occlusion and puts patients in a high-risk category when contralateral endarterectomy is performed. The purpose of this study was to evaluate the long-term outcomes of patients with internal CAO and to determine risk factors predictive of subsequent neurological event, contralateral carotid intervention, or death. Patients with internal CAO shown by duplex ultrasonography were retrospectively identified and followed between January 2002 and June 2010 (follow-up: 1-101 months, mean: 52 months) at a tertiary care hospital. All had multiple duplex examinations available for review. Chi-square analysis was used to determine risk factors for neurologic event, contralateral intervention, or all-cause morality. Multivariate Cox proportional hazard analysis was conducted using univariate risk factors with P values <0.1. Survival was estimated using the Kaplan-Meier method (P < 0.05 significant). Eighty patients with internal CAO were identified and available for analysis. On initial encounter, 30 (38%) were symptomatic, with 26 (87%) having symptoms referable to the side of the occluded internal carotid artery. During follow-up, seven (9%) had a neurologic event, of which six (86%) were referable to the occluded side; 14 (18%) patients underwent a contralateral operation. Nineteen (24%) patients died during the period of study. Although numerous variables of multivessel disease were significant with ?(2) analysis, there was no significant risk factor associated with neurologic event on multivariate analysis. However, the development of a hemodynamically significant stenosis (>50%) or occlusion of the external carotid artery (ECA) ipsilateral to the occlusion on follow-up (P < 0.027) was associated with increased risk of death. Kaplan-Meier analysis showed 7-year survival for patients with ECA disease at follow-up was significantly worse (16.2% ± 10.3% [n = 21] vs. 79% ± 8.7% [n = 59]; P < 0.00001). Frequently, patients present with neurological symptoms referable to the side of the internal CAO. Eighty-six percent of neurologic events that occur in follow-up are attributable to the side of the occluded carotid, indicating that the occluded side continues to contribute to neurologic morbidity over time. Multivariate analysis revealed no single factor to be predictive of subsequent neurologic events. With significant risk of death in patients found to have ipsilateral ECA stenosis during follow-up, it seems reasonable to continue surveillance of the occluded carotid. PMID:22951063

Bryan, Darren S; Carson, John; Hall, Heather; He, Qi; Qato, Khalil; Lozanski, Laurie; McCormick, Susan; Skelly, Christopher L



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)



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)



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



Postprandial lower limb pain: An unusual presentation of visceral arteries occlusion.  


This case report describes an atypical and unique presentation of mesenteric arteries occlusive disease. The patient presented with typical symptoms of chronic mesenteric ischemia, as well as with an atypical new symptom; postprandial buttock and lower limbs pain. Pain followed the time curve of the postprandial abdominal discomfort, starting 30?min after meals and gradually resolving within 2?h. The patient had been tolerating the signs of chronic mesenteric ischemia quite well by adjusting the quantity of food per meal to relieve symptoms. Angiography showed that the celiac artery, the superior mesenteric artery, and distal aorta were occluded, leaving the inferior mesenteric artery as the only feeding vessel of all abdominal viscera and both the lower limbs. Since an English medical literature search returned only one marginally similar case, we consider this case of iliac arteries' "steal syndrome" from the inferior mesenteric artery unique. PMID:25057158

Patelis, Nikolaos; Papoutsis, Konstantinos; Liakopoulos, Dimitrios; Koutsoumpelis, Andreas; Bakogiannis, Christos; Georgopoulos, Sotirios



Recurrent syncope after left atrial appendage occlusion.  


We present the case of a 72-year-old woman with permanent atrial fibrillation and contraindication to long-term oral anticoagulant therapy who underwent left atrial appendage (LAA) occlusion. A 24-mm Amplatzer Cardiac Plug (St Jude Medical) device was deployed. The inferior part of the external disc of the device appeared to be over the posterior leaflet of the mitral valve but no significant mitral stenosis or mitral regurgitation was detected before deployment. After the procedure the patient suffered several syncopes when she tried to stand up. A transesophageal echocardiography (TEE) was performed and no significant differences on the device position were detected, it was not possible to perform the TEE in a stand-up position due to the patient symptoms (hypotension, tachycardia, dizziness, and loss of consciousness). After discussion with the surgical team, surgical removal of the device and surgical exclusion of LAA was performed. The symptoms disappeared and the patient was discharged. In the best of our knowledge, this is the first time that recurrent syncope has been described as a complication of LAA occlusion. © 2014 Wiley Periodicals, Inc. PMID:25044597

Cruz-Gonzalez, Ignacio; Perez-Rivera, Jose-Angel; Bethencourt, Armando



Incompressible viscous flow in tubes with occlusions  

NASA Astrophysics Data System (ADS)

Viscous, incompressible flow in tubes with partial occlusion is investigated using numerical and experimental procedures. The study is related to the problem of atherosclerosis, one of the most common diseases of the circulatory system. One of the computational difficulties in solving the incompressible Navier-Stokes equations is the lack of pressure or vorticity boundary conditions. A finite difference approach, referred to as the interior constraint (IC) method, is proposed to resolve this difficulty. As a general numerical method, it is formulated for both the stream function-vorticity and primitive (physical) variable formulations. The procedure is explained using a one dimensional model with extensive numerical tests presented for two dimensional cases, including flow in a driven cavity and flow over a backward facing step. Results are obtained with second-order accuracy. Next, the IC method is applied to flow in a tube with an occlusion, which is used as the model for blood flow in stenosed arteries in the study of the pathology of atherosclerosis. Numerical results are obtained for both steady and pulsatile flows. Results are compared with those of SIMPLE, one of the commercially available numerical algorithms. The pulsatile flow study revealed several interesting new features. It suggested that the high shear stress is not likely to initiate atherosclerosis lesions. The recirculation region, which is a prominent feature of the unsteady flow, is more likely to cause the initiation and development of the disease. Experimental measurements for steady flow complement the numerical study and show qualitative agreement.

Huang, Huaxiong


Optimal management of infrainguinal arterial occlusive disease  

PubMed Central

Peripheral arterial occlusive disease is becoming a major health problem in Western societies as the population continues to age. In addition to risk of limb loss, the complexity of the disease is magnified by its intimate association with medical comorbidity, especially cardiovascular and cerebrovascular disease. Risk factor modification and antiplatelet therapy are essential to improve long-term survival. Surgical intervention is indicated for intermittent claudication when a patient’s quality of life remains unacceptable after a trial of conservative therapy. Open reconstruction and endovascular revascularization are cornerstone for limb salvage in patients with critical limb ischemia. Recent advances in catheter-based technology have made endovascular intervention the preferred treatment approach for infrainguinal disease in many cases. Nevertheless, lower extremity bypass remains an important treatment strategy, especially for reasonable risk patients with a suitable bypass conduit. In this review, we present a summary of current knowledge about peripheral arterial disease followed by a review of current, evidence-based medical and surgical therapy for infrainguinal arterial occlusive disease. PMID:25368519

Pennywell, David J; Tan, Tze-Woei; Zhang, Wayne W



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

...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...



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

Code of Federal Regulations, 2011 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...



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...



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

Code of Federal Regulations, 2012 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...



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

Code of Federal Regulations, 2010 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...



Occlusion detectable stereo-systematic comparison of detection algorithms  

Microsoft Academic Search

In stereo algorithms with more than two cameras, the improvement of accuracy in correspondence search is often reported. On the other hand, another important aspect of the polynocular stereo is the ability of occlusion detection. The camera matrix stereo SEA, which we have developed, offers a simple but effective framework to detect the presence of occlusion and to obtain reliable

Kiyohide Satoh; Yuichi Ohta



Occlusion analysis: Learning and utilising depth maps in object tracking  

Microsoft Academic Search

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

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



Occlusions of Branch Retinal Arterioles following Amniotic Fluid Embolism  

Microsoft Academic Search

Amniotic fluid embolism is a serious complication of pregnancy with a high mortality. We present a 28-year-old healthy woman who underwent dilatation and curettage for an elective abortion, followed by the sudden loss of vision in her left eye. Occlusion of one branch retinal arteriole was the initial finding of her left fundus, and two occlusions developed consecutively on the

In Taek Kim; Jeong Beom Choi



FAP-Enhanced Group Therapy for Chronic Pain  

Microsoft Academic Search

Chronic pain is often maintained as part of a series of vicious circles. Orofacial pain, for instance, can be related to spasms of the chewing muscles, which can be both the cause and the effect of a variety of factors including dysfunctional oral habits, changes in dental occlusion, continuous excessive contraction, and any combination of these. Increasing pain can provoke

Luc Vandenberghe


Chronic Incomplete Obstruction of the Ureter: A New Experimental Model  

Microsoft Academic Search

To produce a chronic moderate hydronephrosis in dog, a method of partial ureteral occlusion using a specially designed polypropylene obturator was developed. In 11 of 14 dogs undergoing this procedure, excretory urography constantly revealed a moderate degree of hydronephrosis persisting for 7 weeks. Combination of this method in one ureter with the vaginal-cuff cutaneous ureterostomy, previously reported, in the contralateral

Setsuo Masui; Yoshiharu Hiratsuka; Asami Ariyoshi; Kimitaka Sakamoto



Occlusion of the anterior cerebral artery after head trauma.  


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. PMID:23805374

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



Preventing biofilm formation and associated occlusion by biomimetic glycocalyxlike polymer in central venous catheters.  


The use of catheters and other implanted devices is constantly increasing in modern medicine. Although catheters improve patients' healthcare, the hydrophobic nature of their surface material promotes protein adsorption and cell adhesion. Catheters are therefore prone to complications, such as colonization by bacterial and fungal biofilms, associated infections, and thrombosis. Here we describe the in vivo efficacy of biologically inspired glycocalyxlike antiadhesive coatings to inhibit Staphylococcus aureus and Pseudomonas aeruginosa colonization on commercial totally implantable venous access ports (TIVAPs) in a clinically relevant rat model of biofilm infection. Although noncoated TIVAPs implanted in rats were heavily colonized by the 2 biofilm-forming pathogens with a high percentage of occlusion, coating TIVAPs reduced their initial adherence and subsequently led to 4-log reduction in biofilm formation and reduced occlusion. Our antiadhesive approach is a simple and generalizable strategy that could be used to minimize clinical complications associated with the use of implantable medical devices. PMID:24795479

Chauhan, Ashwini; Bernardin, Aude; Mussard, Windy; Kriegel, Irène; Estève, Marc; Ghigo, Jean-Marc; Beloin, Christophe; Semetey, Vincent



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



Acute renal artery occlusion following infliximab infusion  

PubMed Central

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

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



Prosthetic occlusive device for an internal passageway  

NASA Technical Reports Server (NTRS)

An occlusive device is disclosed for surgical implant to occlude the lumen of an internal organ. The device includes a cuff having a backing collar and two isolated cuff chambers. The fluid pressure of one chamber is regulated by a pump/valve reservoir unit. The other chamber is unregulated in pressure but its fluid volume is adjusted by removing or adding fluid to a septum/reservoir by means of a hypodermic needle. Pressure changes are transmitted between the two cuff chambers via faying surfaces which are sufficiently large in contact area and thin as to transmit pressure generally without attenuation. By adjusting the fluid volume of the septum, the operating pressure of the device may be adjusted to accommodate tubular organs of different diameter sizes as well as to compensate for changes in the organ following implant without reoperation.

Tenney, J. B., Jr. (inventor)



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

PubMed Central

Background Perinatal asphyxia and exposure to intrauterine infection are associated with impaired neurodevelopment in preterm infants. Acute exposure to non-injurious infection and/or inflammation can either protect or sensitize the brain to subsequent hypoxia-ischemia. However, the effects of subacute infection and/or inflammation are unclear. In this study we tested the hypothesis that acute-on-chronic exposure to lipopolysaccharide (LPS) would exacerbate white matter injury after subsequent asphyxia in preterm fetal sheep. Methods Fetal sheep at 0.7 gestational age received a continuous LPS infusion at 100 ng/kg for 24 hours, then 250 ng/kg/24 hours for 96 hours, plus 1 ?g boluses of LPS at 48, 72, and 96 hours or the same volume of saline. Four hours after the last bolus, complete umbilical cord occlusion or sham occlusion was induced for 15 minutes. Sheep were sacrificed 10 days after the start of infusions. Results LPS exposure was associated with induction of microglia and astrocytes and loss of total and immature and mature oligodendrocytes (n?=?9) compared to sham controls (n?=?9). Umbilical cord occlusion with saline infusions was associated with induction of microglia, astrogliosis, and loss of immature and mature oligodendrocytes (n?=?9). LPS exposure before asphyxia (n?=?8) was associated with significantly reduced microglial activation and astrogliosis and improved numbers of immature and mature oligodendrocytes compared to either LPS exposure or asphyxia alone. Conclusions Contrary to our initial hypothesis, the combination of acute-on-chronic LPS with subsequent asphyxia reduced neuroinflammation and white matter injury compared with either intervention alone. PMID:24886663



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

PubMed Central

This work evaluated the occlusive versus non-occlusive application of microemulsion (ME) for the transdermal delivery of progesterone. The mechanisms of enhanced skin penetration were investigated. ME comprised of oleic acid, Tween 80, propylene glycol, and water, was used neat or with ethanol as a volatile cosurfactant. The ME formulations enhanced progesterone transdermal flux compared to the saturated drug solution in 14% aqueous propylene glycol (control). Ethanol-containing ME (EME) was better than the ethanol-free system (EFME). Open application of EFME produced a marginal reduction in flux compared to occlusive application. For EME, open application reduced the flux by 26–28% with the flux remaining significantly higher than that obtained with EFME. The mechanistic studies revealed synergism between ethanol and EFME with EME, producing greater flux than the sum of fluxes obtained from 40% ethanol in water and EFME. Penetration enhancement and supersaturation played a role in enhanced transdermal delivery, but other mechanisms were also possible. This study thus introduced EME as a transdermal delivery system for progesterone with good potential for open application as a spray. PMID:23008820

El Maghraby, Gamal M.



Chronic Bronchitis  


... Calendar Read the News View Daily Pollen Count COPD Program This program offers comprehensive, individualized care for people with chronic obstructive pulmonary disease (COPD) including emphysema and chronic bronchitis. Learn more. Doctors ...


Caries process on occlusal surfaces: evolving evidence and understanding.  


Management of the caries process on occlusal surfaces of permanent molars has proven a major challenge. The onset of caries on these surfaces takes place soon after their eruption, and the permanent first molars, followed by the second molars, remain the sites in the dentition which show the highest caries prevalence. This paper is structured in the form of questions and answers in which traditional concepts of caries susceptibility of occlusal surfaces are appraised and confronted with the current evidence. Then, research studies examining the role of biological determinants on the development and arrest of occlusal caries in young permanent teeth are discussed. Finally, the contribution of these studies in terms of developing the available scientific evidence and our understanding of the caries process on occlusal surfaces is analyzed. The current evidence does not support the concept that the early onset and high prevalence of occlusal caries in young permanent teeth are due to a particularly low inherent resistance of the occlusal surface or due to the presence of inaccessible fissure-like structures on these surfaces. Evidence is provided to show that the most influential biological determinants of the development and arrest of occlusal caries are thick plaque accumulation on the groove-fossa system and the stage of tooth eruption limiting mechanical oral function. Consequently, active occlusal lesions are significantly more prevalent in erupting than in fully erupted teeth. The major contribution of this review is to provide updated knowledge about the biological principles determining the development and arrest of caries on occlusal surfaces of erupting teeth. PMID:24577073

Carvalho, J C



Effect of traumatic occlusion on CGRP and SP immunoreactive nerve fibre morphology in rat molar pulp and periodontium.  


Traumatic occlusion provides a trauma that affects the whole tooth and its supporting tissues. To study the effect of this trauma on CGRP and SP immunoreactive nerve morphology in pulp and periodontium, traumatic occlusion was induced in 2-months-old rats. The occlusal surface of the first maxillary molar in 30 rats were unilaterally raised 1 mm with a composite material. At different observation periods up to 30 days, the rats were transcardiacally perfused, the jaws demineralized, sectioned and processed for immunohistochemistry with the avidin-biotin-peroxidase method. Changes in nerve morphology, distribution and density in first and second molars and their supporting tissues were analyzed and compared in experimental (n = 30) and control rats (n = 14). Already after 5 days with traumatic occlusion, 22% of the experimental teeth had increased density of CGRP and SP immunoreactive nerves locally in gingiva, the periodontal ligament and the pulp, while in 15%, axonal proliferation and changed nerve morphology were found in the whole pulp (severe reaction). During a 20-day period, the pulpal nerve reactions progressed and included the whole pulp in 46% of the experimental teeth. The periodontal nerve responses were still localized only to the cervical and apical regions, and they remained local in these areas throughout the experimental periods. After 20 days the number of teeth with severe nerve changes seemed to decrease. The study shows that an unilateral change in occlusion of the first molar initiate nerve responses in the total molar dentition. In this experimental model the pulpal axons containing CGRP and SP reacted more serious to occlusal trauma than the nerves in the periodontium. The results indicate that the nerve changes in some cases might be transient. PMID:1373126

Kvinnsland, I; Heyeraas, K J



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



Effects of visual occlusion and fatigue on motor performance in water.  


The purpose of this study was to test the effects of visual occlusion and fatigue on the motor performance of vertical skills in synchronized swimming. Experienced synchronized swimmers (n = 12) were randomly assigned to either an exercise or nonexercise (control) activity group. Subjective ratings of fatigue were obtained from the swimmers who then each performed four vertical skills under alternating conditions of vision and visual occlusion before and after either a swimming (designed to induce fatigue) or nonphysical activity. A main effect of activity (p < .03) was found for two measures of performance accuracy (lateral and anterior total distance traveled) but not for lateral and anterior maximum deviation from vertical, indicating that fatigue played a role in executing the skills. The data also indicate that the maintenance of a stationary position is a skill of greater difficulty than maintaining a true vertical. In contrast with previous research findings on synchronized swimmers, a significant effect of vision in all conditions was found, with performance decrements in the conditions of visual occlusion showing that vision provided important sensory input for the swimmers. PMID:16060427

Sullivan, Elke A; Hooper, Sue L



Occlusion-amblyopia following high dose oral levodopa combined with part time patching  

PubMed Central

Part time occlusion therapy is not reported to cause occlusion (reverse) amblyopia. However, when combined with high dose oral levodopa, an increase in the plasticity of the visual cortex can lead to occlusion amblyopia. In this case report, we describe a six year old child who developed occlusion amblyopia following part time patching combined with oral levodopa. PMID:23571255

Kothari, Mihir



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


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

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



Functional Patterns of Molar Occlusion in Platyrrhine Primates  

E-print Network

mechanics . Dentition Molars . Occlusion Tooth wear Platyrrhine. ABSTRACT Mechanico-functional features the particular kinds of insects fed upon by the different genera and the de- tailed characters of the dentition

Rosenberger, Alfred H.


Bilateral Central Retinal Artery Occlusion in Behçet Disease.  


Abstract Purpose: To report a case of bilateral central retinal artery occlusion as the primary ocular manifestation of Behçet disease. Methods: A 38-year-old patient, with no history of previous ocular complaints, admitted with bilateral sudden vision loss. His ophthalmologic examination revealed a visual acuity of no light perception in both eyes and the diagnosis of bilateral central retinal artery occlusion. A detailed systemic investigation was conducted. Results: With the history of recurrent oral and genital ulcers, and the presence of ocular and skin findings, the diagnosis of Behçet disease was made. Despite a potent immunosuppressive therapy the patient became absolutely blind. Conclusions: Even though retinal arteries are rarely affected in Behçet disease, in the cases of retinal artery occlusion, it should be considered among the differential diagnosis. To our knowledge this is the first reported case of bilateral central retinal artery occlusion as the primary ocular manifestation of Behçet disease. PMID:24654996

Esen, Ebru; Sizmaz, Selcuk; Sariyeva, Ayna; Demircan, Nihal



Chemical burn caused by topical application of garlic under occlusion.  


Allium sativum (garlic) can cause an irritant contact dermatitis, secondary to naturopathic practices. We report an unusually severe case of chemical burn following garlic applied under occlusion. PMID:24456964

Xu, Shuai; Heller, Marissa; Wu, Peggy A; Nambudiri, Vinod E



Continuous Occlusion Test to Determine Detrusor Contractile Performance  

Microsoft Academic Search

PurposeA study was conducted to determine the merits of the continuous occlusion test as a method of detrusor contractility assessment by comparing it with other stop tests and with contractility derived from pressure-flow analysis.

Maryrose P. Sullivan; Catherine E. DuBeau; Neil M. Resnick; Ernest G. Cravalho; Subbarao V. Yalla



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. PMID:22934114

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



Correlation between inclination of occlusal plane and masticatory movement  

Microsoft Academic Search

Objectives: The purpose of this study was to investigate the relationship between the inclination of the occlusal plane and masticatory movement.Methods: Masticatory movements of 41 young adults were measured using the three-dimensional Mandibular Movement Analyzing System. The inclination of the occlusal plane was measured in the sagittal plane using a three-dimensional digitizer.Results: In the sagittal plane, the masticatory closing path

T. Ogawa; K. Koyano; T. Suetsugu



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.



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)



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


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

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



Chronic kidney disease  


Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... kidney disease. If it worsens to end-stage renal disease , and how ... Kidney failure is the last stage of chronic kidney disease. ...


Total protein  


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


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)



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

PubMed Central

We herein present the case of a 77-year-old man who had fever and right hypochondriac pain. He visited his doctor and underwent contrast computed tomography (CT), and he was suspected to have a liver abscess. He received an antibiotic treatment and his symptoms soon disappeared, but the tumor did not get smaller and its density on contrast CT image got stronger. He underwent biopsy and moderately differentiated hepatocellular carcinoma (HCC) was found. Extended left hepatic and caudate lobectomy was performed. Histological examination showed moderately differentiated HCC with narrowing and occlusion both in the arteries and portal veins associated with mild chronic inflammation. The mechanisms of spontaneous regression of HCC, such as immunological reactions and tumor hypoxia, have been proposed. In our case, histological examination showed the same findings. However, the mechanism is complex, and therefore further investigations are essential to elucidate it. PMID:24926228

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



Spontaneous massive necrosis of hepatocellular carcinoma with narrowing and occlusion of the arteries and portal veins.  


We herein present the case of a 77-year-old man who had fever and right hypochondriac pain. He visited his doctor and underwent contrast computed tomography (CT), and he was suspected to have a liver abscess. He received an antibiotic treatment and his symptoms soon disappeared, but the tumor did not get smaller and its density on contrast CT image got stronger. He underwent biopsy and moderately differentiated hepatocellular carcinoma (HCC) was found. Extended left hepatic and caudate lobectomy was performed. Histological examination showed moderately differentiated HCC with narrowing and occlusion both in the arteries and portal veins associated with mild chronic inflammation. The mechanisms of spontaneous regression of HCC, such as immunological reactions and tumor hypoxia, have been proposed. In our case, histological examination showed the same findings. However, the mechanism is complex, and therefore further investigations are essential to elucidate it. PMID:24926228

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



Usefulness of Doppler derived end diastolic flow gradient across the patent ductus arteriosus in selecting coils for ductal occlusion.  


Transcatheter closure of patent ductus arteriosus (PDA) with coils is accepted as an alternative to surgical ligation. We evaluated whether flow gradient across PDA, obtained by Doppler echocardiography, can aid in selecting coils for percutaneous ductal occlusion. 79 consecutive patients with PDA, who underwent successful percutaneous coil occlusion were retrospectively reviewed. Patients with other structural heart disease and pulmonary hypertension with right-to-left shunt were excluded. Echocardiogram and cardiac catheterization were done in all patients. Gianturco (Occluding Spring Emboli; Cook, Bloomington, IN) non-detachable coils of 0.038 and 0.052-inch core sizes were used for ductal occlusion. Trough diastolic gradient was correlated with the size and the number of coils used. Mean age was 8.6 years (range 1.3 to 27 years); 24 males and 55 females; PDA diameter ranged from 1.3 to 4.5 mm. Number of coils used varied from 1 to 4. Echocardiography measured PDA size was 2.5 ± 0.6 mm and significantly differed from angiographically measured size 2.9 ± 0.6 mm (P = 0.05). End diastolic gradient below 38 mmHg predicted use of multiple coils or coils with larger surface area. End diastolic gradient correlated inversely with total surface area of the coils, which indirectly predicted size and number of coils. Thus, the prediction of the size and the number of coils for PDA occlusion can be assisted by the trough diastolic gradients of PDA. PMID:21968576

Chaurasia, Amit Kumar; Harikrishnan, S; Bijulal, S; Krishnamoorthy, K M; Sivasankaran, S; Tharakan, J A



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

PubMed Central

Objective The aims of this study were to use a 3-dimensional (3D) system to compare molar relationship assessments performed from the buccal and lingual aspects, and to measure differences in occlusal contact areas between Class II and Class I molar relationships. Methods Study casts (232 pairs from 232 subjects, yielding a total of 380 sides) were evaluated from both the buccal and lingual aspects, so that molar relationships could be classified according to the scheme devised by Liu and Melsen. Occlusal contact areas were quantified using 3D digital models, which were generated through surface scanning of the study casts. Results A cusp-to-central fossa relationship was observed from the lingual aspect in the majority of cases classified from the buccal aspect as Class I (89.6%) or mild Class II (86.7%). However, severe Class II cases had lingual cusp-to-mesial triangular fossa or marginal ridge relationships. Mean occlusal contact areas were similar in the Class I and mild Class II groups, while the severe Class II group had significantly lower values than either of the other 2 groups (p < 0.05). Conclusions Buccal and lingual assessments of molar relationships were not always consistent. Occlusal contact areas were lowest for the Class II-severe group, which seems to have the worst molar relationships - especially as seen from the lingual aspect. PMID:23112949

Jang, Sook-Yoon; Kim, Minji



Dental occlusion influences knee muscular performances in asymptomatic females.  


Some authors claim that occlusal appliances can enhance athletic performance. Therefore this study investigated the influence of dental occlusion on knee muscle strength performance. Twelve healthy female subjects (mean age 24.1 ± 3.1 years) without temporomandibular joint dysfunction participated in this study. Isokinetic quadriceps and hamstring strength were assessed in relation to three randomized jaw conditions: mouth closed in maximum intercuspidation without splint, mouth closed on a balanced splint which optimized contact over the dental arch, mouth closed on a piece of resin of 1 mm which created an imbalanced occlusion. Tests were performed at 60°/s and 240°/s in concentric and 30°/s in eccentric exertions. Concentric performances did not show any significant difference between the 3 jaw conditions (p > 0.05). By contrast, in the eccentric trials related to quadriceps performance, significant differences (p < 0.05) were observed between the resin condition and the two other modalities (without splint or with a balanced splint). The imbalanced occlusion created by the resin component corresponded to an average decrease of 9% in eccentric peak torque. The eccentric hamstring peak torques also showed a significant difference (p < 0.05) between measurements with splint and with resin (7% decrease when occlusion was imbalanced). In conclusion, among asymptomatic females, artificial imbalanced occlusion induces immediate and significant alteration of knee eccentric muscle performances. Therefore, occlusion examination should be undertaken on a regular and frequent basis for high-level athletes. Moreover, for athletes using mouthguards, muscular performance assessments should be planned with and without the dental protection. PMID:24045628

Grosdent, Stéphanie; O'Thanh, Roseline; Domken, Olivier; Lamy, Marc; Croisier, Jean-Louis



Dental occlusion influences knee muscular performances in asymptomatic females.  


Some authors claim that occlusal appliances can enhance athletic performance. Therefore, this study investigated the influence of dental occlusion on knee muscle strength performance. Twelve healthy female subjects (mean age, 24.1 ± 3.1 years) without temporomandibular joint dysfunction participated in this study. Isokinetic quadriceps and hamstring strength were assessed in relation to 3 randomized jaw conditions: mouth closed in maximum intercuspidation without splint, mouth closed on a balanced splint which optimized contact over the dental arch, mouth closed on a piece of resin of 1 mm which created an imbalanced occlusion. Tests were performed at 60 and 240°·s in concentric and 30°·s in eccentric exertions. Concentric performances did not show any significant difference between the 3 jaw conditions (p > 0.05). In contrast, in the eccentric trials related to quadriceps performance, significant differences (p ? 0.05) were observed between the resin condition and the 2 other modalities (without splint or with a balanced splint). The imbalanced occlusion created by the resin component corresponded to an average decrease of 9% in eccentric peak torque. The eccentric hamstring peak torques also showed a significant difference (p ? 0.05) between measurements with splint and with resin (7% decrease when occlusion was imbalanced). In conclusion, among asymptomatic females, artificial imbalanced occlusion induces immediate and significant alteration of knee eccentric muscle performances. Therefore, occlusion examination should be undertaken on a regular and frequent basis for high-level athletes. Moreover, for athletes using mouthguards, muscular performance assessments should be planned with and without the dental protection. PMID:24263658

Grosdent, Stéphanie; O'Thanh, Roseline; Domken, Olivier; Lamy, Marc; Croisier, Jean-Louis



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

PubMed Central

T/QRS ratio monitoring is used to help identify fetal asphyxia. However, immature animals have greater capacity to maintain blood pressure during severe asphyxia, raising the possibility that they may show an attenuated T/QRS increase during asphyxia. Chronically instrumented fetal sheep at 0.6 of gestation (0.6?GA; n = 12), 0.7?GA (n = 12), and 0.8?GA (n = 8) underwent complete umbilical cord occlusion for 30?min, 25?min, or 15?min, respectively. Cord occlusion was associated with progressive metabolic acidosis and initial hypertension followed by severe hypotension, with a more rapid fall in mean arterial blood pressure (MAP) and carotid blood flow (CaBF) with advancing gestation. T/QRS ratio rose after occlusion more rapidly at 0.8?GA than in immature fetuses, to a similar final peak at all ages, followed by a progressive fall that was slower at 0.8?GA than in the immature fetuses. The increase in T/QRS ratio correlated with initial hypertension at 0.8?GA (P < 0.05, R2 = 0.38), and conversely, its fall correlated closely with falling MAP in all gestational groups (P < 0.01, R2 = 0.67). In conclusion, elevation of the T/QRS ratio is an index of onset of severe asphyxia in the last third of gestation, but not of fetal compromise. PMID:24693290

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



Management of myofascial pain: low-level laser therapy versus occlusal splints.  


The present study was designed to compare the effects of low-level laser with occlusal splints in patients with signs and symptoms of myofascial pain (MP) dysfunction syndrome. A total of 40 (34 women and 6 men, with a mean age of 32.84 [SD, 10.70] years) were selected after the diagnosis of MP according to the Research Diagnostic Criteria for Temporomandibular Disorder. The patients were randomly divided into 2 groups: study group (n = 20) and control group (n = 20). Low-level laser was applied to patients in the study group 2 times per week, for a total of 10 sessions. Patients in the control group were instructed to wear occlusal splints 24 h/d for 3 months. The functional examination was based on Research Diagnostic Criteria for Temporomandibular Disorder and pressure pain threshold values were obtained with the aid of an algometer in both groups. Patients' self-report of pain was evaluated with visual analog scale. Comparisons were made within and between the groups before and after treatment. Vertical movements showed statistically significant improvements after the treatments in both groups (P < 0.01), but when the groups were compared with each other, there were no significant difference between the groups. In both groups, tenderness to palpation of the muscles decreased significantly. Pressure pain threshold evaluations and visual analog scale scores revealed similar results, too. This particular type of low-level laser therapy (820 nm, 3 J/cm2, 300-mW output power) is as effective as occlusal splint in pain release and mandibular movement improvement in MP. PMID:21119408

Öz, Selcen; Gökçen-Röhlig, Bilge; Saruhanoglu, Alp; Tuncer, Erman Bülent



Induction of hepatic veno-occlusive disease in dogs.  

PubMed Central

The authors attempted to induce hepatic veno-occlusive disease (VOD) in 64 dogs. Preparative treatments included combinations of total-body irradiation (TBI) or localized hepatic irradiation (LI) or both and chemotherapy consisting of dimethylbusulfan (DMB), L-phenylalanine mustard (L-PAM), methotrexate, or monocrotaline. VOD occurred infrequently in those dogs given 9.2 Gy TBI and DMB (1/10), TBI and/or LI (9.2-27 Gy) with L-PAM (2/36) or high dose methotrexate and LI (0/2). Specifically, VOD occurred in the dogs with a shorter interval between TBI and DMB or in the dog that received the glutathione reductase inhibitor, buthionine sulfoximide (BSO) before L-PAM. In contrast, among 17 dogs given monocrotaline, 8 developed VOD, particularly when used with L-PAM +/- irradiation (7/13). The major cause of death, early gastrointestinal toxicity, was further augmented by higher doses of irradiation, by shortening the interval between LI and L-PAM administration to less than 4 weeks, and administering BSO or monocrotaline before L-PAM. Gastrointestinal toxicity was lessened by giving low dose cyclophosphamide given before L-PAM. VOD can be produced in dogs especially with monocrotaline or BSO given before and L-PAM +/- irradiation. However, gastrointestinal toxicity renders the study of VOD beyond the acute phase difficult. Nevertheless, this approach appears useful for the study of VOD in other animals and for developing agents aimed at preventing VOD. Images Figure 1 p[117]-b Figure 2 Figure 3 PMID:3101503

Shulman, H. M.; Luk, K.; Deeg, H. J.; Shuman, W. B.; Storb, R.



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)



Recanalization of Acute and Subacute Venous and Synthetic Bypass-Graft Occlusions With a Mechanical Rotational Catheter  

SciTech Connect

PurposePercutaneous mechanical thrombectomy (PMT) is now established as an alternative treatment of acute arterial occlusions in addition to fibrinolysis and surgical thrombectomy. The objective of this retrospective study was the investigation of a rotational atherothrombectomy catheter in terms of safety and efficacy in the treatment of acute and subacute femoropopliteal bypass occlusions.Materials and MethodsForty-two patients (average age 65.8 {+-} 9.1 years) with acute (<14 days [n = 31]) and subacute (14-42 days [n = 11]) femoropopliteal bypass occlusions were treated consecutively with a rotational debulking and removal catheter (Straub Rotarex). The average occlusion length was 28.4 {+-} 2.9 (24-34) cm. Thirty-four (81 %) patients underwent venous bypass, and 8 (19 %) patients underwent polytetrafluoroethylene bypass.ResultsThe technical success rate was 97.6 % (41 of 42). In 1 patient, blood flow could not be restored despite the use of the atherothrombectomy system. The average catheter intervention time was 6.9 {+-} 2.1 (4-9) min. Ankle-brachial index increased from 0.39 {+-} 0.13 to 0.83 {+-} 0.11 at discharge and to 0.82 {+-} 0.17 after 1 month (p < 0.05). There were a total of 2 (4.8 %) peri-interventional complications: One patient developed a distal embolism, which was successfully treated with local lysis, and another patient had a small perforation at the distal anastomosis, which was successfully treated with a stent.ConclusionPMT with the Rotarex atherothrombectomy catheter represents a safe and effective option in the treatment of acute and subacute femoropopliteal bypass occlusions because it can quickly restore blood flow.

Wissgott, Christian, E-mail:; Kamusella, Peter; Andresen, Reimer [Westkuestenklinikum Heide-Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Institute of Diagnostic and Interventional Radiology/Neuroradiology (Germany)



Transcatheter vessel occlusion: angiographic results versus clinical success  

SciTech Connect

A review was made of 219 transcatheter vessel occlusion procedures performed over a ten-year period for control of hemorrhage, tumor palliation, or blood supply redistribution prior to intra-arterial chemotherapy. Complete angiographic success was obtained in 85% of the procedures, with partial success in 8%; complete clinical success was achieved in 53% of patients, with partial success in 23%. the most satisfactory clinical results were obtained with hemorrhagic gastritis and pelvic trauma. Embolizations for duodenal ulcer hemorrhage and transhepatic variceal occlusion were the least clinically successful, although isobutyl-cyanoacrylate appeared to be a significant improvement in angiographic therapy for duodenal ulcer. The overall complication rate was 13%, with one third of the complications clinically silent. These results indicate that transcatheter vessel occlusion is a relatively safe and effective method for control of hemorrhage or tumor infarction.

Feldman, L.; Greenfield, A.J.; Waltman, A.C.; Novelline, R.A.; Van Breda, A.; Luers, P.; Athanasoulis, C.A.



Ambient Occlusion Effects for Combined Volumes and Tubular Geometry  

PubMed Central

This paper details a method for interactive direct volume rendering that computes ambient occlusion effects for visualizations that combine both volumetric and geometric primitives, specifically tube-shaped geometric objects representing streamlines, magnetic field lines or DTI fiber tracts. The algorithm extends the recently presented the directional occlusion shading model to allow the rendering of those geometric shapes in combination with a context providing 3D volume, considering mutual occlusion between structures represented by a volume or geometry. Stream tube geometries are computed using an effective spline-based interpolation and approximation scheme that avoids self-intersection and maintains coherent orientation of the stream tube segments to avoid surface deforming twists. Furthermore, strategies to reduce the geometric and specular aliasing of the stream tubes are discussed. PMID:23559506

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



Using computerized cephalometrics to analyze the vertical dimension of occlusion.  


A computer program that uses cephalometric analyses for determining the patient's occlusal vertical dimension has recently been introduced. Data generated from this computer implies changes in incisal-pin position for articulated casts. This study evaluated the accuracy of this vertical-dimension program using 24 completely dentate, white male subjects with clinically acceptable occlusal vertical dimensions. A cephalometric radiograph was made, and measurements from the tracing were entered into the computer for analysis. Recommended incisal-pin changes ranged from -11 to +25.3 mm, with a mean change of 8.4 mm for all methods tested. These results showed a low correlation with each subject's clinically determined occlusal vertical dimension. PMID:8240648

Edwards, C L; Richards, M W; Billy, E J; Neilans, L C



Cerebrovascular occlusion in a transsexual man taking mestranol.  


The Collaborative Study Group for the Study of Stroke in Young Women studied 598 women from age 15 to 44 years with cerebrovascular disease. They found that the use of oral contraceptives was significantly more prevalent in women who had suffered a thrombotic stroke than in women who had not had strokes. The risk of thrombotic stroke was estimated to be nine times greater in users of oral contraceptives than in nonusers. We report a case in which a previously healthy man who was using an oral contraceptive drug developed middle cerebral artery occlusion. In the absence of other predisposing factors in this case, it appears that the cerebrovascular occlusion was related to estrogen administration. The occurrence of persistent severe headaches in patients using estrogenic hormones may be a clue to impending cerebrovascular occlusion. PMID:718332

deMarinis, M; Arnett, E N



Femoral artery occlusion secondary to a spontaneously "migrated" hip prosthesis: case report.  


A 77-year-old male patient was admitted to the hospital with a worsening acute ischemia of the left lower extremity. The patient, who had a coxarthrosis and was being followed by the orthopedic clinic, had undergone a total hip prosthesis, with a revision performed at the sixth month of its placement. The physical examination revealed the absence of the femoral, popliteal and distal pulses of the left lower extremity. The left hip movements were painful and limited in external rotation posture. Doppler ultrasonography showed an acute occlusion of the left common femoral artery due to the dislocated hip prosthesis, and right-to-left femorofemoral expanded polytetrafluoroethylene graft bypass was carried out. After successful surgery and an uneventful postoperative period with palpable femoral and popliteal pulses, the patient was put on low molecular weight heparin and referred to orthopedics once the ischemia had subsided with the intervention. Case reports regarding occlusions due to migration of total hip prosthesis are rare in the literature. The emphasis of this case report is to describe one such case. PMID:20517776

Tihan, Deniz Necdet; Ali?, Halil; Aksoy, Murat; Gülo?lu, Recep; Kurto?lu, Mehmet; Dikici, Fatih



Functional dental occlusion: an anthropological perspective and implications for practice.  


Physiologic changes occur in dental occlusion throughout life, resulting from the interplay between functional demands and reciprocating adaptive responses. These changes have been reported in the anthropological literature and they reflect evolutionary changes in the human stomatognathic system during the Paleolithic, hunter-gatherer period. Specific occlusal changes occur in response to different environments, leading to extensive variation within and between extinct and extant human populations. For example, functional demands can cause occlusal and interproximal tooth wear, resulting in shortening of the dental arch, continual tooth eruption and changes in masticatory patterns. Since the advent of farming through to our current industrialized culture, functional demands on the human masticatory system, and its adaptive responses to these demands, have been reduced considerably. Indeed, it is only occasionally that functional demands are severe enough to lead to obvious pathology in the modern human dentition. In contrast to normal masticatory activity, 'modern-day conditions' such as dental caries, periodontal disease and erosion, can lead to significant changes in dental occlusion that are pathological and need to be treated. The masticatory system is a dynamic, functional unit that displays considerable change over a lifetime. In this concept paper, it is proposed that modern human populations living in industrialized environments display dental occlusions that can be considered to be 'neotenous'; that is, our dentitions tend to reflect an unworn stage of our ancestors that was only seen in infants, juveniles and young adults. Clinicians can draw on both phylogenetic and ontogenetic perspectives of 'functional dental occlusion' to differentiate continual physiological changes occurring over time that require ongoing review, from pathological responses that require intervention. PMID:24444303

Kaidonis, J A; Ranjitkar, S; Lekkas, D; Brook, A H; Townsend, G C



The effects of naris occlusion on mouse nasal turbinate development.  


Unilateral naris occlusion, a standard method for causing odor deprivation, also alters airflow on both sides of the nasal cavity. We reasoned that manipulating airflow by occlusion could affect nasal turbinate development given the ubiquitous role of environmental stimuli in ontogenesis. To test this hypothesis, newborn mice received unilateral occlusion or sham surgery and were allowed to reach adulthood. Morphological measurements were then made of paraffin sections of the whole nasal cavity. Occlusion significantly affected the size, shape and position of turbinates. In particular, the nasoturbinate, the focus of our quantitative analysis, had a more delicate appearance on the occluded side relative to the open side. Occlusion also caused an increase in the width of the dorsal meatus within the non-occluded and occluded nasal fossae, compared with controls, and the position of most turbinates was altered. These results suggest that a mechanical stimulus from respiratory airflow is necessary for the normal morphological development of turbinates. To explore this idea, we estimated the mechanical forces on turbinates caused by airflow during normal respiration that would be absent as a result of occlusion. Magnetic resonance imaging scans were used to construct a three-dimensional model of the mouse nasal cavity that provided the input for a computational fluid dynamics simulation of nasal airflow. The simulation revealed maximum shear stress values for the walls of turbinates in the 1 Pa range, a magnitude that causes remodeling in other biological tissues. These observations raise the intriguing possibility that nasal turbinates develop partly under the control of respiratory mechanical forces. PMID:24311813

Coppola, David M; Craven, Brent A; Seeger, Johannes; Weiler, Elke



Low back pain - chronic  


Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low ... waist, leads to pain. Many people with chronic back pain have arthritis. Or they may have extra wear ...


Chronic Diarrhea  


... as: Disorders of the pancreas (e.g. chronic pancreatitis, pancreatic enzyme deficiencies, cystic fibrosis) Intestinal disorders (e. ... Altered immune function (e.g. immunoglobulin deficiencies, AIDS, autoimmune disease) Hereditary disorders (e.g. cystic fibrosis, enzyme ...


Chronic Meningitis  


... not infections can cause chronic meningitis. They include sarcoidosis and certain disorders that cause inflammation, such as ... For disorders that are not infections, such as sarcoidosis and Behçet syndrome: Corticosteroids or other drugs that ...


[Chronic migraine].  


The classification of the International Headache Society (IHS) generally differentiates episodic from chronic headache. Chronic migraine is defined as headache on 15 and more days a month over more than 3 months and headache on 8 days or more fulfils the criteria for migraine or were triptan/ergot-responsive when thought to be migrainous in early stages of the attack. The prevalence of chronic migraine is estimated at 2-4?%. The quality of life is highly compromised in this condition and comorbidities are much more frequent compared to episodic migraine. Data from prospective randomized studies are scarce as most patients with chronic migraine were excluded from previous trials and only few studies were conducted for this condition. The efficacy for prophylactic treatment compared with placebo is proven for topiramate and onabotulinum toxin A. PMID:24337617

Diener, H C; Holle, D; Müller, D; Nägel, S; Rabe, K



TOTAL Full-TOTAL Full-  

E-print Network

- X TOTAL Full- Part- X TOTAL Alternative Energy 6 . . 6 11 . . 11 13 2 . 15 Biomedical Engineering 52 English 71 . 4 75 70 . 4 74 72 . 3 75 Geosciences 9 . 1 10 15 . . 15 19 . . 19 History 37 1 2 40 28 3 3 34

Portman, Douglas


Near-infrared spectroscopic assessment of oxygen delivery to free flaps on monkeys following vascular occlusions and inhalation of pure oxygen  

NASA Astrophysics Data System (ADS)

In recent studies, near-infrared spectroscopy (NIRS) has been considered as a potentially ideal noninvasive technique for the postoperative monitoring of plastic surgery. In this study, free flaps were raised on rhesus monkeys' forearms and oxygen delivery to these flaps was monitored following vascular occlusions and inhalation of pure oxygen. Optical fibers were adopted in the probe of the oximeter so that the detection could be performed in reflectance mode. The distance between emitter and detector can be adjusted easily to achieve the best efficacy. Different and repeatable patterns of changes were measured following vascular occlusions (arterial occlusion, venous occlusion and total occlusion) on flaps. It is clear that the near-infrared spectroscopy is capable of postoperatively monitoring vascular problems in flaps. NIRS showed high sensitivity to detect the dynamic changes in flaps induced by inhalation of pure oxygen in this study. The experimental results indicated that it was potential to assess tissue viability utilizing the dynamic changes induced by a noninvasive stimulation. It may be a new assessing method that is rapid, little influenced by other factors and brings less discomfort to patients.

Tian, Fenghua; Ding, Haishu; Cai, Zhigang; Wang, Guangzhi; Zhao, Fuyun



Balloon-Assisted Occlusion of the Internal Iliac Arteries in Patients with Placenta Accreta/Percreta  

SciTech Connect

Background. Placenta accreta/percreta is a leading cause of third trimester hemorrhage and postpartum maternal death. The current treatment for third trimester hemorrhage due to placenta accreta/percreta is cesarean hysterectomy, which may be complicated by large volume blood loss. Purpose. To determine what role, if any, prophylactic temporary balloon occlusion and transcatheter embolization of the anterior division of the internal iliac arteries plays in the management of patients with placenta accreta/percreta. Methods. The records of 28 consecutive patients with a diagnosis of placenta accreta/percreta were retrospectively reviewed. Patients were divided into two groups. Six patients underwent prophylactic temporary balloon occlusion, followed by cesarean section, transcatheter embolization of the anterior division of the internal iliac arteries and cesarean hysterectomy (n = 5) or uterine curettage (n = 1). Twenty-two patients underwent cesarean hysterectomy without endovascular intervention. The following parameters were compared in the two groups: patient age, gravidity, parity, gestational age at delivery, days in the intensive care unit after delivery, total hospital days, volume of transfused blood products, volume of fluid replacement intraoperatively, operating room time, estimated blood loss, and postoperative morbidity and mortality. Results. Patients in the embolization group had more frequent episodes of third trimester bleeding requiring admission and bedrest prior to delivery (16.7 days vs. 2.9 days), resulting in significantly more hospitalization time in the embolization group (23 days vs. 8.8 days) and delivery at an earlier gestational age than in those in the surgical group (32.5 weeks). There was no statistical difference in mean estimated blood loss, volume of replaced blood products, fluid replacement needs, operating room time or postoperative recovery time. Conclusion. Our findings do not support the contention that in patients with placenta accreta/percreta, prophylactic temporary balloon occlusion and embolization prior to hysterectomy diminishes intraoperative blood loss.

Bodner, Leonard J.; Nosher, John L. [UMDNJ-Robert Wood Johnson Medical School, Department of Radiology (United States)], E-mail:; Gribbin, Christopher [St. Peter's University Hospital, Department of Radiology (United States); Siegel, Randall L.; Beale, Stephanie [UMDNJ-Robert Wood Johnson Medical School, Department of Radiology (United States); Scorza, William [Saint Peter's University Hospital, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine (United States)



Plasma concentration of platelet-derived microparticles is related to painful vaso-occlusive phenotype severity in sickle cell anemia.  


High plasma level of microparticles (MPs) deriving mainly from erythrocytes and platelets has been detected in sickle cell anemia (SCA) patients. Flow cytometry was used to determine the concentration of MPs in two groups of SCA patients exhibiting marked differences in painful vaso-occlusive crisis rates [a non-severe group (n?=?17) and a severe group (n?=?12)], and in a control group composed of healthy subjects (n?=?20). A 3- to 4-fold increase of total MP plasma concentration was detected in SCA patients. Higher platelet-derived MPs concentration was detected in the severe SCA group while erythrocyte-derived MPs concentration was increased in the non-severe SCA patient group only. Our results suggest that plasma concentration of MPs shed by platelets is a biomarker of the vaso-occlusive phenotype-related severity. PMID:24475257

Nebor, Danitza; Bowers, Andre; Connes, Philippe; Hardy-Dessources, Marie-Dominique; Knight-Madden, Jennifer; Cumming, Vanessa; Reid, Marvin; Romana, Marc



Plasma Concentration of Platelet-Derived Microparticles Is Related to Painful Vaso-Occlusive Phenotype Severity in Sickle Cell Anemia  

PubMed Central

High plasma level of microparticles (MPs) deriving mainly from erythrocytes and platelets has been detected in sickle cell anemia (SCA) patients. Flow cytometry was used to determine the concentration of MPs in two groups of SCA patients exhibiting marked differences in painful vaso-occlusive crisis rates [a non-severe group (n?=?17) and a severe group (n?=?12)], and in a control group composed of healthy subjects (n?=?20). A 3- to 4-fold increase of total MP plasma concentration was detected in SCA patients. Higher platelet-derived MPs concentration was detected in the severe SCA group while erythrocyte-derived MPs concentration was increased in the non-severe SCA patient group only. Our results suggest that plasma concentration of MPs shed by platelets is a biomarker of the vaso-occlusive phenotype-related severity. PMID:24475257

Nebor, Danitza; Bowers, Andre; Connes, Philippe; Hardy-Dessources, Marie-Dominique; Knight-Madden, Jennifer; Cumming, Vanessa; Reid, Marvin; Romana, Marc



Temporary balloon occlusion of the uterine arteries to control hemorrhage during hysterectomy in a case of uterine arteriovenous fistula.  


Arteriovenous fistula is any abnormal connection between an artery and a vein that bypasses the normal capillary bed and shunts arterial blood directly to the venous circulation. Uterine arteriovenous fistula (UAVF) is a potentially life-threatening condition by causing massive bleeding. This report describes a case of UAVF with massive hemorrhage. Prior to surgery, endovascular catheters for balloon occlusion were placed within bilateral uterine arteries. During surgery, the surgeon requested temporary balloon inflation for navigating and identifying inflow arteries. The balloon was kept inflated during the ligation of the vessels. Once ligation was completed, the balloon was deflated to confirm hemostasis. A total hysterectomy with removal of the UAVF was successfully achieved without significant blood loss. The fistula, in the resected specimen, was confirmed histologically with Elastica van Gieson staining. The preoperative placement of endovascular balloon-occlusion catheters should be considered when hysterectomy is planned where UAVF is located at the cardinal ligament. PMID:25227922

Yamamoto, Naoko; Koga, Kaori; Akahane, Masaaki; Wada-Hiraike, Osamu; Fujii, Tomoyuki; Osuga, Yutaka



Digital image analysis in dental research applied for treatment of fissures on occlusal surfaces of premolars.  


The aim of this paper was to quantitatively assess caries changes of teeth by using digital image analysis. Digital images of stained sections of crowns of teeth were acquired with a computer-assisted light microscope. In each image, spots representing the main and total demineralization of enamel were segmented to determine their area. The area of total demineralization was significantly different between premolars with sealed fissures and unprotected premolars as indicated by the Mann-Whitney test. Fissures on occlusal surfaces of premolars were characterized by their width, height, and distance from the bottom of the fissure to the enamel-dentin junction. This distance was also significantly different between protected and unprotected teeth. The results of our in vitro studies of enamel lesions allow us to plan an effective diagnosis, prophylaxis, and treatment of early caries changes in in vivo conditions. PMID:12918908

Kaczmarek, Elzbieta; Matthews-Brzozowska, Teresa; Miskowiak, Bogdan



Acute Inferior Wall Myocardial Infarction due to Occlusion of the Wrapped Left Anterior Descending Coronary Artery  

PubMed Central

Acute occlusion of the left anterior descending coronary artery (LAD) generally results in ST segment elevations in precordial leads and reciprocal ST segment depression in inferior leads. The occurrence of isolated inferior myocardial infarction due to occlusion of LAD is very rare. We describe an isolated acute inferior myocardial infarction due to occlusion of a wrapped LAD at the apex which continues as the large posterior descending coronary artery (PDA) beyond the occlusion. PMID:24826303

Sunil Roy, Thottuvelil Narayanan; Nagham, Jafar Saeed; Anil Kumar, Rajappan



Atypical mycobacteria in a superficial femoral artery occlusion  

PubMed Central

There is indirect evidence that atherosclerosis may occur in association with bacterial infection. The authors report the case of a young woman who presented with right calf claudication caused by a short occlusion of the superficial femoral artery. Histological examination of the excised segment of artery revealed atheroma and atypical mycobacteria within adventitial caseating granulomata. The possible causes are discussed. PMID:22701070

Determann, C; Hill, AT; Monaghan, H; Fraser, SCA



Tubal occlusion after inguinal hernia repair. A case report.  


Midtubal occlusion and infertility occurred subsequent to an inguinal hernia repair. Recognition of the traumatic etiology is important because other causes of midtubal obstruction, such as endometriosis, tuberculosis and adenomatoid tumor of the oviduct, may be considered contraindications to reconstructive surgery. Once recognized, the condition is highly amendable to microsurgical reconstruction. PMID:2030492

Urman, B C; McComb, P F



Recombinant tissue plasminogen activator for central venous access device occlusion  

Microsoft Academic Search

Maintaining and restoring the function of central venous access devices (CVAD) is an important component of pediatric oncology nursing care. Until 1999, Abbokinase Open Cath (urokinase; Abbott, Abbott Park, IL), a thrombolytic agent was the product primarily used to resolve thrombotic occlusions in intravascular devices. Changes in the manufacturing process mandated by the FDA have resulted in a lack of

Casey Hooke



Sex Differences during Visual Scanning of Occlusion Events in Infants  

ERIC Educational Resources Information Center

A growing number of sex differences in infancy have been reported. One task on which they have been observed reliably is the event-mapping task. In event mapping, infants view an occlusion event involving 1 or 2 objects, the occluder is removed, and then infants see 1 object. Typically, boys are more likely than girls to detect an inconsistency…

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



Modification of polyurethane to reduce occlusion of enteral feeding tubes  

SciTech Connect

Feeding tubes are used to supply nutritional formula to immobilized patients. The most common cause for failure of enteral feeding tubes is their occlusion. The purpose of this study was to examine whether occlusion of enteral feeding tubes could be minimized using an additive. An open, intermittent enteral feeding system was simulated in the laboratory and data was collected over a period ranging from 2 to 6 days. Feeding formula was cycled through a feeding tube in either the presence or absence of simulated gastric acid in an effort to generate a reproducible occlusion. Pressures in the tube were measured frequently throughout these cycles. We observed pressure spikes with each cycle, but never a complete occlusion. Pressure spikes formed only when simulated gastric acid was mixed with the feeding solution. Large amounts of feeding formula adsorbed onto polyurethane surfaces in the presence of gastric acid. The maximum pressure was reduced by about half from 2.0 psi to 0.8 psi when polyvinyl alcohol (PVA) was added. The addition of PVA to polyurethane also reduced the contact angle from 83° (untreated) to approximately 64° in the presence of PVA. Furthermore, when formula was added to polyurethane in the presence of PVA the thickness of the layer that remained on the surface was almost 10 times greater in controls than on PVA-treated surfaces. These results suggest that a treatment that increases the hydrophilicity of the feeding tube may help minimize clogging.

Gaither, Kari A.; Tarasevich, Barbara J.; Goheen, Steven C.



Occlusion-Based Accurate Silhouettes from Video Streams  

E-print Network

Occlusion-Based Accurate Silhouettes from Video Streams Pedro M.Q. Aguiar, Ant´onio R. Miranda) estimate of its silhouette from the set of video frames. To minimize the ML cost function, we developed a greedy algorithm that updates the object silhouette, converging in few iterations. Our experiments

Aguiar, Pedro M. Q.


Learning about Occlusion: Initial Assumptions and Rapid Adjustments  

ERIC Educational Resources Information Center

We examined 6-month-olds' abilities to represent occluded objects, using a corneal-reflection eye-tracking technique. Experiment 1 compared infants' ability to extrapolate the current pre-occlusion trajectory with their ability to base predictions on recent experiences of novel object motions. In the first condition infants performed at asymptote…

Kochukhova, Olga; Gredeback, Gustaf



Coronary artery ectasia--a variant of occlusive coronary arteriosclerosis  

Microsoft Academic Search

In a study of 1000 consecutive coronary arteriograms, 12 patients (all men) had coronary artery ectasia. Ectasia was found most frequently in the circumflex or right coronary artery. Only 1 patient had ectasia in the left anterior descending coronary artery. In 11 patients, ectasia of one artery was associated with severe stenosis or occlusion of other vessels, typical of arteriosclerosis.

R H Swanton; M L Thomas; D J Coltart; B S Jenkins; M M Webb-Peploe; B T Williams



Efficient Detection of Occlusion prior to Robust Face Recognition  

PubMed Central

While there has been an enormous amount of research on face recognition under pose/illumination/expression changes and image degradations, problems caused by occlusions attracted relatively less attention. Facial occlusions, due, for example, to sunglasses, hat/cap, scarf, and beard, can significantly deteriorate performances of face recognition systems in uncontrolled environments such as video surveillance. The goal of this paper is to explore face recognition in the presence of partial occlusions, with emphasis on real-world scenarios (e.g., sunglasses and scarf). In this paper, we propose an efficient approach which consists of first analysing the presence of potential occlusion on a face and then conducting face recognition on the nonoccluded facial regions based on selective local Gabor binary patterns. Experiments demonstrate that the proposed method outperforms the state-of-the-art works including KLD-LGBPHS, S-LNMF, OA-LBP, and RSC. Furthermore, performances of the proposed approach are evaluated under illumination and extreme facial expression changes provide also significant results. PMID:24526902

Dugelay, Jean-Luc



[Thrombolysis of acute arterial occlusion with rt PA].  


The use of thrombolytic agents to treat peripheral arterial occlusions is a new method. There have been clinical trials with Streptokinase, Urokinase and rt-PA (recombinant tissue plasminogen activator). Despite its advantages, information about complications caused by the use of rt-PA and about its place in treatment is still not complete. And there are not enough studies that are made to form a safe protocol for the use of rt-PA in the treatment of acute peripheral arterial occlusions. The aim of this study was to establish a dose range for rt-PA and to follow the patients with a protocol during and after thrombolysis. Between May 1999 to January 2000, 14 patients with symptoms of pain, poikilothermia, cyanosis and loss of function came to Istanbul Medical Faculty Emergency Surgery Unit. Bolus injection of 5 mgr of rt-PA was followed by 15 minutes of interval. The extent of thrombolysis was checked by angiography and then bolus injection of 5 mgr of rt-PA was repeated. After angiographic control, patients having insufficient thrombolysis, received 0.05 mgr/kg/hour of infusion for 12 hours. At the end of 12 hours, thrombolytic treatment ended with a control angiography. A thromboembolectomy operation was made to patients still having an occlusion after thrombolysis. On the other hand, to avoid re-occlusions, all of the patients received 1.5 mgr/kg/day low molecular weight heparin (enoxyparine). PMID:11705216

Kurto?lu, M; Granit, V; Necefli, A; Kurto?lu, M; Gülo?lu, R



History of materials used for recording static and dynamic occlusal contact marks: a literature review  

PubMed Central

In the discipline of prosthetic dentistry it is important not only to examine the occlusion, but to be able to record, store, and transfer the information. Over the years many occlusion testing materials have been used. It has been suggested the clinical recording and transfer of information using waxes and other occlusion recording materials have disadvantages relating to inaccuracy and problems of manipulation. Therefore, there has been introduction of many new systems for recording occlusion contacts to overcome such problems. The correct physiological recovery of occlusion posses as much a challenge as ever for every dentist and technician. Even the smallest high spots measuring just a few microns can cause dysfunctions like temporo-mandibular pain. Occlusal proportions are being constantly changed with every procedure. Therefore, an understanding of the synergy of the teeth in static and dynamic occlusion forms the basis of good dentistry. The purpose of this review article is to give and overview of the various materials and methods that have been used to record occlusal contact marks. Key words:Occlusal contact marks, Occlusion indicators, Occlusion test materials, Occlusion recording materials. PMID:24455051

Rahul, G R.; Poduval, Soorya T.; Shetty, Karunakar; Gupta, Bhawna; Rajora, Varun



Extratropical cyclone occlusion Journal: McGraw Hill 2008 Yearbook of Science & Technology  

E-print Network

ForReview Extratropical cyclone occlusion Journal: McGraw Hill 2008 Yearbook of Science Keywords: extratropical cyclone, fronts, frontal structure, occlusion, trowal Abstract: The notion of extratropical cyclone occlusion has been controversial since it was first proposed just after World War I

Williams, Justin


Chronic urticaria.  

PubMed Central

OBJECTIVE: To review the pathophysiology of chronic urticaria in light of recent evidence for it being an autoimmune disease, and to recommend appropriate management. QUALITY OF EVIDENCE: An extensive literature review was supplemented with a MEDLINE search. Articles from easily available journals were preferred. These consisted of the most recent basic articles on autoimmunity in relation to chronic urticaria and a selection of previous articles on pathophysiology, which illustrate consistencies with recent evidence. The investigation and management protocol is supported by original and relevant literature. MAIN FINDINGS: The histopathology and immunohistology of chronic urticaria and certain clinical studies were a prelude to definitive evidence that most instances of chronic urticaria are autoimmune. Although allergic and other causes are uncommon, these must be sought because identification can lead to cure or specific treatment. Management of the much more common autoimmune urticaria is based on principles derived from the demonstrated pathogenesis and on results of published clinical trials. CONCLUSIONS: In most instances, chronic urticaria is an autoimmune disease, but uncommon allergic or other causes must be considered. PMID:9805172

Leznoff, A.



Chronic incomplete obstruction of the ureter: a new experimental model.  


To produce a chronic moderate hydronephrosis in dog, a method of partial ureteral occlusion using a specially designed polypropylene obturator was developed. In 11 of 14 dogs undergoing this procedure, excretory urography constantly revealed a moderate degree of hydronephrosis persisting for 7 weeks. Combination of this method in one ureter with the vaginal-cuff cutaneous ureterostomy, previously reported, in the contralateral ureter is a useful model for split renal function study of unilateral chronic hydronephrosis or obstructive nephropathy analogous to that of clinical case. PMID:3824699

Masui, S; Hiratsuka, Y; Ariyoshi, A; Sakamoto, K



Bruxism in children and transverse plane of occlusion: Is there a relationship or not?  

PubMed Central

OBJECTIVE: To assess the occurrence of bruxism in deciduous dentition and a potential association between the habit and the presence or absence of posterior crossbite. METHODS: A total of 940 patient files were assessed. They were gathered from the archives of University of São Paulo City - UNICID; however, 67 patient files were dismissed for not meeting the inclusion criteria. Therefore, 873 children, males and females, comprised the study sample. They were aged between 2-6 years old and came from six different public primary schools from the east of the city of São Paulo. Data were collected through questionnaires answered by parents/guardians and by clinical examinations carried out in the school environment in order to obtain the occlusal characteristics in the transverse direction. First, a descriptive statistical analysis of all variables was performed (age, sex, race, posterior crossbite, bruxism, headache and restless sleep); then, the samples were tested by means of chi-square test with significance level set at 0.05%. A logistic regression model was applied to identify the presence of bruxism. RESULTS: The prevalence of this parafunctional habit was of 28.8%, with 84.5% of patients showing no posterior crossbite. Regarding the association of bruxism with crossbite, significant results were not found. Children with restless sleep have 2.1 times more chances of developing bruxism, whereas children with headache have 1.5 more chances. CONCLUSION: Transverse plane of occlusion was not associated with the habit of bruxism.

Nahás-Scocate, Ana Carla Raphaelli; Coelho, Fernando Vusberg; de Almeida, Viviane Chaves



Measurement of regional forearm muscle haemodynamics via the near-infrared spectroscopy venous occlusion technique: the impact of hand circulatory occlusion.  


The purpose of this study was to examine whether circulatory occlusion of the hand impacts on regional forearm muscle haemodynamics as determined by the near-infrared spectroscopy (NIRS) venous occlusion technique (NIRSVOT). Twenty-five young, healthy participants (18 males and 7 females; 28 ± 4 years; 71 ± 7 kg) completed two experimental protocols that were performed on the dominant arm: (1) a series of five venous occlusion trials with a suprasystolic cuff (>260 mmHg) applied to the wrist and (2) five venous occlusion trials without hand-occlusion. Both protocols were performed twice in a counterbalanced manner. NIRS data were obtained from the flexor digitorum superficialis (FDS) muscle using a dual wavelength, continuous-wave spectrophotometer. FDS muscle blood flow (Q(FDS)), vascular conductance (C(FDS)), O2 consumption (Vo(2FDS)), and venous O2 saturation (SvO2) were calculated from NIRS data during the initial 5 s of venous occlusion. Circulatory occlusion of the hand via wrist cuffing significantly (P < 0.05) reduced Q(FDS) (-36 ± 23%), CFDS (-37 ± 23%), Vo2(FDS) (-14 ± 31%) and SvO2 (-14 ± 12%). These findings indicate that hand-occlusion, via wrist cuffing, adversely impacts on regional forearm haemodynamics as determined by the NIRS-VOT. Consequently, it is recommended that future investigators avoid hand-occlusion when using the NIRS-VOT to quantify spontaneous haemodynamics of regional forearm muscle. PMID:25419965

Cross, T J; van Beekvelt, M; Constantini, K; Sabapathy, S



Comparative Evaluation of the Total Hepatitis C Virus Core Antigen, Branched-DNA, and Amplicor Monitor Assays in Determining Viremia for Patients with Chronic Hepatitis C during Interferon Plus Ribavirin Combination Therapy  

Microsoft Academic Search

An assay prototype designed to detect and quantify total hepatitis C virus (HCV) core antigen (HCV core Ag) protein in serum and plasma in the presence or absence of anti-HCV antibodies has been recently developed by Ortho-Clinical Diagnostics. The aim of the study was to evaluate the sensitivity, specificity, and reproduc- ibility of the Total HCV core Ag assay in

Pascal Veillon; Christopher Payan; Gaston Picchio; Michele Maniez-Montreuil; Philippe Guntz; Francoise Lunel



Change of Distribution and Timing of Bite Force after Botulinum Toxin Type A Injection Evaluated by a Computerized Occlusion Analysis System  

PubMed Central

Purpose The aim of this study was to determine the force distribution and pattern of mastication after injection of botulinum toxin type A (BTX-A) into both masseter muscles. The hypothesis to be tested was that the difference between right and left balance of occlusal force diminishes over time following BTX-A injection. Materials and Methods Fifteen patients were submitted to BTX-A injection therapy for subjective masseter hypertrophy. A total of 25 U of BTX-A (50 U in total) was injected into two points located 1 cm apart at the center of the lower one-third of both masseter muscles. All patients were examined using the T-Scan occlusion analysis system before and 4, 8, 12, and 24 weeks after BTX-A injection. Results A significant change in force balance was found between the right and left sides over time and the difference between the two sides decreased with the time post-injection, reaching a minimum at 12 weeks. Comparison of the force balance between the anterior and posterior occlusions revealed no significant difference at any of the time points. The occlusion and disclusion times (right and left sides) did not differ significantly with time since BTX-A injection. Conclusion A decline in the difference in the clenching force between the left and right sides was found with increasing time up to 12 weeks following BTX-A injection. PMID:24954346

Song, Ji Hee; Cho, Eunae S.; Kim, Seong Taek



Ultrastructural features of masseter muscle exhibiting altered occlusal relationship - a study in a rodent model  

SciTech Connect

The role of occlusion on Tempormandibular Disorders (TMD) is still unclear, mainly regarding muscular function. The aim of this study was to evaluate the occlusion highlights on masseter ultra morphology. Twenty Wistar rats were randomly divided in four groups: 10 for control group, 10 for occlusal alteration group (CCO). Rats underwent unilateral amputation of the left inferior and superior molar cusps to simulate an occlusal wear situation. The rats of control group had no occlusal wear. Half of the animals of each group was sacrificed in 14 days after the occlusal consuming and half 30 days after the occlusal consuming. The masseter muscles ipsilateral to the amputated molars were excised and processed for light microscopy, electron microscopy. The light microscopy did not show differences between the groups. The electron microscopy was able to detect a degree of intracellular damage in muscle fibers of CCO group: swollen mitochondria with disrupted cristae and cleared matrix, signs of hypercontraction of I bands and myofibril disorganization.

Lisboa, Marcio V.; Aciole, Gilberth T. S.; Oliveira, Susana C. P. S.; Marques, Aparecida M. C.; Pinheiro, Antonio L. B.; Santos, Jean N. [School of Dentistry, Federal University of Bahia, Salvador, BA, 40110-150 (Brazil); Baptista, Abrahao F.; Aguiar, Marcio C. [Biomorphology Department, Federal University of Bahia, Bahia, 40110-150 (Brazil)



Ultrastructural features of masseter muscle exhibiting altered occlusal relationship—a study in a rodent model  

NASA Astrophysics Data System (ADS)

The role of occlusion on Tempormandibular Disorders (TMD) is still unclear, mainly regarding muscular function. The aim of this study was to evaluate the occlusion highlights on masseter ultra morphology. Twenty Wistar rats were randomly divided in four groups: 10 for control group, 10 for occlusal alteration group (CCO). Rats underwent unilateral amputation of the left inferior and superior molar cusps to simulate an occlusal wear situation. The rats of control group had no occlusal wear. Half of the animals of each group was sacrificed in 14 days after the occlusal consuming and half 30 days after the occlusal consuming. The masseter muscles ipsilateral to the amputated molars were excised and processed for light microscopy, electron microscopy. The light microscopy did not show differences between the groups. The electron microscopy was able to detect a degree of intracellular damage in muscle fibers of CCO group: swollen mitochondria with disrupted cristae and cleared matrix, signs of hypercontraction of I bands and myofibril disorganization.

Lisboa, Marcio V.; Aciole, Gilberth T. S.; Oliveira, Susana C. P. S.; Marques, Aparecida M. C.; Baptista, Abrahão F.; Pinheiro, Antonio L. B.; Aguiar, Marcio C.; Santos, Jean N.



Chronic Pain  

Microsoft Academic Search

The primary purposes of acute pain and the reason it is noxious are to interrupt ongoing activity in order to warn the sufferer of tissue damage, to discourage movement that might exacerbate injury or prevent healing, and to teach the organism to avoid the pain-producing circumstances. Therefore, it is no wonder that when pain persists to become chronic, many sufferers

Malcolm H. Johnson


The relation of ST segment deviations in 12-lead conventional Electrocardiogram, right and posterior leads with the site of occlusion in acute inferior myocardial infarction  

PubMed Central

Background: In addition to diagnosing the acute myocardial infarction (MI), stratifying high-risk patients and proper treatment strategies are important issues in managing patients complaining of chest pain and suspecting MI. Many studies have been conducted to predict the occlusion site by interpreting the ST segment deviations in Electrocardiogram (ECG).Additional posterior and right precordial leads are suggested in literature to increase the sensitivity of prediction. The goal of this study was to determine the relation of ST segment changes in ECG (conventional 12 leads ECG besides right and posterior leads) with the site of occlusion within the vessel. Methods: Retrospectively, from total 138 patients, 76 of them were analyzed as single vessel acute Inferior ST elevation Myocardial infarction (I-STEMI)-ST which 56 (74%) had Right Coronary Artery (RCA) occlusion [22(29.3%) proximal RCA, 24(32%) middle RCA and 10(13.3%) distal occlusion of RCA], 19(25%) had Left Circumflex artery (LCx) lesion and one had middle Left Anterior Descending (LAD) artery occlusion. On admission ECGs and coronary artery intervention films, were reported within maximum time of 6 days in hospital stay, and re-evaluated by two cardiologists. Results: Fiol’s algorithm was 93% sensitive and 50% specific for predicting RCA occlusion. The ST elevation in lead III was associated with RCA stenosis (Odds Ratio (OR): 12, Confidence Interval (CI): 2.2-68.9), the association between ST elevation in lead II with LCx involvement was not significant. The V4R was a good marker for RV involvement on-admission, (OR=8, CI: 1.6-37.5). Sum of ST deviation in posterior leads (V7 to V9) ? 2mm had positive and significant relation to LCx stenosis (OR=4, CI: 1.3-14). Conclusion: Benefit of adding posterior and right leads to 12-lead ECG is shown to be noteworthy in present and prior studies, in identifying LCx stenosis and poor prognosis involvement. PMID:25664304

Karbalaie, Shahrokh; Hosseini, Kaveh; Bozorgi, Ali



Veno-Occlusive Disease of the Liver in the Absence of Elevation in Bilirubin in Pediatric Patients after Hematopoietic Stem Cell Transplantation.  


Veno-occlusive disease (VOD) of the liver is a well-described and significant complication of hematopoietic stem cell transplantation (HSCT), with limited successful therapeutic options in severe cases. Prompt diagnosis and initiation of treatment is crucial to restrict the extent of disease. However, a subset of patients may not meet all current diagnostic criteria at presentation, and waiting for these to be met may delay therapy. We retrospectively reviewed 794 HSCT patients treated at our institution between 2003 and 2013, identifying 17 (2.1%) who developed VOD. Of these, 5 (29%) were noted to have an absence of elevated bilirubin at the time of VOD diagnosis and reversal of portal venous flow on ultrasound. Median total and conjugated bilirubin at VOD diagnosis were 1.0 and 0.2 mg/dL, respectively. All 5 patients were subsequently diagnosed with multiorgan failure associated with VOD, including 1 with encephalopathy. Four were treated with intravenous high-dose methylprednisolone (500 mg/m(2) per dose every 12 hours for 6 doses). One patient received defibrotide therapy in addition to steroids and another supportive care alone. VOD resolved in 4 of 5 patients, with median time to resolution of VOD, defined as recovery of all organ function and normalization of bilirubin and portal venous flow, of 8 days. Two patients died later from progressive primary disease and chronic graft-versus-host disease, respectively. We conclude that a high index of suspicion for VOD should be maintained in patients despite lack of bilirubin elevation in the presence of other diagnostic criteria such as hepatomegaly, abdominal pain, ascites, or weight gain. Early ultrasound evaluation in these patients may lead to more timely diagnosis and therapeutic interventions. PMID:25300869

Myers, Kasiani C; Dandoy, Christopher; El-Bietar, Javier; Davies, Stella M; Jodele, Sonata



Chronic motor tic disorder  


Chronic vocal tic disorder; Tic - chronic motor tic disorder ... Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start ...


Chronic obstructive pulmonary disease  


COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... Smoking is the main cause of COPD. The more a person smokes, the ... develop COPD. But some people smoke for years and never get ...


Chronic Kidney Disease (CKD)  


... > Kidney Disease > Chronic Kidney Disease Chronic Kidney Disease (CKD) An estimated 31 million people in the United States are living with chronic kidney disease (CKD). What is CKD? The term “chronic kidney ...


Chronic Pain Medicines  


MENU Return to Web version Chronic Pain | Chronic Pain Medicines How is chronic pain treated? Treatment of chronic ... or she tells you how to use your pain medicine. If you have questions about side effects or ...


The role of thrombolytics in acute and chronic occlusion of the hand.  


Distal arm and hand ischemia from vessel thrombosis or embolism remains a difficult clinical challenge. The causes of ischemia are variable and include connective tissue disease, embolism, atherosclerosis, and iatrogenic etiology. Although reports are limited, treatment with catheter-directed thrombolysis has favorable results in cases of acute thrombosis, with most patients (80%) demonstrating improvement. Digital amputation rates are less than 10% and the hand is often salvaged. Bleeding and access-site complications remain prevalent in patients undergoing intra-arterial thrombolysis. This review discusses etiology, treatment approaches, outcomes, and complications when thrombolytic therapy is used for distal arm and hand ischemia. PMID:25455353

De Martino, Randall R; Moran, Steven L



Use of Double-Occlusion Balloon Catheter: Preoperative Portal Vein Embolization for Induction of Future Remnant Liver Hypertrophy  

SciTech Connect

Purpose: To evaluate the efficacy and safety of using double-occlusion balloon catheters in preoperative portal vein embolization (PVE) to induce future remnant liver hypertrophy. Materials and Methods: PVE was achieved with gelatin sponges by using double-occlusion balloon catheter in seventeen patients with hepatobiliary malignant tumors. The ipsilateral approach was used in thirteen patients and the contralateral approach in four patients due to large size of tumor in the right hepatic lobe.Surgery was performed in 15 patients, 14-27 days (mean, 21.9 days)after PVE. Computed tomographic liver volumetric studies were performed before embolization and before surgery. The changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), prothrombintime (PT), and total bilirubin levels before and after the PVE were evaluated. Complications were evaluated after PVE. Results: PVE using double-occlusion balloon catheter was successful in all cases, irrespective of approach technique. The future remnant liver (FRL) volumes were 251-920 cm{sup 3} (mean, 437cm{sup 3}) before PVE and 281-1042 cm{sup 3} (mean, 555cm{sup 3}) after PVE. The mean increase in the volume of the FRL was 28.6%; this represented 37% of the pre resection volume of the liver. Clinical and biologic tolerance of PVE was mandatory. There were no complications. Conclusions: PVE using the double-occlusion balloon catheter is safe and well-tolerated and can be performed technically with ease. This hypertrophy allows hepatectomy to be performed safely when the FRL volume is initially insufficient inpatients with hepatobiliary tumors.

Kim, Min Joo; Choo, Sung Wook, E-mail:; Do, Young Soo; Park, Kwang Bo; Han, Yoon Hee; Choo, In Wook; Cho, Jae Min [Sungkyunkwan University School of Medicine, 50Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Department of Radiology, Samsung MedicalCenter (Korea, Republic of); Cho, Jae Won; Kim, Sung Joo; Sohn, Tae Sung [Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Department of General Surgery, SamsungMedical Center (Korea, Republic of)



Disruption of the small-intestine mucosal barrier after intestinal occlusion: a study with light and electron microscopy.  


It is known that the gut may serve as a reservoir for various microorganisms, which under specific circumstances may intrude into the systemic circulation, causing systemic infections. The aim of the present study was to estimate the "critical time" of disruption of the small-intestine mucosal barrier in conditions of experimentally induced intestinal occlusion, based on the histopathological alterations observed under light and electron microscopy. Forty rabbits underwent small-intestine obstruction through ligation with a nonabsorbable suture. Blood cultures from portal vein and inferior vena cava, as well as cultures from the peritoneal fluid, a hepatic fragment, and a mesenteric lymph node, were obtained before the ligation (0 h). The same cultures were repeated at 4 and 8 h (group A, 20 rabbits) and at 6 and 12 h after the ligation (group B, 20 rabbits). Small-intestine specimens proximal to the occlusion were taken for examination under the optic and electronic microscope in the same time intervals. Five of 20 rabbits of group A died within 4 h and 6 of 20 rabbits of group B died within 6 h after the operation. All anaerobic cultures were negative. All aerobic cultures that became positive developed Escherichia coli colonies. Intestinal epithelium of dead animals was transformed to cuboid with destruction of goblet cells and alteration in secretion of acid polysaccharides. The mucosal appearance of all rabbits that survived 12 hours after ligation was the same. The disruption of the mucosal barrier begins 4 h after complete intestinal occlusion. At 12 h after complete intestinal occlusion, the disruption is total with different degrees of severity. PMID:12554336

Kabaroudis, A; Papaziogas, B; Koutelidakis, I; Kyparissi-Kanellaki, M; Kouzi-Koliakou, K; Papaziogas, T



[Acute occlusions of cerebral arterial vessels - intravenous versus intraarterial thrombolysis].  


In selected stroke patients intravenous thrombolysis and/or endovascular therapies lead to a significant reduction of long term disabilities. In case of no contraindications, patients with acute ischemic stroke, which arrive within the time window on the emergency unit, should receive thrombolysis consequently and current data indicate that patients with a severe acute ischemic stroke and a proximal cerebral arterial vessel occlusion (i. e. main stem of the arteria cerebri media, posterior, maybe also anterior, arteria carotis interna and basilaris) should preferentially be treated endovascularly, patients with a peripheral cerebral arterial vessel occlusion (i. e. main branch of the arteria cerebri media, anterior and posterior) and mild symptoms with intravenous thrombolysis. PMID:22923354

Heldner, M; Gralla, J; Hungerbühler, H; Fischer, U; Arnold, M



Paraplegia due to Acute Aortic Coarctation and Occlusion.  


Coarctation and occlusion of the aorta is a rare condition that typically presents with hypertension or cardiac failure. However, neuropathy or myelopathy may be the presenting features of the condition when an intraspinal subarachnoid hemorrhage has compressed the spinal cord causing ischemia. We report two cases of middle-aged males who developed acute non-traumatic paraplegia. Undiagnosed congenital abnormalities, such as aortic coarctation and occlusion, should be considered for patients presenting with nontraumatic paraplegia in the absence of other identifiable causes. Our cases suggest that spinal cord ischemia resulting from acute spinal subarachnoid hemorrhage and can cause paraplegia, and that clinicians must carefully examine patients presenting with nontraumatic paraplegia because misdiagnosis can delay initiation of the appropriate treatment. PMID:24851152

Park, Chang-Bum; Jo, Dae-Jean; Kim, Min-Ki; Kim, Sang-Hyun



Infants' knowledge about occlusion and containment events: a surprising discrepancy.  


The present research examined whether infants acquire general principles or more specific rules when learning about physical events. Experiments 1 and 2 investigated 4.5-month-old infants' ability to judge how much of a tall object should be hidden when lowered behind an occluder versus inside a container. The results indicated that at this age infants are able to reason about height in occlusion but not containment events. Experiment 3 showed that this latter ability does not emerge until about 7.5 months of age. The marked discrepancy in infants' reasoning about height in occlusion and containment events suggests that infants sort events into distinct categories, and acquire separate rules for each category. PMID:11340923

Hespos, S J; Baillargeon, R



Acute Occlusive Mesenteric Ischemia: Surgical Management and Outcomes  

Microsoft Academic Search

  Acute mesenteric ischemia secondary to arterial occlusion (AMI) remains a highly lethal condition. To examine recent trends\\u000a in management and associated outcomes, we examined our institutional experience over a recent 10-year period. All patients\\u000a treated for AMI between January 1990 and January 2000 were identified (76 patients, 77 cases) and their medical records examined.\\u000a At presentation, 64% demonstrated peritonitis and

Matthew S. Edwards; Gregory S. Cherr; Timothy E. Craven; Amy W. Olsen; George W. Plonk; Randolph L. Geary; John L. Ligush; Kimberley J. Hansen



Fetal Tracheal Occlusion for the Treatment of Congenital Diaphragmatic Hernia  

Microsoft Academic Search

Background  Congenital diaphragmatic hernia (CDH) continues to be associated with significant mortality and morbidity rates despite advances\\u000a in neonatal care. Fetal intervention for CDH has been studied for 25 years. After initial difficulties encountered with open\\u000a fetal repair, attention has turned to tracheal occlusion (TO) as a method to correct pulmonary hypoplasia before birth. This\\u000a article reviews our contribution to this

Jean-Martin Laberge; Hélène Flageole



Radial Optic Neurotomy in Central Retinal Vein Occlusion: Preliminary Results  

Microsoft Academic Search

Background: To investigate the efficacy of radial optic neurotomy (RON) on visual prognosis and clinical findings in central retinal vein occlusion (CRVO). Methods: Prospective, non-randomised, self-controlled comparative trial. Six patients with ischemic CRVO who had visual acuity (VA) less than or equal to 0.1 and duration of CRVO at least 1 month, and 6 patients with non-ischemic CRVO who maintained

Berkant Kaderli; Remzi Avci; Oner Gelisken



Automatic Occlusion Removal from Facades for 3D Urban Reconstruction  

Microsoft Academic Search

\\u000a Object removal and inpainting approaches typically require a user to manually create a mask around occluding objects. While\\u000a creating masks for a small number of images is possible, it rapidly becomes untenable for longer image sequences. Instead,\\u000a we accomplish this step automatically using an object detection framework to explicitly recognize and remove several classes\\u000a of occlusions. We propose using this

Chris Engels; David Tingdahl; Mathias Vercruysse; Tinne Tuytelaars; Hichem Sahli; Luc Van Gool


Digital subtraction angiography in pediatric cerebrovascular occlusive disease  

SciTech Connect

While conventional angiography has been used to demonstrate cerebrovascular occlusive disease in the past, digital subtraction angiography (DSA) is capable of showing progressive vascular involvement with ease, simplicity, and extremely low morbidity, making it particularly well suited for children and outpatients either alone or coordinated with computed tomography. The authors discuss the usefulness and advantages of DSA as demonstrated in 7 infants and children with hemiplegia, 4 of whom had sickle-cell disease.

Faerber, E.N.; Griska, L.A.B.; Swartz, J.D.; Capitanio, M.A.; Popky, G.L.



Cyclic variation in onset of central retinal vein occlusion.  

PubMed Central

We studied the seasonal incidence of onset of symptoms of central retinal vein occlusion (CRVO) in 105 patients over a 5-year period. Their onset showed a significant cyclic variation (p less than 0.01), being most frequent in the months September through to February. We believe this seasonal variation may in part reflect seasonal changes in haemostasis and retinal perfusion, though other unidentified factors play a significant role. PMID:3814564

Lavin, M J; Dhillon, B J



Open surgery for chronic limb ischemia: a review.  


This review considers the role of the different revascularization strategies in patients with chronic limb ischemia (CLI) and reveals that clinical evidence guiding therapeutic decision-making in CLI is poor and only careful basic recommendations can be made. For diffuse aortoiliac disease with occlusion of the aorta, aortobifemoral bypass remains the best option if the patient is fit for open surgery. Unilateral iliac occlusion should be treated by primary stenting, but an iliofemoral bypass may be the best option when the disease extends down to the common and deep femoral arteries. For infrainguinal revascularisation, bypass using the saphenous vein remains the best option for patients with occlusion of the superficial femoral artery >25 cm and for patients with multiple occlusions of the infrapopliteal arteries. In the absence of leg veins, arm veins should be used. Prosthetic grafts are the last option. Endovascular techniques are recommended in patients with short arterial lesions and limited life expectancy <2 years. Finally some patients with CLI are best treated by primary amputation. In conclusion, this review demonstrates that neither an endo- first nor a bypass-first attitude is appropriate in patients with CLI and suggests that these patients should be cared for by specialists in a multidisciplinary center in order to preserve their life and limbs, to conduct clinical trials and to control costs. PMID:24126509

Ricco, J B; Thanh Phong, L; Belmonte, R; Schneider, F; Valagier, A; Illuminati, G; Regnault De La Mothe, G



Outcome in patients with basilar artery occlusion treated conventionally  

PubMed Central

Background: Most data on the outcome of basilar artery occlusion are from recent case series of patients treated with intra-arterial thrombolysis. The limited knowledge on the outcome after a conventional treatment approach comes from a few small case series of highly selected patients. Objective: To provide more data on the outcome of conventional treatment. Methods: Data were analysed on patients from three centres with symptomatic basilar artery occlusion treated conventionally. Conventional therapy was defined as treatment with antiplatelets, anticoagulation, or both. Results: Data were available on 82 patients. The case fatality was 40%. Among survivors, 65% remained dependent (Rankin score 4–5). Patients younger than 60 years (odds ratio = 3.1 (95% confidence interval, 1.0 to 9.5)) and those with a minor stroke (OR = 3.1 (1.0 to 9.6)) were more likely to have a good outcome (Rankin score 0–3). Patients with a progressive stroke were less likely to have a good outcome (OR = 0.3 (0.08 to 1.2)) than patients with a maximum deficit at onset or fluctuating symptoms at presentation. Conclusions: Conventional treatment of symptomatic basilar artery occlusion is associated with a poor outcome in almost 80% of patients, which emphasises the importance of the search for a more effective treatment approach. PMID:16107358

Schonewille, W; Algra, A; Serena, J; Molina, C; Kappelle, L



Cost aggregation and occlusion handling with WLS in stereo matching.  


This paper presents a novel method for cost aggregation and occlusion handling for stereo matching. In order to estimate optimal cost, given a per-pixel difference image as observed data, we define an energy function and solve the minimization problem by solving the iterative equation with the numerical method. We improve performance and increase the convergence rate by using several acceleration techniques such as the Gauss-Seidel method, the multiscale approach, and adaptive interpolation. The proposed method is computationally efficient since it does not use color segmentation or any global optimization techniques. For occlusion handling, which has not been performed effectively by any conventional cost aggregation approaches, we combine the occlusion problem with the proposed minimization scheme. Asymmetric information is used so that few additional computational loads are necessary. Experimental results show that performance is comparable to that of many state-of-the-art methods. The proposed method is in fact the most successful among all cost aggregation methods based on standard stereo test beds. PMID:18632351

Min, Dongbo; Sohn, Kwanghoon



Grassmann manifold based shape matching and retrieval under partial occlusions  

NASA Astrophysics Data System (ADS)

Shape matching and recognition is a challenging task due to geometric distortions and occlusions. A novel shape matching approach based on Grassmann manifold is proposed that affine transformations and partial occlusions are both considered. An affine invariant Grassmann shape descriptor is employed which projects one shape contour to a point on Grassmann manifold and gives the similarity measurement between two contours based on the geodesic distance on the manifold. At first, shape contours are parameterized by affine length and accordingly divided into local affine-invariant shape segments, which are represented by the Grassmann shape descriptor, according to their curvature scale space images. Then the Smith-Waterman algorithm is employed to find the common parts of two shapes' segment sequences, and get the local similarity of shapes. The global similarity is given by the found common parts, and finally the shape recognition accomplished by the weighted sum of local similarity and global similarity. The robustness of the Grassmann shape descriptor is analyzed through subspace perturbation analysis theory. Retrieval experiments show that our approach is effective and robust under affine transformations and partial occlusions.

Li, Chenxi; Shi, Zelin; Liu, Yunpeng; Xu, Baoshu



The effectiveness of a mouth guard to protect against strong occlusion caused by modified electroconvulsive therapy.  


Modified electroconvulsive therapy (m-ECT) is a treatment for mental disease such as depressive disorder. Although a muscle relaxant is used during current application, strong occlusion occurs due to the proximity of the electrode to the temporal and masseter muscles. Although a feedback mechanism to avoid excessive occlusion occurs unconsciously, the mechanism does not work under general anesthesia. Strong occlusion may cause complications such as tooth injury, pain of the jaw, lip laceration, and bleeding of the gums. Although there was a report that the insertion of shock-absorbing materials such as gauze reduces complications, there has been no study on the effectiveness of a mouth guard (MG) for alleviating the occlusal force during m-ECT. The present study investigated the effectiveness of MG for alleviation of the occlusal force and complications during m-ECT. An ethyl-vinyl-acetate (EVA) MG was used as a shock absorbing material to mitigate the strong occlusion during m-ECT to investigate the influence of MG on the occlusal force and its effectiveness. The results showed that the occlusal force was alleviated by 58 ± 22% on average using MG during m-ECT. It also helped reduce intra-oral problems such as pain and bleeding. The results suggest the effectiveness of MG for alleviating the occlusal force during m-ECT and avoiding complications due to strong occlusion. PMID:25364808

Ogami, Saori; Yamada, Morimasa; Kanazawa, Mayuko; Takeda, Kiyoshi; Kimura, Naoaki; Mizutani, Hideki; Kohase, Hikaru; Fukayama, Haruhisa



Surgical Results of the Carotid Occlusion Surgery Study  

PubMed Central

Object The Carotid Occlusion Surgery Study (COSS) was conducted to determine if STA-MCA bypass, when added to best medical therapy, would reduce subsequent ipsilateral stroke in patients with complete ICA occlusion and an elevated OEF in the cerebral hemisphere distal to the carotid occlusion. A recent publication reported the methodology of COSS in detail and briefly outlined the major findings of the trial.29 The surgical results of COSS are described in detail in this report. Methods The Carotid Occlusion Surgery Study (COSS) was a parallel group, prospective, 1:1 randomized, open-label, blinded-adjudication treatment trial. Participants with angiographic confirmed complete occlusion of the ICA causing either a transient ischemic attack (TIA) or ischemic stroke within 120 days and hemodynamic cerebral ischemia demonstrated by an increased oxygen extraction fraction (OEF) measured by positron emission tomography (PET) were randomized to either surgical or medical treatment. The surgical patients underwent a STA-MCA cortical branch anastomosis. One hundred and ninety-five patients were randomized: 97 to the surgical group and 98 to the medical group. Results In the intention-to-treat analysis, the two-year rates of the primary endpoint were 0.210 for the surgical group and 0.227 for the medical group (p=0.78, log rank). Fourteen (15%) of the 93 patients who had an STA-MCA arterial bypass had an endpoint ipsilateral hemispheric stroke in the 30 day peri-operative period, 12 within two days. The STA-MCA arterial bypass patency rate was 98% at the 30 day post-operative visit and 96% at the last follow-up examination. STA-MCA arterial bypass markedly improved, although it did not normalize, the level of elevated OEF in the symptomatic cerebral hemisphere. Five operated patients and one non-operated patient in the surgical group had an endpoint ipsilateral hemispheric stroke after the 30 day peri-operative period. No baseline characteristics or intra-operative variables were identified that permitted the identification of those who would experience a procedure related stroke. Conclusions In spite of excellent bypass graft patency and improved cerebral hemodynamics, STA-MCA anastomosis did not provide an overall benefit on ipsilateral two-year stroke recurrence, mainly due to a much better than expected stroke recurrence rate (22.7%) in the medical group in the trial, but also because of a significant peri-operative stroke rate (15%). PMID:23101451

Grubb, Robert L.; Powers, William J.; Clarke, William R.; Videen, Tom O.; Adams, Harold P.; Derdeyn, Colin P.



Cognitive impairment induced by permanent bilateral common carotid occlusion exacerbates depression-related behavioral, biochemical, immunological and neuronal markers.  


There is a strong link between cognitive impairment and depression, but up to date it is not clear whether cognitive impairment is 'cause' or 'consequence' of depression. Therefore, we here examined the effect of cognitive impairment induced by permanent occlusion of common carotid arteries, a model known as two-vessel occlusion (2VO), on chronic unpredictable stress (CUS)-induced depression-related markers in rats. Male Sprague-Dawley rats underwent 2VO or sham surgery. Sixty days after the surgery, the cognitive function of the rats was tested using the radial arm maze task measuring working and reference memory. Subsequently, the animals were randomly assigned to undergo 21 days of CUS or to stay non-stressed. One week after the last stressor, psychomotor retardation, a feature of depression-like behavior, was assessed using the forced swim test (FST) by measuring time spent on immobility. Plasma amino acid (glutamine, glutamate and glycine) and serum pro-inflammatory cytokine (interleukin 6) levels, and hippocampus CA1 neuronal damage were measured 24h after FST exposure. Results show that 2VO increased immobility in the FST only when rats had been exposed to CUS. In addition, 2VO surgery intensified the effect of CUS on IL-6, glutamate and glycine levels and increased CA1 hippocampal damage. In conclusion, our findings show that cognitive impairment may predispose to depression by intensifying the effect of stress on depression-related behavioral, biochemical, immunological and neuronal markers. PMID:25446000

Khojasteh, Fatemeh; Nahavandi, Arezo; Mehrpouya, Sara; Homberg, Judith R; Mirzamohammadi, Solmaz; Raufi, Safoora; Soleimani, Mansoureh; Barati, Mahmood



Endovascular Repair of a Type III Thoracoabdominal Aortic Aneurysm in a Patient with Occlusion of Visceral Arteries  

SciTech Connect

The successful endovascular repair of a type III thoracoabdominal aortic aneurysm (TAAA) with the use of a tube endograft is reported. A 56-year-old male with a 6.4-cm type III TAAA, a 4.2-cm infrarenal abdominal aortic aneurysm, and chronic renal insufficiency presented with flank pain, nausea, acute anuria, and serum creatinine of 6.1 mg/dl. Acute occlusion of the left solitary renal artery was diagnosed and emergent recanalization with percutaneus transluminal angioplasty and stenting was performed successfully, with reversal of the serum creatinine level at 1.6 mg/dl. Further imaging studies for TAAA management revealed ostial occlusion of both the celiac artery (CA) and the superior mesenteric artery (SMA) but a hypertrophic inferior mesenteric artery (IMA) providing retrograde flow to the aforementioned vessels. This rare anatomic serendipity allowed us to repair the TAAA simply by using a two-component tube endograft without fenestrations (Zenith; William Cook, Bjaeverskov, Denmark) that covered the entire length of the aneurysm, including the CA and SMA origins, since a natural arterial bypass from the IMA to the CA and SMA already existed, affording protection from gastrointestinal ischemic complications. The patient had a fast and uneventful recovery and is currently doing well 6 months after the procedure. To our knowledge, this is the first report in the English literature of successful endovascular repair of a TAAA involving visceral arteries with the simple use of a tube endograft.

Klonaris, Chris, E-mail:; Katsargyris, Athanasios; Giannopoulos, Athanasios; Georgopoulos, Sotiris; Tsigris, Chris; Michail, Othon; Marinos, George; Bastounis, Elias [Vascular Division, LAIKON Hospital, Athens University Medical School, First Department of Surgery (Greece)



Health literacy and knowledge of chronic disease  

Microsoft Academic Search

We sought to examine the relationship between health literacy and knowledge of disease among patients with a chronic disease. A total of 653 new Medicare enrollees aged 65 years or older who had at least one chronic disease (115 asthma, 266 diabetes, 166 congestive heart failure, 214 hypertension), completed both the in-person and telephone survey. Health literacy measured by the

Julie A Gazmararian; Mark V Williams; Jennifer Peel; David W Baker



Balloon occlusion retrograde transvenous obliteration of gastric varices in two non-cirrhotic patients with portal vein thrombosis.  


This report describes two non-cirrhotic patients with portal vein thrombosis who underwent successful balloon occlusion retrograde transvenous obliteration (BRTO) of gastric varices with a satisfactory response and no complications. One patient was a 35-year-old female with a history of Crohn's disease, status post-total abdominal colectomy, and portal vein and mesenteric vein thrombosis. The other patient was a 51-year-old female with necrotizing pancreatitis, portal vein thrombosis, and gastric varices. The BRTO procedure was a useful treatment for gastric varices in non-cirrhotic patients with portal vein thrombosis in the presence of a gastrorenal shunt. PMID:24497799

Borghei, Peyman; Kim, Seung Kwon; Zuckerman, Darryl A



Orthodontic occlusal reconstruction after conservative treatment of unicystic ameloblastoma in an adolescent patient: 10-year follow-up.  


Conservative treatment of an ameloblastoma often requires an occlusal reconstruction. In this article, we report the successful interdisciplinary treatment of a 14-year-old girl with a unicystic ameloblastoma in the mandible. One year after the marsupialization, enucleation with bone curettage was performed with extraction of the impacted third molar, but the proximal second molar could be maintained. The conservative treatment required long-term use of an obturator, and it caused a total open bite. Additionally, the patient genetically had a Class II malocclusion with severe crowding. Consequently, orthodontic treatment was performed after 4 premolar extractions. There was no recurrence of the ameloblastoma 10 years after the enucleation. PMID:23992819

Tomita, Yuko; Kuroda, Shingo; Takahashi, Takumi; Ohura, Ritsuko; Tanaka, Eiji



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 Acute Lymphoblastic Leukemia; 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; Testicular Lymphoma; Waldenström Macroglobulinemia



Haemosiderin-Laden Sputum Macrophages for Diagnosis in Pulmonary Veno-Occlusive Disease  

PubMed Central

Aims Pulmonary veno-occlusive disease (PVOD) is a rare condition of pulmonary arterial hypertension (PAH), in which post-capillary veins are affected. Since the therapeutic approach in PVOD differs from other forms of PAH, it is crucial to establish the diagnosis. Due to the fact that affected patients are often hemodynamically unstable, minimal invasive procedures are necessary for the diagnostic work-up. Chronic alveolar haemorrhage has been observed during bronchoalveolar lavage in PVOD cases. This study therefore investigates whether signs of alveolar haemorrhage can also be found in the sputum of these patients. Methods and Results Six patients suffering from PVOD were included in this analysis. As controls, patients with idiopathic PAH (n?=?11), chronic thromboembolic PH (n?=?9) and with sclerodermia-associated PH (n?=?10) were assessed. Sputum from every patient was obtained by a non-invasive manner. The amount of haemosiderin-laden macrophages was determined using the Golde score. There were statistically significant more haemosiderin-laden macrophages in the sputum of patients suffering from PVOD as compared to the other groups (P<0.05). Assuming a cut-off of 200 on the Golde score, all of the 6 PVOD patients surpassed this value compared with only 1 out of the 30 cases with precapillary PH. Thus, sensitivity and specificity with respect to the diagnosis of PVOD was 100% and 97%, respectively. Conclusion The content of haemosiderin-laden macrophages in the sputum of patients suffering from PVOD is significantly higher as compared to other forms of PH and may be useful in the non-invasive diagnostic work-up of these patients. PMID:25501010

Speich, Rudolf; Treder, Ula; Stricker, Hans; Goede, Jeroen; Ulrich, Silvia; Stämpfli, Simon F.; Breitenstein, Alexander



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.  


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 ankylosis and anterior open bite. PMID:20599355

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



Artery of percheron occlusion in an elderly male: a case report.  


Acute bilateral paramedian thalamic and mesencephalic infarcts are uncommon. Occlusion of the artery of Percheron (AOP) is presumed to cause this specific stroke syndrome. However, occlusion of the AOP is rare and early diagnosis is challenging. Here we described a 70-year-old male patient who presented with acute disturbance of consciousness due to acute bilateral paramedian thalamo-mesencephalic infarction secondary to AOP occlusion. Anticoagulant therapy was administered, and his consciousness gradually improved. PMID:25436032

Chang, Yuh-Ming; Fan, Yang-Kai



Effectiveness of enoxaparin for prevention of radial artery occlusion after transradial cardiac catheterization  

Microsoft Academic Search

The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial\\u000a access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac\\u000a catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of low molecular\\u000a weight heparins for prevention of this complication has

Hasan Feray; Cemil Izgi; Diler Cetiner; Ebubekir Emre Men; Yelda Saltan; Ayhan Baltay; Reyhan Kahraman



Use of Nitinol Stents Following Recanalization of Central Venous Occlusions in Hemodialysis Patients  

SciTech Connect

Purpose. To retrospectively review the patency of endovascular interventions with nitinol stent placement for symptomatic central venous occlusions in hemodialysis patients. Methods. A retrospective review of all patients who underwent endovascular interventions for dysfunctional hemodialysis grafts and fistulas was performed from April 2004 to August 2006. A total of 6 patients presented with arm and/or neck and facial swelling and left brachiocephalic vein occlusion. The study group consisted of 3 men and 3 women with a mean age of 79.5 years (SD 11.2 years). Of these 6 patients, 1 had a graft and 5 had fistulas in the left arm. The primary indication for nitinol stent placement was technical failure of angioplasty following successful traversal of occluded central venous segments. Patency was assessed from repeat fistulograms and central venograms performed when patients redeveloped symptoms or were referred for access dysfunction determined by the ultrasound dilution technique. No patients were lost to follow-up. Results. Nitinol stent placement to obtain technically successful recanalization of occluded venous segments was initially successful in 5 of 6 patients (83%). In 1 patient, incorrect stent positioning resulted in partial migration to the superior vena cava requiring restenting to prevent further migration. Clinical success was observed in all patients (100%). Over the follow-up period, 2 patients underwent repeat intervention with angioplasty alone. Primary patency was 83.3% (95% CI 0.5-1.2) at 3 months, and 66.7% at 6 and 12 months (0.2-1.1, 0.1-1.2). Secondary patency was 100% at 12 months with 3 patients censored over that time period. Mean primary patency was 10.4 months with a mean follow-up of 12.4 months. No complications related to recanalization of the occluded central venous segments were observed. Conclusion. Our initial experience has demonstrated that use of nitinol stents for central venous occlusion in hemodialysis patients is associated with good mid-term patency and may exceed historical observations with prior use of Wallstents.

Rajan, Dheeraj K., E-mail:; Saluja, Jasdeep S. [Toronto General Hospital, University Health Network University of Toronto, Division of Vascular and Interventional Radiology, Department of Medical Imaging (Canada)



Early Experience with the Amplatzer Vascular Plug II for Occlusive Purposes in Arteriovenous Hemodialysis Access  

SciTech Connect

The Amplatzer Vascular Plug Type II (AVP II) has proven effective in the therapeutic embolization of various vascular lesions. It benefits from very rapid occlusion of the target lesion and can be deployed, retrieved, and redeployed if required. There is no literature available on use of the AVP II in the maintenance, closure, and management of complicated arteriovenous access in hemodialysis patients. In this series, we present our clinical experience with the use of the AVP II for embolization of problematic hemodialysis access. The AVP II is a self-expandable Nitinol wire-mesh device. Mounted on a delivery wire it has the capability to be deployed, recaptured, and redeployed. In total seven patients (four males: one diabetic, all nonsmokers), with ages ranging from 44 to 81 years (mean, 63 years), were treated between July 2008 and January 2009. One patient had not started dialysis. The remaining six patients had varied histories, with the time on hemodialysis ranging from 1 to 21 years. Retrospective review of clinical notes revealed patient demographics, type of access, device size, deployment site, and outcomes. Indications for embolization included steal syndrome (one patient), high-flow tributaries (two patients), and limb swelling (four patients). All patients had clinical and sonographical follow-up to 3 months. Surgical ligation had either failed, was considered a contraindication due to concerns regarding wound healing, or was considered difficult due to complex venous anatomy. Only one device was used in each patient, ranging from 6 to 16 mm in diameter. Immediate technical success was seen in 100%. All these patients were followed up clinically in the vascular access radiology clinic at 4 weeks and 3 months. Occlusion of the treated vessel and resolution of symptoms were reconfirmed in 100% of cases at 3 months. It was also noted whether patients were having successful dialysis, if required. There were no complications. Average procedural time was 19 min. We conclude that the AVP II is an efficient, safe, and technically simple occlusion device for use in arteriovenous access.

Powell, Steven, E-mail:; Narlawar, Ranjeet; Odetoyinbo, Tolulola; Littler, Peter [Royal Liverpool University Hospital, Department of Interventional Radiology (United Kingdom); Oweis, Deyana [Royal Liverpool University Hospital, Department of Renal Medicine (United Kingdom); Sharma, Ajay; Bakran, Ali [Royal Liverpool Hospital, Department of Transplant Surgery (United Kingdom)



Prevention of Arteriovenous Shunt Occlusion Using Microbubble and Ultrasound Mediated Thromboprophylaxis  

PubMed Central

Background Palliative shunts in congenital heart disease patients are vulnerable to thrombotic occlusion. High mechanical index (MI) impulses from a modified diagnostic ultrasound (US) transducer during a systemic microbubble (MB) infusion have been used to dissolve intravascular thrombi without anticoagulation, and we sought to determine whether this technique could be used prophylactically to reduce thrombus burden and prevent occlusion of surgically placed extracardiac shunts. Methods and Results Heparin?bonded ePTFE tubular vascular shunts of 4 mm×2.5 cm (Propaten; W.L Gore) were surgically placed in 18 pigs: a right?sided side?to?side arteriovenous (AV, carotid?jugular) shunt, and a left?sided arterio?arterial (AA, carotid?carotid) interposition shunt in each animal. After shunt implantation, animals were randomly assigned to one of 3 groups. Transcutaneous, weekly 30?minute treatments (total of 4 treatments) of either guided high MI US+MB (Group 1; n=6) using a 3% MRX?801 MB infusion, or US alone (Group 2; n=6) were given separately to each shunt. The third group of 6 pigs received no treatments. The shunts were explanted after 4 weeks and analyzed by histopathology to quantify luminal thrombus area (mm2) for the length of each shunt. No pigs received antiplatelet agents or anticoagulants during the treatment period. The median overall thrombus burden in the 3 groups for AV shunts was 5.10 mm2 compared with 4.05 mm2 in AA (P=0.199). Group 1 pigs had significantly less thrombus burden in the AV shunts (median 2.5 mm2) compared with Group 2 (median 5.6 mm2) and Group 3 (median 7.5 mm2) pigs (P=0.006). No difference in thrombus burden was seen between groups for AA shunts. Conclusion Transcutaneous US with intravenous MB is capable of preventing thrombus accumulation in arteriovenous shunts without the need for antiplatelet agents, and may be a method of preventing progressive occlusion of palliative shunts. PMID:24518555

Kutty, Shelby; Wu, Juefei; Hammel, James M.; Abraham, Joseph R.; Venkataraman, Jeeva; Abdullah, Ibrahim; Danford, David A.; Radio, Stanley J.; Lof, John; Porter, Thomas R.



Detection of underdiagnosed concurrent branch retinal artery occlusion in a patient with central retinal vein occlusion using spectral domain optical coherence tomography  

PubMed Central

Background Combined branch retinal artery and central retinal vein occlusion is a rare condition that has been infrequently reported. This case report, aside from reporting the above-mentioned condition, highlights the importance of performing spectral domain optical coherence tomography in establishing a complete diagnosis, especially in uncertain and complicated cases. We also present spectral domain optical coherence tomography findings of a case of combined unilateral simultaneous central retinal vein and branch retinal artery occlusion. Case presentation We present a single case of an initially missed, unilateral branch retinal artery occlusion combined with central retinal vein occlusion in a 51-year-old female Chinese patient without a significant past medical history, who experienced sudden, painless vision diminution in her right eye eleven days prior to presentation. She eventually recovered visual acuity to 0.60, despite having presented with poor vision. Conclusion Combined unilateral central retinal vein and branch retinal artery occlusion may occur in patients with no medical history of arterial hypertension and diabetes mellitus and can achieve a relatively good visual outcome. This case reaffirms the significance of performing a spectral domain optical coherence tomography examination in patients suffering from central retinal vein occlusion with suspicion of unilateral simultaneous branch retinal artery occlusion to identify the affected pathological areas. PMID:25015220



Selectively active markers for solving of the partial occlusion problem in matchmoving and chromakeying workflow  

NASA Astrophysics Data System (ADS)

Matchmoving (Match Moving) is the process used for the estimation of camera movements for further integration of acquired video image with computer graphics. The estimation of movements is possible using pattern recognition, 2D and 3D tracking algorithms. The main problem for the workflow is the partial occlusion of markers by the actor, because manual rotoscoping is necessary for fixing of the chroma-keyed footage. In the paper, the partial occlusion problem is solved using the invented, selectively active electronic markers. The sensor network with multiple infrared links detects occlusion state (no-occlusion, partial, full) and switch LED's based markers.

Mazurek, Przemys?aw



Anterior choroidal artery ischaemic patterns predict outcome of carotid occlusion  

PubMed Central

Objective To investigate whether anterior choroidal artery (AChA) territory sparing or AChA infarction restricted to the medial temporal lobe (MT), implying good collateral status, predicts good outcome, defined as modified Rankin Scale 0–2, at discharge in acute internal carotid artery (ICA) occlusion. Methods The authors studied consecutive patients with acute ICA occlusion admitted to an academic medical centre between January 2002 and August 2010, who underwent MRI followed by conventional angiography. The pattern of AChA involvement on initial diffusion-weighted imaging was dichotomised as spared or MT only versus other partial or full. The association of AChA infarct patterns and good outcome at discharge was calculated by multivariate logistic regression with adjustment. Results For the 60 patients meeting entry criteria, mean age was 68.3 years and median admission NIH Stroke Scale score was 19. AChA territory was spared or restricted to the MT in 27 patients and other partially involved or fully involved in 33 patients. AChA territory spared or ischaemia restricted to MT only, compared with other partial infarct patterns or full infarct, was independently associated with good discharge outcome (44.4% vs 12.1%, OR 7.24, 95% CI 1.32 to 39.89, p=0.023). Conclusion In acute ICA occlusion, the absence of AChA infarction or restriction to the MT is an independent predictor of good discharge outcome. Analysis of AChA infarct patterns may improve early prognostication and decision-making. PMID:22492212

Lee, Meng; Saver, Jeffrey L.; Hao, Qing; Starkman, Sidney; Salamon, Noriko; Ali, Latisha K.; Kim, Doojin; Ovbiagele, Bruce; Song, Sarah; Raychev, Radoslav; Abcede, Hermelind; Fiaz, Rana; Liebeskind, David S.



Robust lane sensing and departure warning under shadows and occlusions.  


A prerequisite for any system that enhances drivers' awareness of road conditions and threatening situations is the correct sensing of the road geometry and the vehicle's relative pose with respect to the lane despite shadows and occlusions. In this paper we propose an approach for lane segmentation and tracking that is robust to varying shadows and occlusions. The approach involves color-based clustering, the use of MSAC for outlier removal and curvature estimation, and also the tracking of lane boundaries. Lane boundaries are modeled as planar curves residing in 3D-space using an inverse perspective mapping, instead of the traditional tracking of lanes in the image space, i.e., the segmented lane boundary points are 3D points in a coordinate frame fixed to the vehicle that have a depth component and belong to a plane tangent to the vehicle's wheels, rather than 2D points in the image space without depth information. The measurement noise and disturbances due to vehicle vibrations are reduced using an extended Kalman filter that involves a 6-DOF motion model for the vehicle, as well as measurements about the road's banking and slope angles. Additional contributions of the paper include: (i) the comparison of textural features obtained from a bank of Gabor filters and from a GMRF model; and (ii) the experimental validation of the quadratic and cubic approximations to the clothoid model for the lane boundaries. The results show that the proposed approach performs better than the traditional gradient-based approach under different levels of difficulty caused by shadows and occlusions. PMID:23478598

Tapia-Espinoza, Rodolfo; Torres-Torriti, Miguel



Occlusion of both caval veins by an endovascular occluder.  


Minimally invasive surgery (MIS) for redo mitral/tricuspidal surgery is going to increase, offering good results for early and late mortality and morbidity. In a case of redo surgery through a right thoracotomy (RT), when tricuspid surgery is planned, the superior (SVC) and inferior caval veins (IVC) are usually isolated and snared in order to prevent air embolism and significant blood regurgitation. We describe our experience in eight redo patients, operated for combined mitral/tricuspid or isolated tricuspid surgery, where the endovascular occlusion of the SVC and IVC was obtained by means of an endovascular occluder (Equalizer). PMID:22465589

Sansone, Fabrizio; Barbero, Cristina; Rinaldi, Mauro



Graft occlusion after deployment of the Symmetry Bypass System.  


Recently the Symmetry Bypass System (SJM, St. Paul, MN) became available. Now the system is frequently applied for vein-graft to aorta anastomoses in off-pump coronary artery bypass operations. This report describes a complication associated with the use of the Symmetry Bypass System (SJM) in a patient undergoing a standard off-pump coronary artery bypass procedure. A novel imaging system (SPY, Novadaq, Toronto, Canada) was applied for intraoperative assessment of graft function, and this system immediately diagnosed the occlusion of the proximal mechanical anastomosis caused by a mobile atheromatous aortic plaque. PMID:12735592

Reuthebuch, Oliver T; Kadner, Alexander; Lachat, Mario L; Turina, Marko I



Embolic occlusion of arteriovenous fistula due to infective endocarditis.  


A 45-year-old male on maintenance hemodialysis through right radio cephalic arteriovenous fistula (AVF) also had mitral regurgitation. He presented with fever and chills of 2 days duration along with pain and swelling at median cubital fossa of right upper limb. Local examination revealed warmth, redness, and tenderness at median cubital fossa. AVF thrill was absent. Echocardiography revealed vegetations on the mitral valve. An extensive search of literature did not reveal an instance of embolic occlusion of AVF due to vegetations of infective endocarditis. PMID:25484539

Ram, R; Swarnalatha, G; Mahapatra, S; Dakshinamurty, K V



Symptomatic Steno-Occlusion in Patients with Acute Cerebral Infarction: Prevalence, Distribution, and Functional Outcome  

PubMed Central

Background and Purpose Symptomatic steno-occlusion (SYSO) in acute ischemic stroke has a significant impact on treatment options and prognosis. However, the prevalence, distribution, clinical characteristics, and outcome of SYSO are not well known. Methods We retrospectively identified 3,451 patients hospitalized because of ischemic stroke within 24 hours of symptom onset at 9 stroke centers in South Korea. Patients who did not undergo magnetic resonance imaging were excluded. SYSO was defined as stenosis or occlusion of cerebral arteries with relevant ischemic lesions in the corresponding arterial territory. The number, location, and severity of SYSOs and their effects on functional outcome were analyzed. Results In total, 1,929 of 3,057 subjects (63.1%) had SYSO. The most frequently affected vessels were the middle cerebral artery (34.6%), extracranial internal carotid artery (14%), vertebral artery (12.4%), and basilar artery (8.7%). SYSO predicted poor outcome on the modified Rankin Scale 3-6 (odds ratio, 1.77; 95% confidence interval, 1.46-2.15) with adjustments. Involvement of 2 or more vessels was observed in 30.6% of patients with SYSO and independently increased the risk of poor outcome (odds ratio, 2.76; 95% confidence interval, 2.12-3.59). The severity of SYSO was associated with outcome and showed a significant dose-response trend (P<0.001). The effect of SYSO on outcome did not significantly differ by individual arterial location (P for contrast=0.21). Conclusions Approximately 60% of patients with acute ischemic stroke had SYSO, and the severity and number were inversely correlated with outcome. The results suggest that SYSO could predict stroke outcome. PMID:24741563

Kang, Jihoon; Park, Tai Hwan; Lee, Kyung Bok; Park, Jong-Moo; Ko, Youngchai; Lee, Soo Joo; Hong, Keun-Sik; Cho, Yong-Jin; Lee, Ji Sung; Lee, Juneyoung; Lee, Byung-Chul; Yu, Kyung-Ho; Kim, Dae-Hyun; Cha, Jae-Kwan; Lee, Jun; Jang, Myung Suk; Han, Moon-Ku



Renal responses of normal and preascitic broilers to systemic hypotension induced by unilateral pulmonary artery occlusion.  


During the pathophysiological progression of pulmonary hypertension syndrome (PHS; ascites), broilers concurrently develop systemic hypotension (low mean systemic arterial pressure) that may initiate renal retention of water and solute, contributing to fluid accumulation in the abdominal cavity (ascites). In male Single Comb White Leghorns, glomerular filtration is autoregulated over a systemic arterial pressure range of 110 to 60 mm Hg, and corresponding reductions in urine flow are attributed to a phenomenon known as pressure natriuresis. Acute unilateral pulmonary artery occlusion was used in the present study to reduce systemic arterial pressure toward the lower autoregulatory limit for glomerular filtration, and to evaluate kidney function in normal and preascitic broilers. Preascitic broilers characteristically exhibited lower (P < or = 0.05) values for mean systemic arterial pressure (91 vs 100 mm Hg) and percentage saturation of hemoglobin with oxygen (73 vs 84%), higher hematocrits (35 vs 30%), heavier right ventricles (3.44 vs 2.32 g), and higher right:total ventricular weight ratios (0.32 vs 0.24) than normal broilers. Body weights (2,445 vs 2,429 g, respectively), left ventricle plus septum weights (7.16 vs 7.19 g), and heart rates (349 vs 341 beats/min) were similar. Preascitic broilers exhibited larger (P < or = 0.05) dependent reductions in glomerular filtration, urine flow, osmolal clearance, and solute excretion and had a higher free water clearance than normal broilers in response to pulmonary artery occlusion. The differences observed between normal and preascitic broilers demonstrate that systemic hypotension can trigger renal mechanisms contributing to fluid and solute retention during development of PHS. PMID:10626655

Forman, M F; Wideman, R F



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.



Dento-facial relationships in individuals with normal occlusion.  


The aim of this study was to evaluate the relationships of selected facial measurements with mesio-distal crown widths and dental arch dimensions in individuals with normal occlusions. A cross-sectional study was conducted on 276 subjects with Angle's Class I normal occlusions. Three-dimensional images of the face and dental casts were captured and analyzed using stereophotogrammetric systems. Significant correlations were found between the sagittal facial variables and both upper and lower dental arch dimensions and to lesser degree with the horizontal and vertical variables. The values of correlation coefficients calculated between facial and dental crown measurements ranged from .01 to .50 for upper teeth and .01 to .49 for lower teeth. The values of correlation coefficients between facial and upper dental arch dimensions ranged from .01 to .55 and those between facial and lower dental arch dimensions ranged from .01 to .60. A principal components analysis showed that the sagittal dimensions, face height, nose, labial fissure, binocular widths were positively associated with dental arch dimensions and mesio-distal crown diameters in males. On the other hand, only the sagittal variables were associated with dental dimensions in females. The results of this study confirm that positive associations exist between facial and dental arch dimensions. These relationships should be taken into consideration when attempts are made to modify dental arch size as part of orthodontic treatment. Moreover, these relationships are also relevant to prosthodontists involved with selecting tooth sizes that display optimal functional balance with the craniofacial structures. PMID:23755965

Al-Khatib, Ali R; Rajion, Zainul A; Masudi, Sam'an M; Hassan, Rozita; Townsend, Grant C



Repigmentation of pretibial vitiligo with calcineurin inhibitors under occlusion.  


Treatment of vitiligo is a challenge, especially in children. Recently, topical calcineurin inhibitors have been introduced in the management of vitiligo, but significant repigmentation is not achieved except on the face. Large pretibial lesions of a 15-year-old female with progressive vitiligo were treated twice daily over six months with 0.1% tacrolimus ointment on the right and 1% pimecrolimus cream on the left side without effect. Additional overnight occlusion with polyurethane and hydrocolloid foils during the following 18 months led to substantial repigmentation on both sides (tacrolimus-treated side, 88% repigmented area; pimecrolimus-treated side, 73%). Tacrolimus serum levels measured at four different time points did not exceed 1.8 ng/ml. This case report on a direct comparison of topical tacrolimus and pimecrolimus in vitiligo shows that on the shins considerable improvement could be induced with both agents only by additional long-term occlusion and that tacrolimus was somewhat more effective than pimecrolimus. PMID:18042249

Hartmann, Anke; Bröcker, Eva-Bettina; Hamm, Henning



Chronic Eosinophilic Leukemia  


Search Español Chronic Myeloproliferative Neoplasms Treatment (PDQ®) Last Modified: November 11, 2014 General Information About Chronic Myeloproliferative Neoplasms Myeloproliferative neoplasms are a group of ...


CT Findings in Acute, Subacute, and Chronic Ischemic Colitis: Suggestions for Diagnosis  

PubMed Central

Purpose. This paper aims at evaluating CT findings of occlusive and nonocclusive ischemic colitis (IC), in correlation with the etiology and the different phases of the disease. Materials and Methods. CT examination and clinical history of 32 patients with proven IC were retrospectively reviewed. The CT findings were analyzed according to the different phases of the disease (acute, subacute, and chronic). Results. Among the 32?CT examinations performed in the acute phase, 62.5% did not present signs of occlusion of the superior mesenteric artery (SMA) or inferior mesenteric artery (IMA), whereas IMA occlusion was detected in 37.5% of CT examinations. In the acute phase, the presence of pericolic fluid was found in 100% of patients undergoing progressive resorption from acute to subacute phase if an effective reperfusion occurred; the bowel wall thickening was observed in 28.1% patients in acute phase and in 86.4% patients evaluated in subacute phase. The unthickened colonic wall was found in all conditions where ischemia was not followed by effective reperfusion (71.9% of cases), and it was never found in chronic phase, when the colon appeared irregularly thickened. Conclusion. CT allows determining the morphofunctional alterations associated with the IC discriminating the occlusive forms from the nonocclusive forms. CT, furthermore, allows estimating the timing of ischemic damage. PMID:25247191

Iacobellis, Francesca; Berritto, Daniela; Fleischmann, Dominik; Gagliardi, Giuliano; Brillantino, Antonio; Mazzei, Maria Antonietta; Grassi, Roberto



Comparing Outcomes of Two Vascular Inflow Occlusion Techniques and Treatment without Vascular Occlusion during Major Hepatectomy in Patients with Hepatitis B-Related Hepatocellular Carcinoma  

PubMed Central

Background Significant hemorrhage together with blood transfusion has negative impact on postoperative morbidity, mortality, and long-term survival of liver resection. Various techniques of vascular occlusion have been developed to reduce intraoperative blood loss. The objective of this study was to compare the outcomes of Pringle maneuver, hemi-hepatic vascular occlusion, and treatment without vascular occlusion used during liver resection. Method Data of 574 patients with Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), who underwent major hepatectomy between January 2009 to March 2013 by Pringle maneuver (N?=?158), hemi-hepatic vascular inflow occlusion (N?=?216), or without any vascular occlusion (N?=?200), were included in this retrospective study. Perioperative blood transfusion, intraoperative blood loss, and postoperative liver function, and surgical complications were analyzed and compared between the three groups. Result There were no significant difference observed in postoperative bilirubin, liver enzyme, and albumin levels between three groups (P>0.05). 5 patients (2.5%) in no occlusion group, 2 (1.3%) in Pringle group, and 8 (3.7%) in hemi-hepatic group had liver failure; but, there were no differences (P>0.05). The overall postoperative complications rate between three groups did not reach significant differences (33.5% vs 34.2% vs 42.6%, respectively; P>0.05). However, significant differences in intraoperative blood loss between no occlusion group (638.2±426.8 ml) and Pringle group (518.0±451.0 ml) or hemi-hepatic group (513.0±366.7 ml) (P<0.01). Conclusion Although there were no differences found between three groups regarding postoperative complications rate, no vascular occlusion group had more blood loss than the other two groups during liver resection. PMID:25203056

Huang, Zhiping; Zhang, Peng; Wang, Haiqing; Yan, Lunan; Wang, Wentao



The central retinal artery occlusion in the right eye followed by a branch retinal artery occlusion in the left eye four days later  

PubMed Central

A 65-year-old woman was admitted to our clinic with complaints of sudden, painless, decrease in vision, and sectoral visual field defect in the left eye and later presented to our clinic again with a history of sudden loss of vision in her right eye. In this case study we reported that the patient had branch retinal artery occlusion (BRAO) in the left eye and at the same time progressing central retinal artery occlusion (CRAO) in the right eye. PMID:24145559

Caglar, Cagatay; Caglar, Zeliha; Gul, Adem



Central retinal vein occlusion: a prospective histopathologic study of 29 eyes in 28 cases.  

PubMed Central

The clinical and histopathologic features of 29 eyes from 29 patients with central retinal vein occlusion (CRVO) are reported. A fresh or a recanalized thrombus was observed in each eye. This study considers the temporal aspects of the cases, and it notes the different morphologic features of the occlusion. These observations explain most of the variability of the changes observed in previous reports. We believe that these different features represent the various stages in the natural evolution of such a thrombus. The interval between CRVO and histopathologic study in our series ranged from six hours to more than 10 years. Local and systemic factors were reviewed and were found to be important in the pathogenesis of thrombus formation. Local diseases with a predisposing effect on CRVO included: glaucoma, papilledema, subdural hemorrhage, optic nerve hemorrhage, and drusen of the optic nerve head. Associated systemic diseases included: hypertension, cardiovascular and cerebrovascular disease, diabetes mellitus, and leukemia with thrombocytopenia. A fresh thrombus in the CRVO was observed in three (10.3%), and a recanalized thrombus in 26 eyes (89.7%). Endothelial-cell proliferation was a conspicuous feature in 14 (48.3%) of the eyes. Chronic inflammation in the area of the thrombus, and/or vein wall or perivenular area was observed in 14 (48.3%) of the eyes. Arterial occlusive disease was observed in seven eyes (24.6%). Cystoid macular edema was found in 26 (89.7%) of the eyes. Images FIGURE 15 A FIGURE 15 B FIGURE 15 C FIGURE 15 D FIGURE 15 E FIGURE 15 F FIGURE 15 G FIGURE 1 A FIGURE 1 B FIGURE 1 C FIGURE 2 A FIGURE 2 B FIGURE 2 C FIGURE 2 D FIGURE 2 E FIGURE 3 A FIGURE 3 B FIGURE 3 C FIGURE 3 D FIGURE 3 E FIGURE 3 F FIGURE 4 A FIGURE 4 B FIGURE 4 C FIGURE 5 A FIGURE 5 B FIGURE 5 C FIGURE 6 A FIGURE 6 B FIGURE 7 A FIGURE 7 B FIGURE 7 C FIGURE 7 D FIGURE 8 A FIGURE 8 B FIGURE 9 A FIGURE 9 B FIGURE 9 C FIGURE 9 D FIGURE 10 A FIGURE 10 B FIGURE 11 A FIGURE 11 B FIGURE 11 C FIGURE 12 A FIGURE 12 B FIGURE 12 C FIGURE 12 D FIGURE 13 A FIGURE 13 B FIGURE 13 C FIGURE 13 D FIGURE 14 A FIGURE 14 B FIGURE 16 A FIGURE 16 B FIGURE 17 A FIGURE 17 B FIGURE 17 C FIGURE 17 D FIGURE 17 E FIGURE 17 F FIGURE 18 A FIGURE 18 B FIGURE 18 C FIGURE 19 A FIGURE 19 B FIGURE 19 C FIGURE 19 D FIGURE 19 E FIGURE 20 A FIGURE 20 B FIGURE 20 C FIGURE 20 D FIGURE 21 A FIGURE 21 B FIGURE 22 A FIGURE 22 B FIGURE 23 A FIGURE 23 B FIGURE 23 C FIGURE 23 D FIGURE 23 E FIGURE 23 F FIGURE 23 G FIGURE 23 H FIGURE 24 A FIGURE 24 B FIGURE 25 A FIGURE 25 B FIGURE 26 A FIGURE 26 B FIGURE 26 C FIGURE 26 D FIGURE 27 A FIGURE 27 B FIGURE 27 C FIGURE 28 FIGURE 29 PMID:7342407

Green, W R; Chan, C C; Hutchins, G M; Terry, J M



Tooth displacement due to occlusal contacts: a three-dimensional finite element study.  


The use of the Finite Element Method (FE) is an appropriate way to study occlusal forces and tooth movement. The purpose of this study was to evaluate the effects of different occlusal contact patterns on tooth displacement in an adult dentition using a three-dimensional FE model of a human maxilla and mandible. Initially, images of a computerized tomography scan were redrawn in a computer program (CATIA) followed by the FE mesh construction. The MSC/Patran software was used to develop the FE mesh comprising 520,445 elements and 106,633 nodes. The MSC/Nastran program was utilized as pre and post-processor for all mathematical calculations necessary to evaluate dental and mandibular biomechanics. Four occlusal patterns were tested: FEM 1 - standard occlusal contacts; FEM 2 - removal of mesial marginal and mesial tripoidism contacts; FEM 3 - removal of distal marginal and distal tripoidism contacts; FEM 4 - similar to FEM 3 with added contacts between upper and lower incisors. Small changes in the standard distribution of occlusal contacts resulted in an imbalance of occlusal forces and changes in dental positioning. All simulations tested showed mesial displacement of posterior teeth. The most significant changes were registered in the model presenting unstable occlusal contacts when the anterior teeth were in occlusion (FEM 4). These findings may explain mandibular incisors crowding and maxillary incisors flaring as a result of small variations in dental contacts. PMID:17168929

Gomes de Oliveira, S; Seraidarian, P I; Landre, J; Oliveira, D D; Cavalcanti, B N




E-print Network

EFFETS DE LA MALADIE DE PARKINSON SUR LA R�ALISATION ACOUSTIQUE DES OCCLUSIVES DU FRAN�AIS LU'affaiblissement des occlusives en français dans la parole de personnes atteintes de la maladie de Parkinson. Les Parkinson, est influencé par les caractéristiques articulatoires inhérentes des consonnes. Mots

Boyer, Edmond


Immediate cystic duct occlusion using an endoluminal absorbable polyglycolic acid screw  

Microsoft Academic Search

Endoscopic in situ occlusion of the cystic duct and ablation of the gallbladder could constitute a useful alternative to cholecystectomy in certain patients. The purpose of this study was to examine the feasibility of endoluminal occlusion of the cystic duct using a biodegradable polyglycolic acid screw and simultaneous gallbladder mucosal ablation with a Sotradecol-ethanol mixture.

R. C. W. Bell; G. V. Stiegmann; J. Sun; J. Kim; J. Durham; M. S. Lucia



A Multi-Level Supporting Scheme for Face Recognition under Partial Occlusions and  

E-print Network

A Multi-Level Supporting Scheme for Face Recognition under Partial Occlusions and Disguise Jacky S, Hong Kong Abstract. Face recognition has always been a challenging task in real- life surveillance videos, with partial occlusion being one of the key factors affecting the robustness of face recognition

Wong, Kenneth K.Y.


Important Factors for the Hearing Loss Caused by the Triple Semicircular Canal Occlusion in Guinea Pigs  

Microsoft Academic Search

Hypothesis: Dynamic recording of the auditory brainstem response is helpful in verifying harmful procedure(s) to hear- ing during triple semicircular canal occlusion (TSCO) surgery. The damage to the membranous semicircular labyrinth is the single major contributor to hearing loss caused by TSCO. Background: Posterior semicircular canal occlusion has been recognized as an efficient method of eliminating vertigo with- out causing

Shankai Yin; Dongzhen Yu; Zhengnong Chen; Zhenyu Cao; Jian Wang



Thrombolytic Therapy in Acute Occlusion of the Intracranial Internal Carotid Artery Bifurcation  

Microsoft Academic Search

PURPOSE: To evaluate efficacy and clinical benefit of early thrombolytic therapy in intracranial internal carotid artery occlusion. METHODS: Thirty-two patients (mean age, 56 years) with acute intracranial internal carotid artery occlusion were studied clinically and with CT and angiography before and after thrombolytic therapy with intravenous alteplase (n 5 16), superselective intraar- terial alteplase (n 5 8), and superselective intraarterial

Olav Jansen; Rudiger von Kummer; Michael Forsting; Werner Hacke; Klaus Sartor


Morphological consequences of early reperfusion following thrombotic or mechanical occlusion of the rat middle cerebral artery  

Microsoft Academic Search

The early morphological consequences of recirculation following middle cerebral artery (MCA) occlusion were studied in two rat models. The proximal MCA was occluded for 1 h by either a surgical clip or platelet thrombus; subsequently, 1 h of recirculation was facilitated. Following clip occlusion and recirculation, mild astrocytic swelling, especially around blood vessels, was detected in reperfused cortical and striatal

W. D. Dietrich; H. Nakayama; B. D. Watson; H. Kanemitsu



Consecutive Macular Edema and Visual Outcome in Branch Retinal Vein Occlusion  

PubMed Central

Purposes. The study introduced the concept of “consecutive macular edema” and evaluated the validity of visual outcome in macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods. Patients were categorized into the gainer group and the nongainer group according to the final visual acuity. We analyzed clinical characteristics involving total and consecutive duration of ME between the two groups. Results. Among the total 71 eyes of 71 patients, intravitreal bevacizumab injection (26 patients), triamcinolone (21), and natural course (33) were enrolled. The consecutive duration of ME was shorter in the gainer group than in the nongainer group (3.33 ± 1.50 and 5.24 ± 2.39 months; P = 0.000). After exclusion of macular ischemia, consecutive duration of ME in gainer group was also significantly shorter than in nongainer group (3.62 ± 1.60 and 6.11 ± 4.20 months; P = 0.010). Conclusions. The duration of ME in the nongainer group was longer than in the gainer group. In particular, the consecutive duration was an important factor in determining the final visual outcome. Clinical Trial Registration. Approval by Hallym University Sacred Heart Hospital Institutional Review Board/Ethics Committee was obtained for this retrospective study. PMID:24967098

Baek, Sung Uk; Kwon, Soon Il; Park, In Won; Choi, Kyung Jun



Quantitative assessment of renal arterial occlusion in a porcine model using spatial frequency domain imaging  

PubMed Central

We present the results of a feasibility study with spatial frequency domain imaging (SFDI) to produce quantitative measurements of optical property and chromophore concentration maps of three porcine kidneys utilizing a renal occlusion model at the near-infrared wavelengths of 658, 730, and 850 nm. Using SFDI, we examined the dynamics of absolute oxygen saturation (StO2). The mean StO2 for the kidneys varied from approximately 60% before occlusion, to 20% during occlusion, to 55% after reperfusion. We also present, for the first time to the best of our knowledge, reduced scattering coefficient (?s?) maps of the kidney during occlusion. We observed a substantial decrease in the wavelength dependence of scattering (i.e., scattering power) in the three kidneys, with a mean decrease of 18% ± 2.6%, which is indicative of an increase in scatterer size, and is likely due to tissue changes such as edema that follow from occlusion and inflammation. PMID:24104815

Nadeau, K. P.; Ponticorvo, A.; Lee, H. J.; Lu, D.; Durkin, A. J.; Tromberg, B. J.




PubMed Central

Chronic urticaria (CU) is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ‘idiopathic’ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented. PMID:22345759

Sachdeva, Sandeep; Gupta, Vibhanshu; Amin, Syed Suhail; Tahseen, Mohd



Using occlusal wear information and finite element analysis to investigate stress distributions in human molars  

PubMed Central

Simulations based on finite element analysis (FEA) have attracted increasing interest in dentistry and dental anthropology for evaluating the stress and strain distribution in teeth under occlusal loading conditions. Nonetheless, FEA is usually applied without considering changes in contacts between antagonistic teeth during the occlusal power stroke. In this contribution we show how occlusal information can be used to investigate the stress distribution with 3D FEA in lower first molars (M1). The antagonistic crowns M1 and P2–M1 of two dried modern human skulls were scanned by ?CT in maximum intercuspation (centric occlusion) contact. A virtual analysis of the occlusal power stroke between M1 and P2–M1 was carried out in the Occlusal Fingerprint Analyser (OFA) software, and the occlusal trajectory path was recorded, while contact areas per time-step were visualized and quantified. Stress distribution of the M1 in selected occlusal stages were analyzed in strand7, considering occlusal information taken from OFA results for individual loading direction and loading area. Our FEA results show that the stress pattern changes considerably during the power stroke, suggesting that wear facets have a crucial influence on the distribution of stress on the whole tooth. Grooves and fissures on the occlusal surface are seen as critical locations, as tensile stresses are concentrated at these features. Properly accounting for the power stroke kinematics of occluding teeth results in quite different results (less tensile stresses in the crown) than usual loading scenarios based on parallel forces to the long axis of the tooth. This leads to the conclusion that functional studies considering kinematics of teeth are important to understand biomechanics and interpret morphological adaptation of teeth. PMID:21615398

Benazzi, Stefano; Kullmer, Ottmar; Grosse, Ian R; Weber, Gerhard W



Endovascular Treatment of Tandem Internal Carotid and Middle Cerebral Artery Occlusions  

PubMed Central

Objective Extracranial internal carotid artery (ICA) angioplasty and intracranial thrombectomy may be a safe and efficacious therapeutic option for recanalization of a subset of arterial occlusions termed tandem occlusions of Internal carotid artery and Middle cerebral artery (TIM). Background Approximately 25% of patients with middle cerebral artery (MCA) occlusion will have a concomitant ICA occlusion and 50% of patients with an ICA occlusion will have a proximal MCA occlusion. Cervical ICA occlusion with MCA embolic occlusion is associated with a low rate of recanalization and poor outcome after intravenous thrombolysis. We report our experience on acute ischemic stroke patients with TIM occlusion treated with extracranial ICA angioplasty/stenting and intracranial thrombectomy and/or standard intravenous thrombolysis. Design/Methods A retrospective analysis of 7 patients from our stroke database was done. 6 patients of the 7 patients were treated with extracranial ICA angioplasty and intracranial thrombectomy and/or intravenous thrombolysis. We examined early neurological improvement (defined by a reduction of National Institutes of Health Stroke Scale (NIHSS) > 8 points). We also evaluated the rate of successful recanalization based on thrombolysis in cerebral infarction (TICI) score of 2b or 3. Results All but one of the 6 treated patients achieved a TICI score of 2b or 3 signifying successful recanalization. In addition, treated patients had an early reduction of their NIHSS by greater than 8 points. The 1 patient who did not to achieve TICI 2b or 3 also failed to show early neurological improvement. Four of the treated patients had a follow up NIHSS at 90 days of 1 or less and mRS at 90 days of 0. Conclusions In cases of tandem occlusions of ICA and MCA, multimodal therapy consistent of intravenous thrombolysis and/or extracranial ICA stenting and intracranial thrombectomy to achieve recanalization may be a safe and efficacious therapeutic option for recanalization. Further prospective studies are warranted. PMID:25422711

Dababneh, Haitham; Bashir, Asif; Hussain, Mohammed; Guerrero, Waldo R; Morgan, Walter; Khanna, Anna Yuzefovich; Mocco, J Duffy



Central Sensitization and MAPKs are Involved in Occlusal Interference-Induced Facial Pain in Rats  

PubMed Central

We previously developed a rat dental occlusal interference model of facial pain that was produced by bonding a crown onto the right maxillary first molar and was reflected in sustained facial hypersensitivity that was suggestive of the involvement of central sensitization mechanisms. The aim of the present study was to investigate potential central mechanisms involved in the occlusal interference-induced facial hypersensitivity. A combination of behavioral, immunohistochemical, Western blot and electrophysiological recording procedures was used in 98 male adult Sprague-Dawley rats that either received the occlusal interference or were sham-operated or naive rats. Immunohistochemically labeled astrocytes and microglia in trigeminal subnucleus caudalis (Vc) showed morphological changes indicative of astrocyte and microglial activation after the occlusal interference. Prolonged upregulation of p38 MAPK and ERK was also documented in Vc after placement of the occlusal interference, and was expressed in both neurons and glial cells at time points when rats showed peak mechanical facial hypersensitivity. The i.t. administration of the p38 MAPK inhibitor SB203580 to the medulla significantly inhibited the occlusal interference-induced hypersensitivity, and the ERK inhibitor PD98059 produced an even stronger effect. Central sensitization of functionally identified Vc nociceptive neurons following placement of the occlusal interference was also documented by extracellular electrophysiological recordings, and i.t. administration of PD98059 could reverse the neuronal central sensitization. These novel findings suggest that central mechanisms including central sensitization of trigeminal nociceptive neurons and non-neuronal processes involving MAPKs play significant roles in the production of occlusal interference-induced facial pain. Perspective Central mechanisms including trigeminal nociceptive neuronal sensitization, non-neuronal processes involving glial activation and MAPKs play significant roles in occlusal interference-induced facial pain. These mechanisms may be involved in clinical manifestations of facial pain that have been reported in patients with an occlusal interference. PMID:23642433

Cao, Ye; Li, Kai; Fu, Kai-Yuan; Xie, Qiu-Fei; Chiang, Chen-Yu; Sessle, Barry J.



Chronic mesenteric ischemia: Time to remember open revascularization  

PubMed Central

Chronic mesenteric ischemia is caused by stenosis or occlusion of one or more visceral arteries. It represents a therapeutic challenge and diagnosis and treatment require close interdisciplinary cooperation between gastroenterologist, vascular surgeon and radiologist. Although endovascular treatment modalities have been developed, the number of restenoses ultimately resulting in treatment failure is high. In patients fit for open surgery, the visceral arteries should be revascularized conventionally. These patients will then experience long term relief from the symptoms, a better quality of life and a better overall survival. PMID:23539677

Keese, Michael; Schmitz-Rixen, Thomas; Schmandra, Thomas



Systemic antiatherosclerotic treatment for the peripheral arterial occlusive disease patient.  


Symptomatic and asymptomatic peripheral arterial occlusive disease (PAD) is indicative of widespread atherosclerosis. The major threat is from cardiovascular ischaemic events; thus, an important therapeutic goal is to modify atherosclerotic risk factors. Data from several large drug trials indicate that patients with PAD may gain as much, if not more, benefit from aggressive secondary prevention than those with other manifestations of atherothrombosis. In fact, the level of care for patients with PAD is lower as compared with those with ischaemic heart disease, although PAD is defined to be a coronary artery risk equivalent. This paper reviews observational data and generalisation from trials in patients with other manifestations of cardiovascular disease that support the importance of treating key risk factors such as smoking, diabetes, hypertension and hyperlipidaemia in PAD patients. PMID:16218880

Baumgartner, Iris



Spontaneous Complete Occlusion of Middle Cerebral Artery Aneurysm: Case Report  

PubMed Central

There are few observation papers regarding the natural history of an aneurysm. We report on a case of a completely occluded middle cerebral artery (MCA) aneurysm. A 47-year-old female patient presented with a headache and was diagnosed with rupture of a right MCA aneurysm. Due to a high risk of direct neck clipping, she received conservative treatment after craniotomy and wrapping of her aneurysm. The patient's condition showed improvement, with complete occlusion of the aneurysm and considerable reduction of the aneurysm in size after approximately three years. This is a rare case of an aneurysm of MCA that showed spontaneous resolution. Finally, on the angiogram, characteristics of an aneurysm to occlude spontaneously will be presumed based on literature reviews. PMID:23346548

Kim, Byung Jin; Kim, Jung Soo; Jeon, Kyoung Dong



Sarcopenia: An emphasis on occlusion training and dietary protein  

PubMed Central

Demographics reveal that the world's population aged 60 years and older will triple from 600 million in 2000 to more 2 billion by the year 2050. To remain independent and healthy, an important factor to consider is the maintenance of skeletal muscle, as the elderly seem to become prone to a progressive loss of skeletal muscle with aging, termed sarcopenia. Interventions should focus on resistance training and optimal nutrition. Low intensity occlusion training may provide a mode of resistance training more applicable to the elderly, due to the lower loads used. Furthermore, an emphasis must be placed on high quality protein adequately distributed throughout the day to maximize protein synthesis. The use of drug therapy may be of some benefit, but it appears exercise and diet likely plays a more prominent role in the preservation of muscle mass and strength than administration of synthetic hormones. PMID:22110294

Loenneke, J P; Pujol, T J



Antiphospholipid Syndrome and Vascular Ischemic (Occlusive) Diseases: An Overview  

PubMed Central

Antiphospholipid syndrome (APS) is primarily considered to be an autoimmune pathological condition that is also referred to as "Hughes syndrome". It is characterized by arterial and/or venous thrombosis and pregnancy pathologies in the presence of anticardiolipin antibodies and/or lupus anticoagulant. APS can occur either as a primary disease or secondary to a connective tissue disorder, most frequently systemic lupus erythematosus (SLE). Damage to the nervous system is one of the most prominent clinical constellations of sequelae in APS and includes (i) arterial/venous thrombotic events, (ii) psychiatric features and (iii) other non-thrombotic neurological syndromes. In this overview we compare the most important vascular ischemic (occlusive) disturbances (VIOD) with neuro-psychiatric symptomatics, together with complete, updated classifications and hypotheses for the etio-pathogenesis of APS with underlying clinical and laboratory criteria for optimal diagnosis and disease management. PMID:18159581



The ABCs of RVO: a review of retinal venous occlusion.  


Retinal vein occlusions are important causes of loss of vision; indeed, they are the second most common retinal vascular disease, following diabetic retinopathy. For this reason alone, primary eye-care providers must be well versed in diagnosis and management. Risk factors, though not universally agreed upon, include but are not limited to advancing age, systemic hypertension, arteriolarsclerosis, diabetes, hyperlipidaemia, blood hyperviscosity, thrombophilia, ocular hypertension and glaucoma. Typically, visual loss is secondary to macular oedema and/or retinal ischaemia. Treatment modalities have included observation, systemic thrombolysis and haemodilution, radial optic neurotomy, chorioretinal anastomosis, vitrectomy, laser photocoagulation and intravitreal injection of anti-inflammatory and, most recently, anti-vascular endothelial growth factors. PMID:24256639

MacDonald, Derek



Plaque debulking for femoro-popliteal occlusions: techniques and results.  


Although currently there is a trend of using percutaneous transluminal angioplasty (PTA) and stenting for the treatment of long occlusions of superficial femoral artery, many studies reported comparable results in terms of mid- and long-term patency between PTA and stenting and plaque debulking techniques such as remote endarterectomy, directional atherectomy catheter atherectomy and laser guided atherectomy. A successful debulking procedure is strongly associated with patients comorbidities, length of lesions and clinical presentation. In the last decade many new devices have been proposed to improve debulking results. Despite encouraging data about technical feasibility and limb salvage rate, debulking is still associated with a low rate of long-term primary and secondary patency. However, randomized clinical trials are expected and can hopefully provide conclusions on the effective durability of these procedures. PMID:23443599

Lenti, M; Marucchini, A; Isernia, G; Simonte, G; Ciucci, A; Cao, P; Verzini, F



Veno-occlusive disease in hematopoietic stem cell transplantation recipients.  


Veno-occlusive disease (VOD) is a potentially fatal complication of hematopoietic stem cell transplantation that affects the liver, as well as other organs. Although mild cases resolve on their own, severe cases of VOD carry a high mortality rate. The diagnosis usually is clinically based, with nonspecific signs such as weight gain, ascites, hepatomegaly, right upper quadrant abdominal pain, and elevated serum bilirubin. Although studies are ongoing, no U.S. Food and Drug Administration-approved treatments for VOD exist to date. Therefore, supportive care is a critical part of the treatment plan. Oncology nurses should be familiar with the risk factors and clinical signs of VOD so that patients can be monitored closely for its occurrence. Accurate and timely recognition of VOD is crucial for appropriate treatment. PMID:23022934

Sosa, Elisabeth C



Transient middle cerebral artery occlusion induces microglial priming in the lumbar spinal cord: a novel model of neuroinflammation  

Microsoft Academic Search

BACKGROUND: Middle cerebral artery occlusion (MCAo) in mice results in a brain infarct, the volume of which depends on the length of occlusion. Following permanent occlusion, neuropathological changes – including a robust glial inflammatory response – also occur downstream of the infarct in the spinal cord. METHODS: We have performed short, transient MCAo in mice to induce penumbral damage spanning

Katie Moisse; Ian Welch; Tracy Hill; Kathryn Volkening; Michael J Strong



Laser-assisted versus mechanical recanalization of femoral arterial occlusions.  


A randomized clinical trial was performed to test the hypothesis that a laser-heated probe is superior to standard techniques to reopen occluded femoral arteries. Twenty patients were treated with a standard guidewire and balloon dilation method. In a second group of 20 patients, the laser probe was initially used as a nonheated mechanical device. If the probe was unsuccessful in mechanically reopening the artery, an Argon laser was activated to heat the probe. The mean length of occlusion was 15.9 +/- 10.3 cm. The success rate for the laser probe was 15 of 20 (75%), which was not significantly different from the standard method, 19 of 20 (95%). Most of the success in the laser-probe group was due to the probe's mechanical properties. The laser probe was successful as a cold, mechanical device in 13 of 15 (87%) arteries. It was necessary to heat the probe in 5 patients. When heated, the laser probe assisted recanalization in 2 but perforated the artery in 3 cases. The results of this randomized trial do not support the hypotheses behind the use of the thermal laser probe. The laser probe functions primarily as a mechanical device. The thermal activation does not significantly improve the success rate without increasing the risk of perforation. This small additional benefit does not justify the large cost of current thermal laser devices. This controlled study also demonstrates a higher success rate in long occlusions than previous reports of mechanical balloon recanalization. This is due to a combination approach of retrograde and anterograde probing of the occluded segment. PMID:1833969

Tobis, J M; Conroy, R; Deutsch, L S; Gordon, I; Honye, J; Andrews, J; Profeta, G; Chatzkel, S; Berns, M



[Endothelium-protective effects of vinpocetine, pentoxifylline and enalapril in patients with chronic brain ischemia].  


The influence of vinpocetine, pentoxifylline and enalapril on endothelium functions has been studied in a group of in 172 patients with chronic brain ischemia. The endothelium-protective effect of drugs was manifested as the inhibition of the Willebrand factor output during arteriovenous occlusion test and as the renewal of endothelium-depended vasodilation. The extent of neurologic deficit reduction correlated with decrease in the activated endothelium-depended output of the Willebrand factor. PMID:21678652

Vaizova, O E; Vengerovsky, A I; Alifirova, V M



Coating bioabsorption and chronic bare metal scaffolding versus fully bioabsorbable stent.  


Advances in coronary stent technology, including refinement of the stent alloy, strut thickness, stent geometry, passive coating, and drug elution, have dramatically enhanced the safety and efficacy of percutaneous coronary intervention (PCI) with stenting. Stents are currently used in over 90% of coronary interventions and the use of drug-eluting stents (DES) has been disseminated to more complex lesion subsets such as total occlusions, long lesions, bifurcation lesions, and for patients with acute myocardial infarction. DES continue to demonstrate reduction in restenosis and the need for repeat revascularisation but are associated with delayed healing and re-endothelialisation, which have led to an increased rates of late stent thrombosis, dependency on prolonged dual antiplatelet therapy, impaired in-vessel reactivity, and chronic inflammation. As scientists and clinicians better understand the mechanism for late restenosis and stent thrombosis, a variety of solutions in regard to stent technology have been proposed, including stent coating, polymer bioabsorption, and fully biodegradable stents. Bare metal stents were improved by the reduction of strut thickness, changes in stent geometry, and the addition of passive coating, which lead to improvements in efficacy and reduction of restenosis. In addition, there is continued improvement in the polymer technology for DES, including new biocompatible, thinner durable polymers, and bioabsorbable polymers that completely bioabsorb within 3-12 months after stent implantation. These features potentially minimise the chronic inflammatory response and late stent thrombosis. Finally, fully bioabsorbable stents, both polymeric and metallic, continue to be developed in order to eliminate any late stenting effects and potentially may enable complete vessel restoration. This manuscript will discuss the wide variety of new stent technologies and compare and contrast durable metallic and polymeric stents to current biodegradable stent technology. PMID:22100674

Waksman, Ron; Pakala, Rajbabu



Baseline Characteristics and Risk Factors of Retinal Vein Occlusion: A Study by the Korean RVO Study Group  

PubMed Central

We investigated the demographic characteristics and risk factors of Korean patients with naÏve central or branch retinal vein occlusion (CRVO or BRVO). This study enrolled 41 clinical sites throughout Korea and included 557 consecutive patients with retinal vein occlusion (RVO) from May through November 2010. A total of 557 patients with new-onset RVO participated in this study. Two hundred and three (36.4%) patients were diagnosed with CRVO and 354 (63.6%) patients were diagnosed with BRVO. Comparisons between the two groups showed that the prevalence of diabetes mellitus was significantly higher in CRVO patients and hypertension was significantly higher in BRVO patients (P = 0.001 and 0.002, respectively). Poor baseline visual acuity was significantly associated with female and old age in BRVO patients (P = 0.002 and 0.013, respectively), whereas the wide intraretinal hemorrhage (CRVO, P = 0.029; BRVO, P < 0.001) and the macular ischemia (CRVO, P < 0.001; BRVO, P < 0.001) were associated with both groups. The study results show the clinical features of RVO in Korean patients. Hypertension is strongly associated with BRVO and diabetes mellitus is more strongly associated with CRVO in Korean patients with RVO. As the first nationwide study performed by the Korean Retinal Society, the results of this study can be applied to future studies on RVO. PMID:23341724

Lee, Joo Yong; Kim, Ha Kyoung; Yoon, Hee Seong; Kang, Se Woong; Kim, June-Gone; Park, Kyu Hyung; Jo, Young Joon



Histological effects of occlusive dressing on healing of incisional skin wounds.  


Occlusive dressing is widely accepted and used to manage skin ulcers. However, with respect to its application to incisional wounds, most studies have been conducted about the clinical effects on incisional healing of surgical sites. Studies of the histological effects of occlusive dressing for incisional wounds have been few. The aim of this study was to clarify the histological effects of occlusive dressings on healing of incisional skin wounds. Rat dorsal skin was incised down to the panniculus and sutured immediately. Dressing types included 2-octyl cyanoacrylate and hydrocolloid materials as occlusive dressings and no-dressing as the open therapy. Histological examination and dermoscopic observation were performed 1, 2, 4 and 7 days after surgery. The findings from each dressing type were compared. In the open therapy group, the upper portion of the edge of incision was necrosed minimally and finally healed with wide scar formation. However, in the occlusive dressing groups, micronecrosis of the incision edge seen in the no-dressing group was not observed, healing was more rapid and the remaining scar was finer. Occlusive dressing can prevent micronecrosis of the incision edge, resulting in rapid and excellent healing. This study shows that the efficacy of and supports the use of occlusive dressing in incisional wound management. PMID:23279979

Yamamoto, Naoto; Kiyosawa, Tomoharu



Comparison of occlusion break responses and vacuum rise times of phacoemulsification systems  

PubMed Central

Background Occlusion break surge during phacoemulsification cataract surgery can lead to potential surgical complications. The purpose of this study was to quantify occlusion break surge and vacuum rise time of current phacoemulsification systems used in cataract surgery. Methods Occlusion break surge at vacuum pressures between 200 and 600 mmHg was assessed with the Infiniti® Vision System, the WhiteStar Signature® Phacoemulsification System, and the Centurion® Vision System using gravity-fed fluidics. Centurion Active FluidicsTM were also tested at multiple intraoperative pressure target settings. Vacuum rise time was evaluated for Infiniti, WhiteStar Signature, Centurion, and Stellaris® Vision Enhancement systems. Rise time to vacuum limits of 400 and 600 mmHg was assessed at flow rates of 30 and 60 cc/minute. Occlusion break surge was analyzed by 2-way analysis of variance. Results The Centurion system exhibited substantially less occlusion break surge than the other systems tested. Surge area with Centurion Active Fluidics was similar to gravity fluidics at an equivalent bottle height. At all Centurion Active Fluidics intraoperative pressure target settings tested, surge was smaller than with Infiniti and WhiteStar Signature. Infiniti had the fastest vacuum rise time and Stellaris had the slowest. No system tested reached the 600-mmHg vacuum limit. Conclusions In this laboratory study, Centurion had the least occlusion break surge and similar vacuum rise times compared with the other systems tested. Reducing occlusion break surge may increase safety of phacoemulsification cataract surgery. PMID:25074069



Ray-casting CRT algorithm for holographic 3D display with full parallax occlusion effect  

NASA Astrophysics Data System (ADS)

In this paper, a full parallax occlusion algorithm for holographic 3D display is developed and the motion parallax and dynamic occlusion effect of the reconstructed 3D object is successfully demonstrated. The ray-casting, directional clustering and vertical angle marking technologies are integrated with coherent ray tracing (CRT) hologram computation algorithm. By applying the vertical angle marking technology, only a single pass of the entire horizontal viewing angle is needed to compute full parallax occlusion. The complexity of the algorithm is reduced by about one order compared to standard occlusion algorithm which considers the entire range of combination of horizontal and vertical viewing angles for occlusion. Compared to conventional CRT computation which does not consider occlusion effect, the algorithm has also increased the computation speed to about 350%. The algorithm is able to work with any forms of 3D data. The optimal horizontal angular resolution has also been identified as 0.007 degree for our system experimentally which enables the optimization of the algorithm. Various 3D objects with full parallax occlusion effect have been reconstructed optically.

Liang, Xinan; Pan, Yuechao; Xu, Xuewu



Occlusal enamel complexity in middle miocene to holocene equids (Equidae: Perissodactyla) of North America.  


Four groups of equids, "Anchitheriinae," Merychippine-grade Equinae, Hipparionini, and Equini, coexisted in the middle Miocene, but only the Equini remains after 16 Myr of evolution and extinction. Each group is distinct in its occlusal enamel pattern. These patterns have been compared qualitatively but rarely quantitatively. The processes influencing the evolution of these occlusal patterns have not been thoroughly investigated with respect to phylogeny, tooth position, and climate through geologic time. We investigated Occlusal Enamel Index, a quantitative method for the analysis of the complexity of occlusal patterns. We used analyses of variance and an analysis of co-variance to test whether equid teeth increase resistive cutting area for food processing during mastication, as expressed in occlusal enamel complexity, in response to increased abrasion in their diet. Results suggest that occlusal enamel complexity was influenced by climate, phylogeny, and tooth position through time. Occlusal enamel complexity in middle Miocene to Modern horses increased as the animals experienced increased tooth abrasion and a cooling climate. PMID:24587267

Famoso, Nicholas A; Davis, Edward Byrd



Primary Analysis of a Phase II Randomized Trial Radiation Therapy Oncology Group (RTOG) 0212: Impact of Different Total Doses and Schedules of Prophylactic Cranial Irradiation on Chronic Neurotoxicity and Quality of Life for Patients With Limited-Disease Small-Cell Lung Cancer  

SciTech Connect

Purpose: To determine the effect of dose and fractionation schedule of prophylactic cranial irradiation (PCI) on the incidence of chronic neurotoxicity (CNt) and changes in quality of life for selected patients with limited-disease small-cell lung cancer (LD SCLC). Methods and Materials: Patients with LD SCLC who achieved a complete response after chemotherapy and thoracic irradiation were eligible for randomization to undergo PCI to a total dose of 25 Gy in 10 daily fractions (Arm 1) vs. the experimental cohort of 36 Gy. Those receiving 36 Gy underwent a secondary randomization between daily 18 fractions (Arm 2) and twice-daily 24 fractions (Arm 3). Enrolled patients participated in baseline and follow-up neuropsychological test batteries along with quality-of-life assessments. Results: A total of 265 patients were accrued, with 131 in Arm 1, 67 in Arm 2, and 66 in Arm 3 being eligible. There are 112 patients (42.2%) alive with 25.3 months of median follow-up. There were no significant baseline differences among groups regarding quality-of-life measures and one of the neuropsychological tests, namely the Hopkins Verbal Learning Test. However, at 12 months after PCI there was a significant increase in the occurrence of CNt in the 36-Gy cohort (p = 0.02). Logistic regression analysis revealed increasing age to be the most significant predictor of CNt (p = 0.005). Conclusions: Because of the increased risk of developing CNt in study patients with 36 Gy, a total PCI dose of 25 Gy remains the standard of care for patients with LD SCLC attaining a complete response to initial chemoradiation.

Wolfson, Aaron H., E-mail: [University of Miami Miller School of Medicine, Miami, FL (United States); Bae, Kyounghwa [Department of Statistics, Radiation Therapy Oncology Group, Philadelphia, PA (United States); Komaki, Ritsuko; Meyers, Christina [M. D. Anderson Cancer Center, Houston, TX (United States); Movsas, Benjamin [Henry Ford Health System, Detroit, MI (United States); Le Pechoux, Cecile [Institute Gustave Roussy, Villejuif (France); Werner-Wasik, Maria [Thomas Jefferson Medical College, Philadelphia, PA (United States); Videtic, Gregory M.M. [Cleveland Clinic, Cleveland, OH (United States); Garces, Yolanda I. [Mayo Clinic, Rochester, MN (United States); Choy, Hak [University of Texas Southwestern, Dallas, TX (United States)



Sciatic nerve ischaemia after iliac artery occlusion balloon catheter placement for placenta percreta.  


Placenta percreta is a complex obstetric condition and a cause of life-threatening peripartum haemorrhage. National guidelines advise preoperative placement of internal iliac artery occlusion balloon catheters in such cases to reduce haemorrhage, avoid caesarean hysterectomy and preserve fertility. Maternal complications of prophylactic occlusion balloon catheter insertion include puncture-site complications and arterial thrombosis, the signs of which are usually immediately clinically evident. Presentation of ischaemic nerve injury attributable to iliac artery thrombosis secondary to the presence of an occlusion balloon catheter is as yet unreported. Awareness of this possible complication and local unit guidelines may allow early detection and treatment. PMID:24572724

Teare, J; Evans, E; Belli, A; Wendler, R



Balloon Occlusion Types in the Treatment of Coronary Perforation during Percutaneous Coronary Intervention  

PubMed Central

Coronary artery perforation is an uncommon complication in patients with coronary heart disease undergoing percutaneous coronary intervention. However, pericardial tamponade following coronary artery perforation may be lethal, and prompt treatment is crucial in managing such patients. Balloon occlusion and the reversal of anticoagulant activity are the common methods used to prevent cardiac tamponade by reducing the amount of bleeding. Herein, we discuss the pros and cons of currently used occlusion types for coronary perforation. Optimal balloon occlusion methods should reduce the amount of bleeding and ameliorate subsequent myocardial ischemia injury, even during cardiac surgery. PMID:25506463

Wang, Xiangfei; Ge, Junbo



Life-threatening Cerebral Edema Caused by Acute Occlusion of a Superior Vena Cava Stent  

SciTech Connect

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

Sofue, Keitaro, E-mail:; Takeuchi, Yoshito, E-mail:; Arai, Yasuaki, E-mail: [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan)] [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan); Sugimura, Kazuro, E-mail: [Kobe University, Department of Radiology, Graduate School of Medicine (Japan)] [Kobe University, Department of Radiology, Graduate School of Medicine (Japan)



Successful Recanalization of a Longstanding Right Common Iliac Artery Occlusion with a Radiofrequency Guidewire  

SciTech Connect

We describe a case of successful recanalization of a longstanding right common iliac occlusion with a radiofrequency (RF) guidewire. The patient had been symptomatic with claudication for 3 years, and a preliminary attempt to cross the lesion using conventional techniques proved unsuccessful. Using low and medium intensity RF pulses and a PowerWire, a tract through the occlusion was established, which allowed subsequent stenting with an excellent angiographic result and a good immediate clinical response. We propose this as a useful technique in the peripheral arterial system for occlusive lesions not amenable to traditional recanalization techniques.

Tapping, C. R.; Uri, I. F.; Dixon, S.; Bratby, M. J.; Anthony, S.; Uberoi, R., E-mail: [John Radcliffe Hospital, Department of Radiology (United Kingdom)



Right Coronary Artery Fistula and Occlusion Causing Myocardial Infarction after Blunt Chest Trauma  

PubMed Central

Myocardial infarction (MI) secondary to coronary artery fistula and the subsequent occlusion of the distal right coronary artery (RCA) after blunt chest trauma is a rare entity. Here, we describe a case of coronary artery fistula and occlusion with an inferior MI that occurred following blunt chest trauma. At the initial visit to the emergency room after a car accident, this patient had been undiagnosed with acute myocardial infarction, readmitted five months after ischemic insult, and revealed to have experienced MI due to RCA-right atrial fistula and occlusion of the distal RCA. He underwent coronary surgery and recovered without complications. PMID:25207252

Kim, Kun Il; Lee, Won Yong; Ko, Ho Hyun; Kim, Hyoung Soo; Lee, Hee Sung



Acute Central Retinal Vein Occlusion Secondary to Reactive Thrombocytosis after Splenectomy  

PubMed Central

The diagnosis and treatment of central retinal vein occlusion was reported in a young patient. Central retinal vein occlusion was probably related to secondary to reactive thrombocytosis after splenectomy. The patient was treated with steroids for papilledema and administered coumadin and aspirin. The symptoms resolved, and the findings returned to normal within three weeks. Current paper emphasizes that, besides other well-known thrombotic events, reactive thrombocytosis after splenectomy may cause central retinal vein occlusion, which may be the principal symptom of this risky complication. Thus, it can be concluded that followup for thrombocytosis and antithrombotic treatment, when necessary, are essential for these cases. PMID:25276452

Oncel Acir, Nursen; Borazan, Mehmet



Early panretinal photocoagulation for the treatment of ischemic central retinal vein occlusion  

NASA Astrophysics Data System (ADS)

Objective: To evaluate the safety and efficacy of treating ischemic central retinal vein occlusion (CRVO)with early panretinal photocoagulation(PRP). Methods:24 eyes of 24 cases suffered from ischemic CRVO with history shorter than 3 months were included in this study. PRP treatments were completed through 3 to 5 times of laser therapy with total laser burns of 1000 to 2000(mean 1505+/-384).Patients were followed up 3 months to 2 years, mean 18.4+/-8.0 months.The neovascularization regression and visual acuity were compared before and after PRP, also the long-term complications were observed. Results:3 eyes of iris neovascularization (INV) regressed after PRP and there was no significant difference in visual acuity between prelaser and postlaser. No neovascular glaucoma(NVG) occurred and 2 eyes occurred vitreous hemorrhage during the follow up period.. Conclusions: Early panretinal photocoagulation is safe and efficacious in preventing and reducing complications of ischemic CRVO. It can save valuable treatment time for some patients

Yu, Zikui; He, Naizhen



Chronic diseases in the European Union: the prevalence and health cost implications of chronic pain.  


The objective of this study was to assess recent data on the prevalence of chronic pain as part of chronic diseases; the prevalence of chronic pain as a chronic condition in its own right; the costs attributed to chronic pain; and the European Union (EU) policies to addressing chronic pain. Recent literature was reviewed for data on the prevalence and cost implications of chronic pain in the EU. Following on from an earlier systematic review, 8 databases were searched for prevalence and 10 for cost information from 2009 to 2011 and relevant EU organizations were contacted. Ten cost and 29 prevalence studies were included from the 142 full papers screened. The general adult population reported an average chronic pain prevalence of 27%, which was similar to those for common chronic conditions. Fibromyalgia had the highest unemployment rate (6%; Rivera et al., Clin Exp Rheumatol. 2009;27[Suppl 56]:S39-S45) claims for incapacity benefit (up to 29.9%; Sicras-Mainar et al., Arthritis Res Ther. 2009;11:R54), and greatest number of days of absence from work (Rivera et al., Clin Exp Rheumatol. 2009;27[Suppl 56]:S39-S45). Chronic pain is common and the total population cost is high. Despite its high impact, chronic pain as a condition seems to have had little specific policy response. However, there does appear to be sufficient evidence to at least make addressing chronic pain a high priority alongside other chronic diseases as well as to conduct more research, particularly regarding cost. PMID:23216170

Leadley, R M; Armstrong, N; Lee, Y C; Allen, A; Kleijnen, J



Micro-computed tomography analysis of changes in the periodontal ligament and alveolar bone proper induced by occlusal hypofunction of rat molars  

PubMed Central

Objective To three-dimensionally elucidate the effects of occlusal hypofunction on the periodontal ligament and alveolar bone proper of rat molars by micro-computed tomography (micro-CT). Methods Occlusal function in the molar area was restricted by attaching an anterior bite plate on the maxillary incisors and a metal cap on the mandibular incisors of 5-week-old male Wistar rats for 1 week. The periodontal ligament space and alveolar bone proper around roots of the mandibular first molar were assessed by histology and micro-CT. Results The periodontal ligament space was narrower and the alveolar bone proper was sparser and less continuous in the hypofunction group than in the control group. Further, both the volume of the periodontal ligament and the volumetric ratio of the alveolar bone proper to the total tissue in the region of interest were significantly lower in the hypofunction group (p < 0.05). Conclusions Occlusal hypofunction induces atrophic changes in the periodontal ligament and alveolar bone proper of rat molars. PMID:25309866

Hosomichi, Jun; Nakamura, Saeko; Ono, Takashi



[Surgical treatment of chronic mesenteric ischemia: report of one case].  


Although the classic therapy for chronic mesenteric ischemia is surgical revascularization, endovascular therapy is a new therapeutic option. We report a 55 year-old female, with a 2 years history of post prandial abdominal pain, diarrhoea, and weight loss, with occlusion of both mesenteric arteries and critical stenosis of the celiac artery. The initial treatment consisted in angioplasty and celiac artery stent placement in two occasions, with a brief symptomatic relief. Finally, a visceral artery bypass was performed, with good post operative outcome and complete symptomatic resolution at one year follow up. In our opinion endovascular therapy is a good therapeutic option for chronic mesenteric ischemia in high surgical risk patients, specially when dealing with stenotic injuries. It may also be a complement for patients who need to recover their nutritional status prior to revascularization surgery. On the other hand, due to the long term patency and symptomatic relief, surgical treatment is a good option in low risk patients. PMID:17369989

Marín P, Juan; Manríquez C, Luis; Schweizer H, Helmuth; Tellez M, Juan; Rossel D, Gonzalo



Can contrast-enhanced ultrasound with second-generation contrast agents replace computed tomography angiography for distinguishing between occlusion and pseudo-occlusion of the internal carotid artery?  

PubMed Central

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. METHOD: Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal carotid arteries were previously classified as occluded by Doppler ultrasound (without contrast). The patients were examined again with Doppler ultrasound, as well as with contrast-enhanced ultrasound and computed tomography angiography. The diagnosis was based on the presence or absence of flow. RESULTS: Among the 78 cervical internal carotid arteries identified as occluded by Doppler ultrasound, occlusion was confirmed by computed tomography angiography in only 57 (73.1%), compared with 59 (77.5%) for which occlusion was confirmed by contrast-enhanced ultrasound (p>0.5 vs. computed tomography angiography). Comparing contrast-enhanced ultrasound with Doppler ultrasound, we found that the proportion of cervical internal carotid arteries classified as occluded was 24.4% higher when the latter was used (p<0.001). CONCLUSIONS: We conclude that, in making the differential diagnosis between occlusion and pseudo-occlusion of the cervical internal carotid artery, contrast-enhanced ultrasound with a second-generation contrast agent is significantly more effective than conventional Doppler ultrasound and is equally as effective as the gold standard (computed tomography angiography). Our findings suggest that contrast-enhanced ultrasound could replace computed tomography angiography in this regard.

Ventura, Carlos Augusto Pinto; da Silva, Erasmo Simão; Cerri, Giovanni Guido; Leão, Pedro Puech; Tachibana, Adriano; Chammas, Maria Cristina




EPA Science Inventory

A co-occlusion process was evaluated as a commercially and ecologically acceptable strategy for the development of genetically improved baculovirus insecticides. oinfection of Spodoptera frugiperda (IPLB-SF-21) tissue culture cells with Aucographa californica nuclear polyhedrosis...


Revascularization for Symptomatic Occlusion of the Anterior Cerebral Artery Using Superficial Temporal Artery  

PubMed Central

Isolated symptomatic occlusion of the anterior cerebral artery (ACA) is a rare condition and until date, only few cases regarding the revascularization of the ACA have been reported. This paper reports on successful attempt to revascularize the ACA using superficial temporal artery (STA) in patient with isolated symptomatic occlusion of the ACA. A 69-year-old man presented with several episodes of transient weakness involving left lower extremity. Cerebral angiography showed occlusion of the right ACA at the A2 segment. After medical treatment failure, the patient underwent STA-ACA bypass surgery. Subsequent to surgery, there was immediate disappearance of transient ischemic attack and follow-up angiography showed favorable revascularization of the ACA territory. Bypass surgery can be considered in the patients with symptomatic occlusion of the ACA, who have experienced failure in medical treatment. PMID:24527195

Lee, Sang Chul; Kang, Hyun-Seung; Kim, Jeong Eun



Early characterization of occlusal overloaded cervical dental hard tissues by en face optical coherence tomography  

NASA Astrophysics Data System (ADS)

Early diagnosis of occlusal overload is an important issue in dental medicine. The high occlusal forces can cause irreversible damage to the dental hard tissues. Our study proposes the early microstructural characterization of occlusal overloaded bicuspids, with abnormal crown morphology, by en face optical coherence tomography (eFOCT). The dental samples were investigated using an eFOCT system operating at 1300 nm in B-scan and C-scan mode. The eFOCT images obtained from these teeth visualized cracks, which didn't reach the tooth surface. The ?CT and histological images confirmed the microstructural defects identified on eFOCT images. In conclusion, eFOCT is a promising imaging method for the early diagnosis of occlusal overload on bicuspids with normal crown morphology and for the prophylaxis of dental wear.

Marcauteanu, Corina; Negrutiu, Meda; Sinescu, Cosmin; Stoica, Eniko Tunde; Ionita, Ciprian; Florin, Topala; Vasile, Liliana; Bradu, Adrian; Dobre, George; Podoleanu, Adrian G.



Understanding Chronic Bronchitis  


... Stop Smoking Get Involved Donate Lung Disease Asthma COPD Influenza Lung Cancer Disparities Reports Lung Disease Finder ... commonly referred to as Chronic Obstructive Pulmonary Disease (COPD). How Serious is Chronic Bronchitis? People often ignore ...


Influence of occlusal loading on peri-implant clinical parameters. A pilot study  

PubMed Central

Objectives: To investigate the relation between occlusal loading and peri-implant clinical parameters (probing depth, bleeding on probing, gingival retraction, width of keratinized mucosa, and crevicular fluid volume) in patients with implant-supported complete fixed prostheses in both arches. Material and Methods: This clinical study took place at the University of Valencia (Spain) dental clinic. It included patients attending the clinic for regular check-ups during at least 12 months after rehabilitation of both arches with implant-supported complete fixed ceramo-metallic prostheses. One study implant and one control implant were established for each patient using the T-Scan®III computerized system (Tesco, South Boston, USA). The maxillary implant closest to the point of maximum occlusal loading was taken as the study implant and the farthest (with least loading) as the control. Occlusal forces were registered with the T-Scan® III and then occlusal adjustment was performed to distribute occlusal forces correctly. Peri-implant clinical parameters were analyzed in both implants before and two and twelve months after occlusal adjustment. Results: Before occlusal adjustment, study group implants presented a higher mean volume of crevicular fluid (51.3±7.4 UP) than the control group (25.8±5.5 UP), with statistically significant difference. Two months after occlusal adjustment, there were no significant differences between groups (24.6±3.8 UP and 26±4.5 UP respectively) (p=0.977). After twelve months, no significant differences were found between groups (24.4±11.1 UP and 22.5±8.9 UP respectively) (p=0.323). For the other clinical parameters, no significant differences were identified between study and control implants at any of the study times (p>0.05). Conclusions: Study group implants receiving higher occlusal loading presented significantly higher volumes of crevicular fluid than control implants. Crevicular fluid volumes were similar in both groups two and twelve months after occlusal adjustment. Key words:Occlusal loading, crevicular fluid, peri-implant clinical parameters, T-Scan®. PMID:24316708

Pellicer-Chover, Hilario; Viña-Almunia, José; Romero-Millán, Javier; Peñarrocha-Oltra, David; Peñarrocha-Diago, María



3D face recognition under expressions, occlusions, and pose variations.  


We propose a novel geometric framework for analyzing 3D faces, with the specific goals of comparing, matching, and averaging their shapes. Here we represent facial surfaces by radial curves emanating from the nose tips and use elastic shape analysis of these curves to develop a Riemannian framework for analyzing shapes of full facial surfaces. This representation, along with the elastic Riemannian metric, seems natural for measuring facial deformations and is robust to challenges such as large facial expressions (especially those with open mouths), large pose variations, missing parts, and partial occlusions due to glasses, hair, and so on. This framework is shown to be promising from both--empirical and theoretical--perspectives. In terms of the empirical evaluation, our results match or improve upon the state-of-the-art methods on three prominent databases: FRGCv2, GavabDB, and Bosphorus, each posing a different type of challenge. From a theoretical perspective, this framework allows for formal statistical inferences, such as the estimation of missing facial parts using PCA on tangent spaces and computing average shapes. PMID:23868784

Drira, Hassen; Ben Amor, Boulbaba; Srivastava, Anuj; Daoudi, Mohamed; Slama, Rim



Sterile inflammation after permanent distal MCA occlusion in hypertensive rats.  


The pathophysiology of stroke is governed by immune reactions within and remote from the injured brain. Hypertension, a major cause and comorbidity of stroke, entails systemic vascular inflammation and may influence poststroke immune responses. This aspect is, however, underestimated in previous studies. Here we aimed to delineate the sequence of cellular inflammation after stroke in spontaneously hypertensive (SH) rats. Spontaneously hypertensive rats were subjected to permanent middle cerebral artery occlusion and killed after 1 or 4 days. Immune cells of the peripheral blood and those which have infiltrated the injured brain were identified and quantified by flow cytometry. The spatial distribution of myeloid cells and T lymphocytes, and the infarct volume were assessed by histology. We observed a concerted infiltration of immune cells into the ischemic brain of SH rats. At day 1, primarily neutrophils, monocytes, macrophages, and myeloid dendritic cells entered the brain, whereas the situation at day 4 was dominated by microglia, macrophages, lymphatic dendritic cells, and T cells. Postischemic inflammation did not cause secondary tissue damage during the subacute stage of experimental stroke in SH rats. Considering the intrinsic vascular pathology of SH rats, our study validates this strain for further translational research in poststroke inflammation. PMID:24220169

Möller, Karoline; Boltze, Johannes; Pösel, Claudia; Seeger, Johannes; Stahl, Tobias; Wagner, Daniel-Christoph



Analytical and numerical analysis of human dental occlusal contact.  


The knowledge of contact forces in teeth surfaces during mastication or para-functional movements can help to understand processes related to friction and wear of human dental enamel. The development of a numerical model for analysis of the occlusal contact between two antagonistic teeth is proposed, which includes three basic steps: the characterisation of the surface roughness, its homogenisation using an assumed distribution function and the numerical determination of the resulting forces. Finite element strain results for the main different asperities are statistically combined, deriving the predicted macroscopic behaviour of the interface. Axisymmetric and 3D numerical models with an elasto-plastic constitutive law are used to simulate micro-indentations and micro-contacts, respectively. The contact is allowed to occur locally in planes not necessarily parallel to the surface's mean plane, a problem for which there is no analytical solution. The three identified parameters, homogenised surface hardness (3.68 GPa), surface yield stress (3.08 GPa) and static friction coefficient (0.23), agree with the experimental values reported in the literature. PMID:22289073

Bastos, Flávia de Souza; Barbosa de Las Casas, Estevam; Martinez Oller, Sergio



Localizer with high occlusion immunity using diffraction optics  

NASA Astrophysics Data System (ADS)

The chromatic method of diffraction range finding can be exploited to construct a 3D localizer that tracks the position of a pointer, a 3-D scanner or a robotic end-effecter. A spectrogram is made using a diffraction grating as the primary objective of an optical system that tracks a broad band emitter such as a tungsten filament or white L.E.D. Image processing on the resulting spectra transforms the spectrogram at the input to distance and displacement at the output. The behavior conforms to geometric optics following the Diffraction Equation. This novel technique has unique features. For example, the number of samples increases with target distance, reversing the loss of resolution as a function of distance that is endemic to triangulation. The plurality of samples also can overcome occlusion liability common to time-of-flight range finders, since multiple paths exist between emitter and sensor. The grating can be made from inexpensive embossed plastic, and a wave length sensor can be constructed from garden variety color cameras. The method is robust at a grazing exodus angles that allow for a compact configuration of the receiver. In this paper we disclose the theory of operation including a mathematical model, and we demonstrate the method empirically.

Ditto, Thomas D.; Farges, Jacques



Incidence and Predictors of Radial Artery Occlusion Associated Transradial Catheterization  

PubMed Central

In this study, we sought to assess the incidence and predictors of radial artery occlusion (RAO), which is a significant complication of transradial cardiac catheterization. We prospectively evaluated the results of 106 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) via the transradial approach (TRA). At the 3rd h of intervention, the radial artery was checked by palpation; color doppler ultrasonography was performed at the 24th h. Fluoroscopy duration, procedure success, and complications of the radial artery were recorded. The procedure was successfully completed in all patients. RAO was detected in eight female and two male patients. In terms of RAO, there was a statistically significant difference between males and females (p=0.019). Other parameters did not show a significant correlation with RAO. Altough did not have any effect on procedural success, eight patients developed transient radial artery spasm. Gender was not associated with radial arterial spasms (p=0.19). TRA in the diagnosis and treatment of coronary artery disease has shown high procedural success and low complication rates; it addition, it presents a low economic burden. It should be used widely and be involved in the routine cardiology residency program. PMID:24151442

Tuncez, Abdullah; Kaya, Zeynettin; Aras, Dursun; Y?ld?z, Abdulkadir; Gül, Enes Elvin; Tekinalp, Mehmet; Karaka?, Mehmet Fatih; K?sac?k, Halil Lütfü



Is there a threshold duration of vascular occlusion for hindlimb reactive hyperemia?  


Relatively brief changes in perfusion pressure and flow through arterioles occur in a number of conditions, such as in the flying environment and during such common everyday activities such as bending forward at the waist. Also, brief periods of negative vertical acceleration (G(z)) stress, which reduces perfusion in the lower body, has been shown to impair the regulation of arterial pressure during subsequent positive G(z) stress. To examine the contribution that reactive hyperemia makes in these settings, studies on the hindlimb circulation of anesthetized rats (n = 8) were carried out by imposing graded duration vascular occlusion (1, 2, 4, 10, and 30 s) to test the hypothesis that there is a threshold duration of reduction in perfusion that must be exceeded for reactive hyperemia to be triggered. Vascular conductance responses to 1 s of terminal aortic occlusion were no different before and after myogenic responses were blocked with nifedipine, indicating that 1 s of occlusion failed to elicit reactive hyperemia. Two seconds of occlusion elicited a small but significant elevation in hindlimb vascular conductance. The magnitude of the reactive hyperemia was graded in direct relation to the duration of occlusion for the 2-, 4-, and 10-s periods of occlusion and appeared to be approaching a plateau for the 30-s occlusion. Thus there is a threshold duration of terminal aortic occlusion (approximately 2 s) required to elicit reactive hyperemia in the hindlimbs of anesthetized rats, and the reactive hyperemia that results possesses a threat to the regulation of arterial pressure. PMID:16160019

Rogers, Jennifer; Sheriff, Don D



Radiofrequency Guide Wire Recanalization of Venous Occlusions in Patients with Malignant Superior Vena Cava Syndrome  

SciTech Connect

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

Davis, Robert M.; David, Elizabeth; Pugash, Robyn A.; Annamalai, Ganesan, E-mail: [Sunnybrook Health Sciences Centre, Department of Interventional Radiology (Canada)



Successful catheter directed thrombolysis of IVC and renal vein occlusive thrombus.  


Thrombus formation is a recognised complication of IVC filter placement, however IVC and bilateral renal vein occlusion secondary to thrombus is much less common. We present a case of infrahepatic caval and bilateral renal vein occlusion secondary to thrombosis of a suprarenal IVC filter. With progressive clinical deterioration and failure of conservative medical management the patient underwent successful mechanical disruption and catheter directed thrombolysis. PMID:22256445

McCarthy, E; Mahony, N O; Guiney, M; Ryan, J M



Occlusal characteristics during different emergence stages of the permanent dentition in Tanzanian Bantu and finnish children.  


Occlusal characteristics and anomalies were studied among 869 (428 boys, 441 girls) Tanzanian Bantu children aged 3.5-16 years and 706 (319 boys, 387 girls) Finnish children aged 5-11 years during different emergence stages of the permanent dentition. Various occlusal variables were registered according to described criteria. Multiple linear regression, ANOVA, t-test, Chi-square and logistic regression models were used to test for various statistically significant differences between different subgroups. Significant differences between Tanzanians and Finns were found for malocclusion, neutral and distal molar occlusion, mean values for overjet and overbite, overjet greater than 5 mm, deep bite and anterior open bite (all P < 0.0001). The most prevalent anomalies among Tanzanians were anterior open bite (7-19 per cent), increased overjet (3-19 per cent) and distal molar occlusion (3-16 per cent). For the Finns, distal molar occlusion (18-38 per cent) was the most prevalent anomaly, followed by deep bite (4-22 per cent) and increased overjet (4-40 per cent). An anterior crossbite was rare and equally distributed among the two ethnic groups. Girls had a larger mean value for overbite (P = 0.003) and more often a deep bite (P < 0.01) than boys. Mandibular incisor crowding among children with neutral occlusion (Class I malocclusion) occurred significantly more often among Finnish than Tanzanian children. In conclusion, various developmental changes in occlusion were observed leading to variation in occlusal characteristics and anomalies according to the emergence stages of the permanent dentition. Most of the classic malocclusions occur among Tanzanian children, but the prevalence differs from that in other parts of the world. PMID:15222708

Mugonzibwa, Emeria A; Eskeli, Ritva; Kuijpers-Jagtman, Anne M; Laine-Alava, Maija T; van't Hof, Martin A



Occlusal characteristics during different emergence stages of the permanent dentition in Tanzanian Bantu and finnish children  

Microsoft Academic Search

Occlusal characteristics and anomalies were studied among 869 (428 boys, 441 girls) Tanzanian Bantu children aged 3.5-16 years and 706 (319 boys, 387 girls) Finnish children aged 5-11 years during different emergence stages of the permanent dentition. Various occlusal variables were registered according to described criteria. Multiple linear regression, ANOVA, t-test, Chi-square and logistic regression models were used to test

E. A. Mugonzibwa; R. Eskeli; A. M. Kuijpers-Jagtman; M. T. Laine-Alava; M. A. van't Hof



Isobutyl-2-cyanoacrylate pulmonary emboli associated with occlusive embolotherapy of cerebral arteriovenous malformations.  


Three patients had cerebral arteriovenous malformations (AVM) treated by occlusive embolotherapy using isobutyl-2-cyanoacrylate (IBC). At necropsy two had asymptomatic IBC pulmonary emboli. The numbers of emboli and the size of pulmonary vessels occluded correlated roughly with an increasing frequency and volume of injectate made in the cerebral tissue. The extent of pulmonary vascular occlusion in one case suggests that pulmonary vascular hypertension could develop as a complication of this form of treatment. PMID:6526389

Coard, K; Silver, M D; Perkins, G; Fox, A J; Vinuela, E V



Conceptualizing Chronic Poverty  

Microsoft Academic Search

This paper provides a meaning for the term chronic poverty “in a nutshell” and explores the concepts of poverty, vulnerability and poverty dynamics that underpin this meaning. Subsequently, it reviews “who” is chronically poor, “why” they stay poor and what is known about policies to reduce chronic poverty. Despite the limited knowledge available it is clear that hundreds of millions

Andrew Shepherd



An automatic occlusion device for remote control of tumor tissue ischemia.  


We developed an automatic occlusion device for remote control of tumor tissue ischemia. The device consists of a flexible cannula encasing a shape memory alloy wire with its distal end connected to surgical suture. Regional tissue occlusion was tested on both the benchtop and the animal models. In the benchtop test, the occlusion device introduced quantitative and reproducible changes of blood flow in a tissue simulating phantom embedding a vessel simulator. In the animal test, the device generated a cyclic pattern of reversible ischemia in the right hinder leg tissue of a black male C57BL/6 mouse. We also developed a multimodal detector that integrates near infrared spectroscopy and electron paramagnetic resonance spectroscopy for continuous monitoring of tumor tissue oxygenation, blood content, and oxygen tension changes. The multimodal detector was tested on a cancer xenograft nude mouse undergoing reversible tumor ischemia. The automatic occlusion device and the multimodal detector can be potentially integrated for closed-loop feedback control of tumor tissue ischemia. Such an integrated occlusion device may be used in multiple clinical applications such as regional hypoperfusion control in tumor resection surgeries and thermal ablation processes. In addition, the proposed occlusion device can also be used as a research tool to understand tumor oxygen transport and hemodynamic characteristics. PMID:20082532

El-Dahdah, Hamid; Wang, Bei; He, Guanglong; Xu, Ronald X



An Automatic Occlusion Device for Remote Control of Tumor Tissue Ischemia  

PubMed Central

We developed an automatic occlusion device for remote control of tumor tissue ischemia. The device consists of a flexible cannula encasing a shape memory alloy wire with its distal end connected to surgical suture. Regional tissue occlusion was tested on both the benchtop and the animal models. In the benchtop test, the occlusion device introduced quantitative and reproducible changes of blood flow in a tissue simulating phantom embedding a vessel simulator. In the animal test, the device generated a cyclic pattern of reversible ischemia in the right hinder leg tissue of a black male C57BL/6 mouse. We also developed a multimodal detector that integrates near infrared spectroscopy and electron paramagnetic resonance spectroscopy for continuous monitoring of tumor tissue oxygenation, blood content, and oxygen tension changes. The multimodal detector was tested on a cancer xenograft nude mouse undergoing reversible tumor ischemia. The automatic occlusion device and the multi-modal detector can be potentially integrated for closed-loop feedback control of tumor tissue ischemia. Such an integrated occlusion device may be used in multiple clinical applications such as regional hypoperfusion control in tumor resection surgeries and thermal ablation processes. In addition, the proposed occlusion device can also be used as a research tool to understand tumor oxygen transport and hemodynamic characteristics. PMID:20082532

El-Dahdah, Hamid; Wang, Bei; He, Guanglong; Xu, Ronald X.



SPECT with N-isopropyl-p iodoamphetamine in occlusive cerebrovascular diseases  

SciTech Connect

The role of SPECT imaging with N-isopropyl-p iodoamphetamine (I-123 IMP) in the detection of angiographically documented occlusive cerebrovascular diseases was evaluated in 24 patients, and the results of regional cerebral blood flow (rCBF) were compared with x-ray CT. Twelve patients had internal carotid occlusion, ten had intracranial occlusion beyond the circle of Willis, one had common carotid occlusion, and one had basilar artery occlusion. SPECT images were obtained with a gamma camera, which was rotated 360 degrees around the patient's head 30 minutes after an intravenous injection of 3 mCi of I-123 IMP. CT images in the transverse plane were obtained, and the regions of reduced attenuation were identified for comparison of topographic extension of the lesion with the regions of decreased rCBF seen on SPECT. In six cases, the lesions seen on the SPECT images were distinctly more extensive than those seen on CT. In the remaining 18 cases, the extent of the lesion was identical on both CT and SPECT images. Radiochemical and radionuclide impurities, the distance of the detector from the head, and the nature of the collimator affected the SPECT results. I-123 IMP SPECT imaging complements CT findings in detecting the ischemic zones beyond the regions identified on CT images, and may have a major rule in the management of patients with occlusive cerebrovascular diseases.

Higa, T.; Tanaka, T.; Ikekubo, K.; Komatsu, T.; Torizuka, K.



Delayed Brain Infarction due to Bilateral Vertebral Artery Occlusion Which Occurred 5 Days after Cervical Trauma  

PubMed Central

Vertebral artery (VA) injuries usually accompany cervical trauma. Although these injuries are commonly asymptomatic, some result in vertebrobasilar infarction. The symptoms of VA occlusion have been reported to usually manifest within 24 hours after trauma. The symptoms of bilateral VA occlusions seem to be more severe and seem to occur with shorter latencies than those of unilateral occlusions. A 48-year-old man had a C3-4 fracture-dislocation with spinal cord compression that resulted from a traffic accident. After surgery, his initial quadriparesis gradually improved. However, he complained of sudden headache and dizziness on the 5th postoperative day. His motor weakness was abruptly aggravated. Radiologic evaluation revealed an infarction in the occipital lobe and cerebellum. Cerebral angiography revealed complete bilateral VA occlusion. We administered anticoagulation therapy. After 6 months, his weakness had only partially improved. This case demonstrates that delayed infarction due to bilateral VA occlusion can occur at latencies as long as 5 days. Thus, we recommend that patients with cervical traumas that may be accompanied by bilateral VA occlusion should be closely observed for longer than 5 days. PMID:25328652

Jang, Donghwan; Kim, Choonghyo; Lee, Seung Jin



Fast Occlusion and Shadow Detection for High Resolution Remote Sensing Image Combined with LIDAR Point Cloud  

NASA Astrophysics Data System (ADS)

The orthophoto is an important component of GIS database and has been applied in many fields. But occlusion and shadow causes the loss of feature information which has a great effect on the quality of images. One of the critical steps in true orthophoto generation is the detection of occlusion and shadow. Nowadays LiDAR can obtain the digital surface model (DSM) directly. Combined with this technology, image occlusion and shadow can be detected automatically. In this paper, the Z-Buffer is applied for occlusion detection. The shadow detection can be regarded as a same problem with occlusion detection considering the angle between the sun and the camera. However, the Z-Buffer algorithm is computationally expensive. And the volume of scanned data and remote sensing images is very large. Efficient algorithm is another challenge. Modern graphics processing unit (GPU) is much more powerful than central processing unit (CPU). We introduce this technology to speed up the Z-Buffer algorithm and get 7 times increase in speed compared with CPU. The results of experiments demonstrate that Z-Buffer algorithm plays well in occlusion and shadow detection combined with high density of point cloud and GPU can speed up the computation significantly.

Hu, X.; Li, X.



Characteristics, detection methods and treatment of questionable occlusal carious lesions: findings from the national dental practice-based research network.  


Questionable occlusal carious lesions (QOC) can be defined as an occlusal tooth surface with no cavitation and no radiographic radiolucencies, but caries is suspected due to roughness, surface opacities or staining. An earlier analysis of data from this study indicates 1/3 of patients have a QOC. The objective of this report has been to quantify the characteristics of these common lesions, the diagnostic aids used and the treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the USA and Denmark in the National Dental Practice-Based Research Network participated. When consenting patients presented with a QOC, information was recorded about the patient, tooth, lesion and treatments. A total of 2,603 QOC from 1,732 patients were analyzed. The lesions were usually associated with a fissure, on molars, and varied from yellow to black in color. Half presented with a chalky luster and had a rough surface when examined with an explorer. There was an association between color and luster: 10% were chalky-light, 47% were shiny-dark and 42% were mixtures. A higher proportion of chalky than of shiny lesions were light (22 vs. 9%; p < 0.001). Lesions light in color were less common in adults than in pediatric patients (9 vs. 32%; p < 0.001). Lesions that were chalky and light were more common among pediatric than among adult patients (22 vs. 6%; p < 0.001). This is the first study to investigate characteristics of QOC in routine clinical practice. Clinicians commonly face this diagnostic uncertainty. Determining the characteristics of these lesions is relevant when making diagnostic and treatment decisions. PMID:24480989

Makhija, S K; Gilbert, G H; Funkhouser, E; Bader, J D; Gordan, V V; Rindal, D B; Pihlstrom, D J; Qvist, V




PubMed Central

Objective To compare the prevalence of co-morbid depression between patients with chronic primary headache syndromes and chronic post-traumatic headaches. Method A prospective cross-sectional analysis of all patients presenting sequentially to a community-based general neurology clinic during a 2-year period for evaluation of chronic headache pain was conducted. Headache diagnosis was determined according to the International Headache Society’s Headache Classification criteria. Depression was determined through a combination of scores on the clinician administered Hamilton Rating Scale for Depression and patients’ self-report. An additional group of patients who suffered traumatic brain injuries (TBI) but did not develop post-traumatic headaches was included for comparison. Results A total of 83 patients were included in the study: 45 with chronic primary headaches (24 with chronic migraine headaches, 21 with chronic tension headaches), 24 with chronic post-traumatic headaches, and 14 with TBI but no headaches. Depression occurred less frequently among those with chronic post-traumatic headaches (33.3%) compared to those with chronic migraine (66.7%) and chronic tension (52.4%) headaches (Chi-Square = 7.68; df = 3; p = 0.053), and did not significantly differ from TBI patients without headaches. A multivariate logistic regression model using depression as the outcome variable and including headache diagnosis, gender, ethnicity, and alcohol and illicit substance use was statistically significant (Chi-Square = 27.201; df = 10; p < 0.01) and identified primary headache (migraine and tension) diagnoses (Score = 7.349; df = 1; p = 0.04) and female gender (Score = 15.281; df = 1; p < 0.01) as significant predictor variables. The overall model accurately predicted presence of co-morbid depression in 74.7% of the cases. Conclusions Co-morbid depression occurs less frequently among patients with chronic post-traumatic headaches and TBI without headaches than among those with chronic primary headaches. PMID:24066406




Protective effect of S-adenosylmethionine on hepatic ischemia-reperfusion injury during hepatectomy in HCC patients with chronic HBV infection  

PubMed Central

Background Although hepatectomy is often performed with the Pringle maneuver, the problem of hepatic ischemia-reperfusion injury (HIRI) can also be serious. Thus, the present study was designed to investigate the protective effect of S-adenosylmethionine (SAMe) on HIRI, especially for patients with hepatocellular carcinoma (HCC) associated with chronic hepatitis B virus (HBV) infection and cirrhosis. Methods Eighty-one HCC patients with chronic HBV infection, undergoing partial hepatectomy with inflow occlusion, were divided into three groups. In the pretreatment group (PR group, n?=?26), patients were given SAMe two hours before surgery. In the post-treatment group (PO group, n?=?25), patients were given SAMe six hours after surgery. And in the control group (control group, n?=?30), patients received partial hepatectomy without any SAMe. All pre-, intra- and postoperative blood samples were collected to measure the plasma levels of transaminases, bilirubin and cytokines. The results were compared among the three groups. Results There were no statistically significant intergroup differences observed in age, gender, hepatic inflow occlusion time and the results of liver function tests. Preoperative administration of SAMe (PR group) significantly reduced the plasma levels of alanine transaminase (ALT), aspartate transferase (AST), total bilirubin (TBIL) and direct bilirubin (DBIL) as compared to the other two groups. In the PO group, TBIL and DBIL were significantly lower than in the control group. Significant differences were also seen in IL-6 and TNF-? between the PR group and the other groups. In all groups, postoperative liver reserve function in the PR group as revealed by ICGR15 (Post ICGR15) was at its best before abdominal closure. Compared to the control group, the risk of complications and the hospital stay after surgery were significantly meliorated in the PR group. Additionally, patients with cirrhosis had a more acute rate of change in ALT and AST than non-cirrhotic patients. Conclusions Taken together, our preliminary findings suggest that preoperative administration of SAMe is useful and safe for reducing the HIRI in partial hepatectomy, especially for HCC patients whose disease is associated with chronic HBV infection and cirrhosis. PMID:24485003



Congenital Portosystemic Shunts and AMPLATZER Vascular Plug Occlusion in Newborns  

Microsoft Academic Search

Congenital portosystemic shunts (CPSs) may cause myriad manifestations. They can be detected prenatally, in infancy, or later.\\u000a They may involute, cause acute symptoms, or remain unrecognized and cause chronic disease. As CPSs can require treatment,\\u000a early diagnosis allows close monitoring. In symptomatic patients, interventional catheterization embolization of CPSs can\\u000a be undertaken at any age.

William N. Evans; Alvaro Galindo; Ruben J. Acherman; Abraham Rothman; Dean P. Berthoty



Long-Term Outcome after Vitrectomy for Macular Edema with Retinal Vein Occlusion Dividing into the Occlusion Site  

PubMed Central

Purpose. To investigate the efficacy of treatment for macular edema secondary to retinal vein occlusion (RVO) with vitrectomy. Methods. This retrospective study identified patients with macular edema associated with RVO between January 2004 and April 2006. Inclusion criteria were eyes with (1) preoperative visual acuity (VA) of 20/40 or worse, (2) a central foveal thickness (CFT) greater than 250??m, and (3) vitrectomy with internal limiting membrane and intravitreal triamcinolone acetonide. Each patient had their RVO classified as a major or macular BRVO or hemispheric RVO (HSRVO). Results. Forty-six eyes with major BRVO, 18 eyes with macular BRVO, and 17 eyes with HSRVO were investigated. VA was significantly improved at 24 months after surgery for each group (P < 0.05). Vision in the macular BRVO group 24 months after surgery was significantly better than that in other groups (P < 0.05). For each group, a concomitant reduction of CFT was noted at every time point when compared to preoperative values (P < 0.001). Conclusions. In macular BRVO, the postoperative vision 24 months after surgery was significantly better than the other groups. These findings suggest that additional and earlier treatments might be more important for patients with major BRVO and HSRVO than for those with macular BRVO. PMID:25371814

Iwase, Takeshi; Oveson, Brian C.



Endovascular treatment of severe acute basilar artery occlusion.  


Severe acute basilar artery occlusion (BAO) has a high mortality rate but as yet no effective treatment has been developed. This study aimed to evaluate the feasibility and safety of combined mechanical thrombectomy, intra-arterial thrombolysis, and emergent stent placement for patients with severe acute BAO. Eighteen patients who were unconscious after confirmed onset of BAO and who were given arterial interventional treatment from March 2011 to June 2013 at our department were included in this study. The mean age was 59.56years (range: 31-76years) and patients were in a critical physical condition upon admission, and had a mean National Institutes of Health Stroke Scale (NIHSS) score of 25.94 (range: 18-35). All patients were treated with mechanical thrombectomy, 10 of whom received mechanical thrombectomy only. Of the others, eight were also treated with intra-arterial thrombolysis, three were treated with emergent stent placement, and 17 were treated with recanalization with an achieved recanalized rate of 94.4%. The average number of passes through the stent was 1.5 (range: 1-3) and five patients died (27.8%). Thirteen patients survived, and the mean NIHSS score was 6.54 (range: 0-16). Seven patients showed a modified Rankin Scale score ?2, and the rate of good prognoses was 38.9%. In the treatment of patients with severe acute BAO, intra-arterial mechanical thrombectomy combined with thrombolysis or stent placement are effective strategies to restore blood flow and preserve life, and these strategies have a low incidence of complications. PMID:25443091

Wang, Liang; Shi, Wanchao; Su, Zhiguo; Liu, Xiaozhi; Su, Hua; Liu, Jun; Liu, Zhenlin; Lawton, Michael T



Radial artery occlusion after percutaneous coronary interventions – an underestimated issue  

PubMed Central

The femoral approach is the most common arterial access for percutaneous coronary artery interventions. Despite the convenience and simplicity of this approach, it is burdened with a high risk of arterial puncture bleeding, which worsens the prognosis of the patient. An alternative approach through the radial artery has been gaining more and more popularity in recent years. This is due to a significant reduction of local bleeding complications as compared with the femoral artery approach. The use of the radial approach in patients with ST-segment elevation myocardial infarction improves outcome, reducing the risk of death, subsequent myocardial infarction and stroke, and is the preferred approach according to the latest ESC guidelines. In addition to improving safety, it is beneficial for improving patient comfort, with a shorter recovery after the procedure, shorter hospitalization and lower medical costs. One of the major complications of procedures performed through the radial approach is radial artery occlusion (RAO). Although it usually has an asymptomatic course, RAO eliminates the ability to use the radial artery as an access in the future. A number of factors that contribute to the occurrence of RAO have been identified, such as the size of the sheath and the catheter, diameter ratio of the sheath to the diameter of the radial artery, insufficient anticoagulation and, above all, the way of obtaining hemostasis at the puncture site: the duration of artery compression after sheath removal and the preservation of artery patency during compression (so-called patent hemostasis). This paper presents the current state of the art about the factors that contribute to the occurrence of RAO and methods for preventing this complication. PMID:24570753

Kubler, Piotr; Szczepa?ski, Andrzej; Pi?tek, Joanna; St?pkowski, Micha?; Reczuch, Krzysztof



Comparison of the effects of ureteral calculosis and occlusion on muscular sensitivity to painful stimulation in rats.  


An animal model of muscular hyperalgesia was developed. In humans, this disorder follows painful crises due to ureteral calculosis. Changes in vocalization thresholds to electrical stimulation of the obliquus externus muscle of both sides were studied in a group of rats with chronically implanted muscles before and after the production of a stone in one ureter. In another group of rats with implanted muscles, it had been verified preliminarily that these thresholds did not vary widely from day to day. On the contrary, a significant lowering in threshold (max 31%) in the muscle ipsilateral to the implanted ureter appeared the day after the production of the stone and persisted for the subsequent 10 days of observation, although less pronounced during the last 5 days. Hypersensitivity to manual pressure was also observed, mainly in the ipsilateral muscle, in most rats during the same period. In order to differentiate between the effects due to the presence of the stone in the ureteral lumen and those due to the spontaneous occlusion which frequently occurred in the implanted ureter, 2 other groups of rats were studied. In one, a unilateral ureteral ligature was performed; in the other, the production of a stone was combined with a ligature (placed distally to the stone). Ligature alone never induced any hyperalgesic effect. Stone plus ligature produced a marked hyperalgesia (max 39%) in the ipsilateral muscle, which lasted for only 5 days. It is concluded that the ureteral stone is the factor responsible for the appearance of muscular hyperalgesia. PMID:2087333

Giamberardino, M A; Vecchiet, L; Albe-Fessard, D



Efficient, Long-term Hepatic Gene Transfer Using Clinically Relevant HDAd Doses by Balloon Occlusion Catheter Delivery in Nonhuman Primates  

PubMed Central

Helper-dependent adenoviral vectors (HDAd) are devoid of all viral coding sequences and are thus an improvement over early generation Ad because they can provide long-term transgene expression in vivo without chronic toxicity. However, high vector doses are required to achieve efficient hepatic transduction by systemic intravenous injection, and this unfortunately results in dose-dependent acute toxicity. To overcome this important obstacle, we have developed a minimally invasive method to preferentially deliver HDAd into the liver of nonhuman primates. Briefly, a balloon occlusion catheter was percutaneously positioned in the inferior vena cava to occlude hepatic venous outflow. HDAd was injected directly into the occluded liver via a percutaneously placed hepatic artery catheter. Compared to systemic vector injection, this approach resulted in substantially higher hepatic transduction efficiency using clinically relevant low vector doses and was accompanied by mild-to-moderate acute but transient toxicities. Transgene expression was sustained for up to 964 days. These results suggest that our minimally invasive method of delivery can significantly improve the vector's therapeutic index and may be a first step toward clinical application of HDAd for liver-directed gene therapy. PMID:19050700

Brunetti-Pierri, Nicola; Stapleton, Gary E; Law, Mark; Breinholt, John; Palmer, Donna J; Zuo, Yu; Grove, Nathan C; Finegold, Milton J; Rice, Karen; Beaudet, Arthur L; Mullins, Charles E; Ng, Philip



Relationship between articulation paper mark size and percentage of force measured with computerized occlusal analysis  

PubMed Central

PURPOSE Articulation paper mark size is widely accepted as an indicator of forceful tooth contacts. However, mark size is indicative of contact location and surface area only, and does not quantify occlusal force. The purpose of this study is to determine if a relationship exists between the size of paper marks and the percentage of force applied to the same tooth. MATERIALS AND METHODS Thirty dentate female subjects intercuspated into articulation paper strips to mark occlusal contacts on their maxillary posterior teeth, followed by taking photographs. Then each subject made a multi-bite digital occlusal force percentage recording. The surface area of the largest and darkest articulation paper mark (n = 240 marks) in each quadrant (n = 60 quadrants) was calculated in photographic pixels, and compared with the force percentage present on the same tooth. RESULTS Regression analysis shows a bi-variant fit of force % on tooth (P<.05). The correlation coefficient between the mark area and the percentage of force indicated a low positive correlation. The coefficient of determination showed a low causative relationship between mark area and force (r2 = 0.067). The largest paper mark in each quadrant was matched with the most forceful tooth in that same quadrant only 38.3% of time. Only 6 2/3% of mark surface area could be explained by applied occlusal force, while most of the mark area results from other factors unrelated to the applied occlusal force. CONCLUSION The findings of this study indicate that size of articulation paper mark is an unreliable indicator of applied occlusal force, to guide treatment occlusal adjustments. PMID:22439094

Qadeer, Sarah; Kerstein, Robert; Kim, Ryan Jin Yung; Huh, Jung-Bo



Retinal arteriolar occlusions due to cytomegalovirus retinitis in elderly patients without HIV  

PubMed Central

Background Five of 7 (71%) elderly immunocompetent patients with cytomegalovirus retinitis had retinal arteriolar occlusions versus 2 of 8 (25%) elderly immunocompromised patients and 1 of 19 (5%) younger HIV-infected patients. Compared to HIV-infected patients, elderly patients were more likely to have occlusive events, neovascularization or hemorrhage, and underlying vasculopathy. The purpose of this study is to report the novel finding of extensive retinal arteriolar occlusions and neovascularization in immunocompetent patients with cytomegalovirus retinitis. This is a retrospective observational cohort study of cytomegalovirus retinitis (CMVR) in a university setting. Seven patients were elderly but not immunocompromised, 8 were elderly and iatrogenically immunocompromised, and 16 were HIV-infected. All patients underwent polymerase chain reaction testing of intraocular fluid. Primary outcome measure was visual acuity. Secondary outcome measures were vascular occlusions, ischemic complications, and response to treatment. Results Mean age was 73, 70, and 41 years for immunocompetent, immunocompromised, and HIV-infected patients, respectively. Diabetes and vascular disease were common in the elderly. Vision loss to less than 5/200 occurred in 50% of the immunocompetent elderly patients, and 17% of CMV eyes in immunocompromised and HIV patients. Occlusion of the entire retinal vasculature occurred in 4/7 (57%) of immunocompetent patients despite lack of Zone I involvement, and rubeosis occurred in three, disc neovascularization in one, and vitreous hemorrhage in two patients. Vascular occlusive events were less common in immunocompromised patients and rare in the HIV-infected. Conclusions CMVR in non-HIV-infected elderly patients is associated with retinal arteriolar occlusions. An intact host immune response may increase damage to retinal vessels. Prompt diagnosis may avert catastrophic vision loss. PMID:23514532



Endarterectomy of an Occluded ICA: Short Segment Occlusion with Distal Patency Maintained by an Aberrant Ascending Pharyngeal Artery  

PubMed Central

Summary The authors report a case in which an anomalous ascending pharyngeal artery maintained patency of the internal carotid artery beyond an occlusion. The patient presented with ipsilateral transient ischaemic attacks and was found to have an internal carotid artery occlusion on Doppler ultrasound. Subsequent angiography demonstrated retrograde flow in the ipsilateral APA, perfused by pharyngeal anastomoses from the contralateral APA with slow antegrade flow in the ipsilateral ICA distal to the occlusion. Carotid endarterectomy resulted in abolition of the TIA's. PMID:20670505

Patel, M.C.; Higgins, J.N.P.; Kirkpatrick, P.J.



Effect of right ventricular pressure on the end-diastolic left ventricular pressure-volume relationship before and after chronic right ventricular pressure overload in dogs without pericardia.  


We studied the effect of chronic right ventricular pressure overload on diastolic ventricular interdependence in dogs without pericardia, instrumented to measure left ventricular pressure, right ventricular pressure, and 3 left ventricular dimensions. We studied 12 dogs before (control) and nine dogs after 6 weeks of pulmonary artery constriction producing systolic right ventricular pressure greater than or equal to 70 mm Hg. Compared to control, following pulmonary artery band there was greater (P less than 0.01) interventricular septal mass (53 +/- 15 vs. 35 +/- 7 mg, mean +/- SD), thickness (15 +/- 2 vs. 10 +/- 1 mm), and ratio of the surface area of the interventricular septal to total left ventricular surface area (0.38 +/- 0.03 vs. 0.33 +/- 0.02), but unchanged left ventricular free wall mass (81 +/- 12 vs. 84 +/- 14 mg) and thickness (11 +/- 2 vs. 11 +/- 2 mm). End-diastolic right and left ventricular pressures and left ventricular volume were varied by vena cava and pulmonary artery occlusions and releases. Volume was calculated as an ellipsoid and the data in each dog fit to: left ventricular pressure = a0 + a1V + a2V2 + a3V3 + a4V4 + bPRV, r greater than or equal to 0.91 in each dog. During control, b was similar, whether calculated from both pulmonary artery and vena cava occlusions (0.47 +/- 0.09) or from vena cava occlusions alone (0.43 +/- 0.11), and was greater than the ratio of the interventricular septal surface area to left ventricular surface area (0.33 +/- 0.02, P less than 0.05). Following the pulmonary artery band, b decreased to 0.21 +/- 0.10 (P less than 0.05) and was less than the ratio of interventricular septal surface area to the left ventricular surface area which increased to 0.38 +/- 0.03 (P less than 0.05). We conclude that the effect of alterations in right ventricular pressure on the end-diastolic left ventricular pressure volume relationship, independent of the pericardium, is reduced following the pulmonary artery band that produces interventricular septal hypertrophy. These results are consistent with the hypothesis that the effect of alterations of right ventricular pressure on the diastolic left ventricular pressure-volume relationship depends on the relative elastance of the interventricular septum and left ventricular free wall, and not simply on the ratio of the interventricular septal surface area to the left ventricular surface area. PMID:6733867

Little, W C; Badke, F R; O'Rourke, R A



Lipoprotein metabolism and LCAT activity in chronic renal failure dogs supplemented with PUFA oils.  

E-print Network

??Serum total cholesterol (TC), lipoprotein cholesterol distribution, and lecithin:cholesterol acyltransferase (LCAT) activities of chronic renal failure dogs were investigated. Control dogs (n = 14) and… (more)

Malcik, Kimberly L



Bacteriological study of chronic maxillary sinusitis  

Microsoft Academic Search

A total of 50 patients (61 sinuses) of chronic maxillary sinusitis and 50 controls were studied. The patients were scanned radiologically (Water's view for PNS) and antral washes cultured aerobically and anaerobically. Pure acrobic growth was obtained from 21 (34%) sinuses, pure anaerobic from 17 (28%) sinuses, mixed from 15 (25%) aspirate, 8 (13%) were sterile. Common aerobic isolates were

Archana Thakur; Anandita Mandai; K. L. Sawhney



Hydrocarbon exposure and chronic renal disease  

Microsoft Academic Search

The study objective was to investigate further the potential role of long-term exposure to hydrocarbons (HCs) in the development of idiopathic chronic glomerulopathy (ICG) using a more refined measurement of HC exposure. A total of 321 pairs of cases and controls, matched by age, gender, and geographical area, were assembled. A detailed questionnaire was blindly administered to cases and controls

Nabih R. Asal; Harold L. Cleveland; Christian Kaufman; Wato Nsa; Deborah I. Nelson; Robert Y. Nelson; Elisa T. Lee; Beverly Kingsley



Chronic Intestinal Pseudoobstruction.  


Patients with chronic intestinal pseudoobstruction (CIP) experience a constellation of symptoms including abdominal pain, nausea, fullness, and malaise which fluctuates in severity and invariably result in a diminished quality of life. Though surgical resection or transplantation may be an option for some, there currently is no cure for CIP. Thus, management strategies utilize pharmacologic, intravenous, endoscopic, and surgical techniques to promote transit, minimize painful bloating, reduce complications of stasis, and improve quality of life. Prokinetic agents such as erythromycin, metoclopramide, cisapride, neostigmine, and tegaserod may be effective for acute exacerbations. Octreotide may reduce symptoms of bacterial overgrowth and bloating by stimulating migrating motor complexes. Enteral tubes for venting and nutritional support may reduce hospitalizations. Total parenteral nutrition (TPN), fraught with well-known complications, may be the only tolerated source for nutrients and fluid. Advanced disease may magnify nutritional problems, difficulties of long term intravenous and intestinal access, and poor symptom control. Because the initial process may manifest in other intestinal regions following surgery, resection of involved segments should be performed with caution. Small intestinal transplantation is a high-risk surgery performed in persons unable to tolerate intravenous (IV) nutrition. Optimal management for persons with CIP should not only provide nutritional and symptom focused care but should be part of a supportive network which links patients to their appropriate healthcare needs. PMID:15238207

Lyford, Greg; Foxx-Orenstein, Amy



The effect of occlusal contact localization on the stress distribution in complete maxillary denture.  


The fracture of acrylic resin dentures is an unresolved problem in removable prosthodontics despite many efforts to determine its cause. Unfavourable occlusion could be playing an important role in the fracture of the denture. The aim of this study was to investigate the effect of occlusal contact localization on the stress distribution in complete maxillary denture bases utilizing two-dimensional finite element analysis. The results of this study have shown that maximum compressive stresses in a complete maxillary denture under functional masticatory forces concentrates always on the artificial tooth/denture base junction irrespective to the occlusal contact localization. Tensile stresses were observed in areas toward the midline, although the midline itself usually had lower stresses. Shifting the occlusal contacts to a more buccal localization resulted in an increase of the calculated stresses. As a conclusion, it can be speculated that the buccal placement of the occlusal contacts may play a role in the fatigue fracture of the complete maxillary denture. PMID:16774509

Ate?, M; Cilingir, A; Sülün, T; Sünbülo?lu, E; Bozda?, E



Limitations of collateral flow after occlusion of a single cortical penetrating arteriole  

PubMed Central

Occlusions of penetrating arterioles, which plunge into cortex and feed capillary beds, cause severe decreases in blood flow and are potential causes of ischemic microlesions. However, surrounding arterioles and capillary beds remain flowing and might provide collateral flow around the occlusion. We used femtosecond laser ablation to trigger clotting in single penetrating arterioles in rat cortex and two-photon microscopy to measure changes in microvessel diameter and red blood cell speed after the clot. We found that after occlusion of a single penetrating arteriole, nearby penetrating and surface arterioles did not dilate, suggesting that alternate blood flow routes are not actively recruited. In contrast, capillaries showed two types of reactions. Capillaries directly downstream from the occluded arteriole dilated after the clot, but other capillaries in the same vicinity did not dilate. This heterogeneity in capillary response suggests that signals for vasodilation are vascular rather than parenchymal in origin. Although both neighboring arterioles and capillaries dilated in response to topically applied acetylcholine after the occlusion, the flow in the territory of the occluded arteriole did not improve. Collateral flow from neighboring penetrating arterioles is neither actively recruited nor effective in improving blood flow after the occlusion of a single penetrating arteriole. PMID:20842163

Nishimura, Nozomi; Rosidi, Nathanael L; Iadecola, Costantino; Schaffer, Chris B



NIHSS Score Is Poorly Predictive of Proximal Occlusion in Acute Cerebral Ischemia  

PubMed Central

Background and Purpose Multimodal imaging is gaining an important role in acute stroke. The benefit of obtaining additional clinically relevant information must be weighed against the detriment of increased cost, delaying time to treatment and adverse events such a contrast-induced nephropathy. Use of NIHSS score to predict a proximal arterial occlusion (PO) is suggested by several case series as a viable method of selecting cases appropriate for multimodal imaging. Methods 699 patients enrolled in a prospective cohort study involving CTA imaging in acute stroke were dichotomized according to the presence of a PO, including a subgroup of 177 subjects with MCA M1 occlusion. Results The median NIHSS of patients found to have a PO was higher than the overall median (9 versus 5, p<0.0001). The median NIHSS score of patients with MCA M1 occlusion was 14. NIHSS score ? 10 had 81% positive predictive value for PO but only 48% sensitivity, with the majority of subjects with PO presenting with lower NIHSS scores. All patients with NIHSS ? 2 would need to undergo angiographic imaging to detect 90% of PO. Conclusions High NIHSS score correlates with the presence of a proximal arterial occlusion in patients presenting with acute cerebral ischemia. No NIHSS score threshold can be applied to select a subgroup of patients for angiographic imaging without failing to capture the majority of cases with clinically important occlusive lesions. The finding of minimal clinical deficits should not deter urgent angiographic imaging in otherwise appropriate patients suspected of acute stroke. PMID:19608992

Maas, Matthew B.; Furie, Karen L.; Lev, Michael H.; Ay, Hakan; Singhal, Aneesh B.; Greer, David M.; Harris, Gordon J.; Halpern, Elkan; Koroshetz, Walter J.; Smith, Wade S.



Immediate cystic duct occlusion using an endoluminal absorbable polyglycolic acid screw.  


Endoscopic in situ occlusion of the cystic duct and ablation of the gallbladder could constitute a useful alternative to cholecystectomy in certain patients. The purpose of this study was to examine the feasibility of endoluminal occlusion of the cystic duct using a biodegradable polyglycolic acid screw and simultaneous gallbladder mucosal ablation with a Sotradecol-ethanol mixture. Eight pigs had operative cholecystotomy. A polyglycolic acid screw was twisted into the cystic duct after the proximal cystic duct mucosa was thermally ablated using electrocautery. Cholecystography confirmed occlusion of the cystic duct. Synchronous ablation of the gallbladder mucosa was then done by instilling absolute alcohol and 2% Sotradecol. The gallbladder was drained. Animals were sacrificed on days 14, 28, and 42. All animals survived operation and showed no untoward effects. Postmortem gross inspection showed gallbladders were shrunken and surrounded with adhesions from adjacent tissue. Cholangiography and cholecystography confirmed occlusion of the cystic duct in 6 of 8 pigs (75%). Histopathologic examination showed extensive areas of mucosal necrosis mixed with small areas of epithelial regeneration. Immediate occlusion of the cystic duct is possible using an endoluminal polyglycolic acid screw. PMID:8389061

Bell, R C; Stiegmann, G V; Sun, J; Kim, J; Durham, J; Lucia, M S



Occlusal force, electromyographic activity of masticatory muscles and mandibular flexure of subjects with different facial types  

PubMed Central

Objective The aim of this study was to evaluate whether vertical facial patterns influence maximal occlusal force (MOF), masticatory muscle electromyographic (EMG) activity, and medial mandibular flexure (MMF). Material and Methods Seventy-eight dentate subjects were divided into 3 groups by Ricketts's analysis: brachyfacial, mesofacial and dolychofacial. Maximum occlusal force in the molar region was bilaterally measured with a force transducer. The electromyographic activities of the masseter and anterior temporal muscles were recorded during maximal voluntary clenching. Medial mandibular flexure was calculated by subtracting the intermolar distance of maximum opening or protrusion from the distance in the rest position. The data were analyzed using ANOVA followed by Tukey's HSD test. The significance level was set at 5%. Results Data on maximum occlusal force showed that shorter faces had higher occlusal forces (P<0.0001). Brachyfacial subjects presented higher levels of masseter electromyographic activity and medial mandibular flexure, followed by the mesofacial and dolychofacial groups. Additionally, dolychofacial subjects showed significantly lower electromyographic temporalis activities (P<0.05). Conclusion Within the limitations of the study, it may be concluded that maximum occlusal force, masticatory muscle activity and medial mandibular flexure were influenced by the vertical facial pattern. PMID:21655772

CUSTODIO, William; GOMES, Simone Guimarães Farias; FAOT, Fernanda; GARCIA, Renata Cunha Matheus Rodrigues; DEL BEL CURY, Altair Antoninha