Sample records for chronic total occlusion

  1. Optical coherence tomography for imaging of chronic total occlusions

    NASA Astrophysics Data System (ADS)

    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

    2005-09-01

    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.

  2. Retrograde chronic total occlusion intervention: tips and tricks.

    PubMed

    Wu, Eugene B; Chan, Wilson W M; Yu, Cheuk Man

    2008-11-15

    Retrograde approach via collateral channels in coronary angioplasty for chronic total occlusion (CTO) can improve the success rate. Most interventionists will meet a few cases where the retrograde approach will provide unequaled advantages, but many are held back from taking retrograde approach by lack of proper equipment and expertise. In this article, we give detail description of techniques to shorten the guiding catheter, to traverse the collateral channels, and to cross the CTO. We also illustrate the difficulties in collateral channel crossing with different examples providing a basic guide for case selection purposes. We hope that many others would find rewardingly successful cases of retrograde approach CTO percutaneous coronary intervention, as in our experience. PMID:19012325

  3. Effect of Revascularization of Chronic Total Occlusion on Tandem Stenoses in a “Donor” Artery

    PubMed Central

    2014-01-01

    The presence, severity, and extent of ischemia predict the outcome of coronary artery disease. Indeed the extent of myocardial ischemia and viability determines the value of revascularization in coronary stenosis after acute myocardial infarction. In multivessel coronary artery disease, noninvasive methods for the evaluation of ischemia are often inadequate to guide percutaneous coronary intervention. It is a common misperception that revascularization might not benefit a myocardial segment in the chronic total occlusion distribution when that segment is supplied by well-developed collateral vessels, because severe ischemia is unlikely to be present under these circumstances. An 82-year-old man presented with acute coronary syndrome, tandem stenoses in a “donor” artery, and a chronic total occlusion of the right coronary artery. We present a rationale for using fractional flow reserve to determine the existence of ischemia and to aid in deciding the best approach to the treatment of that ischemia. PMID:25425993

  4. Excimer laser atherectomy to overcome intraprocedural obstacles in chronic total occlusion percutaneous intervention: Case examples.

    PubMed

    Sapontis, James; Grantham, J Aaron; Marso, Steven P

    2015-02-15

    Technical advances and the development of the Hybrid algorithm have been associated with higher success rates in chronic total occlusion percutaneous coronary intervention (CTO-PCI). Nevertheless, there are still intraprocedural obstacles that result in failure or prolonged procedure time. The Excimer coronary laser (EL) has been repurposed in CTO-PCI to overcome such obstacles. This case series illustrates the use of the EL in four technically complex scenarios including the balloon resistant lesion, the impenetrable proximal cap, device resistance in stent restenosis, and difficulty with device tracking in the subintima. © 2014 Wiley Periodicals, Inc. PMID:25257254

  5. Treatment of the chronic total occlusion: A call to action for the interventional community.

    PubMed

    Carlino, Mauro; Magri, Caroline J; Uretsky, Barry F; Brilakis, Emmanouil S; Walsh, Simon; Spratt, James C; Hanratty, Colm; Grantham, J Aaron; Rinfret, Stéphane; Thompson, Craig A; Lombardi, William L; Galassi, Alfredo R; Sianos, George; Latib, Azeem; Garbo, Roberto; Karmpaliotis, Dimitri; Kandzari, David E; Colombo, Antonio

    2015-04-01

    There is substantial evidence that recanalization of a chronic total occlusion is beneficial; nonetheless, it is generally underutilized in clinical practice. We consider the Aesop's fable of the "Fox and the Grapes" as analogous to the current situation in interventional cardiology. The technical challenges in achieving CTO recanalization has led interventionalists, clinical cardiologists, and sometimes even patients to believe that CTO recanalization is not effective, and, therefore, not needed. This perspective reviews available data regarding efficacy and safety of CTO percutaneous coronary intervention (PCI) in the current drug-eluting stent era, discusses areas where more studies are required, and encourages the interventional community to utilize CTO PCI where appropriate based on current evidence. © 2014 Wiley Periodicals, Inc. PMID:25382239

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

    PubMed

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

    2015-02-15

    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. PMID:25044668

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

    PubMed

    Wu, Eugene B; Ikari, Yuji

    2013-07-01

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

  8. Computed tomography as a tool for percutaneous coronary intervention of chronic total occlusions.

    PubMed

    Magro, Michael; Schultz, Carl; Simsek, Cihan; Garcia-Garcia, Hector M; Regar, Evelyn; Nieman, Koen; Mollet, Nico; Serruys, Patrick W; van Geuns, Robert-Jan

    2010-05-01

    Chronic total occlusions (CTO) constitute a major challenge in percutaneous coronary revascularisation (PCI). The development of new interventional strategies, the availability of purpose made tools including dedicated catheters and wires, as well as increasing expertise by the operators, have contributed to the modest success rates which today hover around 75%. Case selection is of utmost importance since failure of this high risk procedure with its typically high radiation doses, high contrast doses and increased complication rates is associated with long term adverse events. Imaging of the coronary arteries using the gold standard of invasive coronary angiography allows characterisation of the chronic total occlusion and is often able to predict the probability of successful recanalisation. Multislice computed tomography (MSCT) is increasingly being utilised as a non-invasive diagnostic imaging modality to detect coronary artery disease. Its ability to provide information on the soft tissue (including plaque) surrounding the lumen has been applied to better define the morphological features of CTOs. In fact, the amount of calcification, tortuosity and actual length of the occluded segment which are established predictors of success, are all better characterised by MSCT. Three dimensional reconstruction of the coronary anatomy and its integration with two dimensional fluoroscopy images during the actual CTO-PCI procedure may help to identify the best angiographic projection, offering a directional guide at the angiographically "missing segment". More technological advances are needed to optimise this multi-modality imaging integration. Whether this will result in better success rates for CTO-PCI is still the subject of ongoing research. It is then that we can evaluate the true benefit of the use of MSCT for CTO against the risk from excessive radiation associated with this strategy. PMID:20542818

  9. Retrograde Percutaneous Recanalization of Chronic Total Occlusion of the Coronary Arteries Procedural Outcomes and Predictors of Success in Contemporary Practice

    Microsoft Academic Search

    Sudhir Rathore; Osamu Katoh; Hitoshi Matsuo; Mitsuyasu Terashima; Nobuyoshi Tanaka; Yoshihisa Kinoshita; Masashi Kimura; Etsuo Tsuchikane; Mariko Ehara; Keiko Asakura; Yasushi Asakura; Takahiko Suzuki

    2010-01-01

    Background—Retrograde approach through collaterals has been introduced for percutaneous recanalization of chronic total occlusion (CTO) of the coronary arteries. We investigated the safety and efficacy of retrograde approaches used for percutaneous recanalization of CTO in a consecutive series of patients. Methods and Results—We studied 157 consecutive patients who underwent retrograde CTO recanalization between 2003 and 2008 at a single center.

  10. Transluminal Recanalization of Chronic Total Occlusion of Radial Artery Using Rendezvous Technique: A Case Report and Literature Review

    PubMed Central

    Arabi, Mohammad; Ahmed, Ishtiaq; Qattan, Nabeel

    2014-01-01

    Although endovascular management of lower extremity peripheral arterial disease (PAD) is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO) using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger. PMID:25161805

  11. Ventricular tachycardic storm with a chronic total coronary artery occlusion treated with percutaneous coronary intervention

    PubMed Central

    2015-01-01

    A 66-year-old man with a history of coronary artery disease was evaluated due to ventricular tachycardic (VT) storm. The patient continued to have frequent recurrences of VT despite treatment with amiodarone and lidocaine. Since the ventricular arrhythmia could be related to myocardial ischemia related to a chronic total occlusion (CTO) of the right coronary artery, the patient underwent successful percutaneous coronary intervention of the CTO, followed by implantable cardioverter defibrillator implantation. He had no further episodes of VT during his hospital stay. After 9 months of follow-up, he had no further chest pain or clinically apparent recurrent ischemia. Interrogation of his defibrillator has shown brief nonsustained episodes of ventricular tachycardia, but the patient has not required delivery of a shock. The temporal association between treatment of the CTO and resolution of the VT, as well as the lack of recurrence of sustained VT, suggest a causative link between underlying ischemia produced by a chronically occluded coronary artery and provocation of VT and lend supportive evidence to this treatment approach.

  12. Impact of proctoring on success rates for percutaneous revascularisation of coronary chronic total occlusions

    PubMed Central

    Sharma, Vinoda; Jadhav, S T; Harcombe, A A; Kelly, P A; Mozid, A; Bagnall, A; Richardson, J; Egred, M; McEntegart, M; Shaukat, A; Oldroyd, K; Vishwanathan, G; Rana, O; Talwar, S; McPherson, M; Strange, J W; Hanratty, C G; Walsh, S J; Spratt, J C; Smith, W H T

    2015-01-01

    Objective To assess the impact of proctoring for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in six UK centres. Methods We retrospectively analysed 587 CTO procedures from six UK centres and compared success rates of operators who had received proctorship with success rates of the same operators before proctorship (pre-proctored) and operators in the same institutions who had not been proctored (non-proctored). There were 232 patients in the pre-proctored/non-proctored group and 355 patients in the post-proctored group. Complexity was assessed by calculating the Japanese CTO (JCTO) score for each case. Results CTO PCI success was greater in the post-proctored compared with the pre-proctored/non-proctored group (77.5% vs 62.1%, p<0.0001). In more complex cases where JCTO?2, the difference in success was greater (70.7% vs 49.5%, p=0.0003). After proctoring, there was an increase in CTO PCI activity in centres from 2.5% to 3.5%, p<0.0001 (as a proportion of total PCI), and the proportion of very difficult cases with JCTO score ?3 increased from 15.3% (35/229) to 29.7% (105/354), p<0.0001. Conclusions Proctoring resulted in an increase in procedural success for CTO PCI, an increase in complex CTO PCI and an increase in total CTO PCI activity. Proctoring may be a valuable way to improve access to CTO PCI and the likelihood of procedural success. PMID:25852949

  13. Re-canalization of peripheral chronic total occlusions using the BridgePoint Stingray re-entry device.

    PubMed

    Jessup, David B; Lombardi, William

    2011-12-01

    Percutaneous intervention of peripheral chronic total occlusions (CTO) is increasingly common, but Interventionalists still face significant barriers to successful treatment of CTO lesions in the coronary and peripheral anatomy. The greatest overall challenges are in crossing the CTO lesion and re-entering the true lumen from a successful subintimal crossing. We present a case report of a patient with a CTO of a lower extremity artery, in which treatment with a new, novel system was used to address both of these challenges. PMID:21281359

  14. Reliable femoral chronic total occlusion model using a thin biodegradable polymer coated copper stent in a porcine model.

    PubMed

    Kim, Nan Yeol; Lim, Kyung Seob; Jeong, Myung Ho; Bae, In Ho; Park, Jun-Kyu; Nah, Jae-Woon; Park, Dae Sung; Lee, So Youn; Jang, Eun Jae; Kim, Jong Min; Kim, Jung Ha; Kee, Hae Jin; Cho, Soo-Na; Sim, Doo Sun; Park, Keun-Ho; Hong, Young Joon; Oh, Sang-Gi; Kim, Sang-Hyung; Ahn, Youngkeun; Kang, Jung Chaee

    2015-04-01

    Chronic total occlusions (CTOs) are common in patients with peripheral arterial disease (PAD). This study aimed to examine the feasibility and reliability of a CTO induced by a thin biodegradable polymer (polyglycolic acid) coated copper stent in a porcine femoral artery. Novel thin biodegradable polymer coated copper stents (9 mm long) were crimped on an angioplasty balloon (4.5 mm diameter × 12 mm length) and inserted into the femoral artery. Histopathologic analysis was performed 35 days after stenting. In five of six stented femoral arteries, severe in-stent restenosis and total occlusion with collateral circulation were observed without adverse effects such as acute stent thrombosis, leg necrosis, or death at 5 weeks. Fibrous tissue deposition, small vascular channels, calcification, and inflammatory cells were observed in hematoxylin-eosin, Carstair's, and von Kossa tissue stains; these characteristics were similar to pathological findings associated with CTOs in humans. The neointima volume measured by micro-computed tomography was 93.9 ± 4.04 % in the stented femoral arteries. CTOs were reliably induced by novel thin biodegradable polymer coated copper stents in porcine femoral arteries. Successful induction of CTOs may provide a practical understanding of their formation and application of an interventional device for CTO treatment. PMID:25804307

  15. Initial and Long-Term Results of Endovascular Therapy for Chronic Total Occlusion of the Subclavian Artery

    SciTech Connect

    Babic, Srdjan, E-mail: sdrbabic@sezampro.rs [Institute for Cardiovascular Disease 'Dedinje,', Department of Vascular Surgery (Serbia); Sagic, Dragan [Institute for Cardiovascular Disease 'Dedinje', Department of Interventional Radiology (Serbia); Radak, Djordje [Institute for Cardiovascular Disease 'Dedinje,', Department of Vascular Surgery (Serbia); Antonic, Zelimir [Institute for Cardiovascular Disease 'Dedinje', Department of Interventional Radiology (Serbia); Otasevic, Petar [Institute for Cardiovascular Disease 'Dedinje', Department of Cardiology (Serbia); Kovacevic, Vladimir [Institute for Cardiovascular Disease 'Dedinje', Department of Interventional Radiology (Serbia); Tanaskovic, Slobodan; Ruzicic, Dusan; Aleksic, Nikola; Vucurevic, Goran [Institute for Cardiovascular Disease 'Dedinje,', Department of Vascular Surgery (Serbia)

    2012-04-15

    Purpose: To study the initial and long-term results of angioplasty and primary stenting for the treatment of chronic total occlusion (CTO) of the subclavian artery (SA). Materials and Methods: From January 1999 to February 2010, 56 patients (25 men with a mean age of 58 {+-} 8 years) underwent endovascular treatment for CTO of the SA. Duplex scans and arteriograms confirmed occlusion in all cases. Indications for recanalization were subclavian steal syndrome in 33 patients (58.1%), arm claudication in 13 patients (23.2%), and coronary ischemia in 7 patients (12.5%) who had a history of previous coronary artery bypass grafting that included left internal thoracic artery graft. Three patients (5.4%) were treated before the scheduled coronary artery bypass surgery, which included left internal thoracic artery graft. After successful recanalization, all arteries were stented, and all of the patients were followed-up at 1, 3, 6, and 12 months after surgery and annually thereafter. Results: Successful recanalization of the SA was achieved in 46 patients (82.1%), and the complication rate was 7.1%. During follow-up (mean 40 {+-} 26 months; range 2 to 125), the primary patency rates after 1 and 3 years were 97.9% and 82.7%, respectively. At the end of follow-up, 76% of the arteries showed no evidence of restenosis. Univariate analysis failed to identify any variable predictive of long-term patency of successfully recanalized SA. Conclusion: Percutaneous transluminal angioplasty with stenting of the complete total occlusion of the SA is a safe and effective procedure associated with low risks and good long-term results.

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

    PubMed

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

    2014-06-01

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

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

    PubMed Central

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

    2006-01-01

    Background Endovascular recanalization (guidewire traversal) of peripheral artery chronic total occlusion (CTO) can be challenging. X-Ray angiography resolves CTO poorly. Virtually “blind” device advancement during X-ray-guided interventions can lead to procedure failure, perforation and hemorrhage. Alternatively, magnetic resonance imaging (MRI) may delineate the artery within the occluded segment to enhance procedural safety and success. We hypothesized that real-time MRI (rtMRI) guided CTO recanalization can be accomplished in an animal model. Methods and Results Carotid artery CTO was created by balloon injury in 19 lipid overfed swine. After 6–8 weeks, two underwent direct necropsy analysis for histology, three underwent primary X-ray-guided CTO recanalization attempts, and the remaining 14 underwent rtMRI-guided recanalization attempts in a 1.5T interventional MRI system. rtMRI intervention used custom CTO catheters and guidewires that incorporated MRI receiver antennae to enhance device visibility. The mean length of the occluded segments was 13.3 ± 1.6cm. rtMRI-guided CTO recanalization was successful in 11/14 swine and only 1/3 swine using X-ray alone. After unsuccessful rtMRI (n = 3), X-ray-guided attempts also were all unsuccessful. Conclusions Recanalization of long CTO is feasible entirely using rtMRI guidance. Low profile clinical-grade devices will be required to translate this experience to humans. Endovascular recanalization of chronic total arterial occlusion (CTO) is challenging under conventional X-ray guidance because devices are advanced almost blindly. MRI can image CTO borders and luminal contents, and could potentially guide these procedures. We test the feasibility of real-time MRI guided wire traversal in a swine model of peripheral artery CTO using custom active MRI catheters. PMID:16490819

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

    PubMed Central

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

    2013-01-01

    Background: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of the left anterior descending (LAD) specifically is associated with improved long-term 5 year survival as compared to PCI failure. The procedure is associated with usage of different types of dedicated guidewires by simple or complex techniques aiming to reopen the occluded artery. Aim: To describe types and outcome of guidewires used in LAD-CTO utilizing a first intentional single wiring simple strategy. Methods: A single center prospective registry for all consecutive patients with a PCI attempt to a native LAD CTO. The initial strategy for lesion crossing was Single wiring. Results: A total of 30 patients with LAD CTO lesions (100%), were recorded. Mean age was 71.6 + 15 years, 77% were Males, risk factors Hypertension in 63%, Diabetes 27%, Dyslipidemia 57%, smoking 40%, hereditary in 13% of patients. Isolated guidewire (GW) success rate was very high 93%. Single wiring was the prevailing technique used in 97% of successfull lesions (83% of total cases) while only 3% were by multiple wiring techniques. Successful single antegrade wiring represented 63% with a GW success rate of 92% of cases. Successful single retrograde wiring represented 13% with a GW success rate of 67%. Successful Crossing GW types in our patients were 44% Soft Tapered GWs; fielder XT (44%), 36% were Soft Non Tapered Pilot 50 (28%), whisper (8%), while 16% were Stiff Non tapered GWs; Miracle 12 (8%), Miracle 6 (4%), Miracle 3 (4%), and 4% were Stiff Tapered GWs; Progress 200 (4%). Conclusions: Single wiring as an initial strategy in PCI for LAD-CTO lesions has a high success rate and is associated with a 44% majority of Soft Tapered GWs, 36% Soft Non Tapered, 16% Stiff Non tapered GWs, and 4% Stiff Tapered GWs. PMID:23983909

  19. Radial approach and single wiring as first intentional strategies in chronic total occlusions of the left anterior descending coronary artery

    PubMed Central

    Nassar, Yasser; Boudou, Nicolas; Carrie, Didier

    2013-01-01

    Background Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of the left anterior descending coronary artery (LAD) specifically is associated with improved long-term 5 years survival as compared to PCI failure. Simpler PCI techniques may be successful and safer than complex techniques which are perceived to have high failure rates and technical complexity. We aimed to describe the safety and effectiveness of first intentional single wiring and radial approach in the treatment of patients with a CTO of the native LAD coronary artery at Toulouse Rangueil university hospitals. Patients and methods The study was a single center prospective registry. All patients showed evidence of myocardial viability in LAD territory. The operators’ initial strategy was to start by a radial access as a first choice whenever feasible; if not, a femoral access was chosen. The initial strategy for lesion crossing in either antegrade or retrograde approaches was single wiring by lesion crossing using one guidewire (GW) as a simple technique. Results A total of 30 patients with 30 LAD CTO lesions (100%) were recorded. Mean age was 71.6 + 15 years, 77% were males and 23% were females. The access route was radial 66% of the time and femoral 54% of the time and with double access for contralateral injection in 40% of the patients. Sheaths and catheters sizes 6F were used in 53% of the patients, and 7F in 73% of the patients. Overall lesion success rate was 83% of lesions. Single wiring was the prevailing technique used in 97% of successful lesions (83% of total cases), while only 3% were by multiple wiring techniques. Successful single antegrade wiring represented 63% of our total study cases with a GW success rate of 92% of cases. Successful single retrograde wiring represented 13% of our cases with a GW success rate of 67%. Q-wave myocardial infarction (MI), stent thrombosis, stroke, emergency coronary artery bypass graft (CABG), major bleeding, radiation dermatitis, cardiac tamponade or clinical perforation requiring any hemostatic maneuvers did not occur. There was a post-procedural Troponin rise of 3x normal levels in 30% of patients, and contrast induced nephropathy in 7%. Intra-aortic balloon counterpulsation (IABCP) was used in 3% of patients and cardiac death occurred in 3% of patients. Conclusion Single wiring and radial access as initial strategies in PCI for LAD-CTO lesions in either approaches antegrade or retrograde are associated with a high procedural success rate and an acceptable incidences of adverse events. PMID:24174849

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

    SciTech Connect

    Siablis, Dimitris, E-mail: siablis@upatras.gr; 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)

    2012-06-15

    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.

  1. 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

    2013-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    1986-01-01

    Reported are eight patients with idiopathic chronic pancreatitis and two patients with alcoholic pancreatitis who had near total distal pancreatectomy for disabling pain and underwent simultaneous segmental pancreatic autotransplantation of the body and tail of the gland to the femoral area in an attempt to prevent or delay the onset of diabetes. The median follow-up period was 31 months, and follow-up study in nine patients ranged from 24 to 54 months. Patency of the grafts was determined by angiography and selected percutaneous venous assays for insulin. Islet cell function was determined by oral glucose tolerance tests, intravenous (I.V.) glucose tolerance tests, and I.V. glucagon stimulation studies. Segmental autotransplantation was technically successful in eight patients, only one of whom required insulin (at 2 years after grafting). The other seven patients with technically successful grafts have remained insulin independent, including two patients who later underwent pyloric preserving pancreatoduodenectomy for completion pancreatectomy. Variable pain relief was observed in patients who underwent near total pancreatectomy, but pain was unrelieved in those patients who underwent limited distal resection. Patients with idiopathic pancreatitis appear to have better pain relief and preservation of endocrine function than alcoholic patients. Segmental pancreatic autotransplantation prevents or delays the onset of diabetes mellitus and should be considered as an alternative for those patients who require extensive pancreatic resection for chronic pancreatitis. PMID:3521508

  4. Sharp Recanalization for Chronic Left Iliac Vein Occlusion

    SciTech Connect

    Ito, Nobutake, E-mail: nobutake@rad.med.keio.ac.jp; 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)

    2012-08-15

    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.

  5. New approaches to total occlusions: the guiding light

    NASA Astrophysics Data System (ADS)

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

    2003-06-01

    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.

  6. Percutaneous Endovascular Treatment of Chronic Iliac Artery Occlusion

    SciTech Connect

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

    2004-09-15

    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.

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

    Microsoft Academic Search

    MAJID KALANI; JAN APELQVIST; M. Blomback; KERSTIN BRISMAR; B. Eliasson; JAN W. ERIKSSON; BENGT FAGRELL; ANDERS HAMSTEN; OLE TORFFVIT; GUN JORNESKOG

    2003-01-01

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

  8. Infarct size and regional perfusion following coronary occlusion in the chronically sympathectomized canine ventricle

    E-print Network

    Beck, Linda Yvonne

    1978-01-01

    INFARCT SIZE AND REGIONAL PERFUSION FOLLOWING CORONARY OCCLUSION IN THE CHRONICALLY SYMPATHECTOMIZED CANINE VENTRICLE A Thesis by LINDA YVONNE BECK Submitted to the Graduate College of Texas A&M University in partial fulfillment... of the requirement for the degree of MASTER OF SCIENCE May 1978 Major Sub)set: Biology INFARCT SIZE AND REGIONAL PERFUSION FOLLOWING CORONARY OCCLUSION IN THE CHRONICALLY SYMPATHECTOMIZED CANINE VENTRICLE A Thesis by LINDA YVONNE BECK Approved as to style...

  9. Procedural Safety and Potential Vascular Complication of Endovascular Recanalization for Chronic Cervical Internal Carotid Artery Occlusion

    Microsoft Academic Search

    Mao-Shin Lin; Lung-Chun Lin; Hung-Yuan Li; Cheng-Hsin Lin; Chi-Chao Chao; Chih-Neng Hsu; Yen-Hung Lin; Shih-Chung Chen; Yen-Wen Wu; Hsien-Li Kao

    Background—Patients with chronic cervical internal carotid artery occlusion (ICAO) and cerebral ischemia may benefit from revascularization. The feasibility of endovascular recanalization for chronic ICAO has been reported recently, but its safety is still unproven. We report the follow-up results of 54 chronic ICAO patients who underwent endovascular recanalization, focusing on potential vascular complications and corresponding management. Methods and Results—Endovascular recanalization

  10. Transpopliteal Balloon-Assisted Excimer–Laser Atherectomy for the Treatment of Chronic Femoropopliteal Occlusions: Feasibility and Initial Results

    PubMed Central

    Lüdtke, Christopher W; Scheer, Fabian; Kamusella, Peter; Wissgott, Christian; Andresen, Reimer

    2014-01-01

    PURPOSE Recanalization of chronic total occlusions (CTOs) of the femoropopliteal arteries depends on a successful lesion crossing with the guide wire. The aim of this retrospective study was to evaluate the safety, feasibility, and the primary results of retrograde recanalization of CTOs with balloon-assisted excimer–laser atherectomy (ELA) via a transpopliteal approach after failed antegrade attempts. METHODS A total number of 15 patients (10 male, 5 female) with a mean age of 68.5 years (range: 43–91 years) treated with retrograde transpopliteal ELA in the years 2009–2012 were included retrospectively. After unsuccessful antegrade recanalization attempts with conventional guide wires and catheters, patients were treated with a retrograde recanalization attempt via a transpopliteal access using an excimer laser, followed by pressure-only balloon angioplasty (POBA). The mean length of the CTOs in the femoropopliteal arteries was 17.8 ± 5.4 cm (range: 9–29 cm). RESULTS Technically successful recanalization was achieved in 14 of 15 patients. Provisional stenting was done in two cases. There were no major adverse events regarding the laser atherectomy or popliteal access site. One acute reocclusion was observed in the first 48 hours after intervention. The ankle-brachial Index increased from preinterventional 0.45 ± 0.07 to 0.77 ± 0.29 (P < 0.05) in the follow-up period (1.5 months), resulting in a primary patency of 80%. CONCLUSION The retrograde ELA for recanalization of chronic femoropopliteal occlusions via a popliteal access turned out to be a safe and effective procedure with promising primary results. Thus it may be an endovascular treatment option for long chronic occlusions after failed antegrade recanalization or in patients who are not suitable for surgery.

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

    NASA Astrophysics Data System (ADS)

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

    2001-05-01

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

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

    PubMed Central

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

    2014-01-01

    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

  13. Occlusal disorders among patients with total clefts of lip, alveolar bone, and palate.

    PubMed

    Paradowska-Stolarz, Anna; Kawala, Beata

    2014-01-01

    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

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

    Microsoft Academic Search

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

    1996-01-01

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

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

    SciTech Connect

    Lorenz, Jonathan M., E-mail: jlorenz@radiology.bsd.uchicago.edu; Regalado, Sidney; Navuluri, Rakesh, E-mail: rnavuluri@gmail.com; Zangan, Steven; Thuong Van Ha; Funaki, Brian [University of Chicago Hospitals, Department of Radiology, Section of Interventional Radiology (United States)

    2010-06-15

    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.

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

    SciTech Connect

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

    2011-04-15

    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.

  17. Localized temperature measurements while using a radio frequency total occlusion ablation system in a porcine model

    NASA Astrophysics Data System (ADS)

    Neet, John M.; Siglinger, Marlin R.; Palmer, Gail

    2003-06-01

    A RF ablation guide wire with an optical coherence reflectometry guidance system has been developed to percutaneously open total occlusions in arteries. The ablation energy does generate heat as does any electrosurgical application of RF energy. Prior histology studies using this device had shown that the heat generated in the total occlusion was not a clinical concern. In this study, a novel fiber-optic based temperature measurement sensor was used to actually measure the temperature rise in an artery in vivo in a porcine model. The optical temperature measurement system is immune to RF emissions and interference and could be delivered in the same catheter as the guide wire. Temperature rises in the occluded arteries in a worst-case scenario were shown to be less than 10°C, localized to the volume adjacent to the ablation tip, and the temperature returned to ambient within a few seconds after the energy was no longer applied. The temperature data is in agreement with the prior histology studies.

  18. Occlusion of the common femoral artery by cement after total hip arthroplasty: a case report

    PubMed Central

    2009-01-01

    Introduction The incidence of vascular injuries after total hip arthroplasty is extremely low. In this report we describe an unusual injury to the common femoral artery. Case presentation A 59-year-old Caucasian woman presented with rest pain, numbness and cramps in the operated limb after hip replacement. Cement leakage under the transverse ligament had caused occlusion of the common femoral artery necessitating vascular reconstruction. She had a good functional recovery at follow-up. Conclusion To the best of our knowledge, this is the first well-documented case reporting this pathomechanism of vascular lesion to the femoral artery. This case report highlights the potential risk of such a limb-threatening complication, and awareness should lead to prevention by meticulous surgical technique (correct technique of pressurization) or to early detection of the lesion. PMID:19946562

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

    PubMed Central

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

    2012-01-01

    Objectives To study the fetal outcome with the use of McDonald cerclage and total cervical occlusion in women with recurrent mid-trimester miscarriages or preterm deliveries, as well as complications of total cervical occlusion in the women. Methods Prospective descriptive observational study on patients with two or more mid-trimester miscarriages, deliveries before 36 weeks, or patients who have experienced failure of transvaginal cerclage. Results Twenty-six women were studied. Of these, 92% delivered at term. Two women delivered at 33 and 35 weeks, respectively. There was one neonatal death. Take home baby rate was 96.2%. There was no serious maternal morbidity among the patients. Conclusion The addition of external cervical OS occlusion to McDonald cerclage could improve fetal outcome in women with recurrent mid-trimester miscarriages and preterm deliveries. PMID:22359730

  20. Protective effect of total flavones from Elsholtzia blanda (TFEB) on myocardial ischemia induced by coronary occlusion in canines

    Microsoft Academic Search

    Ling Haiyun; Lou Yijia; Lou Honggang; Wu Honghai

    2004-01-01

    This study was undertaken to determine the effect of total flavones from Elsholtzia blanda (Benth.) Benth. (TFEB), a traditional Chinese medicine, on myocardial ischemia induced by coronary occlusion in Beagle dogs. Infarct size of left ventricle, serum activity of creatine kinase-MB (CK-MB) and malondialdehyde (MDA), hemorrheologic variables and homodynamic parameters including mean arterial pressure (MAP), coronary blood flow (CBF), coronary

  1. Trans-venous occlusion of incompetent pelvic veins for chronic pelvic pain in women: a systematic review.

    PubMed

    Hansrani, Vivak; Abbas, Abeera; Bhandari, Sahil; Caress, Ann-Louise; Seif, Mourad; McCollum, Charles N

    2015-02-01

    Chronic pelvic pain (CPP) affects 24% of women worldwide; the cause cannot be identified in 40% despite invasive investigations. Dilated, refluxing pelvic veins may be a cause of CPP and treatment by trans-venous occlusion is increasingly performed when gynecological causes are excluded, but is it effective? A systematic review of the literature published between 1966 and July 2014 was conducted. Two authors independently reviewed potential studies according to a set of eligibility criteria, with a third assessor available as an arbiter. Thirteen studies including 866 women undergoing trans-venous occlusion of pelvic veins for CPP were identified (Level of evidence: one study grade 2b, 12 studies grade four). Statistical significant improvements in pelvic pain were reported in nine of the 13 studies. Technical success was reported in 865 of 866 (99.8%) with low complication rates: coil migration in 14 women (1.6%), abdominal pain in ten women (1.2%) and vein perforation in five (0.6%). In a study on varicose veins of the legs, recurrence was seen in 13% of 179 women 5-years following coil embolization. Subjective improvements in pain were seen in all 13 studies after treatment by trans-venous occlusion. All 13 studies were of poor methodological quality. Complication rates were low and no fatalities occurred. Well-designed studies are essential to determine whether pelvic vein incompetence (PVI) is associated with CPP, and to explore whether trans-venous occlusion of PVI improves quality of life for these women. PMID:25590499

  2. Total-body 3D magnetic resonance angiography influences the management of patients with peripheral arterial occlusive disease

    Microsoft Academic Search

    Mathias Goyen; Christoph U. Herborn; Knut Kröger; Stefan G. Ruehm; Jörg F. Debatin

    2006-01-01

    High-resolution total-body 3D MR angiography (MRA) has recently become available, revealing additional clinically relevant\\u000a disease in patients with peripheral arterial occlusive disease (PAOD). However, the actual impact of total-body MRA on patient\\u000a management in patients with PAOD has not been investigated so far. Two hundred forty-nine consecutive patients with angiographically\\u000a proven PAOD were prospectively examined by means of contrast-enhanced total-body

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

    PubMed Central

    Dib, Abraham; Sanchez, José-Miguel; López-Valverde, Antonio

    2015-01-01

    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. Key words:Myofascial pain, occlusal adjustment, electromyography, T-Scan III, occlusal interferences. PMID:25475783

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

    PubMed Central

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

    2014-01-01

    Subintimal angioplasty is an effective method for the treatment of long superficial femoral artery (SFA) occlusions. One of the major limiting factors for the success of this procedure is the failure to re-enter the true lumen. The recently introduced luminal re-entry devices provide a high technical success rate, but failures can occur. In such cases, a retrograde popliteal approach can serve as a potential backup option. However, the need to reposition the patient remains a drawback. Here, we report a case of an 81-year-old male with a long SFA occlusion treated using a retrograde distal SFA approach in the supine position after the initial failure of antegrade angioplasty. PMID:24876860

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

    Microsoft Academic Search

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

    2006-01-01

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

  6. A complex dissected chronic occlusion: targeted balloon dilatation of false lumen to access true lumen, combined localized subintimal tracking and re-entry, parallel wire, contralateral injection and a useful antegrade lumen re-entry technique.

    PubMed

    Hussain, Farrukh; Golian, Mehrdad; Tam, James W

    2012-02-01

    Chronic total occlusion (CTO) angioplasty is one of the most challenging procedures remaining for the interventional operator. Recanalizing CTOs can improve exercise capacity, symptoms, left ventricular function and possibly reduce mortality. Multiple strategies such as escalating wire, parallel wire, see-saw, contralateral injection, subintimal tracking and re-entry (STAR), retrograde wire techniques (controlled antegrade retrograde subintimal tracking, CART), reverse CART, confluent balloon, rendezvous in coronary, and other techniques have all been described. Selection of the most appropriate approach is based on assessment of vessel course, length of occluded segment, presence of bridging collaterals, presence of bifurcating side branches at the occlusion site, and other variables. Today, with significant operator expertise and the use of available techniques, the literature reports a 50-95% success rate for recanalizing CTOs. PMID:22690300

  7. Non-ST elevation myocardial infarction related to total coronary artery occlusion – prevalence and patient characteristics

    PubMed Central

    Smolka, Grzegorz; Pysz, Piotr; Kozyra, Andrzej; Ocha?a, Andrzej

    2015-01-01

    Introduction Acute coronary occlusion (ACO) may also present as non-ST elevation myocardial infarction (NSTEMI) and thus veil the real threat. Aim Based on combined analysis of electrocardiography and echocardiography findings, we aimed to describe profile of NSTEMI patients at increased risk of ACO. Material and methods It was a retrospective study that included patients referred for cardiac catheterisation due to NSTEMI. Patients were selected into the study in two different time frames. Firstly, all consecutive NSTEMI patients were enrolled in a 12-month period to detect the prevalence of ACO (prevalence group). Secondly, all NSTEMI patients with ACO hospitalized in the previous 5 years were also enrolled (NSTEMI-ACO group). All patients had 12-lead electrocardiogram (ECG) and the transthoracic echocardiography (TTE) performed before the cardiac catheterisation. Results Fifty-three consecutive patients (37 males) were enrolled into the prevalence group in a 12-month period. Ten (19%) of them were diagnosed with ACO. Thirty-four consecutive patients were enrolled into the NSTEMI-ACO group. Non-ST elevation myocardial infarction patients with ACO were younger as compared to NSTEMI patients without ACO. Non-ST elevation myocardial infarction patients with ACO were less likely to have anterior wall ischaemia as detected by ECG, which was not reflected by TTE results. Combined assessment of ischaemia by ECG and impaired contractility by TTE did not reveal any significant differences between NSTEMI patients with or without ACO. Conclusions The identification of NSTEMI patients with ACO is challenging. Therefore, the utmost caution should be paid to prevent delay of coronary angiography in NSTEMI patients who have increased risk of ACO. PMID:25848364

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

    PubMed Central

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

    2012-01-01

    Background Although the prevalence of inspiratory muscle strength training has increased in clinical medicine, its effect on diaphragm fiber remodeling is not well-understood and no relevant animal respiratory muscle strength training-rehabilitation experimental models exist. We tested the postulate that intrinsic transient tracheal occlusion (ITTO) conditioning in conscious animals would provide a novel experimental model of respiratory muscle strength training, and used significant increases in diaphragmatic fiber cross-sectional area (CSA) as the primary outcome measure. We hypothesized that ITTO would increase costal diaphragm fiber CSA and further hypothesized a greater duration and magnitude of occlusions would amplify remodeling. Methodology/Principal Findings Sprague-Dawley rats underwent surgical placement of a tracheal cuff and were randomly assigned to receive daily either 10-minute sessions of ITTO, extended-duration, 20-minute ITTO (ITTO-20), partial obstruction with 50% of cuff inflation pressure (ITTO-PAR) or observation (SHAM) over two weeks. After the interventions, fiber morphology, myosin heavy chain composition and CSA were examined in the crural and ventral, medial, and dorsal costal regions. In the medial costal diaphragm, with ITTO, type IIx/b fibers were 26% larger in the medial costal diaphragm (p<0.01) and 24% larger in the crural diaphragm (p<0.05). No significant changes in fiber composition or morphology were detected. ITTO-20 sessions also yielded significant increases in medial costal fiber cross-sectional area, but the effects were not greater than those elicited by 10-minute sessions. On the other hand, ITTO-PAR resulted in partial airway obstruction and did not generate fiber hypertrophy. Conclusions/Significance The results suggest that the magnitude of the load was more influential in altering fiber cross-sectional area than extended-duration conditioning sessions. The results also indicated that ITTO was associated with type II fiber hypertrophy in the medial costal region of the diaphragm and may be an advantageous experimental model of clinical respiratory muscle strength training. PMID:23133678

  9. Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease.

    PubMed

    Rad, Masoud Pezeshki; Kazemzadeh, Gholam Hosain; Ziaee, Masood; Azarkar, Ghodsieh

    2015-01-01

    Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS) were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56%) patients were male subjects and 18 patients (44%) were female. Twenty-three (56%) patients of the study population were aged <60 years and 18 (43/9%) patients were aged >60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion. PMID:25758875

  10. Juxtarenal aortic occlusion.

    PubMed Central

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

    1992-01-01

    The authors' experience with 113 aortic occlusions in 103 patients during a 26-year period (1965 to 1991) is reviewed. The authors found three distinct patterns of presentation: group I (n = 26) presented with acute aortic occlusion, group II (n = 66) presented with chronic aortic occlusion, and group III (n = 21) presented with complete occlusion of an aortic graft. Perioperative mortality rates were 31%, 9%, and 4.7% for each respective group and achieved statistical significance when comparing group I with group II (p = 0.009) and group I with group III (p = 0.015). Group I presented with profound metabolic insults due to acute ischemia and fared poorly. Group II presented with chronic claudication and did well long-term. Group III presented with acute ischemia but did well because of established collateral circulation. The treatment and expected outcome of aortic occlusion depends on the cause. PMID:1616381

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

    SciTech Connect

    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)

    1996-09-15

    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.

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

    PubMed Central

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

    2014-01-01

    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. PMID:25624845

  13. Total knee replacement in acute and chronic traumatic events.

    PubMed

    Benazzo, Francesco; Rossi, Stefano M P; Ghiara, Matteo; Zanardi, Alessandro; Perticarini, Loris; Combi, Alberto

    2014-12-01

    Total knee replacement (TKR) is a widely used procedure for the treatment of post-traumatic arthritis. This type of solution has also been used recently for the treatment of acute fractures around the knee, particularly in joints that were already arthritic before the trauma. The purpose of this paper is to present our experience with TKR in both acute and chronic traumatic events, highlighting the main problems associated with these conditions and focussing on the indications, principles of technique, tips, tricks and pitfalls of this procedure. The main issues related to post-traumatic arthritis and the problem of TKR in acute fractures are discussed, and our case series of both groups of patients is presented. PMID:25457327

  14. Relationship between brachial artery blood flow and total [hemoglobin+myoglobin] during post-occlusive reactive hyperemia.

    PubMed

    Bopp, Christopher M; Townsend, Dana K; Warren, Steve; Barstow, Thomas J

    2014-01-01

    The associations between macrovascular and microvascular responses reported previously during post-occlusive reactive hyperemia have been inconsistent. The purpose of this study was therefore to determine the temporal relationship between the reactive hyperemic responses within a conduit artery and the downstream microvessels. Conduit artery blood flow was measured in the brachial artery with pulsed Doppler ultrasound. A potential analog of microvascular flow, changes in skeletal muscle total[hemoglobin+myoglobin] (T[Hb+Mb]), was assessed with near-infrared spectroscopy (NIRS). We found a high degree of correlation between these two measures (r=0.91). Cross-correlation analysis revealed two distinct response patterns. In 10 of our 15 subjects there was time displacement between peak brachial artery blood flow (BABF) and T[Hb+Mb] responses; in the remaining 5 the peaks were coincident. Granger causality testing suggested that reactive hyperemia in the macrovessel determined hyperemia in the downstream microvessels in all 15 study subjects. Time constants for the on (?1) and off (?2) kinetics of each response were calculated; our initial hypothesis was that ?1 and ?2 for T[Hb+Mb] would correlate with ?1 and ?2 for BABF, respectively. However, only for ?2 was this observed (r=0.52; p<0.05). No similar relationship was observed for ?1. Adipose tissue thickness did not influence either time constant for T[Hb+Mb]. Taken together, our results show that the temporal characteristics of the hyperemic response in the conduit artery are qualitatively reflected in the downstream microvasculature, but mechanisms for quantitative differences remain to be identified. PMID:24189121

  15. Anatomic bifurcated reconstruction of chronic bilateral innominate-superior vena cava occlusion using the Y-stenting technique.

    PubMed

    Amin, Parth; Sharafuddin, Mel J; Laurich, Chad; Nicholson, Rachael M; Sun, Raphael C; Roh, Simon; Kresowik, Timothy F; Sharp, William J

    2012-02-01

    This article presents the case of a 42-year-old man who presented with superior vena cava (SVC) syndrome due to fibrosing mediastinitis with multiple failed attempts at recanalization. We initially treated him with unilateral sharp needle recanalization of the right innominate vein into the SVC stump followed by stenting. Although his symptoms improved immediately, they did not completely resolve. Six months later, he returned with worsening symptoms, and venography revealed in-stent restenosis. The patient requested simultaneous treatment on the left side. The right stent was dilated, and a 3-cm-long occlusion of the left innominate vein was recanalized, again using sharp needle technique, homing into the struts of the right-sided stent. Following fenestration of the stent, a second stent was deployed from the left side into the SVC, and the two Y limbs were sequentially dilated to allow a true bifurcation anatomy (figure). The patient had complete resolution of his symptoms and continues to do well 6 months later. PMID:22304866

  16. Complete spontaneous regression of a total pneumothorax in a patient with chronic obstructive lung disease.

    PubMed

    Gonlugur, U; Ugur, G; Mirici, A; Arzu, M; Yildiz, M; Muammer, Y

    2011-11-14

    A 61-year old man presented with a sudden onset of breathlessness. The total left pneumothorax was overlooked on the initial chest radiograph. One month later, the patient had a partial pneumothorax less than 20% on the radiograph, although he did not receive any therapy against pneumothorax, such as oxygen inhalation or needle aspiration. After the observation for one month, the lungs totally expanded. Pulmonary function tests demonstrated severe chronic obstructive pulmonary disease. To our knowledge, this is the first case in which the total secondary pneumothorax showed a spontaneous remission. PMID:22514577

  17. 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

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

    1991-07-01

    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.

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

    PubMed Central

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

    2011-01-01

    Background: The Overall Nutritional Quality Index (ONQI) algorithm is a nutrient profiling scheme that incorporates over 30 dietary components, and aims to rank foods by relative healthfulness. Purpose: To assess whether diets with a higher ONQI score predict lower risk of major chronic disease risk. Methods: A total of 62,284 healthy women from the Nurses’ Health Study and 42,382 healthy men from Health Professionals Follow-Up Study were followed from 1986 to 2006. Dietary data were collected from questionnaires at baseline. Each food was scored by the ONQI algorithm and the average ONQI score for the diet consumed by each participant was computed. Total chronic disease was defined as cardiovascular disease (CVD), cancer, diabetes and nontrauma death. Data analysis was conducted in 2010. Results: A total of 20,004 and 13,520 chronic disease events were documented in women and men, respectively. The ONQI score was inversely associated with risk of total chronic disease, CVD, diabetes and all-cause mortality (p-trend?0.01), but not cancer, in both cohorts. Women in the highest compared to lowest quintile of the ONQI score had a relative risk (95% CI) of 0.91 (0.87, 0.95) for chronic disease, 0.79 (0.71, 0.88) for CVD, 0.86 (0.78, 0.96) for diabetes and 0.90 (0.84, 0.97) for all-cause mortality. Men in the highest compared to lowest quintile of the ONQI score had a relative risk of 0.88 (0.83, 0.93) for chronic disease, 0.77 (0.70, 0.85) for CVD, 0.84 (0.73, 0.96) for diabetes and 0.89 (0.83, 0.97) for all-cause mortality. Conclusions: The ONQI scoring system was associated with modestly lower risk of chronic disease and all-cause mortality. PMID:21496749

  19. Stent Placement for Chronic Iliac Arterial Occlusive Disease: the Results of 10 Years Experience in a Single Institution

    PubMed Central

    Park, Kwang Bo; Kim, Jae Hyung; Han, Yoon Hee; Kim, Dong Ik; Kim, Duk Kyung; Kim, Young Wook; Shin, Sung Wook; Cho, Sung Ki; Choo, Sung Wook; Choe, Yeon Hyeon; Choo, In-Wook

    2005-01-01

    Objective We wanted to retrospectively evaluate the long-term therapeutic results of iliac arterial stent placement that was done in a single institution for 10 years. Materials and Methods From May 1994 to April 2004, 206 patients who underwent iliac arterial stent placement (mean age; 64±8.8) were followed up for evaluating the long term stent patency. Combined or subsequent bypass surgery was performed in 72 patients. The follow up period ranged from one month to 120 months (mean; 31±25.2 months). The factors that were analyzed for their effect on the patency of stents were age, the stent type and diameter, the lesion site, lesion shape, lesion length, the Society of Cardiovascular and Interventinal Radiology criteria, the total run off scores, the Fontaine stage and the cardiovascular risk factors (diabetes mellitus, hypertension and smoking). Follow-up included angiography and/or CT angiography, color Doppler sonography and clinical evaluation with the ankle-brachial index. Results Two hundred and eighty-four stents were placed in 249 limbs of 203 patients. The technical success rate was 98% (203/206). The primary patency rates of the stents at 3, 5, 7 and 10 year were 87%, 83%, 61% and 49%, respectively. One hundred seventy-seven patients maintained the primary stent patency until the final follow up and 26 patients showed stenosis or obstruction during the follow up. Secondary intervention was performed in thirteen patients. Lesions in the external iliac artery (EIA) or lesions in both the common iliac artery (CIA) and EIA were a poor prognostic factor for stent patency. The run off score and stent diameter also showed statistically significant influence on stent patency. The overall complication rate was 6%. Conclusion Iliac arterial stent placement is a safe treatment with favorable long term patency. Lesions in the EIA or lesions in both the EIA and CIA, poor run off vessels and a stent having the same or a larger diameter than 10 mm were the poor prognostic factors for long term stent patency. PMID:16374084

  20. Endovascular recanalization of infrapopliteal occlusions in patients with critical limb ischemia

    PubMed Central

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

    2014-01-01

    Background Endovascular therapies are increasingly used for treatment of critical limb ischemia (CLI). Infrapopliteal (IP) occlusions are common in CLI, and successful limb salvage may require restoration of arterial flow in the distribution of a chronically occluded vessel. We sought to describe the procedural characteristics and outcomes of patients with IP occlusions who underwent endovascular intervention for treatment of CLI. Methods All patients with IP interventions for treatment of CLI from 2006 to 2012 were included. Angiographic and procedural data were compared between patients who underwent intervention for IP occlusions vs IP stenosis. Restenosis was determined by Doppler ultrasound imaging. Limb salvage was the primary end point of the study. Additional end points included primary patency, primary assisted patency, secondary patency, occlusion crossing success, procedural success, and amputation-free survival. Results A total of 187 patients with CLI underwent interventions for 356 IP lesions, and 77 patients (41%) had interventions for an IP occlusion. Patients with an intervention for IP occlusion were more likely to have zero to one vessel runoff (83% vs 56%; P < .001) compared with interventions for stenosis. Compared with IP stenoses, IP occlusions were longer (118 ± 86 vs 73 ± 67 mm; P < .001) and had a smaller vessel diameter (2.5 ± 0.8 vs 2.7 ± 0.5 mm; P =.02). Wire crossing was achieved in 83% of IP occlusions, and the overall procedural success for IP occlusions was 79%. The overall 1-year limb salvage rate was 84%. Limb salvage was highest in the stenosis group, slightly lower in the successful occlusion group, and lowest in the failed occlusion group (92% vs 75% vs 58%, respectively; P = .02). Unsuccessfully treated IP occlusions were associated with a significantly higher likelihood of major amputation (hazard ratio, 5.79; 95% confidence interval, 1.89–17.7) and major amputation or death (hazard ratio, 2.69; 95% confidence interval, 1.09–6.63). Conclusions Successful endovascular recanalization of IP occlusions can be achieved with guidewire and support catheter techniques in most patients. In patients selected for an endovascular-first approach for IP occlusions in CLI, this strategy can be successfully implemented with favorable rates of limb salvage. PMID:24393279

  1. Plasma levels of acylated and total ghrelin in pediatric patients with chronic kidney disease

    Microsoft Academic Search

    Maria Fernanda Soares Naufel; Milena Bordon; Talita Marques de Aquino; Eliane Beraldi Ribeiro; João Tomás de Abreu Carvalhaes

    2010-01-01

    This cross-sectional study set out to compare total and acyl ghrelin levels in children with mild chronic kidney disease (CKD)\\u000a undergoing conservative treatment (n?=?19) with children with end-stage renal disease (ESRD) undergoing hemodialysis (n?=?24), and with healthy controls (n?=?20). The relationship between ghrelin levels and parameters of renal function, nutritional status, and selective hormones\\u000a were investigated. ESRD patients had higher

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

    SciTech Connect

    Ferro, Carlo; Rossi, Umberto G., E-mail: urossi76@hotmail.com; 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)

    2013-06-15

    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.

  3. Pitfalls after total parathyroidectomy and parathyroid autotransplantation in chronic renal failure.

    PubMed

    Baker, L R; Otieno, L S; Brown, A L; Carroll, M J; Cattell, W R; Farrington, K

    1991-01-01

    We have described 4 patients with chronic renal failure receiving regular haemodialysis treatment who underwent total parathyroidectomy with autotransplantation of parathyroid fragments into the forearm musculature for hypercalcaemic hyperparathyroidism. In all, there was an immediate and profound fall in plasma calcium levels. Hypercalcaemia recurred 1-5 years post-operatively and was resistant to resection of the autograft. In 3 cases, thallium-technetium subtraction scanning and multiple venous sampling for estimation of parathyroid hormone levels suggested multiple sites of hypersecretion of parathyroid hormone in the neck. In 1 case, these investigations revealed a mediastinal adenoma which was successfully removed. These cases reinforce previous suggestions that total parathyroidectomy is frequently incomplete and undermine the procedure of total parathyroidectomy with autotransplantation in patients with persisting uraemia. PMID:1962665

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

    PubMed Central

    Bhandary, Rahul; Thomas, Biju; Kumari, Suchetha

    2014-01-01

    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

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

    PubMed Central

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

    2015-01-01

    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

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

    SciTech Connect

    Teichgraeber, Ulf Karl-Martin, E-mail: ulf.teichgraeber@charite.de; 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)

    2010-04-15

    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.

  7. 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

    Kuhan, Ganesh, E-mail: gkuhan@nhs.net; 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)

    2012-10-15

    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.

  8. Total aortic replacement for chronic aortic dissection occurring in patients with and without Marfan's syndrome.

    PubMed Central

    Crawford, E S; Crawford, J L; Stowe, C L; Safi, H J

    1984-01-01

    Total aortic replacement including aortic valve was performed successfully in the two patients in whom this method of treatment was utilized to correct a chronic dissecting aortic aneurysm. Both patients had moderately severe aortic insufficiency producing increasing heart strain and progressive enlargement of the false lumen of aortic dissection involving the entire aorta despite ideal blood pressure control. In addition, one patient had Marfan's syndrome. The surgical treatment for both patients was performed in two stages. At the first operation, cardiopulmonary bypass, profound hypothermia, and circulatory arrest were employed while the aortic valve and the ascending and transverse aortic arch were replaced and the coronary and brachiocephalic vessels were reattached to the composite valve-graft used for replacement. At the second operation, the entire descending thoracic and abdominal aortic segments were replaced with a graft and the intercostal, lumbar, and visceral arteries reattached thereto. Left vocal cord paralysis occurred in both patients and transient mild paraparesis occurred in only one. Both patients are alive and well, one at 13 months and one at 6 weeks. This experience suggests an additional treatment modality for selected patients with complications of chronic aortic dissection. Images Fig. 1. Fig. 2. PMID:6231006

  9. Mystery of Environmental MysteryEffects of Light, Occlusion, and Depth of View

    Microsoft Academic Search

    Arthur E. Stamps

    2007-01-01

    The purpose of this article is to estimate the strengths of the relationships between judgments of mystery and amount of light, depth of view, and occlusion, whether visual and locomotive occlusion or just visual occlusion. Three experiments were conducted with totals of 145 respondents and 33 scenes. Light had the largest effect on mystery, followed by occlusion of both vision

  10. Treatment of secondary hyperparathyroidism in patients with chronic renal failure by total parathyroidectomy and parathyroid autograft.

    PubMed Central

    Diethelm, A G; Adams, P L; Murad, T M; Daniel, W W; Whelchel, J D; Rutsky, E A; Rostand, S G

    1981-01-01

    Sixty-one patients with chronic renal failure and secondary hyperparathyroidism underwent total parathyroidectomy and parathyroid autograft. Symptoms relieved by parathyroidectomy included bone pain, pruritus, soft tissue calcification, muscle weakness and healing of fractures. Serum parathormone levels measured before and after operation in 48 patients returned to normal in all but two patients. Serum alkaline phosphatase levels also returned toward normal after operation, except in one patient with a retained parathyroid gland. Complete radiographic studies before and after operation were available in 30 of 61 patients. Twenty-three of 24 patients with osteitis fibrosa had evidence of healing, and in one patient no change occurred. Osteosclerosis noticed in 23 patients improved slightly in eight patients, did not change in 14 and became worse in one. Pathologic examinations revealed 45 patients to have diffuse hyperplasia and 16 nodular hyperplasia. There were two early postoperative deaths, in the first 30 days, and 16 late postoperative deaths, from four months to four years afterward. In no case did the operation contribute to death. Some patients required the administration of supplemental calcium after operation, but in no instance did profound hypocalcemia occur. No patient developed recurrent hyperparathyroidism. Images Fig. 1. Fig. 4. Fig. 5. Fig. 6. Fig. 7. Fig. 8. Fig. 9. Fig. 10. Fig. 11. Fig. 12. Fig. 13. PMID:7247522

  11. Can total knee arthroplasty be safely performed in patients with chronic renal disease?

    PubMed Central

    2014-01-01

    Background and purpose The prevalence of chronic renal disease (CRD) is rising worldwide. Patients with CRD are more likely to have associated medical problems and are at greater risk of postoperative morbidity and mortality. We evaluated patient characteristics and risk of early revision, surgical site infection (SSI), thromboembolic events, mortality, and re-admission of patients with CRD undergoing total knee arthroplasty (TKA). We hypothesized that this patient population would have higher rates of complications. Patients and methods We conducted a retrospective analysis of data that had been prospectively collected by a Total Joint Replacement Registry. All primary TKAs performed from 2005 through 2010 were included. 41,852 primary TKA cases were evaluated, of which 2,686 (6.4%) TKA procedures had been performed in CRD patients. Patient characteristics, comorbidities, and general health status were evaluated. Cox proportional hazard regressions and logistic regressions were used to evaluate the association of CRD with outcomes while adjusting for confounding variables. Results The mean age of the CRD cohort was 67 years and approximately two-thirds of the patients were female. The median follow-up time was 2.1 years. Compared to TKA patients without CRD the CRD patients were older, had poorer general health, and had a higher prevalence of comorbidities. They had a higher incidence of deep SSI (0.9% vs. 0.7%), superficial SSI (0.5% vs. 0.3%), deep vein thrombosis (0.6% vs. 0.4%), any-time mortality (4.7% vs. 2.4%), 90-day mortality (0.4% vs. 0.2%), and 90-day re-admission (10% vs. 6.0%) than patients without CRD. However, after adjustment for confounding variables, CRD patients were at 1.9 times (95% CI: 1.1–3.5) increased risk of superficial SSI, 1.3 times (CI: 1.1–1.6) increased risk of re-admission within 90 days, and 1.5 times (CI: 1.2–1.8) increased risk of mortality at any point after the procedure. The risks of all other complications were not statistically significantly different in patients with CRD compared to patients without CRD. Conclusions CRD patients undergoing TKA have more comorbidities and a higher risk for superficial SSI, 90-day re-admission, and any-time mortality. PMID:24397745

  12. Determinants of lumbar artery occlusion among patients with sciatica: A three-year follow-up with magnetic resonance angiography

    Microsoft Academic Search

    Jaro Karppinen; Mauno Kurunlahti; Simo Taimela; Marianne Haapea; Heikki Vanharanta; Osmo Tervonen

    2005-01-01

    We showed previously that chronic Chlamydia pneumoniae infection increases the risk of lumbar artery occlusion. We did not evaluate, however, the effect of other risk factors for cardiovascular diseases in combination with this chronic infection. The purpose of this study was to investigate the combined effect of chronic C. pneumoniae infection and other known determinants of artery occlusion in a

  13. Image analysis and occlusion.

    PubMed

    Wright, P S

    1992-09-01

    This study was designed to investigate the measurement of the occlusal contact area (surface) using commercially available equipment and computer programs for image processing and analysis. A stable occlusal record was made using an addition curing silicone rubber putty and was placed on a light source onto which a video camera was focused. This image was digitized and standard thickness records were used to calibrate the appropriate threshold for measurement of contact and near contact surfaces. Differences between individuals and within individuals with and without their partial dentures are large. This method has the potential to be a powerful tool in the study of occlusion. PMID:1432767

  14. Acute arterial occlusion - kidney

    MedlinePLUS

    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. ...

  15. Low free to total PSA ratio is not a good discriminator of chronic prostatitis and prostate cancer: An Indian experience.

    PubMed

    Thakur, V; Talwar, M; Singh, P P

    2014-01-01

    Aims: To find out the utility of free to total PSA ratio in discriminating chronic prostatitis and prostate cancer. Setting and design: The patients visited urology clinics at Batra Hospital and Medical Research Center, New Delhi. Background: The use of serum free to total PSA as a diagnostic tool for prostate cancer has led to early detection of prostate cancer; however, the effect of inflammation on f/t PSA ratio restricts its use in early detection of cancer. Materials and Methods: The study was conducted in age related 101 patients which include 27 carcinoma patients (group I), 34 BPH patients (group II) and 40 chronic prostatitis patients (group III). Serum total PSA (tPSA) and free PSA (fPSA) were analyzed on Elecsys 2010. These were compared with histological reports of biopsy specimen. Other biochemistry tests were done on Randox Imola. P Value was calculated using one way ANOVA with posthoc Bonferroni analysis. Results: Serum total PSA levels were comparable in group I and III and were higher than group II (P < 0.049). Serum fPSA in group I was not significantly different from group II and III, However, group II has higher levels than group III (P < 0.035). Difference was significant for f/t PSA ratio in group I and II (P < 0.00) and group II and III (P < 0.000).Group I and III were with comparable levels (P < 0.807). Conclusions: f/t PSA ratio is not a good discriminator for malignancy and chronic prostatitis. This limitation of f/t PSA ratio must be taken into consideration while interpreting the results clinically. PMID:25494133

  16. 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

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

    2013-01-01

    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

  17. Endovascular Treatment Strategies in Aortoiliac Occlusion

    SciTech Connect

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

    2009-05-15

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

  18. Influence Of Chronic Exercise On Red Cell Antioxidant Defense, Plasma Malondialdehyde And Total Antioxidant Capacity In Hypercholesterolemic Rabbits

    PubMed Central

    Alipour, Mohsen; Mohammadi, Mustafa; Zarghami, Nosratollah; Ahmadiasl, Nasser

    2006-01-01

    Despite the knowledge on the antiatherogenic effects of exercise, the mechanism by which exercise reduces atherogenic risk remains unknown. In this study, we investigated the hypothesis that chronic exercise-induced oxidative stress may increase plasma total antioxidant capacity and antioxidant defense in the red cells. For 8 weeks, 60 male Dutch rabbits were fed rabbit chow with or without the addition of 2% cholesterol. The animals were further divided into rest and exercise groups (n = 15 for each group). Animals in exercise groups ran on a rodent treadmill at 15 m/min for 10 to 60 minutes gradually for 5 days per week for a total of 8 weeks. At the end of experiments, blood samples were collected and glutathione peroxidase (GPX), superoxide dismutase (SOD), and catalase (CAT) activities were determined in red blood cells. Total antioxidant capacity (TAC), malondialdehyde (MDA) and total thiol (T-SH) levels were measured in plasma. Thoracic aorta and carotid arteries were isolated for histological examination to evaluate atherosclerosis. Eight weeks of chronic exercise reduced atherogenic diet-induced atherosclerotic lesions in all the arteries studied, along with positive changes in cholesterol profile, especially increase of serum HDL-C level. Plasma MDA, TAC and T-SH concentrations were enhanced by exercise in both control and hypercholesterolemic diet groups. Erythrocyte catalase activity was significantly increased by chronic exercise (p < 0.05), whereas total SOD activity rose with exercise only in the control group. Surprisingly, GPX activity was significantly reduced (P < 0.05) in response to exercise in the control group and also in the high cholesterol diet group. Exercise is a useful tool for the prevention and regression of atherosclerosis which is evident by our findings of the enhancement of plasma TAC and positive change in serum cholesterol profile. However, the effect of exercise on red cell antioxidant activities is limited in the hypercholesterolemic animals compared to control animals, possibly in part because of alterations in the ability to adapt to exercise-induced oxidative stress in high cholesterol diet. Key Points Plasma MDA, TAC and T-SH concentrations were enhanced by exercise in both control and high cholesterol diet groups. GPX activity was significantly reduced in response to exercise in the control group and also in the high cholesterol diet group. Eight weeks of chronic exercise reduced atherogenic diet-induced atherosclerotic lesions in all the arteries studied. PMID:24357965

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

    PubMed

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

    2007-08-01

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

  20. Synovial C-reactive protein as a marker for chronic periprosthetic infection in total hip arthroplasty.

    PubMed

    Omar, M; Ettinger, M; Reichling, M; Petri, M; Guenther, D; Gehrke, T; Krettek, C; Mommsen, P

    2015-02-01

    The aim of this study was to assess the role of synovial C-reactive protein (CRP) in the diagnosis of chronic periprosthetic hip infection. We prospectively collected synovial fluid from 89 patients undergoing revision hip arthroplasty and measured synovial CRP, serum CRP, erythrocyte sedimentation rate (ESR), synovial white blood cell (WBC) count and synovial percentages of polymorphonuclear neutrophils (PMN). Patients were classified as septic or aseptic by means of clinical, microbiological, serum and synovial fluid findings. The high viscosity of the synovial fluid precluded the analyses in nine patients permitting the results in 80 patients to be studied. There was a significant difference in synovial CRP levels between the septic (n = 21) and the aseptic (n = 59) cohort. According to the receiver operating characteristic curve, a synovial CRP threshold of 2.5 mg/l had a sensitivity of 95.5% and specificity of 93.3%. The area under the curve was 0.96. Compared with serum CRP and ESR, synovial CRP showed a high diagnostic value. According to these preliminary results, synovial CRP may be a useful parameter in diagnosing chronic periprosthetic hip infection. Cite this article: Bone Joint J 2015; 97-B:173-6. PMID:25628278

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

    SciTech Connect

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

    1988-07-01

    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.

  2. Endovascular Treatment of Veno-Occlusive Behcet's Disease

    SciTech Connect

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

    2012-08-15

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

  3. The effects of long-acting bronchodilators on total mortality in patients with stable chronic obstructive pulmonary disease

    PubMed Central

    2010-01-01

    Background Chronic obstructive pulmonary disease (COPD) is the 4th leading cause of mortality worldwide. Long-acting bronchodilators are considered first line therapies for patients with COPD but their effects on mortality are not well known. We performed a comprehensive systematic review and meta-analysis to evaluate the effects of long-acting bronchodilators on total mortality in stable COPD. Methods Using MEDLINE, EMBASE and Cochrane Systematic Review databases, we identified high quality randomized controlled trials of tiotropium, formoterol, salmeterol, formoterol/budesonide or salmeterol/fluticasone in COPD that had a follow-up of 6 months or longer and reported on total mortality. Two reviewers independently abstracted data from the original trials and disagreements were resolved by iteration and consensus. Results Twenty-seven trials that included 30,495 patients were included in the review. Relative risk (RR) for total mortality was calculated for each of the study and pooled together using a random-effects model. The combination of inhaled corticosteroid (ICS) and long-acting beta-2 agonist (LABA) therapy was associated with reduced total mortality compared with placebo (RR, 0.80; p = 0.005). Neither tiotropium (RR, 1.08; p = 0.61) nor LABA by itself (RR, 0.90; p = 0.21) was associated with mortality. Conclusions A combination of ICS and LABA reduced mortality by approximately 20%. Neither tiotropium nor LABA by itself modifies all-cause mortality in COPD. PMID:20459831

  4. Influence of the assay for measuring serum albumin on corrected total calcium in chronic hemodialysis patients.

    PubMed

    Kato, Akihiko; Takita, Takako; Furuhashi, Mitsuyoshi; Fujimoto, Taiki; Suzuki, Hiroo; Hakamada, Masahiro; Maruyama, Yukitaka

    2011-12-01

    The Japanese Society for Dialysis Therapy guideline for secondary hyperparathyroidism recommends the use of albumin-corrected serum Ca as a therapeutic target in chronic hemodialysis patients; however, the assay used for albumin measurement may affect the corrected Ca level. In this study, we examined the impact of the albumin assay on corrected Ca levels in hemodialysis patients. We measured serum albumin using bromocresol green (BCG) and modified bromocresol purple (BCP) assays, and corrected Ca for albumin using Payne's formula in 422 hemodialysis patients (age 66±13 years; time on hemodialysis 116±111 months). Serum albumin values were 3.7±0.4 (1.4-4.6) g/dL by BCG and 3.3±0.4 (1.0-4.3) g/dL by modified BCP, with the differences between the two assays ranging from 0.0 to 0.6 with a mean of 0.35±0.09 g/dL. Serum C-reactive protein and globulin values were significantly higher in patients with differences in albumin greater than 0.5 g/dL (P<0.01). Based on the BCG method, 71 patients (16.8%) were classified with hypocalcemia, 51 (12.1%) with hypercalcemia, and 300 (70.0%) as normocalcemic. In contrast, when using modified BCP, 33 patients (7.9%) were labeled as hypocalcemic, while 92 (21.8%) were hypercalcemic. Depending on the use of either BCG or modified BCP, a discrepancy of classification was observed in 79 patients (18.7%): 41 patients were re-classified from normocalcemic to hypercalcemic, and 38 patients were re-classified from hypocalcemic to normocalcemic by selecting the modified BCP assay. These findings suggest that the type of assay used for albumin measurement has an impact on albumin-corrected Ca levels. PMID:22107690

  5. Total pancreatectomy with islet autotransplantation for chronic pancreatitis: do patients with prior pancreatic surgery have different outcomes?

    PubMed

    Morgan, Katherine A; Theruvath, Tom; Owczarski, Stefanie; Adams, David B

    2012-08-01

    Total pancreatectomy with immediate islet autotransplantation (IAT) can be an effective therapy in patients with chronic pancreatitis. Patient selection criteria for radical resection are not well defined. The impact of prior pancreatic surgery on quality of life outcomes in patients undergoing IAT is evaluated. A retrospective review of a prospectively collected database of patients undergoing pancreatectomy with islet autotransplantation was undertaken. Patients having undergone prior pancreatic resection and/or drainage procedures were compared with those without prior pancreatic operative history. Sixty-one patients underwent pancreatectomy with IAT for pancreatitis. Twenty-three patients had a prior history of pancreatic surgery (Group S); 38 had no prior history of pancreatic surgery (Group NS). Demographics between the groups were similar. Patients in Group S took more daily oral morphine equivalents and had a lower psychological quality of life preoperatively. Operative times and blood loss were similar between the patient groups. Islet yields were lower for patients in Group S. Postoperatively, daily insulin requirements at 6 months and 1 year trended higher in Group S. Postoperative quality of life scores at 6 months were improved and similar between the groups. Quality of life metrics continued to improve beyond 1 year of follow-up, with a trend toward greater improvement in the NS Group. Total pancreatectomy for chronic pancreatitis improves quality of life in patients with and without a prior history of pancreatic surgery. This study demonstrates that IAT without preceding pancreatic surgery may enhance outcomes measured by long term insulin requirements and quality of life. PMID:22856498

  6. Total vertebrectomy for stabilisation of chronic spinal lumbar luxation in a paraplegic dog without nociception.

    PubMed

    Tertuliano Marinho, P V; Zani, C C; De Biasi, F; Bahr Arias, M V

    2014-10-01

    An adult male crossbred dog was referred with a history of a road traffic accident that took place 1 month earlier. Neurological examination revealed paraplegia with absent nociception in the pelvic limbs. On epaxial palpation, significant curvature of the anatomical axis of the spine between the third and fourth lumbar vertebrae was observed, with the presence of a bone end almost piercing the dog's skin. Survey radiographs of the lumbar spine revealed severe dislocation between L3 and L4 vertebrae. During surgery, the spinal cord was not visible between the dislocated segments. Because of difficulties in reducing the lumbar luxation during surgery, vertebrectomy and vertebral shortening were performed. After alignment between vertebrae L3 and L5, eight cortical orthopaedic screws and bone cement were used for fixation. After 30 days, the dog started to use a wheelchair and was considered by its owner to have a good quality of life with no evidence of pain. To the authors' knowledge, this is the first case of severe luxation treated by total vertebrectomy and spine shortening in a dog. This surgery can be considered as an option in the management of severe spine luxation when the spinal cord is physically transected. PMID:24962201

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

    SciTech Connect

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

    1981-12-01

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

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

    NASA Technical Reports Server (NTRS)

    Dijk, Derk-Jan

    1999-01-01

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

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

    PubMed

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

    2014-08-01

    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

  10. Analysis of occlusal variables, dental attrition, and age for distinguishing healthy controls from female patients with intracapsular temporomandibular disorders

    Microsoft Academic Search

    Donald A. Seligman; Andrew G. Pullinger

    2000-01-01

    Statement Of Problem. Confusion about the relationship of occlusion to temporomandibular disorders (TMD) persists. Purpose. This study attempted to identify occlusal and attrition factors plus age that would characterize asymptomatic normal female subjects. Methods And Material. A total of 124 female patients with intracapsular TMD were compared with 47 asymptomatic female controls for associations to 9 occlusal factors, 3 attrition

  11. Journal of Clinical Sleep Medicine Supplement to Vol. 7, No. 5, 2011S19 Neurobehavioral responses to acute total and chronic partial

    E-print Network

    Pennsylvania, University of

    Journal of Clinical Sleep Medicine Supplement to Vol. 7, No. 5, 2011S19 Neurobehavioral responses to acute total and chronic partial sleep deprivation occur in healthy adults and are particularly evident deficits-- such differences are manifested in proportionality between the mean and variance as sleep loss

  12. A New Occlusion Device: Application of the ArtVentive Endoluminal Occlusion System (EOS)—First in Human Clinical Trial

    SciTech Connect

    Venbrux, Anthony C., E-mail: avenbrux@mfa.gwu.edu [The George Washington University Medical Center, Division of Vascular and Interventional Radiology (United States); Rudakov, Leon, E-mail: leonrudakov@artventivemedical.com [Artventive Medical Group, Inc. (United States); Plass, Andre, E-mail: andre.plass@usz.ch; Emmert, Maximilian Y., E-mail: maximilian.emmert@usz.ch [University Hospital Zurich, Clinic for Cardiac and Vascular Surgery (Switzerland); Ebner, Adrian, E-mail: adrianebner@fundacor.com.py [Sanatorio Privado Santa Clara, Cath Lab Department (Paraguay)

    2013-05-24

    PurposeThe purpose of this study was to determine the safety and efficacy of a new endoluminal occlusion device, ArtVentive endoluminal occlusion system (EOS), to occlude the spermatic vein in symptomatic males with varicoceles.MethodsThe ArtVentive EOS device has been developed for percutaneous, peripheral occlusion of the peripheral arterial and venous vasculature. The system is comprised of an implantable occlusion device and a delivery catheter. At present, there are two device sizes: (a) size 1 for target vessels ranging between 3.5 and 5.5 mm in diameter, and (b) size 2 for target vessels 5.5–8.5 mm in diameter. The treatment group included six adult males, ages 22–34 years. Nine target vessels were occluded. A total of 20 devices were implanted in six subjects.ResultsThe acute occlusion rate at the end of the procedure was 100 % occurring in nine of nine vessels. The spermatic veins of all patients remained occluded on venography at 30 days follow-up. Pain scores related to varicoceles decreased in five of six patients.ConclusionsAlthough we recognize this study is limited, initial experience indicates that the ArtVentive EOS is a safe and effective new device for occlusion of vessels (varicoceles). The device has potential applications in other clinical conditions requiring occlusion of veins or arteries.

  13. CHRONIC FEEDING ALCOHOL-CONTAINING DIETS VIA TOTAL ENTERAL NUTRITION INDUCES ALCOHOL DEHYDROGENASE (ADH) AND INSULIN RESISTANCE

    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...

  14. Photoacoustic removal of occlusions from blood vessels

    DOEpatents

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

    2002-01-01

    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.

  15. Perspectives on occlusion and requirements for validation.

    PubMed

    Lansdown, Terry C; Burns, Peter C; Parkes, Andrew M

    2004-05-01

    This paper discusses the limitations and potential of using an occlusion test to assess visual distraction and the suitability of an in-vehicle information system (IVIS) task for driving. This discussion was expanded from issues raised during a UK workshop on occlusion. The paper describes the research history and empirical foundations of occlusion. It describes some of the occlusion technology and applications for this procedure. Issues concerning the occlusion tasks and the duration and timing of occlusion are presented. The main part of this paper focuses on the priority research considerations for occlusion. The paper concludes with a description of some alternatives to occlusion and future research needs. It is concluded that the occlusion test has some promise, however the empirical basis for occlusion is lacking. If occlusion is to be developed as a metric to determine maximal safe visual distraction, substantial barriers remain. PMID:15145285

  16. Total homocysteine levels relation with chronic complications of diabetes, body composition, and other cardiovascular risk factors in a population of patients with diabetes mellitus type 2

    Microsoft Academic Search

    D. A. de Luis; N. Fernandez; M. L. Arranz; R. Aller; O. Izaola; E. Romero

    2005-01-01

    ObjectiveThe significance of hyperhomocysteinemia in type 2 diabetes is further complicated by the multiple ways of considering impaired renal function and vitamin status. The aim of our study was to analyze the relationship between total homocysteine (tHcy) in a population of type 2 diabetic patients and chronic complications. We also analyzed the relationship between tHcy and the body composition of

  17. Sequential bilateral retinal artery occlusion

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2013-01-01

    Summary Background: Successful treatment of chronic occlusion of inferior vena cava (IVC) and iliocaval confluence with angioplasty and stent implantation is very rare. Case Report: We present a case of a 59-year-old patient with iatrogenic occlusion of IVC following L3/L4 discectomy. The wall of the ventral IVC was ruptured during the operation. Results: The torn wall was treated by patch angioplasty, resulting in a permanent IVC occlusion, as confirmed by angiography. Iatrogenic permanent occlusion of IVC was successfully treated with recanalization and implantation of a non-covered aortic stent. PMID:23493805

  19. Bilateral Central Vein Occlusion in a Case of Diaphragmatic Eventration

    PubMed Central

    STER, Anda-Maria; STAN, Cristina; GHERVAN, Mihaela

    2014-01-01

    Central Retinal Vein Occlusion (CRVO) is a severe retinal pathology, which causes visual impairment usually after the age of 40. Mostly unilateral, less than 10% of cases are bilateral. Affected young adults (under the age of 40), usually exhibit a hidden, underlying systemic disease. Thorough testing has to be done in order to spot the pathogenic agent. We present the case of a 25 years old woman with bilateral CRVO caused by Diaphragmatic Eventration and Chronic Respiratory Failure. PMID:25705293

  20. A unified mathematical model to quantify performance impairment for both chronic sleep restriction and total sleep deprivation

    E-print Network

    recovery process after chronic sleep restriction. Our model describes the beneficial effects of banking in revised form 28 February 2013 Accepted 12 April 2013 Available online 24 April 2013 Keywords been shown to result from sleep banking. Published by Elsevier Ltd. 1. Introduction Sleepiness

  1. Comparison of direct and indirect occlusal contact examinations with different clenching intensities.

    PubMed

    Komiyama, O; Obara, R; Iida, T; Asano, T; Masuda, M; Uchida, T; De Laat, A; Kawara, M

    2015-03-01

    The aims of this study were to examine the change of occlusal contact area following the increment of clenching intensity using silicone materials and electromyography (EMG) in normal subjects and to compare direct intra-oral examination with indirect examination using dental casts mounted by means of two impression methods. Participants were 7 men and 5 women with no more than one missing tooth per quadrant and no pain in the head and neck region. During the task, intercuspal position was maintained with minimal force, 20% maximum voluntary contraction (MVC) and 40% MVC using electromyography visual feedback. Three types of occlusal contact examinations were performed with the aid of blue silicone material in randomised order: (i) intra-oral direct occlusal contact examination (DE), (ii) indirect occlusal contact examination with dental casts using conventional impression method (IEC) and (iii) using occlusal impression method (IEO). Total occlusal contact area during DE and IEO significantly increased from baseline to 20% MVC and from baseline to 40% MVC, but not during IEC. Total occlusal contact area during DE in all tooth clenching conditions was significantly larger compared to IEO and IEC (P < 0·05). At 40% MVC, total occlusal contact area during IEO was significantly larger than during IEC (P < 0·05). These findings suggest that indirect occlusal contact examinations may not accurately reflect the intra-oral occlusal condition. If the intra-oral condition is reproduced using dental casts, these findings also suggest the occlusal impression method was more accurate compared to the conventional method (240 words). PMID:25270097

  2. Endoluminal occlusion devices: technology update

    PubMed Central

    Zander, Tobias; Medina, Samantha; Montes, Guillermo; Nuñez-Atahualpa, Lourdes; Valdes, Michel; Maynar, Manuel

    2014-01-01

    Endoluminal occlusion has been performed since the early beginning of interventional radiology. Over recent decades, major technological advances have improved the techniques used and different devices have been developed for changing conditions. Most of these occlusion devices have been implemented in the vascular territory. Early embolization materials included glass particles, hot contrast, paraffin, fibrin, and tissue fragments such as muscle fibers and blood clots; today, occlusion materials include metallic devices, particles, and liquid materials, which can be indicated for proximal or distal occlusion, high-flow and low-flow situations, and in large-caliber and small-caliber vessels, based on need. Technological progress has led to a decreased size of delivery catheters, and an increase in safety due to release systems that permit the withdrawing and replacement of embolization material. Furthermore, bioactive embolization materials have been developed to increase the efficacy of embolization or the biological effect of medication. Finally, materials have been modified for changing indications. Intravascular stents were initially developed to keep an artery open; however, by adding a covering membrane, these stents can be used to occlude the wall of a vessel or other endoluminal structures. This article gives an overview of the devices most utilized for occlusion of endoluminal structures, as well as their major purpose in the endovascular territory. PMID:25489252

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

    ClinicalTrials.gov

    2014-05-22

    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

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

    PubMed

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

    2008-04-01

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

  5. Occlusive versus nonocclusive calcipotriol ointment treatment for palmoplantar psoriasis.

    PubMed

    Duweb, G A; Abuzariba, O; Rahim, M; al-Taweel, M; al-Alem, S; Abdulla, S A

    2001-01-01

    Thirty-nine patients with a clinical diagnosis of palmoplantar psoriasis [23 (58%) males and 16 (42%) females] were included in this study with the aim of evaluating the efficacy of occlusive calcipotriol 50 micrograms/mg ointment vs. nonocclusive therapy. Patients were randomized to either twice-weekly overnight calcipotriol ointment under occlusion or twice-daily topical nonocclusive application of the same ointment for 6 weeks. The effect of treatment was assessed on the basis of a psoriasis signs score for erythema, thickness and scaliness, which was graded from 0 (absent) to 4 (most severe) at the first visit, after 2 weeks and at the end of treatment. Analysis of our results showed that twice-weekly occlusive calcipotriol ointment was as effective as the twice-daily application. The mean total score at baseline was 6 for the occlusive group and 6.1 for the nonocclusive group. The score decreased to 1.5 in both groups at the end of treatment. No significant adverse effects were reported by patients or investigators. We conclude that occlusive calcipotriol ointment is effective in the treatment of palmoplantar psoriasis and may produce even better results with more frequent use, such as application on alternate days. PMID:11447774

  6. Partial Occlusion Drawing in Autistic Children 

    E-print Network

    Hodgson, Eleanor

    INTRODUCTION: Partial occlusion drawing in autistic individuals has received little attention in previous research. In normally developing children field independence is positively correlated with partial occlusion drawing (Morra et al., 1996...

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

    PubMed

    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

    2015-03-01

    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

  8. Images from self-occlusion

    Microsoft Academic Search

    Marc Alexa; Wojciech Matusik

    2011-01-01

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

  9. Common Carotid Artery Occlusion: A Case Series

    PubMed Central

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

    2013-01-01

    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

  10. Intractable pneumothorax managed by talc pleurodesis and bronchial occlusion with spigots

    PubMed Central

    Ishida, Atsuko; Kida, Hirotaka; Muraoka, Hiromi; Nishine, Hiroki; Mineshita, Masamichi; Miyazawa, Teruomi

    2015-01-01

    Three cases of inoperable secondary spontaneous pneumothorax were diagnosed in patients with chronic obstructive pulmonary disease. Two cases initially underwent bronchial occlusion with endobronchial Watanabe spigot (EWS), while one underwent talc poudrage with pleuroscopy. As air leaks were not stopped completely in all cases with the initial procedures, we performed additional interventional treatments: pleuroscopic talc poudrage in cases when bronchial occlusion was performed first; and bronchial occlusion with EWS for a case that initially underwent talc pleurodesis. The air leaks ceased in all cases without complication. We successfully removed chest tubes 2–10 days after secondary procedure, which was 10–23 days after the first procedure. The combination of talc pleurodesis and bronchial occlusion with EWS, when a single, initial interventional treatment fails, can be considered in cases of intractable, inoperable secondary pneumothorax. PMID:25802742

  11. Direct Pressure Monitoring Accurately Predicts Pulmonary Vein Occlusion During Cryoballoon Ablation

    PubMed Central

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

    2013-01-01

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

  12. Influence of different narrative instructions to record the occlusal contact with silicone registration materials.

    PubMed

    Obara, R; Komiyama, O; Iida, T; Asano, T; De Laat, A; Kawara, M

    2014-03-01

    This study examined the influence of narrative instructions on the occlusal contact area, occlusal contact point and masticatory muscle activities in normal subjects. Twelve healthy men and 12 healthy women with no more than one missing tooth per quadrant participated. Surface EMG was recorded from the masseter and temporal muscle. As a control measurement, intercuspal position was maintained to produce a habitual clenching record (NCR) while the occlusal contact area and occlusal contact point was recorded by means of silicone material. Subsequently, the occlusal contact area was recorded with the narrative instruction for minimum clenching record (MCR), light clenching record (LCR) and strong clenching record (HCR). While the EMG activity (%MVC) increased modestly from MCR to LCR (from 9·3 ± 2·0% to 11·5 ± 1·5%), the occlusal contact area increased rapidly (from 17·2 ± 11·3 mm(2) to 26·8 ± 15·6 mm(2) ) (P < 0·05). Both EMG activity and occlusal contact area increased gradually from LCR to NCR (to 17·7 ± 2·0% and to 31·4 ± 14·2 mm(2) , respectively). Finally, EMG activity still increased from NCR to HCR (to 44·5 ± 3·7%) (P < 0·05), but the occlusal contact area remained stable (to 36·8 ± 16·6 mm(2) ). Occlusal contact points at left posterior, right posterior, anterior and total area were not significantly different between each task. This study showed that narrative instructions while recording the bite can result in largely stable occlusal contact area. An adequate narrative instruction may therefore contribute to taking a stable occlusal recording in natural dentition. PMID:24447195

  13. Three hypothesis algorithm with occlusion reasoning for multiple people tracking

    NASA Astrophysics Data System (ADS)

    Reta, Carolina; Altamirano, Leopoldo; Gonzalez, Jesus A.; Medina-Carnicer, Rafael

    2015-01-01

    This work proposes a detection-based tracking algorithm able to locate and keep the identity of multiple people, who may be occluded, in uncontrolled stationary environments. Our algorithm builds a tracking graph that models spatio-temporal relationships among attributes of interacting people to predict and resolve partial and total occlusions. When a total occlusion occurs, the algorithm generates various hypotheses about the location of the occluded person considering three cases: (a) the person keeps the same direction and speed, (b) the person follows the direction and speed of the occluder, and (c) the person remains motionless during occlusion. By analyzing the graph, our algorithm can detect trajectories produced by false alarms and estimate the location of missing or occluded people. Our algorithm performs acceptably under complex conditions, such as partial visibility of individuals getting inside or outside the scene, continuous interactions and occlusions among people, wrong or missing information on the detection of persons, as well as variation of the person's appearance due to illumination changes and background-clutter distracters. Our algorithm was evaluated on test sequences in the field of intelligent surveillance achieving an overall precision of 93%. Results show that our tracking algorithm outperforms even trajectory-based state-of-the-art algorithms.

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

    PubMed Central

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

    1993-01-01

    OBJECTIVE--To prove the safety and effectiveness of high frequency rotational ablation of coronary artery stenoses and occlusion in humans. SUBJECTS--106 patients with symptoms (91 men, 15 women) who had 67 significant stenoses, mainly types B and C, and 46-chronic occlusions. MAIN OUTCOME MEASURES--Mean change in diameter stenosis after rotational angioplasty alone and in combination with percutaneous transluminal coronary angioplasty immediately after treatment and 24 hours and six months later; restenosis rates at six months; complication of treatment. RESULTS--Rotational ablation could not be used in five stenoses and 16 chronic occlusions because of inability to reach or cross the lesion with the Rotablator guide wire. In four cases rotational ablation failed. Initial angiographic and clinical success by rotational ablation was achieved in 40 of the 67 stenoses (60%) and in 18 of the 46 chronic occlusions (39%). Additional balloon angioplasty was performed in 45 patients, increasing the success rates to 79% and 54%, respectively. In the 62 stenoses treated by rotational ablation the angiographic diameter stenoses were reduced from 76% (SD 14%) to 32% (14%) after Rotablator treatment alone and from 75% (11%) to 33% (17%) with additional balloon angioplasty. In the 30 chronic occlusions treated by rotational ablation the angiographic diameter stenoses were reduced to 38% (18%). At six months angiographic restenosis was evident in nine of the 25 (36%) stenoses treated with rotational ablation alone, in seven of the 22 (32%) stenoses treated with rotational and balloon angioplasty, and in 14 of the 24 (58%) chronic occlusions. There were no procedural deaths and two patients (2%) underwent emergency coronary artery bypass grafting. Although no transmural infarction occurred, there were five (6%) non-Q wave infarctions (two embolic side branch occlusions, two subacute occlusions, and one acute occlusion). Clinically insignificant slight increases in creatine kinase activity were seen in five patients (6%). Severe coronary artery spasm unresponsive to medical treatment was provoked in seven cases (8%). CONCLUSIONS--High frequency rotational ablation is a safe and effective method for treating type B and C coronary artery lesions with results comparable to percutaneous transluminal coronary balloon angioplasty. The combined use of rotational ablation and balloon angioplasty is feasible and is necessary in about half of all procedures, in most cases because the lumen created by the biggest burr is too small. Images PMID:8217440

  15. Resolution of Inferior venous baffle leak and total venous occlusion using a bare stent and the gore® excluder® aortic extension in transposition of the great arteries after mustard procedure.

    PubMed

    Ross, Michael M; Schamberger, Marcus S; Hoyer, Mark H

    2014-06-27

    We present a patient with a history of Mustard repair for transposition of the great arteries. The patient presented with complete inferior venous baffle obstruction and a large baffle leak after several years of cyanosis. Complete relief of the obstruction and exclusion of the baffle leak were accomplished with the use of a combination of bare metal stenting and the Gore® Excluder® aortic extender. To our knowledge this represents the first reported use of the Gore® Excluder® aortic extender in the setting of inferior venous baffle leak and associated total inferior vena cava obstruction. © 2014 Wiley Periodicals, Inc. PMID:24976189

  16. Retinal vein occlusion: current treatment.

    PubMed

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

    2011-01-01

    Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is very complex and a multidisciplinary approach is required in order to identify and correct the associated risk factors. Laser therapy remains the gold standard in RVO, but only modest functional improvement has been shown in branch retinal occlusion forms. Multicenter studies of intravitreal drugs present them as an option to combine with laser. Anti-vascular endothelial growth factor, corticosteroids and sustained-release implants are the future weapons to stop disease progression and get a better visual outcome. Consequently, it is useful to clarify some aspects of the pathology that allow a better patient management. PMID:20938213

  17. Vascular tumors simulating occlusive disease.

    PubMed

    Schröder, A; Peters, A; Riepe, G; Larena, A; Meierling, S; Mentzel, T; Katenkamp, D; Imig, H

    2001-02-01

    Two cases of vascular tumors of large vessels with intraluminal growth simulating venous thrombosis and arterial occlusive disease are reported. One was a borderline malignant epithelioid hemangioendothelioma of the femoral vein and the other a malignant epithelioid angiosarcoma of the carotid artery. Immunohistochemical studies permitted to classify the tumors. Treatment consisted in surgical resection. No recurrence and no metastasis are noted at 24 months. Uncertainty regarding biological behaviour of vascular tumors and treatment persists. PMID:11284093

  18. Pulmonary Veno-occlusive Disease

    Microsoft Academic Search

    Peter F. Clardy; Jess Mandel

    \\u000a Pulmonary veno-occlusive disease (PVOD) is a rare and highly lethal disorder of the pulmonary vasculature. In contrast to\\u000a the insights into pathophysiology and management that have characterized the diagnosis and treatment of idiopathic pulmonary\\u000a arterial hypertension (IPAH; formerly known as primary pulmonary hypertension) over the past decade, the pathophysiologic\\u000a mechanisms underlying PVOD are incompletely understood, the clinical diagnosis is notoriously

  19. Aortitis and aortic occlusion in Crohn disease.

    PubMed

    Delay, Charline; Schwein, Adeline; Lejay, Anne; Gaertner, Sébastien; Aleil, Boris; Thaveau, Fabien; Georg, Yannick; Chakfe, Nabil

    2015-02-01

    Patients with Crohn disease (CD) or ulcerative colitis are known to be at increased risk of arterial thromboembolic complications. We report the case of a 33-year-old woman suffering from CD for 19 years who presented lower limb claudication. Computed tomography scan revealed an aortoiliac occlusion extending from the level of the inferior mesenteric artery to both iliac bifurcations. Endovascular recanalization was attempted as a first option but failed. We then performed an aortobi-femoral bypass through a left retroperitoneal approach that allowed a total relief of the symptoms. Histologic study of the aorta demonstrated a nonspecific aortitis with lymphohistiocytic cell infiltration in the media and adventitia tunica. There was no signs of associated vasculitis. At the light of a literature review, we discussed our surgical strategy and the inflammation of the aortic wall as local factor of thrombosis that has never been previously described. PMID:25463334

  20. Serotonin-immune interactions in detoxified chronic alcoholic patients without apparent liver disease: activation of the inflammatory response system and lower plasma total tryptophan.

    PubMed

    Maes, M; Lin, A; Bosmans, E; Vandoolaeghe, E; Bonaccorso, S; Kenis, G; De Jongh, R; Verkerk, R; Song, C; Scharpé, S; Neels, H

    1998-05-01

    The aims of the present study were to examine (1) the inflammatory response system (IRS), through measurements of serum interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), sgp130 (the soluble form of the IL-6 transducer signal protein), CC16 (Clara Cell protein; an endogenous anti-cytokine), IL-1R antagonist (IL-1RA), IL-8 and sCD14; and (2) the availability of plasma total tryptophan to the brain in chronic alcoholic patients without apparent liver disease (AWLD). Detoxified AWLD patients had significantly lower plasma tryptophan and serum CC16 and significantly higher serum IL-1RA and IL-8 concentrations than normal volunteers. There were significant correlations between the availability of tryptophan to the brain and serum IL-6, IL-8 and IL-1RA (all negative) and CC16 (positive). The results suggest that (1) there is, in detoxified AWLD patients, an activation of the monocytic arm of cell-mediated immunity and a lowered anti-inflammatory capacity of the serum; and that (2) lower availability of plasma tryptophan to the brain in detoxified AWLD patients is related to activation of the IRS. Lower CC16 may be one factor predisposing chronic alcoholic patients toward infectious disorders. PMID:9657419

  1. Early Detection of Complete Vascular Occlusion in a Pedicle Flap Model Using Quantitation Spectral Imaging

    PubMed Central

    Pharaon, Michael R.; Scholz, Thomas; Bogdanoff, Scott; Cuccia, David; Durkin, Anthony J.; Hoyt, David B.; Evans, Gregory R. D.

    2012-01-01

    Background Vascular occlusion after tissue transfer is a devastating complication that can lead to complete flap loss. Spatial frequency domain imaging is a new, noncontact, noninvasive, wide-field imaging technology capable of quantifying oxygenated and deoxygenated hemoglobin levels, total hemoglobin, and tissue saturation. Methods Pedicled fasciocutaneous flaps on Wistar rats (400 to 500 g) were created and underwent continuous imaging using spatial frequency domain imaging before and after selective vascular occlusion. Three flap groups (control, selective arterial occlusion, and selective venous occlusion) and a fourth group composed of native skin between the flaps were measured. Results There were no statistically significant differences between the control flap group and the experimental flap groups before selective vascular occlusion: oxyhemoglobin (p = 0.2017), deoxyhemoglobin (p = 0.3145), total hemoglobin (p = 0.2718), and tissue saturation,(p = 0.0777). In the selective arterial occlusion flap group, percentage change in total hemoglobin was statistically different from that of the control flap group (p = 0.0218). The remaining parameters were not statistically different from those of the control flap: percentage change in oxyhemoglobin (p = 0.0888), percentage change in deoxyhemoglobin (p = 0.5198), and percentage change in tissue saturation (p = 0.4220). The selective venous occlusion flap group demonstrated changes statistically different compared with the control flap group: percentage change in oxyhemoglobin (p = 0.0029) and deoxyhemoglobin, total hemoglobin, and tissue saturation (p < 0.0001). Conclusions Spatial frequency domain imaging provides two-dimensional, spatially resolved maps of tissue oxyhemoglobin, deoxyhemoglobin, total hemoglobin, and tissue saturation. Results presented here indicate that this can be used to quantify and detect physiologic changes that occur after arterial and venous occlusion in a rodent tissue transfer flap model. This portable, noncontact, noninvasive device may have a high clinical applicability in monitoring postoperative patients. PMID:21124132

  2. Association between near occlusal contact areas and mixing ability.

    PubMed

    Horie, T; Kanazawa, M; Komagamine, Y; Hama, Y; Minakuchi, S

    2014-11-01

    This study investigated the relationship between occlusal contact and near contact areas defined by clenching intensity using electromyograms (EMGs) and mixing ability assessed with colour-changeable chewing gum. Participants comprised 44 dentate adults (24 men, 20 women) with a mean age of 28·2 ± 6·8 years. Silicone material was used to measure the occlusal contact and near contact areas (the area of each type of tooth, the total area of the first molar and second molar, the second premolar to the second molar and the first premolar to the second molar) defined by clenching intensity at 10% maximum voluntary contraction (MVC). Colour-changeable chewing gum was used to assess mixing ability. A colorimeter was used to measure colour changes, and the calculated colour difference (?E) was used as a measure of mixing ability. Correlation analysis of ?E and occlusal contact and near contact areas revealed a significant positive correlation of 0·47 at 0-160 ?m thicknesses of the silicone registration material of the second molar (P < 0·01). The near contact area with a thickness up to 200 ?m was correlated with mixing ability, with the correlation strengthening as the interocclusal distance increased up to 160 ?m. Notably, occlusal contact and near contact areas of the second molar were strongly correlated with mixing ability in dentate adults. PMID:25155067

  3. Occlusal considerations in implantology: good occlusal practice in implantology.

    PubMed

    Davies, S J

    2011-03-01

    This article is concerned with implants that are being used for fixed crown and bridgework rather than removable prostheses. The huge increase in the provision of implants over the past two decades is set to continue. Most of the research is related to avoiding failures in implants. This research, in the main, has concentrated on the essential interface between the artificial implant and living bone: osseointegration. The other interface, which is worthy of our full attention, is the one between the implant-supported crown and the antagonist tooth: the occlusion. PMID:21608499

  4. Comorbidities in combined retinal artery and vein occlusions

    PubMed Central

    2013-01-01

    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

  5. ACUTE RETINAL ARTERIAL OCCLUSIVE DISORDERS

    PubMed Central

    Hayreh, Sohan Singh

    2011-01-01

    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

  6. Total Proteome Analysis Identifies Migration Defects as a Major Pathogenetic Factor in Immunoglobulin Heavy Chain Variable Region (IGHV)-unmutated Chronic Lymphocytic Leukemia*

    PubMed Central

    Eagle, Gina L.; Zhuang, Jianguo; Jenkins, Rosalind E.; Till, Kathleen J.; Jithesh, Puthen V.; Lin, Ke; Johnson, Gillian G.; Oates, Melanie; Park, Kevin; Kitteringham, Neil R.; Pettitt, Andrew R.

    2015-01-01

    The mutational status of the immunoglobulin heavy chain variable region defines two clinically distinct forms of chronic lymphocytic leukemia (CLL) known as mutated (M-CLL) and unmutated (UM-CLL). To elucidate the molecular mechanisms underlying the adverse clinical outcome associated with UM-CLL, total proteomes from nine UM-CLL and nine M-CLL samples were analyzed by isobaric tags for relative and absolute quantification (iTRAQ)-based mass spectrometry. Based on the expression of 3521 identified proteins, principal component analysis separated CLL samples into two groups corresponding to immunoglobulin heavy chain variable region mutational status. Computational analysis showed that 43 cell migration/adhesion pathways were significantly enriched by 39 differentially expressed proteins, 35 of which were expressed at significantly lower levels in UM-CLL samples. Furthermore, UM-CLL cells underexpressed proteins associated with cytoskeletal remodeling and overexpressed proteins associated with transcriptional and translational activity. Taken together, our findings indicate that UM-CLL cells are less migratory and more adhesive than M-CLL cells, resulting in their retention in lymph nodes, where they are exposed to proliferative stimuli. In keeping with this hypothesis, analysis of an extended cohort of 120 CLL patients revealed a strong and specific association between UM-CLL and lymphadenopathy. Our study illustrates the potential of total proteome analysis to elucidate pathogenetic mechanisms in cancer. PMID:25645933

  7. Effect of total lymphoid irradiation on functional status in chronic multiple sclerosis: importance of lymphopenia early after treatment--the pros

    SciTech Connect

    Devereux, C.; Troiano, R.; Zito, G.; Devereux, R.B.; Kopecky, K.J.; Friedman, R.; Dowling, P.C.; Hafstein, M.P.; Rohowsky-Kochan, C.; Cook, S.D.

    1988-07-01

    To determine whether immunosuppression by total lymphoid irradiation (TLI) slowed deterioration of chronic progressive multiple sclerosis (MS), functional impairment score and blood lymphocyte counts were compared at 6-month intervals through 4 years following treatment of MS patients by either TLI (n = 27) or sham irradiation (n = 21). At each interval, 20 to 30% fewer TLI-treated patients had deteriorated (p less than 0.05 at 6, 12, and 18 months), and the difference in mean functional impairment score between groups became progressively greater (p less than 0.01 at 42 and 48 months). Benefit accrued principally to the 17 TLI-treated patients with absolute blood lymphocyte counts less than 900/mm3 3 months after treatment, whose mean functional impairment score remained within 0.6 units of baseline (p = NS), whereas the ten TLI patients with higher post-treatment lymphocyte counts had progressive deterioration (p less than 0.05 to p less than 0.001 versus TLI-treated patients with lower lymphocyte counts at all intervals except 30 months) and had deteriorated by more than 5 functional scale units by 42 and 48 months. Side effects were minor and complications rare in TLI-treated patients, but one TLI-treated patient developed staphylococcal sepsis. Thus, TLI slows deterioration of chronic progressive MS, with what appears to be enduring benefit through 4 years compartmented to patients with greater induced lymphopenia. Modification of lymphoid irradiation regimens to increase the proportion of MS patients who achieve a favorable degree of lymphopenia and to avert functional hyposplenism may further improve the benefit/risk ratio.

  8. Rationale and design of the Left Atrial Appendage Occlusion Study (LAAOS) III

    PubMed Central

    Healey, Jeff; Vincent, Jessica; Brady, Kate; Teoh, Kevin; Royse, Alistair; Shah, Pallav; Guo, Yingqiang; Alings, Marco; Folkeringa, Richard J.; Paparella, Domenico; Colli, Andrea; Meyer, Steven R.; Legare, Jean-François; Lamontagne, François; Reents, Wilko; Böning, Andreas; Connolly, Stuart

    2014-01-01

    Background Occlusion of the left atrial appendage (LAA) is a promising approach to stroke prevention in atrial fibrillation (AF). However, evidence of its efficacy and safety to date is lacking. We herein describe the rationale and design of a definitive LAA occlusion trial in cardiac surgical patients with AF. Methods We plan to randomize 4,700 patients with AF in whom on-pump cardiac surgical procedure is planned to undergo LAA occlusion or no LAA occlusion. The primary outcome is the first occurrence of stroke or systemic arterial embolism over a mean follow-up of four years. Other outcomes include total mortality, operative safety outcomes (chest tube output in the first post-operative 24 hours, rate of post-operative re-exploration for bleeding in the first 48 hours post-surgery and 30-day mortality), re-hospitalization for heart failure, major bleed, and myocardial infarction. Results Left Atrial Appendage Occlusion Study (LAAOS) III is funded in a vanguard phase by the Canadian Institutes for Health Research (CIHR), the Canadian Network and Centre for Trials Internationally, and the McMaster University Surgical Associates. As of September 9, 2013, 162 patients have been recruited into the study. Conclusions LAAOS III will be the largest trial to explore the efficacy of LAA occlusion for stroke prevention. Its results will lead to a better understanding of stroke in AF and the safety and efficacy of surgical LAA occlusion. PMID:24516797

  9. Sickle cell vaso-occlusion.

    PubMed

    Fabry, M E; Kaul, D K

    1991-06-01

    A polymerizable cell is a requirement for sickle cell vaso-occlusion, but other factors clearly modulate the course of the disease. Hemolysis produces a young red cell population that is capable of adhesion and may result in polymer formation in cells that would otherwise have remained deformable during transit through the microcirculation owing to prolonged delay time for polymerization. In addition, a young red cell population will have a higher activity of K:Cl cotransport, which is capable of rapidly dehydrating cells under acid conditions, thus promoting a vicious circle of hemolysis and adhesion. Transient occlusion may stimulate the release of vasoactive substances, which may lead to involvement of a larger area. In the past, research aimed at reducing the incidence of painful crisis was primarily focused on antisickling agents. Currently, hydroxyurea, which increases the level of fetal hemoglobin, which may be described as a natural antisickling agent, is undergoing clinical trials. Future research may involve agents that inhibit sickle cell adhesion, K:Cl cotransport, or vasoactive substances. PMID:1864816

  10. The occlusion rate and patterns of saphenous vein after radiofrequency ablation

    PubMed Central

    Choi, Jung Hyun; Park, Ho-Chul

    2013-01-01

    Purpose Radiofrequency ablation (RFA) is a widely accepted to treat the varicose vein. However, outcome studies for occlusion rate and patterns of the saphenous vein after RFA are scarce. The purpose of our study is to report the results of RFA in patients with varicose vein. Methods We retrospectively reviewed the clinical outcomes after RFA using ClosureFAST (Covidien) catheter. We evaluated the occlusion rate and patterns with duplex scanning after RFA. Results A total of 200 limbs (148 patients) underwent RFA. The truncal veins were ablated in 163 great saphenous veins (GSV) and 41 small saphenous veins (SSVs). The mean age was 52.1 ± 11.9 years and female to male ratio was 125 : 87. At the mean follow-up of 13.9 months, the CEAP score, VCSS, and QoL score were significantly improved 2.33 ± 0.78 to 1.29 ± 0.96 (P < 0.0001), 3.48 ± 0.98 to 0.63 ± 1.16 (P < 0.0001), and 6.91 ± 6.69 to 3.38 ± 4.74 (P < 0.0001), respectively. The occlusion rate was 94.6% (53/56) in GSV and 94.5% (17/18) in SSV. The most common occlusion pattern in GSV was total occlusion of main trunk with patent superficial inferior epigastric vein in 41.1%. And, the most common pattern in SSV was the total occlusion of SSV with stump in 66.7%. Conclusion RFA is an effective modality in the treatment of varicose vein. At the mean follow-up of 13.9 months, the occlusion rate was 94.6%in GSV and 94.5% in SSV. There are several patterns of saphenous occlusion after RFA. PMID:23397027

  11. Approximate Ambient Occlusion For Trees Kyle Hegeman

    E-print Network

    Paris-Sud XI, Université de

    Approximate Ambient Occlusion For Trees Kyle Hegeman Stony Brook University Simon Premoze Michael- proximation to integrated visibility over a hemisphere (ambient oc- clusion) that allows interactive rendering approximation to full global illumination which has be- come quite popular is ambient occlusion [Christensen

  12. Acute occlusion of the abdominal aorta

    Microsoft Academic Search

    Scott M. Surowiec; Halit Isiklar; Suha Sreeram; Victor J. Weiss; Alan B. Lumsden

    1998-01-01

    Background: Acute aortic occlusion most commonly results from aortic saddle embolus or thrombosis of an atherosclerotic abdominal aorta. The purpose of this study was to review the experience at a university hospital to better define the diagnosis and management of this uncommon process.Methods: A retrospective chart review was performed from patients admitted to Emory University Hospital with acute occlusion of

  13. The effect of occlusal forces on restorations.

    PubMed

    Larson, Thomas D

    2012-01-01

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

  14. The effect of occlusal forces on restorations.

    PubMed

    Larson, Thomas D

    2014-09-01

    This review will focus on the effect occlusal forces, both normal masticatory force and paranormal bruxing and clenching force, have on various restorative materials and their interaction with the teeth through a variety of bonding mechanisms. Salient physical properties of each of the materials will be reviewed, as well as the effect occlusal force has on restoration durability. PMID:25318197

  15. Robust Multiple Car Tracking with Occlusion Reasoning

    Microsoft Academic Search

    Dieter Koller; Joseph Weber; Jitendra Malik

    1994-01-01

    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

  16. Bilateral mechanical rotational vertebral artery occlusion.

    PubMed

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

    2013-10-01

    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

  17. Long-term ambient concentrations of total suspended particulates and oxidants as related to incidence of chronic disease in California Seventh-Day Adventists.

    PubMed Central

    Abbey, D E; Mills, P K; Petersen, F F; Beeson, W L

    1991-01-01

    Cancer incidence and mortality in a cohort of 6000 nonsmoking California Seventh-Day Adventists were monitored for a 6-year period, and relationships with long-term cumulative ambient air pollution were observed. Total suspended particulates (TSP) and ozone were measured in terms of numbers of hours in excess of several threshold levels corresponding to national standards as well as mean concentration. For all malignant neoplasms among females, risk increased with increasing exceedance frequencies of all thresholds of TSP except the lowest one, and those increased risks were highly statistically significant. For respiratory cancers, increased risk was associated with only one threshold of ozone, and this result was of borderline significance. Respiratory disease symptoms were assessed in 1977 and again in 1987 using the National Heart, Lung and Blood Institute respiratory symptoms questionnaire on a subcohort of 3914 individuals. Multivariate analyses which adjusted for past and passive smoking and occupational exposures indicated statistically significantly (p less than 0.05) elevated relative risks ranging up to 1.7 for incidence of asthma, definite symptoms of airway obstructive disease, and chronic bronchitis with TSP in excess of all thresholds except the lowest one but not for any thresholds of ozone. A trend association (p = 0.056) was noted between the threshold of 10 pphm ozone and incidence of asthma. These results are presented within the context of standards setting for these constituents of air pollution. PMID:1954938

  18. Occlusion for stimulus deprivation amblyopia

    PubMed Central

    Antonio-Santos, Aileen; Vedula, Satyanarayana S; Hatt, Sarah R; Powell, Christine

    2014-01-01

    Background Stimulus deprivation amblyopia (SDA) develops due to an obstruction to the passage of light secondary to a condition such as cataract. The obstruction prevents formation of a clear image on the retina. SDA can be resistant to treatment, leading to poor visual prognosis. SDA probably constitutes less than 3% of all amblyopia cases, although precise estimates of prevalence are unknown. In developed countries, most patients present under the age of one year; in less developed parts of the world patients are likely to be older at the time of presentation. The mainstay of treatment is removal of the cataract and then occlusion of the better-seeing eye, but regimens vary, can be difficult to execute, and traditionally are believed to lead to disappointing results. Objectives Our objective was to evaluate the effectiveness of occlusion therapy for SDA in an attempt to establish realistic treatment outcomes. Where data were available, we also planned to examine evidence of any dose response effect and to assess the effect of the duration, severity, and causative factor on the size and direction of the treatment effect. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2013), EMBASE (January 1980 to October 2013), the Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to October 2013), PubMed (January 1946 to October 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 28 October 2013. Selection criteria We planned to include randomized and quasi-randomized controlled trials of participants with unilateral SDA with visual acuity worse than 0.2 LogMAR or equivalent. We did not specify any restrictions for inclusion based upon age, gender, ethnicity, co-morbidities, medication use, or the number of participants. Data collection and analysis Two review authors independently assessed study abstracts identified by the electronic searches. Main results We did not identify any trials that met the inclusion criteria specified in the protocol for this review. Authors’ conclusions We found no evidence on the effectiveness of any treatment for SDA. Future randomized controlled trials are needed in order to evaluate the safety and effectiveness of occlusion, duration of treatment, level of vision that can be realistically achieved, effects of age at onset and magnitude of visual defect, optimum occlusion regimen, and factors associated with satisfactory and unsatisfactory outcomes with the use of various interventions for SDA. PMID:24504975

  19. Special report: Occlusive cuff controller

    NASA Technical Reports Server (NTRS)

    Baker, J. T.

    1975-01-01

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

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

    SciTech Connect

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

    1981-12-01

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

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

    SciTech Connect

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

    2010-02-15

    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.

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

    PubMed Central

    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

    2015-01-01

    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

  3. The impact of hypoxemia on serum total and free prostate-specific antigen levels in patients with chronic obstructive pulmonary disease.

    PubMed

    Ozge, Cengiz; Bozlu, Murat; Ozgur, Eylem Sercan; Tek, Mesut; Tunckiran, Ahmet; Muslu, Necati; Ilvan, Ahmet

    2015-05-01

    Prostate-specific antigen (PSA) is the most important biochemical marker in the diagnosis and follow-up of patients with prostate cancer. In recent years, a relationship between PSA levels and hypoxic conditions has been described. However, no study has investigated the PSA levels in patients with chronic obstructive pulmonary disease (COPD). The aim of the present study was to investigate the impact of hypoxemia on serum total (tPSA) and free PSA (fPSA) levels in patients with COPD. Between January 2010 and January 2014, 95 male patients who hospitalized for acute exacerbations of COPD and 80 control subjects were enrolled in the study. Serum tPSA and fPSA levels and f/tPSA ratios were determined in all patients on the first day of hospitalization (exacerbation) and 7 days after the treatment (stable state). Statistical analysis included paired t test and Mann-Whitney U test. No statistically significant differences were found between COPD and control groups with regard to the baseline characteristics, except for smoking status. The levels of serum tPSA and fPSA during exacerbation of COPD were significantly higher than the levels of the stable period (p < 0.01), whereas f/tPSA ratio did not change (p > 0.05). Hypoxemia during acute exacerbation of COPD can cause a rise in serum tPSA and fPSA levels, but f/tPSA ratio is not affected. Acute exacerbation of COPD may be added to list of the events in which PSA measurements must be interpreted with caution. PMID:25837435

  4. Chronic pancreatitis

    PubMed Central

    DiMagno, Matthew J.; DiMagno, Eugene P.

    2015-01-01

    Purpose of review We review selected important clinical observations reported in 2012. Recent findings Celiac disease is a risk factor for pancreatitis. Patients with recurrent acute pancreatitis likely have chronic pancreatitis, do not benefit from pancreatic sphincterotomy, and may not benefit from biliary sphincterotomy. Analysis of endoscopic ultrasonography (EUS) images with an artificial neural network (ANN) program may improve chronic pancreatitis diagnosis compared with clinical interpretation of images. In a multicenter, randomized controlled trial of chronic pancreatitis patients, 90 000 USP U of pancreatin with meals decreased fat malabsorption compared with placebo. Detection of visceral pain in chronic pancreatitis predicts pain relief from various treatments, but nonvisceral pain due to altered central pain processing may respond to agents such as pregabalin. Predictors of surgical pain relief include onset of symptoms less than 3 years and preoperatively no opioid use and less than five endoscopic procedures. Total pancreatectomy for presumed painful chronic pancreatitis remains controversial. Summary Celiacs are at risk for pancreatitis. The diagnosis of chronic pancreatitis may be enhanced by ANN analysis of EUS imaging. Treatment of fat malabsorption requires 90 000 USP U of lipase with meals. Relief of pain from organ directed treatment of chronic pancreatitis may depend upon timing of interventions and whether pain is visceral or nonvisceral. PMID:23852141

  5. Sex Differences in Chondrocyte Maturation in the Mandibular Condyle from a Decreased Occlusal Loading Model

    PubMed Central

    Chen, J.; Utreja, A.; Kalajzic, Z.; Xu, M.; Kilts, T.; Young, M.; Wadhwa, S.

    2012-01-01

    Temporomandibular joint disorders (TMDs) predominantly afflict women of childbearing age. Defects in mechanical loading-induced temporomandibular joint (TMJ) remodeling are believed to be a major etiological factor in the development of TMD. The goal of this study was to determine if there are sex differences in CD-1 and C57BL/6 mice exposed to a decreased occlusal loading TMJ remodeling model. Male and female CD-1 and C57BL/6 mice, 21 days old, were each divided into two groups. They were fed either a normal pellet diet (normal loading) or a soft diet and had their incisors trimmed out of occlusion (decreased occlusal loading) for 4 weeks. The mandibular condylar cartilage was evaluated by histology, and the subchondral bone was evaluated by micro-CT analysis. Gene expression from both was evaluated by real-time PCR analysis. In both strains and sexes of mice, decreased occlusal loading caused similar effects in the subchondral bone, decreases in bone volume and total volume compared with their normal loading controls. However, in both strains, decreased occlusal loading caused a significant decrease in the expression of collagen type II (Col2) and Sox9 only in female mice, but not in male mice, compared with their normal loading controls. Decreased occlusal loading causes decreased bone volume in both sexes and a decrease in early chondrocyte maturation exclusively in female mice. PMID:21597908

  6. Stenting in Acute Lower Limb Arterial Occlusions

    SciTech Connect

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

    2008-07-15

    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.

  7. Workflow Optimization in Vertebrobasilar Occlusion

    SciTech Connect

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

    2012-06-15

    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.

  8. The cerebral representation of temporomandibular joint occlusion and its alternation by occlusal splints.

    PubMed

    Lotze, Martin; Lucas, Christian; Domin, Martin; Kordass, Bernd

    2012-12-01

    Occlusal splints are a common and effective therapy for temporomandibular joint disorder. Latest hypotheses on the impact of occlusal splints suggest an altered cerebral control on the occlusion movements after using a splint. However, the impact of using a splint during chewing on its cerebral representation is quite unknown. We used functional magnetic resonance imaging (fMRI) to investigate brain activities during occlusal function in centric occlusion on natural teeth or on occlusal splints in fifteen healthy subjects. Comparisons between conditions revealed an increased activation for the bilateral occlusion without a splint in bilateral primary and secondary sensorimotor areas, the putamen, inferior parietal and prefrontal cortex (left dorsal and bilateral orbital) and anterior insular. In contrast, using a splint increased activation in the bilateral prefrontal lobe (bilateral BA 10), bilateral temporo-parietal (BA 39), occipital and cerebellar hemispheres. An additionally applied individually based evaluation of representation sites in regions of interest demonstrated that the somatotopic representation for both conditions in the pre- and postcentral gyri did not significantly differ. Furthermore, this analysis confirmed the decreasing effect of the splint on bilateral primary and secondary motor and somatosensory cortical activation. In contrast to the decreasing effect on sensorimotor areas, an increased level of activity in the fronto-parieto-occipital and cerebellar network might be associated with the therapeutic effect of occlusal splints. PMID:22102437

  9. Novel Artificial Urinary Sphincter in the Canine Model: The Tape Mechanical Occlusive Device (TMOD)

    PubMed Central

    Malaeb, Bahaa S; Elliott, Sean P; Lee, Joseph; Anderson, David W; Timm, Gerald W

    2010-01-01

    Objective To assess the functionality, occlusive efficiency and biocompatibility of a novel artificial urinary sphincter, the Tape Mechanical Occlusive Device (TMOD), [GT Urological, Minneapolis, MN], following implantation in a live canine model as well as its occlusive efficiency and sizing parameters in human cadavers. Materials and Methods Three female canines underwent implantation of the device at the level of the bladder neck. Functionality was assessed starting at two weeks post-implantation up to 9 weeks. The devices were activated at 2 weeks, then deactivated for three, thirty minute sessions per day to permit voiding. Urethral occlusion pressures (UOP) and biocompatibility for systemic toxicity and local tissue response were examined. Additionally, the TMOD was inserted in 3 male cadavers to determine sizing parameters and to assess UOP utilizing pressure profilometry. Results In the canine model, UOP increased from a range of 9-42 cm H2O with TMOD deactivated to a range of 57-82 cm H2O with the TMOD activated. Pathological examination revealed unremarkable pseudo-capsular tissues surrounding the device. No histological or structural evidence of systemic toxicity was observed. Sizing parameters similar to other urological implants were confirmed in the male cadavers and urethral occlusion pressures increased from 24-30 cm H2O with the device deactivated to 61-105 cm H2O with the device activated. Conclusion The TMOD meets the current standards for an artificial urinary sphincter in terms of functionality, biocompatibility and achieving desired occlusion pressures following chronic implantation. Additional testing in male canines followed by early human clinical trials is being contemplated. PMID:21067799

  10. Occlusion issues in early Renaissance art

    PubMed Central

    Gillam, Barbara

    2011-01-01

    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

  11. Primary Stenting in Infrarenal Aortic Occlusive Disease

    SciTech Connect

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

    2000-03-15

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

  12. The antioxidant n-acetylcysteine reduced necrosis, but exacerbated liver fibrosis induced by chronic alcohol in rats fed via total enteral nutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Despite many years of research, the molecular mechanisms underlying progression of alcoholic liver injury from simple steatosis through steatohepatitis and fibrosis remain in dispute. In the current study male Sprague-Dawley rats (350 g) were chronically fed a high unsaturated fat diet for 120 d usi...

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

    Microsoft Academic Search

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

    2001-01-01

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

  14. Management of occlusal canting with miniscrews.

    PubMed

    Yáñez-Vico, Rosa Maria; Iglesias-Linares, Alejandro; de Llano-Pérula, Maria Cadenas; Solano-Reina, Alvaro; Solano-Reina, Enrique

    2014-07-01

    A 14-year-old boy with a skeletal Class II malocclusion and open bite whose chief complaint was a posterior crossbite showed a canted occlusal plane with asymmetric gummy smile and mandibular deviation at clinical examination. The treatment with miniscrews focused on the bilateral intrusion of the maxillary posterior teeth and, after resolving the open bite, a new biomechanical technique involving joined miniscrews was applied for an en masse intrusion of the left side. This treatment strategy achieved optimal occlusion with improvements to the sagittal, vertical, and transverse relationships and achieved a harmonious smile. PMID:24364753

  15. Occlusal tooth contacts in natural normal adult dentition in centric occlusion studied by photocclusion technique.

    PubMed

    Athanasiou, A E; Melsen, B; Kimmel, P

    1989-10-01

    The inter- and intraexaminer reproducibility in the interpretation of the registrations of the photocclusion technique as well as the number of occlusal contacts and their intensity in natural normal dentition in centric occlusion were studied in 20 adults. No significant differences were found regarding the inter- and intraexaminer interpretations for both number and intensity of occlusal contacts. A mean number of 23.8 contacts per individual, an almost symmetric and balanced distribution of the contacts between left and right sides of the dentition, and an absence of any significant differences between female and male subjects characterized the normal natural dentition. PMID:2617142

  16. Use of Poly (Amidoamine) Dendrimer for Dentinal Tubule Occlusion: A Preliminary Study

    PubMed Central

    Wang, Tianda; Yang, Sheng; Wang, Lei; Feng, Hailan

    2015-01-01

    The occlusion of dentinal tubules is an effective method to alleviate the symptoms caused by dentin hypersensitivity, a significant health problem in dentistry and daily life. The in situ mineralization within dentinal tubules is a promising treatment for dentin hypersensitivity as it induces the formation of mineral on the sensitive regions and occludes the dentinal tubules. This study was carried out to evaluate the in vitro effect of a whole generation poly(amidoamine) (PAMAM) dendrimer (G3.0) on dentinal tubule occlusion by inducing mineralization within dentinal tubules. Dentin discs were treated with PAMAM dendrimers using two methods, followed by the in vitro characterization using Attenuated total reflection Fourier-transform infrared spectroscopy (ATR-FTIR), X-ray diffraction (XRD), Field emission scanning electron microscopy (FE-SEM) and Energy-Dispersive X-ray Spectroscopy (EDS). These results showed that G3.0 PAMAM dendrimers coated on dentin surface and infiltrated in dentinal tubules could induce hydroxyapatite formation and resulted in effective dentinal tubule occlusion. Moreover, crosslinked PAMAM dendrimers could induce the remineralization of demineralized dentin and thus had the potential in dentinal tubule occlusion. In this in vitro study, dentinal tubules occlusion could be achieved by using PAMAM dendrimers. This could lead to the development of a new therapeutic technique for the treatment of dentin hypersensitivity. PMID:25885090

  17. Practical filtering for efficient ray-traced directional occlusion

    E-print Network

    Egan, Kevin

    Ambient occlusion and directional (spherical harmonic) occlusion have become a staple of production rendering because they capture many visually important qualities of global illumination while being reusable across multiple ...

  18. 21 CFR 878.4020 - Occlusive wound dressing.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  19. 21 CFR 878.4020 - Occlusive wound dressing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  20. 21 CFR 878.4020 - Occlusive wound dressing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  1. 21 CFR 878.4020 - Occlusive wound dressing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  2. The effects of salivas on occlusal forces.

    PubMed

    McCrea, E S; Katona, T R; Eckert, G J

    2015-05-01

    Contacting surfaces of opposing teeth produce friction that, when altered, changes the contact force direction and/or magnitude. As friction can be influenced by several factors, including lubrication and the contacting materials, the aim of this study was to measure the occlusal load alterations experienced by teeth with the introduction of different salivas and dental restorative materials. Pairs of molar teeth were set into occlusion with a weighted maxillary tooth mounted onto a vertical sliding assembly and the mandibular tooth supported by a load cell. The load components on the mandibular tooth were measured with three opposing pairs of dental restorative materials (plastic denture, all-ceramic and stainless steel), four (human and three artificial) salivas and 16 occlusal configurations. All lateral force component measurements were significantly different (P < 0·0001) from the dry (control) surface regardless of the crown material or occlusal configuration, while the effects of the artificial salivas compared to each other and to human saliva depended on the crown material. PMID:25484034

  3. Multimodal Percutaneous Intervention for Critical Venous Occlusive Disease

    Microsoft Academic Search

    Rajeev Dayal; Joshua Bernheim; Daniel G. Clair; Albeir Y. Mousa; Scott Hollenbeck; Brain DeRubertis; James McKinsey; Nicholas J. Morrissey; K. Craig Kent; Peter L. Faries

    2005-01-01

    Critical deep venous thrombosis and occlusion constitutes a small percentage of patients with venous disease, who exhibit severe symptomatology. This study examined the results of multimodal percutaneous therapy for the treatment of complex critical venous thrombotic and occlusive disease. Twenty-five patients presented with critical venous thromboses or occlusions (11 with debilitating unilateral lower extremity edema causing ambulatory impairment, 2 with

  4. Delayed coronary occlusion following primary successful angioplasty: Management and outcome

    Microsoft Academic Search

    A. Schuchert; C. W. Hamm; P. Kalmar; W. Bleifeld

    1991-01-01

    Summary The treatment of delayed coronary occlusion after primary successful percutaneous transluminal coronary angioplasty (PTCA) is more difficult because surgical standby is often not available. The purpose of this study was to assess the therapeutic approaches and outcome of patients with delayed coronary occlusion from 30 to 180 minutes after successful PTCA. A delayed occlusion occurred in 18 (0.9%) (61±11

  5. A case of veno-occlusive disease following liver transplantation

    PubMed Central

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

    2014-01-01

    The present case report describes the diagnosis and treatment of a patient with veno-occlusive disease (VOD) following liver transplantation. Combining the clinical data and relevant literature, the study aimed to consider the causes of VOD following liver transplantation, and the pathogenesis, clinical diagnosis and auxiliary examination features of VOD. A 42-year-old man who had a long history of taking traditional Chinese medicine (essential components unknown) underwent an orthotropic liver transplantation on January 14, 2011, due to small venous occlusion disease of the liver. The patient was treated with tacrolimus as an antirejection therapy following the surgery, and gradually developed right upper quadrant pain and fatigue. The examination results were consistent with the diagnostic standards for VOD. Following treatment with methylprednisolone, the patient was treated with alprostadil and Danhong injections. Forty days later, the patient’s total bilirubin (TBIL) level was observed to have decreased significantly, the liver function had returned to normal and the ascites had decreased, but had not completely disappeared. The patient then underwent a transjugular intrahepatic portosystemic shunt (TIPS) procedure, following which the ascites were shown to have completely disappeared. PMID:24348779

  6. Occlusion handling in videos object tracking: A survey

    NASA Astrophysics Data System (ADS)

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

    2014-02-01

    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.

  7. Occlusion Handling in Videos Object Tracking: A Survey

    NASA Astrophysics Data System (ADS)

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

    2014-02-01

    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.

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

    PubMed Central

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

    2013-01-01

    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

  9. A reasoning system to track movements of totally occluded objects Martin Antenreiter

    E-print Network

    Auer, Peter

    A reasoning system to track movements of totally occluded objects Martin Antenreiter Chair which is able to track objects under partial and total occlusion. The occlusion and movement reasoning uses abstract object descriptions for inference and is based on an extendable knowledge-base. The sys

  10. The effects of ablations in the central nervous system on arrhythmias induced by coronary occlusion in the rat.

    PubMed Central

    Curtis, M. J.; Macleod, B. A.; Walker, M. J.

    1985-01-01

    The role of the central nervous system (CNS) in arrhythmogenesis in the 4 h period following occlusion of a coronary artery was investigated in rats by use of CNS ablations and other procedures. Ablations in the CNS included pithing, spinalization and decerebration combined with acute and chronic surgical preparation and noradrenaline/adrenaline infusions. All procedures involving acute surgery reduced the incidence and severity of the arrhythmias induced by occlusion. Such reductions were most marked in the second (0.5-4 h post-occlusion) arrhythmic period. The observed reductions in arrhythmias could not be explained in terms of involvement of the CNS or adrenoceptor activation. When circulating leucocytes, platelets and serum potassium were measured in a group of pithed rats before and after occlusion, reduced levels (20-50%) of both leucocytes and platelets occurred while serum potassium levels rose by 50-100%. Arrhythmias following coronary occlusion may depend in part on factors in the blood such as leucocytes, platelets and serum potassium and these factors may be altered by acute surgery. PMID:4063585

  11. Nanophthalmos and hemiretinal vein occlusion: A case report

    PubMed Central

    Albar, Ahmad A.; Nowilaty, Sawsan R.; Ghazi, Nicola G.

    2014-01-01

    Many risk factors have been linked to retinal vein occlusions (RVOs) whether central or branch retinal vein occlusion. Ocular risk factors include glaucoma and hypermetropia. Controversy exists to whether short axial length is a risk factor for retinal vein occlusions. We report an extreme case that supports the latter hypothesis. A 33-year-old male presented with decreased visual acuity in the left eye. He turned out to have nanophthalmos with hemiretinal vein occlusion and macular edema with unremarkable systemic work up for retinal vein occlusion except for a glycated hemoglobin (HbA1c) level of 7%. To our knowledge this is the first case report of hemiretinal vein occlusion in the setting of nanophthalmos and suggests that short axial length may be a risk factor for retinal vein occlusion.

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

    ClinicalTrials.gov

    2014-07-22

    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

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

    SciTech Connect

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

    2003-04-15

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

  14. Branch Retinal Artery Occlusion following Dental Extraction

    PubMed Central

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

    2014-01-01

    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

  15. Effectiveness of occlusal splints and low-level laser therapy on myofascial pain.

    PubMed

    Demirkol, Nermin; Sari, Fatih; Bulbul, Mehmet; Demirkol, Mehmet; Simsek, Irfan; Usumez, Aslihan

    2015-04-01

    The present study was designed to evaluate the effects of low-level laser (Nd:YAG) therapy and occlusal splints in patients with signs and symptoms of temporomandibular disorders (TMD) characterized with myofascial pain (MP). A total of 30 patients were selected after being diagnosed with MP according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TDM). The patients were divided into three groups. The first group was occlusal splint (OS) group A (n?=?10), the second was low-level laser therapy (LLLT) group B (n?=?10), and the last group C was placebo (n?=?10). LLLT (1,064 nm, 8 j/cm(2), 250 mW, Fotona) was applied to the patients in the study group once a day for 10 days, for a total of ten sessions. The same parameters and application times were used for placebo group, but the patients were not irradiated. The application was on the trigger points. The patients in the OS group were instructed to wear occlusal splints 12 h/day for 3 weeks. Functional examination was based on RDC/TDM, and pressure pain values were obtained with the Visual Analog Scale. Comparisons were made between the groups before and after the treatment according to Wilcoxon, Mann-Whitney U, and Kruskal-Wallis tests. The pain score values decreased significantly after both LLLT (p?occlusal splint therapy (p??0.05). OS and LLLT are effective for decreasing MP. In addition, this particular type of LLLT is as effective as occlusal splint for pain relief. PMID:24504660

  16. [Controlling the course of arterial occlusive diseases in practice and prognostic aspects (author's transl)].

    PubMed

    Schütz, R M

    1978-01-01

    The earlier an arterial occlusive disease is recognized and intensively treated the more favorable the longterm prognosis. Such therapy includes to an equal extent the elimination or treatment of "risk factors" and intensive collateral training. Assessment of the course of this, per se chronic, disease requires longterm observation. Contrary to general opinion, however, neither clinical angiological findings nor most of the customary angiological methods can give a satisfactorily reliable judgment as a rule: only venous obstruction plethysmography and the Doppler ultrasonic flow measurements provide objective figures. The latter are suitable for general practice with regard to both expenditure of time and money and to the accuracy of their measurements. PMID:414110

  17. Suction Thrombectomy of Thrombotic Occlusion of the Subclavian Artery in a Case of Takayasu's Arteritis

    SciTech Connect

    Purkayastha, Sukalyan; Jayadevan, E.R.; Kapilamoorthy, T.R.; Gupta, A.K. [Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Department of Radiology (India)], E-mail: gupta209@yahoo.com, E-mail: gupta@sctimst.ac.in

    2006-04-15

    Takayasu's arteritis, also known as pulseless disease, is a chronic inflammatory arteritis affecting large vessels, predominantly the aorta and its main branches. Vessel inflammation leads to wall thickening, fibrosis, stenosis, and thrombus formation. Percutaneous removal of arterial thrombus with the use of several devices has been reported, with mixed results. We present a case of Takayasu's arteritis with thrombotic occlusion of the subclavian artery in which pulsed urokinase injection and suction thrombectomy were used to revascularize a threatened limb and to establish the sole arterial supply to the brain.

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

    PubMed Central

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

    2004-01-01

    Summary Eighteen patients with intracranial vertebrobasilar stenosis and occlusion were treated by PTA or stenting. In 11 of 18 cases, only PTA was performed and in seven of 18 cases, we used stents. The mean stenosis before and after PTA/stenting was 82.8% and 22.3%, respectively. In 11 cases of PTA only, the stenotic rate decreased from 81.8% to 29.6%, while 85.0% of the stenotic rate remarkably reduced to 6.0% in seven cases of stenting. The 30 days morbidity and 30 days mortality rate were 5.5% and 5.5%, respectively. There was only one haemorrhagic complication (cerebellar haemorrhage) in cases of stenting, and no ischemic events during or after the procedures. Restenosis (more than 50% stenosis) occurred in four of 18 cases(22.2%) during mean follow-up period of 12 months. Two patients with VA occlusion before treatment, developed restenosis and reocclusion. Complete total occlusion seems to be a high-risk lesion and strict follow-up is required. In this study, PTA/stenting for intracranial vertebrobasilar artery stenosis or occlusion is an effective treatment, but strict indications may be required because procedure-related 30 days morbidity rate was 5.5% in addition to unclear natural history. PMID:20587244

  19. Recanalization of experimental thrombotic arterial occlusion by radiofrequency thermal angioplasty: an angioscopic observation.

    PubMed

    Tamura, Y; Yamazoe, M; Matsubara, T; Igarashi, Y; Izumi, T; Shibata, A; Hayashi, S; Toyoshima, H; Saito, Y; Makino, H

    1989-08-01

    The efficacy of radiofrequency (RF) angioplasty for recanalization of arterial thrombosis was assessed angioscopically in five dogs. A thrombus was induced by balloon injury of the left femoral artery. Within two hr, thrombi led to total occlusion of the artery in three dogs, subtotal occlusion in one, and about 70% obstruction in one. A metal-tipped catheter, with a tip size of 2.0 mm x 5.7 mm, was advanced into the thrombus and RF at 13.56 MHz was delivered repeatedly with gradually increased energies. The arterial lumina were recanalized or enlarged in all dogs. The thrombus surface had a shaggy appearance, and were dark (charring), or mixed dark and white in color. There were relatively large variations in the energies required; 140 J in one, 200 J in two and 250 J in two. The present results suggest that thrombotic arterial occlusion, such as acute occlusion complicating balloon angioplasty, can be treated with RF thermal angioplasty. Angioscopy provided detailed information about thrombus surfaces. The variations in required energies indicate the inability to control the thermal effect by energy settings alone. A more sophisticated method such as measurement of tip temperature will be able to overcome this difficulty. PMID:2531479

  20. Effects of baseline coronary occlusion and diabetes mellitus in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

    PubMed

    Piccolo, Raffaele; Galasso, Gennaro; Iversen, Allan Zeeberg; Eitel, Ingo; Dominguez-Rodriguez, Alberto; Gu, Youlan L; de Smet, Bart J G L; Mahmoud, Karim D; Abreu-Gonzalez, Pedro; Trimarco, Bruno; Thiele, Holger; Piscione, Federico

    2014-10-15

    Several studies have highlighted the prognostic role of preprocedural Thrombolysis In Myocardial Infarction (TIMI) flow in the infarct-related artery (IRA) in patients with ST-segment elevation myocardial infarction (STEMI). However, the impact of preprocedural IRA occlusion in patients with diabetes with STEMI has been insufficiently studied. The aim of this study was to evaluate the effects of baseline IRA occlusion and diabetic status in patients with STEMI who underwent primary percutaneous coronary intervention by using data from a pooled analysis of randomized trials comparing intracoronary with intravenous abciximab bolus administration. A total of 3,046 patients with STEMI who underwent primary percutaneous coronary intervention were included. Diabetes was present in 578 patients (19%). The primary outcome was mortality after a median follow-up period of 375 days. Secondary end points were reinfarction and stent thrombosis. In patients without diabetes, IRA occlusion versus no occlusion was not associated with increased rates of mortality (4.3% vs 2.7%, p = 0.051) and reinfarction (3.3% vs 2.5%, p = 0.33). Patients with diabetes with IRA occlusion compared with those without occlusion showed higher rates of mortality (10.6% vs 4.6%, p = 0.01) and reinfarction (5.6% vs 2.1%, p = 0.03). Baseline IRA occlusion increased the rate of stent thrombosis in the nondiabetic (2.1% vs 1.0%, p = 0.04) and diabetic (3.2% vs 0.8%, p = 0.05) cohorts. Interaction analysis demonstrated that the risk for death and reinfarction was significantly increased when diabetes and IRA occlusion occurred concomitantly. In conclusion, patients with STEMI with diabetes and baseline IRA occlusion had disproportionately higher rates of death and reinfarction. Preprocedural IRA occlusion increased the risk for stent thrombosis, irrespective of diabetic status. PMID:25193670

  1. Technical note: Occlusal fingerprint analysis: quantification of tooth wear pattern.

    PubMed

    Kullmer, Ottmar; Benazzi, Stefano; Fiorenza, Luca; Schulz, Dieter; Bacso, Stefan; Winzen, Olaf

    2009-08-01

    Information about food ingestion and mastication behavior during the lifespan of an individual is encoded in the dental occlusal wear pattern. To decode this information, we describe a new method called occlusal fingerprint analysis (OFA). Structural parameters of wear facets on the occlusal surface of teeth are quantified from digitized casts for the interpretation of occlusal aspects. The OFA provides an individual three-dimensional dental occlusal compass that indicates the major pathways of interaction between antagonists, revealing information about development, spatial position, and enlargement of wear facets. Humans develop a very similar overall pattern of crown contacts, although specific characteristics of wear facets reflect an individual's occlusal relationships and masticatory behavior. We hypothesize that the wear pattern is a unique character and therefore valuable for individual identification. Furthermore we suggest that OFA, when further developed, may be useful for identification of behavioral, biological, and chemical factors affecting crown morphology. PMID:19425091

  2. Effect of delayed albumin hemodilution on infarction volume and brain edema after transient middle cerebral artery occlusion in rats.

    PubMed

    Belayev, L; Busto, R; Zhao, W; Clemens, J A; Ginsberg, M D

    1997-10-01

    The authors examined the effect of delayed high-concentration albumin therapy on ischemic injury in a highly reproducible model of middle cerebral artery (MCA) occlusion in rats. Male Sprague-Dawley rats weighing 270 to 320 g were anesthetized with halothane and subjected to 120 minutes of temporary MCA occlusion induced by means of a poly-L-lysine-coated intraluminal nylon suture inserted retrograde via the external carotid artery into the internal carotid artery and MCA. The agent (20% human serum albumin [HSA]) or control solution (sodium chloride 0.9%) was administered intravenously at a dosage of 1% of body weight immediately after suture removal following a 2-hour period of MCA occlusion. The animals' neurological status was evaluated during MCA occlusion (at 60 minutes) and daily for 3 days thereafter. The brains were perfusion-fixed, and infarct volumes and brain edema were determined. The HSA significantly improved the neurological score compared with saline at 24 hours after MCA occlusion. The rats treated with HSA also had significantly reduced total infarct volume (by 34%) and brain edema (by 81%) compared with saline-treated rats. There was a strong correlation between hematocrit level and brain edema (p < 0.01), and between total infarct volume or brain edema and neurological score at 24, 48, and 72 hours postinjury (p < 0.0002). These results strongly support the beneficial effect of delayed albumin therapy in transient focal ischemia and indicate its possible usefulness in treating patients with acute ischemic stroke. PMID:9322848

  3. Abnormalities of microcirculation in dentoalveolar complex after direct occlusal restorations

    Microsoft Academic Search

    A. Tsimbalistov; Y. Sosnina; E. Statovskaya

    2010-01-01

    Summary  Nowadays, the role of occlusion in etiology and pathogenesis of the inflammation in periodontal tissues have not still become\\u000a clear and considered as biomechanics and articulation. Physiologically, masticatory pressure stimulates metabolic processes\\u000a in periodontal tissues. Occlusal overloading leads to periodontal damages. The aim of this study is to reveal abnormalities\\u000a of microcirculation in periodontal tissues and pulp after direct occlusal

  4. Current Status of Thrombolysis for Peripheral Arterial Occlusive Disease

    Microsoft Academic Search

    Kenneth Ouriel

    2002-01-01

      Acute peripheral arterial occlusion occurs as a result of thrombosis or embolism. A reduction in the prevalence of rheumatic\\u000a heart disease accounts for a shift in the frequency of embolic to thrombotic occlusions. Also, a dramatic increase in the\\u000a number of lower extremity arterial bypass graft procedures explains the predominance of graft occlusions in most recent series\\u000a of patients with

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

    SciTech Connect

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

    2005-06-15

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

  6. Orbital mucormycosis with retinal and ciliary artery occlusions.

    PubMed

    Luo, Q L; Orcutt, J C; Seifter, L S

    1989-08-01

    A 61-year-old man presented with acute, painful loss of vision in the left eye due to a central retinal artery occlusion. Fluorescein angiography confirmed the central retinal artery occlusion and also identified a nasal posterior ciliary artery occlusion. CT scanning revealed a left medial orbital mass with adjacent ethmoid sinusitis. Transnasal ethmoid biopsy disclosed mucormycosis. A left external ethmoidectomy, maxillectomy, and orbital exploration were performed, after which the patient was treated with daily intravenous amphotericin B for six weeks. Coexistence of retinal and nasal posterior ciliary artery occlusion due to mucormycosis may relate to their common origin from the ophthalmic artery. Treatment without exenteration was successful. PMID:2765451

  7. Coil occlusion of the paient ductus arteriosus: lessons learned

    Microsoft Academic Search

    Shubhayan Sanatani; James E. Potts; Angela Ryan; George G. S. Sandor; Derek G. Human; J. A. Gordon Culham

    2000-01-01

    Purpose: To review the clinical outcomes of catheter-directed coil occlusion (coil occlusion) of persistently patent ductus arteriosus\\u000a (PDA) at a pediatric tertiary care hospital.\\u000a \\u000a \\u000a Methods: A retrospective review of all patients referred to the Cardiac Catheterization Laboratory for coil occlusion at our institution\\u000a was performed. Twenty-one consecutive patients (12 female) underwent coil occlusion and follow-up between May 1995 and December

  8. Response of fibrinolytic activity to venous occlusion.

    PubMed Central

    Shaper, A G; Marsh, N A; Patel, I; Kater, F

    1975-01-01

    Resting fibrinolytic activity and the response of the fibrinolytic system to venous occlusion were studied in a group of healthy middle-aged men. All subjects showed increased fibrinolytic activity but of varying degrees. There was a linear relationship between resting and occluded levels of fibrinolytic activity but many subjects with lower levels of fibrinolytic activity showed an anomalous response. Responses over the expected level were more common than unexpectedly low levels of response. Fibrinogen and plasminogen concentrations were inversely correlated with fibrinolytic activity. PMID:1174826

  9. An occlusion insensitive adaptive focus measurement method.

    PubMed

    Aydin, Tarkan; Akgul, Yusuf S

    2010-06-21

    This paper proposes a new focus measurement method for Depth From Focus to recover depth of scenes. The method employs an all-focused image of the scene to address the focus measure ambiguity problem of the existing focus measures in the presence of occlusions. Depth discontinuities are handled effectively by using adaptively shaped and weighted support windows. The size of the support window can be increased conveniently for more robust depth estimation without introducing any window size related Depth From Focus problems. The experiments on the real and synthetically refocused images show that the introduced focus measurement method works effectively and efficiently in real world applications. PMID:20588555

  10. Radial artery occlusion: Preventing Insult to Injury.

    PubMed

    Chandrasekhar, Jaya; Mehran, Roxana

    2015-04-01

    Intra-arterial nitroglycerin prior to transradial sheath removal may reduce the incidence of radial artery occlusion (RAO). Operators must observe careful attention to all aspects of transradial catheterization, particularly patent hemostasis; as well as independently monitor the institutional incidence of RAO to prompt improvements in practice. Future studies on the impact of pre-puncture ultrasound, novel sheaths, hemostatic devices, and potent oral and intravenous antithrombotic therapy on 30-day RAO diagnosed by ultrasound may allow further reduction of RAO in a real-world practice. PMID:25789731

  11. Subintimal Angioplasty for Peripheral Arterial Occlusive Disease: A Systematic Review

    SciTech Connect

    Met, Rosemarie, E-mail: r.met@amc.nl; 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)

    2008-07-15

    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.

  12. [Diagnosis and therapy of non-occlusive mesenteric ischemia (NOMI)].

    PubMed

    Stöckmann, H; Roblick, U J; Kluge, N; Kunze, U; Schimmelpenning, H; Kujath, P; Müller, G; Bruch, H P

    2000-01-01

    Pathophysiologically, the non-occlusive mesenteric ischemia (NOMI) results from reduced blood supply to the intestine, caused by "low cardiac output syndrome", or the use of certain drugs leading to intestinal vasoconstriction and stasis of the microcirculation. Regardless of the aetiopathogenesis, the patient's prognosis crucially depends on rapid diagnosis and initiation of adequate medical or surgical intervention. In a 10-year retrospective chart analysis (1989 to 1998) we identified a total of 62 patients that demonstrated classical features of NOMI. The investigation focused on patients' history, risk factors, clinical symptoms, diagnostic procedures and patient's clinical outcome. The most important associated risk factors and concomitant diseases were reduced cardiac output (caused by preexisting heart failure), renal diseases, diabetes and the use of some specific drugs (digitalis, furosemide, ergotamine). Except for leucocytosis, elevated serum lactate and an increased CK/CK-MB level, all laboratory findings were unspecific. Using abdominal ultrasound and plain abdominal x-ray, 80% of the cases showed positive signs of ileus, subileus and free intraabdominal fluid. The angiographic diagnostics (mesentericography) of non-occlusive mesenteric ischemia showed the typical signs of peripheral vasoconstriction in 90% of the cases. Fifty three patients (86%) presenting with peritoneal signs underwent operative bowel exploration. Necrotic bowel had to be resected in 37 cases (60%). The overall letality was 58%. The progress made in better understanding the pathophysiology of NOMI has led to differential treatment of the disease. Close cooperation between surgeons and radiologists, coupled with early diagnosis and prompt treatment are necessary to optimize the clinical outcome. PMID:10743034

  13. Diffuse aneurysmal disease (chronic aortic dissection, Marfan, and mega aorta syndromes) and multiple aneurysm. Treatment by subtotal and total aortic replacement emphasizing the elephant trunk operation.

    PubMed Central

    Crawford, E S; Coselli, J S; Svensson, L G; Safi, H J; Hess, K R

    1990-01-01

    The life expectancy of patients with aortic aneurysm is significantly prolonged by graft replacement therapy. Regardless, a significant predictor of late death is complications of either residual aortic aneurysmal disease or the development of additional aortic aneurysm. This paper reviews a personal experience in the treatment of 4170 patients with aneurysmal disease of either dissection or medial degenerative origin, indicating that multiple segment involvement was or became present in 1262 (30%) patients, 463 (67%) of 694 patients with dissection, and 799 (23%) of 3476 patients without dissection. Regardless of etiology, multiple involvement varied with the location of the presenting involved segment, i.e., ascending aorta (38%), ascending and arch (70%), descending thoracic aorta (73%), and abdominal aorta (26%). This study was limited in detail to 811 patients who had ascending and ascending and aortic arch replacement for aneurysm. These patients were divided into 3 subgroups: (1) 524 patients with no distal disease; (2) 135 patients with distal disease treated by subtotal replacement in 82 and total replacement in 53; and (3) 152 patients with distal disease not treated. The 5-year survival rate from the time of first operation, including early death from operation was 75% in group 1, 65% in group 2, and 39% in group 3. The causes of death in group 3 patients were aneurysmal rupture and/or associated disease. It is concluded that initial total aortic study and regular postoperative monitoring with computed tomographic scanning is indicated to detect extensive disease or recurrence of disease and that aggressive replacement is indicated except in patients with associated disease that does not permit operation. Images Figs. 1A-E. Figs. 1C-E. Figs. 2A-C. Fig. 2C. Figs. 3A-C. Figs. 4A-D. Fig. 4B. Figs. 4C and D. Figs. 5A-O. Figs. 5A-O. Figs. 5L and M. Figs. 5N and O. Figs. 6A-C. Fig. 6. PMID:2339914

  14. Endovascular Treatment of Chronic Mesenteric Ischemia: Report of Five Cases

    SciTech Connect

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

    1998-07-15

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

  15. Chronic Migraine

    MedlinePLUS

    Home » Chronic Migraine Chronic Migraine Submitted by Admin on Thu, 2007-10-25 18:01 Chronic migraine (CM) best characterizes those patients with a history of migraine who experience headache more than half the time. ...

  16. Incompressible viscous flow in tubes with occlusions

    NASA Astrophysics Data System (ADS)

    Huang, Huaxiong

    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.

  17. Smile line and occlusion: An epidemiological study

    PubMed Central

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

    2013-01-01

    Background: The purpose of the present study was to discuss some new concepts of the desirable characteristics of smile tooth display. Due to the increasing application of cosmetic dental treatments, there is an increasing need for better understanding of the esthetic principles. Materials and Methods: In the present descriptive study, with 212 participants, included were patients with no history of orthodontic treatment, loss or prosthetic replacement of anterior teeth, extracted teeth, lips with asymmetry or a history of trauma. Chi-square test was used to determine possible significances in the relation of smile line to Angle occlusion class, overbite and overjet and arch form. A P level of <0.05 was set as to be significant. Results: Chi-square test indicated that there was a significant difference between the smile design and overbite, overjet and gender but no statistically significant association was found between the smile design and crossbite, molar Angle classification and arch form. Conclusion: Within the limitations of such studies, it might be concluded that there is a significant and important relation between some occlusal parameters and smile design, which must be considered. PMID:24379858

  18. Optimal management of infrainguinal arterial occlusive disease

    PubMed Central

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

    2014-01-01

    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

  19. Tracking of multiple objects under partial occlusion

    NASA Astrophysics Data System (ADS)

    Han, Bing; Paulson, Christopher; Lu, Taoran; Wu, Dapeng; Li, Jian

    2009-05-01

    The goal of multiple object tracking is to find the trajectory of the target objects through a number of frames from an image sequence. Generally, multi-object tracking is a challenging problem due to illumination variation, object occlusion, abrupt object motion and camera motion. In this paper, we propose a multi-object tracking scheme based on a new weighted Kanade-Lucas-Tomasi (KLT) tracker. The original KLT tracking algorithm tracks global feature points instead of a target object, and the features can hardly be tracked through a long sequence because some features may easily get lost after multiple frames. Our tracking method consists of three steps: the first step is to detect moving objects; the second step is to track the features within the moving object mask, where we use a consistency weighted function; and the last step is to identify the trajectory of the object. With an appropriately chosen weighting function, we are able to identify the trajectories of moving objects with high accuracy. In addition, our scheme is able to handle partial object occlusion.

  20. Chronic thromboembolic pulmonary hypertension.

    PubMed

    Hoeper, Marius M; Madani, Michael M; Nakanishi, Norifumi; Meyer, Bernhard; Cebotari, Serghei; Rubin, Lewis J

    2014-07-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but debilitating and life-threatening complication of acute pulmonary embolism. CTEPH results from persistent obstruction of pulmonary arteries and progressive vascular remodelling. Not all patients presenting with CTEPH have a history of clinically overt pulmonary embolism. The diagnostic work-up to detect or rule out CTEPH should include ventilation-perfusion scintigraphy, which has high sensitivity and a negative predictive value of nearly 100%. CT angiography usually reveals typical features of CTEPH, including mosaic perfusion, part or complete occlusion of pulmonary arteries, and intraluminal bands and webs. Patients with suspected CTEPH should be referred to a specialist centre for right-heart catheterisation and pulmonary angiography. Surgical pulmonary endarterectomy remains the treatment of choice for CTEPH and is associated with excellent long-term results and a high probability of cure. For patients with inoperable CTEPH, various medical and interventional therapies are being developed. PMID:24898750

  1. 40 CFR 180.1148 - Occlusion Bodies of the Granulosis Virus of Cydia pomenella; tolerance exemption.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...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...

  2. 40 CFR 180.1148 - Occlusion Bodies of the Granulosis Virus of Cydia pomenella; tolerance exemption.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...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...

  3. 40 CFR 180.1148 - Occlusion Bodies of the Granulosis Virus of Cydia pomenella; tolerance exemption.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...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...

  4. 40 CFR 180.1148 - Occlusion Bodies of the Granulosis Virus of Cydia pomenella; tolerance exemption.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...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...

  5. 40 CFR 180.1148 - Occlusion Bodies of the Granulosis Virus of Cydia pomenella; tolerance exemption.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...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...

  6. Mathematical and mechanical modeling of vaso-occlusion in sickle cell disease

    E-print Network

    Higgins, John M. (John Matthew)

    2007-01-01

    Vaso-occlusive crises cause most of the morbidity and mortality associated with sickle cell disease. The proximal causes of these occlusive events are not well understood. The risks and consequences of vaso-occlusion however ...

  7. Coronary artery spatial distribution of acute myocardial infarction occlusions

    Microsoft Academic Search

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

    2004-01-01

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

  8. Effect of Cotton-Tipped Swab Use on Earwax Occlusion

    Microsoft Academic Search

    Michael L. Macknin; Haitham Talo; Sharon VanderBrug Medendorp

    1994-01-01

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

  9. Occlusion of congenital ventricular septal defects by the buttoned device. \\

    Microsoft Academic Search

    E. B. Sideris; K. P. Walsh; J. L. Haddad; C. R. Chen; S. G. Ren; H. Kulkarni

    1997-01-01

    OBJECTIVES: To study the feasibility of congenital ventricular septal defect occlusion by the buttoned device and to establish guidelines for its safe and effective application. DESIGN: A descriptive study of all patients with a congenital ventricular septal defect undergoing transcatheter occlusion with the buttoned device, from March 1994 to May 1995. These patients were otherwise candidates for elective surgery at

  10. PREVALENCE OF HYPERHOMOCYSTEINEMIA IN PATIENTS WITH RETINAL VEIN OCCLUSION

    Microsoft Academic Search

    M. R. Manaviat; M. R. Shoja; M. R. Besharaty

    Recently multiple studies have shown that elevated homocysteine levels may be associated with ophthalmic vascular disease. To investigate the role of high plasma levels of homocysteine in the patients with retinal vein occlusion, 21 patients with retinal vein occlusion (RVO) and 20 age and sex matched controls without RVO were included in this retrospective case-control study. Information regarding sex, age,

  11. Variations among Dentists in Radiographic Detection of Occlusal Caries

    Microsoft Academic Search

    I. Espelid; A. B. Tveit; A. Fjelltveit

    1994-01-01

    The quality of radiographic diagnosis of occlusal carries was examined with special attention to the diagnosis of lesions in dentin. Eighty-four extracted teeth, most of them with occlusal caries of different severity and some apparently sound, were radiographed. For validation purposes, the lesion depths were recorded during a drilling procedure. Ten dentists interpreted the radiographs. On average, 12% of the

  12. The influence of concentration, exposure duration, and patch occlusivity upon rabbit primary dermal irritation indices.

    PubMed

    Gilman, M R; Evans, R A; De Salva, S J

    1978-01-01

    The Primary Rabbit Dermal Irritation Assay as described in the Federal Hazardous Substances Act (FHSA) is used by the Consumer Products Safety Commission (CPSC) to determine the labeling requirements of household products. One of the more obvious deficiencies of this assay is the descriptive imprecision for preparing the form in which solid materials are applied. Our experimental findings show that form and concentration of test material as well as the length of contact with the skin and the degree of patch occlusivity are prime factors influencing the degree of skin change. Four detergent granular products are evaluated. In the dry powder form with 4 hour exposure all the detergents were non-irritating. The paste at 24 hours under total occlusion was the most irritating. PMID:755678

  13. Acute Aortic Occlusion Presenting as Flaccid Paraplegia

    PubMed Central

    Kilany, Ayman; Al-Hashel, Jasem Y.; Rady, Azza

    2015-01-01

    A 67-year-old male known to be hypertensive and diabetic had a sudden onset of severe low back pain and flaccid paraplegia with no sensory level or bladder affection and the distal pulsations were felt. Acute compressive myelopathy was excluded by MRI of the dorsal and lumbar spines. The nerve conduction study and CSF analysis was suggestive of acute demyelinating polyneuropathy. The patient developed ischemic changes of the lower limb and CT angiography revealed severe stenosis of the abdominal aorta and both common iliac arteries. We emphasize the importance of including acute aortic occlusion in the differential diagnosis of acute flaccid paraplegia especially in the presence of severe back pain even if the distal pulsations were felt.

  14. Prosthetic occlusive device for an internal passageway

    NASA Technical Reports Server (NTRS)

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

    1983-01-01

    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.

  15. Sclerostin and occlusion: A brief review

    PubMed Central

    Bansal, Pankaj; Singh, Pritma; Bey, Afshan; Gupta, Narinder Dev

    2015-01-01

    In its pursuit of understanding the wonders of human body, mankind has stumbled upon yet another discovery which not only is a key to chest of unanswered queries but also opens a plethora of new possibilities. Till recently the osteocytes were considered latent cells merely entrapped in the matrix of bone. With the discovery of beta-catenin pathway and sclerostin molecule, these cells are now being recognized to perform a multitude of physiological functions which are important to bone function and turnover. Mechanosensor function of osteocytes via sclerostin molecule offers new possibilities in alveolar bone preservation. Sclerostin and its inhibitors have potential in prosthetic, regenerative and preventive therapy in dentistry. Osteocytic pathway of sclerostin release and mechanism of its interaction with occlusion is discussed in this article.

  16. Practical management of retinal vein occlusions.

    PubMed

    La Spina, Carlo; De Benedetto, Umberto; Parodi, Maurizio Battaglia; Coscas, Gabriel; Bandello, Francesco

    2012-12-01

    Retinal vein occlusion (RVO) is the second most common cause of visual impairment due to retinal disease after diabetic retinopathy. Nowadays, the introduction of new, powerful diagnostic tools, such as spectral domain optical coherence tomography, and the widespread diffusion of intravitreal drugs, such as vascular endothelial grow factor inhibitors or implantable steroids, have dramatically changed the management and prognosis of RVO. The authors aim to summarize and review the main clinical, diagnostic, and therapeutic aspects of this condition. The authors conducted a review of the most relevant clinical trials and observational studies published within the last 30 years using a keyword search of MEDLINE, EMBASE, Current Contents, and Cochrane Library. Furthermore, for all treatments discussed, the level of evidence supporting its use, as per the US Preventive Task Force Ranking System, is provided. PMID:25135583

  17. Occlusal traits in developmental dyslexia: a preliminary study

    PubMed Central

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

    2013-01-01

    Aim The objective of the study reported here was to assess the orthodontic features in children affected by developmental dyslexia (DD). Patients and methods A total of 28 children affected by DD (22 boys, six girls; mean age: 9.78 ± 1.69 years) were compared with 51 healthy children (38 boys, 13 girls; mean age 9.41 ± 1.48; range 7–10 years). Reading and writing skills were evaluated along with orthodontic features. Results The DD and control groups were not significantly different in terms of total intelligence quotient (P = 0.441) and writing skills (P = 0.805 and P = 0.240, respectively), whereas significant differences were observed between the DD group and control group in both word reading (2.018 ± 1.714 vs 0.917 ± 0.563; P = 0.000) and non-word reading (2.537 ± 1.543 vs 0.862 ± 0.244; P = 0.000). Moreover, for many orthodontic features, there was no significant difference between the two groups; only in prevalence of diastemas (57.14%, P = 0.006), midline diastemas (46.42%, P = 0.007), overbite > 4 mm (71.42%, P = 0.006) and overjet > 4 mm (53.57%, P = 0.001), was there a statistically significant difference. According to univariate logistic regression analysis, the presence of diastemas (odds ratio [OR] 4.33; 95% confidence interval [CI] 1.61–11.65), midline diastemas (OR 4.68; 95% CI 1.61–13.43), an overbite >4 mm (OR 1.75; 95% CI 0.64–4.71), or an overjet >4 mm (OR 2.76; 95% CI 1.06–7.20) seems to play a role in the relationship between occlusal abnormalities and DD in children. Conclusion Children with DD tend to present with altered dental features, particularly in the area of the incisors, suggesting that a persistently different tongue kinematic profile may thus affect both the developmental variability of the tongue and lip and the occlusion. PMID:24009421

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

    PubMed Central

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

    2014-01-01

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

  19. Endovascular repair of abdominal aortic aneurysm using bifurcated stent-graft in a patient with complete occlusion from the common to the external iliac artery.

    PubMed

    Fujimura, Naoki; Harada, Hirohisa; Yashiro, Hideki; Akiyoshi, Takurin; Nakagawa, Motohito; Kanai, Toshio; Obara, Hideaki; Kitagawa, Yuko

    2014-04-01

    Extensive iliofemoral occlusive disease can limit the use of endovascular aortic aneurysm repair (EVAR), and the treatment strategy varies depending on severity of the lesion. In cases of mild iliac artery (IA) stenosis, predilation using a balloon catheter before EVAR is relatively common, and for severe IA stenosis, the technique of internal endoconduits has been reported with good results. In contrast, EVAR using an aortouni-iliac stent graft with femorofemoral crossover bypass has traditionally been used for abdominal aortic aneurysm with IA occlusion. However, EVAR using a bifurcated stent graft has some clear advantages over aortouni-iliac stent grafts. In this report, we describe and discuss technical aspects and feasibility of chronically occluded iliac artery recanalization before EVAR to facilitate the use of bifurcated stent grafts in a patient with concomitant complete common to external IA occlusion. PMID:24360941

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

    PubMed Central

    2014-01-01

    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

  1. Chronic pancreatitis.

    PubMed

    Braganza, Joan M; Lee, Stephen H; McCloy, Rory F; McMahon, Michael J

    2011-04-01

    Chronic pancreatitis is a progressive fibroinflammatory disease that exists in large-duct (often with intraductal calculi) or small-duct form. In many patients this disease results from a complex mix of environmental (eg, alcohol, cigarettes, and occupational chemicals) and genetic factors (eg, mutation in a trypsin-controlling gene or the cystic fibrosis transmembrane conductance regulator); a few patients have hereditary or autoimmune disease. Pain in the form of recurrent attacks of pancreatitis (representing paralysis of apical exocytosis in acinar cells) or constant and disabling pain is usually the main symptom. Management of the pain is mainly empirical, involving potent analgesics, duct drainage by endoscopic or surgical means, and partial or total pancreatectomy. However, steroids rapidly reduce symptoms in patients with autoimmune pancreatitis, and micronutrient therapy to correct electrophilic stress is emerging as a promising treatment in the other patients. Steatorrhoea, diabetes, local complications, and psychosocial issues associated with the disease are additional therapeutic challenges. PMID:21397320

  2. Pulmonary veno-occlusive disease: recent progress and current challenges.

    PubMed

    Montani, David; O'Callaghan, Dermot S; Savale, Laurent; Jaïs, Xavier; Yaïci, Azzedine; Maitre, Sophie; Dorfmuller, Peter; Sitbon, Olivier; Simonneau, Gérald; Humbert, Marc

    2010-07-01

    Pulmonary veno-occlusive disease (PVOD) is an uncommon form of pulmonary arterial hypertension characterised by a progressive obstruction of small pulmonary veins that leads to elevation in pulmonary vascular resistance and right ventricular failure. Despite improved understanding and more efficacious treatment options for PAH overall, the prognosis of PVOD remains dismal. Without therapeutic intervention few patients would be expected to survive more than two years. PVOD may occur in both idiopathic and heritable forms, or develop in association with connective tissue disease, chronic respiratory disease, malignancy or bone marrow transplantation, among other causes. A widespread fibrous intimal proliferation that predominantly involves the pulmonary venules and small veins is the key histopathological hallmark. Surgical lung biopsy is considered the definitive diagnostic test but is associated with significant risk and is not recommended. Distinguishing PVOD from PAH on clinical grounds alone is generally not possible, although PVOD is characterised by a higher male/female ratio and higher tobacco exposure. Instead, non-invasive tests may be helpful and the diagnosis is usually based on an integrated assessment that incorporates high resolution computed tomography (septal lines, ground-glass opacities and lymph node enlargement), pulmonary function testing (lower DLCO), arterial blood gas analysis (lower PaO(2) at rest) and bronchoalveolar lavage (occult alveolar haemorrhage). Treatment of PVOD remains challenging as exposure to pulmonary vasodilators and PAH-specific agents may precipitate acute pulmonary oedema. Nonetheless, a number of successful outcomes describing cautious use of prostanoids, endothelin antagonists and phosphodiesterase type-5 inhibitors have been described. Unfortunately, the long term effects of these agents are variable and lung transplantation remains the treatment of choice. PMID:20456932

  3. Caries process on occlusal surfaces: evolving evidence and understanding.

    PubMed

    Carvalho, J C

    2014-01-01

    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

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

    SciTech Connect

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

    2009-03-15

    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.

  5. Occlusal traits of deciduous dentition of preschool children of Indian children

    PubMed Central

    Bahadure, Rakesh N.; Thosar, Nilima; Gaikwad, Rahul

    2012-01-01

    Objectives: To assess the occlusal relationship, canine relationship, crowding, primate spaces, and anterior spacing in both maxillary and mandibular arches of primary dentition of Indian children of Wardha District and also to study the age-wise differences in occlusal characteristics. Materials and Methods: A total of 1053 (609 males and 444 females) children of 3-5 year age group with complete primary dentition were examined for occlusal relationship, canine relationship, crowding, primate spaces, and anterior spacing in both maxillary and mandibular arches. Results: The data after evaluation showed significant values for all parameters except mandibular anterior spacing, which was 47.6%. Mild crowding was prevalent at 5 year age group and moderate crowding was common at 3 year-age group. Conclusion: Evaluated parameters such as terminal molar relationship and canine relationship were predominantly progressing toward to normal but contacts and crowding status were contributing almost equal to physiologic anterior spacing. Five-year-age group showed higher values with respect to all the parameters. PMID:23633806

  6. Relationship between angiotensin I-converting enzyme insertion/deletion gene polymorphism and retinal vein occlusion

    PubMed Central

    2014-01-01

    To evaluate the association between angiotensin I-converting enzyme insertion/deletion (ACE I/D) gene polymorphism and retinal vein occlusion (RVO). A total of 80 patients with retinal vein occlusion who was admitted to the Eye Department of Kartal Training and Research Hospital between 2008 and 2011, and 80 subjects were enrolled in this retrospective case–control study. Patients who experienced RVO within one week to six months of study enrolment were included, and those with coronary artery diseases, prior myocardial infarction history and coagulation disturbances were excluded from the study. The diagnosis was made by ophthalmoscopic fundus examination and fluorescein angiography. The ACE gene I/D polymorphism was determined by polymerase chain reaction, and the ACE gene was classified into three types: I/I, I/D and D/D. In multivariate logistic regression analysis, ACE D/D genotype (p?=?0.035), diabetes-mellitus (p?=?0.019) and hypertension (p?=?0.001) were found to be independent predictive factors for RVO. The results of the present study reveal that ACE D/D polymorphism is an independent predictive factor for RVO. However, one cannot definitely conclude that ACE gene polymorphism is a risk factor for retinal vein occlusion. PMID:25161389

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

    PubMed Central

    Kothari, Mihir

    2014-01-01

    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

  8. Occlusal treatments in temporomandibular disorders: a qualitative systematic review of randomized controlled trials

    Microsoft Academic Search

    Heli Forssell; Eija Kalso; Pirkko Koskela; Raili Vehmanen; Pauli Puukka; Pentti Alanen

    1999-01-01

    Occlusal treatments (occlusal splints and occlusal adjustment) are controversial but widely used treatment methods for temporomandibular disorders (TMD). To investigate whether studies are in agreement with current clinical practices, a systematic review of randomized controlled trials (RCTs) of occlusal treatment studies from the period 1966 to March 1999 was undertaken. Eighteen studies met the inclusion criteria, 14 on splint therapy,

  9. Diagnosis and management of occlusal wear: a case report.

    PubMed

    Thirumurthy, V R; Bindhoo, Y A; Jacob, Sunil Joseph; Kurien, Anjana; Limson, K S; Vidhiyasagar, P

    2013-09-01

    The rationale for doing full mouth rehabilitation are, when occlusal forces become traumatic hampering the health of periodontal tissues, extensive occlusal diseases, trauma, temporomandibular joint disease and congenital disorders with malformed dentition. Literature exposes that full mouth fixed rehabilitation is one of the taxing procedures in the field of Prosthodontics. A critical aspect for successful occlusal rehabilitation is to determine the aetiology, correct sequence of treatment and most importantly the occlusal vertical dimension and centric relation in which to plan the treatment. A systematic approach in managing these patients can lead to a predictable and favourable prognosis. This article presents the stages of prosthodontic rehabilitation, from diagnosis to final treatment and follow-up, of a bruxer patient with severely worn dentition. PMID:24431762

  10. 21 CFR 878.4020 - Occlusive wound dressing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  11. Functional Patterns of Molar Occlusion in Platyrrhine Primates

    E-print Network

    Rosenberger, Alfred H.

    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

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

    SciTech Connect

    Kundu, Sanjoy, E-mail: sanjoy_kundu40@hotmail.com; 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)

    2011-10-15

    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.

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

    SciTech Connect

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

    1999-03-15

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

  14. Pathophysiological aspects of sickle cell vaso-occlusion

    SciTech Connect

    Nagel, R.L.

    1987-01-01

    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.

  15. Occlusal Caries Depth Measurements Obtained by Five Different Imaging Modalities

    Microsoft Academic Search

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

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

  16. OCCLUSION-FREE IMAGE GENERATION FOR REALISTIC TEXTURE MAPPING

    Microsoft Academic Search

    Diego Ortin; Fabio Remondino

    ABSTRACT: Photo-realistic 3D models are nowadays,required in many applications. The 3D modelling pipeline can be imageor range-based and often ends up with ,a visualization ,of a ,virtual textured model. One of the ,main ,problems ,encountered ,in texture mapping ,is the disturbance in the images by occlusions, which do not allow the generation of photo-realistic textured 3D models. Occlusions can be

  17. Local histograms and image occlusion models

    PubMed Central

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

    2012-01-01

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

  18. Severity of Occlusal Disharmonies in Down Syndrome

    PubMed Central

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

    2012-01-01

    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

  19. Chronic sorrow

    Microsoft Academic Search

    Jean M. Scornaienchi

    2003-01-01

    The concept of chronic sorrow has been used to describe the reaction of parents to the ongoing losses associated with caring for a child with chronic illness or disability. A middle-range theory of chronic sorrow provides a framework for further understanding of this phenomenon. This theory is applied to a case of a family burdened with the unrelenting stress of

  20. Experimental evaluation of intraarterial occlusion-infusion chemotherapy.

    PubMed

    Kudo, S; Wright, K C; Chuang, V P; Wallace, S; Mir, S; Bechtel, W

    1984-11-01

    Intraarterial occlusion-infusion of vincristine and Adriamycin was performed in six dogs using balloon infusion catheters. Tissue toxicity was compared with that obtained when the same drugs were administered by simple arterial infusion. Balloon occlusion of the external iliac artery produced reversed blood flow in the deep femoral, caudal femoral, and superficial circumflex iliac arteries, potentially altering the distribution of the drugs. Thrombosis of arterial branches occurred in three dogs, sooner but no more often in the groups receiving occlusion-infusion chemotherapy. Skin ulceration and dilatation of peripheral small vessels were significantly more frequent and extensive in the groups receiving occlusion-infusion. One infusion dog developed a single small ulcer on the hind paw; five of the six occlusion-infusion dogs developed multiple skin ulcers on the thigh and/or distal extremity. These findings suggest that even though intraarterial occlusion-infusion chemotherapy is not applicable in all instances, the technique does produce significantly greater drug-related effects than simple intraarterial infusion. PMID:6333149

  1. Occlusion regulates epidermal cytokine production and inhibits scar formation.

    PubMed

    Gallant-Behm, Corrie L; Mustoe, Thomas A

    2010-01-01

    Hypertrophic scars are a major clinical problem, yet there are few therapeutics available to prevent or treat scar formation. One of the oldest known and most effective treatments is occlusion with silicone gel. However, little is known about its mode of action. It is hypothesized that occlusion increases the hydration state of the epidermis, and that this affects the epidermal and dermal cell behavior. This study investigated this possibility. Using the rabbit hypertrophic scar model, we determined that occlusion increased the hydration state of the epidermis in a dose-dependent manner, and significantly reduced the scar hypertrophy. Quantitative reverse transcription-polymerase chain reaction and immunohistochemistry showed that occlusion altered keratinocyte behavior, including keratin expression. Furthermore, occlusion significantly decreased the epidermal expression of the profibrotic cytokine interleukin-1beta and increased the epidermal expression of the antifibrotic cytokine tumor necrosis factor alpha. These alterations in the epidermal gene expression resulted in concomitant changes in the expression of the transforming growth factor-beta family members by cells in the dermis, resulting in a decrease in profibrotic signaling within the dermis. In summary, the results of this study indicate that occlusive therapy was able to decrease dermal fibrosis by hydrating the epidermis and altering the pro- and antifibrotic signals produced following injury. PMID:20419876

  2. Occlusion Regulates Epidermal Cytokine Production and Inhibits Scar Formation

    PubMed Central

    Gallant-Behm, Corrie L; Mustoe, Thomas A

    2010-01-01

    Hypertrophic scars are a major clinical problem, yet there are few therapeutics available to prevent or treat scar formation. One of the oldest known and most effective treatments is occlusion with silicone gel. However, little is known about its mode of action. It is hypothesized that occlusion increases the hydration state of the epidermis, and that this affects the epidermal and dermal cell behavior. This study investigated that possibility. Using the rabbit hypertrophic scar model, we determined that occlusion was able to increase the hydration state of the epidermis in a dose dependent manner, and significantly reduced the scar hypertrophy. Quantitative RT-PCR and immunohistochemistry demonstrated that occlusion altered the keratinocyte behavior, including keratin expression. Furthermore, occlusion significantly decreased the epidermal expression of the pro-fibrotic cytokine IL-1? and increased the epidermal expression of the anti-fibrotic cytokine TNF-?. Those alterations in epidermal gene expression resulted in concomitant changes in the expression of TGF-? family members by cells in the dermis, resulting in a decrease in pro-fibrotic signaling within the dermis. In summary, the results of this study indicate that occlusive therapy was able to decrease dermal fibrosis by hydrating the epidermis and altering the pro- and anti-fibrotic signals produced following injury. PMID:20419876

  3. The 'PLUG' odyssey: adventures in experimental fetal tracheal occlusion.

    PubMed

    Bealer, J F; Skarsgard, E D; Hedrick, M H; Meuli, M; VanderWall, K J; Flake, A W; Adzick, N S; Harrison, M R

    1995-02-01

    In animal experiments, it has been shown that tracheal occlusion counteracts the pulmonary hypoplasia associated with congenital diaphragmatic hernia (CDH). Successful clinical implementation requires a reliable, reversible, and atraumatic technique of occluding the fetal trachea. With this clinical goal in mind, the authors evaluated the following three methods of tracheal occlusion in a fetal lamb CDH model: (1) an occluded foam-cuffed endotracheal tube, (2) a foam-cuffed endotracheal tube with a magnetically controlled flow valve, and (3) a tracheal insert constructed of a water-impermeable, expandable, polymeric foam, which is placed by a translaryngeal approach. The foam-cuffed endotracheal tube did not provide consistently reliable fetal tracheal occlusion. Although the magnetically triggered flow valve functioned well, it was not necessary to open the valve in utero (to prevent overdistension of the lungs), and the presence of the valve contributed to several occlusive failures. In contrast, the foam insert was easy to position and to remove from the trachea, while providing reliable tracheal occlusion for several weeks with consequent enlarged fetal lungs, increased lung fluid volumes, complete reduction of abdominal viscera, and improved pulmonary gas exchange after birth. Bronchoscopic evaluation of the foam-occluded neonatal tracheas showed little or no tracheal damage, which was confirmed during necropsy by gross and histological examination. Translaryngeal placement of a compressible, water-impermeable polymeric foam appears to be a simple and safe technique to achieve fetal tracheal occlusion. PMID:7738765

  4. Transient Occlusion of Uterine Arteries in Laparoscopic Uterine Surgery

    PubMed Central

    Kwon, Yong-Soon; Roh, Hyun Jin; Ahn, Jun Woo; Lee, Sang-Hun

    2015-01-01

    Background and Objectives: This study was conducted to determine the feasibility and effectiveness of transient occlusion of the uterine arteries (TOUA) during laparoscopic surgery for benign uterine tumors, with preservation of fertility. Methods: Patients with uterine myoma or adenomyoma underwent laparoscopic uterine surgery, with or without TOUA, performed by a single surgeon (Y.-S.K.). Surgical outcomes included operative time; occurrence of intraoperative injury of blood vessels, nerves, and pelvic organs; and intraoperative blood loss. Results: Of the 168 surgical patients included in this study, 144 were enrolled consecutively during the study period, and 24 had undergone adenomectomy before the study period. A total of 104 women (70 with myoma; 34 with adenomyoma) seeking uterine preservation underwent laparoscopic surgery with TOUA for benign uterine tumors. Sixty-four women (40 with myoma; 24 with adenomyoma) underwent surgery without TOUA. The mean total surgical time of the TOUA groups was 74.85 minutes for uterine myoma and 84.09 minutes for uterine adenomyoma. The mean estimated blood loss during laparoscopic myomectomy and adenomyomectomy was less in the TOUA groups than in the non-TOUA groups (109 vs. 203.4 mL in myomectomy, P < .05; 148.1 vs. 158.9 mL in adenomyomectomy; P < .05). Time to perform TOUA was 13.9 minutes in laparoscopic myomectomy and 7.33 minutes in laparoscopic adenomyomectomy. The hospital stay of the TOUA groups was 3.32 days for uterine myoma and 3.82 days for uterine adenomyoma. No intraoperative conversion to laparotomy was necessary, and no major complications occurred during any of the procedures. Conclusion: Laparoscopic uterine surgery with TOUA could be a safe and effective surgical method for women with symptomatic benign uterine tumors who wish to preserve fertility.

  5. A semiquantitative method of recording experimental tooth erosion and estimating occlusal wear in the rat.

    PubMed

    Sorvari, R; Kiviranta, I

    1988-01-01

    As the erosive agent, a sport-drink mixture with pH 3.2 was given to Osborne-Mendel rats for 6 weeks. Lingual surfaces of the right first mandibular molar crowns were chosen for the recording. With the aid of a drawing tube mounted on a stereomicroscope, enlarged drawings of the surfaces were made encircling the intact and eroded areas. A computer-coupled analyser was used to measure the areas of the total surface, intact surface, eroded enamel and exposed dentine in square millimetres. The data was evaluated statistically and used to calculate erosion changes and to estimate occlusal wear. PMID:3165256

  6. [Radiologically-guided vascular prosthesis after laser recanalization of occlusive lesions of the blood vessels of the lower limbs].

    PubMed

    Rabkin, I Kh; Natsvlishvili, Z G; Kavteladze, Z A

    1991-04-01

    The article deals with the first clinical experience in radiologically-guided prosthetics after laser recanalization of occluded vessels of the lower limbs in 20 patients. The method was introduced into clinical practice after applying separately the methods of radiologically-guided endovascular prosthetics and laser recanalization with subsequent dilatation and experimental substantiation on dogs with artificially created chronic occlusions of the femoral artery. The first results are promising, although the true place of the method in sparing treatment of vessels will be ascertained after rich clinical experience is accumulated and the late-term results studied. PMID:2059500

  7. Caudal mucogingival lesions secondary to traumatic dental occlusion in 27 cats: Macroscopic and microscopic description, treatment and follow-up.

    PubMed

    Gracis, Margherita; Molinari, Elena; Ferro, Silvia

    2014-07-01

    The main aim of this retrospective study was to describe clinical and histopathological findings in cats with mucogingival lesions developed at the contact point of the premolar and molar teeth of the opposite quadrant. Cases were retrieved following manual review of the medical records, dental records and photographic documentation of all feline dental patients visited in the period between February 2001 and August 2011. Cats showing different lesions at different times were calculated as multiple cases. A total of 27 cats (31 cases) with 44 lesions (26 proliferations [59%], 11 clefts [25%] and seven foveae (16%]) were included. Mean age at the time of the first visit was 6.6 years. The lesion object of the study was the main reason for presentation in only five cases (16%). Proliferations showed two different histopathological patterns and had characteristics in common with human oral pyogenic granuloma. Successful treatment was achieved in all cases by removing the occlusal contact by dental extraction or coronal reduction, possibly associated with lesion excision. This study underlines the need for a thorough oral examination and evaluation of dental occlusion in all patients. Causes for the development of traumatic occlusion may include an acquired overbite (possibly secondary to selective dental extraction), congenital or post-traumatic malocclusion, abnormal latero-lateral mobility of the mandible, occlusal drift of the premolar and molar teeth, and/or alveolar bone expansion. PMID:25001492

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

    PubMed

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

    2012-02-01

    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

  9. Balloon test occlusion of the internal carotid artery with stump pressure ratio and venous phase delay technique.

    PubMed

    Wang, Alvin Yi-Chou; Chen, Ching-Chang; Lai, Hung-Yi; Lee, Shih-Tseng

    2013-11-01

    Balloon test occlusion (BTO) is crucial before sacrificing parent arteries. We proposed a simple paradigm combining clinical tolerance with venous phase technique and stump pressure ratio as a criterion for sufficient collateral flow. Internal carotid artery (ICA) occlusion was considered safe for asymptomatic patients who exhibited less than 2 seconds of venous phase delay or had a stump pressure ratio greater than 60%. A total of 37 BTO procedures were performed on 31 patients. Twenty-three patients were monitored clinically and 3 were symptomatic. Venous phase comparison was performed on 27 patients, and 5 failed the test. The stump pressure was measured in all patients, and 7 patients failed the test. In summary, 7 patients failed the BTO, of which 6 received high-flow bypass and 1 of these 6 were symptomatic and exhibited stump pressure ratios less than 60% in the second BTO procedure. Occlusion of the ICA was performed on 29 patients. Only 1 patient developed delayed vasospasm and brain infarction. Adequate collateral flow may be indicated by a stump ratio of 60% or greater with or without a high-flow bypass. Combined with clinical assessment and venous phase technique, ICA occlusion may be a safe option that does not result in delayed ischemic complications. PMID:23849747

  10. Time Management in Acute Vertebrobasilar Occlusion

    SciTech Connect

    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)

    2009-03-15

    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.

  11. [Intestinal occlusion in cocaine-packet ingestion].

    PubMed

    Aldrighetti, L; Graci, C; Paganelli, M; Vercesi, M; Catena, M; Ferla, G

    1993-10-31

    During the last decade, the increase of drug traffic and close customs' control have led smugglers to attempt various methods to pass through customs undetected. One method is the ingestion of large numbers of drug-filled packets (usually containing cocaine), together with anticholinergics inhibiting intestinal peristalsis, by a smuggler, called "body-packer" or "mule". The up-to-date approach to cocaine-packet ingestion is conservative medical management during the spontaneous evacuation of the "ovules". Emergency surgical treatment should be reserved for the complications of cocaine-packet ingestion ("body packer syndrome"), which are bowel obstruction due to clustering of the containers and intraluminal rupture of the "ovules" with massive drug transmucous absorption (acute cocaine intoxication). We describe a case of cocaine-packet ingestion in a 19 year old man who was asymptomatic at admission and thus conservatively treated. During the spontaneous evacuation of ovules, clinical and radiological signs of bowel obstruction appeared and the patient underwent emergency laparotomy with removal of 21 containers, two of them clustered in the distal ileum, causing the occlusion. This case gave reasons for a discussion on the specific features of bowel obstruction in cocaine packet ingestion. The bowel obstruction of cocaine-packet ingestion should be carefully considered and promptly treated because of the potentially lethal consequences (death rate of 56% of cases) of transmucous absorption of cocaine contained in "ovules". In fact, while opioid intoxication can be fought with specific antagonists towards opioid receptors (naloxone), the lack of a specific antidote makes cocaine poisoning particularly dangerous.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8121597

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

    Microsoft Academic Search

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

    1998-01-01

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

  13. Pulmonary veno-occlusive disease in an 11-year-old girl: diagnostic pitfalls.

    PubMed

    Kano, Gen; Nakamura, Keiko; Sakamoto, Izumi

    2014-02-01

    Pulmonary veno-occlusive disease (PVOD) is a rare chronic lung disease that is difficult to diagnose due to non-specific clinical findings. Little is known about the pathogenesis of PVOD. Reported herein is the case of an 11-year-old girl who initially presented with 'bat-wing' shadows on chest radiography. This finding, coupled with prominent hemosiderosis in bronchoalveolar lavage fluid, initially led to a misdiagnosis of idiopathic pulmonary hemosiderosis. Oral prednisolone dramatically improved signs and symptoms initially, but her condition then gradually deteriorated during maintenance therapy with corticosteroids and other immunosuppressants. PVOD was suspected but not confirmed owing to a lack of hallmark radiographic findings and contraindications for lung biopsy. Three years later, while arranging for lung transplantation, the patient experienced sudden onset of fatal massive pulmonary edema. PVOD was confirmed at autopsy. This case provides insights regarding an unfamiliar presentation of PVOD and may help physicians to avoid diagnostic pitfalls. PMID:24548200

  14. Mandibular elevator muscles: physiology, action, and effect of dental occlusion.

    PubMed

    Bakke, M

    1993-10-01

    In spite of differences in embryologic origin, central nervous organization, and muscle fiber distribution, the physiology and action of mandibular elevator muscles are comparable to those of skeletal muscles of the limbs, back, and shoulder. They also share the same age-, sex-, and activity-related variations of muscular strength. With respect to pathogenesis, the type of muscular performance associated with the development of fatigue, discomfort, and pain in mandibular elevators seems to be influenced by the dental occlusion. Clinical research comparing the extent of occlusal contact in patients and controls as well as epidemiologic studies have shown reduced occlusal support to be a risk factor in the development of craniomandibular disorders. In healthy subjects with full natural dentition, occlusal support in the intercuspal position generally amounts to 12-14 pairs of contacting teeth, with predominance of contact on first and second molars. The extent of occlusal contact clearly affects electric muscle activity, bite force, jaw movements, and masticatory efficiency. Neurophysiologic evidence of receptor activity and reflex interaction with the basic motor programs of craniomandibular muscles tends to indicate that the peripheral occlusal control of the elevator muscles is provided by feedback from periodontal pressoreceptors. With stable intercuspal support, especially from posterior teeth, elevator muscles are activated strongly during biting and chewing with a high degree of force and masticatory efficiency, and with relatively short contractions, allowing for pauses. These variables of muscle contraction seem, in general, to strengthen the muscles and prevent discomfort. Therefore, occlusal stability keeps the muscles fit, and enables the masticatory system to meet its functional demands. PMID:8248735

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

    PubMed Central

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

    2014-01-01

    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

  16. What Price Chronic Illness?

    ERIC Educational Resources Information Center

    Weiner, Carolyn; And Others

    1982-01-01

    The debate about cost as it pertains to medical technology misses the mark by not pressing on the central problem of increased prevalence of chronic illness. Far from cost containment, what are needed are additional services which may in the end reduce total costs. (Author/MJL)

  17. Evaluation of the severity of chronic heart failure by the reactivity of peripheral vessels.

    PubMed

    Ino-Oka, E; Ku-Tsuwa, Y; Ohba SKK; Inooka, H

    2001-09-01

    We developed a method to evaluate the severity of chronic cardiac failure by Doppler image analysis. Doppler images of the whole arterial lumen were consecutively recorded on video tape and the power spectrum (sum of intensity multiplied by frequency) of each frame was considered as an index of the blood flow volume (VI). The right brachial artery was occluded for 15-60 seconds by a occluding cuff, and was released quickly. The VI was determined until the VI returned to the level at rest and total VI was calculated as an O2 repayment. The O2 repayment rate (R-Rate) was calculated as a ratio of the O2 repayment divided by total VI during interruption. The cardiac function was evaluated by sub-maximal exercise using bicycle ergometer and was compared with the R-Rate. The subjects were 22 patients (18 males and 4 females) with chronic cardiac failure of NYHA class I (9), class II (6), class III (4), class IV (3) and 12 healthy controls. R-Rate was almost unchanged by the duration of occlusion and showed positive correlation with exercise capacity. R-Rate decreased as the class of NYHA advanced. In conclusion, determination of reactive hyperemia can be used for objectively evaluating the severity of cardiac failure. Doppler sonography; cardiac failure; reactive hyperemia; peripheral circulation PMID:11780719

  18. Chronic kidney disease

    MedlinePLUS

    Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... Chronic kidney disease (CKD) slowly gets worse over months or years. you may not notice any symptoms for some ...

  19. Simultaneous hybrid revascularization for symptomatic lower extremity arterial occlusive disease.

    PubMed

    Joh, Jin Hyun; Joo, Sun-Hyung; Park, Ho-Chul

    2014-04-01

    Multilevel revascularization, using a combination of endovascular and open (hybrid) surgery, is increasingly being used. Hybrid surgery allows complex anatomy to be treated by minimally invasive procedures in medically high risk patients. The aim of the present study was to report a novel hybrid surgery for lesions in the multilevel lower extremity arteries and to evaluate the clinical outcomes. Consecutive patients who presented at a single institution between March 2009 and Feburary 2012 were selected for inclusion in the study. The patients had disabling claudication or critical limb ischemia and underwent treatment for revascularization by open surgery or by a combination of open surgery and endovascular procedure. Retrospective analysis was conducted from a prospectively collected database. All procedures were performed by a vascular surgeon in an operating room. Postoperative surveillance in outpatient clinics was conducted at 3 and 6 months and every 6 months thereafter. A total of 76 patients were included in the study with a mean age of 67.1±11.3 years (range, 42-94 years) and the male to female ratio was 67:9. The most common indication for revascularization was Rutherford category IV (resting pain). The immediate technical success rate of hybrid surgery was 90.5%, with an overall limb salvage rate of 97.4%. The primary patency rates of the hybrid and open groups were 100 and 90.9%, respectively (P=0.441). Therefore, the results of the present study indicate that hybrid surgery is a feasible option for the treatment of multilevel peripheral arterial occlusive disease, showing favorable patency and limb salvage rates. These observations indicate that femoral endarterectomy plays a vital role in hybrid surgery. PMID:24669236

  20. Patterns of recurrent disease after recanalization of femoropopliteal artery occlusions

    SciTech Connect

    Vroegindeweij, Dammis; Tielbeek, Alexander V. [Catharina Hospital, Department of Radiology (Netherlands); Buth, Jaap [Catharina Hospital, Department of Vascular Surgery (Netherlands); Vos, Louwerens D.; Bosch, Harrie C. M. van den [Catharina Hospital, Department of Radiology (Netherlands)

    1997-07-15

    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.

  1. Imaging Natural Occlusal Caries Lesions with Optical Coherence Tomography

    PubMed Central

    Douglas, Shane M.; Fried, Daniel; Darling, Cynthia L.

    2011-01-01

    Several studies have demonstrated that polarization-sensitive optical coherence tomography (PS-OCT) can be used to nondestructively measure the severity of demineralization in the important occlusal surfaces. The purpose of this study was to assess the potential of PS-OCT and OCT methods for the measurement of the depth of natural occlusal carious lesions. Teeth were screened for potential occlusal lesions using near infrared imaging (NIR). A PS-OCT system operating at 1310-nm was used to acquire polarization resolved images of the area of interest on the occlusal surface. The teeth were serial sectioned to 200 ?m thickness and examined with polarized light microscopy (PLM) and Transverse Microradiography (TMR) for comparison. The lesion depth measured nondestructively with PS-OCT was compared to the lesion depth measured with PLM and TMR to assess the performance of these methods and determine if polarization sensitivity is required. The lesion depth measured using OCT correlated well with the lesion depths measured with TMR and PLM. Although polarization sensitivity provided better contrast it was not necessary to have polarization sensitivity to identify deep occlusal lesions. PMID:22228981

  2. Visual Tracking in Occlusion Environments by Autonomous Switching of Targets

    NASA Astrophysics Data System (ADS)

    Imai, Jun-Ichi; Kaneko, Masahide

    Visual tracking is required by many vision applications such as human-computer interfaces and human-robot interactions. However, in daily living spaces where such applications are assumed to be used, stable tracking is often difficult because there are many objects which can cause the visual occlusion. While conventional tracking techniques can handle, to some extent, partial and short-term occlusion, they fail when presented with complete occlusion over long periods. They also cannot handle the case that an occluder such as a box and a bag contains and carries the tracking target inside itself, that is, the case that the target invisibly moves while being contained by the occluder. In this paper, to handle this occlusion problem, we propose a method for visual tracking by a particle filter, which switches tracking targets autonomously. In our method, if occlusion occurs during tracking, a model of the occluder is dynamically created and the tracking target is switched to this model. Thus, our method enables the tracker to indirectly track the “invisible target” by switching its target to the occluder effectively. Experimental results show the effectiveness of our method.

  3. Enrollment Statistics -Engineering TOTAL M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total

    E-print Network

    Hayes, Jane E.

    Enrollment Statistics - Engineering TOTAL M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total Spring 2000 Freshmen 256 8 3 11 19 15 Senior 806 11 9 20 56 34 90 158 26 184 143 16 159 124 18 142 159 24 183 9 3 12 14 2 16 BS Total 1727 MS

  4. Total protein

    MedlinePLUS

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

  5. Percutaneous Retrograde Recanalization of the Celiac Artery by Way of the Superior Mesenteric Artery for Chronic Mesenteric Ischemia

    SciTech Connect

    Joseph, George, E-mail: joseph59@gmail.com; Chacko, Sujith Thomas [Christian Medical College, Department of Cardiology (India)] [Christian Medical College, Department of Cardiology (India)

    2013-02-15

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

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

    SciTech Connect

    Wissgott, Christian, E-mail: cwissgott@wkk-hei.de; 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)

    2013-08-01

    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.

  7. Clinical and xeroradiographic lymphangiography studies of acute and chronic Brugia pahangi infections in dogs.

    PubMed

    Snowden, K; Hammerberg, B; Smallwood, J E

    1986-04-01

    Xeroradiographic lymphangiography was carried out at approximately monthly intervals on five dogs during the first 18 weeks following infection with 400 Brugia pahangi infective larvae in the left rear paw. Clinical signs, body temperatures and microfilaria counts were also monitored during this time. Similar observations were made on nine dogs with chronic infections (one to five years duration) of 200 infective larvae in unilateral inguinal sites. Standard thoracic radiography was conducted on all dogs. Surgical occlusion of the major afferent ducts to the popliteal lymph nodes of the infected and noninfected limbs of a chronically infected dog was performed to study oedema induction and resolution. This non-invasive lymphangiographic technique demonstrated marked differences in lymphatic changes among individual dogs. The severity of lymphatic pathology correlated with clinical signs of limb oedema and low microfilaria counts. Chronically infected dogs also demonstrated a variety of pathological manifestations: two dogs presented lymphatic cording and another showed transient lymphadenitis with fever and pulmonary arterial opacities. Surgical occlusion of major lymphatic ducts in an uninfected limb resulted in short-term oedema, while occlusion caused by B. pahangi in acutely infected dogs resulted in more persistent oedema. Surgical occlusion of a major duct in a chronically infected limb did not result in oedema. Xeroradiographic lymphangiography revealed a spectrum of lymphatic pathology in Brugia pahangi-infected dogs and demonstrated the value of this animal model for the study of the pathogenesis of chronic lymphatic filariasis. PMID:3593469

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

    Microsoft Academic Search

    Shinichi Yoshimura; Yusuke Egashira; Nobuyuki Sakai; Naoya Kuwayama

    2011-01-01

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

  9. Relationship Between Occlusal Plane and Three Levels of Ala Tragus line in Dentulous and Partially Dentulous Patients in Different Age Groups: A Pilot Study

    PubMed Central

    Shaikh, Saquib Ahmed; K, Lekha

    2015-01-01

    Statement of problem: Correct orientation of the occlusal plane plays a vital role in achieving optimal aesthetics, occlusal balance and function of complete dentures. The use of ala tragus line for determination of occlusal plane has been a topic of debate over past many years. Also, the effect of age on level of ala tragal line has not been investigated in the past. Purpose: To determine the effect of age on location of Ala-Tragus line. Materials and Methods: A total of 180 patients (90 males and 90 females) were selected with complete dentition and were grouped according to their age in three age groups with 60 subjects in each age group (Group A: 20-35 y, Group B: 36-50 y, Group C: 51-65 y). Right lateral profile photographs were taken with subjects having fox plane placed intraorally parallel to occlusal plane. Reference points corresponding to inferior border, middle or superior border of tragus and inferior border of ala of nose were marked on photographs. These were joined to get three different levels of Ala-Tragus line. Images were analysed photometrically and most parallel relationship was determined in between arms of fox plane (that represented the occlusal plane) and three different levels of ala tragus line. Data obtained was subjected to statistical analysis using Pearson chi-square and Likelihood-ratio chi-square test. Results: Significant correlation was found between age and level of Ala-Tragus line. The occlusal plane was found to be more parallel to Ala-tragus line when inferior border of tragus was considered as posterior reference point in young adult age group (20-35 y). In older age groups, occlusal plane was found to be more parallel to Ala-tragus line when middle of tragus was considered as posterior reference point. Conclusion: Within the limitations of this study, it can be concluded that a definite relationship exists in between age and level of ala tragus line.

  10. Orbital cellulitis complicated by central retinal artery occlusion.

    PubMed

    Proctor, Charles M; Magrath, George N; de Castro, Luis E Fernández; Johnson, John H; Teed, Ronald G

    2013-01-01

    The authors present a case of a 16-year-old boy who sought treatment in Storm Eye Institute for orbital cellulitis complicated by central retinal artery occlusion. He was examined for severe signs of orbital cellulitis, including decreased vision and an afferent pupillary defect. Intravenous antibiotics failed to provide timely improvement, and the patient was surgically managed with endoscopic orbital decompression. An ocular examination under anesthesia revealed retinal ischemia in the affected eye, and fluorescein angiography confirmed the diagnosis of central retinal artery occlusion. The patient's vision improved slightly following resolution of the infection. Central retinal artery occlusion is a rare complication of orbital cellulitis in adults and has yet to be reported in the pediatric population. PMID:23128536

  11. Transcatheter vessel occlusion: angiographic results versus clinical success

    SciTech Connect

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

    1983-04-01

    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.

  12. Temporomandibular joint function and its effect on concepts of occlusion.

    PubMed

    Weinberg, L A

    1976-05-01

    Many of the premises of dentistry that have evolved empirically have been re-evaluated in the light of newly-developed concepts of TMJ function. Centric relation, although duplicable, may not necessarily be correct. A "functional" centric relation exists when the TMJ radiographs can be correlated with the occlusal findings, in which case, the retruded classical centric relation should be used. When a "dysfunctional" centric relation is present (no correlation between the TMJ radiographs and occlusal findings), the most retruded position should not be used and a therapeutic centric occlusion should be created by the dentist. Subclinical TMJ dysfunction occurs more frequently than commonly thought, because TMJ radiographs are not routinely used. Retruded condylar displacements can be easily overlooked, because the lateral pterygoid muscle has relatively few stretch receptors compared to the elevator muscles of the mandible. Condylar retrusion, therefore, would not necessarily cause lateral pterygoid spasm as might be expected. The exact mechanism of the TMJ suspension system is unknown, although experimental evidence has shown that the condyle can be displaced superiorly with posterior unsupported muscle force. This indicates that the immutability of the condylar path under varying clinical conditions is questionable. Due to the superior displacement characteristics of the TMJ, the condyle does not act as the fulcrum in mandibular kinetics. The fulcrum, therefore, shifts to the teeth and/or bolus, depending on the specific situation. In either instance, whether considering bruxism or mastication, for most patients, an occlusion based on group function is preferable to a canine-protected occlusion to insure TMJ health. Scientifically, no one scheme of occlusion or articulation has been proven to be superior to any other scheme; therefore, the choice is a matter of the personal preference of the dentist. PMID:1063872

  13. Left atrial appendage occlusion by invagination and double suture technique.

    PubMed

    Hernandez-Estefania, Rafael; Levy Praschker, Beltran; Bastarrika, Gorka; Rabago, Gregorio

    2012-01-01

    Left atrial appendage (LAA) plays a crucial role as a source of atrial thrombus in patients with atrial fibrillation (AF). Thus, the need to close LAA becomes evident in patients with AF who undergo concomitant mitral valve surgery. Unfortunately, it has been reported a high rate of unsuccessful LAA occlusion, regardless of the technique employed.We propose a safe and simple method for LAA occlusion consisting in invagination of the appendage into the left atrium, followed by two sutures (purse string suture around the base of the LAA and a reinforce running suture). PMID:21684756

  14. [How do occlusion disorder and stress influence cybernetic masticatory control?].

    PubMed

    Jäger, K; Schneider, M

    1992-01-01

    Chewing forces were registered and compared in three subjects under normal conditions as well as in presence of occlusal interferences, and under stress. Biting force, blood pressure, and concentration of blood catecholamines were measured. Psychic stress was induced by demanding reactions on a test machine. In the presence of occlusal interferences, no significant increase in biting force was recorded. However, the biochemical analysis documented that biting forces appeared to be no longer under local control, but, increased up to 600% when the level of stress was raised. This study confirms the importance of stress as an etiologic factor in masticatory dysfunction. PMID:1598553

  15. A method for analysis of human mandibular occlusal movement.

    PubMed

    Joss, A; Graf, H

    1979-11-01

    A new method was developed to produce perspectives and maps of the top of Posselt's envelope of motion, the part that is mainly determined by occlusal tooth contact. Mandibular occlusal gliding movements were recorded in human subjects by optoelectronic tracking of infrared light emitters fixed to the subjects upper and lower teeth. Recordings were made by a commercially available electronic camera system that was extended to meet the special needs. An elaborate computer program was developed to process the information and convert it into graphic plots. Care was taken to make the system easy to use. PMID:293915

  16. Management of psoriasis vulgaris with a hydrocolloid occlusive dressing.

    PubMed

    Friedman, S J

    1987-08-01

    Because clinical improvement of psoriasis vulgaris was recently observed after the prolonged application of tape, 26 patients with symmetric plaque-type psoriasis were enrolled in a prospective bilateral comparison study evaluating the clinical efficacy of the adhesive hydrocolloid occlusive dressing (HCD). The majority of localized plaques of psoriasis achieved improvement (41%, 14/34) or resolution (47%, 16/34) with the prolonged application of HCD; also, HCD was therapeutically superior to twice-daily applications of fluocinolone acetonide cream, and was comparably effective as erythemogenic ultraviolet B treatment. Although the therapeutic mechanism is not completely understood, occlusive dressings have great potential in the management of limited psoriasis vulgaris. PMID:3631982

  17. 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)

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

    2002-04-01

    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.

  18. Chronic atherosclerotic mesenteric ischemia (CMI).

    PubMed

    Zeller, Thomas; Rastan, Aljoscha; Sixt, Sebastian

    2010-08-01

    Chronic mesenteric ischemia (CMI) is most likely caused by atherosclerosis and less frequently by external compression and vasculitis. Symptomatic CMI is an uncommon, potentially under-diagnosed condition caused by fixed stenoses or occlusion of, in most conditions, at least two visceral arteries. If only one of the three major bowel-providing arteries - the celiac trunk, and the superior and inferior mesenteric arteries - is affected, the patient is usually asymptomatic due to a tight collateral network. The only exception is the celiac artery compression syndrome which represents primarily a compression syndrome of celiac plexus nerves by the arcuate ligament in conjunction with a compression of the celiac trunk. CMI of atherosclerotic origin is associated with a high morbidity and mortality. During the last decade, endovascular revascularization has replaced surgical revascularization as the therapy of choice in most centers. This article reviews the most relevant clinical aspects of the disease and the current practice of diagnosis and treatment of CMI. PMID:20584821

  19. Patterns and forces of occlusal contacts during lateral excursions recorded by the T-Scan II system in young Chinese adults with normal occlusions.

    PubMed

    Wang, Y-L; Cheng, J; Chen, Y-M; Yip, K H-K; Smales, R J; Yin, X-M

    2011-08-01

    The objective was to characterise the patterns and forces of occlusal contacts during lateral mandibular excursions in a young Chinese adult population. Angle Class I normal occlusions in 85 dental students aged 20-29 were evaluated using the T-Scan II occlusal imaging and analysis system. The frequency of occlusal contacts was recorded for right and left lateral excursions at the position of lateral disclusion, at the canine-to-canine position and at the lateral maximal position. At the canine-to-canine position, the occlusal contact patterns were classified, and the relative forces were compared by multiple regression analysis, with ? = 0·05. At the position of lateral disclusion, a high percentage of canine contacts (58·5%) and individual posterior tooth contacts on the working side was observed. At the canine-to-canine position, the canines on the working side contacted most frequently (68·9%), and the occlusal contact patterns could be classified into six groups. At the lateral maximal position, incisors (39·0%) and canines (32·3%) contacted most frequently. At the canine-to-canine position, subjects with occlusal contacts only on canines or on first premolars on the working side had the lowest relative occlusal forces (P < 0·001). Canine protection and group function do not identify all descriptors for lateral occlusal contact patterns in the natural dentition. Six occlusal contact patterns were found at the lateral canine-to-canine position. PMID:21294761

  20. Evaluation of the effect of two different occlusal splints on maximum occlusal force in patients with sleep bruxism: a pilot study

    PubMed Central

    Dogan, Arife; Bek, Bulent

    2014-01-01

    PURPOSE The occlusal splint has been used for many years as an effective treatment of sleep bruxism. Several methods have been used to evaluate efficiency of the occlusal splints. However, the effect of the occlusal splints on occlusal force has not been clarified sufficiently. The purpose of this study was to evaluate the effect of occlusal splints on maximum occlusal force in patients with sleep bruxism and compare two type of splints that are Bruxogard-soft splint and canine protected hard stabilization splint. MATERIALS AND METHODS Twelve students with sleep bruxism were participated in the present study. All participants used two different occlusal splints during sleep for 6 weeks. Maximum occlusal force was measured with two miniature strain-gage transducers before, 3 and 6 weeks after insertion of occlusal splints. Clinical examination of temporomandibular disorders was performed for all individuals according to the Craniomandibular Index (CMI) before and 6 weeks after the insertion of splints. The changes in mean occlusal force before, 3 and 6 weeks after insertion of both splints were analysed with paired sample t-test. The Wilcoxon test was used for the comparison of the CMI values before and 6 weeks after the insertion of splints. RESULTS Participants using stabilization splints showed no statistically significant changes in occlusal force before, 3, and 6 weeks after insertion of splint (P>.05) and participants using Bruxogard-soft splint had statistically significant decreased occlusal force 6 weeks after insertion of splint (P<.05). There was statistically significant improvement in the CMI value of the participants in both of the splint groups (P<.05). CONCLUSION Participants who used Bruxogard-soft splint showed decreases in occlusal force 6 weeks after insertion of splint. The use of both splints led to a significant reduction in the clinical symptoms. PMID:24843394

  1. Hypervolemic treatment of the chronic obliterative arteriopathies of extremities.

    PubMed

    Brassai, Z; Koválszki, P; Pop, G H; Kiss, K; Olosz, E

    1986-01-01

    The efficacy of dextran therapy in forty patients with chronic occlusive arterial disease (twelve with Buerger's disease and twenty-eight with atherosclerosis obliterans) was studied by repeated measurements of the following hemodynamic parameters;: the relative walking distance (RWD), the absolute walking distance (AWD), the oscillometric index (OI), the perfusion pressure of the affected limb (PP) and the Doppler index (DI) - the last two being determined by using an ultrasound technique. The hemodynamic improvements secondary to dextran therapy were demonstrated by the increase of RWD (from 115.3 m to 235.0 m), of AWD (from 170.4 m to 339.0 m), of PP (from 64.6 +/- 12.4 mmHg to 97.6 +/- 13.3 mmHg) and of DI (from 0.38 to 0.65). These results constitute strong arguments for the wider application of dextran therapy in the comprehensive management of chronic occlusive arterial disease. PMID:2422732

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

    PubMed

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

    2015-02-01

    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

  3. TOTAL M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total Spring 2010

    E-print Network

    Hayes, Jane E.

    TOTAL M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total M F Total Spring 2010 Freshmen 400 4 4 8 31 13 44 63 13 76 34 2 36 27 5 32 27 2 29 106 8 34 3 37 0 1 1 X X BS Total 1943 57 236 363 119 180 192 603 42 134 17 MS Total 216 18 2 44 X 32 58 39

  4. Face recognition with contiguous occlusion using markov random fields

    Microsoft Academic Search

    Zihan Zhou; Andrew Wagner; Hossein Mobahi; John Wright; Yi Ma

    2009-01-01

    Partially occluded faces are common in many applica- tions of face recognition. While algorithms based on sparse representation have demonstrated promising results, they achieve their best performance on occlusions that are not spatially correlated (i.e. random pixel corruption). We show that such sparsity-based algorithms can be significantly im- proved by harnessing prior knowledge about the pixel error distribution. We show

  5. Sex Differences during Visual Scanning of Occlusion Events in Infants

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

  6. Argon laser panretinal photocoagulation in ischemic central retinal vein occlusion

    Microsoft Academic Search

    Sohan Singh Hayreh; Marie R. Klugman; Patricia Podhajsky; Gary E. Servais; Edward S. Perkins

    1990-01-01

    We conducted a prospective, planned study of argon laser panretinal photocoagulation (PRP) in ischemic central retinal vein occlusion (CRVO) over a 10-year period in 123 eyes. On comparing the lasered eyes versus the nonlasered eyes, there was no statistically significant difference between the two groups in the incidence of development of angle neovascularization (NV), neovascular glaucoma (NVG), retinal and\\/or optic

  7. Coronary artery ectasia--a variant of occlusive coronary arteriosclerosis

    Microsoft Academic Search

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

    1978-01-01

    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.

  8. Measure Locally, Reason Globally: Occlusion-sensitive Articulated Pose Estimation

    E-print Network

    Black, Michael J.

    and not with the prior. In particular, image evidence for each body part is estimated independently of other parts with by our method which makes weak assumptions about body pose but uses a new occlusion-sensitive image of the image likelihood of a body pose, multiple body parts can, and often do, explain the same image data

  9. Thrombolytic treatment for acute occlusion of the basilar artery

    Microsoft Academic Search

    M Huemer; V Niederwieser; G Ladurner

    1995-01-01

    Sixteen patients with acute occlusion of the basilar artery were treated with systemic fibrinolysis. Recanalisation was achieved in 10 patients; five patients survived and 11 patients died. Survival was associated with vascular recanalisation in every case. Most of the survivors were younger than 50. An age above 50 and a comatose state on admission seem to indicate a poor clinical

  10. Efficient detection of occlusion prior to robust face recognition.

    PubMed

    Min, Rui; Hadid, Abdenour; Dugelay, Jean-Luc

    2014-01-01

    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

  11. Modification of polyurethane to reduce occlusion of enteral feeding tubes

    SciTech Connect

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

    2009-04-27

    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.

  12. Classification of the skeletal variation in normal occlusion.

    PubMed

    Kim, Ji-Young; Lee, Shin-Jae; Kim, Tae-Woo; Nahm, Dong-Seok; Chang, Young-Ii

    2005-05-01

    The aims of this study were to classify normal occlusion samples into specific skeletal types and to analyze the dentoalveolar compensation in a normal occlusion in order to provide the clinically applicable differential diagnostic criteria for an individual malocclusion patient. Lateral cephalograms of 294 normal occlusion samples, who were selected from 15,836 adults through a community dental health survey, were measured. Using a principal component analysis, two factors representing the anteroposterior and vertical skeletal relationships were extracted from 18 skeletal variables. Cluster analysis was then used to classify the skeletal patterns into nine types. Nine types of polygonal charts with a profilogram were created. Discriminant analysis with a stepwise entry of variables was designed to identify several potential variables for skeletal typing, which could be linked with computerized cephalometric analysis for an individual malocclusion patient. Discriminant analysis assigned 87.8% classification accuracy to the predictive model. It was concluded that because the range of a normal occlusion includes quite diverse anteroposterior and vertical skeletal relationships, classifying the skeletal pattern and establishing an individual dentoalveolar treatment objective might facilitate clinical practice. PMID:15898366

  13. Celiac artery stenosis/occlusion treated by interventional radiology.

    PubMed

    Ikeda, Osamu; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki

    2009-08-01

    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas. PMID:18562143

  14. Surgical Porcine Myocardial Infarction Model through Permanent Coronary Occlusion

    PubMed Central

    Munz, Maria R; Faria, Miguel A; Monteiro, Joana R; Águas, Artur P; Amorim, Mário J

    2011-01-01

    Using domestic pigs as an animal model, we here validated a reproducible and standardized myocardial infarction (MI) surgical model, to achieve the largest possible infarct extent with the lowest morbidity and mortality. To this end, we included several anesthetic and perisurgical precautions to minimize surgical complications. Mortality and morbidity rates were compared among groups of pigs that underwent permanent occlusion at different locations of either the left circumflex or left anterior descending artery. In addition, to compare the resulting MI between groups, data were collected by using cardiac biomarkers (including troponin I), electrocardiography, and echocardiography. These data were correlated to the final mean infarct size calculated by microscopic studies. Proximal occlusions lead to high mortality rates, whereas distal occlusions induced rather small MI areas. The optimal occlusion site in terms of morbidity, mortality, and lesion extent was the midpoint of the left anterior descending artery. In this group, only one pig died, and group cardiac data showed a rise in biomarker levels, marked left ventricular dysfunction on electrocardiography and echocardiography, and well-defined transmural MI in both ventricles. Infarct size quantitated through histologic studies revealed an average 15% ventricular lesion. Because interanimal variability in results from this group was negligible, we consider that the induced myocardial injury of this model is reliable. PMID:22330353

  15. Modeling Occlusion by Discriminative AND-OR Structures , Tianfu Wu

    E-print Network

    Zhu, Song Chun

    positions. The model parameters are learned from real images under the latent structural SVM (LSSVM configurations. Inspired by the expres- sive power of AND-OR graph [35], we propose a simple AND-OR structure (which is a directed and acyclic graph) to model the occlusion configurations effectively. Fig.1

  16. An evidence-based assessment of occlusal adjustment as a treatment for temporomandibular disorders

    Microsoft Academic Search

    Yoshihiro Tsukiyama; Kazuyoshi Baba; Glenn T. Clark

    2001-01-01

    Statement of problem. Occlusal adjustment therapy has been advocated as a treatment modality for temporomandibular disorders. In contrast to this position, a panel at the 1996 National Institute of Health technology assessment conference on TMD indicated that no clinical trials demonstrate that occlusal adjustment is superior to noninvasive therapies. Purpose. This article summarizes the published experimental studies on occlusal adjustments

  17. An alternative procedure for discrimination of contacts in centric occlusion and lateral excursion.

    PubMed

    Sato, Yuuji; Koretake, Katsunori; Hosokawa, Ryuji

    2002-12-01

    An alternative procedure for discrimination of contacts in centric occlusion and lateral excursion was introduced for eliminating premature contacts in lateral excursion without the alteration of other intercuspations. This procedure involves the application of red paper for the evaluation of lateral excursive contacts and blue paper for centric occlusion holding contacts to provide improved visibility of occlusal contacts. PMID:12488860

  18. Quantification and validation of predictive values of occlusal variables in temporomandibular disorders using a multifactorial analysis

    Microsoft Academic Search

    Andrew G. Pullinger; Donald A. Seligman

    2000-01-01

    Statement Of Problem. A consensus is lacking on the association between occlusal variables and temporomandibular disorders (TMDs). Purpose. This study estimated the maximum potential power of occlusal variables to differentiate patients with TMD from asymptomatic normal adult subjects. Material And Methods. The occlusal characteristics in 2 sets of female patients with intracapsular TMD (1993, n = 257, and 1998, n

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

    PubMed Central

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

    2013-01-01

    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

  20. A possible biomechanical role of occlusal cusp-fossa contact relationships.

    PubMed

    Wang, M; Mehta, N

    2013-01-01

    Biomechanical features of occlusal contacts are important in understanding the role of the occlusion contributing to masticatory function. Cusp-fossa contact is the typical pattern of occlusion between upper and lower teeth. This includes static relations, such as that during clenching, and dynamic relations when mandibular teeth contact in function along the maxillary occlusal pathways, as during mastication. During clenching in the maximum intercuspal position (ICP), cuspal inclines may take the role of distributing the occlusal forces in multi-directions thus preventing excessive point pressures on the individual tooth involved. During chewing movement on the functional side, the mandible moves slightly from buccal through the maximum ICP to the contralateral side. The part of the chewing cycle where occlusal contacts occur and the pathways taken by the mandible with teeth in occlusal contacts are determined by the morphology of the teeth. The degree of contact is associated with the activity of the jaw muscles. To obtain repeatable static and dynamic occlusal contact information provided by the morphology of the teeth, maximum voluntary clenching and chewing movements with maximum range are needed. In conclusion, in addition to the standard occlusal concepts of centric relation/centric occlusion and group function/cuspid protection relation, biomechanics in static and dynamic cusp-fossa relationships should be included to develop an understanding of occlusal harmony which includes no interfering or deflective contacts in functional occlusal contact. PMID:22882571

  1. Chronic obstructive pulmonary disease

    MedlinePLUS

    COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... heart swelling and heart failure due to chronic lung disease) Pneumonia Pneumothorax Severe weight loss and malnutrition Thinning ...

  2. Chronic Meningitis

    MedlinePLUS

    ... 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 ...

  3. Imaging of mechanical tubal occlusion devices and potential complications.

    PubMed

    Guelfguat, Mark; Gruenberg, Tammy R; Dipoce, Jason; Hochsztein, Jay G

    2012-10-01

    The increasing use of permanent mechanical contraceptive devices has placed growing demands on radiologists. Hysteroscopically placed tubal occlusion devices, in particular, must be evaluated promptly and carefully to verify that they are in a satisfactory location and are functioning effectively. Hysterosalpingography, radiography, ultrasonography, computed tomography, and magnetic resonance imaging all may be useful for this purpose; however, the acquisition and interpretation of images of these devices can be challenging and requires specific knowledge. Verification of tubal occlusion with a hysteroscopically placed device depends heavily on the adequacy of cornual distention with the contrast medium at hysterosalpingography. Some complications of coil (Essure device) placement, such as tubal perforation and device migration, may be clinically occult and their imaging appearances subtle; a high degree of suspicion is needed to detect them at postprocedural imaging. The position of another tubal occlusion device, a radiolucent silicone matrix (Adiana device), is not directly depicted at imaging with x-rays. By contrast, laparoscopically placed locking tubal clips are well depicted at radiography; however, their dislodgement and migration are seldom symptomatic and thus unlikely to be discovered in time to avert pregnancy. The use of any tubal occlusion device is associated with low albeit finite risks of unwanted intrauterine pregnancy, ectopic pregnancy, tubal and uterine perforation, and device migration into the peritoneal cavity. Results of multiple trials show that a substantial percentage of such complications occurred because of image misinterpretation and consequent patient reliance on tubal occlusion alone for contraception. Accurate description and classification of abnormalities in device position or function seen at imaging performed postprocedurally or for other clinical indications will enhance the value of radiologists' contributions to patient care. PMID:23065163

  4. Chronic pain.

    PubMed

    2015-03-18

    Essential facts Chronic pain is pain that persists or recurs for more than three months. It may be related to a condition, or may be pain from an injury or operation that continues after healing would usually take place. According to guidance from the Scottish Intercollegiate Guidelines Network (SIGN), around 18 per cent of Europe's population are currently affected by moderate to severe chronic pain. It has a considerable effect on quality of life, and can cause significant suffering and disability. PMID:25783253

  5. EEG analysis for evaluating chronic cerebral ischemia treated by hyperbaric oxygenation and microneurosurgery

    Microsoft Academic Search

    K.-H. Holbach; H. Wassmann; F. Sanchez

    1978-01-01

    Thirty-five chronic stroke patients, who had internal carotid occlusion that resulted in considerable neurological deficit persisting for an average of 10 weeks, were studied. First, hyperbaric oxygen (HO) therapy was administered to each patient. Subsequently an extra-intracranial anastomosis operation was performed on 21 of these patients. Serial neurological examinations and EEG analyses were performed to assess the clinical course of

  6. Nd:YAG laser in occlusal caries prevention of primary teeth: a randomized clinical trial.

    PubMed

    Raucci-Neto, Walter; de Castro-Raucci, Larissa Moreira Spinola; Lepri, Cesar Penazzo; Faraoni-Romano, Juliana Jendiroba; Gomes da Silva, Jaciara Miranda; Palma-Dibb, Regina Guenka

    2015-02-01

    Dental caries is still the most prevalent chronic disease affecting human populations. Among the preventive treatments performed, it has been reported that laser irradiation combined with topical fluoride can induce an even greater increase in enamel caries resistance. The aim of this study was to evaluate the Nd:YAG laser, with or without fluoride, in occlusal caries prevention of the primary dentition. A double-blind split-mouth study design was used. Fifty-two children with high caries risk (7.6?±?1.4 years) were selected and received the following: G1--the first molar was a negative control, and the second received a resin sealant; G2--the first molar was a negative control, and the second received laser irradiation (50 mJ, 10 Hz, 0.5 W); G3--the first molar received only acidulate phosphate fluoride (APF), and the second received APF + laser; G4--fisrt molar received only fluoride varnish, and the second received fluoride varnish + laser. Patients were followed up to 12 months to evaluate the presence of white-spot lesions and/or caries cavities by three calibrated observers. Thirty-five patients completed the study. Significant differences were found between the treatment and control groups (p?occlusal caries in pits and fissures when used alone with lower energy over a 1-year period. PMID:23955196

  7. The role of occlusal factors on the occurrence of temporomandibular disorders.

    PubMed

    Sousa, Stéphanie Trajano de; Mello, Victor Villaça Cardoso de; Magalhães, Bruno Gama; Morais, Mariana Pacheco Lima de Assis; Vasconcelos, Marcia Maria Vendiciano Barbosa; Junior, Arnaldo de França Caldas; Gomes, Simone Guimarães Farias

    2014-07-16

    Aims: The aim of this study was to investigate the relationship between occlusal factors and temporomandibular disorders (TMD). Methodology: One hundred patients were selected among those who sought medical or dental care in public practice in Recife, Brazil. The presence of malocclusions and absence of five or more posterior teeth were evaluated by the clinical exam. TMD diagnosis was given using Research Diagnostic Criteria (RDC/TMD). Statistics were carried out using Fisher and Mann-Whitney methods with 5% significance level, as well as multiple logistic regression analysis. Results: The sample was mainly comprised of women (83%), individuals over 30 years old (57%) and singles (53%). The percentage of TMD and malocclusion in total sample was 42% and 50%, respectively, while in TMD subjects, malocclusion was present in 38·1%. There was no association between TMD and the occlusal factors studied. Conclusion: It can be concluded that malocclusion and loss of five or more posterior teeth does not contribute to TMD. PMID:25027731

  8. Toxic tacrolimus levels after application of topical tacrolimus and use of occlusive dressings in two bone marrow transplant recipients with cutaneous graft-versus-host disease.

    PubMed

    Olson, Katherine A; West, Kathleen; McCarthy, Philip L

    2014-06-01

    Tacrolimus, a macrolide immunosuppressant, is used topically for the treatment of cutaneous manifestations of graft-versus-host disease (GVHD) for rapid, symptomatic relief of pruritus and erythema. Despite the manufacturer's product information reporting minimal systemic effects of topical tacrolimus, this has not been evaluated in patients with cutaneous GVHD and with occlusive dressings. We describe two patients with cutaneous GVHD who developed toxic tacrolimus levels after receiving several applications of tacrolimus ointment along with occlusive dressings to enhance skin effectiveness. The first patient was a 62-year-old woman with a history of acute myelogenous leukemia (AML) who underwent allogeneic bone marrow transplantation and developed chronic GVHD involving 70% of her body surface area. Her GVHD treatment plan consisted of oral corticosteroids, oral tacrolimus, topical corticosteroids, topical tacrolimus 0.1% ointment twice/day, emollient creams, intravenous rituximab, and photopheresis. The patient's tacrolimus trough levels rose rapidly over the course of 6 days from less than 2 ng/ml to 23 ng/ml, despite oral tacrolimus dosage adjustments. The second patient was a 25-year-old man who developed severe, chronic skin GVHD after undergoing allogeneic sibling bone marrow transplantation for AML. In addition to intravenous corticosteroids, corticosteroid creams, and oral tacrolimus, the patient also received topical tacrolimus twice/day with occlusive dressings. Over the course of 2 days, his tacrolimus trough levels increased from 7.10 ng/ml to 22.10 ng/ml. Although improvement was noted in both patients' skin GVHD with application of the occlusive dressings, the practice was discontinued due to increased and erratic systemic tacrolimus absorption. These case reports suggest that substantial use of topical tacrolimus with occlusive dressings in patients with cutaneous GVHD may contribute to increased systemic absorption resulting in toxic tacrolimus levels. Based on the findings from our two patients as well as published case reports, systemic absorption appears to increase with greater skin permeability, skin barrier dysfunction, amount of body surface area applied, and use of occlusive dressings. When one or more of these factors are present, it may be prudent to monitor tacrolimus levels. PMID:24700567

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

    NASA Astrophysics Data System (ADS)

    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.

    2010-05-01

    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.

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

    SciTech Connect

    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)

    2010-05-31

    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.

  11. Radiation-absorbed doses and energy imparted from panoramic tomography, cephalometric radiography, and occlusal film radiography in children.

    PubMed

    Bankvall, G; Håkansson, H A

    1982-05-01

    The absorbed doses and energy imparted from radiographic examinations of children, using panoramic tomography (PTG), cephalometric radiography (CPR), and maxillary frontal occlusal overview (FOO), were examined. The absorbed dose at various sites of the head were measured with TL dosimeters in a phantom and in patients. The energy imparted was calculated from measurements of areal exposure using a planparallel ionization chamber. The maximum absorbed doses for panoramic tomography were located around the lateral rotation center, for cephalometric radiography in the left (tube side) parotid region, and for frontal occlusal radiography in the nose. The absorbed doses in the eyes, thyroid gland, and skin are discussed and compared with previous reports and, for the most part, are found to be in agreement. The mean energy imparted from all three examination methods is 5 mJ with about 57 percent from panoramic, 33 percent from cephalometric, and 10 percent from frontal occlusal examinations. The energy imparted from cephalometric radiography can be reduced to about 10 percent with the use of an improved examination technique, leaving panoramic tomography responsible for contributing about 80 percent of the total energy imparted. PMID:6954429

  12. Efficacy of biofeedback therapy via a mini wireless device on sleep bruxism contrasted with occlusal splint: a pilot study

    PubMed Central

    Gu, WeiPing; Yang, Jie; Zhang, FeiMin; Yin, XinMin; Wei, XiaoLong; Wang, Chen

    2015-01-01

    Abstract The putative causes of bruxism are multifactorial and there are no definite measures for bruxism management. The aim of this study was to evaluate the efficacy of biofeedback therapy on sleep bruxism, compared with occlusal splint. Twenty-four volunteers with sleep bruxism were divided into two groups: the GTB group that were treated with biofeedback therapy (n ?=?12) and the GTO group that were treated with occlusal splint (n ?=?12). A mini pressure sensor integrated with a monitoring circuit by use of a maxillary biofeedback splint was fabricated. To foster the relaxation of the masticatory muscles and the nervous system, the wireless device received signals from bruxism events and vibrations alerted the bruxer when the threshold was exceeded. Total episodes and average duration of bruxism events during 8 hours of sleep were analyzed with the monitoring program (TRMY1.0). After 6 and 12 weeks, the episodes (P ?=? 0.001) and duration (P < 0.05) in the GTB group declined dramatically. In contrast, there were no significant differences in the GTO group after the treatment (P > 0.05). Furthermore, the episodes had significant differences between the GTB group and the GTO group after the same period of treatment (P ?=? 0.000). The results suggest that biofeedback therapy may be an effective and convenient measure for mild bruxers, when compared with occlusal splint therapy. The mini wireless biofeedback method may be of value for the diagnosis and management of bruxism in the future.

  13. Efficacy of biofeedback therapy via a mini wireless device on sleep bruxism contrasted with occlusal splint: a pilot study.

    PubMed

    Gu, WeiPing; Yang, Jie; Zhang, FeiMin; Yin, XinMin; Wei, XiaoLong; Wang, Chen

    2015-04-01

    The putative causes of bruxism are multifactorial and there are no definite measures for bruxism management. The aim of this study was to evaluate the efficacy of biofeedback therapy on sleep bruxism, compared with occlusal splint. Twenty-four volunteers with sleep bruxism were divided into two groups: the GTB group that were treated with biofeedback therapy (n ?=?12) and the GTO group that were treated with occlusal splint (n ?=?12). A mini pressure sensor integrated with a monitoring circuit by use of a maxillary biofeedback splint was fabricated. To foster the relaxation of the masticatory muscles and the nervous system, the wireless device received signals from bruxism events and vibrations alerted the bruxer when the threshold was exceeded. Total episodes and average duration of bruxism events during 8 hours of sleep were analyzed with the monitoring program (TRMY1.0). After 6 and 12 weeks, the episodes (P ?=? 0.001) and duration (P < 0.05) in the GTB group declined dramatically. In contrast, there were no significant differences in the GTO group after the treatment (P > 0.05). Furthermore, the episodes had significant differences between the GTB group and the GTO group after the same period of treatment (P ?=? 0.000). The results suggest that biofeedback therapy may be an effective and convenient measure for mild bruxers, when compared with occlusal splint therapy. The mini wireless biofeedback method may be of value for the diagnosis and management of bruxism in the future. PMID:25859272

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

    SciTech Connect

    Kim, Min Joo; Choo, Sung Wook, E-mail: choosw@smc.samsung.co.kr; 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)

    2004-01-15

    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.

  15. Long term prognosis after occlusion of middle cerebral artery.

    PubMed Central

    Sacquegna, T; De Carolis, P; Andreoli, A; Ferrara, R; Limoni, P; Testa, C; Lugaresi, E

    1984-01-01

    Seventy patients who had developed occlusion of the middle cerebral artery confirmed by angiography between 1970 and 1980 were followed up after an average of six years. Fourteen patients had died in the acute stage of the initial stroke. In the remaining 56 patients actuarial analysis showed that the observed incidence of survival for five years was 81.8% compared with an incidence of 94.1% in a matched normal population. Six patients sustained new strokes, four of which were ipsilateral to the middle cerebral artery occlusion. The observed cumulative incidence of subsequent strokes was 2% a year for the first five years of follow up. Twelve patients developed epileptic seizures. PMID:6426614

  16. Endobronchial occlusive disease: Nd:YAG or PDT?

    NASA Astrophysics Data System (ADS)

    Regal, Anne-Marie; Takita, Hiroshi

    1991-06-01

    Patients with endobronchial occlusion commonly experience dyspnea, cough, hemoptysis, pneumonitis, and atelectasis. If luminal patency is not re-established, obstructive symptoms may progress to sepsis and death. Although the overall survival of patients with lung cancer may not be altered by relief of airway obstruction, the prognosis for this subset of patients may be improved by eliminating the septic complications of bronchial occlusion. Techniques to treat occluded bronchi include electro-fulguration, cryotherapy, brachytherapy, laser (CO2, Nd-YAG) therapy, and photodynamic therapy (PDT). These represent local forms of treatment and are intended to be palliative. Nd-YAG and PDT are the modalities more frequently utilized in this setting. Comparison of the two treatment forms may furnish insight regarding the appropriate role for each as individual therapies and as part of the armamentarium of cancer therapies.

  17. Branch Retinal Vein Occlusion: Pathogenesis, Visual Prognosis, and Treatment Modalities

    PubMed Central

    Rehak, Jiri; Rehak, Matus

    2008-01-01

    In branch retinal vein occlusion (BRVO), abnormal arteriovenous crossing with vein compression, degenerative changes of the vessel wall and abnormal hematological factors constitute the primary mechanism of vessel occlusion. In general, BRVO has a good prognosis: 50–60% of eyes are reported to have a final visual acuity (VA) of 20/40 or better even without treatment. One important prognostic factor for final VA appears to be the initial VA. Grid laser photocoagulation is an established treatment for macular edema in a particular group of patients with BRVO, while promising results for this condition are shown by intravitreal application of steroids or new vascular endothelial growth factor inhibitors. Vitrectomy with or without arteriovenous sheathotomy combined with removal of the internal limiting membrane may improve vision in eyes with macular edema which are unresponsive to or ineligible for laser treatment. PMID:18293182

  18. Superior mesenteric venous thrombosis in malrotation with chronic volvulus.

    PubMed

    Walsh, D S; Crombleholme, T M

    2000-05-01

    Malrotation can be difficult to diagnose after the newborn period because of intermittent symptoms and vague clinical findings, but malrotation with midgut volvulus is usually quite striking in its presentation. Early diagnosis and surgical treatment are essential to prevent acute ischemic infarction of the bowel, although chronic complications are rare. The authors present an unusual case of mesenteric venous thrombosis secondary to chronic midgut volvulus. A 13-year-old girl presented with an 11-year history of recurrent bouts of abdominal pain evaluated at 3 other institutions without a diagnosis. At the referring hospital, an episode of bilious emesis associated with abdominal pain prompted a computerized tomography scan of the abdomen. This showed a calcified thrombus within the superior mesenteric vein (SMV). At laparotomy, malrotation with chronic 270 degree volvulus was found with evidence of mesenteric venous hypertension. Segmental occlusion was documented on magnetic resonance angiography. SMV thrombosis is an unusual complication of malrotation with chronic midgut volvulus. PMID:10813342

  19. [Chronic diarrhea].

    PubMed

    Stelzer, Teresa; Heuss, Ludwig Theodor

    2014-09-01

    Defined by lasting more than four weeks - is a common but often challenging clinical scenario. It is important to be aware that diarrhoea means different things to different patients. The evaluation of chronic diarrhoea depends on taking an excellent history and careful physical examination as well as planning investigations thoughtfully. Functional diarrhea ist the most common cause of chronic diarrhea in the developed countries and motility disorders are more common than inflammatory, osmotic or secretory causes. In some cases categorizing patients by their stool characteristics can be helpful in directing further evaluation. PMID:25154689

  20. Effects of garlic coated tablets in peripheral arterial occlusive disease

    Microsoft Academic Search

    H. Kiesewetter; F. Jung; E. M. Jung; J. Blume; C. Mrowietz; A. Birk; J. Koscielny; E. Wenzel

    1993-01-01

    For the first time, a weak clinical efficacy of a 12-week therapy with garlic powder (daily dose, 800 mg) is demonstrated in patients with peripheral arterial occlusive disease stage II. The increase in walking distance in the verum group by 46 m (from 161.0 ± 65.1 to 207.1 ± 85.0 m) was significantly higher (P<0.05) than in the placebo group

  1. Tubular Occlusion Optimizes Bonding of Hydrophobic Resins to Dentin

    Microsoft Academic Search

    F. T. Sadek; D. H. Pashley; M. Ferrari; F. R. Tay

    2007-01-01

    Although hydrophobic resins may be bonded to acid-etched dentin with an ethanol wet-bonding technique, the protocol is sensitive to moisture contamination when bonding is performed in deep dentin. This study tested the hypothesis that the use of oxalate or poly(glutamic) acid-modified, diluted ceramicrete (PADC) for dentinal tubule occlusion prevents fluid contamination and improves the bonding of an experimental hydrophobic adhesive

  2. [Studies on the cybernetic aspects of occlusal splint therapy].

    PubMed

    Tschernitschek, H; Feistner, H

    1990-09-01

    This study was focussed on the effects of changes in interocclusal clearance on the activity of oral muscles. Two types of occlusal splints were incorporated in 20 subjects without TMJ-syndrome. Their muscle reactions were recorded electromyographically in the masseter muscle. The results show 5 groups of muscle reaction correlated with the mean postural face height. The changed height of the postural position has a significant influence on the control pattern of the masticatory system. PMID:2269205

  3. Digital subtraction angiography in pediatric cerebrovascular occlusive disease

    SciTech Connect

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

    1984-08-01

    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.

  4. Multimodality imaging of the Essure tubal occlusion device.

    PubMed

    Simpson, W L; Beitia, L

    2012-12-01

    The Essure device is a permanent birth-control device, which is gaining popularity. The micro-inserts are composed of metallic elements that can be seen on radiography, computed tomography, ultrasound, and magnetic resonance imaging. Knowledge of the normal location and appearance of the Essure device will ensure appropriate patient care. The purpose of this review is to describe the Essure tubal occlusion device and illustrate its normal and abnormal appearance using various imaging methods. PMID:22985750

  5. Status Epilepticus after Prolonged Umbilical Cord Occlusion Is Associated with Greater Neural Injury Fetal Sheep at Term-Equivalent

    PubMed Central

    Drury, Paul P.; Davidson, Joanne O.; van den Heuij, Lotte G.; Wassink, Guido; Gunn, Eleanor R.; Booth, Lindsea C.; Bennet, Laura; Gunn, Alistair J.

    2014-01-01

    The majority of pre-clinical studies of hypoxic-ischemic encephalopathy at term-equivalent have focused on either relatively mild insults, or on functional paradigms of cerebral ischemia or hypoxia-ischemia/hypotension. There is surprisingly little information on the responses to single, severe ‘physiological’ insults. In this study we examined the evolution and pattern of neural injury after prolonged umbilical cord occlusion (UCO). 36 chronically instrumented fetal sheep at 125–129 days gestational age (term?=?147 days) were subjected to either UCO until mean arterial pressure was occlusion (n?=?7). Surviving fetuses were killed after 72 hours for histopathologic assessment with acid-fuchsin thionine. After UCO, 11 fetuses died with intractable hypotension and 5 ewes entered labor and were euthanized. The remaining 13 fetuses showed marked EEG suppression followed by evolving seizures starting at 5.8 (6.8) hours (median (interquartile range)). 6 of 13 developed status epilepticus, which was associated with a transient secondary increase in cortical impedance (a measure of cytotoxic edema, p<0.05). All fetuses showed moderate to severe neuronal loss in the hippocampus and the basal ganglia but mild cortical cell loss (p<0.05 vs sham occlusion). Status epilepticus was associated with more severe terminal hypotension (p<0.05) and subsequently, greater neuronal loss (p<0.05). In conclusion, profound UCO in term-equivalent fetal sheep was associated with delayed seizures, secondary cytotoxic edema, and subcortical injury, consistent with the predominant pattern after peripartum sentinel events at term. It is unclear whether status epilepticus exacerbated cortical injury or was simply a reflection of a longer duration of asphyxia. PMID:24797081

  6. Grassmann manifold based shape matching and retrieval under partial occlusions

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

    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.

  7. Mechanical antithrombotic intervention by LAA occlusion in atrial fibrillation.

    PubMed

    Yu, Cheuk-Man; Khattab, Ahmed A; Bertog, Stefan C; Lee, Alex P W; Kwong, Joey S W; Sievert, Horst; Meier, Bernhard

    2013-12-01

    Stroke in patients with atrial fibrillation (AF) is often associated with substantial morbidity and mortality. Oral anticoagulation remains the first-line approach to stroke prevention in such individuals; however, for a considerable proportion of patients, traditional treatment using warfarin is limited by a number of factors, such as the inconvenience of frequent therapeutic monitoring and the risk of haemorrhage. The development of new oral anticoagulants with improved efficacy and safety profiles has provided viable options for oral anticoagulation therapy in patients with nonvalvular (nonrheumatic AF). Nonetheless, in patients who have an increased risk of major haemorrhage, a nonpharmacological approach to antithrombotic therapy remains an attractive alternative. The left atrial appendage (LAA) has been found to be the source of >90% of thrombi in patients with nonvalvular AF; thus, prevention of thrombus formation via transcatheter mechanical LAA occlusion is a novel therapeutic target for stroke prevention in this patient population. In this Review, we present the rationale for LAA occlusion in patients with AF, the available occlusion devices and their clinical evidence to date. We also discuss the roles of various imaging techniques in device implantation and the management strategy for associated procedural complications. PMID:24145892

  8. Chronic Pain

    Microsoft Academic Search

    Malcolm H. Johnson

    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

  9. Open surgery for chronic limb ischemia: a review.

    PubMed

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

    2013-12-01

    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

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

    PubMed

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

    2014-10-01

    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

  11. Surgical Results of the Carotid Occlusion Surgery Study

    PubMed Central

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

    2014-01-01

    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

  12. Chronic Fatigue Syndrome

    MedlinePLUS

    ... she had chronic fatigue syndrome. What Is Chronic Fatigue Syndrome? Chronic fatigue syndrome (CFS) is a complicated disease for doctors ... this and CFS. Continue Who Gets CFS? Chronic fatigue syndrome can affect people of all ages and ...

  13. Chronic Eosinophilic Leukemia

    MedlinePLUS

    ... Español Chronic Myeloproliferative Neoplasms Treatment (PDQ®) Chronic Eosinophilic Leukemia Key Points for This Section Chronic eosinophilic leukemia ... include fever and feeling very tired. Chronic eosinophilic leukemia is a disease in which too many white ...

  14. Chronic pain - resources

    MedlinePLUS

    Pain - resources; Resources - chronic pain ... The following organizations are good resources for information on chronic pain: American Chronic Pain Association - www.theacpa.org National Fibromyalgia and Chronic Pain Association - www.fmcpaware.org ...

  15. Ear infection - chronic

    MedlinePLUS

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... Kerschner JE. Otitis media. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders ...

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

    SciTech Connect

    Klonaris, Chris, E-mail: cklonaris@yahoo.com; 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)

    2007-07-15

    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.

  17. Effects of nisoldipine on coronary collateral perfusion and hemodynamics in chronically instrumented dogs.

    PubMed

    Kenny, D; Hartman, J C; Brooks, H L; Warltier, D C

    1989-01-01

    The effect of a new dihydropyridine slow-channel calcium blocking agent, nisoldipine, on hemodynamics and myocardial blood flow in normal and collateral-dependent areas distal to a chronic coronary artery occlusion were studied in chronically instrumented, conscious dogs. Nisoldipine produced significant and dose-related decreases in arterial blood pressure, an elevation of heart rate and large increases in coronary blood flow velocity. In dogs with an Ameroid constrictor previously implanted to enhance coronary collateral development, this agent produced large increases in perfusion distal to a chronic coronary artery occlusion. In addition, despite a reduction in arterial pressure, nisoldipine preserved renal cortical, intestinal and skeletal muscle blood flow while increasing tissue flow within liver and cerebral cortex. Thus, nisoldipine increases oxygen supply to collateral-dependent myocardium in the presence of reduced driving pressure for collateral perfusion. PMID:2755966

  18. Chronic urticaria.

    PubMed Central

    Burrall, B. A.; Halpern, G. M.; Huntley, A. C.

    1990-01-01

    Urticaria affects 15% to 20% of the population once or more during a lifetime. Chronic urticaria is a frequent recurrent eruption over a period greater than 6 weeks; the cause remains a mystery in more than 75% of cases. Urticaria and angioedema may be produced by immunologic or nonimmunologic means. Urticarial vasculitis, contact urticaria, mastocytosis, physical urticarias, dermatographism, cholinergic urticaria, localized heat urticaria, cold urticaria, aquagenic urticaria, and vibratory angioedema all require specific evaluation and treatment. Chronic idiopathic urticaria is usually controlled by antihistamines; depending on the circadian rhythm of the eruption, sedative or nonsedative antihistamines are prescribed. Some patients will require a combination of H1 and H2 antagonists, or even parenteral corticosteroids. PMID:1970697

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

    PubMed Central

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

    2014-01-01

    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

  20. Chronic Diseases

    Microsoft Academic Search

    Sharon R. Schatz

    Although diabetes mellitus, cardiovascular disease, and human immunodeficiency virus infection are three separate entities,\\u000a each has causal and non-causal risk factors that are common in the stage 5 chronic kidney disease population. The medical\\u000a nutrition therapies are similar, which emphasize adequate protein and energy intakes, fluid control, and possibly carbohydrate\\u000a and fat modifications. Each patient requires an individualized evaluation, taking

  1. Chronic berylliosis

    Microsoft Academic Search

    G. W. H. Schepers

    1962-01-01

    1.The key cases in terms of which the concept chronic berylliosis originally was formulated have been reviewed.2.Of 58 cases there was acceptable proof of exposure to beryllium agents in only 40.3.Beryllium was found in the lungs in only 20 instances, but had previously been reported in 8 additional cases.4.New diagnoses have been suggested for the remaining 30 of the original

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

    PubMed

    Chang, Yuh-Ming; Fan, Yang-Kai

    2015-02-01

    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

  3. Interactive View-Dependent Rendering with Conservative Occlusion Culling in Complex Environments

    Microsoft Academic Search

    Sung-eui Yoon; Brian Salomon; Dinesh Manocha

    2003-01-01

    This paper presents an algorithm combining view-dependent rendering and conservative occlusion culling for interactive display of complex environments. A vertex hierarchy of the entire scene is decomposed into a cluster hierarchy through a novel clustering and partitioning algorithm. The cluster hierarchy is then used for view-frustum and occlusion culling. Using hardware accelerated occlusion queries and frame-to-frame coherence, a potentially visible

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

    SciTech Connect

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

    2007-07-15

    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.

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

    SciTech Connect

    Powell, Steven, E-mail: Steven.Powell@rlbuht.nhs.uk; 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)

    2010-02-15

    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.

  6. Prevention of Arteriovenous Shunt Occlusion Using Microbubble and Ultrasound Mediated Thromboprophylaxis

    PubMed Central

    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.

    2014-01-01

    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

  7. Health literacy and knowledge of chronic disease

    Microsoft Academic Search

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

    2003-01-01

    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

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

    NASA Astrophysics Data System (ADS)

    Mazurek, Przemys?aw

    2013-09-01

    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.

  9. Interventional treatment for portal venous occlusion after liver transplantation: long-term follow-up results.

    PubMed

    Wang, Jianfeng; Yang, Weili; Huang, Qiang; Gao, Kun; Wei, Baojie; Zhai, Renyou; Shi, Yaoping

    2015-01-01

    Portal vein (PV) occlusion after liver transplant is an uncommon clinical situation, and percutaneous interventional treatment for this condition has not been widely described. The aim of this study was to evaluate the long-term treatment effect of interventional treatment for PV occlusion after liver transplantation (LT). Follow-up data of 13 patients who received interventional treatment for PV occlusion after LT between July 2007 and April 2013 were analyzed. Of these, 10 patients had portal hypertension-related signs and symptoms. Percutaneous balloon angioplasty and stent placement were performed, with percutaneous thrombolysis treatment as appropriate. Embolization therapy was required for significant collateral circulation. Technical and clinical success, complications, and patency of PV were analyzed. Both technical and clinical success was achieved in 11 of the 13 patients (84.6%). Direct portogram showed limited PV occlusion in 7 patients and extensive PV occlusion in 4 patients. The former underwent balloon angioplasty followed by stent placement, while the latter underwent balloon angioplasty followed by stent placement and additional percutaneous thrombolysis treatment. Embolization therapy for collateral circulation was performed in all 4 patients with extensive PV occlusion and 1 patient with limited PV occlusion. All stents remained patency during the follow-up (28.5?±?6.8 months). No portal hypertension-related symptoms reoccurred during follow-up. In conclusion, interventional treatment for PV occlusion after LT showed a high success rate and good long-term results. Comprehensive interventional treatment should be used for extensive PV occlusion. PMID:25634164

  10. Robust Lane Sensing and Departure Warning under Shadows and Occlusions

    PubMed Central

    Tapia-Espinoza, Rodolfo; Torres-Torriti, Miguel

    2013-01-01

    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

  11. Occlusal caries depth measurements obtained by five different imaging modalities.

    PubMed

    Kamburo?lu, Kivanç; Kurt, Hakan; Kolsuz, Eray; Özta?, Bengi; Tatar, Ilkan; Çelik, Hakan Hamdi

    2011-10-01

    The study aimed to assess the accuracy and reproducibility of occlusal caries depth measurements obtained from different imaging modalities. The study comprised 21 human mandibular molar teeth with occlusal caries. Teeth were imaged using film, CCD, two different cone-beam computerized tomography (CBCT) units and a microcomputer tomography (micro-CT). Thereafter, each tooth was serially sectioned, and the section with the deepest carious lesion was scanned using a high-resolution scanner. Each image set was separately viewed by three oral radiologists. Images were viewed randomly, and each set was viewed twice. Lesion depth was measured on film images using a digital caliper, on CCD and CBCT images using built-in measurement tools, on micro-CT images using the Mimics software program, and on histological images using AxioVision Rel. 4.7. Intra- and inter-rater reliabilities were assessed according to the Bland/Altman method by calculating Intraclass Correlation Coefficients (ICCs). Mean/median values obtained with intraoral systems were lower than those obtained with 3-D and histological images for all observers and both readings. Intra-observer ICC values for all observers were highest for histology and micro-CT. In addition, intra-observer ICC values were higher for histology and CBCT than for histology and intra-oral methods. Inter-observer ICC values for first and second readings were high for all observers. No differences in repeatability were found between Accuitomo and Iluma CBCT images or between intra-oral film and CCD images. Micro-CT was found to be the best imaging method for the ex vivo measurement of occlusal caries depth. In addition, both CBCT units performed similarly and better than intra-oral modalities. PMID:21116675

  12. Randomized Evaluation of Carotid Occlusion and Neurocognition (RECON) trial

    PubMed Central

    Festa, Joanne R.; Cheung, Ying-Kuen; Pavol, Marykay A.; Derdeyn, Colin P.; Clarke, William R.; Videen, Tom O.; Grubb, Robert L.; Slane, Kevin; Powers, William J.; Lazar, Ronald M.

    2014-01-01

    Objective: To determine whether extracranial-intracranial (EC-IC) bypass can improve cognition over 2 years compared to best medical therapy alone in patients with symptomatic internal carotid artery (ICA) occlusion and increased oxygen extraction fraction (OEF) on PET. Methods: Patients underwent 15O PET and were randomized if OEF ratio was >1.13 on the occluded side. Using blinded baseline and 2-year cognitive assessments, age-adjusted composite z scores were generated from subtests sensitive to right/left hemisphere plus global cognitive functioning. Multiple regression predicted 2-year cognitive change. Results: Eighty-nine patients were enrolled; 41 had increased OEF and were randomized. Two died, 2 were lost to follow-up, and 2 refused 2-year testing. Of the 35 remaining, 6 had ipsilateral stroke or death, leaving 13 surgical and 16 medical patients. Controlling for age, education, and depression, there was no difference in 2-year cognitive change between the medical and surgical arms (95% confidence interval ?0.5 to 0.5, p = 0.9). In post hoc analysis of 26 patients with no stroke in the follow-up period, cognitive improvement was associated with less impaired PET OEF at baseline (p = 0.045). Conclusion: Cognitive improvement following bypass surgery was not superior to medical therapy among patients with recently symptomatic carotid occlusion and increased OEF. Among those with no recurrent stroke, less hemodynamic impairment at baseline was associated with greater cognitive gain in both groups. Reversing cognitive impairment in hemodynamic failure remains an open challenge. Classification of evidence: This study provides Class II evidence that for patients with symptomatic ICA occlusion and increased OEF on PET, EC-IC bypass compared to no bypass does not improve cognitive function after 2 years. PMID:24477109

  13. Sinusoidal Obstruction Syndrome (Hepatic Veno-Occlusive Disease)

    PubMed Central

    Fan, Cathy Q.; Crawford, James M.

    2014-01-01

    Hepatic sinusoidal obstruction syndrome (SOS) is an obliterative venulitis of the terminal hepatic venules, which in its more severe forms imparts a high risk of mortality. SOS, also known as veno-occlusive disease (VOD), occurs as a result of cytoreductive therapy prior to hematopoietic stem cell transplantation (HSCT), following oxaliplatin-containing adjuvant or neoadjuvant chemotherapy for colorectal carcinoma metastatic to the liver and treated by partial hepatectomy, in patients taking pyrrolizidine alkaloid-containing herbal remedies, and in other particular settings such as the autosomal recessive condition of veno-occlusive disease with immunodeficiency (VODI). A central pathogenic event is toxic destruction of hepatic sinusoidal endothelial cells (SEC), with sloughing and downstream occlusion of terminal hepatic venules. Contributing factors are SEC glutathione depletion, nitric oxide depletion, increased intrahepatic expression of matrix metalloproteinases and vascular endothelial growth factor (VEGF), and activation of clotting factors. The clinical presentation of SOS includes jaundice, development of right upper-quadrant pain and tender hepatomegaly, ascites, and unexplained weight gain. Owing to the potentially critical condition of these patients, transjugular biopsy may be the preferred route for liver biopsy to exclude other potential causes of liver dysfunction and to establish a diagnosis of SOS. Treatment includes rigorous fluid management so as to avoid excessive fluid overload while avoiding too rapid diuresis or pericentesis, potential use of pharmaceutics such as defibrotide, coagulolytic agents, or methylprednisolone, and liver transplantation. Proposed strategies for prevention and prophylaxis include reduced-intensity conditioning radiation for HSCT, treatment with ursodeoxycholic acid, and inclusion of bevacizumab with oxaliplatin-based chemotherapeutic regimes. While significant progress has been made in understanding the pathogenesis of SOS and in mitigating against its adverse outcomes, this condition remains a serious complication of a selective group of medical treatments. PMID:25755580

  14. Contribution of nerve growth factor to upregulation of P2X? expression in DRG neurons of rats with femoral artery occlusion.

    PubMed

    Liu, Jiahao; Li, Jialiu David; Lu, Jian; Xing, Jihong; Li, Jianhua

    2011-09-01

    Femoral artery occlusion augments the sympathetic nerve and pressor responses to muscle contraction and muscle metabolites injected into the arterial blood supply of the hindlimb muscles in rats. The underlying mechanism by which these reflex responses are enhanced after muscle vascular insufficiency is unclear. Purinergic P2X(3) receptor has been reported to contribute to the metabolic component of the exercise pressor reflex. Thus the purpose of this study was to examine if chronic femoral occlusion would alter the expression of P2X(3) in dorsal root ganglion (DRG) neurons of rats. Also, P2X(3)-mediated sympathetic responsiveness was examined after femoral occlusion. In addition, the role played by nerve growth factor (NGF) in regulating the expression and response of P2X(3) was examined. Western blot analysis showed that 24 h of femoral ligation increased the levels of P2X(3) (optical density: 0.93 ± 0.07 in control and 1.37 ± 0.10 after occlusion; P < 0.05 vs. control). The fluorescence immunohistochemistry further demonstrated that the occlusion elevated P2X(3) expression in DRG neurons (percentage of P2X(3)-positive cells: 33 ± 3% in control and 51 ± 3% in occlusion; P < 0.05 vs. control). Furthermore, the results showed that responses of renal sympathetic nerve activity and blood pressure to stimulation of P2X were greater in occluded rats than responses in control rats by injection of ?,?-methylene ATP into the arterial blood supply of the hindlimb muscle. Finally, infusion of NGF in the hindlimb muscles of healthy rats increased P2X(3) (optical density: 0.98 ± 0.12 in control and 1.37 ± 0.16 with NGF; P < 0.05 vs. control). The pressor response to injection of ?,?-methylene ATP was increased in the rats with NGF infusion. Likewise, blocking NGF attenuated exaggeration of the reflex response induced by ?,?-methylene ATP in occluded rats. The findings of this study suggest that the levels of P2X(3) in primary afferent neurons are upregulated as the blood supply to the hindlimb is deficient under ischemic conditions, leading to augmentation of the muscle reflex. NGF is closely related to increases in P2X(3) receptor expression and response. PMID:21642505

  15. Left main coronary artery occlusion after percutaneous aortic valve implantation.

    PubMed

    Bartorelli, Antonio L; Andreini, Daniele; Sisillo, Erminio; Tamborini, Gloria; Fusari, Melissa; Biglioli, Paolo

    2010-03-01

    Left main coronary artery occlusion occurred immediately after transfemoral aortic valve implantation in an 87-year-old woman, which resulted in ventricular fibrillation and hemodynamic collapse. This life-threatening complication was promptly diagnosed with transesophageal echocardiography, which showed the disappearance of diastolic left main coronary artery jet flow and was confirmed with aortic root angiography. After prompt defibrillation, hemodynamic support was obtained with intra-aortic balloon pump and inotropic drugs. Functional recovery and survival were achieved with coronary stenting. This report highlights the importance of an integrated team approach of highly skilled specialists for these novel interventions. PMID:20172163

  16. Death After Closed Adolescent Knee Injury and Popliteal Artery Occlusion

    PubMed Central

    Reid, Jeremy J.; Kremen, Thomas J.; Oppenheim, William L.

    2013-01-01

    A healthy adolescent male soccer player sustained a radiograph-negative, effusion-negative physeal injury of the proximal tibia from a ground-level fall with traumatic occlusion of the popliteal artery. Orthopaedic evaluation and arteriography were delayed for 72 hours after the injury. He arrived at a tertiary referral center in multisystem organ failure secondary to lower extremity ischemic necrosis, septic pulmonary thromboembolism, and systemic shock. Emergent medical evaluation, a high index of suspicion, and a careful neurovascular examination are imperative after every closed knee injury in the young athlete. PMID:24427433

  17. A 57-year Follow-up Study of Occlusion

    Microsoft Academic Search

    Rolf Elling Berg; Lisen Espeland; Arild Stenvik

    2008-01-01

    \\u000a Abstract\\u000a \\u000a \\u000a Objective:\\u000a   To analyze occlusal changes occurring between the ages of 8 and 65 years in persons with anterior and\\/or posterior crossbite\\u000a at the age of 8; to examine their attitudes toward dental appearance and their experiences related to their own teeth.\\u000a \\u000a \\u000a \\u000a \\u000a Sample and Methods:\\u000a   Of the 81 people we contacted who had been documented as having crossbite as 8-year-olds

  18. Three-dimensional assessment of dental casts' occlusal surfaces using two impression materials.

    PubMed

    Tarawneh, F M; Panos, P G; Athanasiou, A E

    2008-11-01

    The aim of this study was to assess by means of a three-dimensional computed tomography scanning system the occlusal surface characteristics of dental casts made using two different impression materials. Alginate and polyvinyl siloxane impressions were taken of 20 dental students resulting in 40 dental casts. The casts were paired for each student separately so that each pair consisted of an alginate poured cast and a polyvinyl siloxane poured out cast. The casts were scanned using FlashCT scanner and for each cast, a three-dimensional digital image was obtained. The digitized casts were processed using the three-dimensional imaging software Geomagic Studio 9. A total of 464 paired teeth were digitally separated and superimposed. For each tooth, two measurements were obtained corresponding to the two different impression materials used. The two sets of volumes for all digitally separated teeth were compared and analysed using the Wilcoxon signed test. Larger volume measurements were obtained for teeth separated from alginate poured out casts than from their corresponding ones from polyvinyl siloxane casts (P = 0.005). When the teeth were divided into the groups of incisors, canines and premolars/molars, only the last one exhibited significant difference (P = 0.00). The mean difference between the volumes measured for all 464 teeth separated was 0.041 mm(3) (+/-0.33). The occlusal surfaces of teeth appear differently in dental casts depending on the impression materials used. Impressions of dental casts should be utilized with caution in relation to their research application and in reference with dental wear studies. PMID:18482343

  19. Patterns of missing occlusal units and oral health-related quality of life in SDA patients.

    PubMed

    Baba, K; Igarashi, Y; Nishiyama, A; John, M T; Akagawa, Y; Ikebe, K; Ishigami, T; Kobayashi, H; Yamashita, S

    2008-08-01

    The aim of this study was to explore the relationship between patterns of missing occlusal units (OUs) and oral health-related quality of life (OHRQoL) in subjects with the shortened dental arches (SDAs). Subjects with SDAs were recruited consecutively for 1 month from six university-based prosthodontic clinics. In total, 115 SDA subjects participated (mean age, 58.5 +/- 10.0 years; 71% female). The location and number of missing teeth were examined and the number of missing OUs was calculated. To evaluate OHRQoL, the Japanese version of the Oral Health Impact Profile (OHIP-J) was administered and the summary score of OHIP-J was calculated. The SDA subjects were categorized depending upon the anterior-posterior lengths of the missing or remaining OUs. Regression analyses were performed to investigate the OHIP-J differences between groups of subjects with various anterior-posterior SDA lengths. The analyses revealed that subjects who only lost the second molar contact exhibited significantly better OHRQoL than those who lost more teeth [coefficient: 11.1, 95% confidence interval (CI): 2.8-19.2, P = 0.02]. Furthermore a statistically significant group difference was observed between the groups with and without the first molar occlusal contact (coefficient: 12.8, 95% CI: 1.4 to 24.1, P = 0.03). In conclusion, although our results are of exploratory nature and need validation, patterns of missing OUs are likely to be related to the OHRQoL impairment in SDA subjects with the presence of first molar contact having a particularly important role. PMID:18699971

  20. Regional pulmonary veno-occlusion: a newly identified lesion of equine exercise-induced pulmonary hemorrhage.

    PubMed

    Williams, K J; Derksen, F J; de Feijter-Rupp, H; Pannirselvam, R R; Steel, C M; Robinson, N E

    2008-05-01

    Exercise-induced pulmonary hemorrhage (EIPH) is common in horses following intense exertion, occurring in up to 75% of racing Thoroughbreds and Standardbreds. In spite of this, the pathogenesis of EIPH is poorly understood. In 7 racing Thoroughbred horses with EIPH, 6 sections were collected from the left and right lung, representing the cranial, middle, and caudal region of the dorsal and ventral lung (84 sites total). Grossly, both right and left lungs had numerous dark brown to blue-black foci along the caudodorsal visceral pleura. Tissue sections were stained with hematoxylin-eosin, Masson's trichrome, and Prussian blue. Verhoeff Van Gieson and immunohistochemistry for alpha-smooth muscle actin were used to assess the pulmonary vasculature. Histologic scores (HS = 0-3) were assigned to each region/slide for the presence and severity of 5 findings: interstitial fibrosis, hemosiderin accumulation, pleural/interlobular septal thickness, arterial and venous wall thickness, and evidence of angiogenesis (maximum cumulative HS = 15). Thirty-nine of the 84 (46%) sections were histologically normal (HS = 0); 33/84 (39%) were mildly to moderately affected, with small amounts of hemosiderin and fibrosis (HS = 1-9) while 12/84 (14%), primarily from the dorsocaudal lung, had severe vascular remodeling, fibrosis, and hemosiderin accumulation (HS = 10-15). In the latter, veno-occlusive remodeling of the intralobular veins colocalized with hemosiderosis, fibrosis, hypertrophy of vessels within the pleura, and interlobular septa and bronchial neovascularization. We propose that regional veno-occlusive remodeling, especially within the caudodorsal lung fields, contributes to the pathogenesis of EIPH, with the venous remodeling leading to regional vascular congestion and hemorrhage, hemosiderin accumulation, fibrosis, and bronchial angiogenesis. PMID:18487488

  1. Non-invasive and non-occlusive blood pressure estimation via a chest sensor.

    PubMed

    Sola, Josep; Proenca, Martin; Ferrario, Damien; Porchet, Jacques-Andre; Falhi, Abdessamad; Grossenbacher, Olivier; Yves, Allemann; Rimoldi, Stefano; Sartori, Claudio

    2013-07-10

    The clinical demand for a device to monitor Blood Pressure (BP) in ambulatory scenarios with minimal use of inflation cuffs is increasing. Based on the so-called Pulse Wave Velocity (PWV) principle, this paper introduces and evaluates a novel concept of BP monitor that can be fully integrated within a chest sensor. After a preliminary calibration, the sensor provides non-occlusive beat-by-beat estimations of Mean Arterial Pressure (MAP) by measuring the Pulse Transit Time (PTT) of arterial pressure pulses travelling from the ascending aorta towards the subcutaneous vasculature of the chest. In a cohort of 15 healthy male subjects, a total of 462 simultaneous readings consisting of reference MAP and chest PTT were acquired. Each subject was recorded at three different days: D, D+3 and D+14. Overall, the implemented protocol induced MAP values to range from 80 ± 6 mmHg in baseline, to 107 ± 9 mmHg during isometric handgrip maneuvers. Agreement between reference and chest-sensor MAP values was tested by using intraclass correlation coefficient (ICC = 0.78) and Bland-Altman analysis (mean error = 0.7 mmHg, standard deviation = 5.1 mmHg). The cumulative percentage of MAP values provided by the chest sensor falling within a range of ±5 mmHg compared to reference MAP readings was of 70%, within ±10 mmHg was of 91%, and within ±15mmHg was of 98%. These results point at the fact that the chest sensor complies with the British Hypertension Society (BHS) requirements of Grade A BP monitors, when applied to MAP readings. Grade A performance was maintained even two weeks after having performed the initial subject-dependent calibration. In conclusion, this paper introduces a sensor and a calibration strategy to perform MAP measurements at the chest. The encouraging performance of the presented technique paves the way towards an ambulatory-compliant, continuous and non-occlusive BP monitoring system. PMID:23864147

  2. Effects of ureteral occlusion and ethacrynic acid infusion on renal prostaglandin degradation in the dog.

    PubMed

    Bugge, J F; Stokke, E S; Dahl, E; Kiil, F

    1988-08-01

    The two major renal prostaglandins PGE2 and PGI2 are partly metabolized during a single passage of the kidney. To examine whether stopping glomerular filtration affected the renal degradation, PGE2 and PGI2 were infused into the suprarenal aorta of dogs during ureteral occlusion. Prostaglandin synthesis was blocked by indomethacin, 10 mg kg-1 b.w. i.v. About 20% of PGI2 and 80-90% of PGE2 were metabolized during one passage through the kidney. Prostaglandin degradation and arterial input were proportional (r greater than 0.95). Compared to control conditions at free urine flow, PGI2 degradation was not changed, whereas the degradation of PGE2 was slightly increased by ureteral occlusion. Ethacrynic acid might reduce degradation of PGE2 by inhibiting two degradation enzymes. To examine the influence of ethacrynic acid, PGE2 was infused in different doses into the suprarenal aorta of dogs before and after administration of ethacrynic acid 3 mg kg-1 b.w. i.v. At all dose levels of PGE2, 75-80% was degraded by one passage through the kidney, whether ethacrynic acid was administered or not. However, although ethacrynic acid did not alter the total renal output, the urinary fraction was reduced from 20-30% to 10-15%. We conclude that degradation of both PGE2 and PGI2 is mainly confined to the blood vessels, and that ethacrynic acid in conventional doses does not prevent degradation of PGE2, but redistributes PGE2 output from urine to renal venous blood. PMID:3067518

  3. 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

    ClinicalTrials.gov

    2014-10-30

    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

  4. Motion estimation with non-local total variation regularization

    Microsoft Academic Search

    Manuel Werlberger; Thomas Pock; Horst Bischof

    2010-01-01

    State-of-the-art motion estimation algorithms suffer from three major problems: Poorly textured regions, occlusions and small scale image structures. Based on the Gestalt principles of grouping we propose to incorporate a low level image segmentation process in order to tackle these problems. Our new motion estimation algorithm is based on non-local total variation regularization which allows us to integrate the low

  5. Vascular compromise in chronic volvulus with midgut malrotation.

    PubMed

    Mori, H; Hayashi, K; Futagawa, S; Uetani, M; Yanagi, T; Kurosaki, N

    1987-01-01

    Three cases of chronic volvulus of the small bowel in midgut malrotation are presented, all of whom manifested similar angiographic findings: proximal occlusion of the superior mesenteric artery and vein and development of collateral vessels. These findings may indicate the pathophysiology of chronic volvulus in midgut malrotation; the volvulus is progressive and eventually results in the twisting of the mesenteric root itself, but because of its chronic nature collateral circulation develops, eliminating bowel necrosis. Computed tomography (CT), performed in two cases, revealed dilated, tortuous vessels in the mesentery in addition to the known CT finding of a whirl-like pattern of the volvulated small bowel loops. Sonography, performed in one case, showed an unique feature of whirling sonolucent layers probably representing the volvulated small bowel loops intermixed with dilated mesenteric collateral vessels. We would like to emphasize the usefulness of CT and sonography in the early diagnosis of those cases with vague and nonspecific clinical manifestations. PMID:3299229

  6. New roller pump disposable provides safety and simplifies occlusion setting.

    PubMed

    Lee-Sensiba, K; Azzaretto, N; Carolina, C; DiCarmine, N; Hymowitz, D; Kay, S; Kooker, K; Salogub, M; Wong, E; Tamari, Y

    1997-03-01

    A new disposable insert for the arterial roller pump, the Better-Header, provides safety and functionality beyond what standard tubing provides. It automatically limits pump outlet pressure to a level determined by the user and provides a self-contained, simple means to set pump occlusion. The Better-Header consists of a Starling-like pressure relief valve connected across standard header tubing. As long as arterial line pressure at the pump outlet remains below a set limit, the valve is closed. If line pressure approaches the pressure limit, the valve opens, preventing overpressurization by shunting blood from pump outlet to inlet. The Better-Header can also be used to set occlusion by the "dynamic method" to obtain nonocclusive settings. The Better-Header was evaluated in the lab for its pressure-flow characteristics. Even when the arterial line was completely clamped at a pump flow of 7 L/min, line pressure was limited to a safe level and all circuit connections were preserved. The Better-Header has been used successfully at North Shore University Hospital in over 500 clinical cases covering a wide range of patients and procedures. In several instances, the user was alerted to high pressure situations by fluid flow through the valve and by an audible alarm, allowing rapid correction of the source of pressure. Compared to the standard setup, the Better-Header maintains outlet pressure within safe, user-settable limits, and permits consistent, nonocclusive settings with predictable retrograde flow. PMID:10166361

  7. Occlusion, transparency, and stereopsis: a new explanation for stereo capture.

    PubMed

    Vallortigara, G; Bressan, P

    1994-11-01

    Stereo capture occurs when a regular pattern of repeating elements with zero disparity is superimposed on a disparate subjective figure. The elements enclosed within the subjective contours, but not those outside them, are perceptually captured and pulled on the same depth plane of the disparate figure. The phenomenon has been interpreted as the result either of a spreading of disparity signals from the subjective figure or of the attribution of the depth of certain salient image features to the finer texture elements enclosed in them. We suggest here that, instead, the fact that stereo capture is limited to the texture elements lying within the boundaries of the subjective figure is simply due to ambiguous occlusion information at the monocular level. When the texture elements occlude the inducers of the subjective figure as well, the elements lying outside the boundaries of the subjective figure are also captured. We propose that stereo capture arises as the solution to a conflict between information provided by retinal disparity and occlusion, and show how this effect is related to other previously observed phenomena of conflicting cues to depth. PMID:7975323

  8. Trimeric HIV Env provides epitope occlusion mediated by hypervariable loops

    PubMed Central

    Moscoso, Carlos G.; Xing, Li; Hui, Jinwen; Hu, Jeffrey; Kalkhoran, Mohammad Baikoghli; Yenigun, Onur M.; Sun, Yide; Paavolainen, Lassi; Martin, Loïc; Vahlne, Anders; Zambonelli, Carlo; Barnett, Susan W.; Srivastava, Indresh K.; Cheng, R. Holland

    2014-01-01

    Hypervariable loops of HIV-1 Env protein gp120 are speculated to play roles in the conformational transition of Env to the receptor binding-induced metastable state. Structural analysis of full-length Env-based immunogens, containing the entire V2 loop, displayed tighter association between gp120 subunits, resulting in a smaller trimeric diameter than constructs lacking V2. A prominent basal quaternary location of V2 and V3? that challenges previous reports would facilitate gp41-independent gp120-gp120 interactions and suggests a quaternary mechanism of epitope occlusion facilitated by hypervariable loops. Deletion of V2 resulted in dramatic exposure of basal, membrane-proximal gp41 epitopes, consistent with its predicted basal location. The structural features of HIV-1 Env characterized here provide grounds for a paradigm shift in loop exposure and epitope occlusion, while providing substantive rationale for epitope display required for elicitation of broadly neutralizing antibodies, as well as substantiating previous pertinent literature disregarded in recent reports. PMID:25395053

  9. A part-based probabilistic model for object detection with occlusion.

    PubMed

    Zhang, Chunhui; Zhang, Jun; Zhao, Heng; Liang, Jimin

    2014-01-01

    The part-based method has been a fast rising framework for object detection. It is attracting more and more attention for its detection precision and partial robustness to the occlusion. However, little research has been focused on the problem of occlusion overlapping of the part regions, which can reduce the performance of the system. This paper proposes a part-based probabilistic model and the corresponding inference algorithm for the problem of the part occlusion. The model is based on the Bayesian theory integrally and aims to be robust to the large occlusion. In the stage of the model construction, all of the parts constitute the vertex set of a fully connected graph, and a binary variable is assigned to each part to indicate its occlusion status. In addition, we introduce a penalty term to regularize the argument space of the objective function. Thus, the part detection is formulated as an optimization problem, which is divided into two alternative procedures: the outer inference and the inner inference. A stochastic tentative method is employed in the outer inference to determine the occlusion status for each part. In the inner inference, the gradient descent algorithm is employed to find the optimal positions of the parts, in term of the current occlusion status. Experiments were carried out on the Caltech database. The results demonstrated that the proposed method achieves a strong robustness to the occlusion. PMID:24465420

  10. A new approach to fabricating the occlusal surfaces of removable prostheses.

    PubMed

    Hirayama, H; Andritsakis, P; Petridis, H

    1998-07-01

    A procedure is introduced to fabricate the occlusal surfaces of removable prostheses that oppose ceramic restorations or ceramic denture teeth. It involves the use of a heat-processed glass ceramic material in the form of onlays over the plastic denture teeth. This procedure provides for more wear compatibility, improved esthetics, and individualized occlusion. PMID:9656186

  11. Retinal vein occlusion during flare of multicentric Castleman’s disease

    PubMed Central

    Kozak, Igor; Reid, Erin G

    2013-01-01

    We report a case of successive bilateral retinal vein occlusion in a human immunodeficiency virus (HIV)-positive male with multicentric Castleman’s disease treated successfully with a single injection of intravitreal bevacizumab. Castleman’s disease should be a differential diagnosis of occlusive retinovascular disease and, occasionally, ocular manifestation can lead to systemic diagnosis. PMID:23983453

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

    Microsoft Academic Search

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

    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

  13. EFFETS DE LA MALADIE DE PARKINSON SUR LA RALISATION ACOUSTIQUE DES OCCLUSIVES DU FRANAIS LU

    E-print Network

    Boyer, Edmond

    EFFETS DE LA MALADIE DE PARKINSON SUR LA RÉALISATION ACOUSTIQUE DES OCCLUSIVES DU FRANÇAIS 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

  14. Fabrication of occlusal rims to record the maxillomandibular relation for complete dentures.

    PubMed

    Jayachandran, Sivakumar; Grey, Nicholas

    2014-08-01

    This article describes an alternative method to establish the inclination of the occlusal plane by using the hamular notch, incisive papilla plane. By using this plane, the fabrication of occlusal rims that conform to an ideal relationship may make chairside trimming of the rims more straightforward. PMID:24461948

  15. Testing omnidirectional vision-based Monte-Carlo Localization under occlusion

    E-print Network

    Menegatti, Emanuele

    }@dei.unipd.it Abstract-- One of the most challenging issue in mobile robot navigation is the localization problem to the occlusions of the vision sensor by moving obstacles (e.g other robots); occlusions that are very likely of estimating the pose of the robot inside the environment. In a dynamic multi-agent world a precise

  16. Crowns and other extra-coronal restorations: Occlusal considerations and articulator selection

    Microsoft Academic Search

    F S A Nohl; R W Wassell; J G Steele

    2002-01-01

    For many dentists, occlusion carries an air of mystique. It even seems sometimes that a perverse pleasure is derived in making the whole subject more complicated than it really is. As a clinician, you need to be able to decide what you expect from your proposed restoration, and to identify situations where you may need to alter the existing occlusal

  17. Temporal Profile of In Situ DNA Fragmentation After Transient Middle Cerebral Artery Occlusion in the Rat

    Microsoft Academic Search

    Yi Li; Michael Chopp; Ning Jiang; Fayi Yao; Cecylia Zaloga

    1995-01-01

    Summary: We measured the temporal profile and anatomic distribution of cells exhibiting DNA fragmentation at various durations of reperfusion after middle cerebral artery (MCA) occlusion in the rat. Focal cerebral ischemia was induced in male Wistar rats (n = 62) using an intraluminal monofilament blockade of the MCA. After 2 h of MCA occlusion, the animals were killed at different

  18. An electromyographic and roentgen cephalometric study of occlusal morphofunctional disharmony in children.

    PubMed

    Tallgren, A; Melsen, B; Hansen, M A

    1979-10-01

    In a sample of children with dual bite and symptoms in the masticatory system, the activity of the anterior temporal and masseter muscles was studied electromyographically during clench and light tapping in the posterior occlusal contact position and centric occlusion and in protrusive bite on the incisors. The findings indicated that the optimal muscle function during maximal clench and tapping with displayed in the posterior occlusal contact position, which in the present subjects was situated, on the average, 0.5 to 1 mm. anterior to the centric jaw relation. It should therefore be recommended that, in orthodontic treatment of children with dual bite, the intercuspal position (centric occlusion) should be established in the posterior occlusal relationship. This is in accordance with the opinion of several authors who have emphasized the use of the retruded contact position (the centric jaw relation) as key reference position in orthodontic treatment and occlusal rehabilitation. These authors have further emphasized the importance of stable occlusal contacts in centric relation, centric occlusion, and the various jaw excursions in obtaining and maintaining a harmonious function between the dentition, the temporomandibular joints, and the neuromuscular system. PMID:291342

  19. Effect of Early and Delayed Recanalization on Infarct Pattern in Proximal Middle Cerebral Artery Occlusion

    Microsoft Academic Search

    Marek Humpich; Oliver C. Singer; Richard du Mesnil de Rochemont; Christian Foerch; Heiner Lanfermann; Tobias Neumann-Haefelin

    2006-01-01

    Background: To investigate the effect of early (<6 h) versus delayed (>6 h) recanalization on infarct pattern in acute middle cerebral artery (MCA) occlusion. Methods: 35 patients with acute MCA occlusion (M1 segment; symptom onset <6 h) were analyzed. Stroke MRI was performed immediately after admission (day 0), and on days 1 and 7. In addition, vessel status was assessed

  20. CT-Defined Large Subcortical Infarcts: Correlation of Location with Site of Cerebrovascular Occlusive Disease

    Microsoft Academic Search

    Shinichi Nakano; Kiyotaka Yokogami; Hajime Ohta; Tomokazu Goya; Shinichiro Wakisaka

    PURPOSE: To correlate the location of large subcortical infarcts with the site of cerebrovascular occlusive disease. METHODS: We examined CT and angiographic findings of 38 patients with major arterial occlusive disease and newly developed large subcortical infarcts of 2.0 cm or more, which were classified into three types: striatocapsular infarcts in the basal ganglia, terminal supply area infarcts in the

  1. Supplemental Material "The smallest stroke: Occlusion of one penetrating vessel leads to infarction and a cognitive

    E-print Network

    Kleinfeld, David

    Supplemental Material "The smallest stroke: Occlusion of one penetrating vessel leads to infarction vessel leads to infarction and a cognitive deficit" by Andy Y. Shih, Pablo Blinder, Philbert S. Tsai smallest stroke: Occlusion of one penetrating vessel leads to infarction and a cognitive deficit" by Andy Y

  2. Fast rendering of sound occlusion and diffraction effects for virtual acoustic environments

    E-print Network

    Paris-Sud XI, Université de

    Fast rendering of sound occlusion and diffraction effects for virtual acoustic environments Nicolas to efficiently compute effects of sound occlusion and diffraction by obstacles in general virtual acoustic of the environment and computer graphics hardware to evaluate diffraction effects between a sound source

  3. Total body water and total body potassium in anorexia nervosa

    SciTech Connect

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

    1984-08-01

    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.

  4. A Microarray Study of Middle Cerebral Occlusion Rat Brain with Acupuncture Intervention

    PubMed Central

    Zhang, Chao; Wen, Yan; Fan, Xiaonong; Yang, Sha; Tian, Guang; Zhou, Xueyi; Chen, Yaqiong; Meng, Zhihong

    2015-01-01

    Microarray analysis was used to investigate the changes of gene expression of ischemic stroke and acupuncture intervention in middle cerebral artery occlusion (MCAo) rat brain. Results showed that acupuncture intervention had a remarkable improvement in neural deficit score, cerebral blood flow, and cerebral infarction volume of MCAo rats. Microarray analysis showed that a total of 627 different expression genes were regulated in ischemic stroke. 417 genes were upregulated and 210 genes were downregulated. A total of 361 different expression genes were regulated after acupuncture intervention. Three genes were upregulated and 358 genes were downregulated. The expression of novel genes after acupuncture intervention, including Tph1 and Olr883, was further analyzed by Real-Time Quantitative Polymerase Chain Reaction (RT-PCR). Upregulation of Tph1 and downregulation of Olr883 indicated that the therapeutic effect of acupuncture for ischemic stroke may be closely related to the suppression of poststroke depression and regulation of olfactory transduction. In conclusion, the present study may enrich our understanding of the multiple pathological process of ischemic brain injury and indicate possible mechanisms of acupuncture on ischemic stroke.

  5. Usefulness of lipids, lipoprotein(a) and fibrinogen measurements in identifying subjects at risk of occlusive complications following vascular and endovascular surgery.

    PubMed

    Lippi, G; Veraldi, G F; Dorucci, V; Dusi, R; Ruzzenente, O; Brentegani, C; Guidi, G; Cordiano, C

    1998-10-01

    The study was designed to establish the usefulness of measuring lipoprotein(a) [Lp(a)], total cholesterol, triglycerides, low-density lipoprotein [LDL]-cholesterol, high-density lipoprotein [HDL]-cholesterol, total-to-HDL-cholesterol ratio and fibrinogen in identifying subjects at risk of occlusive complications following vascular and endovascular surgery, including primary successful ileofemoral percutaneous transluminal angioplasty, infrainguinal and aortic bypass graft and carotid endarterectomy. A total of 68 volunteers subjected to vascular and endovascular surgery were recruited to the study. Six months after successful interventions, no occlusive complications verified by angiography were observed in 45 patients (66%; No-restenosis group), whereas significant restenosis or reocclusion occurred in 23 patients (34%; Restenosis group). Significant lower concentrations of Lp(a) (p=0.032), total cholesterol (p<0.0001), LDL-cholesterol (p=0.001) and total-to-HDL-cholesterol ratio (p<0.0001) and higher concentrations of HDL-cholesterol (p=0.048) were observed in the No-restenosis group compared to the Restenosis group. The concentrations of triglycerides (p=0.080) and fibrinogen (p=0.510) did not differ significantly between groups. In multivariate discriminant analysis, the best predictors of restenosis or reocclusion were in decreasing order: LDL-cholesterol, Lp(a), total-to-HDL-cholesterol ratio, HDL-cholesterol and total cholesterol. A statistical difference of particular interest was observed in the overall distribution of Lp(a) concentrations between groups (p<0.0001), occlusive complications being unlikely to occur in patients with Lp(a) concentrations below 50 mg L(-1). The potential interference from a concurrent acute phase response, the most common source of elevation of Lp(a) in humans, was less likely in view of the absence of differences in erythrocyte sedimentation rate between the No-restenosis and Restenosis groups (p=0.463). In conclusion, the results of the present investigation point to a definite role of the combined measurements LDL-cholesterol, Lp(a), total-to-HDL-cholesterol ratio, HDL-cholesterol and total cholesterol in the identification of subjects at risk of occlusive events following vascular and endovascular surgical procedures. PMID:9832342

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

    PubMed Central

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

    2014-01-01

    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

  7. Custom Metal Occlusal Surface for Acrylic Resin Denture Teeth to Enhance Wear Resistance: A Case Report

    PubMed Central

    Shivji, Rizwan Ali; Kamble, Vaibhav D.; Khan, Mohd. Atif

    2012-01-01

    Wear of the occlusal surface of the denture is a known fact which leads to subsequent changes in jaw relation, vertical dimension, loss of aesthetics, aged looks, and decrease in masticatory efficiency. Treatment modalities includes, change of denture set after a regular interval of 4-5 years, use of wear resistant denture teeth that includes wear resistant resin or porcelain teeth, teeth with cast metal occlusal surface, and altering occlusal contact areas of denture teeth by use of silver amalgam fillings. A case report of a patient who had increased tendency of occlusal wear was treated with custom made metal occlusal surface of denture teeth to enhance wear resistance and to improve the masticatory efficiency. PMID:22997592

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

    PubMed Central

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

    2011-01-01

    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

  9. Endovascular Treatment of Tandem Internal Carotid and Middle Cerebral Artery Occlusions

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2011-09-01

    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 (M(1)). The antagonistic crowns M(1) and P(2)-M(1) 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 M(1) and P(2)-M(1) 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 M(1) 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

  11. Blood flow and oxygen consumption with near-infrared spectroscopy and venous occlusion: spatial maps and the effect of time and pressure of inflation.

    PubMed

    Casavola, C; Paunescu, L A; Fantini, S; Gratton, E

    2000-07-01

    We have measured the local blood flow (BF) and oxygen consumption (OC) in the human calf muscle using near-infrared spectroscopy during venous occlusion. Venous occlusion was achieved by inflating a pneumatic cuff around the thigh of the subject. We have investigated the influence of the inflation time and cuff pressure on the recovered values of BF and OC. We have found that if the cuff pressure is increased from a threshold pressure (approximately 30 mm Hg) to a critical pressure (approximately 45 mm Hg) in less than about 6 s, one measures the same values of BF and OC independent of the total inflation time and final cuff pressure. We also report nine-pixel spatial maps of BF and OC to show that this technique can lead to spatially resolved measurements of blood flow and oxygen consumption in tissues. PMID:10958611

  12. Analgesia Evaluation of 2 NSAID Drugs as Adjuvant in Management of Chronic Temporomandibular Disorders

    PubMed Central

    Kurita Varoli, Fernando; Sucena Pita, Murillo; Sato, Sandra; Issa, João Paulo Mardegan; do Nascimento, Cássio

    2015-01-01

    The aim of this triple-blind full-randomized clinical trial was to quantify analgesia in masticatory muscles and temporomandibular joints after occlusal splint therapy associated with the adjuvant administration of nonsteroidal anti-inflammatory drugs (NSAID) isolated or associated with other therapeutic agents. Pain relief was also recorded. Eighteen volunteers who had been suffering from chronic pain in masticatory muscles due to temporomandibular disorders were selected after anamnesis and assessment using RDC/TMD translated to Portuguese. The 3 proposed treatments were NSAID (sodium diclofenac), panacea (sodium diclofenac + carisoprodol + acetaminophen + caffeine), and a placebo. The total treatment duration was 10 days, preceded and succeeded by patients' pain assessment. A washout interval of 11 days was established between each therapy. All participants received all treatments in different moments, in a full randomized crossover methodology. The assessment of drug therapies was performed using visual analogue scale for pain on palpation followed by 11-point numerical scale to quantify pain during treatment. Statistical analysis has shown that, after 10 days of treatment, all therapies were effective for pain relief. NSAID therapy promoted analgesia on the third day, while placebo only promoted analgesia in the eighth day. It has been concluded that sodium diclofenac used as splint adjuvant therapy, promotes significant analgesia in a shorter time. PMID:25874243

  13. [Chronic wounds as a public health problem].

    PubMed

    Situm, Mirna; Koli?, Maja; Redzepi, Gzim; Antoli?, Slavko

    2014-10-01

    Chronic wounds represent a significant burden to patients, health care professionals and the entire health care system. Regarding the healing process, wounds can be classified as acute or chronic wounds. A wound is considered chronic if healing does not occur within the expected period according to the wound etiology and localization. Chronic wounds can be classified as typical and atypical. The majority of wounds (95 percent) are typical ones, which include ischemic, neurotrophic and hypostatic ulcers and two separate entities: diabetic foot and decubital ulcers. Eighty percent of chronic wounds localized on lower leg are the result of chronic venous insufficiency, in 5-10 percent the cause is of arterial etiology, whereas the rest are mostly neuropathic ulcers. Chronic wounds significantly decrease the quality of life of patients by requiring continuous topical treatment, causing immobility and pain in a high percentage of patients. Chronic wounds affect elderly population. Chronic leg ulcers affect 0.6-3 percent of those aged over 60, increasing to over 5 percent of those aged over 80. Emergence of chronic wounds is a substantial socioeconomic problem as 1-2 percent of western population will suffer from it. This estimate is expected to rise due to the increasing proportion of elderly population along with the diabetic and obesity epidemic. It has been proved that chronic wounds account for the large proportion of costs in the health care system, even in rich societies. Socioeconomically, the management of chronic wounds reaches a total of 2-4 percent of the health budget in western countries. Treatment costs for some other diseases are not irrelevant, nor are the method and materials used for treating these wounds. Considering etiologic factors, a chronic wound demands a multidisciplinary approach with great efforts of health care professionals to treat it more efficiently, more simply and more painlessly for the patient, as well as more inexpensively for health care funds. PMID:25326983

  14. Robust Object Recognition under Partial Occlusions Using NMF

    PubMed Central

    Soukup, Daniel; Bajla, Ivan

    2008-01-01

    In recent years, nonnegative matrix factorization (NMF) methods of a reduced image data representation attracted the attention of computer vision community. These methods are considered as a convenient part-based representation of image data for recognition tasks with occluded objects. A novel modification in NMF recognition tasks is proposed which utilizes the matrix sparseness control introduced by Hoyer. We have analyzed the influence of sparseness on recognition rates (RRs) for various dimensions of subspaces generated for two image databases, ORL face database, and USPS handwritten digit database. We have studied the behavior of four types of distances between a projected unknown image object and feature vectors in NMF subspaces generated for training data. One of these metrics also is a novelty we proposed. In the recognition phase, partial occlusions in the test images have been modeled by putting two randomly large, randomly positioned black rectangles into each test image. PMID:18509493

  15. The sieve element occlusion gene family in dicotyledonous plants

    PubMed Central

    Jekat, Stephan B; Nordzieke, Steffen; Reineke, Anna R; Müller, Boje; Bornberg-Bauer, Erich; Noll, Gundula A

    2011-01-01

    Sieve element occlusion (SEO) genes encoding forisome subunits have been identified in Medicago truncatula and other legumes. Forisomes are structural phloem proteins uniquely found in Fabaceae sieve elements. They undergo a reversible conformational change after wounding, from a condensed to a dispersed state, thereby blocking sieve tube translocation and preventing the loss of photoassimilates. Recently, we identified SEO genes in several non-Fabaceae plants (lacking forisomes) and concluded that they most probably encode conventional non-forisome P-proteins. Molecular and phylogenetic analysis of the SEO gene family has identified domains that are characteristic for SEO proteins. Here, we extended our phylogenetic analysis by including additional SEO genes from several diverse species based on recently published genomic data. Our results strengthen the original assumption that SEO genes seem to be widespread in dicotyledonous angiosperms, and further underline the divergent evolution of SEO genes within the Fabaceae. PMID:21422825

  16. Critical occlusion via biofilm induced calcite precipitation in porous media

    NASA Astrophysics Data System (ADS)

    Zhang, Tianyu; Klapper, Isaac

    2014-05-01

    A model for biofilm induced calcite precipitation with pressure driven flow is presented at the scale of a single pore within a porous medium. The system, an extension of previous work (Zhang and Klapper 2010 Water Sci. Technol. 61 2957-64, Zhang and Klapper 2011 Int. J. Non-Linear Mech. 46 657-66), is based on a mixture model including biomaterial, mineral, and water with dissolved components. Computational results suggest the possibility of critical occlusion in the sense that there is a distinguished trans-pore pressure head such that for pressure drops below this level, pore clogging occurs relatively quickly while for pressure drops above, clogging occurs after much longer times if at all. Beyond its relevance to engineered biofilm applications, this phenomenon is suggestive of the subtleties of embedding simple biofilm models in larger media.

  17. Robust object recognition under partial occlusions using NMF.

    PubMed

    Soukup, Daniel; Bajla, Ivan

    2008-01-01

    In recent years, nonnegative matrix factorization (NMF) methods of a reduced image data representation attracted the attention of computer vision community. These methods are considered as a convenient part-based representation of image data for recognition tasks with occluded objects. A novel modification in NMF recognition tasks is proposed which utilizes the matrix sparseness control introduced by Hoyer. We have analyzed the influence of sparseness on recognition rates (RRs) for various dimensions of subspaces generated for two image databases, ORL face database, and USPS handwritten digit database. We have studied the behavior of four types of distances between a projected unknown image object and feature vectors in NMF subspaces generated for training data. One of these metrics also is a novelty we proposed. In the recognition phase, partial occlusions in the test images have been modeled by putting two randomly large, randomly positioned black rectangles into each test image. PMID:18509493

  18. Influence of occlusal splint on competitive athletes performances

    PubMed Central

    D’Ermes, Vittorio; Basile, Mario; Rampello, Alessandro; Di Paolo, Carlo

    2012-01-01

    Summary The purpose of this study was to evaluate the influence of an orthopedic oral device on the performance of competitive athletes. Seven athletes from different sports have been examined during athletic tests with and without an oral device. The athletes were examined by two calibrated gnathologic operators and with specific radiography. All of the subjects were submitted to a postural exam on an electronic platform with and without the oral device applied. All subjects underwent objective tests, performed by federal trainers in specialized centers, to evaluate the athletic performance with and without the occlusal splint. The results showed an improvement of all the tests carried out. Our findings lead us to believe that the use of a costumed oral device, it is able to optimize neuro-muscular coordination and to improve the competitive performance of athletes, while the muscular strength not respond significantly. PMID:23386932

  19. A stereo matching in complex scene and occlusion handling model

    NASA Astrophysics Data System (ADS)

    Pang, Xing; Zhang, Yi; Han, Jing; Bai, Lian-fa

    2014-11-01

    An algorithm is proposed which the tree structure of dynamic programming with self-adaptive parameters and a disparity iterative refinement to improve stereo matching performance. The algorithm model consists of an initialization model and a disparity iterative refinement. To obtain the initial disparity map with "clear" background and whole details, the tree structure of dynamic programming with self-adaptive parameters is presented. A disparity iterative refinement is proposed to estimate the disparity of unreliable pixels in the doubtful regions. The disparity iterative refinement consists of a doubtful regions growing method and a disparity filling based on color similarity. The results of experiment evaluated with Middlebury data sets show that our algorithm can effectively ameliorate "fatting inflating" by occlusion and obtains a high quality of disparity map.

  20. Surgical and endovascular intervention on internal carotid artery near occlusion.

    PubMed

    Koutsoumpelis, A; Kouvelos, G; Peroulis, M; Tzilalis, V; Matsagkas, M

    2015-04-01

    Therapeutic strategy for treating carotid artery near occlusion (CANO) has been controversial. The aim of this study was to review the literature concerning the invasive treatment of atherosclerotic CANO. A review was conducted of the English medical literature from 1980 to 2013 using PubMedand EMBASE database to find studies involving open or endovascular management of CANO. The search identified 20 reports describing invasive treatment of CANO encompassing 770 patients (77.7% men; mean age 66.3±5.2 years). A typical appearance of string sign was noted in nearly 60% of the patients. The vast majority (92.6%) were symptomatic. 479 (62.2%) patients underwent an open procedure, while 291 (38.8%) were treated endovascularly. The technical success rate for the endovascular procedures was 99%, while distal embolic protection devices were applied in most patients (66%). The 30 days procedural stroke rate was 2.1% and 2.4% for open and endovascular repair respectively. During a follow-up period spanning an average of approximately two years the ipsilateral cerebrovascular event rate was 5% and 1.2% for open and endovascular treatmentrespectively. Twenty five (5.2%) restenosis or occlusions were reported for the open procedures, while 13 (5.4%) were also documented for endovascular repair. The current literature concerning the invasive treatment of CANO is weak and cannot support any evidence based recommendation. The necessity to intervene as well as the best therapeutic strategy remains controversial. This review shows that the interventionon symptomatic CANO may consist a relatively safe and effective therapeutic strategy with low perioperative cerebrovascular morbidity for both treatment modalities, although durability and long-term outcomes should be further affirmed. The low incidence of this entity and the dearth of clear evidence support the need for a large multicenter registry to clarify the absolute indications for intervention and define the best therapeutic approach. PMID:25284622

  1. Establishing an experimental rat model of photodynamically-induced retinal vein occlusion using erythrosin B

    PubMed Central

    Chen, Wei; Wu, Ying; Zheng, Mi; Gu, Qing; Zheng, Zhi; Xia, Xin

    2014-01-01

    AIM To develop a reliable, reproducible rat model of retinal vein occlusion (RVO) with a novel photosensitizer (erythrosin B) and study the cellular responses in the retina. METHODS Central and branch RVOs were created in adult male rats via photochemically-induced ischemia. Retinal changes were monitored via color fundus photography and fluorescein angiography at 1 and 3h, and 1, 4, 7, 14, and 21d after irradiation. Tissue slices were evaluated histopathologically. Retinal ganglion cell survival at different times after RVO induction was quantified by nuclear density count. Retinal thickness was also observed. RESULTS For all rats in both the central and branch RVO groups, blood flow ceased immediately after laser irradiation and retinal edema was evident at one hour. The retinal detachment rate was 100% at 3h and developed into bullous retinal detachment within 24h. Retinal hemorrhages were not observed until 24h. Clearance of the occluded veins at 7d was observed by fluorescein angiography. Disease manifestation in the central RVO eyes was more severe than in the branch RVO group. A remarkable reduction in the ganglion cell count and retinal thickness was observed in the central RVO group by 21d, whereas moderate changes occurred in the branch RVO group. CONCLUSION Rat RVO created by photochemically-induced ischemia using erythrosin B is a reproducible and reliable animal model for mimicking the key features of human RVO. However, considering the 100% rate of retinal detachment, this animal model is more suitable for studying RVO with chronic retinal detachment. PMID:24790863

  2. Unit of Enrollment & Degree Level Total Total

    E-print Network

    Shyy, Wei

    Unit of Enrollment & Degree Level Grand Total Total Total Minorities Black Asian Native American Hispanic White Unknown Nonresident Alien Degrees & Certificates Total 12000 10177 2623 698 1379 79 467 7162 1223 Degrees Total 11079 9543 2454 646 1297 75 436 6701 388 1536 Women 5454 4976 1267 395 629 37 206

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

    PubMed Central

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

    2013-01-01

    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

  4. Chronic Pancreatitis

    PubMed Central

    DiMagno, Matthew J.; DiMagno, Eugene P.

    2012-01-01

    Purpose of review We review important new clinical observations in chronic pancreatitis (CP) reported in 2011. Recent findings Smoking increases the risk of non-gallstone acute pancreatitis (AP) and the progression of AP to CP. Binge drinking during Oktoberfest did not associate with increased hospital admissions for AP. The unfolded protein response is an adaptive mechanism to maintain pancreatic health in response to noxious stimuli such as alcohol. Onset of diabetes mellitus in CP is likely due to progressive disease rather than individual variables. Insufficient pancreatic enzyme dosing is common for treatment of pancreatic steatorrhea; 90,000 USP U of lipase should be given with meals. Surgical drainage provides sustained, superior pain relief compared to endoscopic treatment in patients advanced CP with a dilated main duct +/? pancreatic stones. The central acting gabapentoid pregabalin affords a modest 12% pain reduction in patients with CP but ~30% of patients have significant side effects. Summary Patients with non-gallstone related AP or CP of any etiology should cease smoking. Results of this year’s investigations further elucidated the pancreatic pathobiology due to alcohol, onset of diabetes mellitus in CP, and the mechanisms and treatment of neuropathic pain in CP. PMID:22782018

  5. CHRONIC URTICARIA

    PubMed Central

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

    2011-01-01

    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

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

    PubMed Central

    2014-01-01

    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

  7. Multi-disciplinary approach for management of refractory benign occlusive esophageal strictures

    PubMed Central

    Hasan, Syed S.; Cohen, Dan C.; Pfanner, Timothy; Reznik, Scott; Duddempudi, Sushil

    2013-01-01

    Background: Benign occlusive esophageal strictures create substantial morbidity and have poor surgical outcomes. Various endoscopic techniques have been described to manage these strictures. The challenge remains to maintain adequate long-term esophageal patency and to limit the need for serial endoscopic dilations. Little has been reported regarding the management of these benign occlusive strictures. Methods: We report a case series describing the management of technically challenging benign occlusive esophageal strictures. Three patients with occlusive esophageal strictures of differing etiologies were treated using a variety of endoscopic methodologies. Results: The first patient sustained a caustic oropharyngeal injury resulting in a proximal esophageal stricture which was treated by using a combined antegrade retrograde dilation (CARD) with argon plasma coagulation (APC) and needle knife dissection resulting in the successful recanalization and patency of his stricture. A second patient developed an esophageal stricture following radiotherapy, and was treated with a CARD procedure and serial balloon dilations in combination with APC to successfully achieve esophageal luminal patency. The final patient acquired an occlusive esophageal stricture after treatment for thyroid cancer which was treated with endoscopic needle knife dissection followed by serial balloon dilations to successfully manage this stricture. Conclusions: Occlusive esophageal strictures pose a difficult challenge to gastroenterologists and little has been reported with regards to their endoscopic management. Using the CARD technique, needle knife dissection and APC, individually or in combination, luminal patency of occlusive esophageal strictures can be accomplished safely with good results. PMID:24003337

  8. Severe Gingival Recession Caused by Traumatic Occlusion and Mucogingival Stress: A Case Report

    PubMed Central

    Ustun, Kemal; Sari, Zafer; Orucoglu, Hasan; Duran, Ismet; Hakki, Sema S.

    2008-01-01

    Gingival recession is displacement of the soft tissue margin apically leading to root surface exposure. Tooth malpositions, high muscle attachment, frenal pull have been associated with gingival tissue recession. Occlusal trauma is defined as injury resulting in tissue changes within the attachment apparatus as a result of occlusal forces. Trauma from occlusion may cause a shift in tooth position and the direction of the movement depends on the occlusal force. We present the clinical and radiological findings and the limitation of periodontal treatment of a severe gingival recession in a case with traumatic occlusion. A 16 years old male, systemically healthy and non-smoking patient presented to our clinic with severe gingival recession of mandibular canines and incisors. Clinical evaluation revealed extensive gingival recession on the vestibules of mandibular anterior segment. Patient has an Angle class III malocclusion and deep bite. To maintain the teeth until orthodontic therapy and maxillofacial surgery, mucogingival surgeries were performed to obtain attached gingiva to provide oral hygiene and reduce inflammation. After mucogingival surgeries, limited attached gingiva was gained in this case. Regular periodontal maintenance therapy was performed at 2 month intervals to preserve mandibular anterior teeth. Multidisciplinary approach should be performed in this kind of case for satisfactory results. Unless occlusal relationship was corrected, treatment of severe gingival recession will be problematic. For satisfactory periodontal treatment, early diagnosis of trauma from occlusion and its treatment is very important. PMID:19212523

  9. Occlusal Enamel Complexity in Middle Miocene to Holocene Equids (Equidae: Perissodactyla) of North America

    PubMed Central

    Famoso, Nicholas A.; Davis, Edward Byrd

    2014-01-01

    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

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

    PubMed

    Famoso, Nicholas A; Davis, Edward Byrd

    2014-01-01

    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

  11. Combined Total Arch Replacement and Bypass from the Ascending Aorta to the Bilateral Profunda Femoris Arteries

    PubMed Central

    2014-01-01

    A 72-year-old woman who had aortic arch aneurysm was admitted. The patient was unable to walk without assistance because of aortoiliac occlusive disease. Total arch replacement and the ascending aorta to the bilateral profunda femoris artery bypass were performed during the same operation. On outpatient visits, the patient was able to walk with a cane and the ankle-brachial pressure index was markedly improved. This combined procedure is an option for patients with aortoiliac occlusive disease who are not candidates for alternate inflow procedures, especially when the patient has another indication for median sternotomy. PMID:24995068

  12. Usefulness of MRI to differentiate between temporary and long-term coronary artery occlusion in a minimally invasive model of experimental myocardial infarction.

    PubMed

    Abegunewardene, Nico; Vosseler, Markus; Gori, Tommaso; Hoffmann, Nico; Schmidt, Kai-Helge; Becker, Dietmar; Kreitner, Karl-Friedrich; Petersen, Steffen E; Schreiber, Laura M; Horstick, Georg; Münzel, Thomas

    2009-09-01

    The surgical technique employed to determine an experimental ischemic damage is a major factor in the subsequent process of myocardial scar development. We set out to establish a minimally invasive porcine model of myocardial infarction using cardiac contrast-enhanced magnetic resonance imaging (ce-MRI) as the basic diagnostic tool. Twenty-seven domestic pigs were randomized to either temporary or permanent occlusion of the left anterior descending artery (LAD). Temporary occlusion was achieved by inflation of a percutaneous balloon in the left anterior descending artery directly beyond the second diagonal branch. Occlusion was maintained for 30 or 45 min, followed by reperfusion. Permanent occlusion was achieved via thrombin injection. Thirteen animals died peri- or postinterventionally due to arrhythmias. Fourteen animals survived the 30-min ischemia (four animals; group 1), the 45-min ischemia (six animals; group 2), or the permanent occlusion (4 animals; group 3). Coronary angiography and ce-MRI were performed 8 weeks after coronary occlusion to document the coronary flow grade and the size of myocardial scar tissue. The LAD was patent in all animals in groups 1 and 2, with normal TIMI flow; in group 3 animals, the LAD was totally occluded. Fibrosis of the left ventricle in group 1 (4.9 +/- 4.4%; p = 0.008) and group 2 (9.4 +/- 2.9%; p = 0.05) was significantly lower than in group 3 (14.5 +/- 3.9%). Wall thickness of the ischemic area was significantly lower in group 3 versus group 1 and group 2 (2.9 +/- 0.3, 5.9 +/- 0.7, and 6.1 +/- 0.7 mm; p = 0.005). The extent of late enhancement of the left ventricle was also significantly higher in group 3 (16.9 +/- 2.1%) compared to group 1 (5.3 +/- 5.4%; p = 0.003) and group 2 (9.7 +/- 3.4%, p = 0.013). In conclusion, the present model of minimally invasive infarction coupled with ce-MRI may represent a useful alternative to the open chest model for studies of myocardial infarction and scar development. PMID:19472001

  13. Reduced in vivo skeletal muscle oxygen consumption in patients with chronic heart failure—A study using Near Infrared Spectrophotometry (NIRS)

    Microsoft Academic Search

    Khalid Abozguia; Thanh Trung Phan; Ganesh Nallur Shivu; Abdul R. Maher; Ibrar Ahmed; Anton Wagenmakers; Michael P. Frenneaux

    2008-01-01

    Aim: We used Near Infrared Spectrophotometry (NIRS) during arterial occlusion to measure resting skeletal muscle oxygen consumption in chronic heart failure (CHF) patients and in age-matched healthy volunteers (HVs). Methods: Fifteen CHF patients (ten males) and eleven HVs (six males) had echocardiographic evaluation followed by measurement of the oxygen consumption of the brachioradialis muscle using NIRS. This involved continuous measurement

  14. Device and method to determine perineal artery occlusion during road bicycling.

    PubMed

    Parthiban, Sujeeth; Hotaling, James M; Ohlander, Samuel J; Baftiri, Amit P; Freels, Sally; Niederberger, Craig S

    2014-01-01

    Greater than 60 million American men who ride bicycles are at risk of developing erectile dysfunction. One possible reason is occlusion of the perineal arteries. Researchers relied on indirect methods and stationary models to study this problem. We developed a novel system to quantify occlusion among bicycle riders during a road bike ride. Our verification and validation activities show that this system can be safely used on human subjects to measure perineal artery occlusion. The method described in this paper provides a valuable tool to the researchers to study or to develop new solutions that alleviate this problem. The outcomes of these efforts will help millions of cyclists worldwide. PMID:25570811

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

    PubMed Central

    Wang, Xiangfei; Ge, Junbo

    2014-01-01

    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

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

    SciTech Connect

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

    2012-10-15

    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.

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

    SciTech Connect

    Sofue, Keitaro, E-mail: keitarosofue@yahoo.co.jp; Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp; Arai, Yasuaki, E-mail: arai-y3111@mvh.biglobe.ne.jp [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan)] [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan); Sugimura, Kazuro, E-mail: sugimura@med.kobe-u.ac.jp [Kobe University, Department of Radiology, Graduate School of Medicine (Japan)] [Kobe University, Department of Radiology, Graduate School of Medicine (Japan)

    2013-02-15

    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.

  18. Occlusive barriers in combination with particulate Bio-Oss® graft: a pilot study on rabbit calvaria

    PubMed Central

    Beltrán, Víctor; Engelke, Wilfried; Dias, Fernando Jose; Leiva, Carolina; Fuentes, Ramón; Borie, Eduardo

    2014-01-01

    The aim of this study was to histologically evaluate the potential for vertical bone augmentation of the Bio-Oss® graft compared to a blood clot in conjunction with an occlusive barrier in the rabbit calvaria defect model. Metallic dome shaped barriers with 4.5 mm width and 3.5 mm height were positioned in six adult rabbit skulls. At the right side, the barrier was filled with Bio-Oss®, and the left side was filled with a blood clot. After a healing period of three months, the animals were sacrificed, and the samples were prepared for histological and histomorphometric analyses. The total mineralized area (TMA) as well as the newly formed bone (NBA) was calculated as the percentage of the bone augmentation inside the metallic barriers, and parametric statistical analysis was used to describe the findings. The samples with blood clots exhibited significantly less TMA formation than the Bio-Oss® group. However, the difference in the amount of NBA was not statistically significant. Furthermore, the Bio-Oss® specimens exhibited remaining graft particles within the sample. In conclusion, the barriers filled with Bio-Oss® exhibited significantly higher TMA than those with only blood clots, and the remaining Bio-Oss® particles were integrated into newly formed bone tissue to fill the spaces and promote a greater volume than the samples from the blood clot groups. PMID:25126169

  19. Relationship between the two surgical access of aortoiliac occlusive disease and recovery of ED.

    PubMed

    Verim, L; Kalko, Y

    2015-03-01

    Aortoiliac occlusive disease (AIOD) can occur anywhere from the distal abdominal aorta to the common femoral arteries. Patients with AIOD may be asymptomatic or may have intermittent claudication or critical limb ischemia. ED in the young males may be the first symptom of aortoiliac disease. The aims of this study were to determine the outcome of ED in patients who underwent aortoiliac surgery and evaluate the effect of revascularization upon erectile function (EF) by using the international index of EF questionnaire and color duplex Doppler ultrasonography. A total of 60 patients under 65-year-old age eligible for elective repair of AIOD s were included in this study. The patients were randomly divided into two equal groups. The first group (group A) patients were operated by minimally invasive retroperitoneal approach (RPA) and the second group (group B) patients were operated by transperitoneal approach (TPA) to the aorta. The quality of sexual function scale was evaluated preoperatively and at 6 months postoperatively. Surgical revascularization when appropriate, symptomatic AIOD and ED are often improved. As a result of our study, RPA to the aorta is superior to TPA because of recovering with the higher systolic velocity values of penile Doppler in ED cases. PMID:25099637

  20. Total Flavones of Choerospondias axillaris Attenuate Cardiac Dysfunction and Myocardial Interstitial Fibrosis by Modulating NF-?B Signaling Pathway.

    PubMed

    Sun, Bei; Xia, Qiumei; Gao, Zhiyong

    2014-11-27

    This study aimed to investigate the effect of total flavonoids of Choerospondias axillaris (TFC) on myocardial infarction (MI)-induced cardiac dysfunction, interstitial fibrosis and inflammatory reaction and further to clarify the potential signaling pathway involved. Rats were subjected to MI via coronary artery occlusion. The model establishment was confirmed by the occurrence of ST-segment elevation in electrocardiogram. Then, TFC was administrated at doses of 75, 150 and 300 mg/kg for 28 consecutive days (gavage). Body weight and heart weight were recorded. Hemodynamics, infarct size and myocardial fibrosis were examined. Blood samples were collected to determine tumor necrosis factor-? (TNF-?) and interleukin 6, 10 (IL-6, IL-10) levels. The expressions of matrix metalloproteinases-2, 9 (MMP-2, 9), phosphor-IKB? (p-IKB?) and transforming growth factor-?1 (TGF-?1) were assayed by Western blot. The results indicated that TFC significantly improved cardiac dysfunction, the heart coefficient and myocardial fibrosis in MI rat. TFC also decreased the levels of TNF-? and IL-6, but increased IL-10 content. Moreover, treatment with TFC protected the heart from chronic MI injury by decreasing the expressions of MMP-2, 9, TGF-?1 and p-IKB?. The results suggested that TFC attenuated cardiac dysfunction and myocardial interstitial fibrosis by modulating nuclear factor-kappa B (NF-?B) signaling pathway. PMID:25427792

  1. 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

    Wolfson, Aaron H., E-mail: awolfson@med.miami.edu [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)

    2011-09-01

    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.

  2. Evaluation of surface radiation dose to the thyroid gland and the gonads during routine full-mouth intraoral periapical and maxillary occlusal radiography

    PubMed Central

    Sheikh, Soheyl; Bhoweer, Anil Kumar; Arya, Smriti; Arora, Gagandeep

    2010-01-01

    Aim: The quantitative aspects of radiation doses to critical organs can help the dental professionals to take the necessary radiation protective measures as deemed necessary and can help the general public to allay radiation exposure fear in dental radiography, if any. Our study determines the surface radiation dose to thyroid and gonads in full-mouth intraoral periapical (IOPA) and maxillary occlusal radiography. Materials and Methods: A total number of 120 subjects participated in the study. The surface radiation dose was estimated to the thyroid gland and the gonads in full-mouth IOPA radiography using 10 IOPA (E speed films) and in maxillary occlusal radiography. The measurements were calculated using a digital pocket dosimeter (PD-4507). Results: The average dose at the thyroid gland level during full-mouth intraoral and maxillary occlusal radiography was estimated to be 10.93 mRads (1.093 × 10-2 mGy) and 0.4 mRads (4.0 × 10-2 mGy), respectively. The average surface radiation dose at the gonadal region during a full mouth intraoral and maxillary occlusal radiography was estimated to be 1.5 mRads (1.5 × 10-2 mGy) and 0.15 mRads (1.5 × 10-3 mGy), respectively. Conclusion: Our results suggest that although the radiation exposure doses to critical organs namely thyroid and gonads is within the safe limits still precautionary measures for these organs are advocated. PMID:22114389

  3. 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

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

    2015-01-01

    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. PMID:25672421

  4. CO-OCCLUSION AND PERSISTENCE OF A BACULOVIRUS MUTANT LACKING THE POLYHEDRIN GENE

    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...

  5. Three-dimensional mapping of oxygen tension in cortical arterioles before and after occlusion

    PubMed Central

    Kazmi, S. M. Shams; Salvaggio, Anthony J.; Estrada, Arnold D.; Hemati, Michael A.; Shaydyuk, Nazariy K.; Roussakis, Emannuel; Jones, Theresa A.; Vinogradov, Sergei A.; Dunn, Andrew K.

    2013-01-01

    Occlusions in single cortical microvessels lead to a reduction in oxygen supply, but this decrement has not been able to be quantified in three dimensions at the level of individual vessels using a single instrument. We demonstrate a combined optical system using two-photon phosphorescence lifetime and fluorescence microscopy (2PLM) to characterize the partial pressure of oxygen (pO2) in single descending cortical arterioles in the mouse brain before and after generating a targeted photothrombotic occlusion. Integrated real-time Laser Speckle Contrast Imaging (LSCI) provides wide-field perfusion maps that are used to monitor and guide the occlusion process while 2PLM maps changes in intravascular oxygen tension. We present the technique’s utility in highlighting the effects of vascular networking on the residual intravascular oxygen tensions measured after occlusion in three dimensions. PMID:23847732

  6. Recanalization of extracranial internal carotid artery occlusion: A 12-year retrospective study.

    PubMed

    Jiao, Liqun; Song, Gang; Hua, Yang; Ma, Yan; Chen, Yanfei; Wang, Yabing; Ling, Feng

    2013-08-15

    This study aimed to summarize therapy experience of carotid endarterectomy, carotid endarterectomy combined with Fogarty catheter embolectomy, and hybrid surgery for the treatment of extracranial internal carotid artery occlusion. The study included 65 patients with extracranial internal carotid artery occlusion who underwent carotid endarterectomy, carotid endarterectomy combined with Fogarty catheter embolectomy, or hybrid surgery in the Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China between January 2006 and December 2012. Prior to surgery, all patients underwent perfusion CT or xenon CT to evaluate the occlusion. The procedure for each patient was chosen according to digital subtraction angiography data. The carotid artery was successfully recanalized in 46 of 51 patients who underwent carotid endarterectomy, 9 of 10 patients who underwent carotid endarterectomy combined with Fogarty catheter embolectomy, and 3 of 4 patients who underwent hybrid surgery. In patients with symptomatic carotid artery occlusion, the carotid artery can be recanalized by choosing a treatment procedure based on imaging examination findings. PMID:25206530

  7. Retinal Arterial Occlusive Disease in a Young Patient with Cat Scratch Disease

    PubMed Central

    Batsos, Georgios; Kabanarou, Stamatina A.; Fotiou, Pantelis; Rouvas, Alexandros; Xirou, Tina

    2013-01-01

    Purpose To report an unusual case of a branch retinal arterial occlusion and bilateral multifocal retinitis in a young woman with cat scratch disease. Methods A 23-year-old woman was referred to our clinic complaining of a sudden scotoma in the upper part of the visual field of her left eye. Fundoscopy revealed occlusion of an inferior temporal branch of the retinal artery in the left eye and bilateral multifocal retinitis, which was confirmed by fluorescein angiography. Subsequent indocyanine angiography did not reveal choroidal involvement. Laboratory analysis showed rising IgG titers for Bartonella henselae. Results Cat scratch disease was diagnosed, and a 4-week course of doxycycline was initiated. The patient responded well to the antibiotics. Both retinitis and arterial occlusion were resolved, the visual field was regained and the patient reported elimination of her symptoms. Conclusions Cat scratch disease should be considered in the differential diagnosis in young patients with retinal occlusive disease. PMID:24019792

  8. External iliac artery occlusion in a paediatric patient following handlebar trauma

    PubMed Central

    Singla, Animesh A.; McPherson, Danielle; Singla, Apresh A; Cross, Jane; Leslie, Anthony

    2015-01-01

    Arterial occlusion following blunt trauma is an uncommon occurrence. We report an unusual case of delayed external iliac artery occlusion in a young male following blunt abdominal injury. He was successfully treated with thromboendarterectomy and saphenous vein patch repair. There have only been a handful of documented cases occurring in the paediatric population. All patients presenting with groin injury from this mechanism should be carefully investigated and monitored for risk of vascular injury. PMID:25733671

  9. Late seizures in patients with internal carotid and middle cerebral artery occlusive disease following ischaemic events.

    PubMed Central

    De Carolis, P; D'Alessandro, R; Ferrara, R; Andreoli, A; Sacquegna, T; Lugaresi, E

    1984-01-01

    The occurrence of post-infarction epilepsy was investigated in 68 patients with angiographically proven internal carotid artery occlusion and in 56 patients with middle cerebral artery occlusion. Epileptic seizures occurred during follow-up in 9% of the carotid artery group and in 21.4% of the middle cerebral artery group. The different incidence of seizures in the two groups was statistically significant. The physiopathological mechanism of the late post-infarction epilepsy is discussed. PMID:6439825

  10. Implications of Natural Occlusion of Ventilated Racks on Ammonia and Sanitation Practices

    PubMed Central

    Creamer, Michelle A; Petty, Joann; Martin, Tara; Bergdall, Valerie; Hickman-Davis, Judy M

    2014-01-01

    Examination of ventilated rat racks prior to semiannual sanitation revealed silicone nozzles and ventilation ports that were partially or completely occluded with granular debris. We subsequently sought to document performance standards for rack sanitation and investigate the effect of ventilation port occlusion on rack function and animal husbandry practices. We hypothesized that individually ventilated cages with occluded airflow would require more frequent cage changes, comparable to those for static cages (that is, every 3 to 4 d). Sprague–Dawley rats were housed under one of 4 conditions: no airflow occlusion, occluded air-supply inlet, occluded air-exhaust outlet, and occlusion of both inlet and outlet. Cages were changed when daily ammonia concentration exceeded 20 ppm or after 14 d had elapsed. Most cages with unoccluded or partial airflow occlusion remained below the 20 ppm limit until day 12 or 13. Cages with occlusion of both inlet and outlet exceeded 20 ppm ammonia by as early as day 5. Airflow was significantly lower in cages with occlusion of both inlet and outlet airflow. Weekly inspection revealed that occlusion of ventilation ports was detectable by 3 mo after semiannual sanitation. This study demonstrates that silicone nozzles should be removed prior to rack sanitation to improve the effectiveness of cleaning ventilation ports and nozzles. While the rack is in use, silicone nozzles and ventilation ports should be inspected regularly to identify occlusion that is likely to diminish environmental quality in the cage. Intracage ammonia levels are significantly higher when both inlet and outlet airflow are occluded. PMID:24602544

  11. Occlusal plane related to skeletal pattern in mixed dentition stage: a descriptive cephalometric study

    Microsoft Academic Search

    S. Naretto; C. Polastri; R. Slavicek

    2009-01-01

    Summary  Basic studies and researches on craniofacial growth show that occlusal plane changes its position in space and time during\\u000a the whole period of development and growth of the skull until the attainment of the mature dentition stage. The purpose of\\u000a this retrospective study is to evaluate the inclination of the gnatological occlusal plane related to the axio-orbital plane\\u000a and their

  12. Validity of Diagnosis of Questionable Caries Lesions in Occlusal Surfaces of Extracted Third Molars

    Microsoft Academic Search

    A. Wenzel; O. Fejerskov

    1992-01-01

    This study was to evaluate the accuracy of visual inspection, conventional radiography, and digital radiographic methods for the detection of occlusal carious lesions in third molars from a present-day adolescent population. Seventy-eight third molars, considered clinically to be without occlusal cavities, were extracted from young soldiers. Before extraction, an intra-oral radiograph was obtained. After extraction, the teeth were examined visually

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

    PubMed

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

    2011-01-01

    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

  14. Intravitreal triamcinolone acetonide as treatment of macular edema in central retinal vein occlusion

    Microsoft Academic Search

    Jost B. Jonas; Ingrid Kreissig; Robert F. Degenring

    2002-01-01

    Purpose. To report the clinical outcome of a patient receiving an intravitreal injection of triamcinolone acetonide as treatment of bilateral, long-standing, cystoid macular edema due to central retinal vein occlusion. Methods. A 70-years-old patient suffering from bilateral central retinal vein occlusion for 2 years and 1.5 years, respectively, received transconjunctivally an intravitreal injection of 25 mg of crystalline triamcinolone acetonide

  15. Vaso-occlusion in sickle cell disease: pathophysiology and novel targeted therapies

    PubMed Central

    Manwani, Deepa

    2013-01-01

    Recurrent and unpredictable episodes of vaso-occlusion are the hallmark of sickle cell disease. Symptomatic management and prevention of these events using the fetal hemoglobin–reactivating agent hydroxyurea are currently the mainstay of treatment. Discoveries over the past 2 decades have highlighted the important contributions of various cellular and soluble participants in the vaso-occlusive cascade. The role of these elements and the opportunities for therapeutic intervention are summarized in this review. PMID:24052549

  16. Hepatic veno-occlusive disease due to pyrrolizidine (Senecio) poisoning in Arizona.

    PubMed

    Stillman, A S; Huxtable, R; Consroe, P; Kohnen, P; Smith, S

    1977-08-01

    An infant with documented hepatic veno-occlusive disease due to ingestion of pyrrolizidine alkaloids is presented. The alkaloids were ingested in the form of an herbal tea commonly used as a folk remedy among the Mexican-American population. Among these people, this herb is known as gordolobo yerba. The patient presented with acute hepatocellular disease and portal hypertension which progressed over 2 months to extensive hepatic fibrosis. Other potential causes of hepatic venous occlusion were absent. PMID:873137

  17. Implications of natural occlusion of ventilated racks on ammonia and sanitation practices.

    PubMed

    Creamer, Michelle A; Petty, Joann; Martin, Tara; Bergdall, Valerie; Hickman-Davis, Judy M

    2014-03-01

    Examination of ventilated rat racks prior to semiannual sanitation revealed silicone nozzles and ventilation ports that were partially or completely occluded with granular debris. We subsequently sought to document performance standards for rack sanitation and investigate the effect of ventilation port occlusion on rack function and animal husbandry practices. We hypothesized that individually ventilated cages with occluded airflow would require more frequent cage changes, comparable to those for static cages (that is, every 3 to 4 d). Sprague-Dawley rats were housed under one of 4 conditions: no airflow occlusion, occluded air-supply inlet, occluded air-exhaust outlet, and occlusion of both inlet and outlet. Cages were changed when daily ammonia concentration exceeded 20 ppm or after 14 d had elapsed. Most cages with unoccluded or partial airflow occlusion remained below the 20 ppm limit until day 12 or 13. Cages with occlusion of both inlet and outlet exceeded 20 ppm ammonia by as early as day 5. Airflow was significantly lower in cages with occlusion of both inlet and outlet airflow. Weekly inspection revealed that occlusion of ventilation ports was detectable by 3 mo after semiannual sanitation. This study demonstrates that silicone nozzles should be removed prior to rack sanitation to improve the effectiveness of cleaning ventilation ports and nozzles. While the rack is in use, silicone nozzles and ventilation ports should be inspected regularly to identify occlusion that is likely to diminish environmental quality in the cage. Intracage ammonia levels are significantly higher when both inlet and outlet airflow are occluded. PMID:24602544

  18. [Difficulty in reaching objects due to posterior cerebral artery occlusion].

    PubMed

    Takahashi, N; Kawamura, M

    1998-05-01

    We reported two patients who developed an impairment of reaching movement with their right hand due to left posterior cerebral artery occlusion. Both patients showed abnormalities in reaching their own body parts with eyes closed, and in reaching objects presented before them with eyes fixed on the objects. No motor paralysis or ataxia was noted in either patient; nor was there any disturbance of the superficial or deep sensation except for a slight disturbance of articular localization of the right upper limb in one patient. The failure for these patients to reach their own body parts with eyes closed was thought to be caused by an impairment of kinesthesia of the right upper limb. The failure to reach objects with eyes fixed on them was also likely to be explained by the disturbance of kinesthesia besides the same mechanism as ataxie optique. CT scan revealed low density areas in the medial side of the left temporal and occipital lobes and left lateral pulvinar in both patients. These findings, together with anatomical and physiological findings in recent years, suggest that nerve fibers related to kinesthesia may be projected on the parietal association area via the lateral pulvinar. PMID:9805984

  19. Tubular occlusion optimizes bonding of hydrophobic resins to dentin.

    PubMed

    Sadek, F T; Pashley, D H; Ferrari, M; Tay, F R

    2007-06-01

    Although hydrophobic resins may be bonded to acid-etched dentin with an ethanol wet-bonding technique, the protocol is sensitive to moisture contamination when bonding is performed in deep dentin. This study tested the hypothesis that the use of oxalate or poly(glutamic) acid-modified, diluted ceramicrete (PADC) for dentinal tubule occlusion prevents fluid contamination and improves the bonding of an experimental hydrophobic adhesive to acid-etched, ethanol-dehydrated dentin. Mid-coronal and deep acid-etched moist dentin pre-treated with oxalate or PADC was dehydrated by ethanol wet-bonding and infiltrated with the experimental three-step etch-and-rinse hydrophobic adhesive under simulated pulpal pressure. Tensile bond strengths to deep dentin without pre-treatment were severely compromised. Conversely, oxalate and PADC pre-treatments reduced dentin permeability, prevented water contamination, and improved bond strengths. Minimal nanoleakage was identified within hybrid layers created in the oxalate- and PADC-pre-treated deep dentin. The use of tubular occluding agents optimized bonding of hydrophobic resins to dentin. PMID:17525351

  20. Retinal vein occlusion: genetic predisposition and systemic risk factors.

    PubMed

    Giannaki, Kassiani; Politou, Marianna; Rouvas, Alexandros; Merkouri, Efrossyni; Travlou, Anthi; Theodosiadis, Panayiotis; Gialeraki, Argyri

    2013-04-01

    The role of systemic risk factors (age, smoking, diabetes, arterial hypertension) in the development of retinal vein occlusion (RVO) is well established. However, the association of RVO with genetic predisposition to thrombosis remains poorly understood. The aim of the study was to assess any possible additional effect of genetic predisposition to the already well known 'classical' risk factors of RVO in a cohort of elderly Greek patients. Fifty-one elderly patients with RVO and 51 healthy individuals matched for age and sex were evaluated for systemic risk factors (smoking, diabetes, dyslipidemia, arterial hypertension) and coagulation defects (lupus anticoagulant, natural inhibitors of coagulation). Additionally, genotyping was performed for mutations/polymorphisms involved in haemostasis such as: FV G1691A, FV G4070A, FIIG 20210A, MTHFR C677T and A1298C, PAI-1-675 4G/5G, F XIII exon 2G/T, EPCR A4600G and G4678C. We identified systemic risk factors in the majority of the patients Hypertension (P=0.001), dyslipidemia (P=0.029) and diabetes (P=0.01) are associated with RVO in the majority of the patients. The prevalence of prothrombotic risk factors was not significantly different in the patients with RVO compared to controls. Apart from systemic risk factors, genetic predisposition to thrombosis does not seem to have an important association with RVO in this group of elderly patients. PMID:23337712

  1. Primary stent deployment in occlusive subclavian artery disease.

    PubMed

    Kumar, K; Dorros, G; Bates, M C; Palmer, L; Mathiak, L; Dufek, C

    1995-04-01

    Primary (without antecedent balloon dilation) Palmaz stent implantation was successfully performed in 27 consecutive patients entering with 31 obstructed subclavian arteries. Stents (n = 50) were successfully deployed, using the brachial (n = 7), femoral (n = 16), or combined (n = 8) approach, to revascularize 31 subclavian vessels [8 occluded (26%); 23 stenotic (74%)], using a 6 or 7.5 French delivery system. The indications for intervention were arm claudication in 8 patients (30%), subclavian steal syndrome in 11 patients (41%), angina pectoris secondary to impaired blood flow to the left internal mammary artery coronary bypass in 6 patients (22%), and recanalization of a left subclavian occlusion to permit central arterial access and performance of a second interventional procedure 2 patients (7%). The percent diameter stenosis improved from 85 +/- 12% to 6 +/- 7% (P < 0.001); and, the peak and mean translesion gradients decreased, respectively, from 56 +/- 35 mm Hg to 3 +/- 4 mm Hg (P < 0.01), and 29 +/- 18 mm Hg to 2 +/- 2 mm Hg (P < 0.01). Procedural complications encountered were one stent dislodgement with migration into and uneventful deployment within the right external iliac artery, and two brachial artery repairs. No acute vessel closures, deaths, myocardial infarctions, cerebrovascular accidents, transient ischemic attacks, or need for transfusions occurred. Therefore, primary subclavian artery stent deployment can be performed using low-profile sheath systems with excellent success (100%), resulting in immediate restoration of pulsatile flow, and few complications. The incidence of lesion recurrence remains for follow-up studies. PMID:7621536

  2. Incidence and Predictors of Radial Artery Occlusion Associated Transradial Catheterization

    PubMed Central

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

    2013-01-01

    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

  3. [Suffocation death by occlusion of the airways with sand].

    PubMed

    Maxeiner, H; Schneider, V

    1985-01-01

    Eleven cases are reported in which death occurred because of suffocation as a result of occlusion of the respiratory tract by sand (without thoracic compression: 3 cases) or being buried alive (8 cases). Two tables demonstrate the findings and circumstances in the events. Three cases are described in detail. A 22-year-old woman was manhandled by blows and kicks to the head and neck. She became unconscious and her head and neck were covered by a layer of sand so that she suffocated. A 42-year-old man was smothered, while unconscious, in a prone position with his face in the sand, after hard blows to the head by two culprits. A 17-year-old girl finally died by chocking. Previously the culprit had pressed her face into the ground, so that she aspirated particles of soil. The question of vital reactions during aspiration of sand was investigated by microscopic examination of the content of the air passage and by destroying parts of the lungs by sulphuric acid. Minimal aspiration of sand occurred in all cases. Although the postmortal remains were left in the ground, there was no postmortem penetration of sand into the air passage. Histological examinations were carried out to support the diagnosis of violent suffocation. In some cases, there were remarkable findings (mobilization of alveolar cells, hepatocelullar hydropic degeneration), but there were no typical or unanimous findings that pertained to all cases. PMID:4024749

  4. Vertical and torsional VOR in posterior canal occlusion.

    PubMed

    Kanayama, R; Bronstein, A M; Gresty, M A; Brookes, G B

    1995-01-01

    The vertical and torsional vestibulo-ocular reflexes (VOR) were investigated in 3 patients with surgical occlusion of the posterior semicircular canal and 1 patient with singular neurectomy, for treatment of refractory paroxysmal positional vertigo. Stimuli comprised sinusoidal oscillation in the coronal ("roll") and sagittal ("pitch") plane as well as in two oblique planes intermediate between pitch in order to stimulate left anterior + right posterior (LARP) and right anterior + left posterior (RALP) canal pairs separately. One case with left side BPPV was investigated pre and post-operatively. Depression of the vertical and torsional VOR gain was seen 1 week postoperatively when the occluded canal was placed in the optimal plane for stimulation at 1 week postoperatively and subsequently gradually recovered. Recordings in other planes suggested that the contralateral posterior canal was also hypofunctioning, a finding which may explain some residual gait unsteadiness in this case. The other 3 cases who were investigated postoperatively all showed a decrease in downward VOR gain in the "on' direction of the operated canal. The data indicate the specificity of the test procedure and underline the prognostic value of comprehensive pre-operative vestibular assessment. PMID:8749162

  5. Analytical and numerical analysis of human dental occlusal contact.

    PubMed

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

    2013-01-01

    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

  6. Why do young people with chronic kidney disease die early?

    PubMed Central

    Kumar, Shankar; Bogle, Richard; Banerjee, Debasish

    2014-01-01

    Cardiovascular disease poses the greatest risk of premature death seen among patients with chronic kidney disease (CKD). Up to 50% of mortality risk in the dialysis population is attributable to cardiovascular disease and the largest relative excess mortality is observed in younger patients. In early CKD, occlusive thrombotic coronary disease is common, but those who survive to reach end-stage renal failure requiring dialysis are more prone to sudden death attributable mostly to sudden arrhythmic events and heart failure related to left ventricular hypertrophy, coronary vascular calcification and electrolyte disturbances. In this review, we discuss the basis of the interaction of traditional risk factors for cardiovascular disease with various pathological processes such as endothelial dysfunction, oxidative stress, low grade chronic inflammation, neurohormonal changes and vascular calcification and stiffness which account for the structural and functional cardiac changes that predispose to excess morbidity and mortality in young people with CKD. PMID:25374808

  7. [Differential diagnosis and work up of chronic leg ulcers].

    PubMed

    Spoljar, Sanja

    2014-10-01

    Many factors contribute to the pathogenesis of leg ulcers. The main causes are chronic venous insufficiency, peripheral arterial occlusive disease (PAOD) and diabetes. Some leg ulcers are caused by combinations of these well-known etiologic factors. The most common cause of PAOD is arteriosclerosis. In diabetic patients, distal symmetric neuropathy and peripheral vascular disease are probably the most important etiologic factors in the development of leg ulcers. Less frequent causes of chronic leg ulcers are hematologic diseases, autoimmune diseases, genetic defects, infections, primary skin disease, cutaneous malignant diseases, use of some medications and therapeutic procedures, and numerous exogenous factors. Diagnosis of leg ulcer is made upon medical history, clinical picture, palpation of arteries, functional testing and serologic testing. Device-based diagnostic testing should be performed for additional clarification. Also, lesion biopsy should be taken for histopathology, direct immunofluorescence, bacteriology and mycology. The knowledge of differential diagnosis is essential for ensuring treatment success in a patient with leg ulcer. PMID:25326987

  8. Homeostasis of the epidermal barrier layer: a theory of how occlusion reduces hypertrophic scarring.

    PubMed

    O'Shaughnessy, Kristina D; De La Garza, Mauricio; Roy, Nakshatra K; Mustoe, Thomas A

    2009-01-01

    The mechanism of hypertrophic scar reduction using silicone gel sheeting remains elusive. We hypothesize that the decrease in scar formation is due to occlusion and homeostasis of the barrier layer. Using an established model of hypertrophic scarring, rabbits were divided into four groups and scars were tape-stripped or occluded with Kelocote, Cavilon, or Indermil, with each rabbit serving as its own internal control. All wounds were harvested on day 28 and examined histologically to measure the scar elevation index (SEI), epithelial thickness, and cellularity. Immunohistochemistry fluorescence was used to quantify inflammation in the dermis. Transepidermal water loss (TEWL) was measured for each occlusive agent and tape stripping. Ultrastructural analysis was performed by electron microscopy. Kelocote, Cavilon, and Indermil all significantly decreased SEI when compared with controls. Each of the occlusive treatments was shown to decrease TEWL while tape stripping increased TEWL. Tape stripping significantly increased the SEI, epithelial thickness, and cellularity. Immunostaining for macrophages showed increased density of inflammatory cells in the tape-stripped scars. Under electron microscopy, the tape-stripped wounds displayed extensive inflammation and keratinocyte damage. Both unwounded skin and occlusion-treated scars did not display these characteristics. In conclusion, hypertrophic scarring was reduced regardless of occlusive method used. Furthermore, repeated disruption of the permeability barrier by tape stripping led to an increase in scarring. Ultrastructural analysis suggests that occluded wounds may be in an advanced state of wound repair. Occlusion may mediate its effects through establishing homeostasis of the epidermal barrier layer. PMID:19769722

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

    PubMed Central

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

    2014-01-01

    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

  10. A method for in vivo quantitative occlusal strain and stress analysis.

    PubMed

    Arcan, M; Zandman, F

    1984-01-01

    A method to evaluate in vivo dental occlusal relationships by measuring strains and stresses, memorized in a thin wafer during occlusion, is presented. The method is based on the property of some polymers to memorize mechanical birefringence (the photoplastic phenomenon); it provides and records static and kinematic patterns related to the sequence of contacts during occlusion. This sequence determines the intensity levels of contacts according to impressions on the memorizing sheet. The method consists of observing and measuring, with an optical instrument, birefringence patterns appearing on a special memory sheet upon which a patient has occluded according to specific instructions. Two ways may be considered: the strain analysis and the stress analysis approach. The goal of the strain analysis approach is mostly clinical: to help attain harmonization of the static and kinematic occlusal patterns by detecting and eliminating prematurities and interferences through a step-by-step improvement of the strain uniformity. Other clinical uses include: Relating occlusal strain patterns to traumatic occlusion, bruxism or other functional disturbances. Diagnosing pain-dysfunction syndrome of supporting tissues in subjects with removable complete or partial dentures. Substantiating the comparative effect of supporting implants in combination with natural teeth in bridges, etc. The goal of the stress analysis approach is both clinical and theoretical, providing help in understanding the temporo-mandibular mechanical relationship. PMID:6725296

  11. Stress analysis of an all-ceramic FDP loaded according to different occlusal concepts.

    PubMed

    Dittmer, M P; Kohorst, P; Borchers, L; Schwestka-Polly, R; Stiesch, M

    2011-04-01

    The aim of this study was to investigate the influence of four different occlusal concepts on stress distribution in a four-unit fixed dental prosthesis (FDP) made of zirconia. A three-dimensional finite element (FE) model was created and four model versions with between 15 and 42 contact points were developed. A force of 300 N was distributed over the chewing surface according to the different occlusal concepts and virtually applied perpendicularly to the occlusal plane in each version. Then, FE analysis was performed and stress distribution evaluated. Generally, highest tensile stresses were located at the point of load application within the veneering layer and ranged from 104 to 204 MPa. The highest tensile stresses within the framework were located at the basal side of the connectors and ranged between 12 and 39 MPa. This study shows that the distribution of occlusal contact points significantly influences the stresses induced by occlusal forces in four-unit all-ceramic fixed dental prostheses and strongly suggests that the number and distribution of occlusal contacts may be important to minimise fatigue effects caused by cycling. PMID:20819134

  12. Complications and surgical conversion after total aortic repair using endovascular repair in patients with Marfan syndrome.

    PubMed

    Numata, Satoshi; Tsutsumi, Yasushi; Ohashi, Hirokazu

    2015-04-01

    We report a case of a Marfan syndrome patient who developed a complicated clinical course after total aortic repair using a hybrid technique. After hybrid total aortic repair, this patient was required to undergo open thoracic and thoracoabdominal aortic repair due to impending rupture of the aorta. Moreover, the abdominal aortic graft was rereplaced due to debranching graft occlusion of the coeliac artery and the left renal artery. PMID:25575789

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

    PubMed

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

    2014-01-01

    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

  14. Cognitive impairment in patients with symptomatic carotid artery occlusion

    Microsoft Academic Search

    F. C. Bakker

    2003-01-01

    Background\\u000aAlthough transient ischemic attacks (TIAs) by definition do not cause neurologic deficits, cognitive impairment has been suggested in patients with carotid artery disease (CAD) and ipsilateral TIAs. The cause of this impairment has not been elucidated yet. Thrombo-embolism, but also chronic cerebral hypoperfusion have been suggested to play a role. In this light, surgical interventions that improve the blood

  15. Chronic Illness and Patient Satisfaction

    PubMed Central

    Carlin, Caroline S; Christianson, Jon B; Keenan, Patricia; Finch, Michael

    2012-01-01

    Objective To examine how the relationship between patient characteristics, patient experience with the health care system, and overall satisfaction with care varies with illness complexity. Data Sources/Study Setting Telephone survey in 14 U.S. geographical areas. Study Design Structural equation modeling was used to examine how relationships among patient characteristics, three constructs representing patient experience with the health care system, and overall satisfaction with care vary across patients by number of chronic illnesses. Data Collection/Extraction Methods Random digital dial telephone survey of adults with one or more chronic illnesses. Principal Findings Patients with more chronic illnesses report higher overall satisfaction. The total effects of better patient–provider interaction and support for patient self-management are associated with higher satisfaction for all levels of chronic illness. The latter effect increases with illness burden. Older, female, or insured patients are more satisfied; highly educated patients are less satisfied. Conclusions Providers seeking to improve their patient satisfaction scores could do so by considering patient characteristics when accepting new patients or deciding who to refer to other providers for treatment. However, our findings suggest constructive actions that providers can take to improve their patient satisfaction scores without selection on patient characteristics. PMID:22515159

  16. Chronic Conditions and School

    MedlinePLUS

    ... Issues Listen Chronic Conditions and School Article Body My child has a chronic health condition. What do ... the school right away when contact information has changed. Make a health plan . If your child takes ...

  17. Chronic fatigue syndrome - resources

    MedlinePLUS

    Resources - chronic fatigue syndrome; CFS resources ... The following organizations provide information on chronic fatigue syndrome : CFIDS Association of America - www.cfids.org U.S. Centers for Disease Control and Prevention - www.cdc.gov/cfs

  18. Chronic fatigue syndrome

    MedlinePLUS

    CFS; Fatigue - chronic; Immune dysfunction syndrome; Myalgic encephalomyelitis (ME) ... The exact cause of chronic fatigue syndrome (CFS) is unknown. Some theories suggest CFS may be due to: Epstein-Barr virus or human herpes virus-6 (HHV- ...

  19. Understanding Chronic Bronchitis

    MedlinePLUS

    ... news is that chronic bronchitis can be found early and there is much that can be done to treat and help manage the disease. What Causes Chronic Bronchitis? Cigarette smoking is by far the most common cause of ...

  20. Sleep and Chronic Disease

    MedlinePLUS

    ... visit this page: About CDC.gov . Sleep and Sleep Disorders Share Compartir Sleep and Chronic Disease As chronic ... of depression be monitored among persons with a sleep disorder. 4, 5 References Knutson KL, Ryden AM, Mander ...

  1. Chronic Urticaria (Hives)

    MedlinePLUS

    ... chronic hives may be diagnosed with Chronic Idiopathic Urticaria (CIU). Angioedema is a form of hives where ... hour after exposure. For example: people with pressure urticaria get hives on certain parts of the body ...

  2. Chronic myelogenous leukemia (CML)

    MedlinePLUS

    ... leukemia is grouped into several phases: Chronic Accelerated Blast crisis The chronic phase can last for months ... a swollen spleen . Untreated CML leads to the blast crisis phase. Bleeding and infection may occur due ...

  3. Chronic Kidney Diseases

    MedlinePLUS

    ... for a long time, doctors call it a chronic kidney disease. Children's kidney problems may be congenital (say: kun- ... Do Doctors Treat Kidney Problems? The treatment for chronic kidney ... bone disease. Sometimes unhealthy kidneys have problems producing a hormone ...

  4. [Complete occlusion of the left main coronary artery complicated by cardiac arrest and acute massive pulmonary embolism with a favourable outcome--a case report].

    PubMed

    Mar?, Mi?osz; Kurianowicz, Rafa?; Wa?czura, Piotr; Bak, Janusz; Rudnicki, Zbigniew; Olszewski, Miros?aw; Weglarz, Maciej

    2006-02-01

    A case of a 53-year-old male with acute myocardial infarction complicated by cardiac arrest is presented. Due to neurological complications which were transient, the patient was not selected for primary angioplasty. Three days later his condition significantly improved and the patient was transferred to internal ward were he developed cardiogenic shock due to a massive pulmonary embolism. Thrombolysis and low molecular weight heparin were effective and the patient did well during subsequent hospitalisation period. Coronary angiography was performed 4 weeks from hospital admission and revealed a total left main coronary occlusion with good collateral circulation from the right coronary artery. Finally, the patient underwent successful CABG. PMID:16502371

  5. [Chronic, refractory algodystrophy].

    PubMed

    Zyluk, Andrzej

    2006-01-01

    Among the patients suffered form algodystrophy, a subgroup characterized as refractory can be selected. This subgroup consists of exclusively young women, in whom the syndrome develops as a consequence of relatively minor trauma and frequently the course is associated with neurological symptoms and signs. The main problem in these patients is to control a severe, spontaneous pain of the affected limb, while impaired function of the hand is of less importance; in almost all cases the disease leads to almost total disability of the affected limb. The cause of the progressive course of the algodystrophy and resistance to the treatment in these patients remains obscure. We present a series of 9 women in the mean age of 33 years, with chronic, refractory algodystrophy of the upper limb lasting mean of 13 months at presentation. The diagnosis of the syndrome was based on clinical grounds, and the treatment included the following methods: mannitol combined with dexamethasone, regional intravenous blocks with methylprednosolone, regional intravenous blocks with phentolamine, phenoxybenzamine, sympathectomy, salmon calcitonin, continuous brachial plexus anaesthesia with bupivacaine, amitryptyline, gabapentin, thaildomid and botulin toxin. Four of the nine patients responded partially to the treatment, one underwent amputation of the affected hand, two are still under control after implantation of the catheter for continuous brachial plexus anaesthesia, and in remaining two patients the long lasting treatments totally failed. PMID:17585487

  6. [Pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis].

    PubMed

    Montani, David; Dorfmuller, Peter; Maitre, Sophie; Jaïs, Xavier; Sitbon, Olivier; Simonneau, Gérald; Humbert, Marc

    2010-01-01

    The new classification of pulmonary hypertension proposed in the joint European Society of Cardiology (ESC) and European Respiratory Society (ERS) guidelines, combines pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangiomatosis (PCH) from separate categories into a single subcategory within pulmonary arterial hypertension (PAH) because of specific similarities in their diagnosis, prognosis, and management. These diseases are characterized histologically by their predominant involvement of small pulmonary veins (PVOD) and capillaries (PCH). Their precise prevalence is not known, but they are thought to account for 5 to 10% of the forms of PAH initially considered idiopathic. They cannot be distinguished from idiopathic PAH by their clinical or hemodynamic presentation. Only pathology examination can confirm the diagnosis, but lung biopsies are high-risk procedures and not recommended. A less invasive approach combining chest CT (centrilobular ground-glass opacities, septal lines, and mediastinal adenopathy), blood gases (resting hypoxemia), lung function tests [collapse in carbon monoxide diffusion (DLCO)] and bronchoalveolar lavage (occult intra-alveolar hemorrhage) makes it possible to screen the patients at risk of PVOD or HCP and thus avoid a lung biopsy. These patients have a poor prognosis and are at risk of developing severe pulmonary edema after the initiation of specific treatment for PAH. In view of their limited response to specific treatment and poor prognosis, pulmonary transplantation remains the treatment of choice for PVOD and HCP. In patients with the most severe disease, the prudent use of continuous intravenous epoprostenol, can serve as bridge-therapy while awaiting a lung transplant. PMID:19914027

  7. Radial artery occlusion after percutaneous coronary interventions – an underestimated issue

    PubMed Central

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

    2013-01-01

    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

  8. Endovascular treatment of severe acute basilar artery occlusion.

    PubMed

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

    2015-01-01

    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 59.56 years (range: 31-76 years) 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

  9. What Is Chronic Myeloid Leukemia?

    MedlinePLUS

    ... about chronic myeloid leukemia? What is chronic myeloid leukemia? Chronic myeloid leukemia (CML), also known as chronic ... is the same as for adults. What is leukemia? Leukemia is a cancer that starts in the ...

  10. [Neuroprotective effects of a dipeptide mimetic on the GK-2 nerve growth factor in model of permanent common carotid artery occlusion in rats].

    PubMed

    Povarina, P Iu; Gudasheva, T A; Vorontsova, O N; Nikolaev, S V; Antipova, T A; Ostrovskaia, R U; Seredin, S B

    2012-01-01

    The behavioral and biochemical effects of a new dipeptide mimetic of the GK-2 nerve growth factor (NGF) have been studied on a model of chronic cerebral ischemia induced by permanent common carotid artery occlusion in rats. It is established that subchronic intraperitoneal injections of GK-2 (0.5 mg/kg) 4 h after surgery, followed by seven more injections made every 24 h, fully prevent the death of operated animals and reduces the development of habitation deficit (open-field test) and decrease in exploratory activity (novel object examination) two weeks after surgery, as well as fully restores the viability of cerebral cortex cells and decreases the hyperexpression of HSP70 in cerebral cortex. PMID:23156082

  11. Sequential occlusion of the branch retinal artery and branch retinal vein in a patient with hypertension: an interventional case report

    PubMed Central

    Okamoto, Norio; Matsumoto, Chota; Shimomura, Yoshikazu

    2014-01-01

    Background There are some cases that reported central retinal vein occlusion accompanied by ciliary artery occlusion, however, combined branch retinal artery and vein occlusion is a rare condition that has been infrequently reported. We describe in this report one case of retinal vein occlusion and branch retinal artery occlusion occurring simultaneously. Case presentation A 50 year-old woman presented with acute visual loss in her right eye. Fundus photography showed retinal ischemia and tortuous, dilated retinal veins in the right eye. With early phase fluorescein angiography, retinal arteries revealed areas absent of branches. Late phase fluorescein angiography demonstrated that areas absent of branches were still present. Conclusion It is a rare case of branch retinal artery and vein occlusion. PMID:25378899

  12. The Dopamine Agonists Lisuride and Piribedil Protect against Behavioural and Histological Changes following 4Vessel Occlusion in the Rat

    Microsoft Academic Search

    M. A. Caldwell; J.-M. Reymann; D. B. Bentue-Ferrer; H. Allain; B. E. Leonard

    1996-01-01

    The 4-vessel occlusion model of ischaemia in the rat was used to assess the effects of two dopaminergic agonists, lisuride and piribedil, on some behavioural and histological changes. Animals were either sham-operated, subjected to 20 min 4-vessel occlusion, or administered lisuride (0.5 mg\\/kg i.p.) or piribedil (10 mg\\/kg i.p.) 1 h before 20 min 4-vessel occlusion. Both drugs attenuated deficits

  13. Are adolescents with chronic conditions particularly at risk for bullying?

    Microsoft Academic Search

    I. Pittet; A. Berchtold; C. Akre; P.-A. Michaud; J-C Surís

    2010-01-01

    ObjectiveTo compare the prevalence and intensity of victimisation from bullying and the characteristics of the victim of bullying, comparing adolescents with and adolescents without chronic conditions (CC).DesignSchool survey.SettingPostmandatory schools.ParticipantsA total of 7005 students (48% females) aged 16–20 years, distributed into adolescents with CC (728, 50% females) and controls (6277, 48% females). Chronic condition was defined as having a chronic disease

  14. Efficiency of Posterior Tibial Nerve Stimulation in Category IIIB Chronic Prostatitis\\/Chronic Pelvic Pain: A Sham-Controlled Comparative Study

    Microsoft Academic Search

    Sahin Kabay; Sibel Canbaz Kabay; Mehmet Yucel; Hilmi Ozden

    2009-01-01

    Objectives: To evaluate the efficacy of percutaneous posterior tibial nerve stimulation (PTNS) for treatment of the patients with category IIIB chronic non-bacterial prostatitis\\/chronic pelvic pain syndrome. Methods: A total of 89 patients with therapy-resistant pelvic pain were randomized to receive either nerve stimulation (n = 45) or sham treatment (n = 44). The National Institutes of Health Chronic Prostatitis Symptom

  15. Deletion Genotypes Reduce Occlusion Body Potency but Increase Occlusion Body Production in a Colombian Spodoptera frugiperda Nucleopolyhedrovirus Population

    PubMed Central

    Barrera, Gloria; Williams, Trevor; Villamizar, Laura; Caballero, Primitivo; Simón, Oihane

    2013-01-01

    A Colombian field isolate (SfCOL-wt) of Spodoptera frugiperda multiple nucleopolyhedrovirus (SfMNPV) is a mixture of different genotypes. To evaluate the insecticidal properties of the different genotypic variants, 83 plaque purified virus were characterized. Ten distinct genotypes were identified (named A through J). SfCOL-A was the most prevalent (71±2%; mean ± SE) showing a PstI restriction profile indistinguishable to that of SfCOL-wt. The remaining nine genotypes presented genomic deletions of 3.8 - 21.8 Kb located mainly between nucleotides 11,436 and 33,883 in the reference genome SfMNPV-B, affecting the region between open reading frames (ORFs) sf20 and sf33. The insecticidal activity of each genotype from SfCOL-wt and several mixtures of genotypes was compared to that of SfCOL-wt. The potency of SfCOL-A occlusion bodies (OBs) was 4.4-fold higher than SfCOL-wt OBs, whereas the speed of kill of SfCOL-A was similar to that of SfCOL-wt. Deletion genotype OBs were similarly or less potent than SfCOL-wt but six deletion genotypes were faster killing than SfCOL-wt. The potency of genotype mixtures co-occluded within OBs were consistently reduced in two-genotype mixtures involving equal proportions of SfCOL-A and one of three deletion genotypes (SfCOL-C, -D or -F). Speed of kill and OB production were improved only when the certain genotype mixtures were co-occluded, although OB production was higher in the SfCOL-wt isolate than in any of the component genotypes, or mixtures thereof. Deleted genotypes reduced OB potency but increased OB production of the SfCOL-wt population, which is structured to maximize the production of OBs in each infected host. PMID:24116220

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

    PubMed Central

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

    2013-01-01

    Thrombus within an inferior vena cava (IVC) filter reduces filter patency and venous return from the lower extremities, and may progress to complete IVC occlusion. The clinical experiences and outcomes of transcatheter thrombolytic therapy for symptomatic IVC thrombosis following filter implantation have not been widely reported. The aim of the current study was to evaluate the efficiency and safety of trans-catheter thrombolysis for the treatment of symptomatic IVC thrombosis in patients with implanted IVC filters. Transcatheter thrombolysis was used to treat 5 patients with thrombosis of the filter-bearing IVC causing symptoms in 10 limbs from October 2005 to September 2010. The patients were implanted with a second IVC filter through the right internal jugular vein, followed by recanalization of the occluded IVC and intravenous transcatheter thrombolysis. The IVC filters were retrieved through the femoral or right internal jugular vein after the thrombus had dissolved. Technical and clinical outcome, complications and postoperative pulmonary embolism were monitored. A total of 5 filters were implanted and 6 filters were retrieved later. Technically and clinically successful recanalization and thrombolysis were achieved in 5 of 5 patients and 10 of 10 symptomatic limbs. The median thrombolysis period was 13 days (range, 8–14 days). The median dwell time for the filters that were removed was 50.5 days (range, 14–73 days). No major bleeding occurred during the current study. During clinical follow-up, no clinically detectable pulmonary embolism was observed. Endovascular recanalization and transcatheter thrombolysis of IVC thrombosis are efficient, feasible and safe in the presence of an IVC filter. PMID:23403505

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

    PubMed

    Xiao, Liang; Shen, Jing; Tong, Jia-Jie; Zhang, Zhe; Mu, Xiao-Lin; Yi, Zheng-Jia; Bai, Shuo; Xu, Ke

    2013-02-01

    Thrombus within an inferior vena cava (IVC) filter reduces filter patency and venous return from the lower extremities, and may progress to complete IVC occlusion. The clinical experiences and outcomes of transcatheter thrombolytic therapy for symptomatic IVC thrombosis following filter implantation have not been widely reported. The aim of the current study was to evaluate the efficiency and safety of trans-catheter thrombolysis for the treatment of symptomatic IVC thrombosis in patients with implanted IVC filters. Transcatheter thrombolysis was used to treat 5 patients with thrombosis of the filter-bearing IVC causing symptoms in 10 limbs from October 2005 to September 2010. The patients were implanted with a second IVC filter through the right internal jugular vein, followed by recanalization of the occluded IVC and intravenous transcatheter thrombolysis. The IVC filters were retrieved through the femoral or right internal jugular vein after the thrombus had dissolved. Technical and clinical outcome, complications and postoperative pulmonary embolism were monitored. A total of 5 filters were implanted and 6 filters were retrieved later. Technically and clinically successful recanalization and thrombolysis were achieved in 5 of 5 patients and 10 of 10 symptomatic limbs. The median thrombolysis period was 13 days (range, 8-14 days). The median dwell time for the filters that were removed was 50.5 days (range, 14-73 days). No major bleeding occurred during the current study. During clinical follow-up, no clinically detectable pulmonary embolism was observed. Endovascular recanalization and transcatheter thrombolysis of IVC thrombosis are efficient, feasible and safe in the presence of an IVC filter. PMID:23403505

  18. Primary Stenting of Subclavian and Innominate Artery Occlusive Disease: A Single Center's Experience

    SciTech Connect

    Brountzos, E. N., E-mail: platanos@hol.qr; Petersen, B.; Binkert, C.; Panagiotou, I.; Kaufman, J. A. [Oregon Health Sciences University, Dotter Interventional Institute (United States)

    2004-11-15

    Purpose: To review immediate and midterm results of primary stenting for innominate and subclavian artery occlusive lesions. Methods: Retrospective data were collected from 48 consecutive symptomatic patients (27 men and 21 women, median age 64 years) having 49 subclavian and innominate artery lesions treated with stenting. Of the patients 52% had concomitant ischemic heart disease, and 30% had carotid and/or vertebral artery disease. Indication for treatment was vertebrobasilar insufficiency (VBI) in 16.6% of the patients; upper limb ischemia (ULI) in 31.3%; VBI and ULI in 12.5%; transient ischemic attack in 16.7%; angina in 12.5% before or after left internal mammary artery-to-coronary artery bypass grafting; and leg claudication in 10.4% before or after axillofemoral bypass grafting. Balloon-expandable stents were used in 44 lesions and self-expandable stents in 5 lesions. In total, 53 stents were placed in 48 patients. Results: Technical success was 96%, and clinical success 94%. We encountered four complications (two puncture site hematomas, one distal hand embolization and one transient cerebral ischemia). Two patients died within 30 days from other causes, and seven patients were lost to follow-up. Mean follow-up time was 16.7 months (range 0.3 to 68.2). Five patients had recurrent lesions treated by surgical (n = 2) or endovascular (n = 3) means. Cumulative primary patency rate was 91.7% and 77% at 12 and 24 months, respectively. Cumulative secondary patency rate was 96.5% and 91.7% at 12 and 24 months, respectively. Conclusion: Stenting of subclavian and innominate artery lesions resulted in immediate resolution of patients' symptoms with durable midterm effect and few complications in a larger patient group with serious comorbid conditions.

  19. Clinical study on the effect of professional cleaning of occlusal tooth surfaces on laser fluorescence measurements.

    PubMed

    Anttonen, V; Seppä, L; Hausen, H

    2005-01-01

    Manufacturer's advice is to professionally clean teeth before using a laser fluorescence (LF) device in order to avoid false-positive diagnoses. Professional cleaning is not included in routine dental check-ups in children in Finland because it is time-consuming. The aim of our present study was to evaluate the effect of professional cleaning of teeth on LF in children. A total of 642 occlusal surfaces in permanent molars and premolars in 9- to 16-year-olds (n = 46) were first examined visually. After that the first measurements with LF were made without cleaning the teeth. At the same appointment the second measurements were carried out after professional cleaning using a soft rubber cup and either polishing paste or plain water spray. The differences in LF of uncleaned and cleaned teeth were determined separately for teeth with a visual score of 0 (sound) and > 0. In premolars cleaning had no significant effect on LF. In molars, the values increased when the teeth were cleaned, the difference of the measurements being statistically significant in molars with visual score > 0 cleaned with plain water spray. For molars that were cleaned with paste, the differences were not statistically significant. Sealants did not modify the effect of cleaning. As a conclusion cleaning with a rotating instrument and water spray before LF measurements is recommended in teeth with visible plaque. Also in clean teeth, cleaning is advisable in cases where LF readings approach threshold level for operative intervention. The finding that uncleaned teeth gave lower values than cleaned teeth is opposite to what has been suggested. PMID:15942187

  20. Protective effect of paraoxonase 1 gene variant L55M in retinal vein occlusion

    PubMed Central

    Sö?üt, Erkan; Ate?, Ömer; Erkorkmaz, Ünal; Benli, ?smail; Akbas, Ali; Demir, Selim; Özyurt, Hüseyin

    2013-01-01

    Purpose To determine if the paraoxonase 1 L55M and paraoxonase 1 Q192R gene polymorphisms have an effect on the risk of having a retinal vein occlusion (RVO). Methods This case-control prospective study included 120 patients with RVO and 84 control subjects. All subjects were screened for age, gender, hypertension, diabetes, body mass index, fibrinogen, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, total cholesterol, and very low-density lipoprotein. Subjects were also questioned about their smoking habits. Genomic DNA was extracted from peripheral leukocytes from EDTA anticoagulated blood. Genotyping of the paraoxonase 1 L55M and paraoxonase 1 Q192R polymorphisms was performed using real-time PCR. Results The frequency of the paraoxonase 1 (PON1) 55 LL genotype was significantly lower in patients with RVO than in the control subjects (28% versus 55%; p=0.005). Logistic regression analyses were also conducted. After adjusting for gender, diabetes, hypertension, plasma fibrinogen levels, and high-density lipoprotein cholesterol, the lower LL genotype was found to be an independent predictor of RVO (?=1.755; odds ratio=5.783; p<0.001; 95% confidence interval=2.579–12.967). Conclusions Subjects with a lower frequency PON1 55 LL genotype had a higher risk of RVO. These results indicate that paraoxonase gene polymorphisms may be a possible risk factor for RVO. We suggest that the LL genotype may have a protective role in the pathogenesis of RVO in the Turkish population. PMID:23441121

  1. Mechanical Recanalization of Subacute Vessel Occlusion in Peripheral Arterial Disease with a Directional Atherectomy Catheter

    SciTech Connect

    Massmann, Alexander, E-mail: Alexander.Massmann@uks.eu; Katoh, Marcus [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany); Shayesteh-Kheslat, Roushanak [Saarland University Hospital, Department of General Surgery, Visceral, Vascular, and Pediatric Surgery (Germany); Buecker, Arno [Saarland University Hospital, Department of Diagnostic and Interventional Radiology (Germany)

    2012-10-15

    Purpose: To retrospectively examine the technical feasibility and safety of directional atherectomy for treatment of subacute infrainguinal arterial vessel occlusions. Methods: Five patients (one woman, four men, age range 51-81 years) with peripheral arterial disease who experienced sudden worsening of their peripheral arterial disease-related symptoms during the last 2-6 weeks underwent digital subtraction angiography, which revealed vessel occlusion in native popliteal artery (n = 4) and in-stent occlusion of the superficial femoral artery (n = 1). Subsequently, all patients were treated by atherectomy with the SilverHawk (ev3 Endovascular, USA) device. Results: The mean diameter of treated vessels was 5.1 {+-} 1.0 mm. The length of the occlusion ranged 2-14 cm. The primary technical success rate was 100%. One patient experienced a reocclusion during hospitalization due to heparin-induced thrombocytopenia. There were no further periprocedural complications, in particular no peripheral embolizations, until hospital discharge or during the follow-up period of 1 year. Conclusion: The recanalization of infrainguinal arterial vessel occlusions by atherectomy with the SilverHawk device is technically feasible and safe. In our limited retrospective study, it was associated with a high technical success rate and a low procedure-related complication rate.

  2. Particle Filters and Occlusion Handling for Rigid 2D-3D Pose Tracking

    PubMed Central

    Lee, Jehoon; Sandhu, Romeil; Tannenbaum, Allen

    2013-01-01

    In this paper, we address the problem of 2D-3D pose estimation. Specifically, we propose an approach to jointly track a rigid object in a 2D image sequence and to estimate its pose (position and orientation) in 3D space. We revisit a joint 2D segmentation/3D pose estimation technique, and then extend the framework by incorporating a particle filter to robustly track the object in a challenging environment, and by developing an occlusion detection and handling scheme to continuously track the object in the presence of occlusions. In particular, we focus on partial occlusions that prevent the tracker from extracting an exact region properties of the object, which plays a pivotal role for region-based tracking methods in maintaining the track. To this end, a dynamical choice of how to invoke the objective functional is performed online based on the degree of dependencies between predictions and measurements of the system in accordance with the degree of occlusion and the variation of the object’s pose. This scheme provides the robustness to deal with occlusions of an obstacle with different statistical properties from that of the object of interest. Experimental results demonstrate the practical applicability and robustness of the proposed method in several challenging scenarios. PMID:24058277

  3. Edge preserving motion estimation with occlusions correction for assisted 2D to 3D conversion

    NASA Astrophysics Data System (ADS)

    Pohl, Petr; Sirotenko, Michael; Tolstaya, Ekaterina; Bucha, Victor

    2014-02-01

    In this article we propose high quality motion estimation based on variational optical flow formulation with non-local regularization term. To improve motion in occlusion areas we introduce occlusion motion inpainting based on 3-frame motion clustering. Variational formulation of optical flow proved itself to be very successful, however a global optimization of cost function can be time consuming. To achieve acceptable computation times we adapted the algorithm that optimizes convex function in coarse-to-fine pyramid strategy and is suitable for modern GPU hardware implementation. We also introduced two simplifications of cost function that significantly decrease computation time with acceptable decrease of quality. For motion clustering based motion inpaitning in occlusion areas we introduce effective method of occlusion aware joint 3-frame motion clustering using RANSAC algorithm. Occlusion areas are inpainted by motion model taken from cluster that shows consistency in opposite direction. We tested our algorithm on Middlebury optical flow benchmark, where we scored around 20th position, but being one of the fastest method near the top. We also successfully used this algorithm in semi-automatic 2D to 3D conversion tool for spatio-temporal background inpainting, automatic adaptive key frame detection and key points tracking.

  4. Nondestructive Clinical Assessment of Occlusal Caries Lesions using Near-IR Imaging Methods

    PubMed Central

    Staninec, Michal; Douglas, Shane M.; Darling, Cynthia L.; Chan, Kenneth; Kang, Hobin; Lee, Robert C.; Fried, Daniel

    2011-01-01

    Objective Enamel is highly transparent in the near-IR (NIR) at wavelengths near 1300-nm, and stains are not visible. The purpose of this study was to use NIR transillumination and optical coherence tomography (OCT) to estimate the severity of caries lesions on occlusal surfaces both in vivo and on extracted teeth. Methods Extracted molars with suspected occlusal lesions were examined with OCT and polarization sensitive OCT (PS-OCT), and subsequently sectioned and examined with polarized light microscopy (PLM) and transverse microradiography (TMR). Teeth in test subjects with occlusal caries lesions that were not cavitated or visible on radiographs were examined using NIR transillumination at 1310 nm using a custom built probe attached to an indium gallium arsenide (InGaAs) camera and a linear OCT scanner. After imaging, cavities were prepared using dye staining to guide caries removal and physical impressions of the cavities were taken. Results The lesion severity determined from OCT and PS-OCT scans in vitro correlated with the depth determined using polarized light microscopy (PLM) and transverse microradiography (TMR). Occlusal caries lesions appeared in NIR images with high contrast in vivo. OCT scans showed that most of the lesions penetrated to dentin and spread laterally below the sound enamel. Conclusion This study demonstrates that both NIR transillumination and OCT are promising new methods for the clinical diagnosis of occlusal caries. PMID:22109697

  5. Temporary Arterial Balloon Occlusion as an Adjunct to Yttrium-90 Radioembolization

    SciTech Connect

    Hagspiel, Klaus D., E-mail: kdh2n@virginia.edu [University of Virginia Health System, Department of Radiology and Medical Imaging (United States); Nambiar, Ashwin, E-mail: uvashwin@gmail.com [SUNY Downstate Medical Center, Department of Radiology (United States); Hagspiel, Lauren M., E-mail: lmh4gg@virginia.edu [University of Virginia, College of Arts and Sciences (United States); Ahmad, Ehab Ali, E-mail: ehabradiodiagnosis@yahoo.com [Minia University, Department of Radiology (Egypt); Bozlar, Ugur, E-mail: ubozlar@yahoo.com [Gulhane Military Medical Academy, Department of Radiology (Turkey)

    2013-06-15

    Purpose. This study was designed to describe the technique of arterial occlusion using a temporary occlusion balloon system as an alternative to coil occlusion during Yttrium-90 radioembolization of hepatic tumors. Methods. Review of charts, angiography, and follow-up imaging studies of consecutive patients undergoing oncological embolization procedures in which a HyperForm system (ev3 Neurovascular, Irvine, CA) was used. Intraprocedural target vessel occlusion and patency of the target vessel on follow-up were recorded. Clinical data and Bremsstrahlung scans were reviewed for evidence of nontarget embolization. Results. Four radioembolization procedures were performed in three patients (all female, age 48-54 (mean 52) years). Five arteries were temporarily occluded (three gastroduodenal arteries, one right gastric artery, and one cystic artery). All radioembolization procedures were successfully completed. Follow-up imaging (either digital subtraction angiography (DSA) or computed tomography angiography (CTA)) was available for all patients between 28-454 (mean 183) days following the procedure, demonstrating all five vessels to be patent. No clinical or imaging evidence for nontarget embolization was found. Conclusions. Temporary balloon occlusion of small and medium-sized arteries during radioembolization allows safe therapy with preserved postprocedural vessel patency on early and midterm follow-up.

  6. A method for resolving occlusions when multitracking individuals in a shoal.

    PubMed

    Dolado, Ruth; Gimeno, Elisabet; Beltran, Francesc S; Quera, Vicenç; Pertusa, José F

    2014-10-01

    Studying the collective behavior of fishes often requires tracking a great number of individuals. When many fishes move together, it is common for individuals to move so close to each other that some fishes superimpose themselves on others during one or several units of time, which impacts on tracking accuracy (i.e., loss of fish trajectories, interchange of fish identities). Type 1 occlusions arise when two fishes swim so near each other that they look like one long fish, whereas type 2 occlusions occur when the fishes' trajectories cross to create a T- or X-shaped individual. We propose an image processing method for resolving these types of occlusions when multitracking shoals in two dimensions. We assessed processing effectiveness after videorecording shoals of 20 and 40 individuals of two species that exhibit different shoal styles: zebrafish (Danio rerio) and black neon tetras (Hyphessobrycon herbertaxelrodi). Results show that, although the number of occlusions depended on both the number of individuals and the species, the method is able to effectively resolve a great deal of occlusions, irrespective of the species and the number of individuals. It also produces images that can be used in a multitracking system to detect individual fish trajectories. Compared to other methods, our approach makes it possible to study shoals with water depths similar to those seen in the natural conditions of the two species studied. PMID:25294043

  7. Occlusion is hard: Comparing predictive reaching for visible and hidden objects in infants and adults

    PubMed Central

    Hespos, Susan; Gredebäck, Gustaf; von Hofsten, Claes; Spelke, Elizabeth S.

    2009-01-01

    Infants can anticipate the future location of a moving object and execute a predictive reach to intercept the object. When a moving object is temporarily hidden by darkness or occlusion, 6-month-old infants’ reaching is perturbed but performance on darkness trials is significantly better than occlusion trials. How does this reaching behavior change over development? Experiment 1 tested predictive reaching of 6- and 9-month-old infants. While there was an increase in the overall number of reaches with increasing age, there were significantly fewer predictive reaches during the occlusion compared to visible trials and no age-related changes in this pattern. The decrease in performance found in Experiment 1 is likely to apply not only to the object representations formed by infants but also those formed by adults. In Experiment 2 we tested adults with a similar reaching task. Like infants, the adults were most accurate when the target was continuously visible and performance in darkness trials was significantly better than occlusion trials, providing evidence that there is something specific about occlusion that makes it more difficult than merely lack of visibility. Together, these findings suggest that infants’ and adults’ capacities to represent objects have similar signatures throughout development. PMID:20111668

  8. Analysis of Hemodynamics and Aneurysm Occlusion after Flow Diverting Treatment in Rabbit Models

    PubMed Central

    Cebral, Juan R.; Mut, Fernando; Raschi, Marcelo; Hodis, Simona; Ding, Yong-Hong; Erickson, Bradley J.; Kadirvel, Ramanathan; Kallmes, David F.

    2014-01-01

    Purpose to investigate the relationship between hemodynamic conditions created immediately after flow diversion and subsequent occlusion of experimental aneurysms in rabbits. Methods The hemodynamic environment before and after flow diversion treatment of elastase induced aneurysms in 20 rabbits was modeled using image-based computational fluid dynamics. Local aneurysm occlusion was quantified using a voxelization technique on 3D images acquired 8 weeks after treatment. Global and local voxel-by-voxel hemodynamic variables were used to statistically compare aneurysm regions that later thrombosed to regions that remained patent. Results Six aneurysms remained patent at 8 weeks while 14 were completely or nearly completely occluded. Patent aneurysms had statistically larger neck sizes (p=0.0015) and smaller mean transit times (p=0.02). The velocity, vorticity and shear rate were about 2.8 times (p<0.0001) larger in patent regions, i.e. had larger “flow activity”, than regions that progressed to occlusion. Statistical models based on local hemodynamic variables were capable of predicting local occlusion with good precision (84% accuracy), especially away from the neck (92–94%). Predictions near the neck were poorer (73% accuracy). Conclusion These results suggests that the dominant healing mechanism of occlusion within the aneurysm dome are related to slow flow induced thrombosis while near the neck other processes could be at play simultaneously. PMID:24722302

  9. RANKL, Osteopontin, and Osteoclast Homeostasis in a Hyper-Occlusion Mouse Model

    SciTech Connect

    Walker, Cameron G.; Ito, Yoshihiro; Dangaria, Smit; Luan, Xianghong; Diekwisch, Thomas G.H. (UIC)

    2010-11-15

    The biological mechanisms that maintain the position of teeth in their sockets establish a dynamic equilibrium between bone resorption and apposition. In order to reveal some of the dynamics involved in the tissue responses towards occlusal forces on periodontal ligament (PDL) and alveolar bone homeostasis, we developed the first mouse model of hyperocclusion. Swiss-Webster mice were kept in hyperocclusion for 0, 3, 6, and 9 d. Morphological and histological changes in the periodontium were assessed using micro-computed tomography (micro-CT) and ground sections with fluorescent detection of vital dye labels. Sections were stained for tartrate-resistant acid phosphatase, and the expression of receptor activator of nuclear factor-{kappa}B ligand (RANKL) and osteopontin (OPN) was analyzed by immunohistochemistry and real-time polymerase chain reaction (PCR). Traumatic occlusion resulted in enamel surface abrasion, inhibition of alveolar bone apposition, significant formation of osteoclasts at 3, 6 and 9 d, and upregulation of OPN and RANKL. Data from this study suggest that both OPN and RANKL contribute to the stimulation of bone resorption in the hyperocclusive state. In addition, we propose that the inhibition of alveolar bone apposition by occlusal forces is an important mechanism for the control of occlusal height that might work in synergy with RANKL-induced bone resorption to maintain normal occlusion.

  10. Remote-controlled stop of phloem mass flow by biphasic occlusion in Cucurbita maxima.

    PubMed

    Furch, Alexandra C U; Zimmermann, Matthias R; Will, Torsten; Hafke, Jens B; van Bel, Aart J E

    2010-08-01

    The relationships between damage-induced electropotential waves (EPWs), sieve tube occlusion, and stop of mass flow were investigated in intact Cucurbita maxima plants. After burning leaf tips, EPWs propagating along the phloem of the main vein were recorded by extra- and intracellular microelectrodes. The respective EPW profiles (a steep hyperpolarization/depolarization peak followed by a prolonged hyperpolarization/depolarization) probably reflect merged action and variation potentials. A few minutes after passage of the first EPW peak, sieve tubes gradually became occluded by callose, with maximum synthesis occurring approximately 10 min after burning. Early stop of mass flow, well before completion of callose deposition, pointed to an occlusion mechanism preceding callose deposition. This obstruction of mass flow was inferred from the halt of carboxyfluorescein movement in sieve tubes and intensified secretion of aqueous saliva by feeding aphids. The early occlusion is probably due to proteins, as indicated by a dramatic drop in soluble sieve element proteins and a simultaneous coagulation of sieve element proteins shortly after the burning stimulus. Mass flow resumed 30-40 min after burning, as demonstrated by carboxyfluorescein movement and aphid activities. Stop of mass flow by Ca(2+)-dependent occlusion mechanisms is attributed to Ca(2+) influx during EPW passage; the reversibility of the occlusion is explained by removal of Ca(2+) ions. PMID:20584788

  11. Remote-controlled stop of phloem mass flow by biphasic occlusion in Cucurbita maxima

    PubMed Central

    Furch, Alexandra C. U.; Zimmermann, Matthias R.; Will, Torsten; Hafke, Jens B.; van Bel, Aart J. E.

    2010-01-01

    The relationships between damage-induced electropotential waves (EPWs), sieve tube occlusion, and stop of mass flow were investigated in intact Cucurbita maxima plants. After burning leaf tips, EPWs propagating along the phloem of the main vein were recorded by extra- and intracellular microelectrodes. The respective EPW profiles (a steep hyperpolarization/depolarization peak followed by a prolonged hyperpolarization/depolarization) probably reflect merged action and variation potentials. A few minutes after passage of the first EPW peak, sieve tubes gradually became occluded by callose, with maximum synthesis occurring ?10?min after burning. Early stop of mass flow, well before completion of callose deposition, pointed to an occlusion mechanism preceding callose deposition. This obstruction of mass flow was inferred from the halt of carboxyfluorescein movement in sieve tubes and intensified secretion of aqueous saliva by feeding aphids. The early occlusion is probably due to proteins, as indicated by a dramatic drop in soluble sieve element proteins and a simultaneous coagulation of sieve element proteins shortly after the burning stimulus. Mass flow resumed 30–40?min after burning, as demonstrated by carboxyfluorescein movement and aphid activities. Stop of mass flow by Ca2+-dependent occlusion mechanisms is attributed to Ca2+ influx during EPW passage; the reversibility of the occlusion is explained by removal of Ca2+ ions. PMID:20584788

  12. Nampt/PBEF/visfatin serum levels: a new biomarker for retinal blood vessel occlusions

    PubMed Central

    Kaja, Simon; Shah, Anna A; Haji, Shamim A; Patel, Krishna B; Naumchuk, Yuliya; Zabaneh, Alexander; Gerdes, Bryan C; Kunjukunju, Nancy; Sabates, Nelson R; Cassell, Michael A; Lord, Ron K; Pikey, Kevin P; Poulose, Abraham; Koulen, Peter

    2015-01-01

    The main objective of the study was to quantify serum levels of nicotinamide phosphoribosyltransferase (Nampt/pre-B-Cell colony-enhancing factor 1/visfatin) in subjects with a history of retinal vascular occlusions (RVOs), disease conditions characterized by pronounced ischemia, and metabolic energy deficits. A case–control study of 18 subjects with a history of RVO as well as six healthy volunteers is presented. Serum Nampt levels were quantified using a commercially available enzyme-linked immunosorbent assay kit. Serum Nampt levels were 79% lower in patients with a history of RVO compared with that in healthy volunteers (P<0.05). There was no statistically significant difference among the types of RVOs, specifically branch retinal vein occlusions (n=7), central retinal vein occlusions (n=5), hemiretinal vein occlusions (n=3), and central retinal artery occlusions (n=3; P=0.69). Further studies are needed to establish the temporal kinetics of Nampt expression and to determine whether Nampt may represent a novel biomarker to identify at-risk populations, or whether it is a druggable target with the potential to ameliorate the long-term complications associated with the condition, ie, macular edema, macular ischemia, neovascularization, and permanent loss of vision.

  13. Incomplete Colonoscopy in Patients with Occlusive Colorectal Cancer: Usefulness of CT Colonography According to Tumor Location

    PubMed Central

    Kim, Won Ho; Kim, Tae Il; Kim, Nam Kyu; Lee, Kang Young; Kim, Myeong-Jin; Kim, Ki Whang

    2007-01-01

    Purpose We sought to evaluate the clinical usefulness of CT colonography (CTC) after incomplete conventional colonoscopy (CC) for occlusive colorectal cancer (CRC) according to the tumor location. Materials and Methods Seventy-five patients with occlusive CRC underwent subsequent CTC immediately after incomplete CC. Fifty-nine patients had distal CRC and 16 had proximal colon cancer. Experienced radiologists prospectively analyzed the location, length, and TNM staging of the main tumor. The colorectal polyps in the remaining colorectum and additional extraluminal findings were also recorded. Sixty-seven patients underwent colorectal resection. We retrospectively analyzed the surgical outcome and correlated CTC and CC findings. Results The overall accuracies of tumor staging were: T staging, 86%; N staging (nodal positivity), 70% (80%); and intra-abdominal M staging, 94%. Additional colonic polyps were found in 23 patients. Six synchronous carcinomas were detected (9%); three in the proximal colon and three in the distal colon of occlusion. Clinically significant localization errors at CC were noted in 8 patients (12%, 5 proximal colon cancers and 3 distal CRCs) and were corrected by CTC. After CTC, the surgeons modified the initial surgical plan in 11 cases (16%). Conclusion In occlusive CRC, CTC is not only useful in the evaluation of the proximal bowel, but can also provide surgeons with accurate information about staging and tumor localization. CTC is recommended when endoscopists encounter occlusive CRC, regardless of tumor location. PMID:18159583

  14. Transcatheter Thrombolysis with High-Dose Bolus Tissue Plasminogen Activator in Iatrogenic Arterial Occlusion after Femoral Arterial Catheterization

    SciTech Connect

    Tsetis, Dimitrios K. [Medical School of Heraklion, Department of Radiology, University Hospital Heraklion, 71500 Heraklion-Stravrakia, Crete (Greece); Kochiadakis, George E. [Medical School of Heraklion, Department ofCardiology, University Hospital of Heraklion, Crete (Greece); Hatzidakis, Adam A. [Medical School of Heraklion, Department of Radiology, University Hospital Heraklion, 71500 Heraklion-Stravrakia, Crete (Greece); Skalidis, Emannuel I. [Medical School of Heraklion, Department of Cardiology, University Hospital of Heraklion, Crete (Greece); Chryssou, Evangelia G.; Tritou, Ioanna N. [Medical School of Heraklion, Department of Radiology, University Hospital Heraklion, 71500 Heraklion-Stravrakia, Crete (Greece); Vardas, Panos E. [Medical School of Heraklion, Department of Cardiology, University Hospital of Heraklion, Crete (Greece); Gourtsoyiannis, Nicholas C. [Medical School of Heraklion, Department ofRadiology, University Hospital Heraklion, 71500 Heraklion-Stravrakia, Crete (Greece)

    2002-01-15

    Purpose: To assess the efficacy of percutaneous local thrombolysis with high-dose bolus recombinant tissue plasminogen activator (rt-PA) in patients with acute limb ischemia due to arterial thrombosis after cardiac catheterization.Methods: We treated eight patients (7 men; mean age 56 years) with thrombotic occlusion of both the common femoral artery (CFA) and external iliac artery (EIA) in six patients and of the CFA only in two patients. Two 5 mg boluses of rt-PA were injected into the proximal clot through a 5 Fr end-hole catheter and subsequently two additional boluses of 5 mg rt-PA were given through a catheter with multiple side-holes. In case of a significant amount of residual thrombus, a continuous infusion of 2.5 mg/hr of rt-PA was started.Results: Successful lysis was achieved in all patients. The mean duration of lysis was 2 hr 41 min. The mean total amount of rt-PA delivered was 23.16 mg. In four patients unmasked flow-limited dissections confined to the CFA were managed by prolonged balloon dilatation, while in the remaining four patients with extension of the dissection to the external iliac artery one or two Easy Wallstents were implanted. There was prompt relief of lower limb ischemic symptoms and signs in all patients. Two groin hematomas were conservatively treated.Clinical and color Doppler flow imaging follow-up with a mean duration of 15 months, showed no reappearance of ischemic symptoms or development of restenosis in any of the patients. One patient died 6 months after thrombolysis.Conclusions: Transcatheter thrombolysis with high-dose bolus rt-PA is a safe and effective treatment inpatients with iatrogenic arterial occlusion after femoral catheterization. Underlying dissections should be treated by prolonged balloon dilatation but stent implantation is often required.

  15. Loss of PDZK1 Causes Coronary Artery Occlusion and Myocardial Infarction in Paigen Diet-Fed Apolipoprotein E Deficient Mice

    PubMed Central

    Yesilaltay, Ayce; Daniels, Kathleen; Pal, Rinku; Krieger, Monty; Kocher, Olivier

    2009-01-01

    Background PDZK1 is a four PDZ-domain containing protein that binds to the carboxy terminus of the HDL receptor, scavenger receptor class B type I (SR-BI), and regulates its expression, localization and function in a tissue-specific manner. PDZK1 knockout (KO) mice are characterized by a marked reduction of SR-BI protein expression (?95%) in the liver (lesser or no reduction in other organs) with a concomitant 1.7 fold increase in plasma cholesterol. PDZK1 has been shown to be atheroprotective using the high fat/high cholesterol (‘Western’) diet-fed murine apolipoprotein E (apoE) KO model of atherosclerosis, presumably because of its role in promoting reverse cholesterol transport via SR-BI. Principal Findings Here, we have examined the effects of PDZK1 deficiency in apoE KO mice fed with the atherogenic ‘Paigen’ diet for three months. Relative to apoE KO, PDZK1/apoE double KO (dKO) mice showed increased plasma lipids (33% increase in total cholesterol; 49 % increase in unesterified cholesterol; and 36% increase in phospholipids) and a 26% increase in aortic root lesions. Compared to apoE KO, dKO mice exhibited substantial occlusive coronary artery disease: 375% increase in severe occlusions. Myocardial infarctions, not observed in apoE KO mice (although occasional minimal fibrosis was noted), were seen in 7 of 8 dKO mice, resulting in 12 times greater area of fibrosis in dKO cardiac muscle. Conclusions These results show that Paigen-diet fed PDZK1/apoE dKO mice represent a new animal model useful for studying coronary heart disease and suggest that PDZK1 may represent a valuable target for therapeutic intervention. PMID:19956623

  16. Clinical study of the use of the laser fluorescence device DIAGNOdent for detection of occlusal caries in children.

    PubMed

    Anttonen, V; Seppä, L; Hausen, H

    2003-01-01

    Diagnosis of non-cavitated occlusal caries is generally considered problematic. The aim of this study was to evaluate the utility of the laser fluorescence device DIAGNOdent as part of routine dental check-ups in children. A total of 613 occlusal surfaces on permanent molars and 436 surfaces on primary molars in children aged 7-8 (n = 55) and 13-14 years (n = 54) were examined visually, using DIAGNOdent and for most 13- to 14-year-olds also using radiographs. The teeth were not cleaned professionally before examination. To provide a gold standard for carious teeth, the depth of the caries lesion was determined in those lesions that were judged visually to need opening by drilling (51 teeth). The higher the visual score, the higher were the mean DIAGNOdent values, but in each visual category the variation among values was large. The presence of a clear sealant did not affect DIAGNOdent measurements. The values for permanent and primary molars differed slightly. For permanent teeth, Youden's index value was highest (60%) at a cut-off value of 30, which indicates that the overall performance for DIAGNOdent in detecting dentinal caries was best at this point. Using this cut-off, sensitivity was 92% and specificity 69% with visual examination for validation, while sensitivity was 92% and specificity 82% with validation by fissure opening. Of the three methods, radiographic examination was the least accurate. In routine dental check-ups of children, DIAGNOdent appears to be useful as an adjunct to visual examination. PMID:12566634

  17. Parent artery occlusion for unruptured cerebral aneurysms: the Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2.

    PubMed

    Ishii, Akira; Miyamoto, Susumu; Ito, Yasushi; Fujinaka, Toshiyuki; Sakai, Chiaki; Sakai, Nobuyuki

    2014-01-01

    Parent artery occlusion (PAO) is an alternative to surgical clipping or endovascular endosaccular coil embolization for the management of cerebral aneurysms. Most giant and fusiform aneurysms are not amenable to endosaccular coil embolization due to anatomical considerations, such as a broad-neck. However, majority of reports regarding the safety of PAO are based on case series involving a relatively small number of patients. In the present study, a total of 381 consecutive patients with unruptured cerebral aneurysms who were treated with PAO were extracted from the Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and JR-NET2 database, which are nationwide surveys conducted by the Japanese Society of Neuroendovascular Therapy. The mean age of the 381 patients was 58.1 years, and 59.3% were female. The aneurysmal location included the vertebral artery (42%) and the cavernous portion of internal carotid artery (32%). The aneurysm size and shape consisted of fusiform (45%), giant (25%), and large (22%). Symptomatic lesions were present in 59.8% of the population. Technical success was achieved in 98.4%. The 30-day morbidity and mortality rates were 3.1% and 1.0%, respectively. The most frequent procedure-related complication was ischemic stroke, which occurred in 12.9% (distal embolism, 6.0%; branch occlusion, 3.9%). The 30-day morbidity and mortality rates related to ischemic strokes were 2.1% and 0.3%, respectively. PAO for unruptured aneurysms is feasible with a high technical success rate. Peri-procedural management of ischemic stroke is the key to enhance the safety of this treatment option. PMID:24305030

  18. Chronic pelvic pain syndrome\\/chronic prostatitis affect the acrosome reaction in human spermatozoa

    Microsoft Academic Search

    Ralf Henkel; Martin Ludwig; Hans-Christian Schuppe; Thorsten Diemer; Wolf-Bernhard Schill; Wolfgang Weidner

    2006-01-01

    Male genital tract inflammations constitute an important factor of male subfertility in which different mediators are discussed\\u000a damaging sperm membranes. As acrosome reaction (AR) is ultimately a membrane function, this study aimed at investigating the\\u000a effects of the chronic pelvic pain syndrome on AR. In a total of 56 patients with chronic pelvic pain syndrome NIH IIIA and\\u000a NIH IIIB,

  19. Laser angioplasty of totally occluded arteries of the limb

    NASA Astrophysics Data System (ADS)

    Szopinski, Piotr; Hara, Marek; Noszczyk, Wojciech

    1996-03-01

    The authors summarize their experience in the use of Nd-YAG laser in chronic occlusion of lower limb arteries. Percutaneous transluminal laser angioplasty (PTLA) with laser-heated metal and sapphire tips were used as an adjuvant to conventional balloon angioplasty. In cases of reocclusions, endovascular stents were implanted. Laser recanalization was performed in 46 arteries (iliac, superficial femoral, and popliteal). Indications for the procedure were: limb salvage, claudication below 100 m, and temporal or rest pain. Initial clinical and hemodynamic improvement was observed in 37 (80%) patients. Four perforations occurred without clinical sequel. The one-year cumulative clinical patency was 27 (58%) of the 46 lesions. PTLA may be appropriate for high-risk patients, who are unsuitable for surgical reconstruction because of the concomitant diseases. The combination of laser recanalization and implantation of vascular stents may be a promising method in the management of limb ischemia.

  20. Chronic glomerulonephritis with massive IgA deposits

    Microsoft Academic Search

    A. Steciwko; Z. Szewczyk; W. Letachowicz; M. Steciwko

    1985-01-01

    A total of 234 patients with chronic glomerulonephritis, detected on the basis of clinical, immunological and pathomorphological criteria, have been examined. A group of 23 chronic glomerulonephritis patients with massive deposits of immunoglobulin A found by immunofluorescent examination, has been separated on the basis of immunohistochemical studies. In this group, occurrence of different morphological forms of glomerulonephritis has been observed: