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Sample records for dissection case noticed

  1. Aortic dissection after superior mesenteric artery percutaneous stenting. Case report.

    PubMed

    Socrate, A M; Locati, P; Marchetti, G

    2000-03-01

    We report an unusual case of aortic dissection after superior mesenteric artery percutaneous stenting. A 44-year-old patient, who suffered from back pain and fever, was diagnosed as having an aortic dissection. Aortic dissection, extending from the aortic arch (just after left subclavian artery origin) to the aortic carrefour, was successfully diagnosed by means of Duplex scan and CT scan examination. Two pathogenetic hypotheses, malformative and iatrogenic, were discussed. PMID:10838838

  2. Coronary artery dissection following blunt chest trauma: a case report

    PubMed Central

    Swinkels, B.M.; Hoedemaker, G.; Peters, R.H.J.

    2005-01-01

    Coronary artery dissection following blunt chest trauma is rare. We report the case of a 43-year-old woman who was admitted with a subacute inferior myocardial infarction due to dissection of the right coronary artery. Ten days earlier, she had sustained a minimal chest trauma. The literature is reviewed and management is discussed. ImagesFigure 1Figure 2 PMID:25696487

  3. Blindness after bilateral neck dissection: case report and review.

    PubMed

    Pazos, G A; Leonard, D W; Blice, J; Thompson, D H

    1999-01-01

    The primary objective of this review of the literature is to identify the probable causes of blindness after bilateral radical neck dissections. This case report and literature review also discusses possible preventive measures that may avert this catastrophic outcome. Cases of blindness after bilateral radical neck dissection were identified by an electronic literature search, as well as cross-checking all references of the above-identified papers. Eleven previous cases of blindness after bilateral neck dissection were identified. The most common cause was posterior ischemic optic neuropathy (PION), which was permanent. We present the only case in the literature in which blindness occurred after radical neck dissections separated by a span of 9 years. The cause of blindness in our patient was posterior ischemic optic neuropathy. Contributing factors included anemia, hypotension, and disruption of collateral venous return from the neck. PMID:10512147

  4. A case of carotid artery dissection after surgical repair of aortic dissection successfully treated with endovascular therapy using intravascular ultrasound.

    PubMed

    Katoh, Hiromasa; Nozue, Tsuyoshi; Nagamine, Hiroshi; Kawase, Yushi; Michishita, Ichiro

    2014-07-01

    A 71-year-old woman developed the dissection from right brachiocephalic trunk (BCT) to internal carotid artery 6 days after the operation of ascending aortic dissection. Since no improvement of symptoms was observed despite conservative therapy, we performed endovascular therapy (EVT). Although a balloon-expandable stent was implanted in the BCT to seal the entry point of the dissection, the true lumen of the carotid artery was still compressed. Thus, we covered the dissected lesion completely with multiple stents, and her neurological findings improved. This case demonstrates that EVT using multiple stents is an effective strategy to manage dissection of supra-aortic branches. PMID:24142487

  5. Spontaneous Coronary Artery Dissection: A Case Report

    PubMed Central

    Mokhberi, Vahid; Bagheri, Babak; Navidi, Seyfollah; Amini, Seyed Mohammad

    2015-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare and important cause of acute coronary syndrome and sudden cardiac death. Various etiologies are thought to be responsible for this condition, among which underlying atherosclerosis seems to be the most common. SCAD is predominant in women and is usually diagnosed via coronary artery angiography. Therapeutic interventions include medical therapy, percutaneous coronary artery intervention, and surgery based on lesion characteristics. We describe a 36-year-old woman with SCAD presenting with acute chest pain to Fatemeh-Zahra Hospital, Sari, Iran. The patient had no current atherosclerosis risk factors and had given birth 6 months previously. Coronary angiography was performed due to the persistence of the chest pain after initial management, and a spontaneous dissection of the left anterior descending artery was observed. She underwent coronary artery bypass graft and was discharged in good condition. PMID:26697091

  6. Case Misclassification in Studies of Spinal Manipulation and Arterial Dissection

    PubMed Central

    Cai, Xuemei; Razmara, Ali; Paulus, Jessica K; Switkowski, Karen; Fariborz, Pari J; Goryachev, Sergey D; D’Avolio, Leonard; Feldmann, Edward; Thaler, David E

    2014-01-01

    Goals Spinal manipulation has been associated with cervical arterial dissection and stroke but a causal relationship has been questioned by population-based studies. Earlier studies identified cases using International Classification of Diseases-9 codes specific to anatomical stroke location rather than stroke etiology. We hypothesize that case misclassification occurred in these previous studies and an underestimation of the strength of the association. We also predicted that case misclassification would differ by patient age. Materials and methods We identified cases in the Veterans Health Administration database using the same strategy as the prior studies. The electronic medical record was then screened for the word “dissection.” The presence of atraumatic dissection was determined by medical record review by a neurologist. Findings Of 3690 patients found by International Classification of Diseases-9 codes over a 30-month period, 414 (11.2%) had confirmed cervical artery dissection with a positive predictive value of 10.5% (95% CI 9.6–11.5%). The positive predictive value was higher in patients <45 versus ?45 years (41% vs. 9%, p<0.001). We reanalyzed a previous study which reported no association between spinal manipulation and cervical artery dissection (OR=1.12, 95% CI 0.77–1.63), and re-calculated an odds ratio of 2.15 (95% CI 0.98–4.69). For patients under age 45, the OR was 6.91 (95% CI 2.59–13.74). Conclusions Prior studies grossly misclassified cases of cervical dissection and mistakenly dismissed a causal association with manipulation. Our study indicates that the odds ratio for spinal manipulation exposure in cervical artery dissection is higher than previously reported. PMID:25085345

  7. Three cases of cervicocephalic artery dissection in an amusement park.

    PubMed

    Kurita, Naohide; Ueno, Yuji; Watanabe, Masao; Miyamoto, Nobukazu; Shimura, Hideki; Nonaka, Senshu; Tsutsumi, Satoshi; Yasumoto, Yukimasa; Hattori, Nobutaka; Urabe, Takao

    2014-01-01

    About 20 cases of cerebrovascular accidents in amusement parks have been documented. However, only a few cases of amusement park stroke (APS) after roller coaster rides have been reported. Here, we present triggers of stroke, clinical characteristics, and the angiographic appearance of 3 consecutive patients of APS. Their clinical characteristics included young age, absence of atherosclerotic risk factors, and severe injuries. Serial changes in angiographic appearance led to the diagnosis of cervicocephalic artery dissection (CAD). Patients A and B were diagnosed with isolated middle cerebral artery (MCA) dissection, and patient C was diagnosed with internal carotid artery dissection involving MCA dissection. Running excitedly toward an attraction in patient A, a go-kart ride in patient B, and riding in an enhanced motion vehicle in patient C were considered as the likely triggers for APS. We had specific cases with APS associated with CAD, which can occur under diverse contexts other than roller coaster rides at amusement parks. Our findings suggest that the variable directions of the high gravitational forces induced by vehicle riding or running excitedly might injure the MCA or internal carotid artery, and thereby cause CAD in the amusement park. PMID:25263648

  8. Spontaneous Isolated Celiac Artery and Superior Mesenteric Artery Dissections: A Rare Case

    PubMed Central

    Aydin, Sonay; Ergun, Elif; Fatihoglu, Erdem; Durhan, Gamze; Kosar, Pinar Nercis

    2015-01-01

    Summary Background Arterial dissection is defined as the cleavage of the arterial wall by an intramural hematoma. Reports of dissection of the celiac and/or superior mesenteric artery are rare; as far as we know, only 24 cases of spontaneous isolated celiac trunk dissection, and 71 cases of spontaneous isolated superior mesenteric artery dissection have been reported. Case Report The case presents a 48-year-old male with a sudden-onset epigastric pain. A Computed Tomography Angiography of the thoracoabdominal aorta was applied and dissections of both the celiac artery and SMA were determined. A conservative therapeutic approach was preferred and the patient was discharged with anticoagulant and antihypertensive therapy. Conclusions Although rare, spontaneous isolated celiac artery and superior mesenteric artery dissections must be kept in mind in the differential diagnosis of the epigastric pain in the emergency room. Contrast-enhanced Computed Tomography Angiography examination is the method of choice in the diagnosis. PMID:26543511

  9. Stent implantation for treatment of symptomatic spontaneous cervical internal carotid artery dissecting aneurysm. A case report.

    PubMed

    Briganti, F; Tortora, F; Volpe, A; Elefante, A; De Notaris, M; Panagiotopoulos, K

    2005-10-01

    Cervical internal carotid dissections are rare. Approximately one third of the cases are associated with pseudoaneurysm. The first-choice management of cervical carotid dissecting aneurysms consists in anticoagulation or antiplatelet therapy. Surgery is typically indicated in cases of failure of conservative therapy with recurrent cerebral ischemic attacks. In recent years, stent implantation has been also employed for the management of patients with carotid dissecting aneurysms whose neurological conditions were refractory to medical treatment. In the present case we describe the treatment of a patient with a carotid dissecting aneurysm, by means of endovascular stent application and provide angiographic control 24 months after the intervention. PMID:16320195

  10. Spontaneous coronary artery dissection: a case series and literature review

    PubMed Central

    Garcia, Nelson A. Telles; Khan, Abul N.; Boppana, Ratna C.; Smith, Hayden L.

    2014-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare and often lethal cause of acute coronary syndrome, which typically affects young women and otherwise healthy individuals. SCAD can be diagnosed in patients undergoing coronary angiography and can be underestimated. Special techniques such as optical coherence tomography (OCT) and intravascular ultrasound should be used when there is suspicion of the condition. In the majority of cases, the left anterior descending (LAD) artery is involved; however, a few cases of the right coronary artery (RCA) involvement have been reported. This article describes three cases of SCAD in women of different ages, all presenting with chest pain. Coronary angiography in conjunction with OCT was used for diagnosis in two of the cases. One of the patients had involvement of the proximal RCA and underwent percutaneous coronary intervention, whereas the other two patients had mid-LAD disease and were treated conservatively with medical therapy. Presently, there are no specific guidelines for the treatment of SCAD, and therapy is individualized according to extent and severity of the condition. PMID:25317273

  11. Dissection of the aorta in Turner syndrome: two cases and review of 85 cases in the literature

    PubMed Central

    Carlson, M; Silberbach, M

    2007-01-01

    Girls and women with Turner syndrome are at risk for catastrophic aortic dissection and rupture, but the clinical profile for those at risk is not well described. In addition to reporting two new cases, we performed an electronic search to identify all reported cases of aortic dissection associated with Turner syndrome. Particular attention was paid to the reporting of systemic hypertension (HTN) and congenital heart disease (CHD) which are known risk factors for aortic disease in the general population. In total, 85 cases of aortic dissection in TS were reported between 1961 and 2006. Dissection occurred at a young age, 30.7 (range 4–64)?years, which is significantly earlier than its occurrence in the general female population (68?years). Of the cases for which HTN and CHD were explicitly assessed, 15% had HTN alone, 30% had CHD alone and 34% had both. Importantly, in 11% of the cases, neither HTN nor CHD were identified, suggesting that TS alone is an independent risk factor for aortic dissection; however, the cases where no risk factors were identified were very poorly documented. Dissection in women with TS undergoing assisted reproductive techniques (ART) frequently resulted in death. The literature on aortic dissection in TS is sparse and most cases are poorly documented, making it difficult to establish firm guidelines regarding monitoring and treatment. A TS aortic dissection registry has been established to better determine the natural history and risk factors (http://www.tssus.org/readweb.asp?wid?=?3092). PMID:17873120

  12. [Traumatic dissection of the carotid artery: challenges for diagnostics and therapy illustrated by a case example].

    PubMed

    Jansen, G; Popp, J; Dietrich, U; Mertzlufft, F; Bach, F

    2013-10-01

    Traumatic dissection of the carotid artery is an easily overlooked consequence of trauma with notable morbidity and mortality which can be observed in up to 4% of cases involving multiple trauma. Certain mechanisms and patterns of injury as well as specific symptoms should serve as indicators of a dissection and should therefore result in further diagnostic measures. An early diagnosis is of major relevance. This report describes the case of a 45-year-old victim of a traffic accident who showed symptoms of a dissection which had initially not been diagnosed. PMID:24057761

  13. Spontaneous isolated dissection at renal upper abdominal aortic: a rare case report

    PubMed Central

    Liu, Jian-Ping; Liu, Feng-En; Duan, Qing; Ye, Rong; Xiao, Jun-Qi

    2015-01-01

    Arterial dissection is defined as a cleavage of the arterial wall caused by intramural hematoma. Isolated extra-aortic arterial dissection has been reported in renal and carotid arteries in few literatures but suprarenal aorta dissection associated with retrograde formation of a giant descending thoracic aneurysm is considered very rare. We present a quite unusual case of suprarenal aorta dissection associated with retrograde formation of a giant descending thoracic aneurysm sparing both renal and mesenteric vessels, without any branch vessel involvement or visceral damage. Because of the patient’s persistent epigastric pain, endovascular celiac artery stent implantation was performed with 3 multiple overlapping uncovered stents. Twelve months after the procedure, computed tomographic angiography (CTA) of the abdomen showed patency of both celiac stents with thrombus formation in the retrograde dissection sac, and the patient remained asymptomatic. This case and others in the medical literature suggest that endovascular treatment can be feasible in symptomatic patients with spontaneous isolated dissection at renal upper abdominal aortic. PMID:26221391

  14. A rare case of aortic dissection presenting as pure transient global amnesia.

    PubMed

    Kaveeshvar, H; Kashouty, R; Loomba, V; Yono, N

    2015-01-01

    Transient global amnesia (TGA) is a well-described neurological phenomenon. Clinically, it manifests with the sudden onset of a paroxysmal, transient loss of anterograde memory and disorientation but with intact consciousness. Typically, symptoms last for only a few hours. We present an unusual case of aortic dissection presenting with pure TGA in a patient, who had a positive outcome. This is the second case report of a patient with aortic dissection presenting with pure TGA syndrome, but it is the first case in which the patient survived. PMID:26659651

  15. Aortic dissection with a fistulous communication into the right atrium: a case report.

    PubMed

    Vaidiyanathan, D; Meenakshi, K; Elangovan, S; Jayachandran, J; Chokalingam, V; Hussain, A T; Alagesan, R

    1990-12-01

    A case of aortic dissection (type 1, De Bakey) with a rent into the right atrium (RA), diagnosed by echocardiography (echo) and confirmed by aortography, is reported. The patient presented with cardiac failure and a continuous murmur in the right second and third intercostal spaces. The patient has survived for two years with medial treatment. PMID:2278406

  16. Spontaneous internal carotid dissection in a 38-year-old woman: a case report

    PubMed Central

    Abed, Kareem; Misra, Amit; Vankawala, Viren

    2015-01-01

    This case report describes a patient found to have amaurosis fugax as a result of non-traumatic internal carotid dissection. Monocular blindness can be due to multiple causes including keratitis, acute glaucoma, vitreous hemorrhage, uveitis, retinal vascular occlusion, retinal detachment, optic neuropathy, trauma, or vascular malformations. In the setting of headache, neck pain, and an otherwise normal ophthalmic examination, this case report highlights the importance of recognizing transient ischemic attack and carotid artery dissection in the differential diagnosis. To further clarify the diagnosis, carotid ultrasound may aid diagnosis as was seen in this case, where decreased internal carotid artery velocities were found and subsequent CT angiography of the neck confirmed a diagnosis of carotid dissection. If a dissection is present, progression of symptoms may indicate impending cerebral infarction and warrant immediate attention. Antiplatelet therapy is the first-line treatment with anticoagulation, thrombolysis, and surgery reserved for cases of recurrent, progressive symptomatic episodes. Surgical options include endovascular repair such as angioplasty, stent placement, embolization, surgical revascularization, and bypass. PMID:26486115

  17. Aortic Dissection as a Cause of Pulsus Bisferiens: A Case Report and Review.

    PubMed

    Riojas, Christina M; Dodge, Angela; Gallo, Dominic R; White, Paul W

    2016-01-01

    We present a case of a 62-year-old woman who developed an aortic dissection after aortic valve replacement for aortic stenosis and supracoronary replacement of the ascending aorta for aneurysmal dilation. Dynamic compression of the distal aorta by the dissection flap was identified with the detection of abnormal continuous wave Doppler signals heard while performing ankle-brachial indices. Duplex ultrasound (US) and Doppler spectral waveforms confirmed dynamic compression of the distal aorta with each cardiac cycle. We review some of the characteristics of continuous wave Doppler signals, specifically discussing the distinguishing characteristics of pulsus bisferiens, and the use of duplex US in imaging the distal aorta. PMID:26520426

  18. Dissecting aneurysms of the vertebral arteries following cervical manipulation: a case report.

    PubMed Central

    Dunne, J W; Conacher, G N; Khangure, M; Harper, C G

    1987-01-01

    Neck manipulation may uncommonly be associated with serious and even fatal vascular complications. Although well recognised, the nature of the vascular injury has only rarely been directly established by pathological examination. The case is reported of a 43-year-old man who died following neck manipulation, and in whom multiple dissecting aneurysms within both vertebral arteries were demonstrated radiologically and found at necropsy. Bilateral dissecting aneurysms were found both at the level of atlanto-axial articulation and close to the origins of the vertebral arteries. No predisposition was found, other than early atheroma consistent with the patient's age. Images PMID:3559616

  19. Internal carotid artery dissection in stroke from SCUBA diving: a case report.

    PubMed

    Gibbs, J W; Piantadosi, C A; Massey, E W

    2002-01-01

    Although diving with compressed air is generally safe, neurological problems resulting from infarction in SCUBA diving are well known, including arterial gas embolism and decompression sickness (caisson's disease, bends) involving the brain and spinal cord. While air gas embolism forms the overwhelming majority of causes for stroke in divers, internal carotid artery (ICA) dissection is another potential mechanism for central nervous system infarction in the setting of SCUBA diving. A 38 year-old female, who presented with complaints of headache, nausea, vomiting, and left sided hemiparesis after rapid ascent to the surface from a depth of 120 feet of seawater was initially treated for decompression illness in a hyperbaric chamber. Further neurological workup revealed a right ICA dissection. This case demonstrates the dangers of ICA dissection following rapid ascent to the surface from underwater and emphasizes an interesting presentation of stroke associated with SCUBA diving. PMID:12670119

  20. Aortic dissection presenting as acute subtotal left main coronary artery occlusion: a case approach and review of the literature.

    PubMed

    Ruisi, Michael; Fallahi, Arzhang; Lala, Moinakhtar; Kanei, Yumiko

    2015-05-01

    Aortic dissection is the most common fatal condition of the aorta, yet it is often missed on initial clinical presentation. Aortic dissection associated with acute coronary syndrome (ACS) is relatively rare, but if it occurs, it can be diagnostically challenging, and the condition can be fatal. Here we describe a case of aortic dissection presenting as ST-segment elevation myocardial infarction (STEMI) managed via the transradial approach. We describe the current literature on the subject. PMID:25780485

  1. Aortic Dissection Presenting as Acute Subtotal Left Main Coronary Artery Occlusion: A Case Approach and Review of the Literature

    PubMed Central

    Ruisi, Michael; Fallahi, Arzhang; Lala, Moinakhtar; Kanei, Yumiko

    2015-01-01

    Aortic dissection is the most common fatal condition of the aorta, yet it is often missed on initial clinical presentation. Aortic dissection associated with acute coronary syndrome (ACS) is relatively rare, but if it occurs, it can be diagnostically challenging, and the condition can be fatal. Here we describe a case of aortic dissection presenting as ST-segment elevation myocardial infarction (STEMI) managed via the transradial approach. We describe the current literature on the subject. PMID:25780485

  2. Ascending aortic dissection diagnosed with the use of point-of-care sonography. Case report

    PubMed Central

    Nowakowski, Piotr; Drobi?ski, Dominik

    2014-01-01

    The presented case of a patient in cardiogenic shock in the course of aortic dissection with concomitant cerebral circulation illustrates the effectiveness of sonography in the intensive care unit as a tool that aids the diagnostic process. Point-of-care sonography involves ultrasound assessment performed by the attending physician, being an integral part of a physical examination. A 67-year-old female was brought to the emergency department with a suspicion of stroke, comatose, with focal neurological deficits and was admitted to the intensive care unit due to circulatory and respiratory failure. Based on the findings from a bedside ultrasound examination, the diagnostic process was extended, and the patient was rapidly transferred to the department of cardiac surgery with diagnosed ascending aortic dissection. The case presented demonstrates how point-of-care sonography facilitates and accerelates the diagnostic process and speeds up the implementation of de finitive treatment thus affecting the patient's outcome.

  3. A major pain in the … Back and epigastrium: an unusual case of spontaneous celiac artery dissection

    PubMed Central

    Patel, Kumkum Sarkar; Benshar, Orel; Vrabie, Raluca; Patel, Anik; Adler, Marc; Hines, George

    2014-01-01

    A 60-year-old woman with mitral valve prolapse, chronic low back pain, and a 30-pack year smoking history presented for a second admission of poorly controlled mid-back pain 10 days after her first admission. She had concomitant epigastric pain, sharp/burning in quality, radiating to the right side and to the mid-back, not associated with food nor improving with pain medications. She denied nausea, vomiting, diarrhea, constipation, dark stools, or blood per rectum. Our purpose was to determine the cause of the patient's epigastric pain. Physical examination revealed epigastric and mid-back tenderness on palpation. Labs were normal except for a hemoglobin drop from 14 to 12.1 g/dL over 2 days. Abdominal ultrasound and subsequent esophagogastroduodenoscopy were normal. Contrast-enhanced abdominal computed tomographic (CT) scan revealed the development of a spontaneous celiac artery dissection as the cause of the epigastric pain. The patient was observed without stenting and subsequent CT angiography 4 days later did not reveal worsening of the dissection. She was discharged on aspirin and clopidogrel with outpatient follow-up. Thus far, less than 100 cases of isolated spontaneous celiac artery dissections have been reported. The advent of CT scans and magnetic resonance imaging has increasingly enabled its detection. Risk factors may include hypertension, arteriosclerosis, smoking, and cystic medial necrosis. There is a 5:1 male to female ratio with an average presenting age of 55. Management of dissections may include surgical repair, endovascular stenting, and selective embolization. Limited dissections can be managed conservatively with anti-platelet and/or anticoagulation agents and strict blood pressure control, as done in our patient. PMID:25432642

  4. Bilateral dissecting aneurysms of the internal carotid arteries misdiagnosed as skull base tumors: A case report

    PubMed Central

    QI, BIN; LU, ZHI-CHENG; WU, WEI; LI, YI-PING

    2015-01-01

    A 45-year-old female presented with a five-year history of intermittent headaches and a two-month history of left hypoglossal nerve palsy. Computed tomography and magnetic resonance imaging of the head revealed space-occupying lesions in the base of the skull with accompanying bone erosion, which were suggestive of skull base chordomas. However, an endoscopic endonasal transsphenoidal biopsy was also performed and pathological analysis of the lesion suggested a thrombosis. Cranial magnetic resonance angiography revealed old dissecting aneurysms of the bilateral internal carotid arteries (ICAs), which led to a definitive diagnosis. The patient was successfully treated with anticoagulants and antiplatelet agents. The present case study suggests that, for patients with space-occupying lesions of the skull base and symptoms of cranial nerve palsy, the possibility of an ICA dissection should be prioritized during the differential diagnosis. PMID:26622598

  5. Congenital contractural arachnodactyly complicated with aortic dilatation and dissection: Case report and review of literature.

    PubMed

    Takeda, Norifumi; Morita, Hiroyuki; Fujita, Daishi; Inuzuka, Ryo; Taniguchi, Yuki; Imai, Yasushi; Hirata, Yasunobu; Komuro, Issei

    2015-10-01

    Congenital contractural arachnodactyly (CCA) is a connective tissue disease caused by mutations of the FBN2, which encodes fibrillin-2. CCA patients have a marfanoid habitus; however, aortic dilatation and/or dissection as observed in Marfan syndrome have been rarely documented. Here, we report on a Japanese familial case of CCA resulting from a FBN2 splicing mutation (IVS32+5g?a), which leads to exon 32 being skipped, and the patients developed aortic dilatation and type A dissection. Although CCA patients have been believed to have favorable prognoses, repetitive aortic imaging studies must be performed in some patients to detect possible aortic disease early, and genetic testing of FBN2 might be useful to identify such high-risk patients. PMID:25975422

  6. A case of an occlusive right coronary artery dissection after stent implantation: dilemmas and challenges.

    PubMed

    Panoulas, Vasileios F; Figini, Filippo; Giustino, Gennaro; Carlino, Mauro; Chieffo, Alaide; Latib, Azeem; Colombo, Antonio

    2015-01-01

    A 53-year-old man with stable angina had a staged percutaneous coronary intervention to a critical focal stenosis of the mid-segment of the right coronary artery (RCA). Two hours after successful RCA stent implantation, the patient re-presented with inferior ST elevation secondary to acute dissection originating at the distal edge of the stent, causing subtotal occlusion of the distal RCA. The patient had TIMI-2 flow in the posterolateral branch and occlusion of the posterior descending artery. This case describes the procedural challenges the operators were faced with and successful use of the "rescue STAR" technique as a last resort. PMID:25589705

  7. Endoscopic Submucosal Dissection for Recurrent or Residual Superficial Esophageal Cancer after Chemoradiotherapy: Two Cases

    PubMed Central

    Hwang, Changhyeok; Youn, Young Hoon; Choi, Sung-eun; Jung, Young Hak; Park, Hae Yeul; Park, Jae Jun; Kim, Jie Hyun; Park, Hyojin

    2015-01-01

    We report two cases of endoscopic submucosal dissection (ESD) for recurrent or residual esophageal squamous cell carcinoma (ESCC) lesions after chemoradiotherapy for advanced esophageal cancer. Case 1 involved a 64-year-old man who had previously undergone chemoradiotherapy for advanced ESCC and achieved a complete response (CR) for 22 months, until metachronous recurrent superficial ESCC was detected on follow-up esophagogastroduodenoscopy (EGD). We performed ESD and found no evidence of recurrence for 24 months. Case 2 involved a 59-year-old man who had previously undergone chemoradiotherapy for advanced ESCC. He responded favorably to treatment, and most of the tumor had disappeared on follow-up EGD 4 months later. However, there were two residual superficial esophageal lugol-voiding lesions. We performed ESD, and he had a CR for 32 months thereafter. ESD can be considered a viable treatment option for recurrent or residual superficial ESCC after chemoradiotherapy for advanced esophageal cancer. PMID:26668804

  8. Consideration of Two Cases of Ascending Aortic Dissection That Began with Stroke-Like Symptoms

    PubMed Central

    Takahashi, Chiaki; Sasaki, Takashi

    2015-01-01

    We recently experienced two patients with stroke-like symptoms and ascending aortic dissection (AAD) in our outpatient department. Both patients were transferred to our hospital presenting with neurological deficit such as hemiparesis and conjugate deviation. They did not complain from any chest or abdominal pain. Their MRI did not show fresh infarction or main branch occlusion. A chest CT image showed AAD. The former patient was immediately transferred to a tertiary hospital and the latter received conservative management in the cardiovascular department. Discussion. As neither patient was experiencing any pain, we initially diagnosed them with ischemic stroke and began treatment. Fortunately, bleeding complications did not occur. In such cases, problems are caused when intravenous tissue plasminogen activator (t-PA) injection is administered with the aim of reopening the occluded intracranial arteries. In fact, patients with AAD undergoing t-PA injection have been reported to die from bleeding complications without any recognition of the dissection. These findings suggest that confirmation using carotid ultrasound, carotid MR angiography, and a D-dimer test is crucial and should be adopted in emergency departments. PMID:25664193

  9. Ultrasonic dissection system technology in breast cancer: a case-control study in a large cohort of patients requiring axillary dissection.

    PubMed

    Lumachi, F; Basso, S M M; Santeufemia, D A; Bonamini, M; Chiara, G B

    2013-11-01

    In the sentinel node era, axillary dissection (ALND) for breast cancer (BC) is required much less frequently than in the past. However, complications, such as prolonged drainage output and seroma formation, are still observed. Harmonic dissection devices (HDDs) are widely used in laparoscopic and minimally invasive surgery to reduce collateral damage during tissue dissection, but its usefulness in breast surgery is unclear. The aim of this study was to evaluate the efficacy of HDDs compared to that of conventional dissection in performing ALND. One hundred thirty-nine women (median age 61 years, range 34-71 years) with confirmed pT1-2 primary infiltrating ductal BC undergoing curative surgery were enrolled in the study. The population was prospectively randomized between two age- and stage-matched arms: group A (cases)-68 (48.9 %) patients (HDD technique), versus group B (controls)-71 (51.1 %) patients (conventional technique). In group B, skin flaps were obtained using a scalpel, scissors, and electrocautery which was never used for ALND. In group A, for each operation time, the HDDs were used exclusively. The mean operative time, intraoperative blood loss, and drainage output were (A vs. B) 95 ± 22 versus 109 ± 25 min, 56 ± 12 versus 86 ± 15 mL, and 412 ± 83 versus 456 ± 69 mL, respectively (p < 0.01). Twenty-nine (20.9 %) patients developed an axillary seroma: 9 (13.2 %) and 20 (28.2 %) for groups A and B, respectively (p = 0.030). Our study confirms that in patients with BC requiring ALND the use of HDDs is more time efficient than conventional surgery, and reduces intraoperative bleeding, the amount of drainage, and the risk of seroma formation. These results may lead to several short- and long-term advantages. Thus, a careful evaluation of the cost-benefits of nontraditional tools, such as HDDs, should be performed in all patients undergoing modified radical or partial mastectomy and ALND for BC. PMID:24186056

  10. Pulmonary arterial dissection in a post-partum patient with patent ductus arteriosus: Case report and review of the literature

    PubMed Central

    Yaman, Mehmet; Arslan, U?ur; Ate?, Ahmet Hakan; Aksakal, Aytekin

    2015-01-01

    Pulmonary arterial dissection is an uncommon but usually a deadly complication of chronic pulmonary hypertension. A 26-year-old female patient was admitted to our clinics with sudden dyspnea and chest discomfort one hour after giving birth to twins by vaginal delivery. An echocardiography was performed with a pre-diagnosis of pulmonary embolism. However, echocardiographic examination revealed a dilated main pulmonary artery and a dissection flap extending from main pulmonary artery to left pulmonary artery. In summary, in this report, we described a very rare case of pulmonary artery dissection in a pregnant patient with a previously un-diagnosed patent ductus arteriosus without an obvious rise in pulmonary artery pressure and reviewed the relevant literature. PMID:25717357

  11. [Patch plasty of intraoperative acute aortic dissection in a patient with severe aortic valve stenosis;report of a case].

    PubMed

    Motoki, Tatsuo; Nakayama, Taisuke; Shirasaka, Tomonori; Kurushima, Atsushi; Ohtani, Takashi; Fukumura, Yoshiaki

    2015-05-01

    Intraoperative aortic dissection is a rare complication, but is associated with a high mortality. We report a case of 79-year-old woman with severe aortic valve stenosis who underwent aortic valve replacement(AVR). After cardiopulmonary bypass(CPB) was established, aortic dissection started at the inflow cannulation site. Because hemodynamics were stable, we performed AVR as scheduled. After declamping, excessive bleeding from the arterial cannulation site continued. CPB was reestablished by placing the arterial cannula in the left femoral artery. The ascending aorta was opened at the site of cannulation under deep hypothermic circulatory arrest. The entry tear was successfully repaired by entry resection and Hemashield patch plasty. The postoperative course was uneventful, and the patient was discharged on the 22nd postoperative day. Patch plasty may be useful for the management of intraoperative aortic dissection. PMID:25963785

  12. Spontaneous Coronary Artery Dissection: Report of 3 Cases and Literature Review Hormonal, Autoimmune, Morphological Factors.

    PubMed

    Melez, ?pek Esen; Arslan, Murat Nihat; Melez, Deniz O?uzhan; Akçay, Arzu; Büyük, Yalçn; Av?ar, Abdullah; Kumral, Bahadr; ?irin, Gözde; Karayel, Ferah Anl; Da?, Taner; Dokudan, Yasemin Erenç; ?am, Bülent

    2015-09-01

    The number of cases with spontaneous coronary artery dissection (SCAD) is considered to be being underestimated because of a large amount of SCAD leading to sudden death without previous diagnosis. Besides, not only in clinics but also in autopsy practice, correct diagnosis of SCAD is important to prevent forensic malpractice.The article is intended to discuss the pathological findings through the forensic point of view for improving the malpractice expertise in scope of clinicians' timely antemortem diagnosis according to risk factors and in scope of forensic pathologists' the cause of death determination ability according to macroscopical and microscopical findings of the autopsy.In 3 cases reported, the main characteristics were the female sex, pregnancy history and a sudden death without any trauma. However, although there are many women giving birth or using oral contraceptives, only some of them are facing with SCAD. This suggests the possibility of some hereditary factors, whereas hereditary characteristics may be understood in many different ways like hormone-releasing regulating mechanisms as well as immunity, morphology, or any other mechanism. For instance, autoimmunity has been also a hereditary underlying factor for vessel injury considered in presented cases. PMID:26010056

  13. Digital imaging of the dissection and sexual abuse of a corpse - an exceptional case of necrophilia.

    PubMed

    Bauer, Martin; Tatschner, Thomas; Patzelt, Dieter

    2007-05-01

    Regular necrophilia refers to the sexually motivated abuse of corpses and is not considered as severe crime in many western countries. However, the risk of "switching" to necrophilic homicides, i.e., committing a homicide to obtain a dead body, has to be assessed by forensic experts. We present a case of semi-professional dissection, preservation and sexual abuse of the body and body parts of a 14-year-old girl. Every step was documented by the offender on thousands of digital images thus allowing an exact reconstruction of necrophilic acts and fantasies. Three months after the disappearance of the body the remains could be recovered and linked to the deceased by pathological examination and DNA analysis. The offender had excessively used the internet for downloading files with sadistic and necrophilic contents including autopsy instructions. The psychiatric examination of the socially integrated and married patient revealed a severe personality disorder. Two other, previously unsolved cases could be attributed to him showing a clear progression of fantasies and acts. PMID:17157546

  14. Spontaneous coronary artery dissection in a young man with a factor v leiden gene mutation: a case report and review of the literature.

    PubMed

    Khan, Tahir; Danyi, Peter; Topaz, On; Ali, Asghar; Jovin, Ion S

    2013-12-01

    Spontaneous coronary artery dissection is a rare but increasingly recognized cause of acute myocardial ischemia in young adults, especially in women. We report a case of spontaneous coronary dissection in a young healthy man who was also a carrier of the factor V Leiden gene mutation. PMID:24436622

  15. Complications of neck dissection at a tertiary level hospital: study of 30 cases.

    PubMed

    Masud, M K; Ahmad, S M; Karim, M A; Ferdouse, F; Fakir, A Y; Hanif, M A; Abdullah, M; Roy, A S

    2014-10-01

    Metastatic dissemination into lymph nodes of neck occurs frequently in head neck cancers which down grade the patient's curability and survival. Neck dissection is a curable option for its management. To evaluate the complications following different types of neck dissection. This cross sectional study was conducted among patients undergone different types of neck dissection due to cervical nodal metastasis and attended follow up during July 2010 to June 2011 in Department of ENTs and Head-Neck surgery Dhaka Medical College Hospital, Dhaka, Bangladesh. Among 30 selected patient, 23 were male (76.67%) and 7 were female (23.33%), age ranged from 31-72 years (Mean=59.1±5.44). In different modalities of neck dissection 11 were modified neck dissection (36.67%) and 10(33.33%) were radical neck dissection. Common indication was carcinoma of unknown origin (66.67%). Involved neck nodes were commonly level II-IV (69.99%). Nodal stage was N2(50%) and N3 (40%).Common immediate complications were bleeding 03(10%), facial oedema 02 (6.67%) and thoracic duct injury 02(6.67%). Intermediate complications were seroma 05(16.67%), wound infection 04(13.33%) and chylous fistula 02(6.67%), Late Complications were hypertrophic scar 07(23.33%) and shoulder syndrome 06(20%). Proper indications, skilled surgery along with early recognize and treatment in both early and late manifestations of neck dissection preventing its grave sequence. PMID:25481582

  16. Dissecting heart failure.

    PubMed

    Verma, Sameer; Gupta, Sameer; Guglin, Maya

    2014-06-01

    Dissection of ascending aorta is a medical emergency typically presenting with acute chest or back pain and hemodynamic instability. We are reporting a very unusual case of dissection of a large ascending aortic aneurysm presenting as a new onset heart failure. A 46-year-old man presented with gradually increasing dyspnea and orthopnea. His physical examination and laboratory findings were consistent with heart failure. The only unusual feature was a diastolic murmur, which prompted echocardiographic evaluation. Besides left ventricular dilatation, hypertrophy, and severe global hypokinesis, which were expected, we also found severely dilated aortic root with aortic regurgitation and a 8.6×9.7 cm ascending aortic aneurysm with dissection. The patient had a brother who died several years earlier from aortic dissection. Surgical treatment was successful. Type A aortic dissection may rarely present as heart failure. Aortic dissection at young age should prompt screening of first-degree relatives because genetic nature of the disease is very likely. PMID:24418447

  17. A case of anterior cerebral artery dissection caused by scuba diving.

    PubMed

    Fukuoka, Takuya; Kato, Yuji; Ohe, Yasuko; Deguchi, Ichiro; Maruyama, Hajime; Hayashi, Takeshi; Tanahashi, Norio

    2014-08-01

    A 51-year-old man was admitted with right hemiparesis during scuba diving, without headache. Brain magnetic resonance (MR) imaging depicted high-intensity areas in the left superior frontal and cingulate gyri on diffusion-weighted imaging. Dissection of the anterior cerebral artery (ACA) was detected using axial MR angiography and 3-dimensional MR cisternography. Dissection of the ACA during and after scuba diving has not been reported before. Dissection of the arteries should be included in the differential diagnosis when neurologic symptoms occur both during and after scuba diving, even if the patient does not experience headache. Furthermore, the combination of MR cisternography and MR angiography is useful to detect ACA dissection. PMID:24784014

  18. A Case of Early Gastric Cancer Arising from Gastritis Cystica Profunda Treated by Endoscopic Submucosal Dissection

    PubMed Central

    Ogasawara, Naotaka; Noda, Hisatsugu; Kondo, Yoshihiro; Yoshimine, Takashi; Sugiyama, Tomoya; Kimura, Mikitoshi; Inoue, Satoshi; Takahashi, Emiko; Sasaki, Makoto; Kasugai, Kunio

    2014-01-01

    Gastritis cystica profunda (GCP) consists of hyperplasia and cystic dilatation of the gastric glands extending into the submucosa. It occurs in the residual stomach post surgery and in the unoperated stomach. GCP is considered a benign lesion, but there is controversy about its malignant potential. We report a case of early gastric cancer arising from GCP treated by endoscopic submucosal dissection (ESD) in a 55-year-old unoperated man. Upper gastrointestinal endoscopy revealed a 15-mm diameter submucosal tumor (SMT) in the upper corpus of the stomach. The surface had angiotelectasia and slight depression covered with normal mucosa. Neither ulceration nor erosion was seen. Narrow-band imaging endoscopy showed no abnormalities suggesting gastric cancer. Endoscopic ultrasonography visualized the internally low-echoic SMT, harboring tiny cystic lesions, mainly within the second and third layers of the gastric wall. The SMT was removed by ESD to avoid retention and allow for comprehensive diagnosis. It was diagnosed as GCP with partial well-differentiated adenocarcinoma without involvement of the lateral and deep margins, lymphatic invasion, vascular invasion and perineural invasion. The gastric epithelium comprised normal mucosa without dysplasia. ESD seems to be useful for the diagnosis of SMT, including GCP harboring gastric cancer, and avoids unnecessary surgical procedures. PMID:25408629

  19. [Stent-Assisted Coil Embolization of a Dissecting Aneurysm of the Posterior Cerebral Artery:A Case Report].

    PubMed

    Haruma, Jun; Sugiu, Kenji; Yukiue, Tadato; Sasaki, Tatsuya; Hattori, Yasuhiko; Kobayashi, Kazuki; Yoshida, Hideyuki; Muneda, Koji; Date, Isao

    2015-12-01

    Dissecting aneurysms of the posterior cerebral artery(PCA)are rare, especially those at the P1 segment. Here, we describe the case of a 57-year-old woman with a subarachnoid hemorrhage(SAH). Computed tomography angiography(CTA)and digital subtraction angiography(DSA)revealed a small(3mm)dissecting aneurysm with the typical pearl-and-string sign at the right P1 segment. Fourteen days after onset, the patient developed aphasia. DSA revealed vasospasm of the right middle cerebral artery, and we performed endovascular treatment by the intra-arterial injection of 1-(5-isoquinolinesulfonyl)homopiperazine. After this treatment, the patient's symptoms recovered immediately. Vertebral angiography revealed enlargement of the dissecting aneurysm(up to 7mm diameter). We started a loading dose of 300mg aspirin and 400mg clopidogrel after observing growth of the aneurysm. Fifteen days after onset, we performed a stent-assisted coil embolization, and obtained nearly complete obliteration of the aneurysm with preserved patency of the parent artery. Six-month follow-up DSA demonstrated complete occlusion of the aneurysm with good patency of the stented PCA; the patient was at modified Rankin Scale 1. In the treatment of ruptured dissecting aneurysms, parent vessel occlusion(PVO)with aneurysm is common. However, PVO may cause both cerebral infarction of the distal area and perforator occlusion of the occluded vessel. Stent-assisted coil embolization can preserve parent vessel flow and obliterate the aneurysm. Stents offer a therapeutic alternative for PCA dissecting aneurysms, especially when PVO cannot be tolerated. PMID:26646176

  20. Celiac artery dissection seen with ruptured pancreaticoduodenal arcade aneurysms in two cases of celiac artery stenosis from compression by median arcuate ligament.

    PubMed

    Watanabe, Akiko; Kohtake, Hiroshi; Furui, Shigeru; Takeshita, Koji; Ishikawa, Yuichi; Morita, Satoru

    2012-10-01

    We report two cases of ruptured pancreaticoduodenal arcade aneurysms that were successfully treated by embolotherapy. In these cases, contrast-enhanced computed tomography, sagittal reformed images, and angiography revealed celiac artery stenoses due to compression by the median arcuate ligament. Computed tomography also showed acute localized dissection in the distal celiac axis, suggesting that aneurysmal rupture had occurred immediately after development of the dissection. When unruptured pancreaticoduodenal arcade aneurysms are identified in the context of celiac artery dissection, the possibility of rupture may be high and requires strict observation and consideration of embolotherapy. PMID:22795523

  1. Bilateral middle cerebral artery infarction associated with traumatic common carotid artery dissection: a case report and review of literature.

    PubMed

    Chiba, Fumiko; Makino, Yohsuke; Motomura, Ayumi; Inokuchi, Go; Ishii, Namiko; Torimitsu, Suguru; Sakuma, Ayaka; Nagasawa, Sayaka; Saito, Hisako; Yajima, Daisuke; Hayakawa, Mutsumi; Iwase, Hirotaro

    2014-03-01

    Traumatic common carotid artery dissection is very rare, and although it is associated with mild symptoms, it can sometimes be fatal. Therefore, careful examination of common carotid artery dissection and additional pathological examination as appropriate are important during the autopsy of traumatic death patients. A 60-year-old previously healthy drunken woman was run over. She had remained unconscious shortly after the accident, and 15 h later, emerging bilateral cerebral infarction was confirmed using brain computed tomography. Despite conservative management, she died 4 days after the injury due to multiple chest traumas and broad cerebral infarction. A medico-legal autopsy was conducted. According to the autopsy results, microscopically identified common carotid artery dissections with thrombus formation were considered the cause of infarction. In the present case, macroscopic common carotid artery lesions were relatively mild, and this made diagnosis difficult. However, the correct diagnosis was achieved by a combined analysis of the antemortem images and autopsy results. Thus, in such cases, a combined comprehensive analysis of autopsy results and antemortem clinical images is important to determine the exact cause of death. PMID:24480785

  2. Celiac trunk and branches dissection due to energy drink consumption and heavy resistance exercise: case report and review of literature.

    PubMed

    González, Wilma; Altieri, Pablo I; Alvarado, Enrique; Banchs, Héctor L; Colón, Edgar; Escobales, Nelson; Crespo, María

    2015-01-01

    Higher doses and consumption of energy drinks leads to cardiovascular effects and potential consequences. Principal components found in energy drinks such as caffeine, guarana and taurine has been related to dilatation, aneurysm formation, dissection and ruptures. There is no evidence showing an integration of these components and its effects in endothelium and aortic walls due to higher levels of pressure during exercises. We report a case of a 44 years male with celiac trunk and branches dissection due to long-term consumption of energy drinks and intense exercise routine. Our proposition relates cell and vessel walls alterations including elasticity in endothelial wall due to higher blood pressure, resistance by intense exercise routine and long-term consumption of energy drinks. PMID:26035983

  3. Unexpected cause of a right hemiplegia secondary to the painless full-length aortic dissection: a case report and literature review

    PubMed Central

    Huang, Shu; Sun, Jialan; Li, Longxuan

    2015-01-01

    Painless aortic dissections in general are uncommon and are frequently misdiagnosed. Here we reported a rare case of acute ischemic stroke secondary to completely painless acute full-length dissection (DeBakey I) and provide a brief review of the literature. A 56-year-old man was referred to our department with right hemiplegia. Ischaemic stroke and thrombolytic treatment were considered initially. At the second examination, the patient was found to have decreased blood pressure, asymmetrical blood pressure/pulses between the bilateral limbs, and sudden loss of pulse in a lower extremity. Laboratory results revealed leucocytosis, elevated creatinine and CK without obvious cause. An aortic dissection was subsequently confirmed by contrast enhanced thoracic and abdominal CT scan. Our report provides some clues for the early diagnosis of painless aortic dissections. PMID:25932276

  4. Spontaneous Coronary Artery Dissection and Hemodynamic Instability: Can Emergent PCI Be Life Saving? Report of Two Cases and Literature Review

    PubMed Central

    Al Emam, Abdel Rahman A.; Almomani, Ahmed; Gilani, Syed A.

    2014-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. It occurs predominantly among younger females and typically in the absence of atherosclerotic coronary artery disease. It is associated with peripartum period, connective tissue disorders, vasculitides, and extreme exertion. Presentations vary greatly, and this condition can be fatal. Given its rarity, there are no guidelines for management of SCAD. We present the cases of two female patients, with no coronary artery disease risk factors or recent pregnancy, who were presented with non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI), respectively, secondary to SCAD. Both had excellent outcome after emergent percutaneous intervention. Our first patient was presented with NSTEMI with ongoing chest pain and dynamic electrocardiogram (ECG). Emergent left heart catheterization was significant for first obtuse marginal (OM1) dissection, confirmed by optical coherence tomography. Percutaneous coronary intervention (PCI) with two bare metal stents was performed with resolution of symptoms and ECG changes. The second patient is known to have syndrome, presented with STEMI and emergent coronary angiography showed left anterior descending dissection with intramural hematoma confirmed by intravascular ultrasound and treated with a drug-eluting stent with resolution of symptoms and ST changes. Her hospital course was complicated by post–myocardial infarction pericarditis that was improved with colchicine. Both the patients were observed in the coronary care unit for 24 hours. Both remained asymptomatic at 6-month follow-up. SCAD is a rare cause of acute coronary syndrome. In patients with early presentation, limited disease, and ongoing symptoms, emergent cardiac catheterization with percutaneous intervention has excellent outcome. More studies are needed to establish evidence-based management guidelines. PMID:25484560

  5. An extensive DeBakey type IIIb aortic dissection with massive right pleural effusion presenting as abdominal pain and acute anemia: particular case report

    PubMed Central

    Yu, Hui-Chun; Wang, Zhen-Qing; Hao, Yuan-Yuan; An, Feng-Ping; Hu, Yu-Chuan; Deng, Rui-Bing; Yu, Peng; Cui, Guang-Bin; Li, He

    2015-01-01

    We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography angiography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta starting immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a ‘rule-out’ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation. PMID:26089858

  6. A Case of an Upper Gastrointestinal Bleeding Due to a Ruptured Dissection of a Right Aortic Arch

    SciTech Connect

    Born, Christine; Forster, Andreas; Rock, Clemens; Pfeifer, Klaus-Juergen; Rieger, Johannes; Reiser, Maximilian

    2003-09-15

    We report a case of severe upper gastrointestinal hemorrhage with a rare underlying cause. The patient was unconscious when he was admitted to the hospital. No chest radiogram was performed. Routine diagnostic measures, including endoscopy, failed to reveal the origin of the bleeding, which was believed to originate from the esophagus secondary to a peptic ulcer or varices. Exploratory laparotomy added no further information, but contrast-enhanced multislice computed tomography (MSCT) of the chest showed dextroposition of the widened aortic arch with a ruptured type-B dissection and a consecutive aorto-esophageal fistula (AEF). The patient died on the day of admission. Noninvasive MSCT angiography gives rapid diagnostic information on patients with occult upper gastrointestinal bleeding and should be considered before more invasive conventional angiography or surgery.

  7. Traumatic Infra-renal Aortic Dissection After a High-energy Trauma: A Case Report of a Primary Missed Diagnosis

    PubMed Central

    Godry, Holger; Rölleke, Guido; Mumme, Achim; Schildhauer, Thomas A.; Gothner, Martin

    2014-01-01

    A traumatic infra-renal aortic dissection is a rare but life-threatening injury that follows deceleration injuries. The mechanism of blunt abdominal aortic injury involves both direct and indirect forces. The successful management of patients with traumatic injuries depends on a prompt suspicion of the injury and early diagnosis and therapy. Missed injuries in trauma patients are well-described phenomena and implementation of the ATLS® trauma schedule led to a decrease in the number of missed injuries, but trauma computed tomography (CT) scans in injured patients are still not standard. We report on a 54-year old Caucasian female patient who was involved in a car accident. The fellow passenger of the car was seriously injured. The patient had been previously treated at two different hospitals, and a dislocated acetabular fracture had been diagnosed. Because of this injury, the patient was transferred to our institution, a level 1 trauma-center where, according to the nature of the accident as a high-energy trauma, a complete polytrauma management was performed at the time of admission. During the body check, a moderate tension of the lower parts of the abdomen was detected. During the CT scan, an aneurysm of the infra-renal aorta with a dissection from the height of the second lumbar vertebral body to the iliac artery was observed. The patient required an operation on the day of admission. After 19 days post-trauma care the patient was able to leave our hospital in good general condition. Therefore, missed injuries in multiple injury patients could be fatal, and it is essential that the orthopedic surgeon leaves room for suspicion of injuries based on the nature of the trauma. Traumatic injuries of the abdominal aorta are rare. According to the ATLS® trauma schedule, all of the patients who have experienced high-energy trauma and associated fractures should undergo routine screening using a trauma CT scan with contrast agents to detect potential life-threatening injuries. In case of abdominal trauma, an aortic dissection, which can easily be overlooked, has to be considered. PMID:24744835

  8. Postpartum vertebral artery dissection.

    PubMed

    Finley, Amanda; Rogers, Brenton; Richards, Theodore; Vogel, Heather

    2015-01-01

    We report a case of a right vertebral artery dissection in a 35-year-old woman, 3?weeks post partum, with manifestations of vertebrobasilar disease. She was 3?weeks out from the uneventful delivery of her fourth child, with presentation of acute neurological symptoms, predominantly intractable vertigo. Vertigo can have many non-specific generalised symptoms and clinical findings. Postpartum women have a lengthy list of possible aetiologies of vertigo not limited to our initially suspected preeclampsia, dural venous thrombosis and vertebral dissection. PMID:26604230

  9. Polyomino Dissections

    ERIC Educational Resources Information Center

    Hohn, Tiina; Liu, Andy

    2012-01-01

    One of Gardner's passions was to introduce puzzles into the classroom. From this point of view, polyomino dissections are an excellent topic. They require little background, provide training in geometric visualization, and mostly they are fun. In this article, we put together a large collection of such puzzles, introduce a new approach in solving…

  10. Dissecting firearm injury to the head and neck with non-linear bullet trajectory: a case report.

    PubMed

    Can, Muhammet; Yildirim, Nadir; Ataç, Gökçe Kaan

    2010-04-15

    Firearm injuries to the head and neck have a potential for fatal complications caused by damage to neurovascular structures in the region. We herewith present a case of a missile injury to the face, caused by a bullet from a rifle with high muzzle energy that slackened while penetrating a vehicle before hitting the victim. The bullet advanced through the retrofacial spaces following a non-linear course and was retained within the opposite parapharyngeal region without injuring any vital structure. The resultant damage was a 'low-velocity injury'. However, it is noteworthy that the missile had still retained enough energy to penetrate the tissue and travel in a 'dissecting' fashion. It is likely that the blunting of the missile during vehicle penetration and the compactness of the anatomical structures bordering the head and neck spaces, such as fascia and tendons, forced the projectile to follow a non-linear inter-structural path. This case yet again demonstrates that the magnitude of firearm-related tissue damage may also depend upon the shape of the projectile and confirms that the head and neck spaces have anatomical integrity rather than just being arbitrarily designated topographical areas. It has also been confirmed that non-surgical approach with regular follow-ups is a viable option for uncomplicated head and neck injuries. PMID:20106613

  11. Future directions of duodenal endoscopic submucosal dissection

    PubMed Central

    Matsumoto, Satohiro; Miyatani, Hiroyuki; Yoshida, Yukio

    2015-01-01

    Endoscopic therapies for lesions of the duodenum are technically more difficult than those for lesions of the other parts of the gastrointestinal tract due to the anatomical features of the duodenum, and the incidence rate of complications such as perforation and bleeding is also higher. These aforementioned trends were especially noticeable for the case of duodenal endoscopic submucosal dissection (ESD). The indication for ESD of duodenal tumors should be determined by assessment of the histopathology, macroscopic morphology, and diameter of the tumors. The three types of candidate lesions for endoscopic therapy are adenoma, carcinoma, and neuroendocrine tumors. For applying endoscopic therapies to duodenal lesions, accurate preoperative histopathological diagnosis is necessary. The most important technical issue in duodenal ESD is the submucosal dissection process. In duodenal ESD, a short needle-type knife is suitable for the mucosal incision and submucosal dissection processes, and the Small-caliber-tip Transparent hood is an important tool. After endoscopic therapies, the wound should be closed by clipping in order to prevent complications such as secondary hemorrhage and delayed perforation. At present, the criteria for selection between ESD and EMR vary among institutions. The indications for ESD should be carefully considered. Duodenal ESD should have limitations, such as the need for its being performed by experts with abundant experience in performing the procedure. PMID:25901218

  12. Infective Endocarditis Caused by Finegoldia magna Following Aortic Dissection Repair: A Case Report and Data Evaluation

    PubMed Central

    Hussein, Khetam; Savin, Ziv; Shani, Liran; Dickstein, Yaakov; Geffen, Yuval; Raz-Pasteur, Ayelet

    2014-01-01

    Patient: Male, 45 Final Diagnosis: Endocarditis Symptoms: — Medication: — Clinical Procedure: Antibiotic treatment and aortic repair Specialty: Surgery Objective: Unusual clinical course Background: Finegoldia magna (F. magna) is a rare pathogen causing infective endocarditis (IE). Only 7 cases are documented in the literature. Case Report: We report a case of infective endocarditis in a 45-year-old male due to F. magna 2 months after a Bentall procedure. He presented with fever, dyspnea, and chest pain. Aerobic and anaerobic blood samples were drawn before empirical antibiotic treatment was initiated. A transesophageal echocardiogram (TEE) demonstrated several findings involving the prosthetic valve, including a vegetation. The patient underwent a second aortic repair procedure. Tissue cultures obtained from 2 sources in the infected area during the operation were positive for F. magna. The antibiotic regimen was changed in accordance with susceptibility testing to piperacillin/tazobactam. Two weeks after the operation, the patient was released with a recommendation for antibiotic treatment for 8 weeks. Conclusions: We report this case because F. magna in a rare pathogen causing endocarditis. This was a case of prosthetic valve F. magna IE in which the definitive diagnosis was based on tissue cultures following sterile blood cultures. Data evaluation of all F. magna IE reported cases illustrated that tissue cultures were the predominant microbiologic diagnostic tool used. PMID:25515374

  13. Association between Diabetes and Risk of Aortic Dissection: A Case-Control Study in a Chinese Population

    PubMed Central

    He, Xingwei; Liu, Xintian; Liu, Wanjun; Wang, Bei; Liu, Yujian; Li, Zhuxi; Wang, Tao; Tan, Rong; Gao, Bo; Zeng, Hesong

    2015-01-01

    Background It is well-recognized that diabetes represents a powerful independent risk factor for cardiovascular diseases. However, very few studies have investigated the relationship between diabetes and risk of aortic dissection (AD). Aim The aim of this case-control study was to evaluate the association between diabetes and risk of AD in Chinese population. Methods A hospital-based case-control study, consisting of 2160 AD patients and 4320 controls, was conducted in a Chinese population. Demographic, clinical characteristics and risk factors were collected. Diabetes rate of patients with overall AD, Stanford type A AD and type B AD group was compared with that of corresponding matched control groups. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for relationship between diabetes and AD risk. Results The prevalence of diabetes was lower in AD cases than that of control subjects, whether it is the overall AD, type A AD or type B AD group (4.7% vs. 10.0%, 2.9% vs. 8.8%, 5.9% vs. 10.9%, all P<0.001). Furthermore, in multivariate model, diabetes was found to be associated with lower AD risk, which not only applies to the overall AD (OR = 0.2, 95%CI: 0.15–0.26), but also type A AD (OR = 0.12, 95% CI: 0.07–0.20) and type B AD (OR = 0.25, 95%CI: 0.18–0.33). Conclusions We observed the paradoxical inverse relationship between DM and risk of AD in the Chinese population. These results suggest diabetes may play a protective role in the development of AD. However, further studies are needed to enrich related evidence, especially with regard to underlying mechanisms for these trends. PMID:26562793

  14. Horner syndrome secondary to internal carotid artery dissection after a short-distance endurance run: A case study and review

    PubMed Central

    Borgman, Christopher J.

    2012-01-01

    Oculosympathetic paresis, historically known as Horner sydrome, classically results in a triad of ptosis, miosis, and anhydrosis on the affected side. Any interruption or insult to any part of the sympathetic pathway to the eye can result in these classic findings. There are many possible etiologies along the three-neuron pathway, however, a few potentially life threatening causes must always be ruled out, especially in acute presentations. One life threatening etiology, in particular, to rule out is of internal carotid artery dissection (ICAD). A 38-year-old white female was referred to our clinic for a second opinion by her primary care physician for a sudden onset headache, ptosis, and miosis of the left side following a short endurance race 24–48 h prior. Entering visual acuities were 20/20 in the right eye (OD) and 20/20 in the left eye (OS). Emergent magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) revealed a severe left ICAD. The patient was started on oral anticoagulants and oral steroids. Spontaneous resolution occurred three months later upon confirmation with repeat MRI/MRA. This case report reviews the clinical findings, diagnoses, treatment, and management of patients with Horner syndromes secondary to ICAD.

  15. Intramural hematoma or aortic dissection – a diagnostic and therapeutic problem. A case report

    PubMed Central

    Suder, Bogdan; Wasilewski, Grzegorz; Sadowski, Jerzy; Kapelak, Bogus?aw

    2015-01-01

    The authors present a case report of a 60-year-old patient with an ascending aortic aneurysm along with the associated diagnostic and therapeutic problems. The choice of therapy in patients with aortic intramural hematoma is difficult and should be based on comprehensive evaluation of the patient's status as well as on the experience of the radiologist and surgeon.

  16. Dissecting Success Stories on Mathematical Problem Posing: A Case of the Billiard Task

    ERIC Educational Resources Information Center

    Koichu, Boris; Kontorovich, Igor

    2013-01-01

    "Success stories," i.e., cases in which mathematical problems posed in a controlled setting are perceived by the problem posers or other individuals as interesting, cognitively demanding, or surprising, are essential for understanding the nature of problem posing. This paper analyzes two success stories that occurred with individuals of different…

  17. Catheter-induced dissection of the left main coronary artery, the nemesis of an invasive cardiologist A case report and review of the literature.

    PubMed

    Jain, Deepak; Kurowski, Volkhard; Katus, Hugo A; Richardt, Gert

    2002-10-01

    An elderly gentleman had a dissection of the left main coronary artery (LMCA) during coronary angiography. There were critical lesions in the left anterior descending (LAD) and left circumflex arteries. Both the LMCA and the LAD lesions were successfully stented in the same sitting. Thereafter the patient remained symptom free and the six-month follow-up angiogram revealed good angioplasty results in both lesions. We report this case for two reasons - first, acute dissection of the LMCA is a rare but devastating complication of selective coronary angiography and the situation becomes graver if the branch vessels have critical stenosis; that this could be managed percutaneously needs to be highlighted, and second, the case offers an opportunity to review literature pertinent to this awesome occurrence in the catheterization laboratory. PMID:12395225

  18. Dissecting the determinants of depressive disorders outcome: an in depth analysis of two clinical cases

    PubMed Central

    Serretti, Alessandro; Calati, Raffaella; Oasi, Osmano; De Ronchi, Diana; Colombo, Cristina

    2007-01-01

    Clinicians face everyday the complexity of depression. Available pharmacotherapies and psychotherapies improve patients suffering in a large part of subjects, however up to half of patients do not respond to treatment. Clinicians may forecast to a good extent if a given patient will respond or not, based on a number of data and sensations that emerge from face to face assessment. Conversely, clinical predictors of non response emerging from literature are largely unsatisfactory. Here we try to fill this gap, suggesting a comprehensive assessment of patients that may overcome the limitation of standardized assessments and detecting the factors that plausibly contribute to so marked differences in depressive disorders outcome. For this aim we present and discuss two clinical cases. Mr. A was an industrial manager who came to psychiatric evaluation with a severe depressive episode. His employment was demanding and the depressive episode undermined his capacity to manage it. Based on standardized assessment, Mr. A condition appeared severe and potentially dramatic. Mrs. B was a housewife who came to psychiatric evaluation with a moderate depressive episode. Literature predictors would suggest Mrs. B state as associated with a more favourable outcome. However the clinician impression was not converging with the standardized assessment and in fact the outcome will reverse the prediction based on the initial formal standard evaluation. Although the present report is based on two clinical cases and no generalizability is possible, a more detailed analysis of personality, temperament, defense mechanisms, self esteem, intelligence and social adjustment may allow to formalize the clinical impressions used by clinicians for biologic and pharmacologic studies. PMID:17286859

  19. Getting ocean acidification on decision makers' to-do lists: dissecting the process through case studies

    USGS Publications Warehouse

    Cooley, Sarah R.; Jewett, Elizabeth B.; Reichert, Julie; Robbins, Lisa L.; Shrestha, Gyami; Wieczorek, Dan; Weisberg, Stephen B.

    2015-01-01

    Much of the detailed, incremental knowledge being generated by current scientific research on ocean acidification (OA) does not directly address the needs of decision makers, who are asking broad questions such as: Where will OA harm marine resources next? When will this happen? Who will be affected? And how much will it cost? In this review, we use a series of mainly US-based case studies to explore the needs of local to international-scale groups that are making decisions to address OA concerns. Decisions concerning OA have been made most naturally and easily when information needs were clearly defined and closely aligned with science outputs and initiatives. For decisions requiring more complex information, the process slows dramatically. Decision making about OA is greatly aided (1) when a mixture of specialists participates, including scientists, resource users and managers, and policy and law makers; (2) when goals can be clearly agreed upon at the beginning of the process; (3) when mixed groups of specialists plan and create translational documents explaining the likely outcomes of policy decisions on ecosystems and natural resources; (4) when regional work on OA fits into an existing set of priorities concerning climate or water quality; and (5) when decision making can be reviewed and enhanced.

  20. [Isolated spontaneous dissection of visceral arteries].

    PubMed

    Corral, M A; Encinas, J; Fernández-Pérez, G C

    2014-01-01

    We present the cases of two men with isolated spontaneous dissection of visceral arteries diagnosed by multidetector CT. In the first patient, dissection of the celiac trunk was associated with periarterial changes. In the second patient, dissection of the superior mesenteric artery was associated with stenosis at the root of the celiac trunk. Both patients presented with acute pain, which was more intense and longer lasting in the first patient. Aortic dissection was suspected clinically in both patients. Both dissections were short and had patent saccular false lumens and reduced caliber of the true lumens. This morphological type is one of the most uncommon within this rare entity. However, in recent years, the number of cases published is rising. This suggests that this entity may have been underdiagnosed before the widespread use of multidetector CT. We discuss the two morphological classifications of dissection of the visceral arteries and the need to adapt therapeutic management to the particular circumstances of each case. PMID:21724211

  1. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial

    E-print Network

    CADISS trial investigators

    2015-02-12

    common alternative diagnoses were atherosclerosis, an atretic rather than dissected vertebral artery, a narrowed artery without any defi nite evidence of dissection and, in one case, adherent thrombus without clear evidence of dissection. Several...

  2. Pleomorphic adenoma of the accessory parotid gland: case report and reappraisal of intraoral extracapsular dissection for management.

    PubMed

    Tsegga, Tibebu M; Britt, Jennifer D; Ellwanger, Aragon R

    2015-03-01

    Pleomorphic adenoma is the most common tumor of the major and minor salivary glands. Rarely is it found evolving from an ectopic location of major salivary glandular tissue in the mid cheek. A healthy 56-year-old woman presented to our institution with a 20-year duration of a slowly growing right cheek soft tissue mass that was causing facial asymmetry. No significant functional or neurosensory dysfunction was appreciated. Radiologic examination showed a heterogeneous, hyperintense, well-delineated mass within the region of the right buccal fat pad. Fine-needle aspiration biopsy showed benign salivary gland elements consistent with pleomorphic adenoma. The decision was made to perform intraoral extracapsular dissection for removal. Discussion of the clinical assessment and magnetic resonance imaging evaluation with an emphasis on intraoral extracapsular dissection for definitive surgical therapy of longstanding benign salivary gland tumors is emphasized. PMID:25530278

  3. Early history of neck dissection.

    PubMed

    Rinaldo, Alessandra; Ferlito, Alfio; Silver, Carl E

    2008-12-01

    With the exception of distant metastases, the presence of lymph node metastasis in the neck is accepted as the single most important adverse independent prognostic factor and an indicator of survival in squamous carcinoma of the head and neck. Neck dissection in its various forms is the standard surgical treatment for clinical, subclinical and subpathologic metastatic cancer to the neck. The pertinent literature from the beginning of the nineteenth century to the middle of the twentieth century was reviewed. The four giants of late nineteenth century surgery: von Langenbeck, Billroth, von Volkmann and Kocher developed and reported the early cases of different types of neck dissection. Butlin, in England, conceived and developed the concept of elective neck dissection. In 1888, the Polish surgeon Jawdy?sky reported and described in detail the first successful extended en bloc neck dissection. Crile, in 1905 and 1906, reported the first significant series of radical en bloc neck dissections, bringing this procedure to the attention of the medical world as an effective operation with reproducible technique and results. The greatest impetus to the status of this surgical procedure came from Martin and colleagues, who published a monumental report in 1951 of 1,450 cases that established the place and technique of radical neck dissection in the modern treatment of head and neck cancer. Neck dissection, for treatment of cervical lymph node metastases in head and neck cancer, was conceived and attempted in the nineteenth century, with some limited success reported by the end of that era. An effective operation was described and reported in the early twentieth century and evolved by the mid century into a fundamental tool in the management of patients with head and neck cancer. PMID:18488240

  4. Anesthetic management of a patient with polycythemia vera undergoing emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting: a case report

    PubMed Central

    Im, Hyeongwoo; Yang, Jaeyoung; Lee, Sangmin Maria; Lee, Jong Hwan

    2015-01-01

    Polycythemia vera is a chronic progressive myeloproliferative disease characterized by increased circulating red blood cells, and the hyperviscosity of the blood can lead to an increased risk of arterial thrombosis. In a previous survey regarding postoperative outcomes in polycythemia vera patients, an increased risk of both vascular occlusive and hemorrhagic complications have been reported. Aortic surgery involving cardiopulmonary bypass may be associated with the development of a coagulopathy, and as a result, the occurrence of thrombotic complications should be avoided after coronary anastomosis. Thus, optimizing the hemostatic balance is an important concern for anesthesiologists. However, only a few cases of anesthetic management in polycythemia vera patients undergoing concomitant aorta and coronary arterial bypass surgery have ever been reported. Here, we experience a polycythemia vera patient who underwent an emergency repair of a type-A aortic dissection and concomitant coronary artery bypass grafting, and report this case with a review of the relevant literature. PMID:26634086

  5. Dissecting Classroom Ethics.

    ERIC Educational Resources Information Center

    Allchin, Douglas

    1991-01-01

    Described are activities that lead to values clarification. Issues such as dissection, bioengineering, birth control, medical resources, and death are discussed. Included is a student questionnaire on the subject of dissection and the use of animals in laboratories. (KR)

  6. Spontaneous Coronary Artery Dissection with Cardiac Tamponade

    PubMed Central

    Lundstrom, Robert J.

    2015-01-01

    Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome. Clinical presentation ranges from chest pain alone to ST-segment-elevation myocardial infarction, ventricular fibrillation, and sudden death. The treatment of patients with spontaneous coronary artery dissection is challenging because the disease pathophysiology is unclear, optimal treatment is unknown, and short- and long-term prognostic data are minimal. We report the case of a 70-year-old woman who presented with an acute ST-segment-elevation myocardial infarction secondary to a spontaneous dissection of the left anterior descending coronary artery. She was treated conservatively. Cardiac tamponade developed 16 hours after presentation. Repeat coronary angiography revealed extension of the dissection. Medical therapy was continued after the hemopericardium was aspirated. The patient remained asymptomatic 3 years after hospital discharge. To our knowledge, this is the first reported case of spontaneous coronary artery dissection in association with cardiac tamponade that was treated conservatively and had a successful outcome. PMID:26504447

  7. [Pregnancy and coronary artery dissection].

    PubMed

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-01-01

    Acute myocardial infarction during pregnancy is associated with high maternal and fetal mortality. Coronary atherosclerosis is the most common cause due to an increase in the age of the patients and the association with cardiovascular risk factors such as smoking, hypertension, diabetes mellitus, preeclampsia, and the existence of family history of coronary disease. However, thrombosis, coronary dissection or coronary vasospasms are other causes that may justify it. We report the case of a 33 weeks pregnant first-time mother, without cardiovascular risk factors, who presented an acute coronary event in the context of atherosclerotic disease and coronary dissection after percutaneous coronary intervention. PMID:25795261

  8. [Tonsillar microsurgery by bipolar dissection].

    PubMed

    Sánchez del Hoyo, A; Lacosta Nicolás, J L; Má Salóm, J; Martínez Torre, I; Fernández Martín, M J

    1995-01-01

    The 66 amygdalectomies done by the AA. under general anesthesia and tracheal intubation are considered in two groups. The first one was composed by 32 patients operated following a dissection and coagulation procedure with the aid of a bipolar forceps and under microscopical magnification. The second group, 34 cases, underwent the classical procedure with ligature of the bleeding vessels. The usage of the bipolar forceps procure lesser loss of blood as compared with the dissection-ligature procedure. On the contrary, the bipolar clip method showed and increased postoperative pain and also the lagging of the swallow function. Both techniques presented with very similar complications (bleeding, edema, loca infection). PMID:7573857

  9. The Problems of Dissection.

    ERIC Educational Resources Information Center

    Davis, Pat

    1997-01-01

    Describes some problems of classroom dissection including the cruelty that animals destined for the laboratory suffer. Discusses the multilevel approach that the National Anti-Vivisection Society (NAVS) has developed to address the problems of animal dissection such as offering a dissection hotline, exhibiting at science teacher conferences, and…

  10. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Notice in cases of probable fraud. 431.214 Section... Hearings for Applicants and Recipients Notice § 431.214 Notice in cases of probable fraud. The agency may... indicating that action should be taken because of probable fraud by the recipient; and (b) The facts...

  11. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Notice in cases of probable fraud. 431.214 Section... Hearings for Applicants and Recipients Notice § 431.214 Notice in cases of probable fraud. The agency may... indicating that action should be taken because of probable fraud by the recipient; and (b) The facts...

  12. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Notice in cases of probable fraud. 431.214 Section... Hearings for Applicants and Beneficiaries Notice § 431.214 Notice in cases of probable fraud. The agency... facts indicating that action should be taken because of probable fraud by the beneficiary; and (b)...

  13. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Notice in cases of probable fraud. 431.214 Section... Hearings for Applicants and Beneficiaries Notice § 431.214 Notice in cases of probable fraud. The agency... facts indicating that action should be taken because of probable fraud by the beneficiary; and (b)...

  14. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Notice in cases of probable fraud. 431.214 Section... Hearings for Applicants and Beneficiaries Notice § 431.214 Notice in cases of probable fraud. The agency... facts indicating that action should be taken because of probable fraud by the beneficiary; and (b)...

  15. Isolated brachiocephalic artery dissection presenting as acute stroke.

    PubMed

    Mani, Hariharasudan; Ahluwalia, Sharat

    2015-01-01

    Isolated brachiocephalic artery dissection is an extremely rare condition. Its presentation as an acute stroke can pose a significant diagnostic challenge in patients because of its rarity. We present a case of isolated spontaneous brachiocephalic artery dissection presenting as acute cerebrovascular accident. This case also illustrates the treatment dilemma brachiocephalic artery dissection can present, whether to choose antithrombotic/anticoagulation therapy and/or surgery, and also the dilemma in blood pressure management. PMID:26315357

  16. Peripartum presentation of an acute aortic dissection.

    PubMed

    Lewis, S; Ryder, I; Lovell, A T

    2005-04-01

    We report the case of an acute type A aortic dissection occurring in a 35-year-old parturient. The initial diagnosis was missed; a subsequent emergency Caesarean section 3 weeks after presentation was followed by the development of left ventricular failure and pulmonary oedema in the early postoperative period. Echocardiography confirmed the diagnosis of aortic dissection and the patient underwent a successful surgical repair. PMID:15640303

  17. Pulmonary artery dissection: echocardiographic findings and diagnosis.

    PubMed

    Areco, Daniel; Pizzano, Nelson

    2003-05-01

    Pulmonary artery dissection is a rare but life-threatening event, predisposing to sudden cardiac death or cardiogenic shock. It is often associated with underlying congenital disorders predisposing to pulmonary hypertension. Rarely, it is diagnosed by echocardiography or other image techniques. We present a case report of a pulmonary artery dissection, diagnosed primarily by echocardiography. The patient died soon after refusing any interventional approach after a short period under medication. PMID:12848882

  18. Endoscopic management of iatrogenic perforations during endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for colorectal polyps: a case series

    PubMed Central

    Pissas, Dimitrios; Ypsilantis, Efthymios; Papagrigoriadis, Savvas; Hayee, Bu’Hussain

    2015-01-01

    Background: Iatrogenic perforation during therapeutic colonoscopy, reported in up to 1% of endoscopic mucosal resections (EMRs) and up to 14% of endoscopic submucosal dissections (ESDs), has conventionally been an indication for surgery. Aims: We present a case series of successful endoscopic management of iatrogenic colorectal perforation during EMR and ESD, demonstrating the feasibility and safety of the method. Methods: Retrospective analysis of a database of patients undergoing EMR and ESD for colorectal polyps in a tertiary referral centre in the United Kingdom. Results: Four cases of perforation were identified (two EMRs and two ESDs) in a series of 218 procedures (1.8%), all detected at the time of endoscopy and managed with endoscopic clips. Patients were observed in hospital and treated with antibiotics. Their median length of stay was 3 days (range 2–6 days), with no mortality or need for surgery. Conclusion: Surgery is no longer the first choice in the management of iatrogenic perforations during EMR and ESD for colorectal polyps; in selected patients with small perforations and minimal extraluminal contamination, conservative management with application of endoscopic clips, antibiotics and close patient monitoring constitute a safe and effective treatment option, avoiding the morbidity of major surgery. PMID:26136835

  19. Spontaneous Mirror Dissections of Cervicocephalic Arteries

    PubMed Central

    Zhao, W.Y.; Krings, T.; Alvarez, H.; Ozanne, A.; Holmin, S.; Lasjaunias, P.L.

    2006-01-01

    Summary While so-called twin or mirror aneurysms constitute an established subgroup of multiple aneurysms, simultaneous spontaneous mirror dissections of cervicocephalic artery have not yet been reported as a particular entity. Among the patients treated at our institution since 1989, we identified 74 patients with spontaneous, nontraumatic dissections. Six of these cases presented with simultaneous bilateral dissections and four of the six patients had mirror dissections. Acute or chronic headache was present in all four cases. Additional clinical presentations consisted of impaired consciousness, cranial nerve palsy, and tinnitus. Angiography revealed irregular stenosis, dilatation or aneurysms located in the cervical ICA (internal carotid artery), VA (vertebral artery), or MCA (middle cerebral artery) without evident location bias. Although mirror dissections seems to be an exceptional finding, they may shed light on the vulnerability of different arterial segments to specific diseases. Similar to arterial aneurysm formation, pathogenesis of mirror dissection may involve an underlying "shared defect" in the endothelial cells, since these cells demonstrate a bilateral distribution during embryological development. This particular distribution therefore also provides a chronicle trail of the first trigger striking during embryonic development and demonstrates the segmental vulnerability to highly specific triggers. PMID:20569557

  20. 78 FR 41070 - Notice of Single-Case Deviation from Competition Requirements: Transfer of Grantee Request for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ...Notice of Single-Case Deviation from Competition Requirements: Transfer of Grantee Request...Notice of Single-Case Deviation from Competition Requirements: Transfer of Grantee Request...be issuing a grantee transfer without competition for the Detroit Michigan Healthy...

  1. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 false Notice in cases of probable fraud. 431.214 Section 431.214 Public...431.214 Notice in cases of probable fraud. The agency may shorten the period of...action should be taken because of probable fraud by the beneficiary; and (b)...

  2. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 false Notice in cases of probable fraud. 431.214 Section 431.214 Public...431.214 Notice in cases of probable fraud. The agency may shorten the period of...action should be taken because of probable fraud by the recipient; and (b) The...

  3. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 false Notice in cases of probable fraud. 431.214 Section 431.214 Public...431.214 Notice in cases of probable fraud. The agency may shorten the period of...action should be taken because of probable fraud by the beneficiary; and (b)...

  4. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 false Notice in cases of probable fraud. 431.214 Section 431.214 Public...431.214 Notice in cases of probable fraud. The agency may shorten the period of...action should be taken because of probable fraud by the beneficiary; and (b)...

  5. 42 CFR 431.214 - Notice in cases of probable fraud.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 false Notice in cases of probable fraud. 431.214 Section 431.214 Public...431.214 Notice in cases of probable fraud. The agency may shorten the period of...action should be taken because of probable fraud by the recipient; and (b) The...

  6. Spontaneous Coronary Dissection Masquerading as Benign Fascicular Ventricular Tachycardia.

    PubMed

    Ho, Sara Wei-Fen; Lin, Weiqin; Chan, Koo Hui; Seow, Swee-Chong

    2016-01-01

    Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome. Diagnosis of coronary artery dissection is made on coronary angiogram and prompt revascularisation is the key in management. We present a case of coronary artery dissection with an atypical presentation of cardiac arrhythmia mimicking benign fascicular ventricular tachycardia. A high index of suspicion and early coronary angiogram allowed us to diagnose and treat this potentially life-threatening disease. PMID:26475648

  7. [Transesophageal Echocardiography Was Useful to Determine a Therapeutic Strategy for Coronary Artery Ischemia during Surgery for Acute Type A Aortic Dissection: A Case Report].

    PubMed

    Takahashi, Saori; Gamo, Masahiro; Shimizu, Yuko; Kawana, Yuki

    2015-11-01

    A 57-year-old woman presented with acute back pain, diagnosed with acute type A aortic dissection, and we performed emergency ascending aortic replacement. During surgery, until cardiopulmonary bypass was started, the dissection did not extend to the orifice of the both coronary arteries. When aortic replacement was completed and just after the return of spontaneous beating, ventricular fibrillation (Vf) suddenly occurred. At that time, transesophageal echocardiography (TEE) revealed that dissection extended from the left main trunk (LMT) to the left circumflex artery (LCX). Recurrent Vf and circulatory collapse necessitated the application of a percutaneous cardiopulmonary support system (PCPS), while the surgeons performed cardiac massage. Additional emergency coronary artery bypass surgery (CABG) was immediately implemented. After the CABG, TEE showed that the true lumens of the LMT and LCX were dilated, allowing an increased flow to the LAD and LCX. The patient was discharged 2 months later. Although rare, coronary ischemia can be a complication of acute aortic dissection, resulting in decreased survival. Development of dissection to the coronary artery can also occur both intra- and postoperatively. In such instances, rapid diagnosis and treatment are important to save the patient. PMID:26689074

  8. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus

    PubMed Central

    2012-01-01

    A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature. PMID:23254252

  9. Acute aortic dissection diagnosed after embalming: macroscopic and microscopic findings.

    PubMed

    Savall, Frédéric; Dedouit, Fabrice; Piercecchi-Marti, Marie-Dominique; Leonetti, Georges; Rougé, Daniel; Telmon, Norbert

    2014-09-01

    A 58-year-old man died suddenly in Madagascar and poisoning was suspected. The body was embalmed after death and the general state of preservation was good. We found a major aortic dissection with a large false lumen from the aortic root to the common iliac arteries and a hemopericardium with formalinized blood clot. The intimal tear was on the ascending aorta, and an intramural hemorrhage was noted at the right coronary artery, attesting to a retrograde dissection. Microscopic studies confirmed aortic dissection with extensive intramural hemorrhage and also confirmed the retrograde dissection to the right coronary artery with a reduction of 90% of the true lumen. Classically, aortic dissection occurs in individuals with hypertension and individuals with genetic disorders of collagen formation. The diagnosis is often first established at the postmortem examination. Aortic dissection is therefore dealt with largely in necropsy studies. The usual cause of death is rupture into the pericardial sac. One case of bloodless dissection has been reported but the sudden death was explained by acute myocardial ischemia secondary to dissection of the left coronary artery. In our case, we found major hemopericardium and also intramural hemorrhage at the right coronary artery. We were able to make the diagnosis of aortic dissection and exclude the suspicion of homicide 15 days after death and after embalming. PMID:24684562

  10. 76 FR 1152 - Crosstex LIG, LLC; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-07

    ... Energy Regulatory Commission Crosstex LIG, LLC; Notice of Motion for Extension of Rate Case Filing... file a motion to intervene or to protest this filing must file in accordance with Rules 211 and 214 of... or motion to intervene, as appropriate. Such notices, motions, or protests must be filed on or...

  11. 76 FR 76712 - Pelico Pipeline, LLC; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ... Energy Regulatory Commission Pelico Pipeline, LLC; Notice of Motion for Extension of Rate Case Filing...). Any person desiring to participate in this rate proceeding must file a motion to intervene or to... proceeding. Any person wishing to become a party must file a notice of intervention or motion to...

  12. Isolated Superior Mesenteric Artery Dissection with Small Intestine Ischemia

    PubMed Central

    Aimi, Masahito; Amano, Chika; Yoshida, Rika; Matsubara, Takeshi; Mikami, Hironobu; Izumi, Daisuke; Okimoto, Eiko; Ishimura, Norihisa; Ishihara, Shunji; Kinoshita, Yoshikazu

    2015-01-01

    Superior mesenteric artery (SMA) dissection without aortic dissection is a rare condition, and its diagnosis is considered to be difficult. Intestinal infarction is a severe complication of the disease, which may require resection of the intestine. We present a case of isolated SMA dissection. A 53-year-old man experienced sudden pain in the abdomen while playing Japanese pinball and was admitted to our hospital due to acute abdominal symptoms of uncertain cause. Enhanced CT revealed a defect of the root of the SMA, while angiography and intravascular ultrasound findings showed dissection of the SMA wall. Conservative treatment was chosen at the time, while a part of the small intestine was eventually resected because of progressive ischemia. Although SMA dissection is a rare occurrence in cases with acute abdominal symptoms, awareness of the condition is important for differential diagnosis.

  13. Intraoperative aortic dissection in pediatric heart surgery.

    PubMed

    Hibino, Narutoshi; Harada, Yorikazu; Hiramatsu, Takeshi; Yasukochi, Satoshi; Satomi, Gengi

    2006-06-01

    Intraoperative aortic dissection occurred in a 3-year-old-boy undergoing repair of an atrial septal defect. Transesophageal echocardiography was useful for the diagnosis, and conservative medical treatment under close observation was feasible in this case which involved a limited intimal tear. PMID:16714685

  14. Alternatives To Dissection. Second Edition.

    ERIC Educational Resources Information Center

    DeRosa, Bill, Ed.; Winiarskyj, Lesia, Ed.

    This packet attempts to provide educationally sound alternatives to dissection in the classroom, thereby making it possible for teachers to eliminate dissection from the curriculum. This packet can also be used by educators who include dissection in their curricula but consider it important to respect the expression of students' ethical, moral, or…

  15. Dissecting Diversity Part II

    ERIC Educational Resources Information Center

    Matthews, Frank

    2005-01-01

    This article presents "Dissecting Diversity, Part II," the conclusion of a wide-ranging two-part roundtable discussion on diversity in higher education. The participants were as follows: Lezli Baskerville, J.D., President and CEO of the National Association for Equal Opportunity (NAFEO); Dr. Gerald E. Gipp, Executive Director of the American…

  16. Bare Stent Implantation in Iatrogenic Dissecting Pseudoaneurysm of the Superior Mesenteric Artery

    SciTech Connect

    Kutlu, Ramazan Ara, Cengiz; Sarac, Kaya

    2007-02-15

    Iatrogenic arterial dissection leading to the development of dissecting pseudoaneurysms of the superior mesenteric artery (SMA) is a rare complication of angiography. Surgical and endovascular treatment options exist for this important condition. We report a case of bare stent implantation in dissecting pseudoaneurysm of the SMA that developed after angiography in a patient with acute mesenteric ischemia. Although it is rarely published, iatrogenic arterial dissection causing pseudoaneurysm can occur after diagnostic and interventional angiography. Bare stent implantation in dissecting pseudoaneurysm of the SMA could be an advantageous endovascular treatment option in selected cases due its to potential preservation of important side branches of the SMA.

  17. Dissecting intramyocardial hematoma after robotic mitral valve repair.

    PubMed

    McGrath, Tory; Ushukumari, Deepu; Canale, Leonardo; Gillinov, Marc

    2015-03-01

    We report the first case of a dissecting intramyocardial hematoma discovered intraoperatively after robotic mitral valve repair, potential etiologies relevant to robotic surgery, and its successful management. PMID:25742825

  18. 75 FR 56093 - Eagle Rock Desoto Pipeline, LP; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-15

    ... Energy Regulatory Commission Eagle Rock Desoto Pipeline, LP; Notice of Motion for Extension of Rate Case Filing Deadline September 8, 2010. Take notice that on September 8, 2010, Eagle Rock Desoto Pipeline, L.P. (Eagle Rock) filed a request to extend the date for filing its next rate case to May 1, 2012. Eagle...

  19. Isolated Spontaneous Renal Artery Dissection Presented with Flank Pain

    PubMed Central

    Gandhi, Shruti P.; Patel, Kajal; Pal, Bipin C.

    2015-01-01

    Spontaneous renal artery dissection is a rare but important cause of flank pain. We report a case of isolated spontaneous renal artery dissection in 56-year-old man complicated by renal infarction presented with flank pain. Doppler study pointed towards vascular pathology. Computed tomography (CT) angiography was used to make final diagnosis which demonstrated intimal flap in main renal artery with renal infarction. PMID:26090259

  20. Sequential multiple visceral arteries dissections without aortic involvement.

    PubMed

    Bonardelli, Stefano; Battaglia, Giuseppe; Zanotti, Camilla; Cervi, Edoardo; Guadrini, Cristina; Giulini, Stefano M

    2013-05-01

    Isolated dissection of visceral arteries without associated aortic pathology is very rare. Risk factors, etiology, and natural history of this pathology continue to be unclear, and the guidelines for clinical management remain to be defined. We present a case not described previously, with sequential dissections of the celiac trunk, superior mesenteric artery, and renal arteries without aortic involvement. The patient presented with severe back thoracic and abdominal pain and without evidence of peritonitis. An abdominal angio-CT scan showed dissection of the superior mesenteric artery (SMA), with partial thrombosis of the false lumen and subsequent stenosis of around 60%. Conservative treatment with anticoagulants seemed to be appropriate in the beginning, because the patient became asymptomatic spontaneously within a few hours and angio-CT showed dissection but no ischemic lesions. On day 10 after onset, however, he again indicated severe back thoracic and abdominal pain. Emergent CT was performed. The prior SMA dissection appeared to be worse due to increased size of the false lumen, followed by SMA stenosis (about 75?80%). In addition, dissection of the celiac artery and both renal arteries could be seen. The patient underwent angiography and stenting of the main trunk of the SMA, with good clinical and radiologic outcome. Double oral antiplatelet therapy was then introduced. An angio-MRI scan 6 months later showed stability of the multiple dissections. PMID:23522441

  1. "Dissection" of a Hair Dryer

    ERIC Educational Resources Information Center

    Eisenstein, Stan; Simpson, Jeff

    2008-01-01

    The electrical design of the common hair dryer is based almost entirely on relatively simple principles learned in introductory physics classes. Just as biology students dissect a frog to see the principles of anatomy in action, physics students can "dissect" a hair dryer to see how principles of electricity are used in a real system. They can…

  2. Automatic Dissection Of Plantlets

    NASA Astrophysics Data System (ADS)

    Batchelor, B. G.; Harris, I. P.; Marchant, J. A.; Tillett, R. D.

    1989-03-01

    Micropropagation is a technique used in horticulture for generating a monoclonal colony of plants. A tiny plantlet is cut into several parts, each of which is then replanted. At the moment, the cutting is performed manually. Automating this task would have significant economic benefits. A robot designed to dissect plants would need to be equipped with intelligent visual sensing. This article is concerned with the image acquisition and processing techniques which such a machine might use. A program, which can calculate where to cut a plant with an "open" structure, is presented. This is expressed in the ProVision language, which is described in another article presented at this conference. (Article 1002-65)

  3. Acute Myocardial Infarction Due to Spontaneous Dissection of the Right Coronary Artery in a Young Male

    SciTech Connect

    Papadopoulos, Dimitris P. Moyssakis, Ioannis; Perakis, Alexandros; Athanasiou, Andreas; Anagnostopoulou, Sophia; Benos, Ioannis; Votteas, Vassilios E.

    2004-09-15

    Spontaneous coronary artery dissection is a rare cause of acute myocardial infarction. We report a case of a 33-year-old male who presented with an acute inferior myocardial infarction. Coronary arteriography performed 3 hours after the episode revealed a dissection involving the middle segment of right coronary artery. Because of a spiral form of dissection and the TIMI 3 flow grade, our patient was treated medically and repeat coronary angiography 6 months later was decided.

  4. Experience with parametric binary dissection

    NASA Technical Reports Server (NTRS)

    Bokhari, Shahid H.

    1993-01-01

    Parametric Binary Dissection (PBD) is a new algorithm that can be used for partitioning graphs embedded in 2- or 3-dimensional space. It partitions explicitly on the basis of nodes + (lambda)x(edges cut), where lambda is the ratio of time to communicate over an edge to the time to compute at a node. The new algorithm is faster than the original binary dissection algorithm and attempts to obtain better partitions than the older algorithm, which only takes nodes into account. The performance of parametric dissection with plain binary dissection on 3 large unstructured 3-d meshes obtained from computational fluid dynamics and on 2 random graphs were compared. It was showm that the new algorithm can usually yield partitions that are substantially superior, but that its performance is heavily dependent on the input data.

  5. 76 FR 36913 - Washington Gas Light Company; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-23

    ... From the Federal Register Online via the Government Printing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Washington Gas Light Company; Notice of Motion for Extension of Rate Case Filing Deadline Take notice that on June 15, 2011, Washington Gas Light Company (Washington Gas) filed...

  6. 76 FR 18754 - J-W Pipeline Company; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-05

    ... Energy Regulatory Commission J-W Pipeline Company; Notice of Motion for Extension of Rate Case Filing... desiring to participate in this rate proceeding must file a motion to intervene or to protest this filing... to become a party must file a notice of intervention or motion to intervene, as appropriate....

  7. 76 FR 2902 - National Fuel Gas Distribution Corporation; Notice of Motion for Extension of Rate Case Filing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... Motion for Extension of Rate Case Filing Deadline January 11, 2011. Take notice that on January 10, 2011...). Any person desiring to participate in this rate proceeding must file a motion to intervene or to... proceeding. Any person wishing to become a party must file a notice of intervention or motion to...

  8. 75 FR 70752 - ONEOK WesTex Transmission, LLC; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-18

    ... Energy Regulatory Commission ONEOK WesTex Transmission, LLC; Notice of Motion for Extension of Rate Case... desiring to participate in this rate proceeding must file a motion to intervene or to protest this filing... to become a party must file a notice of intervention or motion to intervene, as appropriate....

  9. 76 FR 23808 - Humble Gas Pipeline Company; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-28

    ... Energy Regulatory Commission Humble Gas Pipeline Company; Notice of Motion for Extension of Rate Case...,150 (May 20, 2010). Any person desiring to participate in this rate proceeding must file a motion to... the proceeding. Any person wishing to become a party must file a notice of intervention or motion...

  10. 76 FR 39869 - Lee 8 Storage Partnership; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-07

    ... Energy Regulatory Commission Lee 8 Storage Partnership; Notice of Motion for Extension of Rate Case...,150 (May 20, 2010). Any person desiring to participate in this rate proceeding must file a motion to... the proceeding. Any person wishing to become a party must file a notice of intervention or motion...

  11. 76 FR 76711 - DCP Raptor Pipeline, LLC; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ... Energy Regulatory Commission DCP Raptor Pipeline, LLC; Notice of Motion for Extension of Rate Case Filing...). Any person desiring to participate in this rate proceeding must file a motion to intervene or to... proceeding. Any person wishing to become a party must file a notice of intervention or motion to...

  12. 76 FR 40907 - Ohio Valley Hub, LLC; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-12

    ... Energy Regulatory Commission Ohio Valley Hub, LLC; Notice of Motion for Extension of Rate Case Filing... desiring to participate in this rate proceeding must file a motion to intervene or to protest this filing... to become a party must file a notice of intervention or motion to intervene, as appropriate....

  13. 76 FR 81927 - EasTrans, LLC; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... Energy Regulatory Commission EasTrans, LLC; Notice of Motion for Extension of Rate Case Filing Deadline...). Any person desiring to participate in this rate proceeding must file a motion to intervene or to... proceeding. Any person wishing to become a party must file a notice of intervention or motion to...

  14. 76 FR 41240 - Northwest Natural Gas Company; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... Energy Regulatory Commission Northwest Natural Gas Company; Notice of Motion for Extension of Rate Case... file a motion to intervene or to protest this filing must file in accordance with Rules 211 and 214 of... or motion to intervene, as appropriate. Such notices, motions, or protests must be filed on or...

  15. 76 FR 51969 - New Mexico Gas Company, Inc.; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-19

    ... Energy Regulatory Commission New Mexico Gas Company, Inc.; Notice of Motion for Extension of Rate Case...,150 (May 20, 2010). Any person desiring to participate in this rate proceeding must file a motion to... the proceeding. Any person wishing to become a party must file a notice of intervention or motion...

  16. Refractory dissecting Cellulitis of the Scalp Successfully controlled with Adalimumab.

    PubMed

    Martin-García, Rafael F; Rullán, Jennifer M

    2015-06-01

    Dissecting cellulitis of the scalp (DCS) is an uncommon inflammatory disease that often results in scarring alopecia. Numerous therapies have either proved ineffective or only temporarily effective in the management of this condition. Recent reports show adequate responses to tumor necrosis factor (TNF) inhibitors in cases of DCS. We report a case of severe recalcitrant DCS successfully treated with adalimumab. PMID:26061062

  17. Damage to white matter pathways in subacute and chronic spatial neglect: a group study and 2 single-case studies with complete virtual "in vivo" tractography dissection.

    PubMed

    Thiebaut de Schotten, Michel; Tomaiuolo, Francesco; Aiello, Marilena; Merola, Sheila; Silvetti, Massimo; Lecce, Francesca; Bartolomeo, Paolo; Doricchi, Fabrizio

    2014-03-01

    The exact anatomical localization of right hemisphere lesions that lead to left spatial neglect is still debated. The effect of confounding factors such as acute diaschisis and hypoperfusion, visual field defects, and lesion size may account for conflicting results that have been reported in the literature. Here, we present a comprehensive anatomical investigation of the gray- and white matter lesion correlates of left spatial neglect, which was run in a sample 58 patients with subacute or chronic vascular strokes in the territory of the right middle cerebral artery. Standard voxel-based correlates confirmed the role played by lesions in the posterior parietal cortex (supramarginal gyrus, angular gyrus, and temporal-parietal junction), in the frontal cortex (frontal eye field, middle and inferior frontal gyrus), and in the underlying parietal-frontal white matter. Using a new diffusion tensor imaging-based atlas of the human brain, we were able to run, for the first time, a detailed analysis of the lesion involvement of subcortical white matter pathways. The results of this analysis revealed that, among the different pathways linking parietal with frontal areas, damage to the second branch of the superior longitudinal fasciculus (SLF II) was the best predictor of left spatial neglect. The group study also revealed a subsample of patients with neglect due to focal lesion in the lateral-dorsal portion of the thalamus, which connects the premotor cortex with the inferior parietal lobule. The relevance of fronto-parietal disconnection was further supported by complete in vivo tractography dissection of white matter pathways in 2 patients, one with and the other without signs of neglect. These 2 patients were studied both in the acute phase and 1 year after stroke and were perfectly matched for age, handedness, stroke onset, lesion size, and for cortical lesion involvement. Taken together, the results of the present study support the hypothesis that anatomical disconnections leading to a functional breakdown of parietal-frontal networks are an important pathophysiological factor leading to chronic left spatial neglect. Here, we propose that different loci of SLF disconnection on the rostro-caudal axis can also be associated with disconnection of short-range white matter pathways within the frontal or parietal areas. Such different local disconnection patterns can play a role in the important clinical variability of the neglect syndrome. PMID:23162045

  18. Pregnancy after a previous gestation complicated by an acute aortic dissection.

    PubMed

    Rodrigues, Cátia; Pinto, Luísa; Clode, Nuno; Almeida, Ana G; Cardoso, Conceição; Graça, Luís M

    2009-10-01

    Acute aortic dissection is a rare life-threatening event. No further pregnancies in women who had a previous acute aortic dissection have been reported. We present the case of a chronic hypertensive woman, who in her previous gestation was submitted to an acute aortic dissection repair at 28 weeks of gestation with cesarean delivery at the same operative procedure. The index pregnancy was uneventful. An elective cesarean was performed at 33 weeks' gestation. Aneurysm expansion, rupture or redissections are potential complications of operated aortic dissection. Normal blood pressure values and close cardiologic and obstetrical follow-up are essential to obtain a favourable outcome. PMID:19488938

  19. Ischemia-reperfusion injury in an aortic dissection patient.

    PubMed

    Yin, Zhuo; Yang, J R; Wei, Y S; Liang, B L; Wei, Y B; Zhou, K Q; Wang, Z; Yan, B; Gao, Y L

    2015-07-01

    Aortic dissection is a life-threatening emergency. Well-established risk factors include systemic hypertension, hereditary connective tissue diseases (Marfan syndrome and Ehlers-Danlos syndrome), coarctation of the aorta, bicuspid aortic valve, aortitis, and arch hypoplasia. Ischemia of the viscera, the kidneys, the spinal cord, or the lower extremities due to malperfusion constitutes life-threatening complications that have to be considered in the treatment strategy.We report a rare case of symptomatic ischemia of the lower extremities due to aortic dissection. This case demonstrates that the treating physician needs to be vigilant for ischemia reperfusion injuries such as osteofascial compartment syndrome and acute renal failure in aortic dissection. PMID:25667158

  20. [Acute coronary syndrome during dissection of left main as a complication of radiofrequency ablation].

    PubMed

    Kulawik, Tomasz; Ka?u?a, Bernadetta; Ku?nierz, Jacek

    2012-01-01

    We present a case of 44 year-old female who was admitted to the hospital due to performed radio frequency ablation because of VF during WPW syndrome, which was complicated by dissection of left main. The dissection was treated with success by primary percutaneous coronary intervention with two metal stents. PMID:22427091

  1. Cervical Artery Dissection: A Review of the Epidemiology, Pathophysiology, Treatment, and Outcome

    PubMed Central

    Blum, Christina A.; Yaghi, Shadi

    2015-01-01

    Context Cervical artery dissection (CAD) is a common cause of stroke in young adults. There is controversy over whether anticoagulation is superior to antiplatelet therapy in preventing stroke in patients with CAD, although meta-analyses to date have not shown any difference between the two treatments. Evidence acquisition We performed a PubMed search using each of the keywords: “Cervical artery dissection”, “Dissection”, “Carotid dissection”, and “Vertebral dissection” between January 1st, 1990 and July 1st 2015. We identified evidence-based peer-reviewed articles, including randomized trials, case series and reports, and retrospective reviews that encompass the epidemiology, clinical manifestations, pathophysiology, treatment, and outcome of cervical artery dissection. Results This paper highlights the mechanisms of cervical artery dissection and stroke in patients with dissection as well as the natural history and treatment. Conclusion Given the relatively rare incidence of this disease, multicenter studies with collaborative effort among stroke centers worldwide should be considered to enroll patients with cervical artery dissection in a randomized trial comparing the two treatments. PMID:26478890

  2. Dissect Your Squid and Eat It Too!

    ERIC Educational Resources Information Center

    McGinnis, Patricia

    2001-01-01

    Introduces a science lab activity in which students dissect fresh squids in groups of four and observe the anatomy. Parent volunteers cook the squid mantle for kids to taste. Includes directions for squid dissection. (YDS)

  3. A sinister cause of anterograde amnesia: painless aortic dissection.

    PubMed

    April, Michael D; Fossum, Kurt; Hounshell, Charles; Stolper, Katherine; Spear, Leigh; Semelrath, Kevin

    2015-07-01

    Aortic dissection is a frequently devastating diagnosis classically associated with severe chest pain.We present a case of painless aortic dissection with anterograde amnesia. An 84-year-old man was brought to the emergency department by ambulance, when his wife noted that he developed acute onset complete loss of short-term memory. Medical history was notable for a 4.5-cm fusiform thoracic aortic root aneurysm. On arrival,he denied pain or syncope.On examination, he was mildly hypotensive(110/59 mm Hg); and there were no murmurs, pulse deficits, or focal neurologic deficits. During his stay, he developed left flank pain. Chest radiography demonstrated subtle mediastinal widening and obscuration of the aortic knob compared with previous films. Computed tomography revealed an extensive intimal flap consistent with an aortic dissection involving the sinus of Valsalva and left renal artery. The patient subsequently developed acute onset chest pain after which he became unresponsive. Echocardiography demonstrated tamponade physiology.The family decided to transition to comfort care measures, and the patient died soon after.We identified 7 other cases in the literature of aortic dissection cases with presentations consistent with transient global amnesia,5 of which without neurologic deficits and 3 of which without pain. This case highlights the imperative of a thorough history and high index of suspicion for this catastrophic diagnosis in patients with transient global amnesia who otherwise might be expected to have an excellent prognosis and little need for diagnostic work-up. PMID:25649752

  4. Nested Dissection: A survey and comparison of various nested dissection algorithms

    E-print Network

    Miller, Gary L.

    Nested Dissection: A survey and comparison of various nested dissection algorithms Manpreet S on gaussian elimination. This report discusses one such direct method namely Nested dissection. Nested. This report is a survey of some of the work in the area of nested dissection and attempts to put it together

  5. Evaluation of Educator & Student Use of & Attitudes toward Dissection & Dissection Alternatives

    ERIC Educational Resources Information Center

    Osenkowski, Pamela; Green, Che; Tjaden, Anne; Cunniff, Peggy

    2015-01-01

    Animal dissection has been routinely practiced in American biology classrooms for decades. With technological advancements, more states adopting student choice measures, and increased awareness about ethical concerns surrounding dissection, many useful dissection alternatives have been developed. To understand the current use of animal dissection

  6. Animal Rights Activism Threatens Dissection.

    ERIC Educational Resources Information Center

    Holden, Constance

    1990-01-01

    Discussed is the movement against the use of dissections in science laboratories. Examples of protests across the United States are included. Compared is the plight of using animals in a biology classroom and the demise of the teaching of evolution in some areas. (KR)

  7. Dissection & Science Fairs. [Information Packet.

    ERIC Educational Resources Information Center

    National Anti-Vivisection Society, Chicago, IL.

    This collection of pamphlets and articles reprinted from other National Anti-Vivisection Society (NAVS) publications was compiled to address the issues of classroom laboratory dissection and the use of animals in science fair projects. Three of the pamphlets contained in this packet are student handbooks designed to help students of elementary,…

  8. Selective Neck Dissection (IIa, III): A Rational Replacement for Extended Supraomohyoid Neck Dissection in Patients with N0 Supraglottic and Glottic Squamous Cell Carcinoma

    PubMed Central

    Zohdi, Ismail; El Sharkawy, Louay S; El Bestar, Mahmoud F; Abdel Tawab, Hazem M; Hamela, Mo’men AA; Hareedy, Amal A

    2015-01-01

    OBJECTIVES To evaluate the effectiveness of selective neck dissection of sublevel IIa and level III in cases of glottis and supraglottic laryngeal carcinoma in the absence of lymph node metastasis and to show if there is value in dissecting the sublevel IIb or level IV in these cases. PATIENTS AND METHODS Twenty-five patients with N0 glottic or supraglottic cancer were subjected to unilateral or bilateral selective neck dissection according to the site and the extent of the tumor, and the specimens were histopathologically examined for metastasis. RESULTS Twenty-five patients (23 males and 2 females) with mean age of 55.72 years were included in the study. Lymph node metastasis to sublevel IIa and level III was found in 6/25 (24%) cases with glottic or supraglottic carcinoma, while to sublevel IIb and level IV was found in 1/25 (4%) with P-value of 0.05, which is statistically significant. CONCLUSION Selective neck dissection of level IIb is not required in cases of the supraglottic laryngeal cancer. Dissection of sublevel IIa and level III takes less time and is effective. Dissection of level IV is not needed in the case of supraglottic cancer. PMID:25733946

  9. 75 FR 73075 - Calpine Texas Pipeline, L.P.; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-29

    ... Energy Regulatory Commission Calpine Texas Pipeline, L.P.; Notice of Motion for Extension of Rate Case.... (Calpine Texas) filed a motion to extend the date for filing its next rate case to August 22, 2013. Calpine... file a motion to intervene or to protest this filing must file in accordance with Rules 211 and 214...

  10. Stent-assisted coil embolization for anterior cerebral artery dissection presented with cerebral infarction

    PubMed Central

    Iwasaki, Mitsuhiro; Hattori, Itaro; Sasaki, Makoto; Ishimori, Hisatsugu; Nemoto, Akihiro; Hikita, Chiyoe; Sato, Junko; Fukuta, Shinya; Morimoto, Masafumi

    2015-01-01

    Background: Compared to those found in the vertebrobasilar system, intracranial dissection in the anterior circulation is relatively rare, especially in the anterior cerebral artery (ACA). Moreover, only several cases of ACA dissection that underwent endovascular treatment have been reported. Here we present a rare case of gradually developing ACA dissecting aneurysm causing cerebral infarction, successfully treated by stent-assisted coil embolization. Case Description: A 36-year-old man was admitted with sudden right hemiparesis. Diffusion-weighted magnetic resonance (MR) imaging showed cerebral infarction in the left ACA territory, and MR angiography showed segmental stenosis at the A2 portion of the left ACA. Three-dimensional digital subtraction angiogram showed segmental dilatation and stenosis at the left A2 portion. We diagnosed ACA dissection causing acute cerebral infarction and treated the patient conservatively. Five months after the onset, the dissecting artery at the left A2 portion formed a gradually dilating aneurysm, suggesting increased risk for aneurysmal rupture. We attempted endovascular treatment entailing coil embolization of an aneurysm while preserving the left A2 with stent assistance. The patient remained neurologically stable 6 months after the procedure. Conclusions: Although there are few reported cases of ACA dissection where endovascular treatment was attempted, we consider stent-assisted embolization for gradually developing ACA dissecting aneurysm as an alternative method to prevent bleeding and recurrent infarction. PMID:26677416

  11. A rare complication of pre-Eisenmenger patent ductus arteriosus: Pulmonary artery dissection

    PubMed Central

    Ay, Yasin; Ay, Nuray Kahraman; Aydin, Cemalettin; Kara, Ibrahim; Zeybek, Rahmi

    2013-01-01

    INTRODUCTION Pulmonary artery dissection associated with patent ductus arteriosus is usually seen in patients with pulmonary hypertension and Eisenmenger's syndrome. This paper presents a case with pre-Eisenmenger patent ductus arteriosus complicated by pulmonary artery dissection, and explains how she was surgically treated. PRESENTATION OF CASE The transthoracic echocardiography of a 21-year-old woman complaining of effort dyspnea revealed patent ductus arteriosus. Contrast-enhanced thoracic computed tomography scan showed patent ductus arteriosus and dissection in the main pulmonary artery extending from the edge of the patent ductus arteriosus orifice to the pulmonary valve. The patent ductus arteriosus was divided with pledgeted prolene suture and the dissected aneurysmal portion of the pulmonary artery was resected by surgery. Dacron graft interposition was applied to the main pulmonary artery. DISCUSSION Because rupture causes cardiogenic shock and sudden death, diagnosis is rare in the living subject and pulmonary artery dissection is frequently detected in autopsy. A case with pulmonary artery dissection as a result of patent ductus arteriosus has been reported in the literature, but the patient died in the preoperative period. In our study, the patient was not diagnosed to have Eisenmenger's syndrome, but had pulmonary artery dissection, a complication arising from patent ductus arteriosus. The patient underwent curative surgery that included pulmonary artery dissection repair and closure of the patent ductus arteriosus. CONCLUSION In addition to pulmonary artery aneurysm, pulmonary artery dissection must also be considered as a complication in cases of patent ductus arteriosus with high pulmonary artery pressure diagnosed in adulthood. PMID:23562897

  12. Endovascular coil trapping of a ruptured dissecting aneurysm of the vertebral artery using detachable coils and micro-tornado® coils.

    PubMed

    Kim, Myeong-Soo

    2013-06-01

    We experienced a patient with a ruptured dissecting aneurysm of the vertebral artery who was treated by trapping of the lesion using Guglielmi detachable coils (GDCs) with micro-tornado® coils (MTCs). An 80-year-old male was transferred with a ruptured left vertebral artery dissecting aneurysm (VADA). The dissected portion of the vertebral artery was effectively trapped using GDCs and MTCs. The MTCs used for neurointervention were comprised of various types of coils and we successfully placed them into the parent artery of the dissected segment. The author suggests that this case demonstrates the usefulness of endovascular coil trapping of VADAs using MTCs in achievement of embolization. PMID:23844353

  13. Advanced endovascular techniques for thoracic and abdominal aortic dissections.

    PubMed

    Kölbel, T; Diener, H; Larena-Avellaneda, A; Debus, S

    2013-02-01

    Endovascular treatment of aortic dissection is still in its infancy and consists usually of implantation of thoracic tubular stent-grafts to cover the proximal entry tear and redirect flow into the true lumen. Large registries comparing endovascular treatment by thoracic endovascular aortic repair (TEVAR) with open surgery for aortic dissection of the descending aorta have demonstrated a clear benefit for endovascular treatment with lower mortality and morbidity rates turning TEVAR into the standard treatment for complicated type B aortic dissection. With this momentum of success endovascular techniques continue to challenge open surgical techniques also in the aortic arch and the ascending aorta. TEVAR for aortic dissection has become more complex requiring an individualized treatment strategy as endovascular techniques have developed with the advent of new devices and increased experience of the operators. In many cases straight implantation of a thoracic tubular stent-graft is sufficient. But as rerouting of the blood flow can also change perfusion of vital side-branches the endovascular operator needs to have a large armamentarium of techniques and adjunctive procedures in order to sufficiently address the individual patient morphology. This chapter reviews a variety of endovascular techniques including access techniques, proximal sealing, the Petticoat-technique, false lumen deployment, fenestration techniques, branch vessel stenting and false lumen obstruction by various techniques. PMID:23443592

  14. Unexpected Delayed Colon Perforation after the Endoscopic Submucosal Dissection with Snaring of a Laterally Spreading Tumor

    PubMed Central

    Ko, Young Bo; Lee, Jeong-Mi; Kim, Wan Soo; Kwak, Min Seob; Lee, Ji Wan; Shin, Dong Yeol; Yang, Dong-Hoon; Byeon, Jeong-Sik

    2015-01-01

    Colonic perforation may occur as a complication of diagnostic and therapeutic colonoscopy. The risk factors for perforation after colorectal endoscopic submucosal dissection (ESD) include an inexperienced endoscopist, a large tumor size, and submucosal fibrosis. The mechanisms of perforation include unintended endoscopic resection/dissection and severe thermal injury. Here, we report a case of colon perforation that occurred after ESD with snaring of a laterally spreading tumor. The perforation was completely unexpected because there were no colorectal ESD-associated risk factors for perforation, deep dissection, or severe coagulation injury in our patient. PMID:26668808

  15. Delayed Intestinal Ischemia after Surgery for Type A Acute Aortic Dissection

    PubMed Central

    Kato, Yasuyuki; Motoki, Manabu; Takahashi, Yosuke; Nishimura, Shinsuke; Shibata, Toshihiko

    2015-01-01

    We report a rare case of delayed intestinal ischemia after total arch replacement for type A acute aortic dissection. At the onset of acute aortic dissection, computed tomography (CT) angiography revealed celiac trunk occlusion and progressive dissection into the superior mesenteric artery without stenosis. However, following total arch replacement, visceral malperfusion was not detected by exploratory laparotomy. On postoperative day 12, the patient developed paralytic ileus without an elevated lactate level. CT angiography revealed new superior mesenteric artery stenosis by a thrombosed false lumen with persistent celiac trunk occlusion. Endovascular treatment including stent implantation resolved intestinal ischemia. PMID:26421078

  16. Delayed Intestinal Ischemia after Surgery for Type A Acute Aortic Dissection.

    PubMed

    Morisaki, Akimasa; Kato, Yasuyuki; Motoki, Manabu; Takahashi, Yosuke; Nishimura, Shinsuke; Shibata, Toshihiko

    2015-01-01

    We report a rare case of delayed intestinal ischemia after total arch replacement for type A acute aortic dissection. At the onset of acute aortic dissection, computed tomography (CT) angiography revealed celiac trunk occlusion and progressive dissection into the superior mesenteric artery without stenosis. However, following total arch replacement, visceral malperfusion was not detected by exploratory laparotomy. On postoperative day 12, the patient developed paralytic ileus without an elevated lactate level. CT angiography revealed new superior mesenteric artery stenosis by a thrombosed false lumen with persistent celiac trunk occlusion. Endovascular treatment including stent implantation resolved intestinal ischemia. PMID:26421078

  17. 77 FR 12598 - Notice Correction; A Multi-Center International Hospital-Based Case-Control Study of Lymphoma in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ...-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) The Federal Register notice published on February 24, 2012 (77 FR 11136) announcing the submission to OMB of the project titled, ``A multi-center international hospital-based case-control study of lymphoma in Asia (AsiaLymph) (NCI)'' was submitted with...

  18. A sneeze: an unusual trigger for aortic dissection

    PubMed Central

    Upadhyaya, Subramanya G N; Large, A

    2013-01-01

    We describe a rare case of type B thoracic aortic dissection resulting from a forceful sneeze in a 57-year-old man. The presenting clinical features were not typical and consisted of pleuritic chest pain and breathlessness following a forceful sneeze. There was no haemodynamic compromise. The diagnosis was made incidentally when he underwent a CT pulmonary angiography as part of pulmonary embolism work-up. PMID:24302662

  19. Renal Infarction Caused by Spontaneous Renal Artery Dissection: Treatment with Catheter-Directed Thrombolysis and Stenting

    SciTech Connect

    Jeon, Yong Sun Cho, Soon Gu; Hong, Ki Cheon

    2009-03-15

    Spontaneous renal artery dissection (SRAD) is rare and presents a diagnostic and therapeutic challenge. We report a case of a 36-year-old man who had an SRAD-complicated renal infarction. The patient experienced severe unilateral flank pain. Enhanced abdominal computed axial tomography scan showed renal infarction, and urinalysis showed no hematuria. Selective renal angiography was essential to evaluate the extent of dissection and suitability for repair. The patient was treated with catheter-directed thrombolysis and frenal artery stenting.

  20. Malignant Middle Cerebral Artery Infarction Resulting from Dissection of Middle Cerebral Artery.

    PubMed

    Sakuta, Kenichi; Sengoku, Renpei; Mitsumura, Hidetaka; Kono, Yu; Kan, Issei; Kaku, Shogo; Iguchi, Yasuyuki

    2015-10-01

    A 30-year-old man presented with headache, left hemiparesis, and uncal herniation. Magnetic resonance imaging showed acute infarction in the right middle cerebral artery (MCA). Lifesaving craniotomy proceeded because of the uncal herniation. Assessment of brain tissue led to a diagnosis of MCA dissection. His skin biopsy showed ultrastructural abnormalities of dermal connective tissue. This is the unique case that dissection was diagnosed from both a biopsy specimen of the MCA and the dermal connective tissue. PMID:26279098

  1. The Institute of Surgery and Innovation Trunk Flap Dissection Course.

    PubMed

    Rossi, Sabrina Helena; Mestak, Ondrej; Stampolidis, Nektarios; Vasconcelos, Inês

    2015-11-01

    The Institute of Surgery and Innovation Trunk Flap Dissection Course is a biannual two day course, which covers dissection of flaps in the anterior and posterior trunk on fresh-frozen cadavers. The event is run by the Institute of Surgery and Innovation, and it was held for the first time in November 2013, at the Nottingham City Hospital Training Centre. The course was taught in English by senior faculty from the Department of Plastic Surgery of Nottingham University.The first day was dedicated to raising 8 flaps in the anterior chest and abdomen, while the second day was dedicated to 6 flaps in the posterior trunk and buttocks.There were 3 participants per dissection table and the faculty to participant ratio was 2:1, allowing close supervision and one-on-one teaching. Each flap was briefly introduced by a 10-minute presentation, followed by a live demonstration of how to raise the flap by one of the faculty. The main advantage of this course is that the focus is on practical dissection, rather than lectures. The presentations that were given had a very personal feel, describing real cases encountered in the faculty's previous experience. This served as a platform to discuss dissection tips, tricks, and common pitfalls. Flaps represent the basis of reconstructive surgery; however, they are often taught late in the professional course of a residency as they are technically challenging. This course offers the opportunity to practice skills and receive very comprehensive feedback from experienced faculty.The event is open to trainees of all levels, and it attracted very junior as well as senior trainees from across Europe, thus offering an international prospective.The course's affordability is a luring feature and the excellent content and quality of teaching makes it a highly valuable experience, which I would widely recommend to trainees of all levels. PMID:25003434

  2. Quick Dissection of the Segmental Bronchi

    ERIC Educational Resources Information Center

    Nakajima, Yuji

    2010-01-01

    Knowledge of the three-dimensional anatomy of the bronchopulmonary segments is essential for respiratory medicine. This report describes a quick guide for dissecting the segmental bronchi in formaldehyde-fixed human material. All segmental bronchi are easy to dissect, and thus, this exercise will help medical students to better understand the…

  3. Keeping Dissection Alive for Medical Students

    ERIC Educational Resources Information Center

    Chambers, James; Emlyn-Jones, Daniel

    2009-01-01

    Traditional dissection teaching is being reduced in a number of medical schools, particularly in the United Kingdom. In response to this, 12 medical students from Warwick University, UK, traveled to the Island of Grenada for an intensive extracurricular dissection course at St. George's University. This course not only benefited the host…

  4. Beyond Dissection: Innovative Tools for Biology Education.

    ERIC Educational Resources Information Center

    Larson, Sandra, Ed.

    This catalog lists resources available for classroom use in teaching about anatomy and physiology which are alternatives to dissection. The entries are provided under three main categories: (1) Whole Animal Dissection/Vivisection; (2) Animal Organ or System Anatomy and Physiology; and (3) Other, including animal behavior, biotechnology,…

  5. Direct thrombus aspiration using the Penumbra system for the treatment of pediatric intracranial dissection.

    PubMed

    Fujimoto, Motoaki; Tateshima, Satoshi; Ali, Latisha; Raychev, Radoslav; Vinuela, Fernando

    2013-11-01

    We describe a case of a 15-year-old girl who developed a spontaneous intracranial arterial dissection with distal middle cerebral artery (MCA) occlusions. From the digital subtraction angiography provided, the dissection flap appeared to originate at the internal carotid artery terminus with extension into the right M1 segment and occluding the right anterior cerebral artery, A1 segment. CT perfusion study showed salvageable tissue in the posterior MCA territory, including the motor cortex. In order to avoid further injury to the dissection, clot retrieval systems were not a treatment option. We therefore performed selective thrombus aspiration with the Penumbra system for the occluded central and precentral arteries distal to the non-occlusive dissecting lesion. Sufficient recanalization was achieved and the patient made a marked recovery. Although mechanical thrombectomy with the use of retrieval intracranial stent systems has demonstrated satisfactory recanalization rates, the aspiration methodology remains useful for patients with an accompanying proximal vascular lesion. PMID:23188785

  6. Direct thrombus aspiration using the Penumbra system for the treatment of pediatric intracranial dissection.

    PubMed

    Fujimoto, Motoaki; Tateshima, Satoshi; Ali, Latisha; Raychev, Radoslav; Vinuela, Fernando

    2012-01-01

    We describe a case of a 15-year-old girl who developed a spontaneous intracranial arterial dissection with distal middle cerebral artery (MCA) occlusions. From the digital subtraction angiography provided, the dissection flap appeared to originate at the internal carotid artery terminus with extension into the right M1 segment and occluding the right anterior cerebral artery, A1 segment. CT perfusion study showed salvageable tissue in the posterior MCA territory, including the motor cortex. In order to avoid further injury to the dissection, clot retrieval systems were not a treatment option. We therefore performed selective thrombus aspiration with the Penumbra system for the occluded central and precentral arteries distal to the non-occlusive dissecting lesion. Sufficient recanalization was achieved and the patient made a marked recovery. Although mechanical thrombectomy with the use of retrieval intracranial stent systems has demonstrated satisfactory recanalization rates, the aspiration methodology remains useful for patients with an accompanying proximal vascular lesion. PMID:23162036

  7. Temporary Strecker Stent for Management of Acute Dissection in Popliteal and Crural Arteries

    SciTech Connect

    Manke, Christoph; Geissler, Angela; Seitz, Johannes; Lenhart, Markus; Kasprzak, Piotr; Gmeinwieser, Josef; Feuerbach, Stefan

    1999-03-15

    Stent placement is a widely used bail-out treatment for dissection of peripheral arteries. Below the level of the superficial femoral artery permanent stenting is complicated by a high incidence of subacute thrombosis and restenosis. We present two cases of arterial occlusion due to acute iatrogenic dissection of the popliteal and distal fibular arteries. Successful treatment was achieved with a new bail-out procedure. Strecker stents were implanted to seal off the dissection flap. Stents were retrieved easily after 24 hr using a myocardial biopsy forceps. After stent retrieval the temporarily stented segments were patent and showed a larger lumen compared with segments treated by balloon dilatation alone. Temporary stenting is a simple and safe procedure and offers the advantage of tacking up dissection membranes and preventing recoil. Persistent presence of a metallic implant as a source of continued injury and stimulus for intimal proliferation is avoided.

  8. [Neonatal cervical artery dissection secondary to birth trauma].

    PubMed

    Hamida, N; Hakim, A; Fourati, H; Ben Thabet, A; Walha, L; Bouraoui, A; Mnif, Z; Gargouri, A

    2014-02-01

    Cervical artery dissection is rare in the neonatal period and is most often caused by birth injury during dystocic labor. The severity of this pathology is due to the possibility of serious neurological complications. We report a case of a male newborn who was born vaginally after shoulder dystocia. The extraction was difficult, resulting in a fracture of the right humerus. On the second day of life, the child presented generalized clonic convulsions. Computed tomography of the brain showed an ischemic stroke in the territory of the right middle cerebral artery, the territory of the right posterior cerebral artery, and the right lenticulostriate and capsular regions. Doppler ultrasonography and magnetic resonance angiography showed bilateral carotid artery thrombosis and dissection at the left common carotid artery and its two branches and the right vertebral artery. We discuss the mechanisms of this pathology and we emphasize preventive measures. PMID:24290182

  9. Acute aortic dissection: typical and atypical imaging features.

    PubMed

    Fisher, E R; Stern, E J; Godwin, J D; Otto, C M; Johnson, J A

    1994-11-01

    Acute aortic dissection (AAD) is the most common emergency affecting the aorta. Noninvasive imaging allows prompt and reliable diagnosis of AAD and has largely supplanted aortography. However, atypical imaging features and diagnostic pitfalls can delay lifesaving therapy. An intimal flap is the characteristic feature of AAD. If there is flow within both lumina, typical imaging features are probably present. If the false lumen is thrombosed or there is no intimal tear to permit flow through the false lumen, a distinct intimal flap may not be present. Secondary signs of AAD include an intramural or periaortic acute thrombus, which manifests as a high-attenuation cuff or crescent on unenhanced computed tomographic scans. Other conditions that can reduce the conspicuity of the intimal flap include atypical configurations of the flap, such as seen with short dissections or with multiple false channels, in which case the flaps are complex. Finally, aortic anomalies may cause confusion. PMID:7855340

  10. A Case of In-Situ Reconstruction with a Rifampicin-Bonded Gelatin-Sealed Woven Dacron Graft for Prosthetic Graft Infection with Pseudoaneurysms after Ascending Aortic Replacement for Type A Dissection

    PubMed Central

    2014-01-01

    A 74-year-old woman underwent replacement of the ascending aorta for acute type A aortic dissection. The patient suffered from bacteremia postoperatively and repeated computed tomography showed an increasing diameter of pseudoaneurysms at the site of the proximal anastomosis due to graft infection. Re-mechanical Bentall operation and arch replacement were therefore performed using a composite graft of a rifampicin-bonded gelatin-sealed 24-mm woven Dacron graft and a mechanical valve. The postoperative course was uneventful. We report the successful in situ reconstruction using the above-mentioned Dacron graft and describe the preparation of the rifampicin solution using a surfactant. PMID:24719667

  11. Robot-assisted laparoscopic retroperitoneal lymph node dissection for stage IIIb mixed germ cell testicular cancer after chemotherapy

    PubMed Central

    Lee, Sang Hyub; Kim, Dong Soo; Chang, Sung-Goo

    2015-01-01

    Laparoscopic retroperitoneal lymph node dissection, especially when performed with the da Vinci Surgical System (Intuitive Surgical), has shown excellent cosmetic results with similar oncologic outcomes to those of open surgery. In this study, we present a case of robot-assisted retroperitoneal lymph node dissection performed in an 18-year-old man who was diagnosed with a stage IIIb mixed germ cell tumor and who was initially treated with radical orchiectomy, followed by chemotherapy. This case shows that robot-assisted retroperitoneal lymph node dissection is technically feasible, safe, and cosmetically favorable, even when performed on patients with high-stage disease or after chemotherapy. PMID:26175874

  12. Animal Rights Groups Target High School Dissection.

    ERIC Educational Resources Information Center

    Trotter, Andrew

    1992-01-01

    Two groups leading the charge against dissection are People for the Ethical Treatment of Animals (PETA) and the Student Action Corps for Animals (SACA). Protests by student and community members remain the movement's strongest weapon. (MLF)

  13. GPM Dissects Typhoon Hagupit - Duration: 38 seconds.

    NASA Video Gallery

    NASA/JAXA's GPM Dissects Typhoon Hagupit Animation revealing a swath of NASA/JAXA's Global Precipitation Measurement (GPM) mission's Core Observatory GMI precipitation rates over Typhoon Hagupit. A...

  14. Running, ischaemic stroke and carotid artery dissection

    E-print Network

    Evans, N. R.; Harper, V.; Scoffings, D. J.; Warburton, E. A.

    2015-05-13

    (figure 1). The patient was started on longterm aspirin (75mg daily) and atorvastatin (80mg daily) with advice against participating in activities associated with carotid dissection. The residual deficits two days post-presentation were mild loss of fine...

  15. Dissecting genetic interactions in complex traits 

    E-print Network

    Hemani, Gibran

    2012-06-30

    Of central importance in the dissection of the components that govern complex traits is understanding the architecture of natural genetic variation. Genetic interaction, or epistasis, constitutes one aspect of this, but ...

  16. Postoperative hypertension after radical neck dissection.

    PubMed

    Celikkanat, S; Akyol, M U; Koç, C; Olçer, S; Ensari, S; Turgut, S; Ozdem, C

    1997-07-01

    Postoperative hypertension after radical neck dissection was detected in 20.2% of 109 neck dissections in our department between 1989 and 1993. It was probably caused by carotid sinus denervation and appeared after the vasodilation generated by anesthesia had subsided. If postoperative hypertension was encountered after the first operation, the risk of such hypertension after surgery on the contralateral side significantly increased. PMID:9230330

  17. [Dissecting aneurysm of the thoracic aorta--the value of computed tomography].

    PubMed

    Schurawitzki, H; Imhof, H; Gritzmann, N

    1986-06-01

    For the detection and classification of dissection of the thoracic aorta, in cases where a corresponding tentative diagnosis is made on the basis of clinical and plain thorax radiographs with intravenous contrast medium, computed tomography is the method of choice. In cases in which, primarily, a Type A dissection is suspected, catheter angiography is to be preferred to CT, in spite of being the more invasive method, because it is the only method capable of supplying the information necessary for surgery. In all other cases of dissection of the thoracic aorta computed tomography has the highest clinical-diagnostic value. It furnishes an initial finding on the basis of which the course may be monitored without difficulty where there is a corresponding clinical indication. It is as yet impossible to judge how far routine magnetic resonance imaging will supplant or complement CT in making the initial clinical diagnosis. PMID:3731694

  18. 49 CFR 1105.12 - Sample newspaper notices for abandonment exemption cases.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 20423, a notice of exemption under 49 CFR 1152 Subpart F—Exempt Abandonments permitting the (abandonment... Out-Of-Service Abandonment Exemptions Notice of Intent To Abandon or To Discontinue Rail Service (Name... (station name), which traverses through United States Postal Service ZIP Codes (ZIP Codes) and...

  19. 49 CFR 1105.12 - Sample newspaper notices for abandonment exemption cases.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 20423, a notice of exemption under 49 CFR 1152 Subpart F—Exempt Abandonments permitting the (abandonment... Out-Of-Service Abandonment Exemptions Notice of Intent To Abandon or To Discontinue Rail Service (Name... (station name), which traverses through United States Postal Service ZIP Codes (ZIP Codes) and...

  20. Evaluating dissection in the gross anatomy course: Correlation between quality of laboratory dissection and students outcomes.

    PubMed

    Nwachukwu, Chika; Lachman, Nirusha; Pawlina, Wojciech

    2015-01-01

    Anatomy learned by active exploration through dissection has many proven benefits including improvement of anatomic knowledge. Decreased laboratory time may affect the quality of dissection and ultimately lower student performance in anatomy translating to lower knowledge acquisition. The aim of this study was to determine whether the quality of students' dissection in teams correlates with their performance in the gross anatomy course. Quality of dissections for each team enrolled in a gross anatomy course at Mayo Medical School was evaluated biweekly using a five-point rubric based on course learning objectives. Assessment of anatomic knowledge was based on sequential laboratory practice practical examination scores, achievements on daily audience response system (ARS) quizzes, and final practical, written, and National Board of Medical Examiners(®) (NBME(®) ) Gross Anatomy and Embryology Subject Examinations. Twelve teams comprising 48 students were included in the study. There was a positive correlation between dissection quality and practice practical examination score (R = 0.83) and a negative correlation between dissection quality and ARS quizzes (R = -0.985). Dissection teams with a passing score on their dissection evaluations (>70%) performed better on their final examinations. Based on an end of course survey, students agreed that dissection evaluations should continue to be a part of the course. This study showed that better quality of dissection was associated with higher scores on practice practical examinations, final practical, written, and NBME examinations. The study demonstrated a positive correlation between dissection evaluations, accompanied by formative feedback during the course, and higher scores on final course assessments. PMID:24799441

  1. Percutaneous balloon fenestration and stent placement for lower limb ischemia complicated with type B aortic dissection.

    PubMed

    Yamaguchi, Masato; Sugimoto, Koji; Tsuji, Yoshihiko; Ozaki, Nobuchika; Tsurusaki, Masakatsu; Taniguchi, Takanori; Zamora, Carlos Armando; Okita, Yutaka; Sugimura, Kazuro

    2006-04-01

    We report a case of lower limb ischemia secondary to type B aortic dissection, which was successfully treated with endovascular aortic fenestration and stent placement. In this case, we were not able to restore adequate flow to the ischemic limb by means of aortic balloon fenestration alone, so additional stent placement was required to buttress the true lumen and fenestra. There was no recurrence of lower limb ischemia complications during the follow-up period. Aortic balloon fenestration with stent placement seems to be a safe and effective technique to salvage an ischemic lower limb complicated by acute aortic dissection. PMID:16875314

  2. The Relationship between Spontaneous Multi-Vessel Coronary Artery Dissection and Celiac Disease.

    PubMed

    Bayar, Nermin; Ça??rc?, Göksel; Üreyen, Ça??n Mustafa; Ku?, Görkem; Küçükseymen, Selçuk; Arslan, ?akir

    2015-05-01

    Celiac disease (CD) is an immune-mediated enteropathy involving the small intestines. Genetic and environmental risk factors as well as autoimmunity have been linked to its etiology. Studies have shown that coronary artery disease, autoimmune myocarditis, arrhythmias and premature atherosclerosis are more prevalent in individuals with CD compared to individuals without the disease. In this case report a young male patient with CD presented with acute myocardial infarction with spontaneous coronary artery dissections of two vessels. To the best of our knowledge, this is the first case report of spontaneous multi-vessel coronary artery dissection in a patient with CD. PMID:26023313

  3. Science Teachers and the Dissection Debate: Perspectives on Animal Dissection and Alternatives

    ERIC Educational Resources Information Center

    Oakley, Jan

    2012-01-01

    This study investigated Ontario science and biology teachers' practices and attitudes toward animal dissection and dissection alternatives. The data was collected through a mixed methods approach involving online surveys (n = 153) and subsequent telephone interviews (n = 9) with secondary school science and biology teachers. The findings indicate…

  4. Student injuries in the dissecting room.

    PubMed

    Cornwall, Jon; Davies, Tilman M; Lees, David

    2013-01-01

    Cadaver dissection is the first opportunity for many students to practice handling human tissue and is their first exposure to the occupational hazards involved with this task. Few studies examine dissection room injuries to ascertain the dangers associated with dissecting. We performed a retrospective cohort analysis of dissection room injuries from four student cohorts over an eleven-year period (2001-2011), including second-year medical students, third-year medical students, second-year dental students, and third-year science students. Injury data included activity causing injury, object responsible, and injury site. A total of 163 injuries during 70,039 hours of dissection were recorded, with 66 in third-year medical students, 42 in second-year medical students, 36 in third-year science students, and 16 in second-year dental students. The overall rate was 2.87 injuries per 1,000 dissection hours, with second-year medical students most frequently injured (5.5 injuries per 1,000 hours); third-year medical students were least frequently injured (1.3 injuries per 1,000 hours). A significant difference in injury rates between student groups indicated a higher than expected injury rate to second-year medical students and lower than expected rates to third-year medical students. Injury rates increased for most groups between 2001-2006 and 2007-2011 periods. Most injuries (79%) were from scalpel cuts to the finger or thumb. This study provides injury rates for dissection room injuries to students, indicating differences in injury frequency between cohorts and an increase in injury rate over time. As scalpel cuts were the most likely injury mechanism, targeting scalpel handling with preventative strategies may reduce future injury risk. PMID:23536433

  5. Acute fatal coronary artery dissection following exercise-related blunt chest trauma.

    PubMed

    Barbesier, Marie; Boval, Catherine; Desfeux, Jacques; Lebreton, Catherine; Léonetti, Georges; Piercecchi, Marie-Dominique

    2015-01-01

    Coronary artery injury such as acute coronary dissection is an uncommon and potentially life-threatening complication after blunt chest trauma. The authors report an unusual autopsy case of a 43-year-old healthy man who suddenly collapsed after receiving a punch to the chest during the practice of kung fu. The occurrence of the punch was supported by the presence of one recent contusion on the left lateral chest area at the external examination and by areas of hemorrhage next to the left lateral intercostal spaces at the internal examination. The histological examination revealed the presence of an acute dissection of the proximal segment of the left anterior descending coronary artery. Only few cases of coronary artery dissection have been reported due to trauma during sports activities such as rugby and soccer games, but never during the practice of martial arts, sports usually considered as safe and responsible for only minor trauma. PMID:25066483

  6. Preventable Sternocleidomastoid Muscular Atrophy after Neck Dissection

    PubMed Central

    Yamamoto, Nao; Sawai, Natsuko Yoshimura; Ishimoto, Shunsuke; Ogura, Hide; Aikawa, Tomonao; Kogo, Mikihiko

    2015-01-01

    Background: Modified radical neck dissection (mRND) [preserving the sternocleidomastoid muscle (SCM) and the spinal accessory nerve] and supraomohyoid neck dissection have become common surgical procedures for treating head and neck cancer. Postoperative severe asymmetry of the neck and severe atrophy of the SCM, however, have been demonstrated. Methods: Using computed tomographic images, cross-sectional areas of the SCMs were measured in 99 patients with carcinoma of the oral cavity who underwent unilateral mRND or supraomohyoid neck dissection. An asymmetry index was used. Results: Innervation to the SCM was preserved in 91 patients. The spinal accessory nerve and the innervation were sacrificed in 3 patients; the innervation was repaired in 5 patients. Sacrifice of innervation to the SCM resulted in extremely severe asymmetry. Repair of the innervation prevented severe asymmetry in 40%. Preservation of the innervation prevented severe asymmetry in 75% at the middle portion of the neck and in 56% at the lower portion after mRND. Conclusion: Preserving innervation to the SCM and gentle handling of the nerve during neck dissection could prevent severe asymmetry after neck dissection. PMID:26495217

  7. Bowel "dissection" in microvillus inclusion disease.

    PubMed

    Chiang, Ming-Chou; Hsu, Jen-Fu; Hsueh, Chuen; Chao, Hsun-Chin; Wang, Tzu-Hao; Chen, Chih-Ping; Lai, Ming-Wei

    2015-04-01

    A preterm male neonate was diagnosed as having microvillus inclusion disease based on the characteristics of histological and ultrastructural findings. The peripheral blood sample also revealed MYO5B mutation. He had been on long-term parenteral nutrition. However, a bowel segment was seen in the baby's diaper during hospitalization when he was 5 months old. Serial abdominal ultrasound demonstrated progressive dissection of the bowel wall with detached mucosa in real-time. Small intestinal epithelia were seen on the histology of the detached bowel segment. He died 2 weeks after the episode; postmortem autopsy showed diffuse detachment of mucosa of small bowels without perforation. This is the first report of an infant with microvillus inclusion disease that presented with bowel "dissection". Weakened adhesion and integrity of intestinal epithelial cells caused by MYO5B mutation was speculated to result in the dissection and detachment of the epithelia of the gastrointestinal tract. PMID:23608388

  8. The nature of dissection: Exploring student conceptions

    NASA Astrophysics Data System (ADS)

    York, Katharine

    The model of conceptual change in science describes the process of learning as a complete restructuring of knowledge, when learners discover or are shown more plausible, intelligent alternatives to existing conceptions. Emotions have been acknowledged as part of a learner's conceptual ecology, but the effects of emotions on learning have yet to be described. This research was conducted to examine the role that emotions have on learning for thirteen high school students, as they dissected cats in a Human Anatomy and Physiology class. The project also investigated whether a student's emotional reactions may be used to develop a sense of connectedness with the nonhuman world, which is defined as ecological literacy. This study utilized a grounded theory approach, in which student responses to interviews were the primary source of data. Interviews were transcribed, and responses were coded according to a constant comparative method of analysis. Responses were compared with the four conditions necessary for conceptual change to occur, and also to five principles of ecological literacy. Students who had negative reactions to dissection participated less in the activity, and demonstrated less conceptual change. Two female students showed the strongest emotional reactions to dissection, and also the lowest amount of conceptual change. One male student also had strong negative reactions to death, and showed no conceptual change. The dissection experiences of the students in this study did not generally reflect ecological principles. The two students whose emotional reactions to dissection were the most negative demonstrated the highest degree of ecological literacy. These results provide empirical evidence of the effects that emotions have on learning, and also supports the opinions of educators who do not favor dissection, because it does not teach students to respect all forms of life.

  9. Is Planned Neck Dissection Necessary for Head and Neck Cancer After Intensity-Modulated Radiotherapy?

    SciTech Connect

    Yao Min |. E-mail: min-yao@uiowa.edu; Hoffman, Henry T.; Funk, Gerry F. |; Chang, Kristi; Smith, Russell B. |; Tan Huaming; Clamon, Gerald H.; Dornfeld, Ken |; Buatti, John M. |

    2007-07-01

    Purpose: The objective of this study was to determine regional control of local regional advanced head and neck squamous cell carcinoma (HNSCC) treated with intensity-modulated radiotherapy (IMRT), along with the role and selection criteria for neck dissection after IMRT. Methods and Materials: A total of 90 patients with stage N2A or greater HNSCC were treated with definitive IMRT from December 1999 to July 2005. Three clinical target volumes were defined and were treated to 70 to 74 Gy, 60 Gy, and 54 Gy, respectively. Neck dissection was performed for selected patients after IMRT. Selection criteria evolved during this period with emphasis on post-IMRT [{sup 18}F] fluorodeoxyglucose positron emission tomography in recent years. Results: Median follow-up for all patients was 29 months (range, 0.2-74 months). All living patients were followed at least 9 months after completing treatment. Thirteen patients underwent neck dissection after IMRT because of residual lymphadenopathy. Of these, 6 contained residual viable tumor. Three patients with persistent adenopathy did not undergo neck dissection: 2 refused and 1 had lung metastasis. Among the remaining 74 patients who were observed without neck dissection, there was only 1 case of regional failure. Among all 90 patients in this study, the 3-year local and regional control was 96.3% and 95.4%, respectively. Conclusions: Appropriately delivered IMRT has excellent dose coverage for cervical lymph nodes. A high radiation dose can be safely delivered to the abnormal lymph nodes. There is a high complete response rate. Routine planned neck dissection for patients with N2A and higher stage after IMRT is not necessary. Post-IMRT [{sup 18}F] fluorodeoxyglucose positron emission tomography is a useful tool in selecting patients appropriate for neck dissection.

  10. Esophageal diverticulum exposed during endoscopic submucosal dissection of superficial cancer

    PubMed Central

    Tanaka, Shinwa; Toyonaga, Takashi; Ohara, Yoshiko; Yoshizaki, Tetsuya; Kawara, Fumiaki; Ishida, Tsukasa; Hoshi, Namiko; Morita, Yoshinori; Azuma, Takeshi

    2015-01-01

    Endoscopic submucosal dissection (ESD) is now widely accepted as a strategy to treat superficial esophageal neoplasms. The rate of adverse events, such as perforation, has been decreasing with the improvement of devices and techniques. In this paper, we report a case of esophageal cancer that had a diverticulum under cancerous epithelium. The diverticulum was not detected during preoperative examination, and led to perforation during the ESD procedure. Our case shows that, although rare, some diverticula can exist underneath the mucosal surface without obvious depression. If there is any sign of hidden diverticula during ESD, surgeons should proceed with caution or, depending on the case, the procedure should be discontinued to avoid adverse events. PMID:25780314

  11. Genetics Home Reference: Familial thoracic aortic aneurysm and dissection

    MedlinePLUS

    ... literature OMIM Genetic disorder catalog Conditions > Familial thoracic aortic aneurysm and dissection (often shortened to familial TAAD ) On ... January 2015 What is familial TAAD? Familial thoracic aortic aneurysm and dissection (familial TAAD) involves problems with the ...

  12. Spontaneous coronary artery dissection: a rare diagnosis in a postmenopausal woman

    PubMed Central

    Saleb, Karim; Gibreal, Mohammed; Sodhi, Gurpreet; Solomon, Allen

    2015-01-01

    We report a case of a 50-year-old ex-smoker, postmenopausal woman presenting with an acute myocardial infarction caused by a spontaneous coronary artery dissection of a long ‘wrap-around’ left anterior descending coronary artery. After the diagnostic coronary angiography, she was treated medically with subsequent improvement. PMID:25988070

  13. Hybrid endovascular treatment of an anomalous right subclavian artery dissection in a patient with Marfan syndrome.

    PubMed

    Stanley, Gregory A; Arko, Frank R; Foteh, Mazin I; Jessen, Michael E; DiMaio, J Michael

    2012-08-01

    We report the case of a 26-year-old female patient with Marfan syndrome and an aberrant right subclavian artery (ARSA) with associated Kommerell diverticulum. The patient presented with spontaneous acute dissection of the ARSA that showed fusiform dilation to 4 cm in diameter. Definitive treatment was performed using a two-stage hybrid endovascular technique, including extrathoracic bilateral upper extremity bypass and thoracic endovascular aortic repair with debranching of the right and left subclavian arteries. This was followed by coil and plug embolization to exclude the dissection and prevent subsequent endoleak. PMID:22579900

  14. Anesthetic Management in a Patient With Type A Aortic Dissection and Superior Vena Cava Syndrome

    PubMed Central

    Totonchi, Ziae; Givtaj, Nader; Sakhaei, Mozhgan; Foroutan, Afshin; Chitsazan, Mitra; Chitsazan, Mandana; Pouraliakbar, Hamidreza

    2015-01-01

    Introduction: Induction of general anesthesia in patients with superior vena cava (SVC) syndrome may cause airway obstruction and cardiovascular collapse. Case Presentation: Herein, we introduced a patient with the diagnosis of dissecting aneurysm of the ascending aorta who was candidate for emergency surgery. He also had symptoms of SVC syndrome. To maintain airway patency during anesthetic management, we decided to perform femoro-femoral cardiopulmonary bypass followed by general anesthesia and tracheal intubation. Conclusions: Femoro-femoral bypass prior to initiation of sternotomy is a safe and easy method in patients with aortic dissection and SVC syndrome in whom earlier endotracheal intubation may not be feasible. PMID:26436073

  15. Renal Artery Stent Placement Complicated by Development of a Type B Aortic Dissection

    SciTech Connect

    Haesemeyer, Scott W.; Vedantham, Suresh Braverman, Alan

    2005-01-15

    Percutaneous renal artery angioplasty and stent placement have demonstrated safety and effectiveness in the treatment of selected patients with renovascular hypertension and ischemic nephropathy. Major complications have been predominantly confined to the affected renal artery and kidneys, including renal artery dissection and/or thrombosis, distal embolization, and contrast-related nephropathy. We report a case in which treatment of an ostial renal artery lesion with placement of a balloon-expandable stent was complicated by the development of an acute Type B aortic dissection.

  16. Coronary artery spontaneous dissection in a young male heavy smoker during bed rest

    PubMed Central

    Arslan, Gokhan; Bozlar, Ugur; Iyisoy, Atilla

    2015-01-01

    Spontaneous dissection of coronary artery (SDCA) is an extremely infrequent cause of acute cardiac ischaemic manifestations or sudden cardiac death with complex pathophysiology. This condition mostly affects young women in association with peripartum or postpartum status with no known risk factors for cardiovascular disease although some correlations have been noted with connective tissue disorders contraceptive use or intense physical activity. Herein, we report a case of spontaneous dissection of the left anterior descending artery during bed rest in a 24-year-old young man who had no risk factors except smoking or family history of coronary artery diseases. PMID:26336501

  17. Spontaneous coronary artery dissection in a parturient with Nail-Patella syndrome.

    PubMed

    Nizamuddin, S L; Broderick, D K; Minehart, R D; Kamdar, B B

    2015-02-01

    Spontaneous coronary artery dissection is an uncommon cause of acute coronary syndrome, occurring predominantly in women during and immediately after pregnancy; it carries a mortality rate of greater than 50%. While the exact etiology is unknown, possible contributing factors include pregnancy-related hormonal, connective tissue and hemodynamic changes. We present a case of a 35-year-old multigravid woman with Nail-Patella syndrome who developed an acute myocardial infarction secondary to spontaneous coronary artery dissection during labor which was not diagnosed until after delivery. We hypothesize that abnormal collagen fiber formation found in Nail-Patella syndrome may have put her at an increased risk of coronary dissection and myocardial infarction. Regardless of etiology, a delay in diagnosis of myocardial ischemia can lead to significant morbidity and mortality. In light of the increasing burden of cardiac disease in the obstetric population, clinicians should remain vigilant for signs of myocardial infarction and prepare for definitive diagnosis and treatment. PMID:25433575

  18. Hinged Dissection of Polypolyhedra Erik D. Demaine1

    E-print Network

    Demaine, Erik

    family of 3D hinged dissections for polypolyhedra, i.e., connected 3D solids formed by joining several for reflectionally symmetric faces.) Each hinged dissection consists of a linear number of solid polyhedral pieces from 2D [7]. Along the way, we present hinged dissections for polyplatonics (where P is a platonic

  19. Squid Dissection: From Pen to Ink.

    ERIC Educational Resources Information Center

    Brown, Cindy; Kisiel, Jim

    2003-01-01

    Introduces students to dissection, which is an important part of scientific discovery. Students not only gain an understanding of the anatomy of a squid, but also develop a sense of responsibility and respect for the animal that they are using as a learning tool. (Author/SOE)

  20. The etiology of cervical artery dissection

    PubMed Central

    Haneline, Michael T.; Rosner, Anthony L.

    2007-01-01

    Abstract The etiology of cervical artery dissection (CAD) is unclear, although a number of risk factors have been reported to be associated with the condition. On rare occasions, patients experience CAD after cervical spine manipulation, making knowledge about the cervical arteries, the predisposing factors, and the pathogenesis of the condition of interest to chiropractors. This commentary reports on the relevant anatomy of the cervical arteries, developmental features of CAD, epidemiology of the condition, and mechanisms of dissection. The analysis of CAD risk factors is confusing, however, because many people are exposed to mechanical events and known pathophysiological associations without ever experiencing dissection. No cause-and-effect relationship has been established between cervical spine manipulation and CAD, but it seems that cervical manipulation may be capable of triggering dissection in a susceptible patient or contributing to the evolution of an already existing CAD. Despite the many risk factors that have been proposed as possible causes of CAD, it is still unknown which of them actually predispose patients to CAD after cervical spine manipulation. PMID:19674705

  1. Global Distribution of Dissected Duricrust on Mars

    NASA Technical Reports Server (NTRS)

    Mustard, J. F.; Cooper, C. D.

    2000-01-01

    Evidence for dissected duricrust was identified in high resolution MOC images. Analysis of all available images was used to map the global distribution of this terrain. It is apparently restricted to two latitude bands: 30-60 deg. N and 30-60 deg. S.

  2. Hinged Dissection of Polypolyhedra Erik D. Demaine

    E-print Network

    Demaine, Erik

    interior to the face or on its boundary). For platonic solids, these hinges will be edges of the polyhedron. Souvaine 1 Introduction. A dissection of two figures (solid 2D or 3D shapes, e.g., polygons or polyhedra with labeled faces, a polypoly- hedron of type P is an interior-connected non-self- intersecting solid formed

  3. Cow's Eye Dissection in the Physics Lab.

    ERIC Educational Resources Information Center

    Lapp, David R.; Keenan, James E.

    1991-01-01

    Proposes the science demonstration of dissecting a cow's eye to integrate biology and physics in the study of optics and lenses. Reviews the anatomy of the eye, describes the visual process and covers topics as index of refraction of the cornea, microscopic receptors, the lens, and the retina. (MDH)

  4. Dissecting the pressure field in tidal flow

    E-print Network

    amplitude [N x 107 ] phase relative to the velocity [deg] power [W x107 ] 1 2 3 4 tidal excursion parameterDissecting the pressure field in tidal flow past a headland: When is form drag "real?" Sally Warner waves eddies H L LHH H L L LH #12;Numerical model Gaussian-shaped headland Barotropic tidal velocity D L

  5. Dissecting the pressure field in tidal flow

    E-print Network

    Dissecting the pressure field in tidal flow past a headland: When is form drag "real?" Sally Warner of oscillating flow H L HL velocity form drag power average power floodslack work done on system #12;0 0 0 0 90 180 270 360 90 180 270 360 0 degrees Drag of oscillating flow H L HL velocity form drag power average

  6. Sporulation and Dissection From Kristina Schmidt, USF

    E-print Network

    Aris, John P.

    fresh sporulation media. Tetrad Dissection 1. Transfer 500 µl of sporulation culture to a sterile 1.5 ml medium. Grow 24 hours in drum rotator at 30°C. 3. Transfer 250 µl of culture to a sterile 1.5 ml tube for later use. 7. Transfer to sterile GLASS test tube containing 4.75 ml of sporulation medium. 8. Incubate

  7. 77 FR 13120 - American Midstream (Louisiana Intrastate) LLC ; Notice of Motion for Extension of Rate Case...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-05

    ... Energy Regulatory Commission American Midstream (Louisiana Intrastate) LLC ; Notice of Motion for... Intrastate) LLC (AMLI) filed a motion requesting an extension consistent with the Federal Energy Regulatory... desiring to participate in this proceeding must file a motion to intervene or to protest this filing...

  8. Vertebral artery dissection in a patient practicing self-manipulation of the neck

    PubMed Central

    Mosby, John S.; Duray, Stephen M.

    2011-01-01

    Objective The purpose of this case report is to describe a patient who regularly practiced self-manipulation of her neck who presented with shoulder and neck pain and was undergoing a vertebral artery dissection. Clinical Features A 42-year-old female patient sought care for left shoulder pain with a secondary complaint of left lower neck pain. Twelve days prior, she had had “the worst headache of her life,” which began in her left lower cervical spine and extended to her left temporal region. The pain was sudden and severe, was described as sharp and burning, and lasted 3 hours. She reported nausea, vomiting, and blurred vision. Intervention and Outcome Initial history and examination suggested that the patient's head and neck pain was not musculoskeletal in origin, but vascular. She repeatedly requested that an adjustment be performed, but instead was referred to the local emergency department for further evaluation. Magnetic resonance angiogram revealed a dissection of the left vertebral artery from C6 to the C2-C3 interspace and a 3-mm dissecting pseudoaneurysm at the C3 level. She underwent stent-assisted percutaneous transluminal angioplasty combined with antiplatelet therapy (clopidogrel) and experienced a good outcome. Conclusion This case suggests that careful history taking and awareness of the symptoms of VAD are necessary in cases of sudden head and neck pain. More research is needed on the relationship between vertebral artery dissection and self-manipulation of the neck. PMID:22654686

  9. Recanalization of a ruptured vertebral artery dissecting aneurysm after occlusion of the dilated segment only

    PubMed Central

    Tanabe, Jun; Moroi, Junta; Yoshioka, Shotaro; Ishikawa, Tatsuya

    2014-01-01

    Background: Internal trapping in which the dissecting aneurysm is occluded represents reliable treatment to prevent rebleeding of ruptured vertebral artery (VA) dissecting aneurysms. Various methods of internal trapping are available, but which is most appropriate for preventing both recanalization of the VA and procedural complications is unclear. Case Description: A 61-year-old male presented with subarachnoid hemorrhage caused by rupture of a left VA dissecting aneurysm. Only the dilated segment of the aneurysm was occluded by coil embolization. Sixteen days after embolization, angiography showed recanalization of the treated left VA with blood supplying the dilated segment of the aneurysm, which showed morphological change between just proximal to the coil mesh and just distal to a coil, and antegrade blood flow through this part. Pathological examination showed that the rupture site that had appeared to be the most dilated area on angiography was located just above the orifice of the entrance. However, we think that this case of ruptured aneurysm had an entrance into a pseudolumen that existed proximal to the dilated segment, with antegrade recanalization occurring through the pseudolumen with morphological change because of insufficient coil obliteration of the entrance in the first therapy. Conclusions: This case suggests that occlusion of both the proximal and dilated segments of a VA dissecting aneurysm will prevent recanalization, by ensuring that any entrance to a pseudolumen of the aneurysm is completely closed. Careful follow-up after internal trapping is important, since antegrade recanalization via a pseudolumen may occur in the acute stage. PMID:25396072

  10. Which Comes First: The Use of Computer Simulation of Frog Dissection or Conventional Dissection as Academic Exercise?

    ERIC Educational Resources Information Center

    Akpan, Joseph; Strayer, Jeremy

    2010-01-01

    Science educators and school administrators are reexamining the educational value of animal dissection in the nation's schools and are focusing on simulation as an instructional alternative. One implication of the debate is that simulations can lead to equivalent learning to hands-on dissection. The second implication is whether dissection is…

  11. Vertebral artery dissection and cerebellar infarction following chiropractic manipulation

    PubMed Central

    Chen, W?L; Chern, C?H; Wu, Y?L; Lee, C?H

    2006-01-01

    Vertebral artery dissection (VAD) associated with chiropractic cervical manipulation is a rare but potentially disabling condition. In this report, we present a young patient manifesting with repeated vertigo. Owing to the initial misdiagnosis, the patient later developed cerebellar stroke with inability to stand or walk. Vertigo and disequilibrium are the usual presenting symptoms of this condition, which can result from inner ear or vestibular nerve dysfunction, vertebrobasilar insufficiency, and even lethal cerebellar infarction or haemorrhage; these last two, although rarely seen in young adults, can be caused by traumatic or spontaneous arterial injury, including injury secondary to chiropractic cervical manipulation. A number of cases of VAD associated with chiropractic cervical manipulation have been reported, but rarely in the emergency medicine literature. We present a case of this rare occurrence, and discuss the diagnostic pitfalls. PMID:16373786

  12. Towards a fast implementation of spectral nested dissection

    NASA Technical Reports Server (NTRS)

    Pothen, Alex; Simon, Horst D.; Wang, Lie; Barnard, Stephen T.

    1992-01-01

    We describe the spectral nested dissection (SND) algorithm, a new algorithm for computing orderings appropriate for parallel factorization of sparse, symmetric matrices. The algorithm makes use of spectral properties of the Laplacian matrix associated with the given matrix to compute separators. We evaluate the quality of the spectral orderings with respect to several measures: fill, elimination tree height, height and weight balances of elimination trees, and clique tree heights. We use some very large structural analysis problems as test cases and demonstrate on these real applications (such as the Space Shuttle Solid Rocket Booster) that spectral orderings compare quite favorably with commonly used orderings, outperforming them by a wide margin for some of these measures. The only disadvantage of SND is its relatively long execution time. We will present some recent efforts to improve the execution time using both a multilevel and a hybrid approach. We use SND in computing a multifrontal numerical factorization with the different orderings on an eight processor Cray Y-MP and show its effectiveness. We believe that spectral nested dissection is a major breakthrough in terms of generating efficient sparse orderings for parallel machines.

  13. Therapeutic node dissections in malignant melanoma.

    PubMed

    Karakousis, C P

    1998-06-01

    In the absence of distant disease, therapeutic node dissections in malignant melanoma, i.e., dissections of regional nodal basins for palpable suspicious or biopsy-proven positive nodes, offer the chance of cure. The 5-year survival rates after therapeutic lymphadenectomy closely correlate with expected cure rates. Although they varied greatly in the literature, from 19% to 38%, the currently obtainable survival rates are in the upper ranges of this spectrum because patients now are closely followed-up and operated for early palpable nodal disease. Properly done, these procedures carry a low morbidity, but they should be done thoroughly to completely eradicate regional disease and avoid recurrences in the same nodal basin to achieve the maximum survival that is surgically attainable. PMID:9588722

  14. Recurrent tamponade and aortic dissection in syphilis.

    PubMed

    Stansal, Audrey; Mirault, Tristan; Rossi, Aude; Dupin, Nicolas; Bruneval, Patrick; Bel, Alain; Azarine, Arshid; Minozzi, Catherine; Deman, Anne Laure; Messas, Emmanuel

    2013-11-01

    Syphilitic cardiovascular disease has been described since the 19th century, mainly on autopsy series. Major clinical manifestations are aortic aneurysm, aortic insufficiency, and coronary ostial stenosis. The diagnosis of syphilitic cardiovascular disease is based mainly on positive serologic tests and overt clinical manifestations. We present here a rare and unusual clinical presentation of a tertiary syphilis with recurrent tamponade and type B aortic dissection, whose positive diagnosis was made by polymerase chain reaction on pericardial fluid analysis. PMID:24182507

  15. Dissecting immunity by germline mutagenesis

    PubMed Central

    Choi, Onjee; Rutschmann, Sophie

    2012-01-01

    The last decades have seen numerous approaches being used to decipher biological phenomena, notably the strategies we employ to defend ourselves against pathogenic attacks. From microarrays to genetics to computing technologies, all have supported a better but not yet comprehensive understanding of the pathways regulating our immune system. Limitations are notably exemplified by cases of immune deficiencies in humans that often result in high susceptibility to infections or even death, without the genetic cause being evident. To provide further insight into the mechanisms by which pathogen detection and eradication occur, several in vivo strategies can be used. The current review focuses on one of them, namely germline mutagenesis in the mouse. After describing the main technical aspects of this forward genetic approach, we will discuss particular germline mutants that have all been instrumental in deciphering innate or adaptive immune responses. Mutations in previously uncharacterized genes in the mouse, like Unc93B or Themis, have demonstrated the impartiality of forward genetics and led to the identification of new crucial immunity actors. Some mutants, like PanR1, have informed us on particular protein domains and their specific functions. Finally, certain mutations identified by this non-hypothesis-driven method have revealed previously unknown gene functions, as recently illustrated by memi, which links a particular nucleoside salvage enzyme to cell proliferation and apoptosis. PMID:22681445

  16. Peer-Assisted Learning in a Gross Anatomy Dissection Course

    PubMed Central

    Han, Eui-Ryoung; Chung, Eun-Kyung; Nam, Kwang-Il

    2015-01-01

    Peer-assisted learning encourages students to participate more actively in the dissection process and promotes thoughtful dissection. We implemented peer-assisted dissection in 2012 and compared its effects on students’ self-assessments of learning and their academic achievement with those of faculty-led dissection. All subjects performed dissections after a lecture about upper-limb gross anatomy. Experimental group (n = 134) dissected a cadaver while guided by peer tutors who had prepared for the dissection in advance, and control group (n = 71) dissected a cadaver after the introduction by a faculty via prosection. Self-assessment scores regarding the learning objectives related to upper limbs were significantly higher in experimental group than in control group. Additionally, experimental group received significantly higher academic scores than did control group. The students in peer-assisted learning perceived themselves as having a better understanding of course content and achieved better academic results compared with those who participated in faculty-led dissection. Peer-assisted dissection contributed to self-perception and to the ability to retain and explain anatomical knowledge. PMID:26565616

  17. Peer-Assisted Learning in a Gross Anatomy Dissection Course.

    PubMed

    Han, Eui-Ryoung; Chung, Eun-Kyung; Nam, Kwang-Il

    2015-01-01

    Peer-assisted learning encourages students to participate more actively in the dissection process and promotes thoughtful dissection. We implemented peer-assisted dissection in 2012 and compared its effects on students' self-assessments of learning and their academic achievement with those of faculty-led dissection. All subjects performed dissections after a lecture about upper-limb gross anatomy. Experimental group (n = 134) dissected a cadaver while guided by peer tutors who had prepared for the dissection in advance, and control group (n = 71) dissected a cadaver after the introduction by a faculty via prosection. Self-assessment scores regarding the learning objectives related to upper limbs were significantly higher in experimental group than in control group. Additionally, experimental group received significantly higher academic scores than did control group. The students in peer-assisted learning perceived themselves as having a better understanding of course content and achieved better academic results compared with those who participated in faculty-led dissection. Peer-assisted dissection contributed to self-perception and to the ability to retain and explain anatomical knowledge. PMID:26565616

  18. Familial Thoracic Aortic Aneurysm with Dissection Presenting as Flash Pulmonary Edema in a 26-Year-Old Man

    PubMed Central

    Omar, Sabry; Moore, Tyler; Payne, Drew; Momeni, Parastoo; Mulkey, Zachary; Nugent, Kenneth

    2014-01-01

    We are reporting a case of familial thoracic aortic aneurysm and dissection in a 26-year-old man with no significant past medical history and a family history of dissecting aortic aneurysm in his mother at the age of 40. The patient presented with cough, shortness of breath, and chest pain. Chest X-ray showed bilateral pulmonary infiltrates. CT scan of the chest showed a dissection of the ascending aorta. The patient underwent aortic dissection repair and three months later he returned to our hospital with new complaints of back pain. CT angiography showed a new aortic dissection extending from the left carotid artery through the bifurcation and into the iliac arteries. The patient underwent replacement of the aortic root, ascending aorta, total aortic arch, and aortic valve. The patient recovered well postoperatively. Genetic studies of the patient and his children revealed no mutations in ACTA2, TGFBR1, TGFBR2, TGFB2, MYH11, MYLK, SMAD3, or FBN1. This case report focuses on a patient with familial TAAD and discusses the associated genetic loci and available screening methods. It is important to recognize potential cases of familial TAAD and understand the available screening methods since early diagnosis allows appropriate management of risk factors and treatment when necessary. PMID:25104961

  19. Vertebral artery dissection in evolution found during chiropractic examination.

    PubMed

    Futch, Dan; Schneider, Michael J; Murphy, Donald; Grayev, Allison

    2015-01-01

    A 30-year-old woman presented to an emergency department with sudden onset of transient loss of left peripheral vision. Owing to a history of migraine headaches, she was released with a diagnosis of ocular migraine. Two days later, she sought chiropractic care for the chief symptom of severe neck pain. The chiropractor suspected the possibility of vertebral artery dissection (VAD). No manipulation was performed; instead, MR angiography (MRA) of the neck was obtained, which revealed an acute left VAD with early thrombus formation. The patient was placed on aspirin therapy. Repeat MRA of the neck 3?months later revealed resolution of the thrombus, without progression to stroke. This case illustrates the importance for all healthcare providers who see patients with neck pain and headache to be attentive to the symptomatic presentation of possible VAD in progress. PMID:26564115

  20. Background music in the dissection laboratory: impact on stress associated with the dissection experience.

    PubMed

    Anyanwu, Emeka G

    2015-06-01

    Notable challenges, such as mental distress, boredom, negative moods, and attitudes, have been associated with learning in the cadaver dissection laboratory (CDL). The ability of background music (BM) to enhance the cognitive abilities of students is well documented. The present study was designed to investigate the impact of BM in the CDL and on stress associated with the dissection experience. After 8 wk of normal dissection without BM, various genres of BM were introduced into the cadaver dissection sessions of 260 medical and dental students for 3 wk. Feedback on the impact of BM on students in the CDL and students' attitude were accessed using a questionnaire. Psychological stress assessment was done using Psychological Stress Measure 9. Two batches of 30 students each were made to dissect same areas of the body for 2 h, one batch with BM playing and the other batch without. The same examination was given to both groups at the end. Over 90% of the participants expressed a desire to incorporate BM into the CDL; 87% of the sampled population that expressed love for music also reported BM to be a very useful tool that could be used to enhance learning conditions in the CDL. A strong positive relationship was established between love for music and its perception as a tool for learning in the CDL (P < 0.001). Students that studied under the influence of BM had significantly higher scores (P < 0.001) in the overall examination result. BM reduced the level of stress associated with the dissection experience by ?33%. PMID:26031725

  1. 76 FR 79170 - Southcross CCNG Transmission Ltd.; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... Energy Regulatory Commission Southcross CCNG Transmission Ltd.; Notice of Motion for Extension of Rate... this rate proceeding must file a motion to intervene or to protest this filing must file in accordance... file a notice of intervention or motion to intervene, as appropriate. Such notices, motions,...

  2. 76 FR 79170 - Southcross Mississippi Pipeline, L.P.; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... Energy Regulatory Commission Southcross Mississippi Pipeline, L.P.; Notice of Motion for Extension of... proceeding must file a motion to intervene, or to protest this filing must file in accordance with Rules 211... notice of intervention or motion to intervene, as appropriate. Such notices, motions, or protests must...

  3. Epidemiology and Medication Utilization Pattern of Aortic Dissection in Taiwan

    PubMed Central

    Yeh, Ting-Yu; Chen, Chung-Yu; Huang, Jiann-Woei; Chiu, Chaw-Chi; Lai, Wen-Ter; Huang, Yaw-Bin

    2015-01-01

    Abstract Acute aortic dissection (AD) is a catastrophic condition associated with a high rate of mortality. However, current epidemiological information regarding AD remains sparse. The objective of the present study was to investigate the current epidemiological profile and medication utilization patterns associated with aortic dissection in Taiwan. In this population-based study, we identified cases of AD diagnosed during 2005 to 2012 in the complete Taiwan National Health Insurance (NHI) Research Database. Patients with AD were identified using the International Classification of Disease, Ninth Revision (ICD-9) code 441.0, and surgical interventions were defined using NHI procedure codes. A total of 9092 individuals with a mean age of 64.4?±?15.1 years were identified. The cases were divided into 3 groups: Group A included 2340 patients (25.74%) treated surgically for type A AD; Group B included 1144 patients (12.58%) treated surgically for type B AD, and Group C included 5608 patients (61.68%) with any type of AD treated with medical therapy only. The average annual incidence of AD was 5.6 per 100,000 persons, and the average prevalence was 19.9 per 100,000 persons. Hypertension was the most common risk factor, followed by coronary artery disease and chronic obstructive pulmonary disease. Within 1 year of AD diagnosis, 92% of patients were taking antihypertensive medication. Calcium channel blockers were the most frequently prescribed antihypertensive medication for long-term observation in Taiwan. The annual trends revealed statistically significant increases in the numbers and percentages of prevalence, incidence, and mortality. Changes in patients’ drug utilization in patterns were observed after AD diagnosis. Our study provides a local profile that supports further in-depth analyses in AD-affected populations. PMID:26356726

  4. Biology teachers' dissection practices and the influences that lead to their adoption: An exploratory research

    NASA Astrophysics Data System (ADS)

    Milano, Regina Nicole

    The lack of resolution in the on-going animal dissection debate inspired this mixed methods study to identify Connecticut secondary biology teachers' dissection practices and the influences that lead to their adoption. Qualitative findings indicate past experiences, managing objections to dissection, school culture, goals of biology teaching and ethics as major influences on dissection practices with 58.4% (n=7) of the sample dissecting and 41.6% not dissecting (n=5). Quantitative findings reveal gender, standards and curriculum, advantages of dissection and experiences as a student as major influences on dissection practices with 71.9% (n=92) of the sample dissecting and 28.1% (n=36) not dissecting. The study concludes that dissection policies are necessary and imminent in Connecticut school districts. Furthermore, it advises teacher-initiated, qualitative and quantitative assessments to expose disparities between student dissection perspectives and their own, prior to conducting dissection. Finally, it provides suggestions for addressing potential differences including administrative involvement.

  5. Cadaver Dissection and the Ritual Transformation of Medical Students

    E-print Network

    Laudermilk, Ryan

    2011-12-31

    to prompts such as “Tell me about your first experience dissecting a cadaver...” before being asked scripted questions and follow-up questions based on their answers: 1. What qualities are important for competent dissection? 2. Do you remember your first... cadavers to living patients? 10. Do you think cadaver dissection was beneficial for learning anatomy? Essential? Was it a positive or negative experience over-all? Do you think you could get the same level of instruction without the use of cadavers...

  6. Endovascular repair of a double-lumen dissecting aneurysm

    PubMed Central

    Johnson, Andrew Kelly; Gerard, Carter S; Lopes, Demetrius Klee

    2013-01-01

    Treating dissections and dissecting aneurysms requires maintenance of flow through the true lumen and exclusion of the false lumen from the circulation. A dissecting aneurysm of the vertebral artery presented with both a true and false lumen within the aneurysmal sac. Stenting of the true lumen followed by coil embolization of both lumens was performed. Management options and decision-making are discussed for this unique situation. PMID:23737597

  7. Chronic pulmonary artery dissection associated with pulmonary arterial hypertension

    PubMed Central

    2013-01-01

    Abstract Pulmonary artery dissection is a complication associated with pulmonary arterial hypertension. This complication is described as acute in onset and is frequently fatal without intervention. We describe a patient with idiopathic pulmonary arterial hypertension and chest pain found to have an unsuspected chronic pulmonary artery dissection on postmortem examination. Chronic pulmonary artery dissection should be considered in patients with chest pain and worsening dyspnea, as the frequency this condition may be underestimated. PMID:24618553

  8. Computational Biomechanics in Thoracic Aortic Dissection: Today's Approaches and Tomorrow's Opportunities.

    PubMed

    Doyle, Barry J; Norman, Paul E

    2016-01-01

    Dissection of an artery is characterised by the separation of the layers of the arterial wall causing blood to flow within the wall. The incidence rates of thoracic aortic dissection (AoD) are increasing, despite falls in virtually all other manifestations of cardiovascular disease, including abdominal aortic aneurysm (AAA). Dissections involving the ascending aorta (Type A) are a medical emergency and require urgent surgical repair. However, dissections of the descending aorta (Type B) are less lethal and require different clinical management whereby the patient may not be offered surgery unless complicating factors are present. But how do we tell if a patient will develop a complication later on? Currently, there is no consensus and the evidence base is limited. There is an opportunity for computational biomechanics to help clinicians decide as to which cases to repair and which to manage with blood pressure control. In this review article, we look at AoD from both the clinical and biomechanical perspective and discuss some of the recent computational studies of both Type A and B AoD. We then focus more on Type B where the real opportunity for patient-specific modelling exists. Finally, we look ahead at some of the promising areas of research that may help clinicians improve the decision-making process surrounding Type B AoD. PMID:26101036

  9. The value of systematic lymph node dissection for intrahepatic cholangiocarcinoma from the viewpoint of liver lymphatics.

    PubMed

    Morine, Yuji; Shimada, Mitsuo

    2015-09-01

    Lymph node (LN) metastasis from intrahepatic cholangiocarcinoma (IHCC) might be one of the most important indicators of aggressive surgical resection, yet the value of LN dissection is still controversial. To address this clinical problem, we need to better understand the multidirectional lymphatic outflow from the liver. Although most hepatic lymph flows into the hilar LNs along portal triads, there are also several lymphatic outflows directly communicating with distant areas or the general lymphatic system. Moreover, it has been revealed that LN metastasis spreads to more distal LNs through the hepatoduodenal ligament or other multidirectional lymphatic pathways connected to the general lymphatic system. Therefore, systematic LN dissection might merely be LN sampling in IHCC with LN metastasis. A multidisciplinary strategy focusing on adjuvant treatment after surgery is immediately necessary in these cases. In IHCC without LN metastasis, the accuracy of preoperative imaging assessment of LN metastasis is unsatisfactory and useless for detecting metastatic LNs in clinical settings. Therefore, prophylactic systematic LN dissection for IHCC without preoperative LN swelling is recommended for accurate LN status assessment and reduction of local recurrences. However, this procedure might not offer any clinical benefit according to the results of retrospective comparative studies. In this review, we summarize previous reports regarding lymphatic outflow of the liver and discuss LN dissection for IHCC. PMID:25833009

  10. Differentiated Thyroid Cancer: Indications and Extent of Central Neck Dissection—Our Experience

    PubMed Central

    Calò, Pietro Giorgio; Boi, Francesco; Baghino, Germana; Nicolosi, Angelo

    2013-01-01

    The aim of this retrospective study was to determine the rate of metastases in the central neck compartment and examine the morbidity and rate of recurrence in patients with differentiated thyroid cancer treated with or without a central neck dissection. Two hundred and fifteen patients undergoing total thyroidectomy with preoperative diagnosis of differentiated thyroid cancer, in the absence of suspicious nodes, were divided in two groups: those who underwent a thyroidectomy only (group A; n = 169) and those who also received a central neck dissection (group B; n = 46). Five cases (2.32%) of nodal recurrence were observed: 3 in group A and 2 in group B. Tumor histology was associated with a risk of recurrence: Hürthle cell-variant and tall cell-variant carcinomas were associated with a high risk of recurrence. Multifocality and extrathyroidal invasion also presented a higher risk, while smaller tumors were at lower risk. The results of this study suggest that prophylactic central neck dissection should be reserved for high-risk patients only. A wider use of immunocytochemical and genetic markers to improve preoperative diagnosis and the development of methods for the intraoperative identification of metastatic lymph nodes will be useful in the future for the improved selection of patients for central neck dissections. PMID:24282633

  11. High-Resolution Magnetic Resonance Imaging of Intracranial Vertebral Artery Dissecting Aneurysm for Planning of Endovascular Treatment

    PubMed Central

    Chun, Dong Hyun; Jeong, Young Gyun; Jeong, Hae Woong

    2015-01-01

    The equipment and techniques associated with magnetic resonance imaging (MRI) have rapidly evolved. The development of 3.0 Tesla MRI has enabled high-resolution imaging of the intracranial vessel wall. High-resolution MRI (HRMRI) can yield excellent visualization of both the arterial wall and lumen, thus facilitating the detection of the primary and secondary features of intracranial arterial dissection. In the present report, we describe the manner in which HRMRI affected our endovascular treatment planning strategy in 2 cases with unruptured intracranial vertebral artery dissection aneurysm. HRMRI provides further information about the vessel wall and the lumen of the unruptured intracranial vertebral artery dissecting aneurysm, which was treated by an endovascular approach in the 2 current cases. PMID:26361535

  12. Evaluation of the hemodynamic effectiveness of aortic dissection treatments via virtual stenting.

    PubMed

    Alimohammadi, Mona; Bhattacharya-Ghosh, Benjamin; Seshadhri, Santhosh; Penrose, Justin; Agu, Obiekezie; Balabani, Stavroula; Díaz-Zuccarini, Vanessa

    2014-10-01

    Aortic dissection treatment varies for each patient and stenting is one of a number of approaches that are utilized to Stabilize the condition. Information regarding the hemodynamic forces in the aorta in dissected and virtually stented cases could support clinicians in their choices of treatment prior to medical intervention. Computational fluid dynamics coupled with lumped parameter models have shown promise in providing detailed information that could be used in the clinic; for this, it is necessary to develop personalized workflows in order to produce patient-specific simulations. In the present study, a case of pre- and post-stenting (virtual stent-graft) of an aortic dissection is investigated with a particular focus on the role of personalized boundary conditions. For each virtual case, velocity, pressure, energy loss, and wall shear stress values are evaluated and compared. The simulated single stent-graft only marginally reduced the pulse pressure and systemic energy loss. The double stent-graft results showed a larger reduction in pulse pressure and a 40% reduction in energy loss as well as a more physiological wall shear stress distribution.Regions of potential risk were highlighted. The methodology applied in the present study revealed detailed information about two possible surgical outcome cases and shows promise as both a diagnostic and an interventional tool. PMID:24811307

  13. Spontaneous coronary artery dissection—A review

    PubMed Central

    Yip, Amelia

    2015-01-01

    Spontaneous coronary artery dissection (SCAD) is an infrequent and often missed diagnosis among patients presenting with acute coronary syndrome (ACS). Unfortunately, SCAD can result in significant morbidities such as myocardial ischemia and infarction, ventricular arrhythmias and sudden cardiac death. Lack of angiographic recognition from clinicians is a major factor of under-diagnosis. With the advent of new imaging modalities, particularly with intracoronary imaging, there has been improved diagnosis of SCAD. The aim of this paper is to review the epidemiology, etiology, presentation, diagnosis and management of SCAD. PMID:25774346

  14. Background Music in the Dissection Laboratory: Impact on Stress Associated with the Dissection Experience

    ERIC Educational Resources Information Center

    Anyanwu, Emeka G.

    2015-01-01

    Notable challenges, such as mental distress, boredom, negative moods, and attitudes, have been associated with learning in the cadaver dissection laboratory (CDL). The ability of background music (BM) to enhance the cognitive abilities of students is well documented. The present study was designed to investigate the impact of BM in the CDL and on…

  15. Doing Dissections Differently: A Structured, Peer-Assisted Learning Approach to Maximizing Learning in Dissections

    ERIC Educational Resources Information Center

    Hall, Emma R.; Davis, Rachel C.; Weller, Renate; Powney, Sonya; Williams, Sarah B.

    2013-01-01

    Areas of difficulty faced by our veterinary medicine students, with respect to their learning in dissection classes, were identified. These challenges were both general adult-learning related and specific to the discipline of anatomy. Our aim was to design, implement, and evaluate a modified reciprocal peer-assisted/team-based learning…

  16. Incidence of Branching Patterns Variations of the Arch in Aortic Dissection in Chinese Patients

    PubMed Central

    Tapia, G. Pullas; Zhu, Xiaohua; Xu, Jing; Liang, Pan; Su, Gang; Liu, Hai; Liu, Yang; Shu, Liliang; Liu, Shuiqi; Huang, Chen

    2015-01-01

    Abstract Several authors have described anatomic variations of the aortic arch in 13% to 20% of the patients who do not have aortic disease. However, few studies have evaluated these patterns in the thoracic aortic dissection (TAD). In the authors’ knowledge, this is the first survey that specifically investigates the frequency of these variations in a broad, nonselected group of Chinese patients with aortic dissection. Furthermore, it compares this group with a group of patients without aortic disease. The objective of this study was to define the variation frequency of the aortic arch branches pattern using the tomographic studies of 525 Chinese patients with a diagnosis of TAD. The Stanford classification was used to set the site of the initial tear of the dissection. In addition, we performed an epidemiological analysis of the aortic arch anatomic variations in TAD, and its possible implications for surgical or endovascular treatment. The general hypothesis proposal asserted that Chinese patients with dissection of the aorta have a similar incidence of variations of the aortic arch to the patients without aortic disease. A retrospective study of cases and controls was carried out using the tomographic studies (CT) of all patients admitted to the First Affiliated Hospital of Zhengzhou University, located at Henan-China, with a confirmed diagnosis of aortic dissection from January 2012 until December 2014. The group of cases consisted of 525 patients: 374 men and 151 women, with a mean age of 52.27 years (range, 20–89). The average age of the patients with Stanford A and B aortic dissection was 49.46 and 53.67, respectively. The control group consisted of 525 unselected patients without TAD who underwent a CT scan of the chest due to other indications. This group consisted of 286 men and 239 women, with a mean age of 53.60 years (range, 18–89). All the patients with aneurysm or dissection were excluded from the control group. We performed a statistical analysis of demographic data. The study found 7 different patterns of the aortic arch on both groups of cases and controls. Within the 525 patients with TAD were observed 85 (16.19%) anatomical variations, while the control group showed 112 variations (21.33%); P?=?0.033. The most common anatomical variant was the bovine arch, found in 62 (11.80%) cases of TAD compared with 77 (14.66%) in the control group; P?=?0.172. Anatomical variations were observed in 14.32% of the patients with Stanford A dissection and 17.09% of the patients with Stanford B dissection; P?=?0.425. Patients with Stanford A dissection showed the pattern of bovine arch in 23 (13.21%) of 174 cases. In contrast, the patients with Stanford B dissection showed it in 39 (11.11%) of 351 cases; P?=?0.481. The anatomical variant defined as vertebral artery of direct origin of the aortic arch was more frequent in the patients with Stanford B dissection (5.12%). The patients with Stanford A dissection presented this pattern in 1.14% of the cases; P?=?0.025. This study observed an increased frequency of aortic dissection in the subgroup from 41 to 60 years old. In the subgroup from 41 to 60 years old without TAD, a greater frequency of anatomical variations were found than in the patients with TAD (20.81% vs 14.23%; P?=?0.050). The same fashion was seen in patients older than 80 years (27.27% vs 0%; P?=?0.030). The anatomical variations of the aortic arch with TAD occurred in 14.97% of the male patients and 19.20% of the female patients compared to 21.67% to 20.92% in the control group; P?=?0.026 and P?=?0.681, respectively. The aortic arch variations were found less frequently in the TAD group than in the control group in the present Chinese series. The bovine arch was considered the variant pattern of the major frequency in the patients with TAD and the control group. The anatomical variant of 4 branches, defined as vertebral artery of direct origin of the aortic ar

  17. Diagnosis of Aortic Dissection in Emergency Department Patients is Rare

    PubMed Central

    Alter, Scott M.; Eskin, Barnet; Allegra, John R.

    2015-01-01

    Introduction Aortic dissection is a rare event. While the most frequent symptom is chest pain, that is a common emergency department (ED) chief complaint and other diseases causing chest pain occur much more often. Furthermore, 20% of dissections are without chest pain and 6% are painless. For these reasons, diagnosing dissections may be challenging. Our goal was to determine the number of total ED and atraumatic chest pain patients for every aortic dissection diagnosed by emergency physicians. Methods Design: Retrospective cohort. Setting: 33 suburban and urban New York and New Jersey EDs with annual visits between 8,000 and 80,000. Participants: Consecutive patients seen by emergency physicians from 1-1-1996 through 12-31-2010. Observations: We identified aortic dissection and atraumatic chest pain patients using the International Classification of Diseases 9th Revision and Clinical Modification codes. We then calculated the number of total ED and atraumatic chest pain patients for every aortic dissection, along with 95% confidence intervals (CIs). Results From a database of 9.5 million ED visits, we identified 782 aortic dissections or one for every 12,200 (95% CI [11,400–13,100]) visits. The mean age of dissection patients was 66±16 years and 38% were female. There were 763,000 (8%) with atraumatic chest pain diagnoses. Thus, there is one dissection for every 980 (95% CI [910–1,050]) atraumatic chest pain patients. Conclusion The diagnosis of aortic dissections by emergency physicians is rare and challenging. An emergency physician seeing 3,000 to 4,000 patients a year would diagnose an aortic dissection approximately every three to four years. PMID:26587083

  18. Endoscopic submucosal dissection (ESD) of antral subepithelial lesion suspected of malignancy.

    PubMed

    Marín-Gabriel, José Carlos; Martos-Vizcaíno, Esperanza; Díaz-Tasende, José; Alonso-Riaño, Marina; Pérez-Carreras, Mercedes; Rodríguez-Muñoz, Sarbelio; del-Pozo-García, Andrés J; Colina-Ruizdelgado, Francisco; Castellano-Tortajada, Gregorio

    2015-06-01

    Subepithelial gastric tumours comprise a heterogeneous group of lesions. Endoscopic ultrasonography with fine-needle aspiration (EUS-FNA) is a useful approach but cannot always offer a definitive diagnosis to guide future therapeutic decisions. In the case we describe, biopsy samples of an antral subepithelial lesion and cytological analysis obtained with an EUS-FNA suggested the diagnosis of an adenocarcinoma. Endoscopic submucosal dissection (ESD) allowed en bloc resection of the tumour ensuring diagnosis and providing a definitive treatment. PMID:26031870

  19. The Effect of a Prior Dissection Simulation on Middle School Students' Dissection Performance and Understanding of the Anatomy and Morphology of the Frog.

    ERIC Educational Resources Information Center

    Akpan, Joseph Paul; Andre, Thomas

    1999-01-01

    Reports on a study that examined the prior use of simulation on frog dissection in improving students' actual dissection performance and learning of frog anatomy and morphology. Finds that students who performed the simulation before dissection performed significantly better than students who performed dissection before using the simulation or…

  20. Treatment of a Chronic Aneurysmal Aortic Dissection in a Patient with Marfan Syndrome Using a Staged Hybrid Procedure and a Fenestrated Endograft

    SciTech Connect

    Walkden, R. Miles Morgan, Rob A.; Loftus, Ian; Thompson, Matt

    2008-07-15

    Patients with aneurysmal dissections involving both the thoracic and the abdominal aorta are particularly challenging to treat with endovascular techniques because of the natural communications at the level of the visceral arteries. We present the case of a patient with Marfan syndrome with an aneurysmal aortic dissection involving the thoracic and abdominal aorta who was treated by a combination of endografts, surgical bypass, and a fenestrated tube graft.

  1. Traditional versus Computer-Based Dissections in Enhancing Learning in a Tertiary Setting: A Student Perspective.

    ERIC Educational Resources Information Center

    Franklin, Sue; Peat, Mary; Lewis, Alison

    2002-01-01

    Describes a study that investigates both the use and usefulness of laboratory dissections and computer-based dissections in a tertiary, first-year human biology course. Explores attitudes toward dissection. (DDR)

  2. 78 FR 6838 - Certain Balloon Dissection Devices and Products Containing Same; Institution of Investigation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ...337-TA-865] Certain Balloon Dissection Devices and Products...importation of certain dissection balloons and products containing the...importation of certain dissection balloons and products containing the...Geisingen, Germany; Pajunk Medical Systems L.P., 6611...

  3. Dissecting the transcription networks of a cell using computational genomics

    E-print Network

    Babu, M. Madan

    Dissecting the transcription networks of a cell using computational genomics Hao Lià and Wei Wangy to systematically dissect transcriptional regulatory networks. Effective algorithms have been developed to predict cis-regulatory elements in a genome, to identify the target genes of transcription factors, to infer

  4. Student Attitudes toward Cadaveric Dissection at a UK Medical School

    ERIC Educational Resources Information Center

    Quince, Thelma A.; Barclay, Stephen I. G.; Spear, Michelle; Parker, Richard A.; Wood, Diana F.

    2011-01-01

    A more humanistic approach toward dissection has emerged. However, student attitudes toward this approach are unknown and the influences on such attitudes are little understood. One hundred and fifty-six first-year medical students participated in a study examining firstly, attitudes toward the process of dissection and the personhood of the…

  5. A Modified Dissection Method to Preserve Neck Structures

    ERIC Educational Resources Information Center

    Hankin, Mark H.; Stoller, Jeremy L.

    2009-01-01

    The neck is not only one of the more challenging anatomical regions to dissect but also has important application to clinical conditions, diseases, and procedures. In this study, we describe two simple modifications for dissection of the neck that (1) aid in the identification and preservation of the cutaneous branches of the cervical plexus and…

  6. A Novel 'Cheese Wire' Technique for Stent Positioning Following Difficult Iliac Artery Subintimal Dissection and Aortic Re-Entry

    SciTech Connect

    Watkinson, A. F.

    2009-07-15

    Subintimal wire dissection is a well-established method for traversing difficult vascular occlusions. This technique relies on re-entry of the true lumen distal to the occlusion, which may be difficult in diseased vessels with significant calcification. This case report describes a novel 'cheese wire' technique to allow stent positioning without the use of proprietary re-entry devices.

  7. Ruptured Pancreaticoduodenal Artery Aneurysm Associated with Median Arcuate Ligament Compression and Aortic Dissection Successfully Treated with Embolotherapy

    PubMed Central

    Terada, Takuro; Tamaki, Masato

    2015-01-01

    A 51-year-old man with a ruptured pancreaticoduodenal artery (PDA) aneurysm caused by compression of the celiac artery by the median arcuate ligament and aortic dissection involving the celiac axis was transferred to our hospital for endovascular treatment. A 4-F catheter was advanced into the superior mesenteric artery through the narrow true lumen via the left brachial artery, and coil embolization of the aneurysm was successfully performed. In this case, rapid increase of blood flow in the superior mesenteric artery, which compensated for the decreased celiac blood flow by aortic dissection, increased hemodynamic stress on the PDA, leading to aneurysmal rupture. PMID:25848431

  8. Spontaneous ruptured dissection of the right common iliac artery in a patient with classic Ehlers-Danlos syndrome phenotype.

    PubMed

    Gaines, Rick; Tinkle, Brad T; Halandras, Pegge M; Al-Nouri, Omar; Crisostomo, Paul; Cho, Jae S

    2015-04-01

    Unlike vascular Ehlers-Danlos syndrome (EDS), classic EDS is rarely associated with vascular manifestation. We report the case of a 39-year-old man who presented with acute abdominal pain. At the time of presentation, the patient was in hypovolemic shock, and computed tomography angiogram demonstrated common iliac artery dissection with rupture. He underwent an attempted endovascular repair that was converted to an open repair of a ruptured right common iliac artery dissection. Subsequent genetic testing revealed a substitution of arginine for cysteine in type I collagen, COL1A1 exon 14 c.934C>T mutation, consistent with a rare variant of classic EDS. PMID:25597651

  9. The Effects of Computer Animated Dissection versus Preserved Animal Dissection on the Student Achievement in a High School Biology Class.

    ERIC Educational Resources Information Center

    Kariuki, Patrick; Paulson, Ronda

    The purpose of this study was to examine the effectiveness of computer-animated dissection techniques versus the effectiveness of traditional dissection techniques as related to student achievement. The sample used was 104 general biology students from a small, rural high school in Northeast Tennessee. Random selection was used to separate the…

  10. Structural Dissection for Controlling Complex Networks

    E-print Network

    Wang, Wen-Xu; Zhao, Chen; Liu, Yang-Yu; Lai, Ying-Cheng

    2015-01-01

    Controlling complex networked systems has been a central goal in different fields and understanding controllability of complex networks has been at the forefront of contemporary science. Despite the recent progress in the development of controllability theories for complex networks, we continue to lack efficient tools to fully understand the effect of network topology and interaction strengths among nodes on controllability. Here we establish a framework to discern the significance of links and nodes for controlling general complex networks in a simple way based on local information. A dissection process is offered by the framework to probe and classify nodes and links completely, giving rise to a criterion for strong structural controllability. Analytical results indicate phase transitions associated with link and node categories, and strong structural controllability. Applying the tools to real networks demonstrate that real technological networks are strong structurally controllable, whereas most of real s...

  11. Cervical Artery Dissection: Emerging Risk Factors

    PubMed Central

    Micheli, S; Paciaroni, M; Corea, F; Agnelli, G; Zampolini, M; Caso, V

    2010-01-01

    Cervical artery dissection (CAD) represents an increasingly recognized cause of stroke and the most common cause of ischemic stroke in young adults. Many factors have been identified in association with CAD such as primary disease of arterial wall (fibrodysplasia) and other non-specific diseases related to CAD like Ehlers Danlos-syndrome IV, Marfan’s syndrome, vessel tortuosity. Moreover, an underlying arteriopathy which could be in part genetically determined, has been suspected. The rule of emerging risk factors for CAD such as recent respiratory tract infection, migraine and hyperhomocysteinemia are still a matter of research. Other known risks factors for CAD are major head/neck trauma like chiropractic maneuver, coughing or hyperextension injury associated to car. We examined emerging risks factors for CAD detected in the last years, as CAD pathogenesis is still not completely understood and needs further investigations. PMID:21270941

  12. 75 FR 56093 - Eagle Rock Desoto Pipeline, LP; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-15

    ...Commission [Docket No. PR09-1-002] Eagle Rock Desoto Pipeline, LP; Notice of Motion for Extension...Take notice that on September 8, 2010, Eagle Rock Desoto Pipeline, L.P. (Eagle Rock) filed a request to extend the date for...

  13. 76 FR 76711 - Overland Trail Transmission, LLC; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ... Energy Regulatory Commission Overland Trail Transmission, LLC; Notice of Motion for Extension of Rate... ] 61,150 (May 20, 2010). Any person desiring to participate in this rate proceeding must file a motion... to the proceeding. Any person wishing to become a party must file a notice of intervention or...

  14. 76 FR 1152 - Crosstex North Texas Pipeline, L.P.; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-07

    ... Energy Regulatory Commission Crosstex North Texas Pipeline, L.P.; Notice of Motion for Extension of Rate... desiring to participate in this rate proceeding must file a motion to intervene or to protest this filing... to become a party must file a notice of intervention or motion to intervene, as appropriate....

  15. 76 FR 18754 - J-W Pipeline Company; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-05

    ...Regulatory Commission [Docket No. PR09-6-003] J-W Pipeline Company; Notice of Motion for Extension...Filing Deadline Take notice that on March 28, 2011, J-W Pipeline Company (J-W) filed a request for an extension consistent...

  16. Use of histomorphometry in the assessment of fatal vertebral artery dissection.

    PubMed Central

    Johnson, C P; Lawler, W; Burns, J

    1993-01-01

    AIM--To assess morphometrically the structural changes, which occur with ageing, along the length of the vertebral artery. METHODS--A series of 36 vessels were removed at necropsy from subjects aged between 9 months and 86 years. Image analysis was used to measure the medial width, the circumference, the intimal: medial area ratio and the adventitial: medial area ratio along each artery. The artery from a case of fatal vertebral artery dissection, which occurred after a game of cricket and then chiropractic neck manipulation, was also examined in the same manner. The proteoglycan accumulation in the media was quantified using an eyepiece graticule. RESULTS--The vertebral arteries were, on average, larger around the origin of the vessel from the subclavian artery, and the adventitia were relatively thicker at this point, and also after piercing the dura mater. The media were much thinner within the intracranial segment and pronounced intimal thickening occurred with increasing age. The dissected artery showed undoubtable pre-existent structural abnormalities, in the form of massive proteoglycan accumulation, which predisposes an artery to dissection. CONCLUSIONS--These data should help pathologists faced with the task of assessing the underlying structural integrity of the vessel wall in cases of vertebral artery injury. Images PMID:8254085

  17. Prevention of esophageal strictures after endoscopic submucosal dissection

    PubMed Central

    Kobayashi, Shinichiro; Kanai, Nobuo; Ohki, Takeshi; Takagi, Ryo; Yamaguchi, Naoyuki; Isomoto, Hajime; Kasai, Yoshiyuki; Hosoi, Takahiro; Nakao, Kazuhiko; Eguchi, Susumu; Yamamoto, Masakazu; Yamato, Masayuki; Okano, Teruo

    2014-01-01

    Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have recently been accepted as less invasive methods for treating patients with early esophageal cancers such as squamous cell carcinoma and dysplasia of Barrett’s esophagus. However, the large defects in the esophageal mucosa often cause severe esophageal strictures, which dramatically reduce the patient’s quality of life. Although preventive endoscopic balloon dilatation can reduce dysphagia and the frequency of dilatation, other approaches are necessary to prevent esophageal strictures after ESD. This review describes several strategies for preventing esophageal strictures after ESD, with a particular focus on anti-inflammatory and tissue engineering approaches. The local injection of triamcinolone acetonide and other systemic steroid therapies are frequently used to prevent esophageal strictures after ESD. Tissue engineering approaches for preventing esophageal strictures have recently been applied in basic research studies. Scaffolds with temporary stents have been applied in five cases, and this technique has been shown to be safe and is anticipated to prevent esophageal strictures. Fabricated autologous oral mucosal epithelial cell sheets to cover the defective mucosa similarly to how commercially available skin products fabricated from epidermal cells are used for skin defects or in cases of intractable ulcers. Fabricated autologous oral-mucosal-epithelial cell sheets have already been shown to be safe. PMID:25386058

  18. A Novel Fenestration Technique for Abdominal Aortic Dissection Membranes Using a Combination of a Needle Re-entry Catheter and the 'Cheese-wire' Technique

    SciTech Connect

    Kos, Sebastian; Guerke, Lorenz; Jacob, Augustinus L.

    2011-12-15

    Purpose: This study was designed to demonstrate the applicability of a combined needle-based re-entry catheter and 'cheese-wire' technique for fenestration of abdominal aortic dissection membranes. Methods: Four male patients (mean age: 65 years) with acute complicated aortic type B dissections were treated at our institution by fenestrating the abdominal aortic dissection membrane using a hybrid technique. This technique combined an initial membrane puncture with a needle-based re-entry catheter using a transfemoral approach. A guidewire was passed through the re-entry catheter and across the membrane. Using a contralateral transfemoral access, this guidewire was then snared, creating a through-and-through wire access. The membrane was then fenestrated using the cheese-wire maneuver. Results: We successfully performed: (a) membrane puncture; (b) guidewire passage; (c) guidewire snaring; and (d) cheese-wire maneuver in all four cases. After this maneuver, decompression of the false lumen and acceptable arterial inflow into the true lumen was observed in all cases. The dependent visceral arteries were reperfused. In one case, portions of the fenestrated membrane occluded the common iliac artery, which was immediately and successfully stented. In another case, long-standing intestinal hypoperfusion before the fenestration resulted in reperfusion-related shock and intraoperative death of the patient. Conclusions: The described hybrid approach for fenestration of dissection membranes is technically feasible and may be established as a therapeutic method in cases with a complicated type B dissection.

  19. A gallbladder with the “hidden cystic duct”: A brief overview of various surgical techniques of the Calot’s triangle dissection

    PubMed Central

    Hilton, Joanna

    2015-01-01

    We present a case of a middle-aged female who attended for a routine laparoscopic cholecystectomy as a day case surgery. At operation, she was found to have a distended gallbladder with an unusually prominent distal portion. This has made the dissection of the Calot’s triangle challenging. As a result, the “critical view of safety” technique was applied. This allowed for the clear Calot’s triangle visualization and identification of the cystic duct and artery. This case highlights that the knowledge of various ways of the cystic duct dissection is essential to every surgeon. Furthermore, this helps to adjust the dissection approach on an individual case bases ensuring avoidance of the common bile duct injuries. PMID:25838927

  20. Chronic type B aortic dissection: indications and strategies for treatment.

    PubMed

    Rohlffs, F; Tsilimparis, N; Diener, H; Larena-Avellaneda, A; Von Kodolitsch, Y; Wipper, S; Debus, E S; Kölbel, T

    2015-04-01

    Chronic type B aortic dissection is a distinctive condition that needs individual treatment strategies and different considerations than in therapy of acute or subacute type B aortic dissection. The most common indication for treatment of this complex disease is aneurysmal dilatation of the dissected aortic segment. While open repair of the enlarged dissected aorta remains the best option for good-risk patients and patients with connective tissue disorders in high-volume centers with respective expertise, endovascular management of chronic type B aortic dissection with postdissection aneurysms has significantly gained ground in the past years. But the concept of TEVAR with implantation of a tubular stent-graft into the thoracic aorta to seal the proximal entry tear and reroute the blood flow into the true lumen alone, is not associated with satisfactory results. This is mainly due to the sparse remodeling capacity of the aortic tissue compared to earlier stages of the disease as the aortic wall and the dissection membrane are thickened and more rigid. On the other hand, it is restricted by the most limiting factor for endovascular success in chronic type B aortic dissection: persistent false lumen perfusion. This problem also affects patients with residual dissection after surgical repair of a DeBakey type I aortic dissection or dissection after ascending aortic repair for other pathologies. Hence, it is evident that strategies to achieve endovascular false lumen occlusion are of increasing importance and novel techniques have been introduced to solve the problem of persisting false lumen flow. Thus, the evolution of a large variety of techniques to address the false lumen perfusion issue indicates that complicated chronic type B dissection involves a high diversity in clinical presentation and morphology. A large armamentarium of catheter skills as well as critical individualized treatment strategies are required to address the heterogenous morphological disease pattern for each individual patient. The rapid development in endovascular techniques gives new directions for treatment indications and strategies in chronic aortic dissection and enables new insights into this old disease. PMID:25604323

  1. [Spontaneous coronary artery dissection and ST-segment elevation myocardial infarction (STEMI)].

    PubMed

    Malcles, G; Combaret, N; Motreff, P

    2015-12-01

    Spontaneous coronary artery dissection (SCAD) is a poorly understood and under-diagnosed entity of acute coronary syndrome, affecting predominantly young women. On coronary angiography, the diagnosis remains challenging, particularly in case of intramural hematoma without intimal rupture. Intracoronary imaging, especially by optical coherence tomography (OCT), provides an incremental value in terms of diagnosis and management. We report the case of a 49-year-old woman admitted for STEMI caused by an intramural hematoma. In the discussion part, we aim to review the epidemiology, physiopathology, diagnosis, management and long-term prognosis of SCAD. PMID:26601736

  2. SMAD2 Mutations Are Associated with Arterial Aneurysms and Dissections.

    PubMed

    Micha, Dimitra; Guo, Dong-Chuan; Hilhorst-Hofstee, Yvonne; van Kooten, Fop; Atmaja, Dian; Overwater, Eline; Cayami, Ferdy K; Regalado, Ellen S; van Uffelen, René; Venselaar, Hanka; Faradz, Sultana M H; Vriend, Gerrit; Weiss, Marjan M; Sistermans, Erik A; Maugeri, Alessandra; Milewicz, Dianna M; Pals, Gerard; van Dijk, Fleur S

    2015-12-01

    We report three families with arterial aneurysms and dissections in which variants predicted to be pathogenic were identified in SMAD2. Moreover, one variant occurred de novo in a proband with unaffected parents. SMAD2 is a strong candidate gene for arterial aneurysms and dissections given its role in the TGF-? signaling pathway. Furthermore, although SMAD2 and SMAD3 probably have functionally distinct roles in cell signaling, they are structurally very similar. Our findings indicate that SMAD2 mutations are associated with arterial aneurysms and dissections and are in accordance with the observation that patients with pathogenic variants in genes encoding proteins involved in the TGF-? signaling pathway exhibit arterial aneurysms and dissections as key features. PMID:26247899

  3. Combining Genomic Tools to Dissect Multifactorial Virulence in Pseudomonas

    E-print Network

    Ausubel, Frederick M.

    Combining Genomic Tools to Dissect Multifactorial Virulence in Pseudomonas aeruginosa Daniel G. Lee- ronmental bacterium and important opportunistic human pathogen, Pseudomonas aeruginosa. By comparing PA14 Introduction The growing number of sequenced bacterial genomes, including those of important pathogenic

  4. Spontaneous Coronary Artery Dissection: Not Just a Heart Attack

    MedlinePLUS

    ... Stroke More Coronary Artery Dissection: Not Just a Heart Attack Updated:Sep 3,2015 Sometimes a heart attack ... Disease Go Red For Women Types of aneurysms Heart Attack • Home • About Heart Attacks • Warning Signs of a ...

  5. Chemistry & Biology Structure-Based Dissection of the Natural Product

    E-print Network

    van Aalten, Daan

    Chemistry & Biology Article Structure-Based Dissection of the Natural Product Cyclopentapeptide chemotherapeutic potential as fungicides, pesticides, and antiasthmatics. Argifin, a natural product extensive substrate mim- icry. In an attempt to map the active fragments of this large natural product

  6. The risk for type B aortic dissection in Marfan syndrome.

    PubMed

    Setacci, C; Galzerano, G; Setacci, F; Mazzitelli, G; de Donato, G; Ricci, C

    2015-12-01

    Marfan syndrome is the most prevalent connective tissue disorder, with an autosomal dominant inheritance with variable penetrance. This paper aims to summarize epidemiology and treatment for type B dissection in Marfan patients. PMID:26350976

  7. Stanford-A acute aortic dissection, inflammation, and metalloproteinases: A review.

    PubMed

    Cifani, Noemi; Proietta, Maria; Tritapepe, Luigi; Di Gioia, Cira; Ferri, Livia; Taurino, Maurizio; Del Porto, Flavia

    2015-09-01

    Acute aortic dissection (AAD) is a life-threatening disease with an incidence of about 2.6-3.6 cases per 100,000/year. Depending on the site of rupture, AAD is classified as Stanford-A when the ascending aortic thoracic tract and/or the arch are involved, and Stanford-B when the descending thoracic aorta and/or aortic abdominal tract are targeted. It was recently shown that inflammatory pathways underlie aortic rupture in both type A and type B Stanford AAD. An immune infiltrate has been found within the middle and outer tunics of dissected aortic specimens. It has also been observed that the recall and activation of macrophages inside the middle tunic are key events in the early phases of AAD. Macrophages are able to release metalloproteinases (MMPs) and pro-inflammatory cytokines which, in turn, give rise to matrix degradation and neoangiogenesis. An imbalance between the production of MMPs and MMP tissue inhibitors is pivotal in the extracellular matrix degradation underlying aortic wall remodelling in dissections occurring both in inherited conditions and in atherosclerosis. Among MMPs, MMP-12 is considered a specific marker of aortic wall disease, whatever the genetic predisposition may be. The aim of this review is, therefore, to take a close look at the immune-inflammatory mechanisms underlying Stanford-A AAD. PMID:26339779

  8. Thermal Protection During Percutaneous Thermal Ablation Procedures: Interest of Carbon Dioxide Dissection and Temperature Monitoring

    SciTech Connect

    Buy, Xavier; Tok, Chung-Hong; Szwarc, Daniel; Bierry, Guillaume; Gangi, Afshin

    2009-05-15

    Percutaneous image-guided thermal ablation of tumor is widely used, and thermal injury to collateral structures is a known complication of this technique. To avoid thermal damage to surrounding structures, several protection techniques have been reported. We report the use of a simple and effective protective technique combining carbon dioxide dissection and thermocouple: CO{sub 2} displaces the nontarget structures, and its low thermal conductivity provides excellent insulation; insertion of a thermocouple in contact with vulnerable structures achieves continuous thermal monitoring. We performed percutaneous thermal ablation of 37 tumors in 35 patients (4 laser, 10 radiofrequency, and 23 cryoablations) with protection of adjacent vulnerable structures by using CO{sub 2} dissection combined with continuous thermal monitoring with thermocouple. Tumor locations were various (19 intra-abdominal tumors including 4 livers and 9 kidneys, 18 musculoskeletal tumors including 11 spinal tumors). CO{sub 2} volume ranged from 10 ml (epidural space) to 1500 ml (abdominal). Repeated insufflations were performed if necessary, depending on the information given by the thermocouple and imaging control. Dissection with optimal thermal protection was achieved in all cases except two patients where adherences (one postoperative, one arachnoiditis) blocked proper gaseous distribution. No complication referred to this technique was noted. This safe, cost-effective, and simple method increases the safety and the success rate of percutaneous thermal ablation procedures. It also offers the potential to increase the number of tumors that can be treated via a percutaneous approach.

  9. Polypoid leiomyosarcoma of the esophagus treated by endoscopic submucosal dissection.

    PubMed

    Yamamoto, Yoshinobu; Nishisaki, Hogara; Koma, Yu-ichiro; Sawai, Hiroaki; Sakai, Aya; Mimura, Takuya; Kushida, Saeko; Tsumura, Hidetaka; Sakamoto, Takeshi; Tobimatsu, Kazutoshi; Miki, Ikuya; Sakuma, Toshiko; Tsuda, Masahiro; Mano, Masayuki; Hirose, Takanori; Inokuchi, Hideto

    2015-09-01

    We report a rare case of polypoid leiomyosarcoma of the esophagus that was treated by endoscopic submucosal dissection (ESD). A 63-year-old man with complaints of progressive dysphagia was referred to Hyogo Cancer Center for treatment of esophageal tumor. Esophagoscopy revealed a polypoid tumor 25 mm in diameter on the left side of the upper esophagus. Despite several biopsy specimens, the diagnosis could not be confirmed. Computed tomography showed a protruded, homogeneously enhancing mass in the upper esophagus, but no lymph node enlargement or metastasis. After 1.5 months, the esophagogram showed a filling defect 47 mm in diameter in the upper esophagus. Given this rapid tumor growth, en bloc resection was done by ESD for therapeutic diagnosis. After this treatment, the tumor seemed to grow larger, showing a short stalk and occupying the esophageal lumen. Histopathologically, the tumor comprised pleomorphic spindle cells with mitosis. Tumor invasion involved the lumina propria mucosae and contact with the muscularis mucosae, but not involving the submucosa. Immunohistochemical examination showed positive staining for smooth muscle actin and HHF35, but negative for desmin, caldesmon, CD34, c-kit, DOG1, ALK, S-100 protein and cytokeratin. These histopathological findings were compatible with a diagnosis of esophageal leiomyosarcoma derived from the muscularis mucosae. PMID:25597630

  10. A unifying experimental design for dissecting tree genomes.

    PubMed

    Sun, Lidan; Zhu, Xuli; Zhang, Qixiang; Wu, Rongling

    2015-08-01

    Linkage mapping and association mapping are adopted as an approach of choice for dissecting complex traits, but each shows a limitation when used alone. We propose an open-pollinated (OP) family design to integrate these two approaches into an organizing framework. The design unifies the strengths of population and quantitative genetic studies for evolutionary inference and high-resolution gene mapping. It particularly suits genome dissection of forest trees given their extant populations that are mostly undomesticated. PMID:26094003

  11. Robotic transaxillary central neck dissection: video description of the technique.

    PubMed

    Agcaoglu, Orhan; Aliyev, Shamil; Siperstein, Allan; Berber, Eren

    2012-08-01

    Although various groups have described their experiences with robotic transaxillary thyroidectomy, to our knowledge, robotic central neck dissection has not been described in the North American literature. We here demonstrate the technique of robotic central neck dissection at the time of transaxillary total thyroidectomy. The procedure was performed under general anesthesia through a 6-cm right axillary incision. The robotic camera and 2 working robotic arms were used for the procedure. PMID:22874698

  12. Radical lymph node dissection for cancer of the thoracic esophagus.

    PubMed Central

    Akiyama, H; Tsurumaru, M; Udagawa, H; Kajiyama, Y

    1994-01-01

    OBJECTIVE: The authors documented the localization and frequency of lymphatic spread in squamous cell carcinoma of the thoracic esophagus and evaluated the influence of radical systematic lymph node dissection on patient survival. SUMMARY BACKGROUND DATA: From accumulated surgical experience, it was suggested that some of the patients with lymph nodal involvement from cancer could be cured by its clearance. However, it is only recently that cancer of the esophagus has been evaluated in terms of analyzing lymphatic spread and results of lymphadenectomy. METHODS: Among 1298 patients admitted to the Toranomon Hospital between 1973 and 1993, 913 (70.3%) had resections, including curative and palliative procedures. For this study, 717 patients with TNM RO (resection with no residual tumor at operation in TNM classification) were analyzed. Survival was compared between groups of patients with less extensive thoracoabdominal (two-field) dissections and extensive collothoracoabdominal (three-field) dissections. RESULTS: Comparative study revealed that 5-year survival rate for TNM RO patients after free-field dissection (55.0%) was significantly better (log rank test, p = 0.0013) than the rate after two-field dissection (38.3%). The results were particularly significant in subgroups with stage III and IV (because of nodal factor). Overall 5-year survival rate after all resections was 42.4%. CONCLUSIONS: The role of radical lymph node dissection in cancer of the thoracic esophagus evaluated. Long-term survival was compared between two groups with two- and three-field dissection. It was concluded that survival rate was significantly better in patients with extensive three-field dissection. PMID:8092902

  13. Dissecting innate immunity by germline mutagenesis

    PubMed Central

    Rutschmann, Sophie; Hoebe, Kasper

    2008-01-01

    The innate arm of our immune system is the first line of defence against infections. In addition, it is believed to drive adaptive immune responses, which help fight pathogens and provide long-term memory. As such, the innate immune system is instrumental for protection against pathogens that would otherwise destroy their host. Although our understanding of the innate immune components involved in pathogen sensing and fighting is improving, it is still limited. This is particularly exemplified by increased documentation of innate immune deficiencies in humans that often result in high and recurrent susceptibility to infections or even death, without the genetic cause being evident. To provide further insight into the mechanisms by which pathogen sensing and eradication occur, several strategies can be used. The current review focuses on the forward genetic approaches that have been used to dissect innate immunity in the fruit fly and the mouse. For both animal models, forward genetics has been instrumental in the deciphering of innate immunity and has greatly improved our understanding of how we respond to invading pathogens. PMID:18205789

  14. Endoscopic Submucosal Dissection (ESD) in Colorectal Tumors

    PubMed Central

    Dumoulin, Franz Ludwig; Sido, Bernd; Bollmann, Reinhard; Sauer, Malte

    2014-01-01

    Summary Background Endoscopic submucosal dissection (ESD) – initially developed for the treatment of early gastric cancer in Japan – is an attractive option for en bloc resection of larger sessile or flat colorectal neoplasia. Methods A review of the current literature on colorectal ESD was carried out. Results In contrast to conventional endoscopic mucosal resection (EMR), ESD for larger colorectal neoplasia yields high en bloc resection rates and very low recurrence rates. The frequency of delayed bleeding is similar for EMR and ESD. Higher perforation rates during ESD are mostly due to microperforations identified and treated during the intervention, and are therefore of minor clinical relevance. A major disadvantage of ESD is the necessity for high-level endoscopic skills and long procedure times. ESD also has the potential to replace laparoscopic surgery or transanal endoscopic microsurgery mainly due to its lower complication rates. Conclusion ESD for the resection of larger flat or sessile colorectal lesions has potential advantages over conventional EMR or minimally invasive surgery. Due to the low incidence of early gastric cancer, experience with ESD will remain limited in Western countries. The spread of colorectal ESD will depend on adequate training opportunities and also on modifications yielding a reduction in procedure time. PMID:26288580

  15. [Esophagectomy after endoscopic submucosal dissection (ESD)].

    PubMed

    Nako, Yoshito; Shiozaki, Atushi; Fujiwara, Hitoshi; Konishi, Hirotaka; Kosuga, Toshiyuki; Morimura, Ryo; Murayama, Yasutoshi; Komatsu, Shuhei; Ikoma, Hisashi; Kuriu, Yoshiaki; Nakanishi, Masayoshi; Ichikawa, Daisuke; Okamoto, Kazuma; Sakakura, Chouhei; Otsuji, Eigo

    2014-11-01

    Herein, we report 9 patients who underwent esophagectomy after endoscopic submucosal dissection (ESD) between April 2003 and December 2013. All patients were men, with a mean age of 65 years. En bloc ESD was performed, and no complications arose in any patient. The mean surgical time of esophagectomy was 323 minutes, and mean blood loss was 295 mL. Postoperative complications were present in 5 patients(anastomotic leakage in 3, pulmonary complications in 2, and recurrent laryngeal nerve palsy in 1). In a patient diagnosed with pT1b-SM1 disease after ESD, a residual tumor(pT1a-MM, N0) was detected after esophagectomy. In another patient diagnosed with pT1b-SM2 disease, lymph node metastasis was detected after esophagectomy. In all patients, curative resection was performed, and no recurrences have been observed to date. This highlights the importance of additional esophagectomy after ESD for patients with pT1b disease. Esophagectomy after ESD can be considered a valid treatment because it provides high curative rates with acceptable safety. PMID:25731401

  16. Optogenetic dissection of medial prefrontal cortex circuitry

    PubMed Central

    Riga, Danai; Matos, Mariana R.; Glas, Annet; Smit, August B.; Spijker, Sabine; Van den Oever, Michel C.

    2014-01-01

    The medial prefrontal cortex (mPFC) is critically involved in numerous cognitive functions, including attention, inhibitory control, habit formation, working memory and long-term memory. Moreover, through its dense interconnectivity with subcortical regions (e.g., thalamus, striatum, amygdala and hippocampus), the mPFC is thought to exert top-down executive control over the processing of aversive and appetitive stimuli. Because the mPFC has been implicated in the processing of a wide range of cognitive and emotional stimuli, it is thought to function as a central hub in the brain circuitry mediating symptoms of psychiatric disorders. New optogenetics technology enables anatomical and functional dissection of mPFC circuitry with unprecedented spatial and temporal resolution. This provides important novel insights in the contribution of specific neuronal subpopulations and their connectivity to mPFC function in health and disease states. In this review, we present the current knowledge obtained with optogenetic methods concerning mPFC function and dysfunction and integrate this with findings from traditional intervention approaches used to investigate the mPFC circuitry in animal models of cognitive processing and psychiatric disorders. PMID:25538574

  17. Medical management of acute type a aortic dissection in association with early open repair of acute limb ischemia may prevent aortic surgery

    PubMed Central

    Gionis, Michalis N.; Kaimasidis, George; Tavlas, Emmanouel; Kontopodis, Nikolaos; Plataki, Marina; Kafetzakis, Alexandros; Ioannou, Christos V.

    2013-01-01

    Summary Background: Acute type A aortic dissection (AAAD) is a cardiovascular emergency with a high potential for death. Rapid surgical treatment is indicated to prevent fatal complications. Aggressive appropriate medical management starts at first suspicion and is essential to prevent exacerbation or rupture of the dissection. Despite improved surgical techniques, perioperative care and the development of specialized cardiovascular centers, mortality remains high. Organ ischemia is a catastrophic manifestation of aortic dissection, demanding acute surgical intervention in specialized cardiovascular centers. Case Report: We present the case of a 62-year-old man with isolated acute limb ischemia due to an acute type A aortic dissection treated in a regional general hospital, without a specialized cardiovascular service, with immediate open malperfusion repair and aggressive medical management. The patient did not undergo further surgical aortic repair, and after a 30-month follow-up he remains symptom free and in good clinical condition, suggesting that although aortic surgery remains the gold standard for treatment of acute Type A dissection, appropriate medical management and early malperfusion repair may offer an initial limb- or life-saving procedure. Conclusions: This staged approach gives clinicians more time to properly evaluate and transfer the patient to a specialized cardiovascular center, and in some cases may even offer a definite treatment. PMID:23569563

  18. A robotic-assisted laparoscopic approach for pediatric renal cell carcinoma allows for both nephron-sparing surgery and extended lymph node dissection.

    PubMed

    Cost, Nicholas G; Geller, James I; DeFoor, W Robert; Wagner, Lars M; Noh, Paul H

    2012-10-01

    Partial nephrectomy has been previously reported as safe and effective in appropriately selected children with renal cell carcinoma (RCC). However, there are limited reports of laparoscopic or robotic partial nephrectomy for oncologic surgery in children. Additionally, nodal involvement is common in pediatric RCC, and may present even with small primary tumors. Also, it is suggested that lymph node dissection may provide therapeutic benefit. We present a case of pediatric RCC and demonstrate how the risk of nodal involvement may impact the surgical approach. Robotic-assisted laparoscopy can permit excellent exposure for an oncologically-sound resection, in this case a partial nephrectomy, as well as an extended lymph node dissection. PMID:23084214

  19. Spontaneous coronary artery dissection in a 22-year-old man on lisdexamfetamine

    PubMed Central

    Afzal, Aasim M.; Sarmast, Syed A.; Weber, Nicholas A.

    2015-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of coronary events and sudden cardiac death. SCAD can present with a wide spectrum of clinical presentations and as an entity remains underrecognized. Several risk factors, such as female gender, peripartum and early postpartum state, and atherosclerotic disease, have been attributed to SCAD. Amphetamine use has been attributed to an increased risk for coronary artery events. We present a case of a 22-year-old man on lisdexamfetamine and no other significant medical history who presented with SCAD and was successfully treated with medical management. PMID:26130892

  20. Robot-assisted laparoscopic retroperitoneal lymph node dissection in an adolescent population.

    PubMed

    Cost, Nicholas G; DaJusta, Daniel G; Granberg, Candace F; Cooksey, Raven M; Laborde, Carrie E; Wickiser, Jonathan E; Gargollo, Patricio C

    2012-06-01

    Abstract Laparoscopic retroperitoneal lymph node dissection (RPLND) has been shown to be safe and effective in appropriately selected pediatric and adolescent patients with paratesticular rhabdomyosarcoma (RMS) and testicular germ-cell tumors (T-GCT). While the use of robot-assisted laparoscopy has expanded rapidly in many areas, there are very limited reports of its use with RPLND. We present two cases of adolescents who were treated using robot-assisted laparoscopic RPLND (R-RPLND)-one with paratesticular RMS (PT-RMS) and one with testicular GCT (T-GCT)-with good outcomes and low morbidity. PMID:22142250

  1. Iatrogenic subclavian artery and aortic dissection with mesenteric ischemia following subclavian artery angioplasty: Endovascular management.

    PubMed

    Millán, Xavier; Azzalini, Lorenzo; Dorval, Jean-François

    2015-10-01

    Subclavian stenosis affects up to 5% of patients referred for coronary artery bypass grafting. Albeit usually asymptomatic, this condition can cause myocardial ischemia due to a steal phenomenon from the distal subclavian artery when the left internal mammary artery is used as a coronary bypass. We describe a case of proximal subclavian artery angioplasty complicated with aortic dissection and subsequent life-threatening mesenteric ischemia. For the first time, we illustrate an endovascular approach to both complications consisting in urgent stenting of the celiac trunk and the superior mesenteric artery followed by staged thoracic endovascular aortic repair due to progressive aortic dilatation. © 2015 Wiley Periodicals, Inc. PMID:25712709

  2. Delayed surgery for type A aortic dissection caused by blunt trauma.

    PubMed

    Takahashi, Shinya; Uchida, Naomichi; Takasaki, Taiichi; Sueda, Taijiro

    2015-02-01

    We describe a rare case of delayed surgery for blunt ascending aortic injury. A 77-year-old man was injured in a traffic accident. He lost consciousness and suffered severe blunt trauma to the chest. Computed tomography showed multiple head and chest injuries and acute Stanford type A aortic dissection. The operation was postponed because he was hemodynamically stable and his risk of surgical death was increased due to his other injuries. Serial computed tomography showed growth of the aortic lesion, and aortic surgery was successfully performed 11 months after admission to the hospital. The postoperative course was uneventful. PMID:24887869

  3. Dissecting through barriers: A mixed-methods study on the effect of interprofessional education in a dissection course with healthcare professional students.

    PubMed

    Fernandes, Alisha Rebecca; Palombella, Andrew; Salfi, Jenn; Wainman, Bruce

    2015-01-01

    Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and diminished negative professional stereotypes. An intensive interprofessional gross anatomy dissection course was created in 2009 to facilitate IPE at McMaster University. Data were collected from five cohorts over five years to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions. Each year, 28 students from the medicine, midwifery, nursing, physician's assistant, physiotherapy, and occupational therapy programs were randomly assigned into interprofessional teams for 10 weeks. Sessions involved an anatomy and scope-of-practice presentation, a small-group case-based session, and a dissection. A before/after design measured changes in attitudes and perceptions, while focus group data elaborated on the student experience with the course. Pre- and postmatched data revealed significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative analysis of intraprofessional focus group interviews revealed meaningful improvements in a number of areas including learning anatomy, role clarity, and attitudes towards other health professions. PMID:25641912

  4. Free manual of cadaver dissection modifiable by other anatomists.

    PubMed

    Chung, Beom Sun; Chung, Min Suk

    2015-06-01

    Even in the rapidly changing field of cadaver dissection, published guide books still play an important role in the anatomy lab. However, commercial manuals with lengthy volumes and inflexible copyrights have several limitations which can be complemented by open-source manuals. Recently, the authors have manufactured and distributed a free electronic dissection manual (anatomy.co.kr), where descriptions are written concisely and images are drawn schematically. Moreover, simplified signs are employed to represent the cadaver viewing angles and manner of dissection. Based on the original files of this manual, other anatomists can revise and utilize the descriptions and figures. We expect many updated versions of our manual to be shared between students all over the world. PMID:25577205

  5. Digital dissection system for medical school anatomy training

    NASA Astrophysics Data System (ADS)

    Augustine, Kurt E.; Pawlina, Wojciech; Carmichael, Stephen W.; Korinek, Mark J.; Schroeder, Kathryn K.; Segovis, Colin M.; Robb, Richard A.

    2003-05-01

    As technology advances, new and innovative ways of viewing and visualizing the human body are developed. Medicine has benefited greatly from imaging modalities that provide ways for us to visualize anatomy that cannot be seen without invasive procedures. As long as medical procedures include invasive operations, students of anatomy will benefit from the cadaveric dissection experience. Teaching proper technique for dissection of human cadavers is a challenging task for anatomy educators. Traditional methods, which have not changed significantly for centuries, include the use of textbooks and pictures to show students what a particular dissection specimen should look like. The ability to properly carry out such highly visual and interactive procedures is significantly constrained by these methods. The student receives a single view and has no idea how the procedure was carried out. The Department of Anatomy at Mayo Medical School recently built a new, state-of-the-art teaching laboratory, including data ports and power sources above each dissection table. This feature allows students to access the Mayo intranet from a computer mounted on each table. The vision of the Department of Anatomy is to replace all paper-based resources in the laboratory (dissection manuals, anatomic atlases, etc.) with a more dynamic medium that will direct students in dissection and in learning human anatomy. Part of that vision includes the use of interactive 3-D visualization technology. The Biomedical Imaging Resource (BIR) at Mayo Clinic has developed, in collaboration with the Department of Anatomy, a system for the control and capture of high resolution digital photographic sequences which can be used to create 3-D interactive visualizations of specimen dissections. The primary components of the system include a Kodak DC290 digital camera, a motorized controller rig from Kaidan, a PC, and custom software to synchronize and control the components. For each dissection procedure, the images are captured automatically, and then processed to generate a Quicktime VR sequence, which permits users to view an object from multiple angles by rotating it on the screen. This provides 3-D visualizations of anatomy for students without the need for special '3-D glasses' that would be impractical to use in a laboratory setting. In addition, a digital video camera may be mounted on the rig for capturing video recordings of selected dissection procedures being carried out by expert anatomists for playback by the students. Anatomists from the Department of Anatomy at Mayo have captured several sets of dissection sequences and processed them into Quicktime VR sequences. The students are able to look at these specimens from multiple angles using this VR technology. In addition, the student may zoom in to obtain high-resolution close-up views of the specimen. They may interactively view the specimen at varying stages of dissection, providing a way to quickly and intuitively navigate through the layers of tissue. Electronic media has begun to impact all areas of education, but a 3-D interactive visualization of specimen dissections in the laboratory environment is a unique and powerful means of teaching anatomy. When fully implemented, anatomy education will be enhanced significantly by comparison to traditional methods.

  6. Total thyroidectomy without prophylactic central neck dissection in clinically node-negative papillary thyroid cancer: is it an adequate treatment?

    PubMed Central

    2014-01-01

    Background Cervical lymph node metastases in papillary thyroid cancer are common. Although central neck dissection is indicated in clinically nodal-positive disease, it remains controversial in patients with no clinical evidence of nodal metastasis. The aim of this retrospective study was to determine the outcomes of clinically lymph node-negative patients with papillary thyroid cancer who underwent total thyroidectomy without a central neck dissection, in order to determine the rates of recurrence and reoperation in these patients compared with a group of patients submitted to total thyroidectomy with central neck dissection. Methods Two-hundred and eighty-five patients undergoing total thyroidectomy with preoperative diagnosis of papillary thyroid cancer, in the absence of suspicious nodes, were divided in two groups: those who underwent a thyroidectomy only (group A; n?=?220) and those who also received a central neck dissection (group B; n?=?65). Results Six cases (2.1%) of nodal recurrence were observed: 4 in group A and 2 in group B. Tumor histology was associated with risk of recurrence: Hürthle cell-variant and tall cell-variant carcinomas were associated with a high risk of recurrence. Multifocality and extrathyroidal invasion also presented a higher risk, while smaller tumors were at lower risk. Conclusions The role of prophylactic central lymph node dissection in the management of papillary thyroid cancer remains controversial. Total thyroidectomy appears to be an adequate treatment for clinically node-negative papillary thyroid cancer. Prophylactic central neck dissection could be considered for the more appropriate selection of patients for radioiodine treatment and should be reserved for high-risk patients only. No clinical or pathological factors are able to predict with any certainty the presence of nodal metastasis. In our experience, tumor size, some histological types, multifocality, and locoregional infiltration are related to an increased risk of recurrence. The potential use of molecular markers will hopefully offer a further strategy to stratify the risk of recurrence in patients with papillary thyroid cancer and allow a more tailored approach to offer prophylactic central neck dissection to patients with the greatest benefit. Multi-institutional larger studies with longer follow-up periods are necessary to draw definitive conclusions. PMID:24885654

  7. Role of cadaveric dissections in modern medical curricula: a study on student perceptions

    PubMed Central

    Nirthanan, Selvanayagam N.; Khoo, Tien K.; Tedman, Raymond

    2015-01-01

    The shift from traditional medical curricula to newer teaching and learning approaches such as problem-based learning has often resulted in omission or significant reduction of cadaveric dissections as a method of learning anatomy. The objective of this study was to evaluate students' perception of dissection in a graduate-entry, problem-based learning-based medical curriculum. At the end of the musculoskeletal dissection program in second year, a Likert-type questionnaire was used to explore medical student perceptions of the perceived advantages and challenges of cadaveric dissections in comparison with other anatomy teaching methods. Overall, a majority of students had a positive perception of dissections. Students who attended dissections regularly had significantly more positive perceptions about their experience and were in agreement with statements such as "dissections make learning more interesting" and "I would be disadvantaged if I did not attend dissection classes." Non-regular attendance was associated with statements about dissections such as "I do not like the smell," "time consuming," and "bored with the way it is carried-out." A follow-up study after completion of the medical program revealed a significant improvement of positive perception about dissection. Student perceptions appear to favour a role for cadaveric dissection in learning anatomy in modern medical curricula. However, optimal and effective integration of dissections is important, with consideration given to its structure and extent of content weighed against logistics and availability of resources; while addressing negative perceptions of dissection-based teaching. PMID:26417481

  8. What is happening in our anatomical dissection rooms?

    PubMed

    Hildebrandt, Sabine

    2014-09-01

    A recent student article relates disrespectful and traumatizing events in a modern dissection room. This comment serves to remind anatomical educators' of their duties toward the medical students. It is the anatomical educators' duty to help students not only to become familiar with the structure of the human body but also with the emotional repertoire available when dealing with the living and the dead. And it is the educators' duty to accompany students through the dissection course experience in a manner that keeps them safe from emotional harm. PMID:24648394

  9. Basic dissecting techniques in ultrasound-guided surgery

    PubMed Central

    Koczy, Bogdan; Mielnik, Micha?; Pilecki, Grzegorz; Dzielicki, Józef; Jakubowski, Wies?aw

    2014-01-01

    Ultrasound-guided surgery is an area of minimally-invasive surgery where surgical procedures are performed with the aid of ultrasound imaging throghout the operation. This requires the operator to posses a certain degree of experience in endoscopic procedures, and to be adeptly skillfull in conducting US examinations. It is combining and finely tuning together these two elements that allows to perform efficiently an ultrasound-guided surgical procedure. Accessing an affected site correctly is of utmost importance in surgery, being oftentimes decisive in terms of the procedure's final outcome. In ultrasound-guided procedures, the operative site is accessed percutaneously, with a single point incision, yet tissues situated deeper within are dissected with dissecting techniques in a fluid evironment, typical for this area of surgery. Dissecting techniques in ultrasound-guided surgery are currently divided into basic ones which employ either a hydrodissection needle, surgical instruments, electrosurgical instruments, a thread, or a combination thereof, and advanced ones where either a balloon, a hook dissection technique, or a hybrid one is used. Hydrodissection with a needle was devised based on the rule of complementarity, and is the most frequently applied technique in ultrasound-guided surgery. The immense possibilities that go along with this modality will be of huge benefit to any surgeon, regardless of their field. Dissection with a variety of surgical instruments and electrosurgery instruments is a standard practice in all surgery areas, yet the method of imaging we employ in ultrasound-guided surgery results in certain modifications of these techniques. It is, however, learning the thread technique that facilitates a precise and oftentimes extensive dissection. This technique is successfully applied for dissecting muscle, ligament, tendon, vascular and other structures. Having mastered dissecting techniques allows to perform any minimally-invasive procedure efficiently, be they ultrasound-guided, artroscopic, or endoscopic ones. Various surgical techniques are bridged, resulting in applying the so-called hybrid ones. Their strength lies in excellent imaging results allowing to conduct a surgical procedure both in a body cavity and within a parenchymal organ. PMID:26674391

  10. 78 FR 17429 - Certain Balloon Dissection Devices and Products Containing Same; Commission Determination Not To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-21

    ...337-TA-865] Certain Balloon Dissection Devices and Products...after importation of certain balloon dissection devices and products...Geisingen, Germany; and Pajunk Medical Systems LP of Norcross, Georgia...Medizintechnologie and Pajunk Medical Systems LP filed a motion...

  11. Sternocleidomastoid muscle flap used for repairing the dead space after supraomohyoid neck dissection

    PubMed Central

    Li, Jinzhong; Han, Zhengxue

    2015-01-01

    Surgical site infection (SSI) is a common complication followed neck dissection and dead space is a common reason of SSI. The present study is aimed to explore whether the sternocleidomastoid muscle (SCM) flap transposition to repair the dead space in level II of neck could decrease the postoperative SSI in patients with oral squamous cell carcinoma (OSCC) underwent supraomohyoid neck dissection (SOND). Ninety-six patients with cT2-3N0 OSCC who underwent extended resection of primary cancer combined SOND and reconstructed with free flap from March 2011 to October 2014 in our department were included. Forty-eight cases underwent SCM transposition to repair the potential dead space in level II of the neck, the other 48 cases did not. The two groups were matched at age, gender, concomitant diseases, and perioperative treatments. All the patients underwent exhaustive hemostasis and careful placement of negative pressure drainage. The wound healing was observed on 7 days postoperatively. The SSI rates of neck between the two groups were compared using Fisher’s exact test. The dead space in level II was observed in all the neck wounds after SOND. The neck wounds healed by primary intention in 46 cases underwent SCM flap transposition, and in 39 cases underwent routine SOND only. Two cases with SCM flap transposition and 9 cases in the group without SCM flap transposition presented SSI in neck. There was significant difference in the SSI rate between the two groups (P = 0.0248). The dead space in level II could be an important cause of SSI in neck followed SOND. Repairing of the dead space in level II using SCM flap transposition reduce the SSI rate of neck followed SOND. PMID:25785129

  12. Aneurysm of Sinus of Valsalva Dissecting Into the Interventricular Septum After Aortic Valve Replacement: Diagnosis by Echocardiography and Magnetic Resonance Imaging and Treatment With Surgical Sealant

    PubMed Central

    Park, Kyu-Hwan; Son, Chang-Woo; Son, Jang-Won; Jo, Hyun-Su; Yoon, Joon-Cheol; Lee, Won-Jae; Lee, Sang-Hee; Hong, Geu-Ru; Park, Jong-Seon; Kim, Young-Jo; Choi, Jung-Hyun; Lee, Dong-Hyup

    2011-01-01

    Aneurysm of the sinus of Valsalva that causes dissection of the interventricular septum is an extremely rare entity. In this report we describe a case of aneurysm of the sinus of Valsalva dissecting into the interventricular septum, from the base to mid septum, after aortic valve replacement. After the diagnosis was made by transthoracic echocardiography and magnetic resonance imaging, the patient was successfully treated with surgical sealant-mediated occlusion of the aneurysmal sac and cardiac resynchronization therapy used for the first time. PMID:21949531

  13. Oregon Sea Grant Marine Education Program at Hatfield Marine Science Center Squid Dissection

    E-print Network

    Wright, Dawn Jeannine

    Oregon Sea Grant Marine Education Program at Hatfield Marine Science Center Squid Dissection The Squid Dissection program at Hatfield Marine Science Center is designed to be a 50- minute lab the directions of their marine educator, to systematically dissect a thawed squid and explore the many

  14. Biology Teachers' Dissection Practices and the Influences that Lead to Their Adoption: An Exploratory Research

    ERIC Educational Resources Information Center

    Milano, Regina Nicole

    2010-01-01

    The lack of resolution in the on-going animal dissection debate inspired this mixed methods study to identify Connecticut secondary biology teachers' dissection practices and the influences that lead to their adoption. Qualitative findings indicate past experiences, managing objections to dissection, school culture, goals of biology teaching and…

  15. Hinged Dissection of Polypolyhedra Erik D. Demaine 1# , Martin L. Demaine 1 ,

    E-print Network

    Demaine, Erik

    a general family of 3D hinged dissections for polypolyhedra, i.e., connected 3D solids formed by joining for reflectionally symmetric faces.) Each hinged dissection consists of a linear number of solid polyhedral pieces from 2D [7]. Along the way, we present hinged dissections for polyplatonics (where P is a platonic

  16. A Comparison of V-Frog[C] to Physical Frog Dissection

    ERIC Educational Resources Information Center

    Lalley, James P.; Piotrowski, Phillip S.; Battaglia, Barbara; Brophy, Keith; Chugh, Kevin

    2010-01-01

    The purpose of the present study was to examine and compare the effectiveness of virtual frog dissection using V-Frog[C] and physical frog dissection on learning, retention, and affect. Subjects were secondary students enrolled in year-long life science classes in a suburban high school (N=102). Virtual dissections were done with V-Frog[C], a…

  17. The First Cut Is the Deepest: Reflections on the State of Animal Dissection in Biology Education

    ERIC Educational Resources Information Center

    De Villiers, Rian; Monk, Martin

    2005-01-01

    In biology education, the study of structure has traditionally involved the use of dissection. Animal-rights campaigners have caused biology educators and learners to question the necessity of dissections. This study reviews the research evidence for the efficacy of alternatives to dissection and then turns to research evidence on attitudes to…

  18. An Investigative Alternative to Single-Species Dissection in the Introductory Biology Laboratory

    ERIC Educational Resources Information Center

    Carlin, Joel L.

    2010-01-01

    Dissections of single species (e.g., fetal pig) are a common student learning activity in introductory biology courses. Such dissections demonstrate location of anatomical parts and provide dissection practice but provide less opportunity for student critical thinking, numeracy and demonstration of the scientific method. A comparative anatomy lab…

  19. A Computational Algorithm for Creating Geometric Dissection Puzzles Yahan Zhou Rui Wang

    E-print Network

    Massachusetts at Amherst, University of

    polygons, the challenge is to find a solution with as few pieces as possible. In this paper, we present show 2D dissections ­ the first is a 4- piece dissection, and the second is a 5-piece dissection of a rectan- gle with a rasterized octagon. The bottom two rows show 3D dissec- tions ­ the first is a 6-piece

  20. Perceived Disgust and Personal Experiences are Associated with Acceptance of Dissections in Schools

    ERIC Educational Resources Information Center

    Fancovicova, Jana; Prokop, Pavol; Leskova, Andrea

    2013-01-01

    Animal dissections are essential parts of anatomy/zoology courses, but their effectiveness is influenced by student attitudes and emotions. Here we examined attitudes toward dissections in 397 prospective biology teachers enrolling two Slovak universities. Perceived disgust of dissections negatively correlated with other attitudes toward…

  1. Dissecting eukaryotic translation and its control by ribosome density mapping

    E-print Network

    Herschlag, Dan

    Dissecting eukaryotic translation and its control by ribosome density mapping Yoav Arava, F. Edward of these steps determine both the number and position of ribosomes along the mRNA, but tra- ditional velocity sedimentation assays for the trans- lational status of mRNA determine only the number of bound ribosomes. We

  2. Gastric Wall Dissection as a Complication of Percutaneous Gastrostomy

    SciTech Connect

    Reimer, Wolfgang; Farres, Maria Teresa; Lammer, Johannes

    1996-04-15

    A percutaneous gastrostomy (PG) was complicated by gastric wall dissection and partial tube malposition. It occurred after tangential puncture along the greater curvature of the stomach which was performed in order to avoid an enlarged left lobe of the liver. To prevent this complication we recommend not using hydrophilic guidewires during PG.

  3. Using a Dissecting Microscope in Teaching Introductory Chemistry.

    ERIC Educational Resources Information Center

    Winokur, Robert; Monroe, Manus

    1985-01-01

    To have students develop observational skills and acquire an excitement about chemistry, stereoscopic dissecting microscopes are used to observe the physical characteristics and chemical reactions of various substances. Several of these reactions (including dissolving potassium permanganate in deionized water and reactions between copper metal and…

  4. Exploring Dissections of Rectangles into Right-Angled Triangles

    ERIC Educational Resources Information Center

    Griffiths, Martin

    2013-01-01

    In this article we highlight how a simple classroom activity associated with the dissection of rectangles into right-angled triangles can lead on to a number of interesting explorations for students following a post-16 mathematics course. Several results connected with this construction are obtained, and some of the educational benefits of…

  5. Student Attitudes to Whole Body Donation Are Influenced by Dissection

    ERIC Educational Resources Information Center

    Cahill, Kevin C.; Ettarh, Raj R.

    2008-01-01

    Given the important role that anatomical dissection plays in the shaping of medical student attitudes to life and death, these attitudes have not been evaluated in the context of whole body donation for medical science. First year students of anatomy in an Irish university medical school were surveyed by questionnaire before and after the initial…

  6. MBE Supplementary Material Dissecting Linkage Disequilibrium in African American

    E-print Network

    Xu, Shuhua

    S 1 MBE Supplementary Material Dissecting Linkage Disequilibrium in African American: Roles the data and hence was chosen for further analyses. Under the assumption that African and European were either the African cluster or the European cluster. The natural logarithms of the probability ratio (Ln

  7. Hinged Dissection of Polypolyhedra Erik D. Demaine # Martin L. Demaine #

    E-print Network

    Demaine, Erik

    that lies on the face (either interior to the face or on its boundary). For platonic solids, these hinges. Souvaine # 1 Introduction. A dissection of two figures (solid 2D or 3D shapes, e.g., polygons or polyhedra with labeled faces, a polypoly­ hedron of type P is an interior­connected non­self­ intersecting solid formed

  8. Prototyping Dissection Puzzles with Layered Manufacturing Carlo H. Squin

    E-print Network

    O'Brien, James F.

    typically show them some Hamiltonian dissections of the Platonic solids (Fig.1). In these Hamiltonian used as class exercises in a graduate course on computer-aided solid modeling: Helicoidal sectioning concerned with modeling of solid shapes (CS285). Before we give the students their own assignments, we

  9. There Is More to the Dissection of a Pig's Heart

    ERIC Educational Resources Information Center

    Lee, Yeung Chung

    2004-01-01

    The dissection of the mammalian heart in secondary biology classes need not be restricted to revealing the internal structure of the heart and its function. It could also be used to demonstrate other important aspects of blood circulation, including the blood supply to the heart itself as well as the causes and effects of coronary heart disease.…

  10. Cancer Cell Dissecting the Unique Role of the Retinoblastoma

    E-print Network

    Cancer Cell Article Dissecting the Unique Role of the Retinoblastoma Tumor Suppressor during.01.023 SUMMARY The RB protein family (RB, p107, and p130) has overlapping and compensatory functions in cell-cycle control. However, cancer-associated mutations are almost exclusively found in RB, implying that RB has

  11. Dissection and immunostaining of imaginal discs from Drosophila melanogaster.

    PubMed

    Spratford, Carrie M; Kumar, Justin P

    2014-01-01

    A significant portion of post-embryonic development in the fruit fly, Drosophila melanogaster, takes place within a set of sac-like structures called imaginal discs. These discs give rise to a high percentage of adult structures that are found within the adult fly. Here we describe a protocol that has been optimized to recover these discs and prepare them for analysis with antibodies, transcriptional reporters and protein traps. This procedure is best suited for thin tissues like imaginal discs, but can be easily modified for use with thicker tissues such as the larval brain and adult ovary. The written protocol and accompanying video will guide the reader/viewer through the dissection of third instar larvae, fixation of tissue, and treatment of imaginal discs with antibodies. The protocol can be used to dissect imaginal discs from younger first and second instar larvae as well. The advantage of this protocol is that it is relatively short and it has been optimized for the high quality preservation of the dissected tissue. Another advantage is that the fixation procedure that is employed works well with the overwhelming number of antibodies that recognize Drosophila proteins. In our experience, there is a very small number of sensitive antibodies that do not work well with this procedure. In these situations, the remedy appears to be to use an alternate fixation cocktail while continuing to follow the guidelines that we have set forth for the dissection steps and antibody incubations. PMID:25285379

  12. Dissecting Darknets: Measurement and Performance Analysis Xiaowen Chu, Xiaowei Chen

    E-print Network

    Chu, Xiaowen

    Dissecting Darknets: Measurement and Performance Analysis Xiaowen Chu, Xiaowei Chen Hong Kong-rider problem, Darknets are becoming increasingly popular, which use Sharing Ratio Enforcement to increase their efficiency. We crawled and traced 17 Darknets from September 2009 to Feb 2011, and obtained data sets about

  13. A Novel Approach to the Dissection of the Human Knee

    ERIC Educational Resources Information Center

    Clemente, F. Richard; Fabrizio, Philip A.; Shumaker, Michael

    2009-01-01

    The knee is one of the most frequently injured joints of the human body with injuries affecting the general population and the athletic population of many age groups. Dissection procedures for the knee joint typically do not allow unobstructed visualization of the anterior cruciate or posterior cruciate ligaments without sacrificing the collateral…

  14. The Influence of Emotion on Students' Performance in Dissection Exercises

    ERIC Educational Resources Information Center

    Holstermann, Nina; Grube, Dietmar; Bogeholz, Susanne

    2009-01-01

    This paper investigates the issue of how emotions such as disgust influence students' self-efficacy belief in terms of mastering a dissection task and also how these affect their interest in the biology of the heart. Following models of intrinsic motivation and the development of motivation, we expected disgust to negatively impact on students'…

  15. General Dissection of Female Ant Reproductive System and Brain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Dissection of the reproductive system of ant workers and queens can be useful for answering many questions. Observations of ovarian status in both female castes can be used to identify relationships between other factors and the ovaries, determine whether an individual has laid eggs, and, with more ...

  16. Standard methods for Apis mellifera anatomy and dissection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    An understanding of the anatomy and functions of internal and external structures are fundamental to many studies on the honey bee Apis mellifera. Similarly, proficiency in dissection techniques is vital for many more complex procedures. In this paper, which is a prelude to the other papers of the C...

  17. Fatal dissecting aneurysm of the aorta in a diver.

    PubMed

    James, R; Hayman, J A

    1986-07-01

    A 20-yr-old trained sports diver developed severe chest pain shortly after decompressing from a 40 m repetitive freshwater sinkhole dive, and died 6 h later. An autopsy examination showed a dissecting aneurysm of the aorta with rupture into the left pleural cavity. The relationship between the fatal event and the diving is discussed. PMID:3785985

  18. INVESTIGATION Genetic Dissection of a Major Anthocyanin QTL

    E-print Network

    Bradshaw, Toby

    INVESTIGATION Genetic Dissection of a Major Anthocyanin QTL Contributing to Pollinator in sympatry. Flower color differences resulting from both carotenoid and anthocyanin pigments contribute on anthocyanin concentration and that cis-regulatory change rather than coding DNA mutations cause the allelic

  19. Dissecting Oxygenic Photosynthesis: The Evolution of the "Z"-Scheme

    E-print Network

    Govindjee

    11CHAPTER Dissecting Oxygenic Photosynthesis: The Evolution of the "Z"-Scheme for Thylakoid provide here a summary and the evolution of the so-called "Z" scheme for the electron flow from water that this scheme has been proven to be wrong. For the description and historical evaluation of this early

  20. INVESTIGATION Genetic Dissection of a Key Reproductive Barrier

    E-print Network

    Payseur, Bret

    diverged subspecies, house mice provide a powerful system for understanding the genetics of reproductive responsible for the initial development of reproductive isolation. House mice provide a powerful systemINVESTIGATION Genetic Dissection of a Key Reproductive Barrier Between Nascent Species of House

  1. Preoperative Embolization of a Tumor-Bearing Horseshoe Kidney Via Both Channels of a Concomitant Aortic Dissection

    SciTech Connect

    Palmowski, Moritz Kiessling, Fabian; Lopez-Benitez, Ruben; Kauffmann, Guenter Werner; Hallscheidt, Peter

    2007-06-15

    Renal cell carcinoma arising in a horseshoe kidney is a rare entity. Preoperative tumor embolization can be performed to prevent massive bleeding complications during organ-preserving surgery. We report the first case of a patient with a tumor-bearing horseshoe-kidney in whom the preoperative embolization, already complex because of the abnormal vascular supply, was additionally complicated by an aortic dissection. An aberrant, horseshoe-kidney-supplying artery originated from the false dissection channel of the aorta, and thus had to be catheterized separately while the other tumor-supplying vessels could be reached via the true aortic lumen. After devascularization of the tumor, organ-preserving surgery was performed without bleeding complications.

  2. Spontaneous Dissection of the Renal Artery in Vascular Ehlers-Danlos Syndrome

    PubMed Central

    Pereira, Filipa; Cardoso, Teresa; Sá, Paula

    2015-01-01

    Ehlers-Danlos syndrome (EDS) is a rare heterogeneous group of connective tissue disorders. The vascular type (vEDS) is an autosomal dominant disorder caused by heterozygous mutations in the COL3A1 gene predisposing to premature arterial, intestinal, or uterine rupture. We report a case of a 38-year-old woman with a recent diagnosis of vEDS admitted in the Emergency Department with a suspicion of a pyelonephritis that evolved to a cardiopulmonary arrest. A fatal retroperitoneal hematoma related with a haemorrhagic dissection of the right renal artery was found after emergency surgery. This case highlights the need to be aware of the particular characteristics of vEDS, such as a severe vascular complication that can lead to a fatal outcome. PMID:26175915

  3. Harmonic Scalpel versus Electrocautery Dissection in Modified Radical Mastectomy for Breast Cancer: A Meta-Analysis

    PubMed Central

    Huang, Jinbo; Yu, Yinghua; Wei, Changyuan; Qin, Qinghong; Mo, Qinguo; Yang, Weiping

    2015-01-01

    Background Despite the common use of conventional electrocautery in modified radical mastectomy for breast cancer, the harmonic scalpel is recently emerging as a dominant surgical instrument for dissection and haemostasis, which is thought to reduce the morbidity, such as seroma and blood loss. But the results of published trials are inconsistent. So we made the meta-analysis to assess the intraoperative and postoperative endpoints among women undergoing modified radical mastectomy with harmonic scalpel or electrocautery. Methods A comprehensive literature search of case-control studies from PubMed, MEDLINE, EMBASE and Cochrane Library databases involving modified radical mastectomy with harmonic scalpel or electrocautery was performed. We carried out a meta-analysis of primary endpoints including postoperative drainage, seroma development, intraoperative blood loss and secondly endpoints including operative time and wound complications. We used odds ratios (ORs) with 95% confidence intervals (CIs) to evaluate the effect size for categorical outcomes and standardised mean differences (SMDs) for continuous outcomes. Results A total of 11 studies with 702 patients were included for this meta-analysis. There was significant difference in total postoperative drainage (SMD: -0.74 [95%CI: -1.31, -0.16]; P< 0.01), seroma development[OR: 0.49 (0.34, 0.70); P < 0.01], intraoperative blood loss(SMD: -1.14 [95%CI: -1.81,-0.47]; P < 0.01) and wound complications [OR: 0.38 (0.24, 0.59); P < 0.01] between harmonic scalpel dissection and standard electrocautery in modified radical mastectomy for breast cancer. No difference was found as for operative time between harmonic scalpel dissection and standard electrocautery (SMD: 0.04 [95%CI: -0.41, 0.50]; P = 0.85). Conclusion Compared to standard electrocautery, harmonic scalpel dissection presents significant advantages in decreasing postoperative drainage, seroma development, intraoperative blood loss and wound complications in modified radical mastectomy for breast cancer, without increasing operative time. Harmonic scalpel can be recommended as a preferential surgical instrument in modified radical mastectomy. PMID:26544716

  4. Secondary science classroom dissections: Informing policy by evaluating cognitive outcomes and exploring affective outcomes

    NASA Astrophysics Data System (ADS)

    Allspaw, Kathleen M.

    Animal protection organizations claim that dissection is pedagogically unsound and that it will cause students to lose respect for non-human animals. Science teacher organizations support curricula that teach respect for animal life and include dissection. Prior research compared dissection to dissection alternatives. Four of the six studies revealed no difference between groups on tests of cognitive outcomes. One study revealed that dissection was superior, and one revealed that the alternative was superior. No differences in attitudes toward science, dissection or school were found. Attitudes toward non-human animals were not measured. This study focused on the dissections of earthworms and frogs in middle and high school classrooms. Pre and post-tests of conceptual understanding revealed failing scores and no significant pre/post differences. Because these tests required critical thinking skills, and the dissection activities did not, it is difficult to determine if the poor performance on these tests indicates the inability of the students to think critically, and/or if it indicates the ineffectiveness of dissection. Further studies of dissections that focus on critical thinking would be necessary to make this distinction. Classroom observations, student written narratives, and student and adult interviews revealed mixed attitudes toward non-human animals. Student behaviors during dissection were similar to those behaviors exhibited during non-dissection activities. Most students and adults readily supported worm dissections while they expressed some trepidation about frog dissections. Students and adults universally expressed affection for their pets and opposed the use of their own pets for dissection/research. There was slight support for the use of dogs and cats for dissection/research, but only those students who expressed hate for cats said that they could dissect cats. None of the students or adults expressed a willingness to dissect dogs. Some students abandoned plans for life science careers because they did not want to do further dissections. Students and adults often expressed confliction about the use of animals for food and/or research. Students and adults employed psychological mechanisms including dissociation, conflict reduction and viewing animals as an "outgroup" to rationalize their support for the use of animals for food, dissection and research.

  5. Incomplete segregation of MYH11 variants with thoracic aortic aneurysms and dissections and patent ductus arteriosus

    PubMed Central

    Harakalova, Magdalena; van der Smagt, Jasper; de Kovel, Carolien G F; van't Slot, Ruben; Poot, Martin; Nijman, Isaac J; Medic, Jelena; Joziasse, Irene; Deckers, Jaap; Roos-Hesselink, Jolien W; Wessels, Marja W; Baars, Hubert F; Weiss, Marjan M; Pals, Gerard; Golmard, Lisa; Jeunemaitre, Xavier; Lindhout, Dick; Cuppen, Edwin; Baas, Annette F

    2013-01-01

    Thoracic aortic aneurysms and dissections (TAAD) is a serious condition with high morbidity and mortality. It is estimated that 20% of non-syndromic TAAD cases are inherited in an autosomal-dominant pattern with variable expression and reduced penetrance. Mutations in myosin heavy chain 11 (MYH11), one of several identified TAAD genes, were shown to simultaneously cause TAAD and patent ductus arteriosus (PDA). We identified two large Dutch families with TAAD/PDA and detected two different novel heterozygote MYH11 variants in the probands. These variants, a heterozygote missense variant and a heterozygote in-frame deletion, were predicted to have damaging effects on protein structure and function. However, these novel alterations did not segregate with the TAAD/PDA in 3 out of 11 cases in family TAAD01 and in 2 out of 6 cases of family TAAD02. No mutation was detected in other known TAAD genes. Thus, it is expected that within these families other genetic factors contribute to the disease either by themselves or by interacting with the MYH11 variants. Such an oligogenic model for TAAD would explain the variable onset and progression of the disorder and its reduced penetrance in general. We conclude that in familial TAAD/PDA with an MYH11 variant in the index case caution should be exercised upon counseling family members. Specialized surveillance should still be offered to the non-carriers to prevent catastrophic aortic dissections or ruptures. Furthermore, our study underscores that segregation analysis remains very important in clinical genetics. Prediction programs and mutation evaluation algorithms need to be interpreted with caution. PMID:22968129

  6. Dissecting the mechanisms of squirrel monkey (Saimiri boliviensis) social learning

    PubMed Central

    Holmes, AN; Williams, LE; Brosnan, SF

    2013-01-01

    Although the social learning abilities of monkeys have been well documented, this research has only focused on a few species. Furthermore, of those that also incorporated dissections of social learning mechanisms, the majority studied either capuchins (Cebus apella) or marmosets (Callithrix jacchus). To gain a broader understanding of how monkeys gain new skills, we tested squirrel monkeys (Saimiri boliviensis) which have never been studied in tests of social learning mechanisms. To determine whether S. boliviensis can socially learn, we ran “open diffusion” tests with monkeys housed in two social groups (N = 23). Over the course of 10 20-min sessions, the monkeys in each group observed a trained group member retrieving a mealworm from a bidirectional task (the “Slide-box”). Two thirds (67%) of these monkeys both learned how to operate the Slide-box and they also moved the door significantly more times in the direction modeled by the trained demonstrator than the alternative direction. To tease apart the underlying social learning mechanisms we ran a series of three control conditions with 35 squirrel monkeys that had no previous experience with the Slide-box. The first replicated the experimental open diffusion sessions but without the inclusion of a trained model, the second was a no-information control with dyads of monkeys, and the third was a ‘ghost’ display shown to individual monkeys. The first two controls tested for the importance of social support (mere presence effect) and the ghost display showed the affordances of the task to the monkeys. The monkeys showed a certain level of success in the group control (54% of subjects solved the task on one or more occasions) and paired controls (28% were successful) but none were successful in the ghost control. We propose that the squirrel monkeys’ learning, observed in the experimental open diffusion tests, can be best described by a combination of social learning mechanisms in concert; in this case, those mechanisms are most likely object movement reenactment and social facilitation. We discuss the interplay of these mechanisms and how they related to learning shown by other primate species. PMID:23638347

  7. The role of the pipeline embolization device for the treatment of dissecting intracranial aneurysms.

    PubMed

    de Barros Faria, M; Castro, R Nella; Lundquist, J; Scrivano, E; Ceratto, R; Ferrario, A; Lylyk, P

    2011-12-01

    Intracranial dissecting aneurysms constitute rare lesions with complex management and elevated morbidity and mortality. Results of 23 patients harboring such lesions treated with the PED are reported. Standard dual antiplatelet therapy was instituted. Neurologic and angiographic assessments were obtained at 3, 6, and 12 months. Clinical presentation included SAH (52%), symptoms of mass effect (22%), ischemia (4%), and incidental finding (22%). The posterior circulation was affected in 91% of cases. Total occlusion was demonstrated in 69.5% of patients, with an increment to 87.5% considering only patients with at least 3 months of follow-up. Small aneurysms demonstrated higher rates of total occlusion (6/7) compared with large (5/7) and giant (5/9) ones. Good clinical outcome was achieved in 74% of patients. Reconstructive endovascular treatment of intracranial dissecting aneurysms with the PED provided good clinical and angiographic results with acceptable risks, representing an attractive therapeutic option for this complex disease, especially when parent vessel preservation is mandatory. PMID:21885721

  8. Svensson class IV Ascending aortic dissection, often confused with penetrating ulcer

    PubMed Central

    Mitsomoy, Michel Francklyn; Alexoiu, Valerica; Kirsch, Matthias

    2015-01-01

    TWe present the case of a 64 years old male patient who had recently suffered an infective aortic valve endocarditis (Streptococcus agalactiae) complicated by embolic arthritis of the right hip. Initial echocardiography revealed moderate aortic insufficiency developed on a tricuspid aortic valve with a small vegetation (5 mm × 4 mm) on the left coronary cusp. Furthermore, an aneurysmal dilatation of the ascending aorta (maximal diameter, 54 mm) was noted. Other heart valves and left ventricular function were considered normal. The patient completed a 4 weeks course of antibiotherapy, and the right hip arthritis was treated by drainage and synovectomy. The patient was subsequently referred to surgery on an outpatient basis for the aneurysm of the ascending aorta. Preoperative computed tomography showed localized aortic dissection of the tubular ascending aorta characterized by an intimal tear without medial hematoma but excentric bulging of the aortic wall. This lesion was initially considered a penetrating ulcer of the aortic wall The operative specimen allowed to make differential diagnosis with a penetrating aortic ulcer by showing that the lesion did not develop within an atherosclerotic plaque. However, downstream extension of the dissection was probably limited by the presence of transmural calcifications on its distal side. The patient underwent successful complete aortic root replacement using a stentless Freestyle bioprosthesis with Dacron graft extension as reported previously. PMID:25859316

  9. Blood supply to the thoracolumbar spinal cord in the laboratory mouse using corrosion and dissection techniques.

    PubMed

    Flesarova, Slavka; Mazensky, David; Teleky, Jana; Almasiova, Viera; Holovska, Katarina; Supuka, Peter

    2016-01-01

    Mice are used frequently as experimental models in the study of ischemic spinal cord injury. The aim of the present study was to describe the arterial blood supply to the thoracolumbar spinal cord in the mouse. The study was carried out on 20 adult mice using the corrosion and dissection technique. Dorsal intercostal arteries were found as branches of the thoracic aorta: as 7 pairs in 80 % of cases, as 8 pairs in 15 % of cases and as 9 pairs in 5 % of cases. The paired lumbar arteries arising from the abdominal aorta were present as 5 pairs in all cases. Along the entire thoracic and lumbar spinal regions, we observed left-sided branches entering the ventral spinal artery in 64.2 % and right-sided branches in 35.8 % of cases. Along the entire thoracic and lumbar spinal regions, the branches entering the dorsal spinal arteries were left-sided in 60.8 % of cases and right-sided in 39.2 % of cases. We found some variations in the site of origin of the artery of Adamkiewicz and in the number of dorsal spinal arteries. Documenting the anatomical variations in spinal cord blood supply in the laboratory mouse will aid the planning of future experimental studies and in determining the clinical relevance of such studies. PMID:25636913

  10. Talking about Death: Implementing Peer Discussion as a Coping Mechanism to Overcome Fears about Dissection, Death, and Dying

    ERIC Educational Resources Information Center

    Kotze, Sanet Henriet; Mole, Calvin Gerald

    2013-01-01

    Many studies have reported on the perceptions of medical students toward dissection. It is important to understand the feelings and symptoms experienced during dissection so that they can be adequately handled. Prior to dissection, first year students are given lectures on aspects of dissection, death and dying, and death rituals in various…

  11. Are all hands-on activities equally effective? Effect of using plastic models, organ dissections, and virtual dissections on student learning and perceptions.

    PubMed

    Lombardi, Sara A; Hicks, Reimi E; Thompson, Katerina V; Marbach-Ad, Gili

    2014-03-01

    This study investigated the impact of three commonly used cardiovascular model-assisted activities on student learning and student attitudes and perspectives about science. College students enrolled in a Human Anatomy and Physiology course were randomly assigned to one of three experimental groups (organ dissections, virtual dissections, or plastic models). Each group received a 15-min lecture followed by a 45-min activity with one of the treatments. Immediately after the lesson and then 2 mo later, students were tested on anatomy and physiology knowledge and completed an attitude survey. Students who used plastic models achieved significantly higher overall scores on both the initial and followup exams than students who performed organ or virtual dissections. On the initial exam, students in the plastic model and organ dissection treatments scored higher on anatomy questions than students who performed virtual dissections. Students in the plastic model group scored higher than students who performed organ dissections on physiology questions. On the followup exam, when asked anatomy questions, students in the plastic model group scored higher than dissection students and virtual dissection students. On attitude surveys, organ dissections had higher perceived value and were requested for inclusion in curricula twice as often as any other activity. Students who performed organ dissections were more likely than the other treatment groups to agree with the statement that "science is fun," suggesting that organ dissections may promote positive attitudes toward science. The findings of this study provide evidence for the importance of multiple types of hands-on activities in anatomy laboratory courses. PMID:24585474

  12. Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: “It Is Not Always a Plaque Rupture Event”

    PubMed Central

    Kassimis, George; Manolis, Athanasios; Townend, Jonathan N.

    2015-01-01

    Spontaneous coronary artery dissection (SCAD) is an unusual, but increasingly recognized, cause of ST-elevation myocardial infarction (STEMI), especially among younger patients without conventional risk factors for coronary artery disease (CAD). Although dissection of the coronary intima or media is a hallmark finding, hematoma formation within the vessel wall is often present. It remains unclear whether dissection or hematoma is the primary event, but both may cause luminal stenosis and occlusion. The diagnosis of SCAD is made principally with invasive coronary angiography, although adjunctive intracoronary imaging modalities may increase the diagnostic yield. In STEMI patients, the decision whether to pursue primary percutaneous coronary intervention (PCI) or appropriate conservative medical therapy is based on clinical presentation, the extent of the dissection, the critical anatomy involvement, and the amount of ischaemic myocardium at risk. In this case report, we present two cases of young women with SCAD and STEMI, successfully treated with primary PCI. We briefly illustrate the characteristic aspects of the angiographic presentation and intravascular ultrasound-guided treatment. SCAD should always be considered in young STEMI patients without conventional risk factors for CAD with primary angioplasty to be required in patients with ongoing myocardial ischemia. PMID:26576303

  13. Management of Acute Aortic Syndrome and Chronic Aortic Dissection

    SciTech Connect

    Nordon, Ian M. Hinchliffe, Robert J.; Loftus, Ian M.; Morgan, Robert A.; Thompson, Matt M.

    2011-10-15

    Acute aortic syndrome (AAS) describes several life-threatening aortic pathologies. These include intramural hematoma, penetrating aortic ulcer, and acute aortic dissection (AAD). Advances in both imaging and endovascular treatment have led to an increase in diagnosis and improved management of these often catastrophic pathologies. Patients, who were previously consigned to medical management or high-risk open surgical repair, can now be offered minimally invasive solutions with reduced morbidity and mortality. Information from the International Registry of Acute Aortic Dissection (IRAD) database demonstrates how in selected patients with complicated AAD the 30-day mortality from open surgery is 17% and endovascular stenting is 6%. Despite these improvements in perioperative deaths, the risks of stroke and paraplegia remain with endovascular treatment (combined outcome risk 4%). The pathophysiology of each aspect of AAS is described. The best imaging techniques and the evolving role of endovascular techniques in the definitive management of AAS are discussed incorporating strategies to reduce perioperative morbidity.

  14. Femtosecond laser dissection in C. elegans neural circuits

    NASA Astrophysics Data System (ADS)

    Samuel, Aravinthan D. T.; Chung, Samuel H.; Clark, Damon A.; Gabel, Christopher V.; Chang, Chieh; Murthy, Venkatesh; Mazur, Eric

    2006-02-01

    The nematode C. elegans, a millimeter-long roundworm, is a well-established model organism for studies of neural development and behavior, however physiological methods to manipulate and monitor the activity of its neural network have lagged behind the development of powerful methods in genetics and molecular biology. The small size and transparency of C. elegans make the worm an ideal test-bed for the development of physiological methods derived from optics and microscopy. We present the development and application of a new physiological tool: femtosecond laser dissection, which allows us to selectively ablate segments of individual neural fibers within live C. elegans. Femtosecond laser dissection provides a scalpel with submicrometer resolution, and we discuss its application in studies of neural growth, regenerative growth, and the neural basis of behavior.

  15. Clinical characteristics and management of gastric tube cancer with endoscopic submucosal dissection

    PubMed Central

    Mukasa, Michita; Takedatsu, Hidetoshi; Matsuo, Ken; Sumie, Hiroaki; Yoshida, Hikaru; Hinosaka, Atsushi; Watanabe, Yasutomo; Tsuruta, Osamu; Torimura, Takuji

    2015-01-01

    AIM: To identify the characteristics of gastric tube cancer (GTC) and the complications associated with endoscopic submucosal dissection (ESD) for GTC. METHODS: Between 2007 and 2012, 11 individuals with early gastric cancer in the reconstructed gastric tube after esophagectomy who underwent ESD in this hospital were studied. The characteristics of GTC were identified, and the complications of ESD for GTC were analyzed at three phases: preoperative, intraoperative, and postoperative. RESULTS: A total of 11 consecutive patients with 11 GTCs were selected for this study. All cases underwent en bloc resections by ESD. The median procedure time was 142 min. The average GTC diameter was 26.1 mm, and the average size of the resected lesions was 45.5 mm. The histopathological diagnosis in all cases was a differentiated adenocarcinoma. In the preoperative phase, anastomotic strictures (5/11, 45%) and food residues (4/11, 36.4%) in the gastric tube were the main complications. In the intraoperative phase, bleeding was observed in 5 cases (45%). The postoperative complications observed were delayed bleeding in 2 cases (18.2%) and stenosis in one case (9.1%). The case with stenosis was successfully treated using endoscopic balloon dilatation. CONCLUSION: Minor complications were frequently observed. However, all GTCs underwent en bloc resection with ESD without any serious complications. ESD is considered a useful treatment for GTC. PMID:25624726

  16. Does N ratio affect survival in D1 and D2 lymph node dissection for gastric cancer?

    PubMed Central

    Sakcak, Ibrahim; Y?ld?z, Bar?? Do?u; Av?ar, Fatih Mehmet; Akturan, Saadet; Kilic, Kemal; Cosgun, Erdal; Hamamci, Enver O

    2011-01-01

    AIM: To identify whether there could have been changes in survival if lymph node ratio (N ratio) had been used. METHODS: We assessed 334 gastric adenocarcinoma cases retrospectively between 2001 and 2009. Two hundred and sixteen patients out of 334 were included in the study. Patients were grouped according to disection1 (D1) or dissection 2 (D2) dissection. We compared the estimated survival and actual survival determined by Pathologic nodes (pN) class and N ratio, and SPSS 15.0 software was used for statistical analysis. RESULTS: Ninety-six (44.4%) patients underwent D1 dissection and 120 (55.6%) had D2 dissection. When groups were evaluated, 23 (24.0%) patients in D1 and 21 (17.5%) in D2 had stage migration (P = 0.001). When both D1 and D2 groups were evaluated for number of pathological lymph nodes, despite the fact that there was no difference in N ratio between D1 and D2 groups, a statistically significant difference was found between them with regard to pN1 and pN2 groups (P = 0.047, P = 0.044 respectively). In D1, pN0 had the longest survival while pN3 had the shortest. In D2, pN0 had the longest survival whereas pN3 had the shortest survival. CONCLUSION: N ratio is an accurate staging system for defining prognosis and treatment plan, thus decreasing methodological errors in gastric cancer staging. PMID:22046089

  17. Endoscopic Transesophageal Mediastinal Lymph Node Dissection and En bloc Resection using Mediastinal and Thoracic Approaches (with Video)

    PubMed Central

    Turner, Brian G.; Gee, Denise W.; Cizginer, Sevdenur; Kim, Min-Chan; Mino-Kenudson, Mari; Sylla, Patricia; Brugge, William R.; Rattner, David W.

    2013-01-01

    Background The gold standard for sampling mediastinal lymph nodes (LNs) is cervical mediastinoscopy. Current methods that require transthoracic or cervical incisions can result in significant postoperative pain. Objective To determine feasibility of a novel, transesophageal endoscopic technique for mediastinal LN dissection and en bloc resection. Design non-survival and survival study Setting Animal trial at a tertiary-care academic center. Subjects 12 Yorkshire swine. Interventions An endoscopic cap band mucosectomy device was employed to create an esophageal mucosal defect. Using the tip of the endoscope and biopsy forceps a submucosal tunnel was fashioned and within the submucosal space a hook-knife incised the muscular esophageal wall. The endoscope was then advanced into the mediastinum and chest. Mediastinoscopy and thoracoscopy were performed to identify lymph node stations. Prototype endoscopic devices permitted lymph node dissection prior to removal with an electrocautery snare. A covered prototype stent was placed over the mucosectomy site. Main Outcome and Measurements Feasibility of endoscopic transesophageal lymphadenectomy (LAD). Results Three LNs (1 para-aortic and 2 right paratracheal) were removed in the 3 non-survival swine. Nine swine were survived for 14 days (range:13–14) and had a total of 7 LNs (2 para-aortic and 5 paratracheal) removed. Two swine had no endoscopically visible LNs in the mediastinum or chest. LN dissection and resection was successful in all cases where a node was identified. LAD was completed in 20.0 min (range: 8–60); total procedure time was 70.0 min (range: 28–105). Median LN size was 1.1 cm (range: 0.6–1.4). Limitations Animal study Conclusions An endoscopic transesophageal approach can accomplish mediastinal LN dissection and en bloc resection and provides architecturally intact LN specimens for histologic examination. PMID:20573345

  18. Endovascular Treatment of Basilar Artery Thrombosis Secondary to Bilateral Vertebral Artery Dissection with Symptom Onset Following Cervical Spine Manipulation Therapy

    PubMed Central

    Mikkelsen, Ronni; Dalby, Rikke Beese; Hjort, Niels; Simonsen, Claus Ziegler; Karabegovic, Sanja

    2015-01-01

    Patient: Female, 37 Final Diagnosis: Vertebral artery dissection Symptoms: Neck pain and focal neurological deficits Medication: No previous Clinical Procedure: Endovascular thrombectomy Specialty: Neurology Objective: Rare disease Background: Vertebral artery (VA) dissection (VAD) has been described following neck injury and can be associated with stroke, but the causal association with cervical spine manipulation therapy (cSMT) is controversial. The standard treatment for VAD is antithrombotic medical therapy. To highlight the considerations of an endovascular approach to VAD, we present a critical case of bilateral VAD causing embolic occlusion of the basilar artery (BA) in a patient with symptom debut following cSMT. Case Report: A 37-year-old woman presented with acute onset of neurological symptoms immediately following cSMT in a chiropractic facility. Acute magnetic resonance imaging (MRI) showed ischemic lesions in the right cerebellar hemisphere and occlusion of the cranial part of the BA. Angiography depicted bilateral VAD. Symptoms remitted after endovascular therapy, which included dilatation of the left VA and extraction of thrombus from the BA. After 6 months, the patient had minor sensory and cognitive deficits. Conclusions: In severe cases, VAD may be complicated by BA thrombosis, and this case highlights the importance of a fast diagnostic approach and advanced intravascular procedure to obtain good long-term neurological outcome. Furthermore, this case underlines the need to suspect VAD in patients presenting with neurological symptoms following cSMT. PMID:26647210

  19. Morphological Variation in Leaf Dissection of Rheum palmatum Complex (Polygonaceae)

    PubMed Central

    Wang, Xu-Mei; Hou, Xiao-Qi; Zhang, Yu-Qu; Li, Yan

    2014-01-01

    Aims Rheum palmatum complex comprises all taxa within section Palmata in the genus Rheum, including R. officinale, R. palmatum, R. tanguticum, R. tanguticum var. liupanshanense and R. laciniatum. The identification of the taxa in section Palmata is based primarily on the degree of leaf blade dissection and the shape of the lobes; however, difficulties in species identification may arise from their significant variation. The aim of this study is to analyze the patterns of variation in leaf blade characteristics within and among populations through population-based sampling covering the entire distribution range of R. palmatum complex. Methods Samples were taken from 2340 leaves from 780 individuals and 44 populations representing the four species, and the degree of leaf blade dissection and the shape of the lobe were measured to yield a set of quantitative data. Furthermore, those data were statistically analyzed. Important Findings The statistical analysis showed that the degree of leaf blade dissection is continuous from lobed to parted, and the shape of the lobe is also continuous from broadly triangular to lanceolate both within and between populations. We suggested that taxa in section Palmata should be considered as one species. Based on the research on the R. palmatum complex, we considered that the quantitative characteristics were greatly influenced by the environment. Therefore, it is not reliable to delimitate the species according to the continuously quantitative vegetative characteristics. PMID:25349989

  20. Saphenous Vein Sparing Superficial Inguinal Dissection in Lower Extremity Melanoma

    PubMed Central

    Öztürk, Muhammed Be?ir; Akan, Arzu; Özkaya, Özay; Egemen, Onur; Örero?lu, Ali R?za; Akan, Mithat

    2014-01-01

    Aim. The classic inguinal lymph node dissection is the main step for the regional control of the lower extremity melanoma, but this surgical procedure is associated with significant postoperative morbidity. The permanent lymphedema is the most devastating long-term complication leading to a significant decrease in the patient's quality of life. In this study we present our experience with modified, saphenous vein sparing, inguinal lymph node dissections for patients with melanoma of the lower extremity. Methods. Twenty one patients (10 women, 11 men) who underwent saphenous vein sparing superficial inguinal lymph node dissection for the melanoma of lower extremity were included in this study. The effects of saphenous vein sparing on postoperative complications were evaluated. Results. We have observed the decreased rate of long-term lymphedema in patients undergoing inguinal lymphadenectomy for the lower extremity melanoma. Conclusion. The inguinal lymphadenectomy with saphenous vein preservation in lower extremity melanoma patients seems to be an oncologically safe procedure and it may offer reduced long-term morbidity. PMID:25126426

  1. Are All Hands-On Activities Equally Effective? Effect of Using Plastic Models, Organ Dissections, and Virtual Dissections on Student Learning and Perceptions

    ERIC Educational Resources Information Center

    Lombardi, Sara A.; Hicks, Reimi E.; Thompson, Katerina V.; Marbach-Ad, Gili

    2014-01-01

    This study investigated the impact of three commonly used cardiovascular model-assisted activities on student learning and student attitudes and perspectives about science. College students enrolled in a Human Anatomy and Physiology course were randomly assigned to one of three experimental groups (organ dissections, virtual dissections, or…

  2. Dissection as Inquiry: Using the "Peanut Observation" Activity to Promote a Revised Paradigm of Dissection and Facilitate Student Involvement and Understanding.

    ERIC Educational Resources Information Center

    Bernstein, Penny L.

    2000-01-01

    Introduces the peanut observation activity to teach about the pros and cons of dissection. As an inquiry-based approach, dissection is one way to teach process skills. Lists the progression of the activity as observation, questioning and finding the answer, challenge, discussion, and further examination. (Contains 12 references.) (YDS)

  3. Dissecting estimation of conductances in subthreshold regimes.

    PubMed

    Vich, Catalina; Guillamon, Antoni

    2015-12-01

    We study the influence of subthreshold activity in the estimation of synaptic conductances. It is known that differences between actual conductances and the estimated ones using linear regression methods can be huge in spiking regimes, so caution has been taken to remove spiking activity from experimental data before proceeding to linear estimation. However, not much attention has been paid to the influence of ionic currents active in the non-spiking regime where such linear methods are still profusely used. In this paper, we use conductance-based models to test this influence using several representative mechanisms to induce ionic subthreshold activity. In all the cases, we show that the currents activated during subthreshold activity can lead to significant errors when estimating synaptic conductance linearly. Thus, our results add a new warning message when extracting conductance traces from intracellular recordings and the conclusions concerning neuronal activity that can be drawn from them. Additionally, we present, as a proof of concept, an alternative method that takes into account the main nonlinear effects of specific ionic subthreshold currents. This method, based on the quadratization of the subthreshold dynamics, allows us to reduce the relative errors of the estimated conductances by more than one order of magnitude. In experimental conditions, under appropriate fitting to canonical models, it could be useful to obtain better estimations as well even under the presence of noise. PMID:26432075

  4. Human cadaveric dissection: a historical account from ancient Greece to the modern era

    PubMed Central

    2015-01-01

    The review article attempts to focus on the practice of human cadaveric dissection during its inception in ancient Greece in 3rd century BC, revival in medieval Italy at the beginning of 14th century and subsequent evolution in Europe and the United States of America over the centuries. The article highlights on the gradual change in attitude of religious authorities towards human dissection, the shift in the practice of human dissection being performed by barber surgeons to the anatomist himself dissecting the human body and the enactment of prominent legislations which proved to be crucial milestones during the course of the history of human cadaveric dissection. It particularly emphasizes on the different means of procuring human bodies which changed over the centuries in accordance with the increasing demand due to the rise in popularity of human dissection as a tool for teaching anatomy. Finally, it documents the rise of body donation programs as the source of human cadavers for anatomical dissection from the second half of the 20th century. Presently innovative measures are being introduced within the body donation programs by medical schools across the world to sensitize medical students such that they maintain a respectful, compassionate and empathetic attitude towards the human cadaver while dissecting the same. Human dissection is indispensable for a sound knowledge in anatomy which can ensure safe as well as efficient clinical practice and the human dissection lab could possibly be the ideal place to cultivate humanistic qualities among future physicians in the 21st century. PMID:26417475

  5. Human cadaveric dissection: a historical account from ancient Greece to the modern era.

    PubMed

    Ghosh, Sanjib Kumar

    2015-09-01

    The review article attempts to focus on the practice of human cadaveric dissection during its inception in ancient Greece in 3rd century BC, revival in medieval Italy at the beginning of 14th century and subsequent evolution in Europe and the United States of America over the centuries. The article highlights on the gradual change in attitude of religious authorities towards human dissection, the shift in the practice of human dissection being performed by barber surgeons to the anatomist himself dissecting the human body and the enactment of prominent legislations which proved to be crucial milestones during the course of the history of human cadaveric dissection. It particularly emphasizes on the different means of procuring human bodies which changed over the centuries in accordance with the increasing demand due to the rise in popularity of human dissection as a tool for teaching anatomy. Finally, it documents the rise of body donation programs as the source of human cadavers for anatomical dissection from the second half of the 20th century. Presently innovative measures are being introduced within the body donation programs by medical schools across the world to sensitize medical students such that they maintain a respectful, compassionate and empathetic attitude towards the human cadaver while dissecting the same. Human dissection is indispensable for a sound knowledge in anatomy which can ensure safe as well as efficient clinical practice and the human dissection lab could possibly be the ideal place to cultivate humanistic qualities among future physicians in the 21st century. PMID:26417475

  6. Dissecting disks around B-type protostars

    NASA Astrophysics Data System (ADS)

    Sanchez-Monge, Alvaro; Cesaroni, Riccardo; Beltran, Maite; Kumar, M. S. Nanda; Stanke, Thomas; Zinnecker, Hans; Etoka, Sandra; Galli, Daniele; Hummel, Christian A.; Moscadelli, Luca; Preibisch, Thomas; Ratzka, Thorsten; van der Tak, Floris F. S.; Vig, Sarita; Walmsley, C. Malcolm; Wang, Kuo-Song

    2013-07-01

    Recent theoretical models indicate that OB-type stars could form through disk-mediated accretion, like their low mass counterparts. However, on the observational side, circumstellar disks appear still elusive, especially around the most massive (proto)stars. As for early B-type (proto)stars, an ever growing number of disk candidates has been proposed, but only very few of these present evidence for Keplerian rotation. The advent of ALMA provides us with the necessary sensitivity and angular resolution to assess the existence of such disks and possibly establish their rotation curves. With this in mind, we have performed ALMA observations with the highest possible resolution (~0.4") at 350 GHz to search for circumstellar disks in a couple of presumably massive young stellar objects with luminosities of ~10000 Lsun and associated with bipolar nebulosities suggestive of the presence of disk/outflow systems. By observing simultaneously core and jet tracers, we could reveal molecular cores with velocity gradients perpendicular to the corresponding jets. In at least one case (G35.20-0.74 N), the core structure appears resolved and the velocity field can be fitted with an almost edge-on Keplerian disk rotating about a central mass of 18 Msun. This finding is consistent with the results of a recent study of the CO first overtone bandhead emission at 2.3mum towards G35.20-0.74 N. The disk radius and mass are >2500 au and 3 Msun. To reconcile the observed bolometric luminosity (3x10^4 Lsun) with the estimated stellar mass of 18 Msun, we propose that the latter is the total mass of a binary system.

  7. Bluetongue virus: dissection of the polymerase complex.

    PubMed

    Roy, Polly

    2008-08-01

    Bluetongue is a vector-borne viral disease of ruminants that is endemic in tropical and subtropical countries. Since 1998 the virus has also appeared in Europe. Partly due to the seriousness of the disease, bluetongue virus (BTV), a member of genus Orbivirus within the family Reoviridae, has been a subject of intense molecular study for the last three decades and is now one of the best understood viruses at the molecular and structural levels. BTV is a complex non-enveloped virus with seven structural proteins arranged in two capsids and a genome of ten double-stranded (ds) RNA segments. Shortly after cell entry, the outer capsid is lost to release an inner capsid (the core) which synthesizes capped mRNAs from each genomic segment, extruding them into the cytoplasm. This requires the efficient co-ordination of a number of enzymes, including helicase, polymerase and RNA capping activities. This review will focus on our current understanding of these catalytic proteins as derived from the use of recombinant proteins, combined with functional assays and the in vitro reconstitution of the transcription/replication complex. In some cases, 3D structures have complemented this analysis to reveal the fine structural detail of these proteins. The combined activities of the core enzymes produce infectious transcripts necessary and sufficient to initiate BTV infection. Such infectious transcripts can now be synthesized wholly in vitro and, when introduced into cells by transfection, lead to the recovery of infectious virus. Future studies thus hold the possibility of analysing the consequence of mutation in a replicating virus system. PMID:18632949

  8. Bluetongue virus: dissection of the polymerase complex

    PubMed Central

    Roy, Polly

    2009-01-01

    Summary Bluetongue is a vector-borne viral disease of ruminants that is endemic in tropical and subtropical countries. Since 1998 the virus has also appeared in Europe. Partly due to the seriousness of the disease bluetongue virus (BTV), a member of genus Orbivirus within the family Reoviridae, has been a subject of intense molecular study for the last three decades and is now one of the best understood viruses at the molecular and structural levels. BTV is a complex non-enveloped virus with seven structural proteins arranged in two capsids and a genome of ten double-stranded (ds) RNA segments. Shortly after cell entry the outer capsid is lost to release an inner capsid (the core) which synthesises capped mRNAs from each genomic segment, extruding them into the cytoplasm. This requires the efficient co-ordination of a number of enzymes including helicase, polymerase and RNA capping activities. This review will focus on our current understanding of these catalytic proteins as derived from the use of recombinant proteins, combined with functional assays and the in vitro reconstitution of the transcription/replication complex. In some cases, 3D structures have complemented this analysis to reveal the fine structural detail of these proteins. The combined activities of the core enzymes produce infectious transcripts necessary and sufficient to initiate BTV infection. Such infectious transcripts can now be synthesised wholly in vitro and, when introduced into cells by transfection, lead to the recovery of infectious virus. Future studies thus hold the possibility of analysing the consequence of mutation in a replicating virus system. PMID:18632949

  9. Improved parallel data partitioning by nested dissection with applications to information retrieval.

    SciTech Connect

    Wolf, Michael M.; Chevalier, Cedric; Boman, Erik Gunnar

    2008-12-01

    The computational work in many information retrieval and analysis algorithms is based on sparse linear algebra. Sparse matrix-vector multiplication is a common kernel in many of these computations. Thus, an important related combinatorial problem in parallel computing is how to distribute the matrix and the vectors among processors so as to minimize the communication cost. We focus on minimizing the total communication volume while keeping the computation balanced across processes. In [1], the first two authors presented a new 2D partitioning method, the nested dissection partitioning algorithm. In this paper, we improve on that algorithm and show that it is a good option for data partitioning in information retrieval. We also show partitioning time can be substantially reduced by using the SCOTCH software, and quality improves in some cases, too.

  10. Ectopic Pancreas in the Stomach Successfully Resected by Endoscopic Submucosal Dissection

    PubMed Central

    Tsuzuki, Takao; Ohya, Shogen; Okada, Hiroyuki; Tanaka, Takehiro; Hori, Keisuke; Kita, Masahide; Kawano, Seiji; Kawahara, Yoshiro; Yamamoto, Kazuhide

    2015-01-01

    A 32-year-old Japanese man presented with a gastric submucosal tumor. Esophagogastroduodenoscopy showed a sessile submucosal tumor measuring approximately 10?mm in diameter on the greater curvature of the gastric antrum. Endoscopic ultrasonography examination revealed a solid tumor with a diameter of 11.8?mm, which was located in the deep mucosal and submucosal layers. The internal echogenicity was homogenous and hypoechoic. Biopsy examinations were performed twice but were not diagnostic since only the intact mucosal layer was obtained. The patient was subsequently diagnosed with ectopic pancreas in the stomach by endoscopic submucosal dissection (ESD). This case underscores the usefulness of the ESD technique for the pathological diagnosis of gastric submucosal tumors. PMID:25878668

  11. Endoscopic submucosal dissection for early gastric cancer without interruption of warfarin and aspirin

    PubMed Central

    Tounou, Shigetaka; Morita, Yasushi; Hosono, Tomohiro; Harada, Hideaki; Hayasaka, Kenji; Katsuyama, Yasushi; Suehiro, Satoshi; Nagano, Seishi; Shimizu, Takanori

    2015-01-01

    Many guidelines for the management of antithrombotic therapy in endoscopic procedures state that warfarin should be replaced by heparin in high risk endoscopic procedures. However, heparin bridging therapy is costly, requires a long hospital stay, and is indicated as a risk factor for bleeding after endoscopic submucosal dissection (ESD). It is not yet clear whether it is better to perform gastric ESD on continuous warfarin therapy or heparin bridging therapy. We report the case of a 65-year-old Japanese man who had been diagnosed with early gastric cancer. He had a past medical history of metallic valve replacement for mitral valve regurgitation, coronary artery disease with bare metal stent, and coronary artery bypass graft. Warfarin and low dose aspirin had been used to prevent thromboembolic events in the metallic mitral valve and coronary artery stent. We performed gastric ESD safely on continuous warfarin and low dose aspirin without any complications. PMID:26357675

  12. Stent mal-apposition with resorption of intramural hematoma with spontaneous coronary artery dissection

    PubMed Central

    Lempereur, Mathieu; Fung, Anthony

    2015-01-01

    Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS). Conservative management is typically recommended but revascularization may be necessary if ongoing ischemia or adverse anatomical characteristics are present. Percutaneous coronary intervention (PCI) of SCAD can be fraught with challenges, and intracoronary imaging with optical coherence tomography (OCT) may provide insights on optimizing the acute results and identify long-term stent-related adverse events. We report three cases of SCAD treated with drug-eluting stents (DES) with OCT follow-up showing stent mal-apposition at different stages of follow-up. The clinical significance of these OCT findings and management options are discussed. PMID:26331116

  13. Endovascular glue embolization of dissecting aneurysm of type-3 accessory middle cerebral artery: A contralateral approach.

    PubMed

    Parthasarathy, Rajsrinivas; Goel, Gaurav; Gupta, Vipul; Narang, Karanjit Singh; Anand, Saurabh; Jha, Ajaya Nand

    2015-12-01

    Pediatric intracranial aneurysms are rare with a reported prevalence of 0.5-4.6%. Likewise, anomalous arterial patterns are uncommon in the cerebral circulation. Recognition of these variations and knowledge of vascular territory forms the key to managing pathological conditions associated with these anomalous vessels. Ruptured dissecting aneurysm of type-3 accessory middle cerebral artery (aMCA) has not been reported in the pediatric age group. In addition to type-3 aMCA, the child in this case report had an ipsilateral type-1 aMCA with cortical supply. We describe the patterns of accessory MCA and their vascular territory, state the perplexity involved in deciding the best management strategy, and describe the technical approach we undertook to catheterize this small caliber recurrent artery (type-3 aMCA) originating at an acute angle from the anterior cerebral artery. PMID:26508091

  14. Total thyroidectomy and central lymph node dissection. Experience of a referral centre for endocrine surgery

    PubMed Central

    MONACELLI, M.; LUCCHINI, R.; POLISTENA, A.; TRIOLA, R.; CONTI, C.; AVENIA, S.; DI PATRIZI, M.S.; BARILLARO, I.; BOCCOLINI, A.; SANGUINETTI, A.; AVENIA, N.

    2014-01-01

    Aim Thyroid cancer prognosis is determined by several variables, even with extremely elevated survival rate. The most debated issues are the type of thyroidectomy and extension of lymphadenectomy. Aim of the study is the analysis of benefits of level VI lymphadenectomy associated to total thyroidectomy in the treatment of thyroid cancer. Patients and methods 316 total thyroidectomy with central node dissection were carried out in the Unit of Endocrine Surgery, University of Perugia. Direct parathyroid auto-implantation was carried out if damage or accidental excision occurred. High risk patients received radioiodine treatment. Results Lymph node metastases in the VI level were observed in 42% of cases with a significant difference (p 0.0042) of positive lymph node in level VI comparing tumor larger than 1 cm vs smaller than 1 cm. No significant differences were observed when considering difference of sex, and age. Significant difference (p 0.005) was shown when considering over 45 years old male patients with tumor larger than 1 cm vs smaller ones. The 78% of patients underwent iodine ablation after surgery. Recurrence rate in these patients was 3.2%, with no significant difference compared to not treated patients. Bilateral temporary recurrent nerves palsy were observed in 0.6% of cases, unilateral temporary recurrent nerves palsy in 3.4%, unilateral permanent palsy in 1.5%, temporary hypoparathyroidism in 17%, permanent hypoparathyroidism in 4.4%. Conclusions Total thyroidectomy combined to central node dissection, even in absence of risk factors and without clinical evident nodes, is the treatment of choice offering clear indications to radioiodine ablation. PMID:24979101

  15. Milky Way Tomography IV: Dissecting Dust

    SciTech Connect

    Berry, Michael; Ivezic, Zeljko; Sesar, Branimir; Juric, Mario; Schlafly, Edward F.; Bellovary, Jillian; Finkbeiner, Douglas; Vrbanec, Dijana; Beers, Timothy C.; Brooks, Keira J.; Schneider, Donald P.; /Penn State U. /Washington U., Seattle, Astron. Dept.

    2011-11-01

    We use SDSS photometry of 73 million stars to simultaneously obtain best-fit main-sequence stellar energy distribution (SED) and amount of dust extinction along the line of sight towards each star. Using a subsample of 23 million stars with 2MASS photometry, whose addition enables more robust results, we show that SDSS photometry alone is sufficient to break degeneracies between intrinsic stellar color and dust amount when the shape of extinction curve is fixed. When using both SDSS and 2MASS photometry, the ratio of the total to selective absorption, R{sub V}, can be determined with an uncertainty of about 0.1 for most stars in high-extinction regions. These fits enable detailed studies of the dust properties and its spatial distribution, and of the stellar spatial distribution at low Galactic latitudes (|b| < 30{sup o}). Our results are in good agreement with the extinction normalization given by the Schlegel et al. (1998, SFD) dust maps at high northern Galactic latitudes, but indicate that the SFD extinction map appears to be consistently overestimated by about 20% in the southern sky, in agreement with recent study by Schlafly et al. (2010). The constraints on the shape of the dust extinction curve across the SDSS and 2MASS bandpasses disfavor the reddening law of O'Donnell (1994), but support the models by Fitzpatrick (1999) and Cardelli et al. (1989). For the latter, we find a ratio of the total to selective absorption to be R{sub V} = 3.0 {+-} 0.1(random) {+-} 0.1 (systematic) over most of the high-latitude sky. At low Galactic latitudes (|b| < 5{sup o}), we demonstrate that the SFD map cannot be reliably used to correct for extinction because most stars are embedded in dust, rather than behind it, as is the case at high Galactic latitudes. We analyze three-dimensional maps of the best-fit R{sub V} and find that R{sub V} = 3.1 cannot be ruled out in any of the ten SEGUE stripes at a precision level of {approx} 0.1 - 0.2. Our best estimate for the intrinsic scatter of R{sub V} in the regions probed by SEGUE stripes is {approx} 0.2. We introduce a method for efficient selection of candidate red giant stars in the disk, dubbed 'dusty parallax relation', which utilizes a correlation between distance and the extinction along the line of sight. We make these best-fit parameters, as well as all the input SDSS and 2MASS data, publicly available in a user-friendly format. These data can be used for studies of stellar number density distribution, the distribution of dust properties, for selecting sources whose SED differs from SEDs for high-latitude main sequence stars, and for estimating distances to dust clouds and, in turn, to molecular gas clouds.

  16. 76 FR 4285 - Certain Cased Pencils From the People's Republic of China: Notice of Court Decision Not in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ...China First'') and Shanghai Three Star Stationery Industry Corp. (``Three Star'') and separate rate company Orient International...30, 2007 with respect to China First, Three Star, and SFTC. See Certain Cased Pencils from...

  17. Dissection of the ascending thoracic aorta as a complication of percutaneous coronary intervention

    PubMed Central

    Uyan, Cihangir; Arinc, Huseyin; Gunduz, Huseyin; Akdemir, Ramazan

    2008-01-01

    Acute aortic dissection is a medical emergency with high morbidity and mortality requiring emergent diagnosis and therapy. A 79-year-old woman with acute aortic dissection due to percutaneous coronary intervention was presented. Aortic dissection is an uncommon but potentially lethal illness that can present in an occult manner making the initial diagnosis difficult. Aggressive medical management is mandatory, as well as urgent diagnostic testing and cardiothoracic consultation. PMID:18629358

  18. 37 CFR 2.155 - Notice of publication.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 false Notice of publication. 2.155 Section 2.155 ...RULES OF PRACTICE IN TRADEMARK CASES Publication of Marks Registered Under 1905 Act § 2.155 Notice of publication. The Office will send the...

  19. 78 FR 28205 - Notice of Second Prehearing Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ...: Notice. SUMMARY: Notice of the second prehearing conference for the case: In the Matter of BABY MATTERS.... Mullady, Jr., Esq. and Adrien C. Pickard, Esq. of BLANK ROME, LLP, Counsel for BABY MATTERS LLC;...

  20. 78 FR 2258 - Notice of Telephonic Prehearing Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-10

    ...: Notice. SUMMARY: Notice of telephonic prehearing conference for the case: In the Matter of BABY MATTERS... BLANK ROME, LLP, Counsel for BABY MATTERS LLC shall be provided with a phone number and passcode in...

  1. 76 FR 34974 - Cranberry Pipeline Corporation; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ...Energy Regulatory Commission [Docket No. PR11-113-000] Cranberry Pipeline Corporation; Notice of Filing Take notice that on June 6, 2011, Cranberry Pipeline Corporation (Cranberry) filed to request a case-specific waiver of section...

  2. Crisis resource management of the airway in a patient with Klippel-Feil syndrome, congenital deafness, and aortic dissection.

    PubMed

    Khawaja, Omar M; Reed, J Taylor; Shaefi, Shahzad; Chitilian, Hovig V; Sandberg, Warren S

    2009-04-01

    Klippel-Feil syndrome is a visually arresting deformity wherein severe restriction of cervical motion predicts a difficult airway. Even minor distraction of the neck risks cervical spine or neurologic injury, so regional techniques, awake fiberoptic intubation, or awake tracheostomy are recommended anesthetic approaches. We present a case of aortic dissection in a Klippel-Feil syndrome patient for whom congenital bilateral deafness, coupled with the urgency of the surgery, mitigated against the recommended first-choice techniques. Using anesthesia crisis resource management methods, a multi-member team rehearsed predefined roles and then managed the airway via inhaled induction of anesthesia, followed by flexible fiberoptic intubation. PMID:19299791

  3. Preauricular transparotid approach to mandibular condylar fractures without dissecting facial nerves.

    PubMed

    Yabe, Tetsuji; Tsuda, Tomoyuki; Hirose, Shunsuke; Ozawa, Toshiyuki

    2013-07-01

    Preauricular transparotid approach without dissecting the facial nerve was used for surgical treatment of 15 condylar fractures in 14 patients. The parotid fascia was opened just above the fracture site, and by dissecting the parotid gland and masseter muscle, the fracture was directly exposed. The facial nerve itself was not dissected expressly. All fractures could be reduced accurately and fixed firmly with miniplates. A direct approach just above the fracture site provided good vision of the fracture, avoiding facial nerve palsy caused by strong retraction. Moreover, by not dissecting the facial nerve, the operation time was shortened. This approach was useful for surgical treatment of both condylar neck and subcondylar fractures. PMID:23851809

  4. Application of blunt dissection in ESD of a gastric submucosal tumor.

    PubMed

    Wen, Zong-Quan; Wu, Guang-Yao; Yu, Shao-Ping; Lin, Xiao-Dong; Li, Song-Hu; Huang, Xian-Guang; Zhang, Fu; Zeng, Xiao-Yu; Huang, Hai-Yan; Li, Ai-Mei

    2014-06-01

    We performed endoscopic submucosal dissection of a gastric fundus tumor. It was difficult to strip the tumor completely due to space limitation, and we used blunt dissection to remove the tumor quickly and safely. Firstly, the basal area of the 2.5 cm submucosal tumor located in the gastric fundus was cut open, and the mucosa was dissected. The tumor was difficult to peel, therefore, a snare was used and the tumor was pulled and tightened slightly. Short electronic coagulation was used during the procedure. The tumor was then bluntly dissected. This method ensured rapid and complete removal of the tumor. PMID:24914398

  5. Application of blunt dissection in ESD of a gastric submucosal tumor

    PubMed Central

    Wen, Zong-Quan; Wu, Guang-Yao; Yu, Shao-Ping; Lin, Xiao-Dong; Li, Song-Hu; Huang, Xian-Guang; Zhang, Fu; Zeng, Xiao-Yu; Huang, Hai-Yan; Li, Ai-Mei

    2014-01-01

    We performed endoscopic submucosal dissection of a gastric fundus tumor. It was difficult to strip the tumor completely due to space limitation, and we used blunt dissection to remove the tumor quickly and safely. Firstly, the basal area of the 2.5 cm submucosal tumor located in the gastric fundus was cut open, and the mucosa was dissected. The tumor was difficult to peel, therefore, a snare was used and the tumor was pulled and tightened slightly. Short electronic coagulation was used during the procedure. The tumor was then bluntly dissected. This method ensured rapid and complete removal of the tumor. PMID:24914398

  6. Cell-type Specific Optogenetic Mice for Dissecting Neural Circuitry Function

    E-print Network

    Zhao, Shengli

    Optogenetic methods have emerged as powerful tools for dissecting neural circuit connectivity, function, and dysfunction. We used a Bacterial Artificial Chromosome (BAC) transgenic strategy to express Channelrhodopsin2 ...

  7. Endoscopic submucosal dissection for large colorectal tumor in a Japanese general hospital.

    PubMed

    Ohata, Ken; Nonaka, Kouichi; Minato, Yohei; Misumi, Yoshitsugu; Tashima, Tomoaki; Shozushima, Meiko; Mitsui, Takahiro; Matsuhashi, Nobuyuki

    2013-01-01

    Background and Aims. Endoscopic submucosal dissection (ESD) is not widely used in large colorectal lesions because of technical difficulty and possible complications. We aimed to examine the efficacy and safety of ESD for large colorectal neoplasms. Patients and Methods. During the past 5 years, 608 cases of colorectal neoplasm (?20?mm) were treated by ESD. They were divided into Group A (20-49?mm, 511 cases) and Group B (?50?mm, 97 cases). Results. The average age, lesion size, and procedure time were 67.4 years, 30.0?mm, and 60.0?min in Group A, and they were 67.1 years, 64.2?mm, and 119.6?min in Group B. En bloc resection rates were 99.2% and 99.0% (P = 0.80), and complication rates were 4.1% and 9.9% (P = 0.03). Complications in Group A consisted of perforation (2.7%), bleeding (1.2%), and ischemic colitis (0.2%). Those in Group B were perforation (8.2%) and bleeding (1.0%). Two cases in Group A and none in Group B required emergency surgery for perforation. Conclusions. There was no difference in efficacy between Groups A and B. Complications were more frequent in Group B, but all perforations in Group B were successfully managed conservatively. ESD can be effective and safe for large colorectal tumors. PMID:24072998

  8. Endoscopic Submucosal Dissection for Large Colorectal Tumor in a Japanese General Hospital

    PubMed Central

    Ohata, Ken; Nonaka, Kouichi; Minato, Yohei; Misumi, Yoshitsugu; Tashima, Tomoaki; Shozushima, Meiko; Mitsui, Takahiro; Matsuhashi, Nobuyuki

    2013-01-01

    Background and Aims. Endoscopic submucosal dissection (ESD) is not widely used in large colorectal lesions because of technical difficulty and possible complications. We aimed to examine the efficacy and safety of ESD for large colorectal neoplasms. Patients and Methods. During the past 5 years, 608 cases of colorectal neoplasm (?20?mm) were treated by ESD. They were divided into Group A (20–49?mm, 511 cases) and Group B (?50?mm, 97 cases). Results. The average age, lesion size, and procedure time were 67.4 years, 30.0?mm, and 60.0?min in Group A, and they were 67.1 years, 64.2?mm, and 119.6?min in Group B. En bloc resection rates were 99.2% and 99.0% (P = 0.80), and complication rates were 4.1% and 9.9% (P = 0.03). Complications in Group A consisted of perforation (2.7%), bleeding (1.2%), and ischemic colitis (0.2%). Those in Group B were perforation (8.2%) and bleeding (1.0%). Two cases in Group A and none in Group B required emergency surgery for perforation. Conclusions. There was no difference in efficacy between Groups A and B. Complications were more frequent in Group B, but all perforations in Group B were successfully managed conservatively. ESD can be effective and safe for large colorectal tumors. PMID:24072998

  9. Theoretical and Experimental Dissection of DNA Loop-Mediated Repression

    NASA Astrophysics Data System (ADS)

    Boedicker, James Q.; Garcia, Hernan G.; Phillips, Rob

    2013-01-01

    Transcriptional networks across all domains of life feature a wide range of regulatory architectures. Theoretical models now make clear predictions about how key parameters describing those architectures modulate gene expression, and the ability to construct genetic circuits with tunable parameters enables precise tests of such models. We dissect gene regulation through DNA looping by tuning network parameters such as repressor copy number, DNA binding strengths, and loop length in both thermodynamic models and experiments. Our results help clarify the short-length mechanical properties of DNA.

  10. [Microbiological monitoring of embalmed cadavera during dissection courses (author's transl)].

    PubMed

    Wewalka, G; Lischka, M F; Krammer, E B; Stanek, G

    1979-01-01

    Microbiological monitoring of normal anatomical specimens was done in order to evaluate results which were obtained in a investigation of decay of embalmed cadavera. The process of decay was characterized by massive colonisation with enterobacteria and aerobic sporeformers. Under normal conditions mainly germs from skin and air are cultivated from surfaces of anatomical specimens, but only in small numbers. The number of germs is increased after periods of intensive preparative work. The results show that the main criterion for the microbiological quality of embalmed cadavera is resistency against external germs during course work. This is to be achieved by consequent preventive measures in the dissection laboratory. PMID:543566

  11. Dissecting inhibitory brain circuits with genetically-targeted technologies

    PubMed Central

    Murphey, Dona K.; Herman, Alexander M.; Arenkiel, Benjamin R.

    2014-01-01

    The evolution of genetically targeted tools has begun to allow us to dissect anatomically and functionally heterogeneous interneurons, and to probe circuit function from synapses to behavior. Over the last decade, these tools have been used widely to visualize neurons in a cell type-specific manner, and engage them to activate and inactivate with exquisite precision. In this process, we have expanded our understanding of interneuron diversity, their functional connectivity, and how selective inhibitory circuits contribute to behavior. Here we discuss the relative assets of genetically encoded fluorescent proteins (FPs), viral tracing methods, optogenetics, chemical genetics, and biosensors in the study of inhibitory interneurons and their respective circuits. PMID:25368555

  12. Endoscopic submucosal dissection (ESD) versus simplified/hybrid ESD.

    PubMed

    Toyonaga, Takashi; Man-I, Mariko; Morita, Yoshinori; Azuma, Takeshi

    2014-04-01

    The development of endoscopic submucosal dissection (ESD) has enabled en bloc resection of lesions regardless of size and shape. However, ESD of colorectal tumors is technically difficult. Early stage colorectal tumors can be removed by endoscopic mucosal resection (EMR) but larger tumors may require piecemeal resection. Therefore, ESD with snaring has been proposed for more reliable EMR and easier ESD. This is a good option to fill the gap between EMR and ESD, and a good step to the introduction of full ESD. PMID:24679231

  13. Herophilus and Erasistratus, pioneers of human anatomical dissection.

    PubMed

    Reverón, Rafael Romero

    2014-01-01

    Herophilus (c335 - c280 B.C.) was the founder of the school of anatomy of Alexandria, and was among the first physicians to conduct anatomical dissections in public. He made extraordinary anatomical discoveries and developed standards for measuring the flow of blood from the heart through the arteries. Erasistratus (c310- c250 B.C.) was a disciple and collaborator of Herophilus. He made important contributions in the study and teaching of human anatomy and carried out research at the Museum of Alexandria. PMID:25181783

  14. Genetic Dissection of Learning and Memory in Mice

    PubMed Central

    Mineur, Yann S.; Crusio, Wim E.; Sluyter, Frans

    2004-01-01

    In this minireview, we discuss different strategies to dissect genetically the keystones of learning and memory. First, we broadly sketch the neurogenetic analysis of complex traits in mice. We then discuss two general strategies to find genes affecting learning and memory: candidate gene studies and whole genome searches. Next, we briefly review more recently developed techniques, such as microarrays and RNA interference. In addition, we focus on gene-environment interactions and endophenotypes. All sections are illustrated with examples from the learning and memory field, including a table summarizing the latest information about genes that have been shown to have effects on learning and memory. PMID:15656270

  15. Characterization of residual stresses by WEDM-assisted dissectioning

    NASA Astrophysics Data System (ADS)

    Regener, B.; Krempaszky, C.; Werner, E.; Berhuber, E.; Stockinger, M.

    2010-06-01

    Within the scope of this contribution a wire electric discharge machining assisted dissectioning method is presented, which combines high precision cutting, minimum generation of additional residual stresses during the cutting process and high precision measurement of the resulting distortion. As an example a forged component made of the titanium alloy Ti6Al4V is investigated in a multiple cut procedure. A finite element based mechanical model for the estimation of the residual stress distribution in the component from the distortion data is introduced and discussed.

  16. High pressure jet injection of viscous solutions for endoscopic submucosal dissection (ESD): first clinical experience

    PubMed Central

    Pioche, Mathieu; Lépilliez, Vincent; Déprez, Pierre; Giovannini, Marc; Caillol, Fabrice; Piessevaux, Hubert; Rivory, Jérôme; Guillaud, Olivier; Ciocîrlan, Mihai; Salmon, Damien; Lienhart, Isabelle; Lafon, Cyril; Saurin, Jean-Christophe; Ponchon, Thierry

    2015-01-01

    Background: Long lasting elevation is a key factor during endoscopic submucosal dissection (ESD) and can be obtained by water jet injection of saline solution or by viscous macromolecular solutions. In a previous animal study, we assessed the Nestis Enki II system to combine jet injection and viscous solutions. In the present work, we used this combination in humans in different sites of the digestive tract. Methods: We retrospectively report all of the consecutive ESD procedures performed with jet injection of viscous solutions in four centers. Information was collected about the lesion, the procedure, the histological result, and the outcomes for the patient. Results: In total, 45 resections were completed by six operators: five experts and one beginner with only one previous experience in human ESD. Lesions were located in the esophagus (10), the stomach (11), the duodenum (1), the colon (1) and the rectum (22). Average maximal lesion diameter was 4.8?cm (SD 2.4, range 2?–?11?cm), average lesion surface area was 19.8?cm2 (SD 17.7, range 2.2?–?72?cm2), and average duration of procedure was 79.9?min (SD 50.3?min, range 19?–?225?min). ESD could be conducted while the endoscope was retroflexed at its maximum in 26 cases. Four adverse events were observed: two diminutive perforations and two delayed bleeding occurrences treated conservatively. The R0 resection rate was 91.1?%. The catheter was obstructed in six occurrences of bleeding. Conclusion: Endoscopic submucosal dissection using high pressure injection of viscous macromolecular solutions is safe and effective in different parts of the digestive tract. It does not impede working with the endoscope in the maximal retroflexed position. PMID:26356488

  17. Clinical significance of the muscle-retracting sign during colorectal endoscopic submucosal dissection

    PubMed Central

    Toyonaga, Takashi; Tanaka, Shinwa; Man-I, Mariko; East, James; Ono, Wataru; Nishino, Eisei; Ishida, Tsukasa; Hoshi, Namiko; Morita, Yoshinori; Azuma, Takeshi

    2015-01-01

    Background and study aims: During colorectal endoscopic submucosal dissection (ESD), the feature of a muscle layer being pulled toward a neoplastic tumor is sometimes detected. We call this feature the muscle-retracting sign (MR sign). The aim of this study was to evaluate whether the MR sign is associated with particular types of neoplastic lesions and whether it has any clinical significance for ESD sessions. Patients and methods: A total of 329 patients underwent ESD for 357 colorectal neoplasms. The frequency of positivity for the MR sign was evaluated in different morphologic and histopathologic types of neoplasm. The success rate of complete resection and the incidence of complications were also evaluated according to whether lesions were positive or negative for the MR sign. Results: The rates of positivity for the MR sign in the various lesion types were as follows: laterally spreading tumor?–?granular nodular mixed type (LST-G-M), 9.6?%; laterally spreading tumor?–?granular homogeneous type (LST-G-H) and laterally spreading tumor?–?nongranular type (LST-NG), 0?%; sessile type, 41.2?%. The resection rate was 100?% (329?/329) in lesions negative for the MR sign; however, it was 64.3?% (18?/28) in lesions positive for the MR sign, which was significantly lower (P?dissected with great caution; alternatively, based on the features of the individual case, a switch to surgery should be considered for the benefit of the patient. PMID:26171438

  18. Familial occurrence and heritable connective tissue disorders in cervical artery dissection

    PubMed Central

    Goeggel Simonetti, Barbara; Schilling, Sabrina; Martin, Juan José; Kloss, Manja; Sarikaya, Hakan; Hausser, Ingrid; Engelter, Stefan; Metso, Tiina M.; Pezzini, Alessandro; Thijs, Vincent; Touzé, Emmanuel; Paolucci, Stefano; Costa, Paolo; Sessa, Maria; Samson, Yves; Béjot, Yannick; Altintas, Ayse; Metso, Antti J.; Hervé, Dominique; Lichy, Christoph; Jung, Simon; Fischer, Urs; Lamy, Chantal; Grau, Armin; Chabriat, Hugues; Caso, Valeria; Lyrer, Philippe A.; Stapf, Christian; Tatlisumak, Turgut; Brandt, Tobias; Tournier-Lasserve, Elisabeth; Germain, Dominique P.; Frank, Michael; Baumgartner, Ralf W.; Grond-Ginsbach, Caspar; Bousser, Marie-Germaine; Leys, Didier; Dallongeville, Jean; Bersano, Anna

    2014-01-01

    Objective: In a large series of patients with cervical artery dissection (CeAD), a major cause of ischemic stroke in young and middle-aged adults, we aimed to examine frequencies and correlates of family history of CeAD and of inherited connective tissue disorders. Methods: We combined data from 2 large international multicenter cohorts of consecutive patients with CeAD in 23 neurologic departments participating in the CADISP-plus consortium, following a standardized protocol. Frequency of reported family history of CeAD and of inherited connective tissue disorders was assessed. Putative risk factors, baseline features, and 3-month outcome were compared between groups. Results: Among 1,934 consecutive patients with CeAD, 20 patients (1.0%, 95% confidence interval: 0.6%–1.5%) from 17 families (0.9%, 0.5%–1.3%) had a family history of CeAD. Family history of CeAD was significantly more frequent in patients with carotid location of the dissection and elevated cholesterol levels. Two patients without a family history of CeAD had vascular Ehlers-Danlos syndrome with a mutation in COL3A1. This diagnosis was suspected in 2 additional patients, but COL3A1 sequencing was negative. Two patients were diagnosed with classic and hypermobile Ehlers-Danlos syndrome, one patient with Marfan syndrome, and one with osteogenesis imperfecta, based on clinical criteria only. Conclusions: In this largest series of patients with CeAD to date, family history of symptomatic CeAD was rare and inherited connective tissue disorders seemed exceptional. This finding supports the notion that CeAD is a multifactorial disease in the vast majority of cases. PMID:25355833

  19. Mutations in a TGF-? Ligand, TGFB3, Cause Syndromic Aortic Aneurysms and Dissections

    PubMed Central

    Bertoli-Avella, Aida M.; Gillis, Elisabeth; Morisaki, Hiroko; Verhagen, Judith M.A.; de Graaf, Bianca M.; van de Beek, Gerarda; Gallo, Elena; Kruithof, Boudewijn P.T.; Venselaar, Hanka; Myers, Loretha A.; Laga, Steven; Doyle, Alexander J.; Oswald, Gretchen; van Cappellen, Gert W.A.; Yamanaka, Itaru; van der Helm, Robert M.; Beverloo, Berna; de Klein, Annelies; Pardo, Luba; Lammens, Martin; Evers, Christina; Devriendt, Koenraad; Dumoulein, Michiel; Timmermans, Janneke; Bruggenwirth, Hennie T.; Verheijen, Frans; Rodrigus, Inez; Baynam, Gareth; Kempers, Marlies; Saenen, Johan; Van Craenenbroeck, Emeline M.; Minatoya, Kenji; Matsukawa, Ritsu; Tsukube, Takuro; Kubo, Noriaki; Hofstra, Robert; Goumans, Marie Jose; Bekkers, Jos A.; Roos-Hesselink, Jolien W.; van de Laar, Ingrid M.B.H.; Dietz, Harry C.; Van Laer, Lut; Morisaki, Takayuki; Wessels, Marja W.; Loeys, Bart L.

    2015-01-01

    Background Aneurysms affecting the aorta are a common condition associated with high mortality as a result of aortic dissection or rupture. Investigations of the pathogenic mechanisms involved in syndromic types of thoracic aortic aneurysms, such as Marfan and Loeys-Dietz syndromes, have revealed an important contribution of disturbed transforming growth factor (TGF)-? signaling. Objectives This study sought to discover a novel gene causing syndromic aortic aneurysms in order to unravel the underlying pathogenesis. Methods We combined genome-wide linkage analysis, exome sequencing, and candidate gene Sanger sequencing in a total of 470 index cases with thoracic aortic aneurysms. Extensive cardiological examination, including physical examination, electrocardiography, and transthoracic echocardiography was performed. In adults, imaging of the entire aorta using computed tomography or magnetic resonance imaging was done. Results Here, we report on 43 patients from 11 families with syndromic presentations of aortic aneurysms caused by TGFB3 mutations. We demonstrate that TGFB3 mutations are associated with significant cardiovascular involvement, including thoracic/abdominal aortic aneurysm and dissection, and mitral valve disease. Other systemic features overlap clinically with Loeys-Dietz, Shprintzen-Goldberg, and Marfan syndromes, including cleft palate, bifid uvula, skeletal overgrowth, cervical spine instability and clubfoot deformity. In line with previous observations in aortic wall tissues of patients with mutations in effectors of TGF-? signaling (TGFBR1/2, SMAD3, and TGFB2), we confirm a paradoxical up-regulation of both canonical and noncanonical TGF-? signaling in association with up-regulation of the expression of TGF-? ligands. Conclusions Our findings emphasize the broad clinical variability associated with TGFB3 mutations and highlight the importance of early recognition of the disease because of high cardiovascular risk. PMID:25835445

  20. Cadaveric Temporal Bone Dissection: Is It Obsolete Today?

    PubMed Central

    Naik, Sulabha M.; Naik, Mahendra S.; Bains, Nainjot Kaur

    2013-01-01

    Introduction?Traditionally, surgical training in otology, is imparted by dissecting harvested human cadaveric temporal bones. However, maintenance of a cadaveric temporal bone laboratory is expensive and carries risk of exposure to infection. In recent times, other modalities of training are gaining ground and are likely to eventually replace cadaveric temporal bone dissection altogether. Objectives?Other alternative methods of training are emerging. New technology like simulation and virtual reality as high-fidelity, safer alternatives, are making rapid strides as teaching tools. Other options are the use of animal temporal bones as teaching tools. The advantages of these are compared. Data Synthesis?None of these modalities can replicate the innumerable anatomical variations which are a characteristic feature of the human temporal bone. A novice surgeon not only needs exposure to surgical anatomy and it's variations but also needs to develop hand-eye coordination skills to gain expertise. Conclusion?Deliberate practice on human cadaveric temporal bones only, will confer both mastery in anatomy and surgical technique. The human cadaveric temporal bone is ideal simulator for training in otology. PMID:25992066

  1. How to establish endoscopic submucosal dissection in Western countries

    PubMed Central

    Oyama, Tsuneo; Yahagi, Naohisa; Ponchon, Thierry; Kiesslich, Tobias; Berr, Frieder

    2015-01-01

    Endoscopic submucosal dissection (ESD) has been invented in Japan to provide resection for cure of early cancer in the gastrointestinal tract. Professional level of ESD requires excellent staging of early neoplasias with image enhanced endoscopy (IEE) to make correct indications for ESD, and high skills in endoscopic electrosurgical dissection. In Japan, endodiagnostic and endosurgical excellence spread through personal tutoring of skilled endoscopists by the inventors and experts in IEE and ESD. To translocate this expertise to other continents must overcome two fundamental obstacles: (1) inadequate expectations as to the complexity of IEE and ESD; and (2) lack of suitable lesions and master-mentors for ESD trainees. Leading endoscopic mucosal resection-proficient endoscopists must pioneer themselves through the long learning curve to proficient ESD experts. Major referral centers for ESD must arise in Western countries on comparable professional level as in Japan. In the second stage, the upcoming Western experts must commit themselves to teach skilled endoscopists from other referral centers, in order to spread ESD in Western countries. Respect for patients with early gastrointestinal cancer asks for best efforts to learn endoscopic categorization of early neoplasias and skills for ESD based on sustained cooperation with the masters in Japan. The strategy is discussed here. PMID:26523097

  2. Virtual Temporal Bone Dissection System: Development and Testing

    PubMed Central

    Wiet, Gregory J.; Stredney, Don; Kerwin, Thomas; Hittle, Bradley; Fernandez, Soledad A.; Welling, D. Bradley

    2012-01-01

    Objectives/Hypothesis The objective of this project was to develop a virtual temporal bone dissection system that would provide an enhanced educational experience for the training of otologic surgeons. Study Design A randomized, controlled, multi-institutional single blinded validation study. Methods The project encompassed 4 areas of emphasis: structural data acquisition, integration of the system, dissemination of the system, and validation. Results Structural acquisition was performed on multiple imaging platforms. Integration achieved a cost effective system. Dissemination was achieved on different levels including casual interest, downloading of software, and full involvement in development and validation studies. A validation study was performed at 8 different training institutions across the country using a two arm, randomized trial where study subjects were randomized to a two-week practice session using either the virtual temporal bone or standard cadaveric temporal bones. Eighty subjects were enrolled and randomized to one of the two treatment arms, 65 completed the study. There was no difference between the two groups using a blinded rating tool to assess performance after training. Conclusions 1. A virtual temporal bone dissection system has been developed and compared to cadaveric temporal bones for practice using a multi-center trial. 2. There is no statistical difference seen between practice on the current simulator when compared to practice on human cadaveric temporal bones. 3. Further refinements in structural acquisition and interface design have been identified which can be implemented prior to full incorporation into training programs and use for objective skills assessment. PMID:22294268

  3. Dissecting neural differentiation regulatory networks through epigenetic footprinting

    PubMed Central

    Yaffe, Yakey; Donaghey, Julie; Pop, Ramona; Mallard, William; Issner, Robbyn; Gifford, Casey A.; Goren, Alon; Xing, Jeff; Gu, Hongcang; Cachiarelli, Davide; Tsankov, Alexander; Epstein, Chuck; Rinn, John R.; Mikkelsen, Tarjei S.; Kohlbacher, Oliver; Gnirke, Andreas; Bernstein, Bradley E.

    2014-01-01

    Human pluripotent stem cell derived models that accurately recapitulate neural development in vitro and allow for the generation of specific neuronal subtypes are of major interest to the stem cell and biomedical community. Notch signaling, particularly through the Notch effector HES5, is a major pathway critical for the onset and maintenance of neural progenitor cells (NPCs) in the embryonic and adult nervous system1-3. This can be exploited to isolate distinct populations of human embryonic stem (ES) cell derived NPCs4. Here, we report the transcriptional and epigenomic analysis of six consecutive stages derived from a HES5-GFP reporter ES cell line5 differentiated along the neural trajectory aimed at modeling key cell fate decisions including specification, expansion and patterning during the ontogeny of cortical neural stem and progenitor cells. In order to dissect the regulatory mechanisms that orchestrate the stage-specific differentiation process, we developed a computational framework to infer key regulators of each cell state transition based on the progressive remodeling of the epigenetic landscape and then validated these through a pooled shRNA screen. We were also able to refine our previous observations on epigenetic priming at transcription factor binding sites and show here that they are mediated by combinations of core and stage- specific factors. Taken together, we demonstrate the utility of our system and outline a general framework, not limited to the context of the neural lineage, to dissect regulatory circuits of differentiation. PMID:25533951

  4. How to establish endoscopic submucosal dissection in Western countries.

    PubMed

    Oyama, Tsuneo; Yahagi, Naohisa; Ponchon, Thierry; Kiesslich, Tobias; Berr, Frieder

    2015-10-28

    Endoscopic submucosal dissection (ESD) has been invented in Japan to provide resection for cure of early cancer in the gastrointestinal tract. Professional level of ESD requires excellent staging of early neoplasias with image enhanced endoscopy (IEE) to make correct indications for ESD, and high skills in endoscopic electrosurgical dissection. In Japan, endodiagnostic and endosurgical excellence spread through personal tutoring of skilled endoscopists by the inventors and experts in IEE and ESD. To translocate this expertise to other continents must overcome two fundamental obstacles: (1) inadequate expectations as to the complexity of IEE and ESD; and (2) lack of suitable lesions and master-mentors for ESD trainees. Leading endoscopic mucosal resection-proficient endoscopists must pioneer themselves through the long learning curve to proficient ESD experts. Major referral centers for ESD must arise in Western countries on comparable professional level as in Japan. In the second stage, the upcoming Western experts must commit themselves to teach skilled endoscopists from other referral centers, in order to spread ESD in Western countries. Respect for patients with early gastrointestinal cancer asks for best efforts to learn endoscopic categorization of early neoplasias and skills for ESD based on sustained cooperation with the masters in Japan. The strategy is discussed here. PMID:26523097

  5. The Use of Specially Designed Tasks to Enhance Student Interest in the Cadaver Dissection Laboratory

    ERIC Educational Resources Information Center

    Kang, Seok Hoon; Shin, Jwa-Seop; Hwang, Young-il

    2012-01-01

    Cadaver dissection is a key component of anatomy education. Unfortunately, students sometimes regard the process of dissection as uninteresting or stressful. To make laboratory time more interesting and to encourage discussion and collaborative learning among medical students, specially designed tasks were assigned to students throughout…

  6. Isolated Spontaneous Dissection of the Common Iliac Artery: Percutaneous Stent Placement in Two Patients

    SciTech Connect

    Kwak, Hyo-Sung; Han, Young-Min Chung, Gyung-Ho; Yu, Hee Chul; Jeong, Yeon-Jun

    2006-10-15

    Isolated spontaneous dissection of the common iliac artery (CIA) is a rare entity. Two patients with this condition were successfully treated by percutaneous stent placement. We emphasize the feasibility of nonsurgical management by percutaneous stent placement for isolated spontaneous dissection of the CIA.

  7. 78 FR 17429 - Certain Balloon Dissection Devices and Products Containing Same; Commission Determination Not To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-21

    ... (``Covidien'') on December 21, 2012. 78 FR 6838 (January 31, 2013). The complaint alleged violations of... Certain Balloon Dissection Devices and Products Containing Same; Commission Determination Not To Review an... importation, or sale in the United States after importation of certain balloon dissection devices and...

  8. Students' Physical and Psychological Reactions to Forensic Dissection: Are There Risk Factors?

    ERIC Educational Resources Information Center

    Sergentanis, Theodoros N.; Papadodima, Stavroula A.; Evaggelakos, Christos I.; Mytilinaios, Dimitrios G.; Goutas, Nikolaos D.; Spiliopoulou, Chara A.

    2010-01-01

    The reactions of students to forensic dissection encompass psychologico-emotional and physical components. This exploratory study aimed to determine risk factors for students' adverse physical and psychological reactions to forensic dissection. All sixth-year medical students (n = 304) attending the compulsory practical course in forensic medicine…

  9. The discovery of the body: human dissection and its cultural contexts in ancient Greece.

    PubMed Central

    von Staden, H.

    1992-01-01

    In the first half of the third century B.C, two Greeks, Herophilus of Chalcedon and his younger contemporary Erasistratus of Ceos, became the first and last ancient scientists to perform systematic dissections of human cadavers. In all probability, they also conducted vivisections of condemned criminals. Their anatomical and physiological discoveries were extraordinary. The uniqueness of these events presents an intriguing historical puzzle. Animals had been dissected by Aristotle in the preceding century (and partly dissected by other Greeks in earlier centuries), and, later, Galen (second century A.D.) and others again systematically dissected numerous animals. But no ancient scientists ever seem to have resumed systematic human dissection. This paper explores, first, the cultural factors--including traditional Greek attitudes to the corpse and to the skin, also as manifested in Greek sacred laws--that may have prevented systematic human dissection during almost all of Greek antiquity, from the Pre-Socratic philosopher-scientists of the sixth and fifth centuries B.C. to distinguished Greek physicians of the later Roman Empire. Second, the exceptional constellation of cultural, political, and social circumstances in early Alexandria that might have emboldened Herophilus to overcome the pressures of cultural traditions and to initiate systematic human dissection, is analyzed. Finally, the paper explores possible reasons for the mysteriously abrupt disappearance of systematic human dissection from Greek science after the death of Erasistratus and Herophilus. PMID:1285450

  10. An Algorithm for Creating Geometric Dissection Puzzles Yahan Zhou, yhzhou@cs.umass.edu

    E-print Network

    Massachusetts at Amherst, University of

    - ational math and art [4,7]. In its basic form, the dissection question asks whether any two shapes by the ancient Greeks. One of the earliest examples is a visual proof of the Pythagorean theorem. In Arabic-Islamic mathematics and art, dissection figures are frequently used to construct intriguing patterns ornamenting

  11. GCSE Students' Attitudes to Dissection and Using Animals in Research and Product Testing.

    ERIC Educational Resources Information Center

    Lock, Roger

    1995-01-01

    Questionnaires from students passing the General Certificate of Secondary Education (GCSE) that explored attitudes to dissection and using animals in product testing administered to (n=469) students ages 14-15 showed a high level of support for peers who object to dissection, although objectors are likely to be met with derogatory comments,…

  12. 78 FR 6838 - Certain Balloon Dissection Devices and Products Containing Same; Institution of Investigation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... COMMISSION Certain Balloon Dissection Devices and Products Containing Same; Institution of Investigation... dissection balloons and products containing the same by reason of infringement of certain claims of U.S... desist orders. ADDRESSES: The complaint, except for any confidential information contained therein,...

  13. Science Laboratory Depth of Learning: Interactive Multimedia Simulation and Virtual Dissection Software

    ERIC Educational Resources Information Center

    Yuza, Steve C.

    2010-01-01

    The purpose of this study was to determine the effects of interactive multimedia simulations and virtual dissection software on depth of learning among students participating in biology and chemistry laboratory courses. By understanding more about how simulation and virtual dissection software changes depth of learning, educators will have the…

  14. Dissecting the Dissectors: Knowledge, Attitude, and Practice of Body Bequests by Nigerian Anatomists

    ERIC Educational Resources Information Center

    Anyanwu, Emeka G.; Obikili, Emmanuel N.

    2012-01-01

    Anatomy education in most African countries is limited by an insufficient number of cadavers for students to undertake dissection. This already significant shortage is exacerbated by an increasing number of medical schools and students. Virtual dissections are impractical in alleviating such a shortfall in African anatomy education, and further…

  15. Medical Students' Reactions to Anatomic Dissection and the Phenomenon of Cadaver Naming

    ERIC Educational Resources Information Center

    Williams, Austin D.; Greenwald, Emily E.; Soricelli, Rhonda L.; DePace, Dennis M.

    2014-01-01

    The teaching of gross anatomy has, for centuries, relied on the dissection of human cadavers, and this formative experience is known to evoke strong emotional responses. The authors hypothesized that the phenomenon of cadaver naming is a coping mechanism used by medical students and that it correlates with other attitudes about dissection and body…

  16. Oregon Sea Grant Marine Education Program at Hatfield Marine Science Center Fish Dissection

    E-print Network

    Wright, Dawn Jeannine

    Oregon Sea Grant Marine Education Program at Hatfield Marine Science Center Fish Dissection The Fish Dissection program at Hatfield Marine Science Center is a 50-minute hands-on program for 4th through 12th grade students. Students will work in small groups as they examine a variety of fish, study

  17. Management and associated factors of delayed perforation after gastric endoscopic submucosal dissection

    PubMed Central

    Suzuki, Haruhisa; Oda, Ichiro; Sekiguchi, Masau; Abe, Seiichiro; Nonaka, Satoru; Yoshinaga, Shigetaka; Nakajima, Takeshi; Saito, Yutaka

    2015-01-01

    AIM: To identify the actual clinical management and associated factors of delayed perforation after gastric endoscopic submucosal dissection (ESD). METHODS: A total of 4943 early gastric cancer (EGC) patients underwent ESD at our hospital between January 1999 and June 2012. We retrospectively assessed the actual management of delayed perforation. In addition, to determine the factors associated with delayed perforation, after excluding 123 EGC patients with perforations that occurred during the ESD procedure, we analyzed the following clinicopathological factors among the remaining 4820 EGC patients by comparing the ESD cases with delayed perforation and the ESD cases without perforation: age, sex, chronological periods, clinical indications for ESD, status of the stomach, location, gastric circumference, tumor size, invasion depth, presence/absence of ulceration, histological type, type of resection, and procedure time. RESULTS: Delayed perforation occurred in 7 (0.1%) cases. The median time until the occurrence of delayed perforation was 11 h (range, 6-172 h). Three (43%) of the 7 cases required emergency surgery, while four were conservatively managed without surgical intervention. Among the 4 cases with conservative management, 2 were successfully managed endoscopically using the endoloop-endoclip technique. The median hospital stay was 18 d (range, 15-45 d). There were no delayed perforation-related deaths. Based on a multivariate analysis, gastric tube cases (OR = 11.0; 95%CI: 1.7-73.3; P = 0.013) were significantly associated with delayed perforation. CONCLUSION: Endoscopists must be aware of not only the identified factors associated with delayed perforation, but also how to treat this complication effectively and promptly. PMID:26640340

  18. Dissecting Allele Architecture of Early Onset IBD Using High-Density Genotyping

    PubMed Central

    Prahalad, Sampath; Walters, Thomas; Guthery, Stephen L.; Dubinsky, Marla; Baldassano, Robert; Crandall, Wallace V.; Rosh, Joel; Markowitz, James; Stephens, Michael; Kellermayer, Richard; Pfefferkorn, Marian; Heyman, Melvin B.; LeLeiko, Neal; Mack, David; Moulton, Dedrick; Kappelman, Michael D.; Kumar, Archana; Prince, Jarod; Bose, Promita; Mondal, Kajari; Ramachandran, Dhanya; Bohnsack, John F.; Griffiths, Anne M.; Haberman, Yael; Essers, Jonah; Thompson, Susan D.; Aronow, Bruce; Keljo, David J.; Hyams, Jeffrey S.; Denson, Lee A.; Kugathasan, Subra

    2015-01-01

    Background The inflammatory bowel diseases (IBD) are common, complex disorders in which genetic and environmental factors are believed to interact leading to chronic inflammatory responses against the gut microbiota. Earlier genetic studies performed in mostly adult population of European descent identified 163 loci affecting IBD risk, but most have relatively modest effect sizes, and altogether explain only ~20% of the genetic susceptibility. Pediatric onset represents about 25% of overall incident cases in IBD, characterized by distinct disease physiology, course and risks. The goal of this study is to compare the allelic architecture of early onset IBD with adult onset in population of European descent. Methods We performed a fine mapping association study of early onset IBD using high-density Immunochip genotyping on 1008 pediatric-onset IBD cases (801 Crohn’s disease; 121 ulcerative colitis and 86 IBD undetermined) and 1633 healthy controls. Of the 158 SNP genotypes obtained (out of the 163 identified in adult onset), this study replicated 4% (5 SNPs out of 136) of the SNPs identified in the Crohn’s disease (CD) cases and 0.8% (1 SNP out of 128) in the ulcerative colitis (UC) cases. Replicated SNPs implicated the well known NOD2 and IL23R. The point estimate for the odds ratio (ORs) for NOD2 was above and outside the confidence intervals reported in adult onset. A polygenic liability score weakly predicted the age of onset for a larger collection of CD cases (p< 0.03, R2= 0.007), but not for the smaller number of UC cases. Conclusions The allelic architecture of common susceptibility variants for early onset IBD is similar to that of adult onset. This immunochip genotyping study failed to identify additional common variants that may explain the distinct phenotype that characterize early onset IBD. A comprehensive dissection of genetic loci is necessary to further characterize the genetic architecture of early onset IBD. PMID:26098103

  19. Near-peer driven dissection selective: A primer to the medical school anatomy course.

    PubMed

    Cantwell, Sean; Bonadurer, George F; Pawlina, Wojciech; Lachman, Nirusha

    2015-11-01

    In the anatomy laboratory, skill remains a critical component to unlocking the true value of learning from cadaveric dissection. However, there is little if any room for provision of instruction in proper dissection technique. We describe how near-peer instructors designed a supplemental learning activity to enhance the dissection experience for first-year medical students. This study aimed to evaluate the efficacy of this curriculum in improving participants' understanding of dissection technique and its impact on perceived challenges associated with the anatomy course. Curriculum was designed under faculty guidance and included didactic sessions, low-fidelity models, dissection, student presentations, and clinical correlations. Participants' (n?=?13) knowledge of basic dissection techniques and concepts were assessed before the selective, and both participants' and nonparticipants' (n?=?39) knowledge was assessed at the end of week one and week seven of the anatomy course. Scores were compared using repeated measures ANOVA followed by post hoc t-tests. Thirteen deidentified reflective essays were reviewed by four independent reviewers for themes that aligned with learning objectives. Participants in the selective course scored higher on assessment of dissection techniques and concepts one week after the selective compared to both nonparticipants and their own baseline scores before the selective. Analysis of student reflections resulted in four themes: confidence with dissection skill, sharing resources and transfer of knowledge, learning environment, and psychological impact of perceived challenges of the anatomy course. Near-peer driven supplemental exercises are effective in facilitating dissection skills. This dissection primer increases student confidence and alleviates apprehension associated with anatomy courses. Clin. Anat. 28:985-993, 2015. © 2015 Wiley Periodicals, Inc. PMID:26375596

  20. Toward a Genetic Dissection of Cortical Circuits in the Mouse

    PubMed Central

    Huang, Z. Josh

    2014-01-01

    The mammalian neocortex gives rise to a wide range of mental activities and consists of a constellation of interconnected areas that are built from a set of basic circuit templates. Major obstacles to understanding cortical architecture include the diversity of cell types, their highly recurrent local and global connectivity, dynamic circuit operations, and a convoluted developmental assembly process rooted in the genome. With our increasing knowledge of gene expression and developmental genetic principles, it is now feasible to launch a program of genetic dissection of cortical circuits through systematic targeting of cell types and fate-mapping of neural progenitors. Strategic design of even a modest number of mouse driver lines will facilitate efforts to compile a cell type parts list, build a Cortical Cell Atlas, establish experimental access to modern tools, and provide coordinates for tracing developmental trajectory from circuit assembly to functional operation. PMID:25233312

  1. Vertebral artery dissection after a chiropractor neck manipulation.

    PubMed

    Jones, Jeremy; Jones, Catherine; Nugent, Kenneth

    2015-01-01

    The differential diagnosis for ischemic central nervous system infarcts in young patients includes paradoxic emboli through cardiac shunts, vasculitis, and vascular trauma. We report a young woman who developed headache, vomiting, diplopia, dizziness, and ataxia following neck manipulation by her chiropractor. A computed tomography scan of the head revealed an infarct in the inferior half of the left cerebellar hemisphere and compression of the fourth ventricle causing moderate acute obstructive hydrocephalus. Magnetic resonance angiography revealed severe narrowing and low flow in the intracranial segment of the left distal vertebral artery. The patient was treated with mannitol and a ventriculostomy and had an excellent functional recovery. This report illustrates the potential hazards associated with neck trauma, including chiropractic manipulation. The vertebral arteries are at risk for aneurysm formation and/or dissection, which can cause acute stroke. PMID:25552813

  2. Vertebral artery dissection after a chiropractor neck manipulation

    PubMed Central

    Jones, Jeremy; Nugent, Kenneth

    2015-01-01

    The differential diagnosis for ischemic central nervous system infarcts in young patients includes paradoxic emboli through cardiac shunts, vasculitis, and vascular trauma. We report a young woman who developed headache, vomiting, diplopia, dizziness, and ataxia following neck manipulation by her chiropractor. A computed tomography scan of the head revealed an infarct in the inferior half of the left cerebellar hemisphere and compression of the fourth ventricle causing moderate acute obstructive hydrocephalus. Magnetic resonance angiography revealed severe narrowing and low flow in the intracranial segment of the left distal vertebral artery. The patient was treated with mannitol and a ventriculostomy and had an excellent functional recovery. This report illustrates the potential hazards associated with neck trauma, including chiropractic manipulation. The vertebral arteries are at risk for aneurysm formation and/or dissection, which can cause acute stroke. PMID:25552813

  3. Induced pluripotent stem cell technology for dissecting the cancer epigenome

    PubMed Central

    Semi, Katsunori; Yamada, Yasuhiro

    2015-01-01

    Cancer arises through the accumulation of both genetic and epigenetic alterations. Although the causal role of genetic mutations on cancer development has been established in vivo, similar evidence for epigenetic alterations is limited. Moreover, mutual interactions between genetic mutations and epigenetic alterations remain unclear. Cellular reprogramming technology can be used to actively modify the epigenome without affecting the underlying genomic sequences. Here we introduce recent studies that have utilized this property for cancer research. We propose that just as it has potential for regenerative medicine and disease modeling, cell reprogramming could also be a powerful tool for dissecting the role of the cancer epigenome in the development and maintenance of cancer cells. PMID:26224327

  4. From microscopes to microarrays: dissecting recurrent chromosomal rearrangements

    PubMed Central

    Emanuel, Beverly S.; Saitta, Sulagna C.

    2010-01-01

    Submicroscopic chromosomal rearrangements that lead to copy-number changes have been shown to underlie distinctive and recognizable clinical phenotypes. The sensitivity to detect copy-number variation has escalated with the advent of array comparative genomic hybridization (CGH), including BAC and oligonucleotide-based platforms. Coupled with improved assemblies and annotation of genome sequence data, these technologies are facilitating the identification of new syndromes that are associated with submicroscopic genomic changes. Their characterization reveals the role of genome architecture in the aetiology of many clinical disorders. We review a group of genomic disorders that are mediated by segmental duplications, emphasizing the impact that high-throughput detection methods and the availability of the human genome sequence have had on their dissection and diagnosis. PMID:17943194

  5. Dissecting Alzheimer disease in Down syndrome using mouse models

    PubMed Central

    Choong, Xun Yu; Tosh, Justin L.; Pulford, Laura J.; Fisher, Elizabeth M. C.

    2015-01-01

    Down syndrome (DS) is a common genetic condition caused by the presence of three copies of chromosome 21 (trisomy 21). This greatly increases the risk of Alzheimer disease (AD), but although virtually all people with DS have AD neuropathology by 40 years of age, not all develop dementia. To dissect the genetic contribution of trisomy 21 to DS phenotypes including those relevant to AD, a range of DS mouse models has been generated which are trisomic for chromosome segments syntenic to human chromosome 21. Here, we consider key characteristics of human AD in DS (AD-DS), and our current state of knowledge on related phenotypes in AD and DS mouse models. We go on to review important features needed in future models of AD-DS, to understand this type of dementia and so highlight pathogenic mechanisms relevant to all populations at risk of AD. PMID:26528151

  6. Dissecting the hypothalamic pathways that underlie innate behaviors.

    PubMed

    Zha, Xi; Xu, Xiaohong

    2015-12-01

    Many complex behaviors that do not require learning are displayed and are termed innate. Although traditionally the subject matter of ethology, innate behaviors offer a unique entry point for neuroscientists to dissect the physiological mechanisms governing complex behaviors. Since the last century, converging evidence has implicated the hypothalamus as the central brain area that controls innate behaviors. Recent studies using cutting-edge tools have revealed that genetically-defined populations of neurons residing in distinct hypothalamic nuclei and their associated neural pathways regulate the initiation and maintenance of diverse behaviors including feeding, sleep, aggression, and parental care. Here, we review the newly-defined hypothalamic pathways that regulate each innate behavior. In addition, emerging general principles of the neural control of complex behaviors are discussed. PMID:26552801

  7. Dissection of C. elegans behavioral genetics in 3-D environments

    PubMed Central

    Kwon, Namseop; Hwang, Ara B.; You, Young-Jai; V. Lee, Seung-Jae; Ho Je, Jung

    2015-01-01

    The nematode Caenorhabditis elegans is a widely used model for genetic dissection of animal behaviors. Despite extensive technical advances in imaging methods, it remains challenging to visualize and quantify C. elegans behaviors in three-dimensional (3-D) natural environments. Here we developed an innovative 3-D imaging method that enables quantification of C. elegans behavior in 3-D environments. Furthermore, for the first time, we characterized 3-D-specific behavioral phenotypes of mutant worms that have defects in head movement or mechanosensation. This approach allowed us to reveal previously unknown functions of genes in behavioral regulation. We expect that our 3-D imaging method will facilitate new investigations into genetic basis of animal behaviors in natural 3-D environments. PMID:25955271

  8. Students as teachers in an anatomy dissection course.

    PubMed

    Salomäki, Tiina; Laakkonen, Juha; Ruohoniemi, Mirja

    2014-01-01

    One way to improve students' learning outcomes and well-being is to change teaching practices to allow students to become more active participants. We used an anatomy dissection course to test a cooperative group work method in which first-year veterinary students took turns leading their peer group and were each responsible for teaching the anatomy of a particular topographic region. The important blood vessels, lymphatic system, and nerves of each region of the body were covered. Students felt that exploration of the entire topographic region helped them to acquire a comprehensive understanding of the respiratory apparatus and the cardiovascular and nervous systems. Assigning individual tasks to each group member resulted in sharing the workload equally. Open-ended comments revealed that support from other group members was important for the students' learning experience, but the results also offered insight into a lack of constructive criticism. While teaching was considered challenging, and even a stress factor that hindered learning for some students, group work was generally held to be supportive of learning. The results suggest that more thorough instruction of students in their group work and in their individual tasks is required. Some students experienced difficulty in expressing their concerns openly and in seeking guidance from teachers, demonstrating the need for further investigation regarding students' self-regulation skills. Comments from the open-ended responses suggest that use of a cooperative learning method in anatomy dissection courses not only deepens student understanding of a subject but also offers first-year students an opportunity to practice the generic skills that will be needed in their future profession. PMID:24219999

  9. Resolution of Internal Carotid Dissection with Middle Cerebral Artery Occlusion in Pregnancy

    PubMed Central

    Ulrich, Nicole; Jodry, Dominique

    2015-01-01

    Introduction. Cervical artery dissection (CAD) is a common cause of stroke in younger patients. While the incidence of stroke in pregnancy is increasing, CAD remains a rare cause of ischemic stroke in the pregnant population, with only 30 cases described in the literature, most in the postpartum period. Methods. The case of a pregnant patient at 18 weeks of gestation presenting with CAD and ischemic stroke following intercourse is discussed. Discussion. CAD results from an intimal tear in the carotid artery, allowing accumulation of blood in the vessel wall. Stroke results from embolization of thrombogenic material in the wall. Etiology includes minor trauma, connective tissue disorders, or anatomic variations of the carotid artery. Most patients present with headache and/or neck pain, while ischemic symptoms are seen in at least 50% of patients. In the pregnant population, imaging with MRI or MRA of the head and neck aids in diagnosis. Once the diagnosis is made, patients are treated with either anticoagulation or antiplatelet medications. The optimal treatment in both pregnant and nonpregnant patients has not been well-studied. Conclusion. CAD is an important diagnosis to consider in a pregnant patient with persistent headache, especially if neurological symptoms are present. Imaging should be quickly obtained so treatment can be initiated. PMID:25918654

  10. Emergent total arch replacement for acute type A aortic dissection with aberrant right subclavian artery in a systemic lupus erythematosus patient.

    PubMed

    Kitamura, Hideki; Kimura, Arishige; Fukaya, Shunsuke; Okawa, Yasuhide; Komeda, Masashi

    2016-01-01

    A 50-year-old man with a history of systemic lupus erythematosus and hemodialysis developed acute type A aortic dissection. Computed tomography demonstrated acute type A aortic dissection with chronic distal arch aneurysm and aberrant right subclavian artery that arose from the proximal descending aorta and ran in a retro-esophageal track. Emergent total arch replacement was performed using antegrade cerebral perfusion with circulatory arrest. Both common carotid arteries and the left subclavian artery were chosen as selective cerebral perfusion sites. The right subclavian artery was snared during cerebral perfusion. The right subclavian artery was reconstructed with the right common carotid artery in an end-to-side fashion in the anterior mediastinum. The patient's postoperative course was uneventful, and computed tomography showed excellent blood flow to all four branches. The case description is followed by a discussion of cerebral protection, reconstruction route of the right aberrant subclavian artery and steroids for systemic lupus erythematosus. PMID:24163229

  11. 29 CFR 825.300 - Employer notice requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...employee's FMLA entitlement may be oral or in writing. If such notice is oral, it shall be confirmed in writing...less than one week after the oral notice, in which case the notice...employment, reinstatement, promotion, or any other relief...

  12. 29 CFR 825.300 - Employer notice requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...employee's FMLA entitlement may be oral or in writing. If such notice is oral, it shall be confirmed in writing...less than one week after the oral notice, in which case the notice...employment, reinstatement, promotion, or any other relief...

  13. Outcome analysis of laporoscopic D1 and D2 dissection in patients 70 years and older with gastric cancer

    PubMed Central

    Emir, Seyfi; Sözen, Selim; Bali, ?lhan; Gürdal, Sibel Özkan; Turan, Bünyamin Cüneyt; Y?ld?r?m, Oguzhan; Yeti?yi?it, Tarkan

    2014-01-01

    Objective: Gastric cancer is a worldwide aggressive tumor with a bad prognosis. The purpose of this study was to retrospectively investigate operative findings of 53 patients aged over 70 with gastric cancer who underwent laporoscopic operations in our clinic. Material and methods: A retrospective review of all patients who underwent laporoscopic surgery for pathologically confirmed gastric cancer at our clinic between March 2008 and October 2010 was conducted. D1 resection (Level1 lymphadenectomy) was compared with D2 resection (Levels 1 and 2 lymphadenectomy). The two groups in which D1 and D2 Lymph node Dissection (LND) were applied were compared with respect to number of patients, sex, age, stage of disease, and score of American Society of Anesthesiologists (ASA). We analyzed surgical methods, the use of staplers, operative time, additional organ resections, hospital stay, postoperative complications and the need for re-operation, operative mortality, and the effects of prognostic factors on survival. Results: The patient group consisted of 31 (58%) males and 22 (42%) females. Of the patients, 28 (52%) underwent D1 and 25 (48%) D2 LND. There was a significant difference between the two groups with regard to length of surgery (p < 0.01). The length of operation, blood loss, and transfusion requirement in the D2 group were significantly more than those in the D1 group. There was no mortality in cases that underwent additional organ resection. The survival times of cases with a ? 0.25 ratio of dissected number of lymph nodes to metastatic lymph nodes were significantly longer than those of other cases. The survival time of cases with perineural and vascular invasion was significantly shorter. The survival rates of Stage I patients was significantly higher than those of Stage III (p:0.002) and Stage IV (p:0.003) patients. Conclusions: Although extensive dissection had an increased morbidity, there was no significant statistical difference between the two procedures. Early complications should not be attributed only to the extent of LND. The important prognostic factors related to long-time survival are the stage of the tumor, perineural and perivascular invasion, and metastatic lymph nodes. PMID:25419390

  14. Sensitivity of partial carcass dissection for assessment of porcine cysticercosis at necropsy.

    PubMed

    Lightowlers, M W; Assana, E; Jayashi, C M; Gauci, C G; Donadeu, M

    2015-11-01

    Many interventions against Taenia solium are evaluated by assessing changes in the prevalence of porcine cysticercosis ascertained by carcass dissection. Financial and logistical difficulties often prohibit dissection of entire pig carcasses. We assessed 209 pigs from rural areas of Cameroon and Peru for the presence of T. solium cysticerci and determined the distribution of parasites within the musculature of infected animals. Considering the presence of cysts in the tongue, masticatory muscles and heart, 31 of the 38 (81%) naturally infected animals were identified as having cysts. Dissection of only the tongue, masticatory muscles and heart provides a relatively sensitive and highly specific method for diagnosis of porcine cysticercosis. PMID:26385439

  15. Sensitivity of partial carcass dissection for assessment of porcine cysticercosis at necropsy

    PubMed Central

    Lightowlers, M.W.; Assana, E.; Jayashi, C.M.; Gauci, C.G.; Donadeu, M.

    2015-01-01

    Many interventions against Taenia solium are evaluated by assessing changes in the prevalence of porcine cysticercosis ascertained by carcass dissection. Financial and logistical difficulties often prohibit dissection of entire pig carcasses. We assessed 209 pigs from rural areas of Cameroon and Peru for the presence of T. solium cysticerci and determined the distribution of parasites within the musculature of infected animals. Considering the presence of cysts in the tongue, masticatory muscles and heart, 31 of the 38 (81%) naturally infected animals were identified as having cysts. Dissection of only the tongue, masticatory muscles and heart provides a relatively sensitive and highly specific method for diagnosis of porcine cysticercosis. PMID:26385439

  16. Proximal paraparesis due to aortic dissection extending into bilateral carotid arteries in a patient with Loeys-Dietz syndrome.

    PubMed

    Goshgarian, C; Lugo, A; Salazar, R

    2013-12-01

    The authors report a 66 year-old female with past medical history relevant for thoracic abdominal aneurysm who presented with a complaint of chest pain radiating into her neck. The physical examination was significant for the distinctive facial features of wide spaced eyes and V-shaped uvula. Thoracic CT scan revealed a type I aortic dissection which warranted immediate surgical repair. On post-op day one she was noted to be confused and was found to have acute bilateral lower extremity paraparesis with proximal predominance. Furthermore, her left radial artery line had no pulse waves and no brachial, radial, or ulnar pulses could be detected with Doppler ultrasound. Emergent head CT scan revealed bilateral postcentral gyri infarctions and the thoracic CT scan demonstrated extension of the dissection into the aortic branches, including the left brachial and the bilateral carotid arteries. Consequently, surgical brachial artery repair ensued. In the interim, a repeated head CT scan demonstrated new ischemic infarcts involving the bilateral frontal lobes. Anticoagulation was not indicated due to the high risk of bleeding at surgical site. Genetic testing confirmed the presence of a mutation in the TGFBR2 gene at exon 5. Loeys-Dietz syndrome is an autosomal dominant disease caused by heterozygous mutations in the genes encoding type I or II transforming growth factor-? (TGF-?) receptor. Loeys-Dietz syndrome manifests with aggressive vascular pathology. This case underscores the importance of recognition of this spectrum of clinical and pathologic manifestations to identify and manage Loeys-Dietz syndrome. PMID:23591182

  17. THERAPY OF ENDOCRINE DISEASE: Central neck dissection: a step forward in the treatment of papillary thyroid cancer.

    PubMed

    Sitges-Serra, Antonio; Lorente, Leyre; Mateu, Germán; Sancho, Juan J

    2015-12-01

    Since its introduction in the '70s and '80s, CND for papillary cancer is here to stay. Compartment VI should always be explored during surgery for papillary thyroid carcinoma (PTC) for obvious lymph node metastases. These can be easily spotted by an experienced surgeon or, eventually, by frozen section. No doubt, obvious nodal disease in the Delphian, paratracheal and subithsmic areas should be dissected in a comprehensive manner (therapeutic central neck dissection), avoiding the selective removal of suspicious nodes. Available evidence for routine prophylactic CND is not completely satisfactory. Our group's opinion, however, is that it reduces or even eliminates the need for repeat surgery in the central neck, better defines the extent (and stage) of the disease and provides a further argument against routine radioiodine ablation. Thus, PTC is becoming more and more a surgical disease that can be cured by optimized surgery alone in the majority of cases. Prophylactic CND, however, involves a higher risk for the parathyroid function and should be skilfully performed, preferably only on the same side as the primary tumour and preserving the cervical portion of the thymus. PMID:26088823

  18. Dissecting electrostatic screening, specific ion binding, and ligand binding in an energetic model for glycine riboswitch folding

    SciTech Connect

    Lipfert, Jan; Sim, Adelene Y.L.; Herschlag, Daniel; Doniach, Sebastian

    2010-09-17

    Riboswitches are gene-regulating RNAs that are usually found in the 5{prime}-untranslated regions of messenger RNA. As the sugar-phosphate backbone of RNA is highly negatively charged, the folding and ligand-binding interactions of riboswitches are strongly dependent on the presence of cations. Using small angle X-ray scattering (SAXS) and hydroxyl radical footprinting, we examined the cation dependence of the different folding stages of the glycine-binding riboswitch from Vibrio cholerae. We found that the partial folding of the tandem aptamer of this riboswitch in the absence of glycine is supported by all tested mono- and divalent ions, suggesting that this transition is mediated by nonspecific electrostatic screening. Poisson-Boltzmann calculations using SAXS-derived low-resolution structural models allowed us to perform an energetic dissection of this process. The results showed that a model with a constant favorable contribution to folding that is opposed by an unfavorable electrostatic term that varies with ion concentration and valency provides a reasonable quantitative description of the observed folding behavior. Glycine binding, on the other hand, requires specific divalent ions binding based on the observation that Mg{sup 2+}, Ca{sup 2+}, and Mn{sup 2+} facilitated glycine binding, whereas other divalent cations did not. The results provide a case study of how ion-dependent electrostatic relaxation, specific ion binding, and ligand binding can be coupled to shape the energetic landscape of a riboswitch and can begin to be quantitatively dissected.

  19. Comparison of Modified Radical Mastectomy with Quadrantectomy, Axillary Dissection, and Radiation Therapy in Early Breast Cancer in Japaness Women.

    PubMed

    Sonoo; Kurebayashi; Shimozuma; Ohta; Miyake; Imajo

    1995-10-31

    From January 1987 to December 1993, Stage I (T1N0M0) breast cancers were treated by quadrantectomy with axillary lymph node dissection plus radiation therapy (QUART) in 57 cases and by modified radical mastectomy (MRM) in 57 cases. The results for these two treatment groups were compared retrospectively. Booster irradiation of 10 Gy to the tumor bed was given to 1 of 5 cases with a positive resection margin. The remaining 56 cases received 50 Gy lineac X-ray to the ipsilateral breast. Systemic adjuvant therapy, tamoxifen and /or 5-FU derivatives p.o., were given to the majority of cases in both groups. There were no significant differences between the two groups with regard to the patient background; ie, age, tumor size, pathological node status, histology and estrogen receptor status. During the follow-up period of 12 to 89 months (median 55 months) in the QUART group, no local recurrence was observed and only 1 case of bone metastasis occurred. In the MRM group, recurrence occurred in 4 cases during the follow-up period of 12 to 95 months (median 52 months). These consisted of 2 cases of regional lymph node recurrence and 2 cases of lung metastases. The differences in the disease-free survival rate and the overall survival rate between the two groups were not significant. In the QUART group, mild radiation pneumonitis and mild telangiectasia in the breast skin were observed in 2 cases(3.5%) and 1 case, respectively. Mild arm edema was observed in 4 cases (7%) in each group. These results demonstrated that QUART was as effective as MRM in treating T1M0M0 breast carcinoma in Japanese women. PMID:11091536

  20. Fatal Delayed Esophageal Rupture Following Aortic Clamping for Treatment of Stanford Type B Dissection

    SciTech Connect

    Ito, Hisao; Yamada, Takayuki; Ishibashi, Tadashi; Akiyama, Masatoshi; Nakame, Takahiko; Ito, Yasuhiro; Konnai, Toshiaki

    2003-11-15

    A 65-year-old man underwent a thromboexclusionoperation for management of chronic Stanford type B dissecting aneurysmin 1991. However, long-term follow-up CT scans after the operation revealed that the ascending aorta gradually enlarged and was eventually complicated by recurrent aortic dissection. The patient complained of frequent bloody sputum, whereas chest roentogenography showed no pulmonary abnormalities. Subsequent swallow esophagogram demonstrated that the upper esophagus was deviated to the right and the middle esophagus was greatly compressed by the aortic clamp. Esophageal endoscopy showed a bloody inner surface and marked swelling of the middle esophagus. The patient eventually died of massive hematemesis in 2001. We describe the imaging features of unanticipated complications such as recurrent dissecting aneurysm or impending esophageal rupture.Furthermore, we discuss the cause of hematemesis and document that the aortic clamp migrated and resulted in development of a recurrent aneurysmal dissection, which in turn resulted in esophageal rupture with aneurysmal disruption.

  1. J Physiol 580.3 (2007) pp 961975 961 Pharmacological dissection of the human gastro-

    E-print Network

    Brasseur, James G.

    2007-01-01

    J Physiol 580.3 (2007) pp 961­975 961 Pharmacological dissection of the human gastro- oesophageal and quantify in vivo the skeletal and smooth muscle sphincteric components pharmacologically and clarify

  2. Systematic dissection of regulatory motifs in 2000 predicted human enhancers using a massively parallel reporter assay

    E-print Network

    Kheradpour, Pouya

    Genome-wide chromatin annotations have permitted the mapping of putative regulatory elements across multiple human cell types. However, their experimental dissection by directed regulatory motif disruption has remained ...

  3. A historical perspective: infection from cadaveric dissection from the 18th to 20th centuries.

    PubMed

    Shoja, Mohammadali M; Benninger, Brion; Agutter, Paul; Loukas, Marios; Tubbs, R Shane

    2013-03-01

    Today, the study of human anatomy utilizing the ultimate study guide, the cadaver, is relatively safe. In the past, however, human dissection was dangerous. Prior to the germ theory, antibiotics, and the use of gloves, cadavers were often life threatening to dissectors including both the teacher and the student. Medical students who graduated in the United States before 1880 were unlikely to practice antisepsis in the dissecting room. In the present article, we review human cadaveric dissection in Europe and the United States primarily from the 1700s to the early 1900s in regard to its potential for transmission of infection to the dissector. A brief account of the infectious hazards of human cadavers in general and those of cadavers used for dissection in particular is given. PMID:23037893

  4. Cell type–specific channelrhodopsin-2 transgenic mice for optogenetic dissection of neural circuitry function

    E-print Network

    Zhao, Shengli

    Optogenetic methods have emerged as powerful tools for dissecting neural circuit connectivity, function and dysfunction. We used a bacterial artificial chromosome (BAC) transgenic strategy to express the H134R variant of ...

  5. Dissecting biological ``dark matter'' with single-cell genetic analysis of rare and uncultivated TM7

    E-print Network

    Quake, Stephen R.

    Dissecting biological ``dark matter'' with single-cell genetic analysis of rare and uncultivated TM of a microbial community. environmental microbiology metagenomics microfluidics single-cell analysis The earth

  6. Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

    PubMed Central

    Nagami, Yasuaki; Machida, Hirohisa; Shiba, Masatsugu; Obayashi, Tomoko; Ominami, Masaki; Fukunaga, Shusei; Sugimori, Satoshi; Yamagami, Hirokazu; Tanigawa, Tetsuya; Watanabe, Kenji; Watanabe, Toshio; Tominaga, Kazunari; Fujiwara, Yasuhiro; Arakawa, Tetsuo

    2014-01-01

    Background and Study Aims There are a few reports about the efficacy of endoscopic submucosal dissection (ESD) for adenocarcinomas of the esophagogastric junction (EGJ). However, there is no detailed analysis that divides EGJ cancers into Barrett’s adenocarcinoma and gastric cardia adenocarcinoma. The aim of this study was to analyze the efficacy of ESD for EGJ cancers, comparing these two adenocarcinomas. Patients and Methods This study included 43 patients who underwent ESD for type II EGJ cancers between 2004 and 2011.?Pathological examination of resected specimens confirmed 14 cases of Barrett’s adenocarcinoma and 29 cases of gastric cardia adenocarcinoma. Cutting margins on the oral side were placed 1?cm from the squamocolumnar junction, or 1?cm away from the slight elevation that is an endoscopic sign of subsquamous carcinoma extension. Clinical outcomes, prevalence and length of subsquamous carcinoma extension, and long-term outcomes were compared between these two types of adenocarcinoma. Results No significant differences in clinical outcomes were found between these two types of adenocarcinoma (en bloc, 100?% versus 100?%; complete, 100?% versus 89.7?%; curative, 85.7?% versus 75.9?%). No serious adverse events were encountered. The prevalence of subsquamous carcinoma extension was significantly higher in Barrett’s adenocarcinoma compared with gastric cardia adenocarcinoma. Local and distant recurrence were not observed in any cases with curative resection during the follow-up period (1.6?–?87.6 months). Conclusion ESD for EGJ cancers, including both Barrett’s adenocarcinoma and gastric cardia adenocarcinoma, was efficient and useful. ESD with a 1?cm safety margin may be acceptable for EGJ cancers. PMID:26134607

  7. Current practice with endoscopic submucosal dissection in Europe: position statement from a panel of experts.

    PubMed

    Deprez, P H; Bergman, J J; Meisner, S; Ponchon, T; Repici, A; Dinis-Ribeiro, M; Haringsma, J

    2010-10-01

    Endoscopic submucosal dissection (ESD) is the gold standard technique for performing en bloc resection of large superficial tumors in the upper and lower gastrointestinal tract. Experience in Europe, however, is still limited and ESD is only performed in a few selected centers, with low volumes of cases, no description of training programs, and few published reports. In 2008, a panel of experts gathered in Rotterdam to discuss indications, training, and the wider use of ESD. The panel of experts and participants reached a consensus on five general statements: 1) ESD aims at treating mucosal cancer; 2) treatment aims for R0 resection; 3) ESD should meet quality standards; 4) ESD should be performed following national or European Society of Gastrointestinal Endoscopy (ESGE) guidelines or under institutional review board approval; and 5) ESD cases should be registered. Due to the high level of expertise needed to perform the technique safely, ESD should be performed in a step-up approach, starting with lesions presenting in the rectum or in the distal stomach, then colon, proximal stomach, and finally in the esophagus. Registration is advised either at the local site or at a national or ESGE level, and should include information on indication (Paris classification of lesion, location, and histological results prior to treatment), technique used (e.?g. type of knife), results (en bloc and R0 resection), complications, and follow-up. The panel also agreed on minimal institutional requirements: good quality imaging, experienced histopathologist following the Japanese criteria (2-mm sections, micrometric invasion, vessel and lymphatic infiltration, etc), and dedicated endoscopic follow-up. Moreover, minimum training requirements were also defined: knowledge in indications and instruments, exposure to experts (currently all in Japan), hands-on experience in a model of isolated pig stomach and in live pigs, and management of complications. The experts did not reach a consensus on a minimum case load, or whether the technique should be restricted to expert centers. PMID:20623442

  8. The Quality of Reports on Cervical Arterial Dissection following Cervical Spinal Manipulation

    PubMed Central

    Wynd, Shari; Westaway, Michael; Vohra, Sunita; Kawchuk, Greg

    2013-01-01

    Background Cervical artery dissection (CAD) and stroke are serious harms that are sometimes associated with cervical spinal manipulation therapy (cSMT). Because of the relative rarity of these adverse events, studying them prospectively is challenging. As a result, systematic review of reports describing these events offers an important opportunity to better understand the relation between adverse events and cSMT. Of note, the quality of the case report literature in this area has not yet been assessed. Purpose 1) To systematically collect and synthesize available reports of CAD that have been associated with cSMT in the literature and 2) assess the quality of these reports. Methods A systematic review of the literature was conducted using several databases. All clinical study designs involving CADs associated with cSMT were eligible for inclusion. Included studies were screened by two independent reviewers for the presence/absence of 11 factors considered to be important in understanding the relation between CAD and cSMT. Results Overall, 43 articles reported 901 cases of CAD and 707 incidents of stroke reported to be associated with cSMT. The most common type of stroke reported was ischemic stroke (92%). Time-to-onset of symptoms was reported most frequently (95%). No single case included all 11 factors. Conclusions This study has demonstrated that the literature infrequently reports useful data toward understanding the association between cSMT, CADs and stroke. Improving the quality, completeness, and consistency of reporting adverse events may improve our understanding of this important relation. PMID:23527121

  9. Initial and Middle-Term Outcome of Treatment for Spontaneous Isolated Dissection of Superior Mesenteric Artery.

    PubMed

    Li, Zilun; Ding, Huanyu; Shan, Zhen; Du, Jianliang; Yao, Chen; Chang, Guangqi; Wang, Shenming

    2015-11-01

    Symptomatic isolated dissection of the superior mesenteric artery (SIDSMA) represents an extremely rare condition. Although various treatments including conservative treatment, endovascular stenting (ES), and surgical repair are currently available, consensus treatment guideline is absent due to scarce of SIDSMA cases. Thus, we present our experience in the treatment of SIDSMA at our single center.Fourteen cases of SIDSMA were treated with conservative treatment, catheter-directed thrombolysis (CDT), endovascular stenting (ES), or surgical repair at our center between January 2008 and January 2014. Demographics, clinical manifestations, coexisting medical conditions, imaging feature, treatments, and follow-up outcome of these patients were retrospectively collected and analyzed.For 13 patients without peritonitis, conservative treatment was given for 4 to 6 days initially. After the first observation cycle, symptoms and signs were alleviated in 8 patients, and conservative treatments were continued. The remaining 5 patients received technically and clinically successful ES (in 4) or CDT (in 1) due to worsening symptoms and signs during conservative treatment. One patient with peritonitis underwent emergency surgery, with the necrotic small intestine resected. However, the abdominal pain was not alleviated 17 days postoperatively, ES was thus performed and symptoms relieved immediately. Two weeks after ES, a new aneurysm and partial thrombosis in the distal part of the stent were found by computed tomography angiography in this patient. No intestinal infarction or mortality developed during hospitalization. Follow-up was accomplished in 11 cases, ranging from 4 to 74 months (23.5?±?21.3). Except that one complained with mild abdominal pain, the other 10 achieved complete remission. All patients were free from new aneurysmal formation of SMA and all stents remained patent.For SIDSMA without peritonitis, conservative treatment can be provided with reasonable success rate, while ES may serve as an effective alternative once conservative treatment fails. For SIDSMA with peritonitis, open surgery remains the treatment of choice by resection of necrotic intestine and revasculization. PMID:26559313

  10. Effectiveness of the supraomohyoid neck dissection in clinically N0 neck patients with squamous cell carcinoma of buccal mucosa and gingivobuccal sulcus

    PubMed Central

    Rahamthulla, S. A. K. Uroof; Priya, P. Vani; Hussain, S. M. D. Javeed; Nasyam, Fazil Arshad; Akifuddin, Syed; Srinivas, Velpula Sasidhar

    2015-01-01

    Background: To evaluate the effectiveness of the supraomohyoid neck dissection in clinically N0 neck patients with squamous cell carcinoma of buccal mucosa and gingivobuccal sulcus. Materials and Methods: This was a prospective study of five patients with squamous cell carcinoma of gingivobuccal mucosa of oral cavity with clinically N0 neck, conducted over a period of 2 years from July 2007 to Oct 2009 in the Department of Oral and Maxillofacial Surgery, Narayana Dental College and Hospital. The study was conducted in patients irrespective of age, sex, size, thickness, and type of differentiation of the lesion. All patients have clinically non-palpable lymphnodes (N0 neck), while patients with palpable lymphnodes, patients with previous surgery, and patients with previous radiotherapy were excluded from the study. Results: Level I was the commonest site of neck metastasis in our study. Among the five patients, two (40%) patients (case 2 and 3) had occult cervical metastasis (level IB nodes are histopathologically positive nodes) and the remaining three patients (60%) had no occult cervical metastasis. The recurrence rate was 20% for patients who received postoperative radiotherapy. There was no morbidity and postoperative dysfunction and the mortality rate was only 20% in our study. Conclusion: Supraomohyoid neck dissection is the therapeutic procedure in clinically N0 neck patients with squamous cell carcinoma of buccal mucosa and gingivobuccal sulcus of mandible. Supraomohyoid neck dissection, when indicated, contributes to the concept of less-invasive surgery and offers functional and aesthetic advantages without compromising the clearance with minimal morbidity. PMID:25992339

  11. Physical dissection and characterization of chromosomes V and VIII of Saccharomyces cerevisiae.

    PubMed Central

    Tanaka, S; Isono, K

    1992-01-01

    Chromosomes V and VIII of S. cerevisiae were dissected and ordered clone banks were constructed and characterized. Each bank contains almost the entire chromosome from the left to the right telomere except for a small gap in each case. The size of the banks constructed is in good agreement with the physical length of these chromosomes, 580 kb, estimated by pulsed-field gel electrophoresis. The remaining gap in the ordered clone bank of chromosome V was found to be only 1.6 kb in length and to contain a 1.5 kb-long portion of one of the two Ty elements located in tandem. The gap in the bank of chromosome VIII was 6.4 kb in length and contained four copies of the CUP1 gene. A genomic restriction map analysis of the corresponding region of chromosome VIII revealed that a unit of about 2 kb in length harbouring the CUP1 gene was repeated ten times in strain DC5 rho degrees which was used for the bank construction. A 588.5 kb-long high resolution physical map for chromosome V and a 585.6 kb-long one for chromosome VIII have thus been established. Images PMID:1535703

  12. Electrolyte depletion syndrome (McKittrick-Wheelock syndrome) successfully treated by endoscopic submucosal dissection.

    PubMed

    Ohara, Yoshiko; Toyonaga, Takashi; Watanabe, Daisuke; Hoshi, Namiko; Adachi, Soichiro; Yoshizaki, Tetsuya; Kawara, Fumiaki; Tanaka, Shinwa; Ishida, Tsukasa; Okuno, Tatsuya; Ikehara, Nobunao; Morita, Yoshinori; Umegaki, Eiji; Yokozaki, Hiroshi; Azuma, Takeshi

    2015-10-01

    A 66-year-old woman presented to us with malaise, anorexia and rectal mucous discharge, and her laboratory data showed severe hyponatremia, hypokalemia, hypochloremia and renal failure. Computed tomography revealed massive occupation of the rectum by a large tumor. Colonoscopy revealed a mucus-rich villous tumor in the rectum. As there were no other factors that could cause an electrolyte disorder, she was diagnosed with McKittrick-Wheelock syndrome (MWS). The current standard treatment for MWS is partial surgical colectomy. However, surgeries are invasive and postoperative complications sometimes become an issue. After confirming no signs of submucosal invasion of the tumor by magnifying chromoendoscopic examination, endoscopic submucosal dissection (ESD) was indicated. The tumor was completely removed en bloc without adverse events. The histology showed a mucosal adenocarcinoma containing a villous component, 24.5 x 17.0 cm in size. This removal dramatically improved the patient's symptoms and the electrolyte abnormalities without medication. Although several sessions of endoscopic balloon dilation were required to treat postoperative stricture, she has been symptom-free and had no recurrence for 4 years after treatment. We experienced a case of MWS treated by ESD instead of surgery. ESD should be feasible and beneficial for the treatment of MWS. PMID:26304954

  13. Association weight matrix for the genetic dissection of puberty in beef cattle

    PubMed Central

    Fortes, Marina R. S.; Reverter, Antonio; Zhang, Yuandan; Collis, Eliza; Nagaraj, Shivashankar H.; Jonsson, Nick N.; Prayaga, Kishore C.; Barris, Wes; Hawken, Rachel J.

    2010-01-01

    We describe a systems biology approach for the genetic dissection of complex traits based on applying gene network theory to the results from genome-wide associations. The associations of single-nucleotide polymorphisms (SNP) that were individually associated with a primary phenotype of interest, age at puberty in our study, were explored across 22 related traits. Genomic regions were surveyed for genes harboring the selected SNP. As a result, an association weight matrix (AWM) was constructed with as many rows as genes and as many columns as traits. Each {i, j} cell value in the AWM corresponds to the z-score normalized additive effect of the ith gene (via its neighboring SNP) on the jth trait. Columnwise, the AWM recovered the genetic correlations estimated via pedigree-based restricted maximum-likelihood methods. Rowwise, a combination of hierarchical clustering, gene network, and pathway analyses identified genetic drivers that would have been missed by standard genome-wide association studies. Finally, the promoter regions of the AWM-predicted targets of three key transcription factors (TFs), estrogen-related receptor ? (ESRRG), Pal3 motif, bound by a PPAR-? homodimer, IR3 sites (PPARG), and Prophet of Pit 1, PROP paired-like homeobox 1 (PROP1), were surveyed to identify binding sites corresponding to those TFs. Applied to our case, the AWM results recapitulate the known biology of puberty, captured experimentally validated binding sites, and identified candidate genes and gene–gene interactions for further investigation. PMID:20643938

  14. Factors Associated With Outcomes in Endoscopic Submucosal Dissection of Gastric Cardia Tumors

    PubMed Central

    Jang, Yae Su; Lee, Bong Eun; Kim, Gwang Ha; Park, Do Youn; Jeon, Hye Kyung; Baek, Dong Hoon; Kim, Dong Uk; Song, Geun Am

    2015-01-01

    Abstract Tumors of the gastric cardia are among the most technically difficult lesions to remove by endoscopic submucosal dissection (ESD). This study aimed to evaluate the therapeutic outcomes of ESD in gastric cardia tumors according to clinicopathologic characteristics, and to assess the predictive factors for incomplete resection. We conducted a retrospective observational study of 82 patients with adenomas and early cancers of the gastric cardia who underwent ESD between January 2006 and December 2013 at the Pusan National University Hospital. Therapeutic outcomes of ESD and procedure-related complications were analyzed. En bloc resection, complete resection, and curative resection rates were 87%, 79%, and 66%, respectively. Deep submucosal invasion was the most common cause of noncurative resection in the cases in which complete resection was achieved. On multivariate analyses, hemispheric distribution (anterior hemisphere; odds ratio [OR] 4.808) and depth of tumor invasion (submucosal cancer; OR 22.056) were independent factors associated with incomplete resection. The rates of procedure-related bleeding, perforation, and stenosis were 6%, 1%, and 0%, respectively; none of the complications required surgical intervention. In conclusion, ESD is a safe, effective, and feasible treatment for gastric cardia tumors. However, the complete resection rate decreases for tumors that are located in the anterior hemisphere or have deep submucosal invasion. PMID:26252277

  15. Factors for Endoscopic Submucosal Dissection in Early Colorectal Neoplasms: A Single Center Clinical Experience in China

    PubMed Central

    He, Yu-Qi; Wang, Xin; Li, Ai-Qin; Yang, Lang; Zhang, Jian; Kang, Qian; Tang, Shan; Jin, Peng

    2015-01-01

    Background/Aims Early colorectal (CR) neoplasm can be cured by endoscopic submucosal dissection (ESD), but clinical experience and factors associated with complications from ESD for CR neoplasms in China have not been reported. Methods Seventy-eight cases of early CR neoplasm treated with endoscopic resection performed between December 2012 and December 2013 at Beijing Military General Hospital were included. Factors associated with ESD complications and procedure times were evaluated. Results The en bloc resection rate was 88.5% (69/78), tumor size was 32.1±10.7 mm, and procedure time was 71.8±49.5 minutes. The major complication was perforation, which occurred in 8.97% of the ESD procedures. Multivariate logistic regression analysis indicated that only tumor size (p=0.022) was associated with ESD perforation. Tumor size (p<0.001) and the non-lifting sign (p=0.017) were independent factors for procedure time, and procedure time (p=0.016) was a key factor for en bloc resection. After a median 10 months (range, 4 to 16) of follow-up, no patients had local recurrence. Conclusions This study indicated that ESD is an applicable method for large early CR neoplasm in the colon and rectum. Tumor size and the non-lifting sign might be considerable factors for increased complication rate and procedural time of ESD. PMID:26473124

  16. Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back

    PubMed Central

    Ipek, Emrah; Ermis, Emrah; Demirelli, Selami; Y?ld?r?m, Erkan; Yolcu, Mustafa; Sahin, Bingül Dilekci

    2015-01-01

    We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died. PMID:26290841

  17. Endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of sporadic nonampullary duodenal adenomatous polyps

    PubMed Central

    Marques, Joana; Baldaque-Silva, Francisco; Pereira, Pedro; Arnelo, Urban; Yahagi, Naohisa; Macedo, Guilherme

    2015-01-01

    Although uncommon, sporadic nonampullary duodenal adenomas have a growing detection due to the widespread of endoscopy. Endoscopic therapy is being increasingly used for these lesions, since surgery, considered the standard treatment, carries significant morbidity and mortality. However, the knowledge about its risks and benefits is limited, which contributes to the current absence of standardized recommendations. This review aims to discuss the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in the treatment of these lesions. A literature review was performed, using the Pubmed database with the query: “(duodenum or duodenal) (endoscopy or endoscopic) adenoma resection”, in the human species and in English. Of the 189 retrieved articles, and after reading their abstracts, 19 were selected due to their scientific interest. The analysis of their references, led to the inclusion of 23 more articles for their relevance in this subject. The increased use of EMR in the duodenum has shown good results with complete resection rates exceeding 80% and low complication risk (delayed bleeding in less than 12% of the procedures). Although rarely used in the duodenum, ESD achieves close to 100% complete resection rates, but is associated with perforation and bleeding risk in up to one third of the cases. Even though literature is insufficient to draw definitive conclusions, studies suggest that EMR and ESD are valid options for the treatment of nonampullary adenomas. Thus, strategies to improve these techniques, and consequently increase the effectiveness and safety of the resection of these lesions, should be developed. PMID:26140099

  18. Collaboration between the coroner and emergency physicians: efforts to improve outcomes from aortic dissection.

    PubMed

    Jelinek, George A; Bugeja, Lyndal C; Spanos, Paresa A; Neate, Sandra L; Bergman, Ruth L; Ranson, David L

    2014-11-17

    The Coroners Prevention Unit at the Coroners Court of Victoria (CCV) is a multidisciplinary team that investigates deaths referred by the state's coroners, with a view to identifying prevention opportunities. The death of a woman from acute aortic dissection (AAD) after an emergency department attendance prompted the coroner to request a roundtable meeting with emergency physicians (EPs) from Melbourne. The round table was attended by 17 EPs from Melbourne hospitals, along with representatives from the CCV. The meeting identified important clinical, system and cultural features of AAD presentation and management that might be useful in improving case detection and management, and hence outcomes. A key recommendation was that EPs teach junior staff that AAD is the "subarachnoid haemorrhage of chest pain", to change the way patients with chest pain are assessed, with an emphasis on red flags for AAD being considered at the beginning of any discussion. This innovative collaboration between the CCV and EPs may serve as a model for future interactions between the CCV and the medical profession. PMID:25390270

  19. Values, dissection, and school science: An inquiry into students' construction of meaning

    NASA Astrophysics Data System (ADS)

    Doster, Elizabeth Christina Tsamas

    The purpose of this study is to question how the values found in the secondary science curriculum, specifically those which are inherent in the dissection experience, relate to the personal values of individual students. Additionally, by exploring the human connection between science and science learning, the study questions the implications of this value relationship in students' assignment of meaning to the science. Participants were selected from four basic and intermediate level high school biology classrooms. The data collection methods include participant observation, in-depth student interviews, and videotaping. Analysis of data followed a constant-comparative methodology. Findings indicate students' perception of the dissection experience were contingent on the consistency (or lack thereof) of their personal value systems with the underlying factors found in each of four dimensions of dissection. These dimensions affect students to varying degrees, and many times their influences are overlapping. Taken together, the four dimensions create a multifaceted tool for viewing the dissection phenomenon. The first dimension concerns the moral issues prevalent in the minds of students as they reflect on dissection. The second dimension explores epistemological issues associated with dissection. The third explores the phenomenon of physical aversion to the dissection experience. The fourth dimension focuses on the issue of familiarity as it relates to dissection. Embedded in these four dimensions are degrees of agreement with seven beliefs inherent in the practice of dissection as an aspect of the biology curriculum: (1) killing of animals for the purpose of learning is a justifiable and acceptable behavior; (2) touching the dead body of an animal is a socially and culturally acceptable behavior; (3) the greater the similarity between the body of the animal and the human body, the greater the gains in understanding of human anatomy; (4) cutting apart, probing, and pinning is acceptable treatment of a dead animal's body; (5) the interaction of the students with dissection specimens will result in their gaining understanding of the structure and function of the animal's internal anatomical structures; (6) touching, seeing, or smelling the dead body of an animal is not offensive enough to prevent students from learning from it; and (7) dissection as an activity is independent of the experiences the students are familiar with, and how they interpret those experiences.

  20. A Functional Dissection of PTEN N-Terminus: Implications in PTEN Subcellular Targeting and Tumor Suppressor Activity

    PubMed Central

    Gil, Anabel; Rodríguez-Escudero, Isabel; Stumpf, Miriam; Molina, María; Cid, Víctor J.; Pulido, Rafael

    2015-01-01

    Spatial regulation of the tumor suppressor PTEN is exerted through alternative plasma membrane, cytoplasmic, and nuclear subcellular locations. The N-terminal region of PTEN is important for the control of PTEN subcellular localization and function. It contains both an active nuclear localization signal (NLS) and an overlapping PIP2-binding motif (PBM) involved in plasma membrane targeting. We report a comprehensive mutational and functional analysis of the PTEN N-terminus, including a panel of tumor-related mutations at this region. Nuclear/cytoplasmic partitioning in mammalian cells and PIP3 phosphatase assays in reconstituted S. cerevisiae defined categories of PTEN N-terminal mutations with distinct PIP3 phosphatase and nuclear accumulation properties. Noticeably, most tumor-related mutations that lost PIP3 phosphatase activity also displayed impaired nuclear localization. Cell proliferation and soft-agar colony formation analysis in mammalian cells of mutations with distinctive nuclear accumulation and catalytic activity patterns suggested a contribution of both properties to PTEN tumor suppressor activity. Our functional dissection of the PTEN N-terminus provides the basis for a systematic analysis of tumor-related and experimentally engineered PTEN mutations. PMID:25875300

  1. Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head-and-Neck Squamous Cell Carcinoma

    SciTech Connect

    Thariat, Juliette; Ahamad, Anesa; Williams, Michelle D.; Myers, Jeffrey N.; El-Naggar, Adel K.; Ginsberg, Lawrence E.; Rosenthal, David I.; Glisson, Bonnie S.; Weber, Randal S.; Garden, Adam S.

    2012-03-01

    Background: This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation and to determine the benefit of a neck dissection in those with less than CR by tumor site. Methods: Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx, or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log-rank test and prognostic factors by Cox's proportional hazard model. Results: Nodal CR occurred in 377 (43%) patients, of whom 365 patients did not undergo nodal dissection. The 5-year actuarial regional control rate of patients with CR was 92%. Two hundred sixty-eight of the remaining patients (53%) underwent neck dissections. The 5-year actuarial regional control rate for patients without a CR was 84%. Those who had a neck dissection fared better with 5-year actuarial regional control rates of 90% and 76% for those operated and those not operated (p < 0.001). Variables associated with poorer regional control rates included higher T and N stage, non-oropharynx cancers, non-CR, both clinical and pathological. Conclusions: With 92% 5-year neck control rate without neck dissection after CR, there is little justification for systematic neck dissection. The addition of a neck dissection resulted in higher neck control after partial response though patients with viable tumor on pathology specimens had poorer outcomes. The identification of that subgroup that benefits from additional treatment remains a challenge.

  2. Treatment of acute cervical internal carotid artery dissection using the Solitaire FR revascularization device.

    PubMed

    To, Chiu Yuen; Badr, Yaser; Richards, Boyd

    2012-01-01

    During treatment of a right internal carotid artery terminus aneurysm, an acute iatrogenic flow limiting dissection was caused in the cervical internal carotid. The true lumen was catheterized using a Mirage 0.008 microwire over an Excelsior SL-10 microcatheter, which was exchanged for a Marksman microcatheter. A 6 mm×30 mm Solitaire FR revascularization device was then deployed across the dissection as a salvage technique. PMID:23257942

  3. Treatment of acute cervical internal carotid artery dissection using the Solitaire FR revascularization device.

    PubMed

    To, Chiu Yuen; Badr, Yaser; Richards, Boyd

    2013-11-01

    During treatment of a right internal carotid artery terminus aneurysm, an acute iatrogenic flow limiting dissection was caused in the cervical internal carotid. The true lumen was catheterized using a Mirage 0.008 microwire over an Excelsior SL-10 microcatheter, which was exchanged for a Marksman microcatheter. A 6 mm × 30 mm Solitaire FR revascularization device was then deployed across the dissection as a salvage technique. PMID:23299103

  4. Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head and Neck Squamous Cell Carcinoma

    PubMed Central

    Thariat, Juliette; Ang, K. Kian; Allen, Pamela K.; Ahamad, Anesa; Williams, Michelle D.; Myers, Jeffrey N.; El-Naggar, Adel K.; Ginsberg, Lawrence E.; Rosenthal, David I.; Glisson, Bonnie S.; Morrison, William H.; Weber, Randal S.; Garden, Adam S.

    2014-01-01

    BACKGROUND This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation, and to determine the benefit of a neck dissection in those with less than CR by tumor site. METHODS Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log-rank test and prognostic factors by Cox analyses. RESULTS Nodal CR occurred in 377 (43%) patients of whom 365 patients did not undergo nodal dissection. The 5-year actuarial regional control rate of patients with CR was 92%. Two hundred sixty-eight of the remaining patients (53%) underwent neck dissections. The 5-year actuarial regional control rate for patients without a CR was 84%. Those who had a neck dissection fared better with 5-year actuarial regional control rates of 90% and 76% for those operated and those not operated (p <.001). Variables associated with poorer regional control rates included higher T and N stage, non-oropharynx cancers, non-CR, both clinical and pathological. CONCLUSIONS With 92% 5-year neck control rate without neck dissection after CR, there is little justification for systematic neck dissection. The addition of a neck dissection resulted in higher neck control after partial response though patients with viable tumor on pathology specimens had poorer outcomes. The identification of that subgroup that benefits from additional treatment remains a challenge. PMID:22284033

  5. Ascending Aortic False Aneurysm Formation Associated with Rupture of Acute Type A Aortic Dissection

    PubMed Central

    Mukai, Shogo; Morimoto, Hironobu; Okubo, Shuhei

    2015-01-01

    A 63-year-old man with ruptured acute type A aortic dissection was referred to our hospital. Computed tomography showed a false aneurysm arising from the false lumen located beside the ascending aorta. His hemodynamic status was stable inspite of the ruptured acute aortic dissection. We consider that the containment of the false aneurysm by thin mediastinal structures prevented worsening of his hemodynamic status, and this is extremely rare. PMID:25848434

  6. A Population-Based Study of 30-day Incidence of Ischemic Stroke Following Surgical Neck Dissection

    PubMed Central

    MacNeil, S. Danielle; Liu, Kuan; Garg, Amit X.; Tam, Samantha; Palma, David; Thind, Amardeep; Winquist, Eric; Yoo, John; Nichols, Anthony; Fung, Kevin; Hall, Stephen; Shariff, Salimah Z.

    2015-01-01

    Abstract The objective of this study was to determine the 30-day incidence of ischemic stroke following neck dissection compared to matched patients undergoing non-head and neck surgeries. A surgical dissection of the neck is a common procedure performed for many types of cancer. Whether such dissections increase the risk of ischemic stroke is uncertain. A retrospective cohort study using data from linked administrative and registry databases (1995–2012) in the province of Ontario, Canada was performed. Patients were matched 1-to-1 on age, sex, date of surgery, and comorbidities to patients undergoing non-head and neck surgeries. The primary outcome was ischemic stroke assessed in hospitalized patients using validated database codes. A total of 14,837 patients underwent surgical neck dissection. The 30-day incidence of ischemic stroke following the dissection was 0.7%. This incidence decreased in recent years (1.1% in 1995 to 2000; 0.8% in 2001 to 2006; 0.3% in 2007 to 2012; P for trend <0.0001). The 30-day incidence of ischemic stroke in patients undergoing neck dissection is similar to matched patients undergoing thoracic surgery (0.5%, P?=?0.26) and colectomy (0.5%, P?=?0.1). Factors independently associated with a higher risk of stroke in 30 days following neck dissection surgery were of age ?75 years (odds ratio (OR) 1.63, 95% confidence interval (CI) 1.05–2.53), and a history of diabetes (OR 1.60, 95% CI 1.02–2.49), hypertension (OR 2.64, 95% CI 1.64–4.25), or prior stroke (OR 4.06, 95% CI 2.29–7.18). Less than 1% of patients undergoing surgical neck dissection will experience an ischemic stroke in the following 30 days. This incidence of stroke is similar to thoracic surgery and colectomy. PMID:26287406

  7. Targeting cancer by binding iron: Dissecting cellular signaling pathways.

    PubMed

    Lui, Goldie Y L; Kovacevic, Zaklina; Richardson, Vera; Merlot, Angelica M; Kalinowski, Danuta S; Richardson, Des R

    2015-08-01

    Newer and more potent therapies are urgently needed to effectively treat advanced cancers that have developed resistance and metastasized. One such strategy is to target cancer cell iron metabolism, which is altered compared to normal cells and may facilitate their rapid proliferation. This is supported by studies reporting the anti-neoplastic activities of the clinically available iron chelators, desferrioxamine and deferasirox. More recently, ligands of the di-2-pyridylketone thiosemicarbazone (DpT) class have demonstrated potent and selective anti-proliferative activity across multiple cancer-types in vivo, fueling studies aimed at dissecting their molecular mechanisms of action. In the past five years alone, significant advances have been made in understanding how chelators not only modulate cellular iron metabolism, but also multiple signaling pathways implicated in tumor progression and metastasis. Herein, we discuss recent research on the targeting of iron in cancer cells, with a focus on the novel and potent DpT ligands. Several key studies have revealed that iron chelation can target the AKT, ERK, JNK, p38, STAT3, TGF-?, Wnt and autophagic pathways to subsequently inhibit cellular proliferation, the epithelial-mesenchymal transition (EMT) and metastasis. These developments emphasize that these novel therapies could be utilized clinically to effectively target cancer. PMID:26125440

  8. Genetic dissection of meiotic cytokinesis in Drosophila males.

    PubMed

    Giansanti, Maria Grazia; Farkas, Rebecca M; Bonaccorsi, Silvia; Lindsley, Dan L; Wakimoto, Barbara T; Fuller, Margaret T; Gatti, Maurizio

    2004-05-01

    We have used Drosophila male meiosis as a model system for genetic dissection of the cytokinesis mechanism. Drosophila mutants defective in meiotic cytokinesis can be easily identified by their multinucleate spermatids. Moreover, the large size of meiotic spindles allows characterization of mutant phenotypes with exquisite cytological resolution. We have screened a collection of 1955 homozygous mutant male sterile lines for those with multinucleate spermatids, and thereby identified mutations in 19 genes required for cytokinesis. These include 16 novel loci and three genes, diaphanous, four wheel drive, and pebble, already known to be involved in Drosophila cytokinesis. To define the primary defects leading to failure of cytokinesis, we analyzed meiotic divisions in male mutants for each of these 19 genes. Examination of preparations stained for tubulin, anillin, KLP3A, and F-actin revealed discrete defects in the components of the cytokinetic apparatus, suggesting that these genes act at four major points in a stepwise pathway for cytokinesis. Our results also indicated that the central spindle and the contractile ring are interdependent structures that interact throughout cytokinesis. Moreover, our genetic and cytological analyses provide further evidence for a cell type-specific control of Drosophila cytokinesis, suggesting that several genes required for meiotic cytokinesis in males are not required for mitotic cytokinesis. PMID:15004238

  9. DISSECTING OCD CIRCUITS: FROM ANIMAL MODELS TO TARGETED TREATMENTS.

    PubMed

    Ahmari, Susanne E; Dougherty, Darin D

    2015-08-01

    Obsessive-compulsive disorder (OCD) is a chronic, severe mental illness with up to 2-3% prevalence worldwide. In fact, OCD has been classified as one of the world's 10 leading causes of illness-related disability according to the World Health Organization, largely because of the chronic nature of disabling symptoms.([1]) Despite the severity and high prevalence of this chronic and disabling disorder, there is still relatively limited understanding of its pathophysiology. However, this is now rapidly changing due to development of powerful technologies that can be used to dissect the neural circuits underlying pathologic behaviors. In this article, we describe recent technical advances that have allowed neuroscientists to start identifying the circuits underlying complex repetitive behaviors using animal model systems. In addition, we review current surgical and stimulation-based treatments for OCD that target circuit dysfunction. Finally, we discuss how findings from animal models may be applied in the clinical arena to help inform and refine targeted brain stimulation-based treatment approaches. PMID:25952989

  10. Dissecting the matrilineal components of Tongjiang cattle from southwest China.

    PubMed

    Chen, Shi-Yi; Liu, Yi-Ping; Wang, Wei; Gao, Cheng-Zhong; Yao, Yong-Gang; Lai, Song-Jia

    2008-04-01

    Tongjiang cattle are a local cattle population of Sichuan Province, China, numbering approximately half a million in 2005. They have long been grouped into the Bashan breed, although they have a unique breeding history and phenotypic characteristics, as well as a restricted geographic distribution. Morphologically, they can be divided into two groups based on the basic coat color (black and russet). In order to dissect the matrilineal components of Tongjiang cattle and to compare the body size traits of the two morphological groups, we measured five body size traits among 59 Tongjiang cattle samples and further sequenced the mtDNA D-loop sequence of 54 individuals. Among the 54 mtDNAs, 37 (68.5%) were Bos taurus types and 17 (31.5%) were Bos indicus types. Four known B. taurus haplogroups (T1-T4) and one B. indicus haplogroup (I1) were detected in these samples. Two body size traits differed significantly (P < 0.05) between the black group and the russet group, although the two groups possessed similar matrilineal genetic structure. This is the first report to identify all four B. taurus haplogroups in one local Chinese cattle population. Our results suggest that the contribution of different matrilineal lineages to Chinese cattle might be more complex than we originally thought. PMID:18246422

  11. Dissecting Genetic Networks Underlying Complex Phenotypes: The Theoretical Framework

    PubMed Central

    Zhang, Fan; Zhai, Hu-Qu; Paterson, Andrew H.; Xu, Jian-Long; Gao, Yong-Ming; Zheng, Tian-Qing; Wu, Rong-Ling; Fu, Bin-Ying; Ali, Jauhar; Li, Zhi-Kang

    2011-01-01

    Great progress has been made in genetic dissection of quantitative trait variation during the past two decades, but many studies still reveal only a small fraction of quantitative trait loci (QTLs), and epistasis remains elusive. We integrate contemporary knowledge of signal transduction pathways with principles of quantitative and population genetics to characterize genetic networks underlying complex traits, using a model founded upon one-way functional dependency of downstream genes on upstream regulators (the principle of hierarchy) and mutual functional dependency among related genes (functional genetic units, FGU). Both simulated and real data suggest that complementary epistasis contributes greatly to quantitative trait variation, and obscures the phenotypic effects of many ‘downstream’ loci in pathways. The mathematical relationships between the main effects and epistatic effects of genes acting at different levels of signaling pathways were established using the quantitative and population genetic parameters. Both loss of function and “co-adapted” gene complexes formed by multiple alleles with differentiated functions (effects) are predicted to be frequent types of allelic diversity at loci that contribute to the genetic variation of complex traits in populations. Downstream FGUs appear to be more vulnerable to loss of function than their upstream regulators, but this vulnerability is apparently compensated by different FGUs of similar functions. Other predictions from the model may account for puzzling results regarding responses to selection, genotype by environment interaction, and the genetic basis of heterosis. PMID:21283795

  12. Dissecting the role of infections in atopic dermatitis.

    PubMed

    Biedermann, Tilo

    2006-01-01

    In patients with atopic dermatitis the skin is highly susceptible to infection by bacteria, fungi and viruses. Increasing knowledge about the complex immune network that regulates anti-microbial responses has helped to dissect further the role of infections in atopic dermatitis. Conserved patterns of microbes are recognized by the innate immune system, which mediates microbicidal activity, either directly or through inflammatory responses. New evidence suggests that components of the innate immune system, such as anti-microbial peptides, humoural lectins, nucleotide-binding oligomerization domain-containing (NOD) proteins, and Toll-like receptors not only protect from microbial invasion, but contribute to skin inflammation in atopic dermatitis. In addition, atopic patients tend to develop Th2-dominated immune responses that weaken anti-microbial immunity. This impairment of an appropriate anti-microbial defence compounded by amplified microbe-driven innate and adaptive immune responses leads to the vicious circle of skin inflammation. New microbial management in atopic dermatitis will foster a well-balanced microbial flora, which establishes natural defence mechanisms to maintain immuno-surveillance of the skin. In addition to anti-microbial therapies, other innate immune stimuli may suppress pro-inflammatory signals and help to break the vicious circle of cutaneous inflammation. To elucidate further these different interactions of the skin immune system and microbes in atopic dermatitis, clinical studies and further efforts in basic research are needed. PMID:16648910

  13. Targeting cancer by binding iron: Dissecting cellular signaling pathways

    PubMed Central

    Lui, Goldie Y.L.; Kovacevic, Zaklina; Richardson, Vera; Merlot, Angelica M.; Kalinowski, Danuta S.; Richardson, Des R.

    2015-01-01

    Newer and more potent therapies are urgently needed to effectively treat advanced cancers that have developed resistance and metastasized. One such strategy is to target cancer cell iron metabolism, which is altered compared to normal cells and may facilitate their rapid proliferation. This is supported by studies reporting the anti-neoplastic activities of the clinically available iron chelators, desferrioxamine and deferasirox. More recently, ligands of the di-2-pyridylketone thiosemicarbazone (DpT) class have demonstrated potent and selective anti-proliferative activity across multiple cancer-types in vivo, fueling studies aimed at dissecting their molecular mechanisms of action. In the past five years alone, significant advances have been made in understanding how chelators not only modulate cellular iron metabolism, but also multiple signaling pathways implicated in tumor progression and metastasis. Herein, we discuss recent research on the targeting of iron in cancer cells, with a focus on the novel and potent DpT ligands. Several key studies have revealed that iron chelation can target the AKT, ERK, JNK, p38, STAT3, TGF-?, Wnt and autophagic pathways to subsequently inhibit cellular proliferation, the epithelial-mesenchymal transition (EMT) and metastasis. These developments emphasize that these novel therapies could be utilized clinically to effectively target cancer. PMID:26125440

  14. Functional dissection of Odorant binding protein genes in Drosophila melanogaster.

    PubMed

    Swarup, S; Williams, T I; Anholt, R R H

    2011-08-01

    Most organisms rely on olfaction for survival and reproduction. The olfactory system of Drosophila melanogaster is one of the best characterized chemosensory systems and serves as a prototype for understanding insect olfaction. Olfaction in Drosophila is mediated by multigene families of odorant receptors and odorant binding proteins (OBPs). Although molecular response profiles of odorant receptors have been well documented, the contributions of OBPs to olfactory behavior remain largely unknown. Here, we used RNAi-mediated suppression of Obp gene expression and measurements of behavioral responses to 16 ecologically relevant odorants to systematically dissect the functions of 17 OBPs. We quantified the effectiveness of RNAi-mediated suppression by quantitative real-time polymerase chain reaction and used a proteomic liquid chromatography and tandem mass spectrometry procedure to show target-specific suppression of OBPs expressed in the antennae. Flies in which expression of a specific OBP is suppressed often show altered behavioral responses to more than one, but not all, odorants, in a sex-dependent manner. Similarly, responses to a specific odorant are frequently affected by suppression of expression of multiple, but not all, OBPs. These results show that OBPs are essential for mediating olfactory behavioral responses and suggest that OBP-dependent odorant recognition is combinatorial. PMID:21605338

  15. Genetic Dissection of the Function of Hindbrain Axonal Commissures

    PubMed Central

    Renier, Nicolas; Schonewille, Martijn; Giraudet, Fabrice; Badura, Aleksandra; Tessier-Lavigne, Marc; Avan, Paul; De Zeeuw, Chris I.; Chédotal, Alain

    2010-01-01

    In Bilateria, many axons cross the midline of the central nervous system, forming well-defined commissures. Whereas in mammals the functions of commissures in the forebrain and in the visual system are well established, functions at other axial levels are less clearly understood. Here, we have dissected the function of several hindbrain commissures using genetic methods. By taking advantage of multiple Cre transgenic lines, we have induced site-specific deletions of the Robo3 receptor. These lines developed with the disruption of specific commissures in the sensory, motor, and sensorimotor systems, resulting in severe and permanent functional deficits. We show that mice with severely reduced commissures in rhombomeres 5 and 3 have abnormal lateral eye movements and auditory brainstem responses, respectively, whereas mice with a primarily uncrossed climbing fiber/Purkinje cell projection are strongly ataxic. Surprisingly, although rerouted axons remain ipsilateral, they still project to their appropriate neuronal targets. Moreover, some Cre;Robo3 lines represent potential models that can be used to study human syndromes, including horizontal gaze palsy with progressive scoliosis (HGPPS). To our knowledge, this study is one of the first to link defects in commissural axon guidance with specific cellular and behavioral phenotypes. PMID:20231872

  16. Dissecting Impulsivity and its Relationships to Drug Addictions

    PubMed Central

    Ashenhurst, James R.; Cervantes, M. Catalina; James, Alexander S.; Groman, Stephanie M.; Pennington, Zachary T.

    2015-01-01

    Addictions are often characterized as forms of impulsive behavior. That said, it is often noted that impulsivity is a multidimensional construct, spanning several psychological domains. This review describes the relationship between varieties of impulsivity and addiction-related behaviors, the nature of the causal relationship between the two and the underlying neurobiological mechanisms that promote impulsive behaviors. We conclude that the available data strongly supports the notion that impulsivity is both a risk factor for, and a consequence of, drug and alcohol consumption. While the evidence indicating that subtypes of impulsive behavior are uniquely informative – either biologically or with respect to their relationships to addictions – is convincing, multiple lines of study link “distinct” subtypes of impulsivity to low dopamine D2 receptor function and perturbed serotonergic transmission, revealing shared mechanisms between the subtypes. Therefore, a common biological framework involving monoaminergic transmitters in key frontostriatal circuits may link multiple forms of impulsivity to drug self-administration and addiction-related behaviors. Further dissection of these relationships is needed before the next phase of genetic and genomic discovery will be able to reveal the biological sources of the vulnerability for addiction indexed by impulsivity. PMID:24654857

  17. Interpolations of groundwater table elevation in dissected uplands.

    PubMed

    Chung, Jae-won; Rogers, J David

    2012-01-01

    The variable elevation of the groundwater table in the St. Louis area was estimated using multiple linear regression (MLR), ordinary kriging, and cokriging as part of a regional program seeking to assess liquefaction potential. Surface water features were used to determine the minimum water table for MLR and supplement the principal variables for ordinary kriging and cokriging. By evaluating the known depth to the water and the minimum water table elevation, the MLR analysis approximates the groundwater elevation for a contiguous hydrologic system. Ordinary kriging and cokriging estimate values in unsampled areas by calculating the spatial relationships between the unsampled and sampled locations. In this study, ordinary kriging did not incorporate topographic variations as an independent variable, while cokriging included topography as a supporting covariable. Cross validation suggests that cokriging provides a more reliable estimate at known data points with less uncertainty than the other methods. Profiles extending through the dissected uplands terrain suggest that: (1) the groundwater table generated by MLR mimics the ground surface and elicits a exaggerated interpolation of groundwater elevation; (2) the groundwater table estimated by ordinary kriging tends to ignore local topography and exhibits oversmoothing of the actual undulations in the water table; and (3) cokriging appears to give the realistic water surface, which rises and falls in proportion to the overlying topography. The authors concluded that cokriging provided the most realistic estimate of the groundwater surface, which is the key variable in assessing soil liquefaction potential in unconsolidated sediments. PMID:22107357

  18. Role of antisecretory agents for gastric endoscopic submucosal dissection.

    PubMed

    Fujishiro, Mitsuhiro; Chiu, Philip W Y; Wang, Hsui-Po

    2013-03-01

    Gastric endoscopic submucosal dissection (ESD) causes artificial gastric ulcers and there is no consensus regarding the optimal perioperative management in terms of prevention of intra- or postoperative bleeding and promotion of healing. Traditionally, 8-week administration of proton pump inhibitors (PPI) and mucosal protective agents were used in the same way as for peptic ulcer management. However, recent studies have revealed that prior use of PPI might reduce intraoperative bleeding or early-phase postoperative bleeding, and combination of histamine-2 receptor antagonist (H2RA), and second-look endoscopy might have a similar effect on postoperative bleeding to PPI. Additionally, the advantage of PPI over H2RA is not proven and the optimal duration of PPI may be shortened until 2 weeks when the deteriorating factors for ESD ulcer are excluded. Furthermore, mucosal protective agents may facilitate ulcer healing. Further studies are needed to determine the optimal treatment protocol before and after ESD for both prevention of bleeding complication and promotion of ulcer healing, by using available antisecretory agents and mucosal protective agents. PMID:23368844

  19. Dissection of miRNA pathways using arabidopsis mesophyll protoplasts.

    PubMed

    Martinho, Cláudia; Confraria, Ana; Elias, Carlos Alexandre; Crozet, Pierre; Rubio-Somoza, Ignacio; Weigel, Detlef; Baena-González, Elena

    2015-02-01

    MicroRNAs (miRNAs) control gene expression mostly post-transcriptionally by guiding transcript cleavage and/or translational repression of complementary mRNA targets, thereby regulating developmental processes and stress responses. Despite the remarkable expansion of the field, the mechanisms underlying miRNA activity are not fully understood. In this article, we describe a transient expression system in Arabidopsis mesophyll protoplasts, which is highly amenable for the dissection of miRNA pathways. We show that by transiently overexpressing primary miRNAs and target mimics, we can manipulate miRNA levels and consequently impact on their targets. Furthermore, we developed a set of luciferase-based sensors for quantifying miRNA activity that respond specifically to both endogenous and overexpressed miRNAs and target mimics. We demonstrate that these miRNA sensors can be used to test the impact of putative components of the miRNA pathway on miRNA activity, as well as the impact of specific mutations, by either overexpression or the use of protoplasts from the corresponding mutants. We further show that our miRNA sensors can be used for investigating the effect of chemicals on miRNA activity. Our cell-based transient expression system is fast and easy to set up, and generates quantitative results, being a powerful tool for assaying miRNA activity in vivo. PMID:25680775

  20. Dissection of miRNA pathways using Arabidopsis mesophyll protoplasts.

    PubMed

    Martinho, Cláudia; Confraria, Ana; Elias, Carlos Alexandre; Crozet, Pierre; Rubio-Somoza, Ignacio; Weigel, Detlef; Baena-González, Elena

    2014-10-24

    microRNAs (miRNAs) control gene expression mostly post-transcriptionally by guiding transcript cleavage and/or translational repression of complementary mRNA targets, thereby regulating developmental processes and stress responses. Despite the remarkable expansion of the field, the mechanisms underlying miRNA activity are not fully understood. In this paper, we describe a transient expression system in Arabidopsis mesophyll protoplasts that is highly amenable for the dissection of miRNA pathways. We show that by transiently overexpressing primary miRNAs and target mimics, we can manipulate miRNA levels and consequently impact on their targets. Furthermore, we developed a set of luciferase-based sensors for quantifying miRNA activity that respond specifically to both endogenous and overexpressed miRNAs and target mimics. We demonstrate that these miRNA sensors can be used to test the impact of putative components of the miRNA pathway on miRNA activity, as well as the impact of specific mutations, either by overexpression or by the use of protoplasts from the corresponding mutants. We further show that our miRNA sensors can be used for investigating the effect of chemicals on miRNA activity. Our cell-based transient expression system is fast and easy to set up and generates quantitative results, being a powerful tool for assaying miRNA activity in vivo. PMID:25343984

  1. Dissecting a complex chemical stress: chemogenomic profiling of plant hydrolysates

    PubMed Central

    Skerker, Jeffrey M; Leon, Dacia; Price, Morgan N; Mar, Jordan S; Tarjan, Daniel R; Wetmore, Kelly M; Deutschbauer, Adam M; Baumohl, Jason K; Bauer, Stefan; Ibáñez, Ana B; Mitchell, Valerie D; Wu, Cindy H; Hu, Ping; Hazen, Terry; Arkin, Adam P

    2013-01-01

    The efficient production of biofuels from cellulosic feedstocks will require the efficient fermentation of the sugars in hydrolyzed plant material. Unfortunately, plant hydrolysates also contain many compounds that inhibit microbial growth and fermentation. We used DNA-barcoded mutant libraries to identify genes that are important for hydrolysate tolerance in both Zymomonas mobilis (44 genes) and Saccharomyces cerevisiae (99 genes). Overexpression of a Z. mobilis tolerance gene of unknown function (ZMO1875) improved its specific ethanol productivity 2.4-fold in the presence of miscanthus hydrolysate. However, a mixture of 37 hydrolysate-derived inhibitors was not sufficient to explain the fitness profile of plant hydrolysate. To deconstruct the fitness profile of hydrolysate, we profiled the 37 inhibitors against a library of Z. mobilis mutants and we modeled fitness in hydrolysate as a mixture of fitness in its components. By examining outliers in this model, we identified methylglyoxal as a previously unknown component of hydrolysate. Our work provides a general strategy to dissect how microbes respond to a complex chemical stress and should enable further engineering of hydrolysate tolerance. PMID:23774757

  2. Dissecting ribosome assembly and transport in budding yeast.

    PubMed

    Altvater, Martin; Schütz, Sabina; Chang, Yiming; Panse, Vikram Govind

    2014-01-01

    Construction of the eukaryotic ribosome begins in the nucleolus and requires >300 evolutionarily conserved nonribosomal trans-acting factors, which transiently associate with preribosomal subunits at distinct assembly stages. A subset of trans-acting and transport factors passage assembled preribosomal subunits in a functionally inactive state through the nuclear pore complexes (NPC) into the cytoplasm, where they undergo final maturation before initiating translation. Here, we summarize the repertoire of tools developed in the model organism budding yeast that are spearheading the functional analyses of trans-acting factors involved in the assembly and intracellular transport of preribosomal subunits. We elaborate on different GFP-tagged ribosomal protein reporters and a pre-rRNA reporter that reliably monitors the movement of preribosomal particles from the nucleolus to cytoplasm. We discuss the powerful yeast heterokaryon assay, which can be employed to uncover shuttling trans-acting factors that need to accompany preribosomal subunits to the cytoplasm to be released prior to initiating translation. Moreover, we present two biochemical approaches, namely sucrose gradient analyses and tandem affinity purification, that are rapidly facilitating the uncovering of regulatory processes that control the compositional dynamics of trans-acting factors on maturing preribosomal particles. Altogether, these approaches when combined with traditional analytical biochemistry, targeted proteomics and structural methodologies, will contribute to the dissection of the assembly and intracellular transport of preribosomal subunits, as well as other macromolecular assemblies that influence diverse biological pathways. PMID:24857742

  3. Pulse energy dependence of subcellular dissection by femtosecond laser pulses

    NASA Technical Reports Server (NTRS)

    Heisterkamp, A.; Maxwell, I. Z.; Mazur, E.; Underwood, J. M.; Nickerson, J. A.; Kumar, S.; Ingber, D. E.

    2005-01-01

    Precise dissection of cells with ultrashort laser pulses requires a clear understanding of how the onset and extent of ablation (i.e., the removal of material) depends on pulse energy. We carried out a systematic study of the energy dependence of the plasma-mediated ablation of fluorescently-labeled subcellular structures in the cytoskeleton and nuclei of fixed endothelial cells using femtosecond, near-infrared laser pulses focused through a high-numerical aperture objective lens (1.4 NA). We find that the energy threshold for photobleaching lies between 0.9 and 1.7 nJ. By comparing the changes in fluorescence with the actual material loss determined by electron microscopy, we find that the threshold for true material ablation is about 20% higher than the photobleaching threshold. This information makes it possible to use the fluorescence to determine the onset of true material ablation without resorting to electron microscopy. We confirm the precision of this technique by severing a single microtubule without disrupting the neighboring microtubules, less than 1 micrometer away. c2005 Optical Society of America.

  4. Indication of endovascular treatment of type B aortic dissection--literature review.

    PubMed

    Duarte, João Jackson; Pontes, José Carlos Dorsa Vieira; Benfatti, Ricardo Adala; Ferrachini, Adriana Lugo; Karakhanian, Walter Kegham; Razuk Filho, Alvaro

    2014-01-01

    Aortic dissection is a cardiovascular event of high mortality if not early diagnosed and properly treated. In Stanford type A aortic dissection, there is the involvement of the ascending aorta, whereas in type B the ascending aorta is not affected. The treatment of type A aortic dissection is mainly surgical. The hospital mortality of type B aortic dissection surgical treatment is approximately 20%, while medical therapy is 10%. However, half the patients who are discharged from hospital after medical treatment, progress to aortic complications in the following years, and the mortality in three to five years may reach 25-50%. In addition, the surgical treatment of aortic complications after medical treatment, has also a significant mortality. This way, the endovascular treatment comes up as an interesting alternative of a less invasive treatment for this disease. They presented a mortality rate lower than 10% with more than 80% success rate of occlusion and thrombosis of the false lumen. The INSTEAD TRIAL, which randomized patients with uncomplicated type B aortic dissection for optimal medical therapy and endovascular treatment in addition to optimal medical therapy, showed that after three years of follow up, patients who underwent endovascular treatment had lower mortality and aorta-related complications. Therefore, there is a current tendency to recommend the endovascular treatment as a standard for the treatment of type B aortic dissection. PMID:25372915

  5. Indication of endovascular treatment of type B aortic dissection - Literature review

    PubMed Central

    Duarte, João Jackson; Pontes, José Carlos Dorsa Vieira; Benfatti, Ricardo Adala; Ferrachini, Adriana Lugo; Karakhanian, Walter Kegham; Razuk Filho, Álvaro

    2014-01-01

    Aortic dissection is a cardiovascular event of high mortality if not early diagnosed and properly treated. In Stanford type A aortic dissection, there is the involvement of the ascending aorta, whereas in type B the ascending aorta is not affected. The treatment of type A aortic dissection is mainly surgical. The hospital mortality of type B aortic dissection surgical treatment is approximately 20%, while medical therapy is 10%. However, half the patients who are discharged from hospital after medical treatment, progress to aortic complications in the following years, and the mortality in three to five years may reach 25-50%. In addition, the surgical treatment of aortic complications after medical treatment, has also a significant mortality. This way, the endovascular treatment comes up as an interesting alternative of a less invasive treatment for this disease. They presented a mortality rate lower than 10% with more than 80% success rate of occlusion and thrombosis of the false lumen. The INSTEAD TRIAL, which randomized patients with uncomplicated type B aortic dissection for optimal medical therapy and endovascular treatment in addition to optimal medical therapy, showed that after three years of follow up, patients who underwent endovascular treatment had lower mortality and aorta-related complications. Therefore, there is a current tendency to recommend the endovascular treatment as a standard for the treatment of type B aortic dissection PMID:25372915

  6. Efficacy and Optimal Timing of Endovascular Treatment for Type B Aortic Dissection

    PubMed Central

    Kinoshita, Hajime; Fujimoto, Eiki; Arase, Hiroki; Kurobe, Hirotsugu; Chikugo, Fumio; Sogabe, Hitoshi; Kitaichi, Takashi

    2015-01-01

    Objectives: To determine the efficacy and the optimal timing of thoracic endovascular aortic repair (TEVAR) for closing the primary entry in uncomplicated patients with chronic type B aortic dissection and a patent false lumen (FL). Methods: Thirteen patients underwent TEVAR for aortic dissection between 2008 and 2012. These patients had chronic dissection with a patent FL and expansion of the aorta. Early TEVAR was performed for five patients within 1–7 months from the index dissection (TEVAR-EC group) and delayed TEVAR was performed for eight patients within 1–16 years (TEVAR-DC group). Changes in the diameters and volumes of the true lumen (TL) and FL and the aortic remodeling were assessed by multidetector computed tomography for 3 years after TEVAR. Results: The reduction rate of FL in the thoracic aorta was notably higher in the TEVAR-EC group than in the TEVAR-DC group regardless of the presence or absence of distal retrograde flow. There was a significant TL expansion despite different timings of TEVAR. Conclusions: Early TEVAR resulted in good prognosis and preferable aortic remodeling in uncomplicated patients with chronic type B aortic dissection and a patent FL, and we recommend early TEVAR within seven months after the index dissection.

  7. Right coronary artery dissection and aneurysm presented as acute inferior myocardial infarction from an automobile airbag trauma.

    PubMed

    Zeng, Chunlai; Hu, Wuming; Zhu, Ning; Zhao, Xuyong; Xu, Jian; Ye, Shiyong; Xiang, Yijia; Lv, Linchun

    2015-10-01

    Coronary artery dissection and aneurysm culminating in acute myocardial infarction are rare after blunt chest trauma. We are reporting a case of a previously healthy 52-year-old man who presented with right inferior lobe contusion, pleural effusion, right interlobar fissure effusion, bone fracture of right fourth rib, and acute inferior wall myocardial infarction and who experienced blunt trauma in his right chest wall by an airbag deployment in a car accident. Coronary angiography showed an aneurysm in the middle of right coronary artery with 70% afferent narrowing just distal to the aneurysm with no visible atherosclerotic lesion. A 4.0×20 mm TEXUS Liberté stent in the lesion was deployed, and a good coronary flow was obtained without residual stenosis and the aneurysm vanished. PMID:26319191

  8. Endovascular Treatment of Basilar Artery Thrombosis Secondary to Bilateral Vertebral Artery Dissection with Symptom Onset Following Cervical Spine Manipulation Therapy.

    PubMed

    Mikkelsen, Ronni; Dalby, Rikke Beese; Hjort, Niels; Simonsen, Claus Ziegler; Karabegovic, Sanja

    2015-01-01

    BACKGROUND Vertebral artery (VA) dissection (VAD) has been described following neck injury and can be associated with stroke, but the causal association with cervical spine manipulation therapy (cSMT) is controversial. The standard treatment for VAD is antithrombotic medical therapy. To highlight the considerations of an endovascular approach to VAD, we present a critical case of bilateral VAD causing embolic occlusion of the basilar artery (BA) in a patient with symptom debut following cSMT. CASE REPORT A 37-year-old woman presented with acute onset of neurological symptoms immediately following cSMT in a chiropractic facility. Acute magnetic resonance imaging (MRI) showed ischemic lesions in the right cerebellar hemisphere and occlusion of the cranial part of the BA. Angiography depicted bilateral VAD. Symptoms remitted after endovascular therapy, which included dilatation of the left VA and extraction of thrombus from the BA. After 6 months, the patient had minor sensory and cognitive deficits. CONCLUSIONS In severe cases, VAD may be complicated by BA thrombosis, and this case highlights the importance of a fast diagnostic approach and advanced intravascular procedure to obtain good long-term neurological outcome. Furthermore, this case underlines the need to suspect VAD in patients presenting with neurological symptoms following cSMT. PMID:26647210

  9. Endoscopic Submucosal Dissection for Early Gastric Cancer using the Clutch Cutter: a large single-center experience

    PubMed Central

    Akahoshi, Kazuya; Motomura, Yasuaki; Kubokawa, Masaru; Gibo, Junya; Kinoshita, Nobukatsu; Osada, Shigeki; Tokumaru, Kayo; Hosokawa, Taizou; Tomoeda, Naru; Otsuka, Yoshihiro; Matsuo, Mie; Oya, Masafumi; Koga, Hidenobu; Nakamura, Kazuhiko

    2015-01-01

    Background and study aims: The Clutch Cutter (CC) was developed to reduce the risk of complications related to endoscopic submucosal dissection (ESD) using knives. The CC is able to grasp and coagulate and/or incise the targeted tissue using electrosurgical current, like a biopsy technique. The aim of this study was to evaluate the efficacy and safety of ESD using the CC (ESD-CC) for early gastric cancer (EGC). Patients and methods: From June 2007 to March 2014, 325 consecutive patients with a diagnosis of EGC were enrolled in this prospective study. They had all satisfied the Japanese gastric cancer treatment guidelines for ESD indication, namely confirmation by preliminary endoscopy, endoscopic ultrasound, and endoscopic biopsies. The CC was used for all steps of ESD (marking, circumferential marginal incision, submucosal dissection, and hemostatic treatment). The therapeutic efficacy and safety were assessed. Results: The en-bloc resection rate was 99.7?% (324/325) and the R0 resection rate was 95.3?% (310/325). The mean operating time was 97.2 minutes. Perforation during ESD-CC occurred in one case (0.3?%), which was managed with conservative medical treatment after endoscopic closure of the perforation. Post-ESD-CC bleeding occurred in 11 cases (3.4?%), which were successfully treated by endoscopic hemostatic treatment. The R0 resection rate was significantly low in tumors?>?20?mm (88.9?%), and in the exclusion indication group (73.7?%). Significant differences were seen in the mean operating time, depending upon tumor size, histologic type, location, and indication criteria. Conclusions: ESD-CC is a technically efficient, safe, and easy method for resecting EGC. PMID:26528497

  10. Dissecting gene expression at the blood-brain barrier

    PubMed Central

    Huntley, Melanie A.; Bien-Ly, Nga; Daneman, Richard; Watts, Ryan J.

    2014-01-01

    The availability of genome-wide expression data for the blood-brain barrier is an invaluable resource that has recently enabled the discovery of several genes and pathways involved in the development and maintenance of the blood-brain barrier, particularly in rodent models. The broad distribution of published data sets represents a viable starting point for the molecular dissection of the blood-brain barrier and will further direct the discovery of novel mechanisms of blood-brain barrier formation and function. Technical advances in purifying brain endothelial cells, the key cell that forms the critical barrier, have allowed for greater specificity in gene expression comparisons with other central nervous system cell types, and more systematic characterizations of the molecular composition of the blood-brain barrier. Nevertheless, our understanding of how the blood-brain barrier changes during aging and disease is underrepresented. Blood-brain barrier data sets from a wider range of experimental paradigms and species, including invertebrates and primates, would be invaluable for investigating the function and evolution of the blood-brain barrier. Newer technologies in gene expression profiling, such as RNA-sequencing, now allow for finer resolution of transcriptomic changes, including isoform specificity and RNA-editing. As our field continues to utilize more advanced expression profiling in its ongoing efforts to elucidate the blood-brain barrier, including in disease and drug delivery, we will continue to see rapid advances in our understanding of the molecular mediators of barrier biology. We predict that the recently published data sets, combined with forthcoming genomic and proteomic blood-brain barrier data sets, will continue to fuel the molecular genetic revolution of blood-brain barrier biology. PMID:25414634

  11. Genetic dissection of the Down syndrome critical region.

    PubMed

    Jiang, Xiaoling; Liu, Chunhong; Yu, Tao; Zhang, Li; Meng, Kai; Xing, Zhuo; Belichenko, Pavel V; Kleschevnikov, Alexander M; Pao, Annie; Peresie, Jennifer; Wie, Sarah; Mobley, William C; Yu, Y Eugene

    2015-11-15

    Down syndrome (DS), caused by trisomy 21, is the most common chromosomal disorder associated with developmental cognitive deficits. Despite intensive efforts, the genetic mechanisms underlying developmental cognitive deficits remain poorly understood, and no treatment has been proven effective. The previous mouse-based experiments suggest that the so-called Down syndrome critical region of human chromosome 21 is an important region for this phenotype, which is demarcated by Setd4/Cbr1 and Fam3b/Mx2. We first confirmed the importance of the Cbr1-Fam3b region using compound mutant mice, which carry a duplication spanning the entire human chromosome 21 orthologous region on mouse chromosome 16 [Dp(16)1Yey] and Ms1Rhr. By dividing the Setd4-Mx2 region into complementary Setd4-Kcnj6 and Kcnj15-Mx2 intervals, we started an unbiased dissection through generating and analyzing Dp(16)1Yey/Df(16Setd4-Kcnj6)Yey and Dp(16)1Yey/Df(16Kcnj15-Mx2)Yey mice. Surprisingly, the Dp(16)1Yey-associated cognitive phenotypes were not rescued by either deletion in the compound mutants, suggesting the possible presence of at least one causative gene in each of the two regions. The partial rescue by a Dyrk1a mutation in a compound mutant carrying Dp(16)1Yey and the Dyrk1a mutation confirmed the causative role of Dyrk1a, whereas the absence of a similar rescue by Df(16Dyrk1a-Kcnj6)Yey in Dp(16)1Yey/Df(16Dyrk1a-Kcnj6)Yey mice demonstrated the importance of Kcnj6. Our results revealed the high levels of complexities of gene actions and interactions associated with the Setd4/Cbr1-Fam3b/Mx2 region as well as their relationship with developmental cognitive deficits in DS. PMID:26374847

  12. Dissecting the Transcriptional Response to Elicitors in Vitis vinifera Cells

    PubMed Central

    Belchí-Navarro, Sarai; Bru, Roque; Martínez-Zapater, José M.; Lijavetzky, Diego; Pedreño, María A.

    2014-01-01

    The high effectiveness of cyclic oligosaccharides like cyclodextrins in the production of trans-resveratrol in Vitis vinifera cell cultures is enhanced in the presence of methyl jasmonate. In order to dissect the basis of the interactions among the elicitation responses triggered by these two compounds, a transcriptional analysis of grapevine cell cultures treated with cyclodextrins and methyl jasmonate separately or in combination was carried out. The results showed that the activation of genes encoding enzymes from phenylpropanoid and stilbene biosynthesis induced by cyclodextrins alone was partially enhanced in the presence of methyl jasmonate, which correlated with their effects on trans-resveratrol production. In addition, protein translation and cell cycle regulation were more highly repressed in cells treated with cyclodextrins than in those treated with methyl jasmonate, and this response was enhanced in the combined treatment. Ethylene signalling was activated by all treatments, while jasmonate signalling and salicylic acid conjugation were activated only in the presence of methyl jasmonate and cyclodextrins, respectively. Moreover, the combined treatment resulted in a crosstalk between the signalling cascades activated by cyclodextrins and methyl jasmonate, which, in turn, provoked the activation of additional regulatory pathways involving the up-regulation of MYB15, NAC and WRKY transcription factors, protein kinases and calcium signal transducers. All these results suggest that both elicitors cause an activation of the secondary metabolism in detriment of basic cell processes like the primary metabolism or cell division. Crosstalk between cyclodextrins and methyl jasmonate-induced signalling provokes an intensification of these responses resulting in a greater trans-resveratrol production. PMID:25314001

  13. Predicting flow in aortic dissection: comparison of computational model with PC-MRI velocity measurements.

    PubMed

    Cheng, Z; Juli, C; Wood, N B; Gibbs, R G J; Xu, X Y

    2014-09-01

    Aortic dissection is a life-threatening process in which the weakened wall develops a tear, causing separation of wall layers. The dissected layers separate the original true aortic lumen and a newly created false lumen. If untreated, the condition can be fatal. Flow rate in the false lumen is a key feature for false lumen patency, which has been regarded as one of the most important predictors of adverse early and later outcomes. Detailed flow analysis in the dissected aorta may assist vascular surgeons in making treatment decisions, but computational models to simulate flow in aortic dissections often involve several assumptions. The purpose of this study is to assess the computational models adopted in previous studies by comparison with in vivo velocity data obtained by means of phase-contrast magnetic resonance imaging (PC-MRI). Aortic dissection geometry was reconstructed from computed tomography (CT) images, while PC-MRI velocity data were used to define inflow conditions and to provide distal velocity components for comparison with the simulation results. The computational fluid dynamics (CFD) simulation incorporated a laminar-turbulent transition model, which is necessary for adequate flow simulation in aortic conditions. Velocity contours from PC-MRI and CFD in the two lumens at the distal plane were compared at four representative time points in the pulse cycle. The computational model successfully captured the complex regions of flow reversal and recirculation qualitatively, although quantitative differences exist. With a rigid wall assumption and exclusion of arch branches, the CFD model over-predicted the false lumen flow rate by 25% at peak systole. Nevertheless, an overall good agreement was achieved, confirming the physiological relevance and validity of the computational model for type B aortic dissection with a relatively stiff dissection flap. PMID:25070022

  14. Advances in sentinel node dissection in prostate cancer from a technical perspective.

    PubMed

    Acar, Cenk; Kleinjan, Gijs H; van den Berg, Nynke S; Wit, Esther Mk; van Leeuwen, Fijs Wb; van der Poel, Henk G

    2015-10-01

    The most important feature of sentinel node biopsy for prostate cancer procedure is that staging can be improved. Sentinel nodes might be found outside the extended pelvic lymph node dissection template what renders the sentinel node additive of extended pelvic lymph node dissection. At the same time, staging within the template can be further refined. We reviewed the literature regarding the sentinel node biopsy procedure for prostate cancer. PubMed and Embase were searched for all English-language publications from January 1999 to September 2014 by using the keywords as "prostate cancer" and "sentinel lymph node" plus "biopsy" "dissection" and/or "procedure." The present review discusses step-by-step sentinel node biopsy for prostate cancer. Topics of discussion are: (i) preoperative sentinel node mapping (tracers and imaging); (ii) intraoperative sentinel node identification (surgical procedure and outcome); and (iii) novelties to improve sentinel node identification (pre- and intraoperative approaches). Conventional sentinel node mapping is carried out after the injection of a (99m) Tc-based tracer and subsequent preoperative imaging; for example, lymphoscintigraphy and single-photon emission computed tomography/computed tomography. This approach allowed the detection of sentinel nodes outside the extended lymph node dissection template in 3.6-36% of men with intermediate- and high-risk prostate cancer. Hereby, an overall false negative rate of sentinel nodes was reported between 0% and 24.4%. To further refine the intraoperative sampling procedure, novel imaging methods such as fluorescence imaging have been introduced. Prospective randomized comparison studies are required to confirm the added benefit of sentinel template directed nodal dissection. A proper and obtainable end-point of such a study could be the number of removed positive nodes for carrying out nodal dissection with or without sentinel template directed dissection. Similarly, the clinical impact of novel imaging technologies requires further investigation. PMID:26173593

  15. A mill based instrument and software system for dissecting slide-mounted tissue that provides digital guidance and documentation

    PubMed Central

    2013-01-01

    Background Dissection of specific Areas Of Interest (AOIs) of slide-mounted tumor samples is often used to enrich for cancer cells in order to generate better signal to noise ratios in subsequent biochemical characterization. Most clinical laboratories utilize manual dissection for practical reasons and to avoid the expense and difficulties of laser microdissection systems. Unfortunately, manual methods often lack resolution and process documentation. The goal of this project was to design a dissection system for slide-mounted tissue with better precision than manual methods that also provides digital image guidance and electronic process documentation. Methods An instrument that is essentially a micro tissue mill was developed. It employs a specialized disposable mill bit that simultaneously dispenses liquid, cuts tissue from the slide surface, and aspirates the liquid along with the displaced tissue fragments. A software package was also developed that is capable of transferring digitally annotated AOIs between images of serially cut tissue sections to guide dissection and generate an electronic record of the process. Results The performance of this “meso” dissection system was tested using post dissection visual examination for resolution and accuracy, fluorescence based DNA quantitation for recovery efficiency, and dissection of closely situated mouse-human tissue sections followed by PCR amplification for purity determination. The minimum resolution is a dissected circle smaller than 200 microns in diameter, edge dissection accuracy is tighter than 100 microns, recovery efficiency appears greater than 95%, and recovery purity is greater than 99% relative to a different tissue located 100 microns from the dissection boundary. The system can dissect from both paraffinized and deparaffinized FFPE tissue sections that are mounted on plain glass slides, and it is compatible with DNA, RNA, and protein isolation. Conclusions The mesodissection system is an effective alternative to manual dissection methods and is applicable for biomarker analysis of anatomical pathology samples, where enrichment of AOIs from the tissue section is helpful, but pure cell populations are not required. PMID:24188417

  16. Efficacy and safety of over-the-scope clip: Including complications after endoscopic submucosal dissection

    PubMed Central

    Nishiyama, Noriko; Mori, Hirohito; Kobara, Hideki; Rafiq, Kazi; Fujihara, Shintarou; Kobayashi, Mitsuyoshi; Oryu, Makoto; Masaki, Tsutomu

    2013-01-01

    AIM: To retrospectively review the results of over-the-scope clip (OTSC) use in our hospital and to examine the feasibility of using the OTSC to treat perforations after endoscopic submucosal dissection (ESD). METHODS: We enrolled 23 patients who presented with gastrointestinal (GI) bleeding, fistulae and perforations and were treated with OTSCs (Ovesco Endoscopy GmbH, Tuebingen, Germany) between November 2011 and September 2012. Maximum lesion size was defined as lesion diameter. The number of OTSCs to be used per patient was not decided until the lesion was completely closed. We used a twin grasper (Ovesco Endoscopy GmbH, Tuebingen, Germany) as a grasping device for all the patients. A 9 mm OTSC was chosen for use in the esophagus and colon, and a 10 mm device was used for the stomach, duodenum and rectum. The overall success rate and complications were evaluated, with a particular emphasis on patients who had undergone ESD due to adenocarcinoma. In technical successful cases we included not only complete closing by using OTSCs, but also partial closing where complete closure with OTSCs is almost difficult. In overall clinical successful cases we included only complete closing by using only OTSCs perfectly. All the OTSCs were placed by 2 experienced endoscopists. The sites closed after ESD included not only the perforation site but also all defective ulcers sites. RESULTS: A total of 23 patients [mean age 77 years (range 64-98 years)] underwent OTSC placement during the study period. The indications for OTSC placement were GI bleeding (n = 9), perforation (n = 10), fistula (n = 4) and the prevention of post-ESD duodenal artificial ulcer perforation (n = 1). One patient had a perforation caused by a glycerin enema, after which a fistula formed. Lesion closure using the OTSC alone was successful in 19 out of 23 patients, and overall success rate was 82.6%. A large lesion size (greater than 20 mm) and a delayed diagnosis (more than 1 wk) were the major contributing factors for the overall unsuccessful clinical cases. The location of the unsuccessful lesion was in the stomach. The median operation time in the successful cases was 18 min, and the average observation time was 67 d. During the observation period, none of the patients experienced any complications associated with OTSC placement. In addition, we successfully used the OTSC to close the perforation site after ESD in 6 patients. This was a single-center, retrospective study with a small sample size. CONCLUSION: The OTSC is effective for treating GI bleeding, fistulae as well as perforations, and the OTSC technique proofed effective treatment for perforation after ESD. PMID:23687412

  17. Outcome of Frozen Elephant Trunk Technique for Acute Type A Aortic Dissection

    PubMed Central

    Lin, Hui-Han; Liao, Shou-Fu; Wu, Ching-Feng; Li, Ping-Chun; Li, Ming-Li

    2015-01-01

    Abstract Acute aortic dissections of Stanford type A require emergency surgery repair and present challenges to surgeons. The frozen elephant technique is one of several approaches used to treat aortic arch dissection. The purpose of this meta-analysis was to investigate the clinical effectiveness of the frozen elephant technique for treating acute type A aortic dissection. Medline, Cochrane, Google Scholar, and ClinicalTrials.gov databases were searched up to March 31, 2014, for studies that assessed the use of frozen elephant trunk technique for treating acute type A aortic dissection. The primary outcome was in-hospital mortality. Secondary outcomes included rate of stroke, spinal cord injury, renal failure, and reoperations for bleeding. Eleven studies were included in the analysis that encompassed 881 patients. The mean age ranged from 45.4 to 66.8 years, and the proportion of the population that was male ranged from 45 to 85%. The overall in-hospital mortality rate was 8%. The rate of stroke, spinal cord injury, renal failure, and frequency of reoperations for bleeding were 3, 4, 5, and 5, respectively. Sensitivity analysis indicates that the findings are robust and there was no publication bias. These findings indicate that the frozen elephant techniques does not bring unacceptable mortality or morbidity risk for treating acute type A aortic dissection. PMID:25906096

  18. Clinical profiles and outcomes of acute aortic dissection in a predominantly Hispanic population

    PubMed Central

    Alkhateeb, Haider; Said, Sarmad; Cooper, Chad J.; Rodriguez-Castro, Carlos; Dwivedi, Alok; Onate, Eduardo; Quansah, Raphael; Mukherjee, Debabrata

    2014-01-01

    Background Acute aortic dissection (AAD) is a life-threatening cardiovascular condition with high morbidity and mortality. We sought to assess clinical profiles as well as outcomes of AAD in a predominantly Hispanic population and to explore the relationship between this condition and uncontrolled/untreated hypertension in this community. Material/Methods This was a single-center, retrospective, cross-sectional study of patients admitted with AAD over a 10 years period. Results Fifty-nine cases of AAD were included in the analysis. The group of Hispanics with AAD had more females (48.3%, p=0.002), more dyslipidemia and coronary artery disease (p=0.006 and 0.05, respectively), and a tendency to be older and have more hypertension and diabetes compared to non-Hispanics. Although 70.2% of all patients had hypertension, only 52.5% of them were being treated; of those, only 66.7% achieved optimal blood pressure control prior to presentation. Only 47.4% received beta-blockers for blood pressure control in the acute setting. Longer length of in-hospital stay was associated with older age, higher troponin and creatine kinase levels, and presence of hypertension. In-hospital death occurred in 10 (17%) patients and mortality was significantly associated with higher serum creatinine (p=0.01). Conclusions Hispanic patients with AAD were more likely to be female, of older age, and have more cardiovascular risk factors in comparison to non-Hispanics. In addition, significant under-treatment of hypertension in this population and underutilization of beta-blockers for blood pressure control in the acute settings was evident. Better prevention and timely treatment may improve outcomes for this condition in this population. PMID:24800818

  19. Ultrasound-Guided Percutaneous Removal of Wooden Foreign Bodies in the Extremities with Hydro-Dissection Technique

    PubMed Central

    Park, Hee Jin; Lee, So Yeon; Son, Eun Seok; Chung, Eun Chul; Rho, Myung Ho; Lee, Sun Joo

    2015-01-01

    Objective We described the technique of ultrasound (US)-guided percutaneous removal of the foreign bodies (FB) with hydro-dissection in the radiologic department and presented video files of several cases. Materials and Methods Four patients referred to the radiology department for US evaluation and US-guided percutaneous removal of the FBs in the upper and lower extremities between November, 2006 and November, 2013 were included in this study. The procedures started with US evaluation for the exact location and shape of the FB. A 5 mm-sized skin incision was made at the site of the nearest point from the FB where no passing arteries or tendons were present. We adopted a hydrodissection technique to separate the FB from adjacent tissue using a 2% lidocaine solution. Injected anesthetics detached the FBs from surrounding tissue and thereby facilitated removal. After the tip of the mosquito forceps reached the FB, the wooden FBs were removed. Results The mean time required for the entire procedure was approximately 20 minutes. There were no significant complications during the US-guided removal or long-term complications after the procedure. All 4 FBs were successfully removed from the soft tissue under US guidance. Conclusion Ultrasound-guided percutaneous removal of the FBs with hydro-dissection in the radiology department is a less invasive and safe method over surgical removal in the operating room. Additionally, the use of a guide wire and serial dilator may help minimize soft tissue injury and facilitate the introduction of forceps. PMID:26576123

  20. Reversible cerebral vasoconstriction syndrome with multivessel cervical artery dissections and a double aortic arch.

    PubMed

    Nouh, Amre; Ruland, Sean; Schneck, Michael J; Pasquale, David; Biller, José

    2014-02-01

    Reversible cerebral vasoconstriction syndrome (RCVS) has been associated with exposure to vasoactive substances and few reports with cervical arterial dissections (CADs). We evaluated a 32-year-old woman with history of depression, migraines without aura, and cannabis use who presented with a thunderclap headache unresponsive to triptans. She was found to have bilateral occipital infarcts, bilateral extracranial vertebral artery dissections, bilateral internal carotid artery dissecting aneurysms, and extensive distal multifocal segmental narrowing of the anterior and posterior intracranial circulation with a "sausage on a string-like appearance" suggestive of RCVS. Subsequently, she was found to have a distal thrombus of the basilar artery, was anticoagulated, and discharged home with no residual deficits. We highlight the potential association of CADs and RCVS. The association of RCVS and a double aortic arch has not been previously reported. PMID:24103665

  1. Anatomists' views on human body dissection and donation: an international survey.

    PubMed

    Arráez-Aybar, Luis-Alfonso; Bueno-López, José Luis; Moxham, Bernard John

    2014-12-01

    A survey was conducted to test three hypotheses: anatomists believe that dissection by students conveys not just anatomical knowledge but also essential skills and attitudes, including professionalism; anatomists approve of the donation of their own bodies or body parts/organs for medical/health-care training and research; attitudes towards body dissection and donation are not dependent upon gender or upon the extent of teaching experience, but are related to transcendental convictions relating to beliefs in the afterlife. Eighty-one anatomists, from 29 countries responded to the survey; 80% indicated that they required medical/health-care students to dissect human cadavers (60% females-86% males, p=0.02). Most teachers recorded that dissection was an instrument for training undergraduate students, an instrument for the development of professional skills, and an instrument to help to control emotions in the future doctor rather than being only a means of teaching/learning anatomy facts. Males were more receptive to the concept that dissection helps to control emotions in the future doctor (p=0.02). Most teachers (75%) said they were willing to donate their bodies, 41% saying they would donate body organs only, 9% would donate their entire bodies only, 25% would separately donate organs and also the entire body. The willingness to donate increased significantly with the years of teaching experience (p=0.04). Teachers who were not believers in the afterlife were more likely to donate their organs/bodies than were believers (p=0.03). Our findings showed that anatomists' attitudes towards body dissection and donation are dependent upon gender, upon the extent of teaching experience, and upon transcendental convictions. PMID:25048843

  2. Detergent dissection of membrane proteins of Entamoeba histolytica and its effect on lymphokine release in in vitro.

    PubMed

    Nayeem, M A; Habibullah, C M; Saleem, Y; Ishaq, M; Salma, M

    1991-11-01

    Fifty-two amoebic liver abscess cases were assessed for the release of lymphokines (LMIF) using detergent dissected membrane proteins (DDMP) of axenic Entamoeba histolytica (NIH:200) obtained with sodium deoxycholate treatment. Lymphokines release by T lymphocytes in response to both DDMP and whole amoebic lysate (WAL) was tested by leukocyte migration inhibition test on blood samples from amoebic liver abscess cases. A significant increase was noted in the release of LMIF and 100% positivity was observed with DDMP compared to whole amoebic extract with a positivity of 73%. The difference between means of the above two with regards to release of LMIF was found to be highly significant (P less than 0.005). This shows the patients had high degree of leukocyte sensitization to surface antigens of E. histolytica compared to the whole amoebic lysate. These findings suggest that the antigens shed might have important role as a potent antigen in elicitation of CMI response in amoebic liver abscess cases. PMID:1816085

  3. Hybrid procedure for acute stanford type a aortic dissection with aberrant right subclavian artery.

    PubMed

    Ren, Changwei; Sun, Lizhong; Huang, Lianjun; Lai, Yongqiang; Yang, Sheng; Xu, Shangdong

    2015-03-01

    Aberrant right subclavian artery (ARSA) is an uncommon congenital vascular abnormality. Acute Stanford type A aortic dissection with ARSA is rare. We report a strategy for Stanford type A aortic dissection with ARSA. The ascending aorta and the total aortic arch were replaced and a frozen elephant trunk was implanted into the descending aorta. The right subclavian artery was reconstructed with the perfusion branch of a four-branch prosthetic graft. Two weeks later, the proximal part of the ARSA was sealed with a vascular plug. PMID:24934385

  4. Reduction of Mental Distress in the Dissection Course by Introducing the Body Donor Experience through Anatomical Demonstrations of Organ Systems

    ERIC Educational Resources Information Center

    Bockers, Anja; Baader, Christoph; Fassnacht, Ulrich Kai; Ochsner, Wolfgang; Bockers, Tobias Maria

    2012-01-01

    The practice of dissection teaches students not only the foundations of anatomical knowledge but also encourages the development of professional competencies. Yet, the dissection of cadavers in the gross anatomy course can be a stress factor for medical students. There are a minor proportion of students who demonstrate strong emotional reactions…

  5. Animal Dissection. [Fact Sheet and Resource List Information Packet from the Humane Society of the United States].

    ERIC Educational Resources Information Center

    Balcombe, Jonathan

    Killing animals for classroom dissection causes animal suffering, cheapens the value of life, and depletes wild animal populations, yet it remains commonplace. The Humane Society of the United States (HSUS) addresses the issue in this information packet which includes a fact sheet and three resource lists "on Dissection." The fact sheet discusses…

  6. Dissecting genome-wide association signals for loss-of-function phenotypes in sorghum flavonoid pigmentation traits

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Genome-wide association studies (GWAS) are a powerful method to dissect the genetic basis of traits, though in practice the effects of complex genetic architecture and population structure remain poorly understood. To compare mapping strategies we dissect the genetic control of flavonoid pigmentatio...

  7. Through the Looking Glass: Examining the Practice of Science Classroom Dissection with a Multi-Faceted Lens

    ERIC Educational Resources Information Center

    Witte, Melissa Marie

    2014-01-01

    Dissection of lab specimens is a common procedure in science classrooms, yet there are many unasked and unexamined questions relating to this practice. In addition to ethical considerations, there are personal and environmental health impacts of using conventional dissection, which has historically included animals and animal organs embalmed in…

  8. The Dissection Room Experience: A Factor in the Choice of Organ and Whole Body Donation--A Nigerian Survey

    ERIC Educational Resources Information Center

    Anyanwu, Emeka G.; Obikili, Emmanuel N.; Agu, Augustine U.

    2014-01-01

    The psychosocial impact of human dissection on the lives of medical and health science students has been noted. To assess the impact of the dissection room experience on one's willingness to become a whole body and organ donor, the attitudes of 1,350 students and professionals from the medical, health, and non-health related disciplines to…

  9. Recognition of Spontaneous Vertebral Artery Dissection Preempting Spinal Manipulative Therapy: A Patient Presenting With Neck Pain and Headache for Chiropractic Care

    PubMed Central

    Mattox, Ross; Smith, Linda W.; Kettner, Norman W.

    2014-01-01

    Objective The purpose of this case report is to describe a patient who presented to a chiropractic physician for evaluation and treatment of neck pain and headache. Clinical features A 45-year-old otherwise healthy female presented for evaluation and treatment of neck pain and headache. Within minutes, non-specific musculoskeletal symptoms progressed to neurological deficits, including limb ataxia and cognitive disturbances. Suspicion was raised for cerebrovascular ischemia and emergent referral was initiated. Intervention and outcome Paramedics were immediately summoned and the patient was transported to a local hospital with a working diagnosis of acute cerebrovascular ischemia. Multiplanar computed tomographic and magnetic resonance imaging with contrast revealed vertebral artery dissection of the V2 segment in the right vertebral artery. Anticoagulation therapy was administered and the patient was discharged without complications after 5 days in the hospital. Conclusion This case highlights the potential for patients with vertebral artery dissection to present with nonspecific musculoskeletal complaints. Neurological symptoms may not manifest initially, but their sudden onset indicates the possibility of an ischemic cerebrovascular event. We suggest that early recognition and emergent referral for this patient avoided potential exacerbation of an evolving pre-existing condition and resulted in timely anticoagulation treatment. PMID:25685116

  10. Diagnostic excision of the Rosenmüller's node. Screening for occult metastases before elective regional lymph node dissection in patients with lower limb melanoma?

    PubMed

    Illig, L; Aigner, K R; Biess, B; Göhl, J; Holle, R; Hundeiker, M; Scharfe, G; Tilkorn, H; Tonak, J

    1988-03-15

    Elective radical groin dissection was performed on 297 consecutive patients with high-risk melanoma of the leg, Anderson Stages I, IIA, IIIA. By separate histologic examination of the so-called "Rosenmüller's node," the other inguinal, and the external iliac lymph nodes, the diagnostic excision of the Rosenmüller's node was tested as a suitable mode of screening for metastases before a planned elective regional lymph node dissection. Eighty patients (27%) presented with what was histologically determined to be occult groin metastases. Rosenmüller's node was involved in 30 of these cases; in the remaining 50, however, it was not affected; that is, 63% of the cases were false-negative. Thus, the involvement of Rosenmüller's node is not representative of metastases in the other ilioinguinal lymph nodes, but is rather a matter of chance. In women with superficial spreading melanoma the rate of occult lymph node metastases was significantly lower than that in men with melanomas of the other type. Iliac lymph node involvement was observed in 18 patients (22%) depending on clinical stage and depth of invasion of the primary tumor. PMID:3342377

  11. 75 FR 27375 - Postal Rate Case Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ...Docket No. PI2010-3; Order No. 456] Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice...relevant to management of an anticipated exigent postal rate case. It has scheduled a technical conference for a...

  12. A glimpse into the process of gaining permission for the educational dissection of human cadavers in the Ottoman Empire.

    PubMed

    Akkin, Salih Murat; Dinc, Gulten

    2014-10-01

    Dissection of the human body for educational purposes became officially permitted in the Ottoman Empire only after a long, difficult process. In the West, studies based on the findings of Galen had been taboo during a long period in which dissection of human bodies had been prohibited. Although the first dissection studies since ancient times began to appear in the Western literature in the late 13th and early 14th centuries, the post-Galen taboo against dissection was broken only in the 16th century by the studies of Vesalius. However, in the Eastern World, it was only fairly recently that the idea of the "sanctity of the human body" could be challenged. In the medieval Islamic world, as during the Middle Ages in the West, prohibitions against the dissection of human cadavers continued for social and religious reasons, although the Koran does not specifically ban such dissection. This prohibition also continued through the Ottoman era, which began in the 14th century. The first efforts to end the prohibition on dissection in the Ottoman Empire were made at the beginning of the 19th century during the reign of Sultan Selim III but official permission for dissection was given only in 1841 during the reign of Sultan Abdulmecid. Educational dissections in the Ottoman Empire officially began at the Istanbul Medical School following the granting of this permission. This article will discuss the attempts to end the prohibition of dissection in Ottomans within the scope of the history of anatomical study in Turkey. PMID:24913319

  13. 37 CFR 211.6 - Methods of affixation and placement of mask work notice.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... placement of mask work notice. 211.6 Section 211.6 Patents, Trademarks, and Copyrights U.S. COPYRIGHT OFFICE... placement of mask work notice. (a) General. (1) This section specifies methods of affixation and placement... recognized or is generally known. (c) Methods of affixation and placement of the notice. In the case of...

  14. 37 CFR 211.6 - Methods of affixation and placement of mask work notice.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... placement of mask work notice. 211.6 Section 211.6 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE... placement of mask work notice. (a) General. (1) This section specifies methods of affixation and placement... recognized or is generally known. (c) Methods of affixation and placement of the notice. In the case of...

  15. 37 CFR 211.6 - Methods of affixation and placement of mask work notice.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... placement of mask work notice. 211.6 Section 211.6 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE... placement of mask work notice. (a) General. (1) This section specifies methods of affixation and placement... recognized or is generally known. (c) Methods of affixation and placement of the notice. In the case of...

  16. Coupled Physical and Digital Cadaver Dissection Followed by a Visual Test Protocol Provides Insights into the Nature of Anatomical Knowledge and Its Evaluation

    ERIC Educational Resources Information Center

    Hisley, Kenneth C.; Anderson, Larry D.; Smith, Stacy E.; Kavic, Stephen M.; Tracy, J. Kathleen

    2008-01-01

    This research effort compared and contrasted two conceptually different methods for the exploration of human anatomy in the first-year dissection laboratory by accomplished students: "physical" dissection using an embalmed cadaver and "digital" dissection using three-dimensional volume modeling of whole-body CT and MRI image sets acquired using…

  17. Medical Students' Attitudes toward the Anatomy Dissection Room in Relation to Personality

    ERIC Educational Resources Information Center

    Plaisant, Odile; Courtois, Robert; Toussaint, Paule Joanne; Mendelsohn, Gerald A.; John, Oliver P.; Delmas, Vincent; Moxham, Bernard J.

    2011-01-01

    Assessment of the personalities of medical students could enable medical educators to formulate strategies for the best development of academic and clinical competencies. In this article, we focus on the experience of students in the anatomy dissecting room. While there have been many attempts to evaluate the emotional responses of medical…

  18. Creating Clay Models of a Human Torso as an Alternative to Dissection

    ERIC Educational Resources Information Center

    Shipley, Gwendolyn

    2010-01-01

    Instead of dissecting animals, students create small clay models of human internal organs to demonstrate their understanding of the positioning and interlocking shapes of the organs. Not only is this approach more environmentally friendly, it also forces them to learn human anatomy--which is more relevant to them than the anatomy of other…

  19. proteinsSTRUCTURE O FUNCTION O BIOINFORMATICS Dissecting contact potentials for proteins

    E-print Network

    Thirumalai, Devarajan

    contributions of individual amino acids to commonly used pair potentials derived to identify fold recognition contributions of individual amino acids N.-V. Buchete,1 * J. E. Straub,2 and D. Thirumalai3 1 Laboratory they include chemical diversity of amino acids. The purpose of this article is to dissect the relative

  20. Video Article Live Dissection of Drosophila Embryos: Streamlined Methods for Screening Mutant

    E-print Network

    Zinn, Kai

    Video Article Live Dissection of Drosophila Embryos: Streamlined Methods for Screening Mutant Embryos: Streamlined Methods for Screening Mutant Collections by Antibody Staining. JoVE. 34. http://www.jove.com/index/Details.stp?ID=1647, doi: 10.3791/1647 Abstract Drosophila embryos between stages 14 and 17 of embryonic development

  1. Structural and Functional Dissection of the Heterocyclic Peptide Cytotoxin Streptolysin S*S

    E-print Network

    Nizet, Victor

    Structural and Functional Dissection of the Heterocyclic Peptide Cytotoxin Streptolysin S to thiazole, oxazole, and methylox- azole heterocycles, respectively (3). A DNA gyrase inhibitor, microcin B17­12). Microcin B17 contains four thiazole and four oxazole heterocycles, which are indispensable for biological

  2. Intercostobrachial Nerves as a Novel Anatomic Landmark for Dividing the Axillary Space in Lymph Node Dissection

    PubMed Central

    Li, Jianyi; Zhang, Yang; Zhang, Wenhai; Jia, Shi; Gu, Xi; Ma, Yan; Li, Dan

    2013-01-01

    Purpose. Our aim was to assess the feasibility of using the intercostobrachial nerves (ICBNs) as a possible new anatomic landmark for axillaries lymph node dissection in breast cancer patients. Background Data Summary. The preservation of ICBN is now an accepted procedure in this type of dissection; however, it could be improved further to reduce the number of postoperative complications. The axillary space is divided into lower and upper parts by the ICBN—a thorough investigation of the metastasis patterns in lymph nodes found in this area could supply new information leading to such improvements. Methods. Seventy-two breast cancer patients, all about to undergo lymph node dissection and with sentinel lymph nodes identified, were included in this trial. The lymph nodes were collected in two groups, from lower and upper axillary spaces, relative to the intercostobrachial nerves. The first group was further subdivided into sentinel (SLN) and nonsentinel (non-SLN) nodes. All lymph nodes were tested to detect macro- and micrometastasis. Results. All the sentinel lymph nodes were found under the intercostobrachial nerves; more than 10 lymph nodes were located in that space. Moreover, when lymph nodes macrometastasize or micrometastasize above the intercostobrachial nerves, we also observe metastasis-positive nodes under the nerves; when the lower group nodes show no metastasis, the upper group is also metastasis free. Conclusions. Our results show that the intercostobrachial nerves are good candidates for a new anatomic landmark to be used in lymph node dissection procedure. PMID:23401796

  3. Quantitative Genetic Dissection of Shoot Architecture Traits in Maize: Towards a Functional Genomics Approach

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Quantitative trait loci (QTL) affecting the total number of leaves (TNOL) made prior to flowering and the number of leaves below the ear (NLBE) were mapped and characterized in order to dissect the genetic regulatory components of these agronomically important traits of corn. The full set of interm...

  4. Posterior approach to kidney dissection: An old surgical approach for integrated medical curricula.

    PubMed

    Daly, Frank J; Bolender, David L; Jain, Deepali; Uyeda, Sheryl; Hoagland, Todd M

    2015-11-12

    Integrated medical curricular changes are altering the historical regional anatomy approach to abdominal dissection. The renal system is linked physiologically and biochemically to the cardiovascular and respiratory systems; yet, anatomists often approach the urinary system as part of the abdomen and pelvic regions. As part of an integrated curriculum, the renal system must be covered relatively quickly after the thorax in the cadaver laboratory, often without the opportunity to fully appreciate the rest of the abdominal contents. This article provides dissection instructions that follow one of the historical surgical approaches for nephrectomy, including preservation of the posterior abdominal wall neurovasclature. Dissection procedures were developed for first-year medical students, intending this posterior approach to the kidneys to be their first introduction to the renal system. It has been successfully implemented with the first-year medical students at the University of New England, College of Osteopathic Medicine. Utilizing this posterior approach to the kidney enabled the study of the anatomy of the kidneys, suprarenal glands, and renal vessels, as well as the muscles of the lumbar spine, while maintaining the integrity of the anterior abdominal wall and peritoneal cavity for future gastrointestinal and reproductive system-based dissections. Anat Sci Educ 8: 555-563. © 2015 American Association of Anatomists. PMID:25688744

  5. Dissecting Video Server Selection Strategies in the YouTube CDN

    E-print Network

    Dissecting Video Server Selection Strategies in the YouTube CDN Ruben Torres, Alessandro Finamore.finamore,marco.mellia,maurizio.munafo}@polito.it Abstract--In this paper, we conduct a detailed study of the YouTube CDN with a view to understanding-based geolo- cation techniques to find the geographical location of YouTube servers. A unique aspect of our

  6. The use of planarians to dissect the molecular basis of metazoan regeneration

    E-print Network

    Alvarado, Alejandro Sánchez

    The use of planarians to dissect the molecular basis of metazoan regeneration ALEJANDRO SANCHEZALVARADO, PhD, PHILLIP A. NEWMARK, PhD Freshwater planarians possess remarkable regenerative abilities symmetry and cephalization . Furthermore, planarians occupy an important position in the evolution

  7. A Simple Dissection Method for the Conduction System of the Human Heart

    ERIC Educational Resources Information Center

    Yanagawa, Nariaki; Nakajima, Yuji

    2009-01-01

    A simple dissection guide for the conduction system of the human heart is shown. The atrioventricular (AV) node, AV bundle, and right bundle branch were identified in a formaldehyde-fixed human heart. The sinu-atrial (SA) node could not be found, but the region in which SA node was contained was identified using the SA nodal artery. Gross…

  8. Virtual dissection of pig carcasses Martin Vester-Christensen a,*, Sren G.H. Erbou a

    E-print Network

    . Lyngby, Denmark b Danish Meat Research Institute, Maglegårdsvej 2, DK-4000 Roskilde, Denmark a r t i c l Keywords: Computed tomography Image analysis Pig carcass grading Lean meat percentage Calibration reference for estimating the lean meat percentage (LMP) of pig carcasses. The current reference is manual dissection which

  9. A Human Dissection Training Program at Indiana University School of Medicine-Northwest

    ERIC Educational Resources Information Center

    Talarico, Ernest F., Jr.

    2010-01-01

    As human cadavers are widely used in basic sciences, medical education, and other training and research venues, there is a real need for experts trained in anatomy and dissection. This article describes a program that gives individuals interested in clinical and basic sciences practical experience working with cadavers. Participants are selected…

  10. Structural Dissection of a Highly Knotted Peptide Reveals Minimal Motif with Antimicrobial Activity*S

    E-print Network

    Pompeu Fabra, Universitat

    of antimicrobial peptides for which in vitro activity against plant pathogens (18) and a defensive role (19) wereStructural Dissection of a Highly Knotted Peptide Reveals Minimal Motif with Antimicrobial Activity*S a substan- tially simplified (45% size reduction) version with undi- minished antimicrobial activity against

  11. Molecular dissection of the roles of the SOD genes in mammalian response to low dose irradiation

    SciTech Connect

    Li, Chuan-Yaun

    2009-01-27

    “Molecular dissection of the roles of the SOD genes in mammalian response to low dose irradiation " was started on 09/01/03 and ended on 08/31/07. The primary objective of the project was to carry out mechanistic studies of the roles of the anti-oxidant SOD genes in mammalian cellular response to low dose ionizing radiation.

  12. Dissecting Linkage Disequilibrium in African-American Genomes: Roles of Markers and Individuals

    E-print Network

    Xu, Shuhua

    Dissecting Linkage Disequilibrium in African-American Genomes: Roles of Markers and Individuals admixed populations such as African-American (AfA). On the other hand, it has also been shown that LD such as African-American (AfA) and Mexican- American (McKeigue et al. 2000; Pfaff et al. 2001; Collins- Schramm et

  13. FUNCTIONAL AND POSITIONAL DISSECTION OF A NOVEL QTL AFFECTING THE DURATION OF JUVENILITY IN MAIZE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The regulation of vegetative phase change is particularly amenable to genetic dissection in maize because the boundary between juvenile and adult tissue is discretely delineated by a suite of epidermal markers. Like the reproductive phase change wherein plants switch from producing leaves to flower...

  14. Functional characterization of cohesin subunit SCC1 in Trypanosoma brucei and dissection of mutant phenotypes

    E-print Network

    Schnaufer, Achim

    Functional characterization of cohesin subunit SCC1 in Trypanosoma brucei and dissection of mutant distantly related to yeast and metazoa, we characterized the Trypanosoma brucei SCC1 orthologue. TbSCC1- mosomes during mitosis. In Trypanosoma brucei, the chromosomes contain a single linear DNAmolecule

  15. Behavioral/Systems/Cognitive Genetic Dissection of the Role of Catechol-O-

    E-print Network

    Sandini, Giulio

    Behavioral/Systems/Cognitive Genetic Dissection of the Role of Catechol-O- Methyltransferase 20892 The COMT (catechol-O-methyltransferase) gene has been linked to a spectrum of human phenotypes; genes; mice; stress; calcium/calmodulin-dependent kinase Introduction Catechol-O-methyltransferase (COMT

  16. Type-A acute aortic dissection: combined operation plus stent management.

    PubMed

    Roux, Daniel; Brouchet, Laurent; Concina, Philippe; Elghobary, Tamer; Glock, Yves; Fournial, Gérard

    2002-05-01

    When the port of entry of acute type-A aortic dissection is at the level of the horizontal portion of the aortic arch, the latter should be replaced by a prosthesis. To avoid performing this difficult procedure in an emergency situation, we place a stent in the aortic arch. Then we replace the ascending aorta by a prosthesis. PMID:12022559

  17. Biochemical Society Transactions (2002) Volume 30, part 2 Genetic dissection of plant cell-wall biosynthesis

    E-print Network

    2002-01-01

    Biochemical Society Transactions (2002) Volume 30, part 2 Genetic dissection of plant cell-wall, Department of Plant Biology, 260 Panama Street, Stanford, CA 94305, U.S.A. Abstract The plant cell wall differences in mutant cell walls from wild-type plants by Fourier-transform IR micro- scopy. A more precise

  18. Educational Paradigm Change to Dissect to Prosect or to Game (Simulation) That Is the Question?

    ERIC Educational Resources Information Center

    Ross, Cory

    2015-01-01

    There is no question that a thorough knowledge and understanding of the gross architecture of the human body underlies sound medical practice and, therefore, comprises an early curricular goal. Thus, the exploration of palpable human anatomy in the dissection laboratory addresses the pivotal goal of establishing a comprehension of the three…

  19. Dissection and hemostasis with hydroxilated polyvinyl acetal tampons in open thyroid surgery

    PubMed Central

    Dionigi, Gianlorenzo; Boni, Luigi; Rovera, Francesca; Dionigi, Renzo

    2007-01-01

    Background The essential objectives for thyroidectomy are: avoidance of injury to the recurrent laryngeal nerves, conservation of the parathyroid glands, an accurate haemostasis and an excellent cosmesis. In the last 10 years major improvements and new technologies have been proposed and applied in thyroid surgery; among these mini-invasive thyroidectomy, regional anaesthesia and intraoperative neuromonitoring, and new devices for achieving dissection and haemostasis. Minor bleeding from small vessels could be a major complication in thyroid surgery. The purpose of ligating vessels is to maintain the surgical site free from an excess of blood and reduce blood loss in the patient. Materials and methods Hydroxylated polyvinyl acetal tampons (HPA) are made by a synthetic, open cell foam structure able to absorb fluids up to 25 times the initial weight. We tested their efficacy for small bleeding control and tissue dissection during several thyroid procedures. Results HPA tampons have been found extremely useful to absorb blood coming from minor and diffuse loss, helping to control bleeding by a combined action of fluid absorption and local compression. The porous design of the tampon allows the use of the suction device right through the tampon itself. Thanks to the initial mildly hard consistency, we also used HPA tampons as dissecting instruments. Conclusion In our experience the use of HPA tampons resulted extremely efficient for minor bleeding control, fluids removal and tissue dissection during thyroid surgery. PMID:17411448

  20. Role of aggregated medin in the pathogenesis of thoracic aortic aneurysm and dissection.

    PubMed

    Peng, Siwei; Larsson, Annika; Wassberg, Erik; Gerwins, Pär; Thelin, Stefan; Fu, Xin; Westermark, Per

    2007-12-01

    The pathogenesis of sporadic thoracic aortic aneurysm and dissection, which may lead to rupture of the aorta, remains largely unknown. Amyloid deposits, formed from the medin peptide, are very prevalent in the media of the thoracic aorta. We have studied the occurrence of medin-derived amyloid in specimens from patients with thoracic aortic aneurysm, aortic dissection type A and normal dimensioned aorta. Surprisingly, the amount of amyloid was significantly lower in the aneurysm and dissection groups (0.63+/-0.13 and 0.36+/-0.24 amyloid particles per mm2, respectively) compared to the control material (2.37+/-0.58). However, focal medin immunoreactivity not associated with amyloid was found more conspicuously in the media of the two diseased groups. Recent amyloid research indicates that prefibrillar oligomeric aggregates, rather than mature amyloid fibrils, are toxic to the surrounding cells. The non-amyloid medin immunoreactivity observed may represent such toxic oligomers. This is supported by the fact that aggregated medin induced death of aortic smooth muscle cells in vitro. In addition, cells incubated together with medin increased the production of matrix metalloproteinase-2, a protease that degrades elastin and collagen and subsequently weakens the vessel wall. We therefore propose that medin oligomers are involved in the degeneration process of sporadic thoracic aortic aneurysm and dissection. PMID:17906662