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1

Ascending aortic dissection without intimal tear: a case report.  

PubMed

Aortic dissection may occur without the presence of intimal tear, and it may occur with medial dissection and intramural hematoma. We report a case in which mediastinal enlargement was found in the chest x-ray of a 79-year-old patient with chest and back pain that had started suddenly 1 week before. The patient had a decrease in hematocrit, and transthoracic echocardiography revealed around the heart pericardial fluid 5 cm thick. The ascending aorta could not be evaluated because of the presence of this fluid. The preoperative diagnosis, based on the computerized tomography findings (dissection of ascending aorta and pericardial fluid), was ruptured dissection of the ascending aorta. The patient underwent an emergency operation. Two liters of hemorrhagic fluid was aspirated from the pericardium during the operation. The ascending aorta was opened, but there was no intimal tear. Medial dissection and intramural hemorrhage were seen. The ascending aorta was replaced with a tube graft. Cases such as this, of medial dissection and intramural hematoma in which intimal integrity is preserved, should be approached in the same manner as classical dissections with intimal tear. PMID:12538130

Kaplan, Mehmet; Yapici, Fikri; Erkan, Murat; Sargin, Murat; Demirtas, Mahmut Murat

2002-01-01

2

Bilateral chylothorax following neck dissection: a case report  

PubMed Central

Background Chylothorax is an extremely rare but potentially life-threatening complication after radical neck dissection. We report the case of a bilateral chylothorax after total thyroidectomy and cervico-central and cervico-lateral lymphadenectomy for thyroid carcinoma. Case presentation A 40-year-old European woman underwent total thyroidectomy and neck dissection for papillary thyroid carcinoma. Postoperatively she developed dyspnoea and pleural effusion. A chylothorax was found and the initial conservative therapy was not successful. She had to be operated on again and the thoracic duct was legated. Conclusion The case presentation reports a very rare complication after total thyroidectomy and neck dissection, but it has to be kept in mind to prevent dangerous complications. PMID:24885488

2014-01-01

3

Aortoesophageal fistula secondary to aortic dissection: case report and review.  

PubMed

Aortoesophageal fistula (AEF) formation nearly always results in catastrophic consequences. As a result of its development being extremely rare, many may never consider it in their differential. Although prognosis is extremely grim, early diagnosis and intervention is considered the optimal means to enhance one's prognosis. We present a case of AEF formation secondary to a Stanford B aortic dissection, along with a review of literature and terminology involved in describing such pathology. PMID:21560995

Miller, Tara Nikole; Miller, Ross Allen; Ziebarth, Joel

2011-04-01

4

Conservative treatment of iatrogenic left main coronary artery dissection: report of two cases  

PubMed Central

Revascularization treatment is mostly recommended for iatrogenic left main coronary artery dissection because of potential for catastrophic sequel, even in case of initial TIMI 3 flow and hemodynamic stability. However, conservative treatment seems to be feasible in asymptomatic and hemodinamically stable patient with low-grade dissection. We report two cases of iatrogenic left main coronary dissection managed conservatively. PMID:24400208

Yuksel, Uygar Cagdas; Yalcinkaya, Emre; Gokoglan, Yalcin; Iyisoy, Atila

2013-01-01

5

Clinical presentation and surgical management of dissecting posterior inferior cerebellar artery aneurysms: 2 case reports  

Microsoft Academic Search

Intracranial dissection presenting with subarachnoid hemorrhage (SAH) most commonly involves the vertebral artery. The natural history of this lesion suggests frequent early rehemorrhage and need for urgent treatment. Isolated dissection of the posterior inferior cerebellar artery (PICA) is very rare.We present 2 cases of isolated PICA dissections presenting with SAH. Both patients were middle-aged men who presented with transient loss

Nicholas M. Wetjen; Michael J. Link; Ronald Reimer; Douglas A. Nichols; Caterina Giannini

2005-01-01

6

Successful angioplasty of three cases of coronary artery dissections using hydrophilic wires  

PubMed Central

Three cases of successful angioplasty of high-grade coronary dissections using hydrophilic wires were reported. Our first case had edge dissection after a stent deployed in the left anterior descending artery, after which we found it impossible to track the second stent over the regular wires, and which was successful when we tried with a stiffer hydrophilic wire. The second had spontaneous coronary artery dissections (SCAD), and the third case was a complicated plaque with multiple stenotic and ectatic segments along with dissection and successful angioplasty carried out using the same wires and without additional hardware. These wires also provided adequate support in tracking the required balloons and stents PMID:25489325

Menon, Rajeev; Kapadia, Anuj

2014-01-01

7

Spontaneous coronary artery dissection: a case series and literature review  

PubMed Central

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

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

2014-01-01

8

Significance of prophylactic paratracheal lymphnode dissection in a case of retrosternal goitre: a case report.  

PubMed

An elective or a prophylactic lymph node dissection is the removal of the lymph nodes that are normal on physical examination and on radiographic imaging. This type of dissection is not based on the visible disease in the targeted nodal basins, but on the potential of a radiographically occult tumour which can exist. The pathologic results of an elective lymph node dissection may help in predicting the risk of a future recurrence and, in some solid tumours, guide the delivery of the adjuvant therapy and as in this case, may contribute to a pathological diagnosis. The decision to proceed with an elective node dissection is based on the assessment of the risks and benefits of the procedure. The morbidity of the regional lymph node dissection must be balanced against the potential benefit of the procedure. A thyroid papillary microcarcinoma is defined according to the WHO criteria and Shaha as a thyroid tumour which is smaller than 1-1.5cm. Different terms are currently used to define this thyroid cancer such as small, tiny, minute, minimal or occult papillary carcinomas of the thyroid, impalpable thyroid carcinoma and incidental thyroid papillary cancer. A common clinical scenario is the incidental diagnosis of papillary thyroid microcarcinoma (PTMC) on the histology of the resected thyroid, following the surgery which was done for a presumably benign thyroid disease. PTMC was diagnosed in 7.1% of the patients with a presumably benign thyroid disease. It may be possible that this is an underestimation of the true incidence, because we did not use the serial sectioning technique and maybe because the PTMC which was present was so small that it was grossly not identified and sectioned. Herein, a case which was clinically suspicious and was radiologically and cytologically diagnosed as a case of retrosternal multinodular goitre underwent a near total thyroidectomy and a paratracheal lymphnode dissection. The node was found to have micrometastasis of the follicular variant of a papillary carcinoma and the thyroid, on a retrospective step sectioning, revealed an incidental PTMC. This case has been presented, to highlight the possibility of an incidental PTMC in the thyroid cases which were resected for benign disease and the importance of elective lymphnode dissection in contributing to the diagnosis of PTMC. PMID:23998085

Chandramouleeswari, Kathir; Budhiraja, Shivali; Suryanarayan, Anita; Bose, Jagdeesh Chandra

2013-07-01

9

Endovascular Stent Graft for Treatment of Complicated Spontaneous Dissection of Celiac Artery: Report of Two Cases  

PubMed Central

We report 2 cases of complicated spontaneous dissection of the celiac artery, which were successfully treated by a stent graft. The first patient was a 47-year-old man who presented with acute abdominal pain. CT scan showed ruptured saccular aneurysm with surrounding retroperitoneal hematoma. The second patient was a 57-year-old man with progressive dissecting aneurysm. Endovascular stent graft was placed in the celiac trunk to control bleeding, and to prevent rupture in each patient. Follow-up CT scans showed complete obliteration of a dissecting aneurysm. PMID:23690714

Kang, Ung Rae; Lee, Young-Hwan

2013-01-01

10

A case of painless acute Type-A thoracic aortic dissection.  

PubMed

We describe the case of an 83-year-old lady with a known aneurysmal thoracic aorta, developing acute breathlessness and hypoxia, with no pain and unremarkable cardiovascular examination. As d-dimers were raised, she was treated with low-molecular-weight heparin (LMWH) for suspected pulmonary embolism. CT pulmonary angiography showed acutely dissecting, Type-A, thoracic aortic aneurysm. The patient was treated medically with ?-blockers. Despite a poor prognosis, she remains well 2 months later. Observational studies of patients over 70 with Type-A dissection show only 75.3% experience pain, are offered surgery less and have higher mortality. d-Dimers are almost always elevated in aortic dissection. No previous studies document breathlessness as the only presenting symptom. This case emphasises the need, in older populations, for a low suspicion threshold for aortic dissection. PMID:25117175

Catlow, Jamie; Cross, Tarquin

2015-01-01

11

Aortic Dissection and Postpartum Cardiomyopathy in a Postpartum Young Woman: A Case Report Study  

PubMed Central

Introduction: Aortic dissection is a rare condition in young women and usually related with congenital anomalies of aorta and connective tissue disorders. We reported a 34-year-old postpartum woman with aortic dissection. Case Presentation: The patient complained of respiratory distress and weakness with no abdominal pain or chest pain 20 days after delivery and had no history of hypertension during pregnancy and perinatal or prior heart disease. Postpartum cardiomyopathy and left ventricular dysfunction were diagnosed by imaging study and cardiac enzyme level. Finally, CT-scan was performed and showed aortic dissection. The patient underwent surgery and after surgery, she was alive without any problem. Conclusions: Patients with peripartum cardiomyopathy and aortic dissection could be cured with good medical care. PMID:24910806

Jalalian, Rozita; Saravi, Mehrdad; Banasaz, Bahar

2014-01-01

12

Stanford type A aortic dissection after urgent prosthetic valve replacement: case reports  

PubMed Central

Occurrence of acute aortic dissection after aortic valve replacement is rare, however, it is associated with high mortality and morbidity rates. We report two Asian cases in which acute aortic dissection occurred after urgent aortic valve replacement for infective endocarditis. Successful graft replacement was carried out with preservation of the prosthetic valves in both cases. Our experience with these cases suggests that, even in urgent or emergent situations, surgical intervention for associated aortic dilatation should be considered when aortic valve replacement is performed. PMID:24397918

2014-01-01

13

Bilateral chylothorax following left supraclavicular lymph node dissection for breast cancer: one case report and literature review.  

PubMed

Chylothorax is a rare complication of neck dissection, and bilateral chylothorax is even rarer. However, both are potentially serious and sometimes life-threatening, especially those that are associated with left neck dissection for head and neck neoplasms. We report one case of bilateral chylothorax following left supraclavicular dissection for breast cancer. This case was treated successfully with a new conservative management approach. PMID:24417875

Yang, De-Juan; Ren, Guo-Sheng; Wang, Xiao-Yi

2014-06-01

14

Carotid artery dissection: three cases and a review of the literature.  

PubMed

Carotid artery dissections are potentially disabling, probably underdiagnosed, and mainly affect young-aged and middle-aged people. We present three consecutive cases illustrating different clinical presentations and thereby emphasizing the diagnostic challenge of carotid artery dissections for the emergency physician. Neck and facial pain, headache, unilateral pulsatile tinnitus, partial Horner's syndrome (or oculosympathetic palsy), amaurosis fugax, retinal infarction, and anterior circulation brain ischemia may all occur in isolation or in various combinations. Medical imaging plays a pivotal role in making the right diagnosis. Clinical vigilance is of utmost importance as early diagnosis and timely treatment favor long-term prognosis and even prevent ischemic complications. We review the literature and discuss the pathophysiology, etiology, clinical presentation, diagnosis, imaging techniques, treatment, and prognosis of carotid dissections. PMID:21817907

Schelfaut, Dan; Dhondt, Erwin; De Raedt, Sylvie; Nieboer, Koenraad; Hubloue, Ives

2012-06-01

15

Esthetic neck dissection using an endoscope via retroauricular incision: a report of two cases  

PubMed Central

Various surgical techniques, such as endoscopic surgery and robotic surgery, are developed to optimize the esthetic outcome even in operations for malignancy. A modified face-lift or retroauricular approach are used to minimize postoperative scarring. Recently, robot-assisted surgery is being done in various fields and considered as favorable treatment method by many surgeons. However its high cost is a nonnegligible fraction for many patients. On the other hand, endoscopic surgery, which is cheaper than robotic surgery, is minimally invasive with contentable neck dissection. Although it is a difficult technique for a beginner surgeon due to its limited operation view, we suppose it as an alternative method for robotic surgery. Herein, we report two cases of endoscopic neck dissection via retroauricular incision with a discussion regarding the pros and cons of endoscopic neck dissection. PMID:24627840

Kim, Jae-Young; Cho, Hoon; Cha, In-Ho

2014-01-01

16

Guide Catheter-Induced Aortic Dissection Complicated by Pericardial Effusion with Pulsus Paradoxus: A Case Report of Successful Medical Management  

PubMed Central

Aortic dissection is a rare but potentially fatal complication of percutaneous coronary intervention (PCI). Management strategies of PCI induced dissection are not clearly identified in literature; such occurrences often mandate surgical repair of the aortic root with reimplantation of the coronary arteries. Another trend seen in case reports is the use of coronary-aortic stenting if such lesions permit. Several factors impact the management decision including the hemodynamic stability of the patient; mechanism of aortic injury; size, severity, and direction of propagation of the dissection; presence of an intimal flap; and preexisting atherosclerotic disease. We describe a case of a 65-year-old woman who underwent PCI for a chronic right coronary artery (RCA) occlusion, which was complicated by aortic dissection and pericardial effusion. Our case report suggests that nonsurgical management may also be appropriate for PCI induced dissections, and potentially even those associated with new pericardial effusion.

Avadhani, Sriya A.; Marmur, Jonathan D.

2015-01-01

17

Guide catheter-induced aortic dissection complicated by pericardial effusion with pulsus paradoxus: a case report of successful medical management.  

PubMed

Aortic dissection is a rare but potentially fatal complication of percutaneous coronary intervention (PCI). Management strategies of PCI induced dissection are not clearly identified in literature; such occurrences often mandate surgical repair of the aortic root with reimplantation of the coronary arteries. Another trend seen in case reports is the use of coronary-aortic stenting if such lesions permit. Several factors impact the management decision including the hemodynamic stability of the patient; mechanism of aortic injury; size, severity, and direction of propagation of the dissection; presence of an intimal flap; and preexisting atherosclerotic disease. We describe a case of a 65-year-old woman who underwent PCI for a chronic right coronary artery (RCA) occlusion, which was complicated by aortic dissection and pericardial effusion. Our case report suggests that nonsurgical management may also be appropriate for PCI induced dissections, and potentially even those associated with new pericardial effusion. PMID:25685153

Fiddler, Magdalene; Avadhani, Sriya A; Marmur, Jonathan D

2015-01-01

18

Pathology Case Study: Aortic Dissection and Neck Pain  

NSDL National Science Digital Library

The Department of Pathology at the University of Pittsburgh Medical Center has compiled a wide range of pathology case studies to aid students and instructors in the medical/health science field. This case documents the neck and back pain of a 71-year-old female patient. The patient's history is provided, and includes documentation of her condition throughout the duration of her treatment. The pathologic findings include images and descriptions of the gross and microscopic evaluation. In the "Final Diagnosis" section the official conclusion of the doctor is accompanied by a discussion of the diagnosis and references. Students will find this resource especially helpful, as it provides experience with patient history, lab results, and diagnostics.

Klatt, Edward C., 1951-; Monnin, Kimberly

2007-09-21

19

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

PubMed Central

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

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

2014-01-01

20

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

PubMed

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

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

2015-01-01

21

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

PubMed Central

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.

Takahashi, Chiaki; Sasaki, Takashi

2015-01-01

22

Prediction and Treatment of Difficult Cases in Colorectal Endoscopic Submucosal Dissection  

PubMed Central

Purpose. The aim of this study was to examine the characteristics of difficult cases and the learning curve in colorectal endoscopic submucosal dissection (ESD). Methods. We studied 518 colorectal tumors treated by ESD. Patients were divided into 2 groups such as the difficult ESD group and non-difficult ESD group in view of procedure time and procedure speed, respectively. The clinical features in each group were analyzed, and we also examined cases with severe fibrosis. Furthermore, we divided all cases into 5 periods according to experience of ESDs and investigated the rates of difficult and perforation cases. Results. In view of both procedure time and procedure speed, there were significant differences about mean tumor size, rates of severe fibrosis and perforation, and en bloc resection rate between the two groups. Severe fibrosis was detected in protruding tumors >40?mm in diameter. With respect to the learning curve, the rate of difficult and perforation cases decreased significantly in the late periods compared to the first period. Conclusions. Large tumor size, high rates of severe fibrosis and perforation, and low rate of en bloc resection are related with difficult ESD cases. The increasing of experiences can decrease the rate of difficult cases and perforation. PMID:23935609

Inada, Yutaka; Kamada, Kazuhiro; Katada, Kazuhiro; Uchiyama, Kazuhiko; Takagi, Tomohisa; Yagi, Nobuaki; Naito, Yuji; Wakabayashi, Naoki; Yanagisawa, Akio; Itoh, Yoshito

2013-01-01

23

Two Cases of Subarachnoid Hemorrhage from Spontaneous Anterior Cerebral Artery Dissection : A Case of Simultaneous Hemorrhage and Ischemia Without Aneurysmal Formation and Another Case of Hemorrhage with Aneurysmal Formation  

PubMed Central

Spontaneous anterior cerebral artery (ACA) dissection, although extremely rare, is often associated with severe morbidity and mortality. It could lead to cerebral hemorrhage, ischemic stroke, or, rarely, combination of hemorrhage and ischemia due to hemodynamic changes. Prompt and accurate diagnosis is essential for determining the appropriate management. However, the optimal treatment for ACA dissection remains controversial. Herein, we report on two rare cases of subarachnoid hemorrhage (SAH) caused by ACA dissection; a case presenting with simultaneous SAH and infarction without aneurysmal formation and another case presenting with SAH with fusiform aneurysmal formation. A review of the related literature is provided, and optimal treatments for each type of dissection are suggested. PMID:25045652

Im, Tae-Seop; Suh, Sang-Jun; Lee, Jeong-Ho; Ryu, Kee-Young; Kang, Dong-Gee

2014-01-01

24

Aortic Dissection Occurring 18 Months after Successful Endovascular Repair in an Anatomically Difficult Case of Abdominal Aortic Aneurysm  

PubMed Central

We report an autopsy case of aneurysm dissection that occurred 18 months after the implantation of a Zenith stent graft. A 94-year-old woman, who had undergone an endovascular repair with postoperative reintervention, died of shock due to retroperitoneal hematoma. An autopsy indicated that the stent graft remained firmly fixed to the native aorta, whereas the dissection occurred near the proximal edge of the stent graft but not at the point of attachment between the suprarenal stent hook and the aorta. The luminal surface of the stent graft was almost completely covered with a transparent film with an endothelial cell lining, which might reflect the tissue regeneration observed on histological examination. This was a rare case of acute aortic dissection that occurred 18 months after EVAR, in which the autopsy indicated interesting microscopic findings and the mechanisms underlying the aortic dissection. We believe that aggressive reintervention at the proximal site in elderly women might cause the dissection of the native aorta. PMID:24303225

Takazawa, Yutaka; Okamoto, Hiroyuki; Shigematsu, Kunihiro; Miyata, Tetsuro; Watanabe, Toshiaki

2013-01-01

25

Cocaine-induced postpartum coronary artery dissection: a case report and 80-year review of literature.  

PubMed

The incidence of cocaine-induced myocardial infarction (MI) in pregnancy is unknown. During the peripartum period, cocaine-abusing women are highly susceptible to MI caused by the effect of cocaine on a heart that is already stressed by hemodynamic changes of pregnancy. MI is an infrequent event during pregnancy and the peripartum period, with an estimated rate of 1 in 16,000 patients. Spontaneous coronary artery dissection (SCAD) can account for up to 27% of pregnancy-related MIs. We describe a case of MI diagnosed by increased troponin I levels in a postpartum patient with recent crack cocaine use in the setting of SCAD that required percutaneous coronary intervention of the left anterior descending and diagonal arteries. We also provide a comprehensive review of published literature related to this clinical entity. PMID:23913612

Katikaneni, Pavan K; Akkus, Nuri I; Tandon, Neeraj; Modi, Kalgi

2013-08-01

26

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

PubMed

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

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

2013-11-01

27

Endovascular repair of a type B aortic dissection with a right-sided aortic arch: case report  

PubMed Central

Right-sided aortic arch is a rare anomaly, and aortic dissection involving a right-sided aortic arch is extremely rare. We report the case of a 65-year-old man with a right-sided aortic arch and a right descending aortic dissection and a stent-graft was accurately deployed without perioperative complications. There were no any complaints and complications after 18 months follow-up. The CTA demonstrated that the false lumen was largely thrombosed only with a mild type II endoleak and a mild descending aortic expansion. We feel that endovascular repair is feasible to patient of type B aortic dissection with a right-sided aortic arch. However, long-term clinical efficacy and safety have yet to be confirmed. PMID:23343010

2013-01-01

28

Management of fulminant dissecting cellulitis of the scalp in the pediatric population: Case report and literature review  

PubMed Central

A case of fulminant dissecting cellulitis of the scalp in a fifteen-year-old African American male is reported. The presentation was refractory to standard medical treatment such that treatment required radical subgaleal excision of the entire hair-bearing scalp. Reconstruction was in the form of split-thickness skin grafting at the level of the pericranium following several days of vacuum-assisted closure dressing to promote an acceptable wound bed for skin grafting and to ensure appropriate clearance of infection. Numerous nonsurgical modalities have been described for the treatment of dissecting cellulitis of the scalp, with surgical intervention reserved for patients refractory to medical treatment. The present paper reports a fulminant form of the disease in an atypical age of presentation, adolescence. The pathophysiology, etiology, natural history, complications and treatment options for dissecting cellulitis of the scalp are reviewed, and the authors suggest this method of treatment to be efficacious for severe presentations refractory to medical therapy. PMID:19554179

Arneja, Jugpal S; Vashi, Christopher N; Gursel, Eti; Lelli, Joseph L

2007-01-01

29

Use of real-time three-dimensional transesophageal echocardiography in type A aortic dissections: Advantages of 3D TEE illustrated in three cases.  

PubMed

Stanford type A aortic dissections often present to the hospital requiring emergent surgical intervention. Initial diagnosis is usually made by computed tomography; however transesophageal echocardiography (TEE) can further characterize aortic dissections with specific advantages: It may be performed on an unstable patient, it can be used intra-operatively, and it has the ability to provide continuous real-time information. Three-dimensional (3D) TEE has become more accessible over recent years allowing it to serve as an additional tool in the operating room. We present a case series of three patients presenting with type A aortic dissections and the advantages of intra-operative 3D TEE to diagnose the extent of dissection in each case. Prior case reports have demonstrated the use of 3D TEE in type A aortic dissections to characterize the extent of dissection and involvement of neighboring structures. In our three cases described, 3D TEE provided additional understanding of spatial relationships between the dissection flap and neighboring structures such as the aortic valve and coronary orifices that were not fully appreciated with two-dimensional TEE, which affected surgical decisions in the operating room. This case series demonstrates the utility and benefit of real-time 3D TEE during intra-operative management of a type A aortic dissection. PMID:25566716

Wang, Cindy J; Rodriguez Diaz, Cesar A; Trinh, Muoi A

2015-01-01

30

Vertebral artery dissection due to an esophageal foreign body migration: a case report  

PubMed Central

Unintentional foreign bodies‘ swallowing is a fairly common occurrence in ENT consultation especially among children. They usually pass through the gastrointestinal tract without complications. Migration of a foreign body through the esophageal wall is rare. It represents about 1% to 4% of all cases of foreign bodies‘ ingestion. A 16 year's old female patient has presented to ENT emergency with a painful dysphagia following an accidental ingestion of a metallic pin. Cervical X ray confirmed the presence of the pin while endoscopic investigations have shown no foreign body. Cervical CT scan revealed the migration of the foreign body through the esophageal wall with left vertebral artery dissection. Endoscopic management has been sufficient with an uneventful post operative follow up. Esophageal foreign bodies are very diverse mainly dominated by fish bones (60%) and chicken bones (16%). Metallic pins are rare. The major risks of migration of those foreign bodies are cervical abscess, mediastinitis and oeso-vascular fistulae. Cases of self extrusion through the skin have been reported. Migration of a foreign body through the esophageal wall is rare. Endoscopic management has been sufficient. PMID:25018833

Benmansour, Najib; Ouattassi, Naouar; Benmlih, Amine; Elalami, Mohamed Noureddine

2014-01-01

31

Spontaneous Coronary Artery Dissection in a Young Man with a Factor V Leiden Gene Mutation: A Case Report and Review of the Literature  

PubMed Central

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

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

2013-01-01

32

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

PubMed

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

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

2013-12-01

33

Brainstem ischemic stroke without permanent sequelae during the course of spontaneous internal carotid artery dissectioncase report  

PubMed Central

Summary Background: Internal carotid artery dissection (ICAD) is a frequent cause of a stroke in young patients. Risk factors which can lead to dissection include neck injury and diseases of the inner wall of the artery. Common symptoms in ICAD are cervical pain and headache, Horner’s syndrome, paralysis of the cranial nerves and subsequently cerebral and retinal ischemia. MR angiography in TOF technique and brain MRI in T1- and T2-weighted images, FLAIR and DWI sequences are the method of choice in patients with ICAD but contrast-enhanced multislice computed tomography remains the fastest and the most available diagnostic method. Case Report: A 39-year old woman, previously healthy, presented to the Hospital Emergency Department because of increasing neck pain on the right side and difficulty in swallowing. The neurological examination revealed: drooping of the right eyelid with narrow palpebral fissure, dysarthria, anisocoria (narrower pupil on the right side), unilateral hypoesthesia on the left side, weak palatal and pharyngeal reflexes on both sides, paresthesia within the left half of the body. Seven days before, the patient felt a sudden, severe neck pain radiating to the temporal apophysis. CT angiography revealed a defect in contrast filling within the left internal carotid artery and right vertebral artery. MRI of the head with MR angiography showed internal carotid artery dissection on the left side and dissection of the right vertebral artery and no ischemic changes within the brain. Conclusions: CT and MR angiography are methods characterized by high sensitivity in detecting dissection of the cervical arteries. PMID:22802868

Nesteruk, Tomasz; Nesteruk, Marta; Bulik-Pasi?ska, Marta; Boroszko, Dariusz; Ostrowska, Monika

2012-01-01

34

Postcoital Internal Carotid Artery Dissection Presenting as Isolated Painful Horner Syndrome: A Case Report  

PubMed Central

Postcoital artery dissection is a rare condition. Here we report a 40-year-old male patient with painful Horner syndrome related to postcoital internal carotid artery (ICA) dissection. In neurologic examination of the patient, semiptosis, enophthalmus, and myosis were observed on the left side. There were no carotid bruits. On T1-weighted and fat-suppressed cranial MRI, hyperintensity consistent with intramural hematoma was observed within cervical and temporal petrous segments of left ICA. On cervical and cranial MRA, marked decrease in the calibration of C1 and C2 segments of the left ICA was remarkable. The patient was diagnosed as left ICA dissection and anticoagulant therapy was initiated. A prominent improvement was noted in clinical findings during two months of followup period. PMID:23533855

Tastekin Toz, Hilal; Kahraman Koytak, P?nar; Alparslan, Funda

2013-01-01

35

Preservation of the external jugular vein in bilateral radical neck dissections: technique in two cases and review of the literature.  

PubMed

Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures. Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients' outcomes are discussed. Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency. PMID:25632277

da Rocha, Rodrigo Lima Bastos; Del Negro, André; Tincani, Alfio José; Del Negro, Maíra Soliani; Martins, Antonio Santos

2015-01-01

36

Preservation of the External Jugular Vein in Bilateral Radical Neck Dissections: Technique in Two Cases and Review of the Literature  

PubMed Central

Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures. Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients' outcomes are discussed. Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency.

da Rocha, Rodrigo Lima Bastos; Del Negro, André; Tincani, Alfio José; Del Negro, Maíra Soliani; Martins, Antonio Santos

2015-01-01

37

Immediate surgery for acute internal carotid artery dissection and thrombosis during filter deployment prior to stenting: a case report.  

PubMed

Carotid artery stenting (CAS) is a validated option in the treatment of selected extracranial carotid artery stenosis. Carotid artery dissection during CAS is a rare but potentially devastating complication. We report a case of acute dissection and thrombosis of the left internal carotid artery during filter tip wire engaging maneuvers, complicated by intraoperative complete blindness of the left eye. Immediate conversion to carotid endarterectomy was performed under general anesthesia with electroencephalographic monitoring. The patient was discharged home symptomless and remains asymptomatic eight months after the operation, with normal left internal carotid patency and fully recovered eyesight. In conclusion, the management of acute carotid occlusion during CAS requires emergent evaluation and definitive endovascular or open surgical repair to minimize neurologic morbidity. We advocate that all endovascular procedures are carried out in a well-established surgical environment. PMID:23579380

Tolva, V; Bertoni, G B; Bianchi, P G; Keller, G C; Casana, R

2013-04-11

38

A case report of aneuysmectomy after thrombo-intimectomy for spontaneous isolated superior mesenteric artery dissection.  

PubMed

A 53 year-old man was admitted with acute onset of severe abdominal pain, and we performed emergent thrombectomy and intimectomy for acute, complete occlusion of superior mesenteric artery (SMA) due to its spontaneous dissection. However, 4 months later the operated part of the SMA enlarged due to aneurysm and the patient was treated by aneuysmectomy and iliac-mesenteric bypass using a saphenous vein. Aggressive treatment such as surgical or endovascular procedure is necessary for severe ischemia due to SMA dissection. PMID:23555512

Satokawa, Hirono; Seto, Yuki; Yamamoto, Akihiro; Yokoyama, Hitoshi; Kogure, Michihiko; Satoshi, Ohtani; Gotoh, Mitsukazu

2012-01-01

39

Clam Dissection  

NSDL National Science Digital Library

This online slide presentation features an image rich overview of clam dissections. The 31 slides include images portraying step of a dissection as well as information about each structure and its function. This presentation may serve as an introduction to the laboratory procedure, student review, or virtual dissection.

Kelly Riedell

40

Spontaneous coronary artery dissection.  

PubMed

Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution, and optimal treatment have not yet been firmly established. This article describes five new cases with additional specific characteristics. Five of 2,241 coronary arteriograms taken between September 1989 and November 1992 showed angiographic signs of coronary dissection. Three of the patients were treated pharmacologically, and two were operated on. All were evaluated angiographically 10-18 months after diagnosis and followed up clinically for > or = 20 months. Three patients exhibited acute myocardial infarction, one showed effort angina and the fifth unstable angina. In four cases, coronary dissection was associated with coronary atherosclerosis, but in the fifth the coronary tree was apparently healthy except for the dissection. Dissection affected the right coronary artery in three cases and the left in two. Angiographic evolution varied among the five and was uncorrelated with treatment. Dissection disappeared in three; it persisted, with total obstruction of the artery in the middle of the dissected segment in one case; and advanced to affect the whole left coronary tree in the fifth. After an 18-month follow-up, none of the five patients experienced symptoms. These cases provide a good illustration of the variability of spontaneous coronary dissection as regards etiology, clinical presentation, treatment, and evolution. Coronary dissection is always caused by hemorrhage in the media of the arterial wall; its variability in evolution and in optimal treatment may be derived from the cause of the hemorrage, which possibly was not the same in all cases. PMID:8039214

Pasalodos Pita, J; Vazquez Gonzalez, N; Perez Alvarez, L; Vazquez Rodriguez, J M; Castro Beiras, A

1994-05-01

41

Geometric and flow features of type B aortic dissection: initial findings and comparison of medically treated and stented cases.  

PubMed

Uncomplicated acute type B aortic dissections are usually treated medically, but they can become acutely complicated by rapid expansion, rupture and malperfusion syndromes and in the longer term by chronic dilatation and aortic aneurysm formation. The objective of this study is to use computational fluid dynamics reconstructions of type B aortic dissections to compare geometric and haemodynamic factors between the cases selected for medical treatment and the cases selected for thoracic endovascular aortic repair (TEVAR), and to examine whether any of these factors are associated with the outcome of the medically treated group. This study includes eight type B dissection cases, with four in each group. Aortic flow analyses were carried out based on patient-specific anatomy at initial presentation before treatment. Comparisons between the two groups show that the false lumen to true lumen volume ratio is considerably higher in patients selected for TEVAR. Results from the four medically treated cases indicate that the size of the primary entry tear is the key determinant of the false lumen flow rate, which may influence the long-term outcome of medically treated patients. Potential relations between flow related parameters based on initial anatomy and subsequent anatomical changes in the medically treatment group were examined. Our initial findings based on the limited cases are that high relative residence time is a strong predictor of subsequent false lumen thrombosis, whereas pressure difference between the true and false lumen as well as the location of the largest pressure difference may be associated with the likelihood of subsequent aortic expansion. PMID:25092420

Cheng, Zhuo; Wood, Nigel B; Gibbs, Richard G J; Xu, Xiao Y

2015-01-01

42

Acute tongue swelling, the only initial manifestation of carotid artery dissection: a case report with differentiation of clinical picture.  

PubMed

While it is well known that carotid artery dissection can cause hypoglossal palsy, which can cause muscle atrophy and fat tissue replacement in the chronic stage but what is less well known is the acute edematous stage, which can mimic tongue angioedema. We present a case report of a 52-year-old man presented to accident and emergency department with 3 hr history of right-side tongue swelling. He was initially diagnosed with angioedema and treated with corticosteroids and antihistamines. His tongue swelling persisted and subsequently developed unilateral weakness. Magnetic resonance imaging scan of the tongue, head, and neck revealed denervation of the right half of the tongue because of injury to hypoglossal nerve during extracranial internal carotid artery (ICA) dissection. There was no evidence of ischemic complication of right cerebral artery distribution. He was commenced on antiplatelet therapy to prevent cerebral ischemia as a prophylactic measure. Swelling and weakness of the tongue subsided in the following months. We believe that hypoglossal palsy caused by ICA dissection should be considered in the differential diagnosis of patients who present with acute tongue swelling. PMID:25463346

Ryan, Patrick; Rehman, Sooda; Prince, Sharon

2015-02-01

43

Extrathyroid carcinoma showing thymus-like differentiation (CASTLE): a new case report and review of the therapeutic role of neck dissection and radiotherapy  

PubMed Central

We present here a case of extrathyroid CASTLE (the third case reported in the English literature) treated with excision and neck dissection without radiotherapy. Also, we reviewed the literature and analyzed the therapeutic results of each treatment modality for CASTLE. A 27-year-old male had initially presented with a painless, right neck mass for 2 months. Computed tomography of the neck showed a 3.8?×?3.2?×?3.8 cm heterogeneously enhancing mass at right level IIa, and no definite thyroid lesion was found. An excisional biopsy was done and the pathologic diagnosis was CASTLE. Then we performed a right modified radical neck dissection and right thyroid lobectomy. After three years, no evidence of tumor recurrence was noted. Total excision followed by neck dissection could be a sufficient surgical treatment option for CASTLE. Postoperative radiotherapy might be an alternative treatment option for neck dissection in patients with positive nodal status. PMID:25086818

2014-01-01

44

Carotid Artery Dissection and Stroke Complicating Treatment of Post-mandibular distraction Ankylosis: A Case Report.  

PubMed

Mandibular distraction osteogenesis is an increasingly accepted treatment option for severe upper airway obstruction in grade 3 Robin sequence. Complications are rarely reported but can include fracture, pin dislodgement, tooth bud damage, and temporomandibular joint ankylosis. Operative correction of these complications can carry inherent risks of their own. We present a patient who incurred carotid artery dissection and stroke after release of postdistraction coronoid-zygomatic ankylosis for the treatment of mandibular micrognathia. PMID:25489770

Arnspiger, Sarah A; Felder, John M; Wood, Benjamin C; Rogers, Gary F; Oh, Albert K

2014-12-01

45

Third nerve palsy following carotid artery dissection and posterior cerebral artery thrombectomy: Case report and review of the literature  

PubMed Central

Background: Common causes of oculomotor nerve palsy are diabetes, aneurysmal compression, and uncal herniation. A lesser-known cause of third nerve dysfunction is ischemia, often due to carotid artery dissection. Case Description: An 80-year-old man presented with an acute ischemic stroke with a National Institutes of Health Stroke Scale score of >20 from a high cervical internal carotid artery (ICA) dissection and a tandem ICA terminus embolic occlusion with extension of clot into the adjacent fetal posterior cerebral artery (PCA). We used a stentriever to perform selective PCA thrombectomy, with immediate postthrombectomy development of ipsilateral anisocoria. The anisocoria progressed into complete oculomotor nerve palsy over 8 h after the procedure. Conclusions: The clinical course described in this case is consistent with injury to the third nerve due to mechanical injury or occlusion of perforator supply to the nerve during thrombectomy. Oculomotor nerve palsy is a rare but known complication after ischemia; however, to our knowledge, this is the first case after thrombectomy for a PCA embolus. PMID:25525555

Kogan, Michael; Natarajan, Sabareesh K.; Kim, Nina; Sawyer, Robert N.; Snyder, Kenneth V.; Siddiqui, Adnan H.

2014-01-01

46

[A case with Stanford type A acute aortic dissection that presented with consciousness disturbance and hemiparesis].  

PubMed

The patient was a 63-year-old female who had a past history of hypertension. She suddenly complained of agonizing pain and became comatose soon thereafter. Upon admission, she was in a state of shock, with upper airway obstruction and a coma. The pupils were dilated on both sides. The laboratory data showed that D-dimer was >80µg/mL. Brain CT scan and diffusion weighted MRI of the brain showed no abnormality. On brain 2D-CT angiography, the visualization of the right internal carotid artery and the right vertebral artery was poor. She eventually was able to nod her head in response to verbal commands, but her left extremities were completely hemiplegic. Cerebral angiography showed occlusion of the right vertebral artery at the branching point from the brachiocephalic artery, and was visualized in a retrograde fashion through the left vertebral artery. The brachiocephalic artery was severely stenotic in aortography. During angiography, she became able to speak and complained of back pain. Chest CT just after angiography showed a dissection in the aortic arch. Therefore, she was directed to the cardiovascular surgeon for immediate consultation. During the operation, the aortic dissection was revealed to be Stanford type A. Laceration of the intima was found in the ascending aorta and cardiac tamponade was also found. Total arch replacement was performed. The pathological examination showed that the arterial dissection occurred in the layer of elastic fiber, and the minimum arterial thickness of the medial layer was 0.2mm. The patient improved after the operation and her neurological deficits disappeared completely 13 days after operation. Brain and spinal MRI 15 days after the operation showed no abnormality. PMID:23378388

Oyama, Hirofumi; Yokoyama, Yukifusa; Noda, Tomoyuki; Tamaki, Shuji; Kito, Akira; Okawa, Hideyuki; Maki, Hideki; Yokote, Jun; Kozakai, Motoshi; Wada, Kentaro; Yuhara, Satoshi

2013-02-01

47

Vertebral artery dissection associated with generalized convulsive seizures: a case report.  

PubMed

A 46-year-old male with juvenile myoclonic epilepsy was admitted to the neurological department for convulsive seizures just after lamotrigine was discontinued. On admission he was awake but had a right-sided hemiparesis with Babinski sign and ataxic finger-nose test on the left side. An MR scan showed a left-sided pontine infarction, an infarct in the left cerebellar hemisphere and a right vertebral artery dissection (VAD). The patient was treated with heparin and an oral anticoagulant for 6 months. Recovery of neurologic function was excellent. In patients with symptoms of disturbances of posterior circulation after epileptic seizures, VAD should be considered. PMID:23904852

Amin, Faisal Mohammad; Larsen, Vibeke Andrée; Tfelt-Hansen, Peer

2013-05-01

48

Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature  

Microsoft Academic Search

Single-vessel cervical arterial dissections typically occur in young adults and are a common cause of cerebral ischemia and stroke. Although the pathogenesis of multivessel dissection is unclear, it is thought to be a consequence of underlying collagen vascular disease. We present a 34-year-old previously healthy man who developed bilateral internal carotid and vertebral artery dissection following chiropractic manipulation.

R. N. Nadgir; L. A. Loevner; T. Ahmed; G. Moonis; J. Chalela; K. Slawek; S. Imbesi

2003-01-01

49

Case Report of an Endovascular Repair of a Residual Type A Dissection Using a Not CE Not FDA-Approved Najuta Thoracic Stent Graft System.  

PubMed

This report describes an endovascular repair of a residual type A dissection using a medical device that is not marked by european conformity (CE) or Food and Drug Administration (FDA).The patient underwent ascending aortic surgery for acute type A dissection. The 2-year angio-computed tomography demonstrated patency of the residual false lumen with evolution into a 6?cm aneurysm, the extension of the dissection from the aortic arch to the aortic bifurcation with thrombosis of the right common iliac artery. There was no CE- or FDA-marked medical device indicated for this case or any other acceptable therapeutic alternative.We used the Najuta thoracic stent graft and successfully handled the pathology in a multiple-phase treatment.Technology is evolving with specific grafts for the ascending and fenestrated grafts for the aortic arch. In this single case the Najuta endograft, in spite of the periprocedural problems, was a valid therapeutic option. PMID:25621698

Mangialardi, N; Ronchey, S; Malaj, A; Lachat, M; Serrao, E; Alberti, V; Fazzini, S

2015-01-01

50

Quahog Dissection  

NSDL National Science Digital Library

This Rhode Island Sea Grant informational page presents a descriptive guide to Quahog (a type of hard-shell clam) dissections. The page accompanies students performing a Quahog dissection, using colorful images and highlighted vocabulary terms to illustrate special features. In addition to general anatomy, the reference includes informational sections about feeding & digestion and respiration & circulation. Linked terms direct users to related Sea Grant web pages.

Rhode Island Sea Grant

51

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

SciTech Connect

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.

Born, Christine; Forster, Andreas; Rock, Clemens; Pfeifer, Klaus-Juergen; Rieger, Johannes; Reiser, Maximilian [Ludwig-Maximilians-University Munich, Ziemssenstrasse 1, D-80336 Munich, Institute for Clinical Radiology (Germany)

2003-09-15

52

A Case of Endovascular Treatment for Followed by Side to Side Bypass for Vertebral Artery Dissecting Aneurysms Involved Posterior Inferior Cerebellar Artery  

PubMed Central

Treatment of complex aneurysms usually entails not only direct clipping but also alternative treatment modality. We recently experienced a case of vertebral artery dissecting aneurysm and obtained good treatment outcomes. Our case suggests that the endovascular segmental occlusion with posterior inferior cerebellar artery (PICA) to PICA side anastomosis might be a good treatment option in patients with complex vertebral artery dissecting aneurysms. A 45-year-old woman has a left vertebral dissecting aneurysm with dizziness. Based on the aneurysmal morphology and the involvement of PICA, the patient underwent side to side anastomosis of the PICA. This was followed by the endovascular segmental coil occlusion. The aneurysmal sac was completely obliterated. At a 2-year follow-up, the patient achieved a good patency of both PICA. In conclusion our case suggests that the endovascular segmental occlusion of the parent artery followed by PICA to PICA bypass surgery through a midline suboccipital approach is a reasonable multimodal treatment option in patients with complex vertebral artery dissecting aneurysms. PMID:24570816

Chung, Seung-Young; Park, Moon Sun; Kim, Seong Min

2014-01-01

53

Large Spontaneous Coronary Artery DissectionsA Study of Three Cases, Literature Review, and Possible Therapeutic Strategies  

Microsoft Academic Search

Spontaneous coronary artery dissection is rare, but is now being increasingly recognized as a prominent cause of acute ischemic coronary events occurring usually in relatively young patients, predominantly females. The authors describe the clinical course of 3 patients (1 woman) in whom large spontaneous coronary artery dissections developed. All had diverse clinical presentations; 1 presenting with heart failure, the second

Puneet K. Verma; Manjinder S. Sandhu; Bhagwant R. Mittal; Naveen Aggarwal; Arvind Kumar; Manas Mayank; Anish Bhattacharya; Ram K. Anand; Anil Grover

2004-01-01

54

Conservative treatment of early breast cancer. Long-term results of 1232 cases treated with quadrantectomy, axillary dissection, and radiotherapy.  

PubMed Central

One thousand two hundred and thirty-two women with invasive breast cancer lesions measuring less than 2 cm in diameter, clinically assessed as T1N0-1M0, were treated from 1970 to 1983 at the National Cancer Institute of Milan with quadrantectomy, axillary dissection, and radiotherapy (QUART). Pathologic evidence of lymph-nodes metastases was found in 32% of the patients. Overall survival at 5 and 10 years from surgery was 91% and 78%, respectively. The cumulative probability of survival tends to decrease with increasing tumor size: the 7-year survival rate was 84% in cases in which lesions measured from 1.6 to 2.0 cm, and 94% in cases in which the lesions were less than 0.5 cm. Tumor site in the treated breast did not affect distant outcome. No difference was found between the patients without node metastases and patients with one node involved, whereas the patients with more than one node showed a lower probability of survival. The survival curves of 352 cases treated inside a randomized trial and that of 880 cases routinely treated appear to be superimposable. Local recurrences and new primary ipsilateral tumors were, respectively, 35 (2.8%) and 19 (1.6%); 56 women with local recurrences or second tumors underwent second surgery (total mastectomy, 43; wide resection, 11). Five of them died from distant spread of breast cancer, while 49 are alive and well. In the contralateral breasts 45 carcinomas were recorded during the follow-up time. The results of the present analysis of a large number of T1 cases reconfirm the safety of integrated radiosurgical conservative treatments. PMID:2106841

Veronesi, U; Salvadori, B; Luini, A; Banfi, A; Zucali, R; Del Vecchio, M; Saccozzi, R; Beretta, E; Boracchi, P; Farante, G

1990-01-01

55

Polyomino Dissections  

ERIC Educational Resources Information Center

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…

Hohn, Tiina; Liu, Andy

2012-01-01

56

Dissect It!  

NSDL National Science Digital Library

After dissecting a flower(s), the students will be able to identify the parts necessary for pollination, or reproduction of flowering plants. They will also make comparisons and find patterns in nature, leading them to the understanding of the processes of sexual reproduction in flowering plants, including pollination and fertilization (seed production).

Olga Wood

2012-06-27

57

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

PubMed Central

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

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

2014-01-01

58

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

PubMed Central

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.

Borgman, Christopher J.

2012-01-01

59

Dissecting intramural hematoma of esophagus after thrombolytic therapy: A case report.  

PubMed

Esophageal hematoma is a relatively rare event. We report a case of severe chest pain associated with myocardial infarction and recurrent chest pain after administration of a thrombolytic agent. The chest pain was different from the presenting symptom and accompanied by 2 episodes of hematemesis. Esophageal hematoma was confirmed after endoscopy and computed tomography. Esophageal hematoma is a relatively rare event after thrombolytic therapy. PMID:24585301

Hajsadeghi, Shokufeh; Agah, Shahram; Iranpour, Aida; Chehrehgosha, Haleh; Ghanooni, Amir Hossein; Forghani, Foroogh

2015-02-01

60

Clam Dissection  

NSDL National Science Digital Library

Students observe clams (Mercenaria) in a salt water aquarium, paying attention to siphons and any burrowing. They then remove the clams and describe the external morphology. The clams are then dissected, with special attention made to features (siphons, muscles) that leave observable marks on the shells. They are then provided the shells of a different genus (Mya) and asked to predict the soft tissue morphology and life mode.

Roy Plotnick

61

Extent of neck dissection following transoral robotic surgical resection of oropharyngeal squamous cell carcinoma: A report of a case and potential indications for inclusion of level i in a selective neck dissection.  

PubMed

Background With new minimally invasive surgical techniques playing a role in the management of early oropharyngeal carcinomas, appropriate surgical management of the neck is an increasingly important consideration. Methods We present a case of a 47-year-old patient with a clinical T2N1M0 squamous cell carcinoma of the right tonsil with anterior extension towards the floor of mouth from the right glossotonsillar sulcus. Imaging revealed a solitary necrotic lymph node in IIA. The decision was made to proceed with a transoral robotic pharyngectomy and selective neck dissection (SND) of levels II-IV, followed by adjuvant radiotherapy. Results A post-operative scan revealed progressive regional disease in the anterior aspect of level IB, and, as such, a completion neck dissection of level I was performed. Conclusion Special consideration must be given to level I particularly in patients with glossotonsillar sulcus involvement and anterior extension towards the floor of mouth. This article is protected by copyright. All rights reserved. PMID:25491163

Noel, Christopher W; Foreman, Andrew; Goldstein, David P; deAlmeida, John R

2014-12-01

62

Retroperitoneal approach for dissection of inflamed pelvic viscera in acute pelvic inflammatory disease- case report.  

PubMed

Tubo-ovarian abscesses can rupture spontaneously after a manual examination or an accidental trauma. A critically ill patient with septic peritonitis will only deteriorate if timely surgical removal of pus is not done. The operation of choice is removal of free pus, together with the abscess, the uterus, the tubes and usually, the ovaries. Anatomy is distorted, dependable landmarks are obscured and tissues are thick and oedematous. Loops of densely adhered intestine are difficult to separate. If an intra peritoneal approach is used, it is likely that the fragments of ovary will be left behind. This can subsequently cause signs and symptoms of ovarian remnant syndrome. Injury to the serosa of distended bowel occurs inadvertently, thus increasing the morbidity which results from the procedure. We are hereby presenting a unique case of a ruptured tubo-ovarian abscess where a retroperitoneal approach was used. PMID:24995219

Sharma, Nidhi; Ganesh, Deepa; Srinivasan, Jayashree; S, Jayakumar; Mathew, Renu

2014-05-01

63

Retroperitoneal Approach for Dissection of Inflamed Pelvic Viscera in Acute Pelvic Inflammatory Disease- Case Report  

PubMed Central

Tubo-ovarian abscesses can rupture spontaneously after a manual examination or an accidental trauma. A critically ill patient with septic peritonitis will only deteriorate if timely surgical removal of pus is not done. The operation of choice is removal of free pus, together with the abscess, the uterus, the tubes and usually, the ovaries. Anatomy is distorted, dependable landmarks are obscured and tissues are thick and oedematous. Loops of densely adhered intestine are difficult to separate. If an intra peritoneal approach is used, it is likely that the fragments of ovary will be left behind. This can subsequently cause signs and symptoms of ovarian remnant syndrome. Injury to the serosa of distended bowel occurs inadvertently, thus increasing the morbidity which results from the procedure. We are hereby presenting a unique case of a ruptured tubo-ovarian abscess where a retroperitoneal approach was used. PMID:24995219

Ganesh, Deepa; Srinivasan, Jayashree; S, Jayakumar; Mathew, Renu

2014-01-01

64

Postpartum spontaneous dissection of the first obtuse marginal branch of the left circumflex coronary artery causing acute coronary syndrome: a case report and literature review  

PubMed Central

Introduction Spontaneous coronary artery dissection is a rare but important cause of acute coronary syndrome. It can cause unstable angina, acute myocardial infarction, and sudden death. The condition commonly affects young females with about one-third of the cases occurring during pregnancy and the peripartum period. The diagnosis may occasionally be overlooked as the patients are often young and have no risk factors for coronary artery disease. Case presentation Here we report the case of a 29-year-old African American woman who presented with acute coronary syndrome due to spontaneous dissection of the first obtuse marginal branch of the left circumflex coronary artery at three weeks post-partum and recovered requiring only medical management, possibly by longitudinal distribution of the intramural hematoma leading to good distal flow. Conclusions Spontaneous coronary artery dissection should be suspected in all young multiparous females presenting with chest pain in the peripartum period even in the absence of risk factors. Urgent diagnosis by angiography is required. It is recommended that treatment should be tailored to meet individual circumstances. Patients who present with single-vessel disease and hemodynamic stability, and who receive medical treatment with anticoagulation, nitrates and a beta-blocker, should experience good results. PMID:23510019

2013-01-01

65

Dissecting the star formation history of starburst galaxies: the case of NGC 7673  

NASA Astrophysics Data System (ADS)

We have collected archival data on NGC 7673 to constrain the star formation history that produced the young star clusters and the field stellar population in this galaxy during the last 2 Gyr. We have considered the sample of 50 star clusters detected by Hubble Space Telescope/WFPC2 in the UV,V and I bands and estimated their age, intrinsic reddening and mass via comparison of their colours with STARBURST99 models. We have found two prominent epochs of cluster formation occurred about 20 and 2 Myr ago, with somewhat minor events between 3 and 6 Myr ago. The star clusters are characterized by an intrinsic reddening E(B - V) < 0.4 mag and a mass lower than 2 × 106Msolar. Out of the 50 star clusters, we have selected 31 located within the boundaries of the (IUE) large slit that was employed to obtain the spectrum of NGC 7673 between 1150 and 3350 Å. For each cluster, we have built a synthetic spectrum corresponding to the age, mass and intrinsic reddening derived from the cluster colours, properly redshifted to NGC 7673. The spectra have then been added together in a final, clusters integrated spectrum. This and the IUE, FUSE spectra of NGC 7673 have allowed us to describe the star formation history of the unresolved stars in the field as either exponentially decaying or multiburst. In the first case, we have derived an e-folding time of 700 (900) Myr and an initial star formation rate of 16 (13) Msolaryr-1 when the Fitzpatrick's (Calzetti's) extinction law is used. In the case of a multiburst star formation history, we have assumed that the same bursts which produced the star clusters built up also the field population. In this way, the field population turns out to be composed by a young (<40 Myr) component three (two) times brighter than the star clusters, and a component as old as ~850 (450) Myr, about 200 (100) times more massive than the star clusters together. These star formation histories fit equally well the observed UV spectrum of NGC 7673.

Pasquali, A.; Castangia, P.

2008-03-01

66

Aortic dissection presenting as pleural effusion  

PubMed Central

Aortic dissection is a life threatening emergency. This case illustrates the unusual way an aortic dissection can present. This patient presented with sharp, left interscapular pain, which subsided after a while and left-sided pleural effusion. Further investigations revealed that this was a case of thoracic aortic dissection with a leak into pleural space. She underwent thoracic endovascular aortic repair with stent graft insertion. PMID:22692486

Somasamudra, Pramod; Smith, Ed; Tandan, Ronja

2011-01-01

67

63 FR 8977 - Notice of Case Filed With the Office of Hearings and Appeals; Week of January 12 Through January...  

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1998-02-23

68

63 FR 8976 - Notice of Cases Filed With the Office of Hearings and Appeals; Week of January 5 through January...  

Federal Register 2010, 2011, 2012, 2013, 2014

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1998-02-23

69

[A case of dissecting aneurysm of the basilar artery presented as superior pons type of Foville's syndrome].  

PubMed

Here we report a 47-year-old man with dissecting aneurysm of the basilar artery who developed Foville's syndrome due to upper pons involvement. At first he had an abrupt onset of dysarthria and weakness in his left upper and lower extremities during his work. Neurological examination on admission revealed mild disturbance of consciousness, absent light reaction on the left side, hypesthesia of the left face, absent gag reflex, dysarthria, and left hemiparesis with ataxia. On the second hospital day he developed paralysis of conjugate eye movement to the right, left central facial palsy, and left hemiplegia, and hyperhidrosis of the left side of the body. He was diagnosed to have superior pons type of Foville's syndrome. Computed tomography showed low density area in the right upper pons, and the basilar artery had marked lateral shift, dilatation, and calcification. Vertebral angiography demonstrated dissecting aneurysm of the basilar artery. Although it is very rare that dissecting aneurysm of the basilar artery causes the brain stem symptoms, its possibility should be considered when computed tomography shows marked lateral shift, dilatation, and/or calcification of the basilar artery. PMID:8565344

Nakaso, K; Nakayasu, H; Isoe, K; Nakashima, K; Takahashi, K

1995-09-01

70

Single-incision plus one-port laparoscopic abdominoperineal resection with bilateral pelvic lymph node dissection for advanced rectal cancer: a case report.  

PubMed

With regard to laparoscopic and robotic abdominoperineal resection (APR) for primary rectal malignancies, limited data have been published in the literature. Single-incision laparoscopic surgery (SLS) has been successfully introduced for treating colorectal cancer. Here we describe our experience of APR with SLS plus one port (SLS + 1) for treating advanced rectal cancer. A 65-year-old man underwent the procedure, which involved a 35-mm incision in the left side of the umbilicus for the insertion of a single multichannel port as well as the insertion of a 5-mm port into the right lower quadrant. The sigmoid colon and rectum were mobilized from the pelvic floor using a medial and lateral approach. After the rectum with the mesorectum was completely mobilized according to the total mesorectal excision, the sigmoid colon was intracorporeally transected. The specimen was removed through the perineal wound. Terminal colostomy was fashioned at the left lower trocar site. Lateral pelvic lymph node dissection was bilaterally performed. There were no perioperative complications. The total operating time was 592 minutes, and the estimated blood loss was 180 mL. To our knowledge, this is the first reported case of SLS + 1 APR with lateral pelvic lymph node dissection for treating rectal cancer. We conclude that SLS + 1 APR is a technically promising alternative method for treating selected patients with advanced rectal cancer. PMID:25594635

Tokuoka, Masayoshi; Ide, Yoshihito; Takeda, Mitsunobu; Hashimoto, Yasuji; Matsuyama, Jin; Yokoyama, Shigekazu; Morimoto, Takashi; Fukushima, Yukio; Nomura, Takashi; Kodama, Ken; Sasaki, Yo

2015-01-01

71

Rupture of an aortic dissection into the right atrium in a patient with a previous aortic valve replacement: a case report.  

PubMed

We report the case of a 73-year-old man with a history of previous aortic valve replacement in 1990 and rupture of an aortic dissection into the right atrium. The patient was admitted to the emergency room because of chest pain, stopped not long after. The electrocardiogram did not show any signs of ischemia and myocardial enzymes were not increased. Transthoracic echocardiography revealed aortic root dilation (maximum diameter 60 mm) extended to the aortic arch, and the presence of a flow from the ascending aorta to the right atrium (evocative of a fistula between the two chambers). The aortic valvular prosthesis function was good. Transesophageal echocardiography confirmed an aorta-right atrium fistula. Cardiac catheterization did not show any luminal obstructions in the coronary arteries; there was a small shunt from the aorta to the right atrium. The ascending aorta and the aortic root were replaced with a Dacron graft. Right and left sinuses were reimplanted to the graft. The fistula was repaired with 4-0 pledgeted Prolene sutures. The surgeon's diagnosis was "type A aortic dissection in a patient with an ascending aorta aneurysm and an old ascending aorta-right atrium fistula". PMID:16161500

Panzarella, Gaetano; Carlino, Gabriella; Fattouch, Kahlil; Ruvolo, Giovanni; Messina, Luigi; Hoffmann, Enrico; Incalcaterra, Egle; Novo, Salvatore

2005-08-01

72

NOTICE  

Atmospheric Science Data Center

ASDC Notice Page   EOSDIS User Satisfaction Survey Extended Users of EOSDIS data centers should watch ... For the results of previous surveys, please see American Customer Satisfaction Index Reports. This year’s survey began on August 20 ...

2013-09-26

73

Endoscopic submucosal dissection to treat ileal high-grade dysplasia after ileoanal anastomosis for familial adenomatous polyposis: report of a case.  

PubMed

Restorative proctocolectomy has become the most common surgical option for familial adenomatous polyposis patients, based on the premise that the technique yields good functional results and reduces colorectal cancer risk. However, several adenomas may develop in the pouch mucosa in later years, and even cancer (at the anastomosis or in the pouch mucosa) has been reported. Endoscopic submucosal dissection (ESD) would then be indicated, even if severe fibrosis extended into the submucosal layer. Endoscopic resection of an ileal tumor from the thin wall of the ileum carries a high-risk of perforation. Our present case demonstrates the successful use of ESD to treat an ileal neoplasm, a technically difficult lesion with a high-risk of complications. PMID:25491906

Sugimoto, Takafumi; Yoichi, Takuya; Suzuki, Kensuke; Kawai, Toshihiro; Yashima, Yoko; Sato, Shinpei; Kawamoto, Jun; Obi, Shuntaro

2014-12-01

74

Spontaneous bilateral internal carotid artery dissection.  

PubMed

Spontaneous internal carotid artery dissection is not an uncommon cause of ischaemic stroke in younger patients, but multiple cervical arterial dissections at presentation are uncommon. Recurrence of dissection in a previously normal artery is common. In this case report we review the history, clinical findings and management of a 42-year-old woman who presented with stroke and Horner syndrome and was found to have spontaneous bilateral internal carotid artery dissection. She was not anticoagulated due to concerns relating to the size of her infarct. She was treated with a combination of aspirin and clopidogrel. We use dual antiplatelets for the management of cervical dissections as a part of the CADISS trial. The patient made good progress with the multidisciplinary team and was discharged on day 22 with support from the community stroke team. PMID:22110554

Ardhalapudi, Srujan; Addy, Victoria; Da Costa, David

2009-01-01

75

Aortic Dissection Type A in Alpine Skiers  

PubMed Central

Patients and Methods. 140 patients with aortic dissection type A were admitted for cardiac surgery. Seventy-seven patients experienced their dissection in the winter season (from November to April). We analyzed cases of ascending aortic dissection associated with alpine skiing. Results. In 17 patients we found skiing-related aortic dissections. Skiers were taller (180 (172–200)?cm versus 175 (157–191)?cm, P = 0.008) and heavier (90 (68–125)?kg versus 80 (45–110)?kg, P = 0.002) than nonskiers. An extension of aortic dissection into the aortic arch, the descending thoracic aorta, and the abdominal aorta was found in 91%, 74%, and 69%, respectively, with no significant difference between skiers and nonskiers. Skiers experienced RCA ostium dissection requiring CABG in 17.6% while this was true for 5% of nonskiers (P = 0.086). Hospital mortality of skiers was 6% versus 13% in nonskiers (P = 0.399). The skiers live at an altitude of 170 (0–853) m.a.s.l. and experience their dissection at 1602 (1185–3105; P < 0.001) m.a.s.l. In 82% symptom start was during recreational skiing without any trauma. Conclusion. Skiing associated aortic dissection type A is usually nontraumatic. The persons affected live at low altitudes and practice an outdoor sport at unusual high altitude at cold temperatures. Postoperative outcome is good. PMID:23971024

Schachner, Thomas; Fischler, Nikolaus; Dumfarth, Julia; Bonaros, Nikolaos; Krapf, Christoph; Schobersberger, Wolfgang; Grimm, Michael

2013-01-01

76

Interactive Frog Dissection  

NSDL National Science Digital Library

University of Virginia Curry School of Education's Instructional Technology Program has announced Interactive Frog Dissection. The tutorial combines text with 60 in-line color images and 17 QuickTime movies illustrating dissection procedures and internal organs. Numerous clickable image maps provide interactive practice. Research with pre-Web versions of the program suggests it is a valuable preparation tool or even a useful substitute for laboratory dissection.

77

Peripartum presentation of an acute aortic dissection.  

PubMed

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

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

2005-04-01

78

63 FR 41817 - Notice of Cases Filed With the Office of Hearings and Appeals, Week of June 22 Through June 26, 1998  

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1998-08-05

79

62 FR 39833 - Notice of Cases Filed; With the Office of Hearings and Appeals Week of June 16 through June 20, 1997  

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1997-07-24

80

62 FR 18111 - Notice of Cases Filed with the Office of Hearings and Appeals; Week of March 10 Through March 14...  

Federal Register 2010, 2011, 2012, 2013, 2014

...DEPARTMENT OF ENERGY Office of Hearing and Appeals Notice of Cases Filed with the Office of Hearings and Appeals; Week of March 10 Through...Notice were filed with the Office of Hearings and Appeals of the Department of...

1997-04-14

81

"Hands-Off" Dissection?  

ERIC Educational Resources Information Center

Computer programs and models are used to express respect for life by not sacrificing any animal but these alternatives might be deeply flawed. Alternatives to dissection are perverse alternatives that tend to preserve the features of inappropriate dissections like destructiveness, reductionism and objectification.

Allchin, Douglas

2005-01-01

82

Flower Dissection Lab  

NSDL National Science Digital Library

From Fairchild Tropical Botanic Garden, this site presents a simple Flower Dissection Lab using orchids and composite flowers. This pdf document contains the materials needed and instructions for the lab, as well as a worksheet for students to complete as they dissect their flower.

2007-12-27

83

[Bilateral cervical arterial dissection as a sign of proximal aortic dissection: a rare cause of recidivating TIA].  

PubMed

Proximal aortic dissection is a life-threatening disease. In addition to other complications, involvement of the brain-supplying arteries can lead to acute cerebral ischemia. In the presented case, only the patient's clinical course and duplex sonography, which showed bilateral cervical arterial dissections, led to the diagnosis of aortic dissection. This case emphasizes that early ultrasound examination is crucial in patients with suspected cerebral ischemia. PMID:16897049

Grabowski, A

2006-10-01

84

ASSOCIATION OF INTERNAL CAROTID ARTERY DISSECTION AND CHIROPRACTIC MANIPULATION  

Microsoft Academic Search

BACKGROUND- To determine the relationship between chiropractic manipulative therapy (CMT) and internal carotid artery dissection (ICAD), a MEDLINE literature search was performed for the years 1966 through 2000 using the terms internal carotid dissection. Literature that included information concerning causation of ICAD, as well as all case studies and series, was selected for review. REVIEW SUMMARY- In reviewing the cases

Michael T. Haneline; Arthur C. Croft; Benjamin M. Frishberg

2003-01-01

85

Vertebral and carotid artery dissection following chiropractic cervical manipulation  

Microsoft Academic Search

A 50-year-old woman presented a sudden left occipital headache and a posterior circulation stroke after cervical manipulation\\u000a for neck pain. Magnetic resonance imaging documented a left intracranial vertebral artery occlusive dissection associated\\u000a with an ipsilateral internal carotid artery dissection with vessel stenosis in its prepetrous tract. This is the first reported\\u000a case showing an associate vertebral and carotid artery dissection

Giuliano Parenti; Giovanni Orlandi; Mariacristina Bianchi; Maria Renna; Antonio Martini; Luigi Murri

1999-01-01

86

Spontaneous esophageal mucosal dissection in a patient with upper digestive bleeding and esophageal varices.  

PubMed

We present a case of mucosal esophageal dissection in a 44-year-old patient with alcoholic cirrhosis admitted for upper digestive bleeding. The endoscopic aspect was of chronic mucosal dissection in the esophagus and 3rd degree esophageal varices with red signs. To our knowledge, it is the only case with spontaneous esophageal mucosal dissection and portal hypertension with esophageal varices. PMID:21776303

Negreanu, L; Tribus, L C; Purcarea, M; Fierbinteanu Braticevici, C

2011-05-15

87

Spontaneous esophageal mucosal dissection in a patient with upper digestive bleeding and esophageal varices  

PubMed Central

We present a case of mucosal esophageal dissection in a 44–year–old patient with alcoholic cirrhosis admitted for upper digestive bleeding. The endoscopic aspect was of chronic mucosal dissection in the esophagus and 3rd degree esophageal varices with red signs. To our knowledge, it is the only case with spontaneous esophageal mucosal dissection and portal hypertension with esophageal varices. PMID:21776303

Tribus, LC; Purcarea, M; Fierbinteanu Braticevici, C

2011-01-01

88

Cardiac tamponade – presentation of type A aortic dissection  

PubMed Central

Acute aortic dissection usually presents with severe chest and/or back pain but may have a varied presentation ranging from syncope, stroke, and heart failure to shock or tamponade. We present classic chest computed tomography images of a case of type A aortic dissection presenting with cardiac tamponade. PMID:25432649

Fadahunsi, Opeyemi; Romeo, Michael

2014-01-01

89

Virtual Pig Dissection  

NSDL National Science Digital Library

Dissection can be an aspect of scientific education that can make some parties queasy, but it is a fascinating way to learn more about the different body systems, their operations, and basic animal anatomy. Entering the world of pig dissection can make budding scientists even more squeamish, but they need never fear, as this site allows these individuals the opportunity to engage in a bit of virtual pig dissection. Originally created by Professor Earl W. Fleck of Whitman Collegeâ??s biology department, the site lets users go inside the pig to learn about its various systems, via a set of high-quality color photographs, which can be viewed at different angles and perspectives. Of course, what would a lab be without a quiz? Rounding out the site, visitors can take short quizzes on the pigâ??s anatomy and such.

Fleck, Earl W.

90

Parametric binary dissection  

NASA Technical Reports Server (NTRS)

Binary dissection is widely used to partition non-uniform domains over parallel computers. This algorithm does not consider the perimeter, surface area, or aspect ratio of the regions being generated and can yield decompositions that have poor communication to computation ratio. Parametric Binary Dissection (PBD) is a new algorithm in which each cut is chosen to minimize load + lambda x(shape). In a 2 (or 3) dimensional problem, load is the amount of computation to be performed in a subregion and shape could refer to the perimeter (respectively surface) of that subregion. Shape is a measure of communication overhead and the parameter permits us to trade off load imbalance against communication overhead. When A is zero, the algorithm reduces to plain binary dissection. This algorithm can be used to partition graphs embedded in 2 or 3-d. Load is the number of nodes in a subregion, shape the number of edges that leave that subregion, and lambda the ratio of time to communicate over an edge to the time to compute at a node. An algorithm is presented that finds the depth d parametric dissection of an embedded graph with n vertices and e edges in O(max(n log n, de)) time, which is an improvement over the O(dn log n) time of plain binary dissection. Parallel versions of this algorithm are also presented; the best of these requires O((n/p) log(sup 3)p) time on a p processor hypercube, assuming graphs of bounded degree. How PBD is applied to 3-d unstructured meshes and yields partitions that are better than those obtained by plain dissection is described. Its application to the color image quantization problem is also discussed, in which samples in a high-resolution color space are mapped onto a lower resolution space in a way that minimizes the color error.

Bokhari, Shahid H.; Crockett, Thomas W.; Nicol, David M.

1993-01-01

91

Teachers' Professional Knowledge and Noticing: The Case of Multiple Representations in the Mathematics Classroom  

ERIC Educational Resources Information Center

Teachers notice through the lens of their professional knowledge and views. This study hence focuses not solely on teachers' noticing, but also on their knowledge and views, which allows insight into how noticing is informed and shaped by professional knowledge. As a discipline-specific perspective for noticing we chose dealing with multiple…

Dreher, Anika; Kuntze, Sebastian

2015-01-01

92

Intraoperative aortic dissection in pediatric heart surgery.  

PubMed

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

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

2006-06-01

93

The use of gelatin-resorcin-formalin glue in acute aortic dissection type A  

Microsoft Academic Search

Objectives: The Gelatin-resorcin-formalin (GRF) glue is widely used in the surgical treatment of dissecting aneurysms. This paper is focused on our experience with the GRF glue in cases, operated for acute aortic dissection type A. Methods: Between September 1990 and December 1997, 164 patients were operated on for acute aortic dissection type A. In 148 patients GRF was used to

Suhji Fukunaga; Matthias Karck; Wolfgang Harringer; Joachim Cremer; Christine Rhein; Axel Haverich

1999-01-01

94

Alternative surgical dissection techniques.  

PubMed

The bipolar scissors, coblator, harmonic scalpel, and somnoplasty techniques are widely available and offer new choices for the operating arena. There are advantages and disadvantages to all four techniques. With time, these dissection methods will prove their lasting power. Otolaryngologists have already begun to expand their applications and will surely play a role in their use and development. PMID:15823600

Carroll, Thomas; Ladner, Keith; Meyers, Arlen D

2005-04-01

95

Video Gallery: Shark Dissection  

NSDL National Science Digital Library

This video gallery is from the Museum's Seminars on Science, a series of distance-learning courses designed to help educators meet the new national science standards. There are 16 videos each covering dissection of a different part of the dogfish shark. There is a downloadable pdf for each video.

96

Doing without Dissection.  

ERIC Educational Resources Information Center

Both the National Science Teachers Association (NSTA) and the National Association of Biology Teachers (NABT) have issued position statements on the use of animals in the classroom. Dissection has not become extinct, but its role is far smaller than it used to be. (MLF)

Texley, Juliana

1992-01-01

97

Traumatic vertebral artery dissection in an adult with brachial plexus injury and cervical spinal fractures  

PubMed Central

We present a case of a 32 year-old right-hand dominant woman who sustained a right brachial plexus injury, ipsilateral fractures of the cervical spine transverse processes, and vertebral artery dissection. She presented to us four days following the initiating accident. Magnetic Resonance Imaging showed normal brachial plexus along with vertebral artery dissection with intramural thrombus and vascular lumen occlusion. The dissection was managed conservatively. A repeat CAT-SCAN Angiography three months later showed healing of the dissection plus vascular lumen re-canalization. There were no sequelae due to the dissection. The details of the case are discussed in this report. PMID:17822530

2007-01-01

98

Neck dissections: radical to conservative  

PubMed Central

Background Neck dissection is an important surgical procedure for the management of metastatic nodal disease in the neck. The gold standard of neck nodal management has been the radical neck dissection. Any modification in the neck dissection is always compared with this standard. Over the last few decades, in order to alleviate the morbidity of radical neck dissection, several modifications and conservative procedures have been advocated. These procedures retain certain lymphatic or non-lymphatic structures and have been shown not to compromise oncological safety. Methods A literature search of the Medline was carried out for all articles on neck dissections. The articles were systematically reviewed to analyze and trace the evolution of neck dissection. These were then categorized to address the nomenclature, management of node positive and node negative neck including those who had received chemoradiation. Results The present article discusses the neck nodal nomenclature, the radical neck dissection, its modifications and migration to more conservative procedures and possible advances in the near future. Conclusion Radical neck dissection is now replaced with modified radical neck dissections in most situations. Attempts are being made to replace modified radical neck dissections with selective neck dissections for early node positivity. Sentinel node biopsy is being studied to address the issue of node negative neck. More conservative surgeries are likely to replace the 'radical' surgeries of bygone era. This process is facilitated by earlier detection of the disease and better understanding of cancer biology. PMID:15836786

Harish, K

2005-01-01

99

Multiple idiopathic arterial aneurysms masquerading as aortic dissection  

PubMed Central

We report the case of a 58-year-old lady who presented with abdominal pain and backache. Although initial evaluation was strongly suggestive of abdominal aortic dissection, she was ultimately found to have multiple arterial aneurysms. Work-up for underlying vasculitis was negative. Surgical repair was planned and the patient was referred to a cardiovascular surgeon. This case highlights the importance of careful radiological assessment in patients with suspected aortic dissection. PMID:23420724

Naha, Kushal; Vivek, G; Shetty, Ranjan K; Dias, Lorraine Simone

2013-01-01

100

Sheep Brain Dissection  

NSDL National Science Digital Library

A sheep brain is used to teach about memory and where it takes place because its brain structure and functions are similar to the human brain. Students will be exposed briefly to the fact that electrochemical connections made between brain cells help us remember the thoughts, skills, experiences, and knowledge that make each of us unique. Through dissections, students will learn about the cortex, brain cells, and where the three main subdivisions of memory (working, long-term, and skill memory) take place.

Science NetLinks (The museum of science, art and human perception at the Palace of Fine Arts;)

2004-04-30

101

Choosing the correct treatment for acute aortic type B dissection.  

PubMed

Acute type B aortic dissection is a life threatening disease process, which remains a clinical dilemma despite advances in technology, surgical technique and postoperative management. The variability of presenting symptoms, lack of a consensus on indications for treatment and differing opinions about the optimal timing for repair have added to the management confusion. Medical management has been the standard of care for acute uncomplicated type B dissection. Surgical repair and endovascular intervention are reserved for those who present with, or subsequently develop, dissection-related complications. Complicated dissections occur in 25% of cases and may include organ malperfusion, aortic rupture, periaortic hematoma, and uncontrolled hypertension. In the past decade thoracic endovascular aortic repair (TEVAR) has gained widespread acceptance as the modality of choice for the treatment of complicated type B dissection. This transition is representative of advances in technology, physician experience with aortic endografts and lower morbidity and mortality rates associated with TEVAR. The best medical therapy remains the standard of care for uncomplicated dissection, however this strategy fails to prevent long-term aortic-related morbidity and mortality. Recent data suggest that early TEVAR lowers aortic-related events and improves long-term aortic specific survival by covering the entry tear, promoting false lumen thrombosis and inducing aortic wall remodeling. The paucity of supporting data has created controversy surrounding the optimal treatment strategy for acute type B dissection. Nonetheless, recent healthcare trends show a paradigm shift towards the utilization of early TEVAR in acute type B dissection. PMID:25644833

Singh, M; Hager, E; Avgerinos, E; Genovese, E; Mapara, K; Makaroun, M

2015-04-01

102

Hybrid Strategy for Residual Arch and Thoracic Aortic Dissection following Acute Type A Aortic Dissection Repair  

PubMed Central

Progressive dilatation of the false lumen in the arch and descending aorta has been encountered in one-third of survivors as a late sequelae following repair of ascending aortic dissection. Conventional treatment for the same requiring cardiopulmonary bypass and deep hypothermic circulatory arrest is associated with high morbidity and mortality especially in the elderly cohort of patients. Herein we report a case of symptomatic progressive aneurysmal dilatation of residual arch and descending thoracic aortic dissection following repair of type A aortic dissection, successfully treated by total arch debranching and ascending aortic prosthesis to bicarotid and left subclavian bypass followed by staged retrograde aortic stent-graft deployment. This case report with relevant review of the literature highlights this clinical entity and the present evidence on its appropriate management strategies. Close surveillance is mandatory following surgical repair of type A aortic dissection and hybrid endovascular procedures seem to be the most dependable modality for salvage of patients detected to have progression of residual arch dissection. PMID:24716088

Agrawal, Vivek; Parameshwarappa, Shashidhar Kallappa; Savlania, Ajay; Kumar, Santhosh; Madathipat, Unnikrishnan

2014-01-01

103

Aortic dissection presenting an acute onset of neuroradicular syndrome complicated by coeliac and superior mesenteric artery embolism.  

PubMed

Aortic dissection is a catastrophic medical emergency with complex and changeable clinical presentations. We report a case of aortic dissection complicated by coeliac and superior mesenteric artery embolism, which is hardly been reported till date. PMID:25358642

Zeng, Lixiong; Yuan, Hong; Jiang, Weihong; Yang, Kan; Zhang, Zhihui

2014-12-01

104

Dissecting aneurysm of the middle cerebral artery treated with heparin infusion in a 6-year-old child; neurological recovery with delayed spontaneous thrombosis: case illustration and literature review.  

PubMed

Aneurysms in the pediatric population are a rare pathology with specific features which requires a deep knowledge of their pathogenesis for the best therapeutic choice; the authors report their experience with a patient presenting aneurysm of the middle cerebral artery (MCA) associated with proximal stenosis of the vessel. A six-year-old girl came to our observation after sudden onset of headache and left hemiparesis. Angio-MRI and angio-CT scan showed a right MCA dissecting aneurysms associated with proximal stenosis of the vessel. Patient started a therapy with low molecular weight heparin (LMWH), replaced, 15 days later, with acetyl-salicylic acid (ASA). Patient showed a rapid and almost complete neurological recovery, despite several radiological exams confirmed a complete occlusion of the right MCA. As many other authors noted, dissecting aneurysms in the pediatric population are probably due to a defect of the entire arterial wall. Combination of stenosis, turbulence and partial thrombosis of the aneurysm led to a complete occlusion of artery involved, leading to the formation of collateral circles. In our case, complete thrombosis was probably delayed with anticoagulant therapy and the progressive reinforcement of collateral circles lead to the patient's neurological recovery. PMID:21766201

Anichini, G; Passacantilli, E; Lenzi, J; Guidetti, G; Santoro, A

2012-04-01

105

[A case of acute aortic dissection presenting with cerebral ischemic symptoms: utility of 3D CT angiography and CT perfusion for the diagnosis of acute stroke].  

PubMed

A 76-year-old woman presented at our hospital complaining of loss of consciousness, dysarthria, and upper extremity paresis. Head CT showed no remarkable findings. 3D CT angiography (CTA) and CT perfusion (CTP) revealed acute aortic dissection (AAD) involving the innominate artery and decreased cerebral blood flow in the right cerebral hemisphere, although there were no clinical signs of AAD. The patient underwent emergency allograft replacement performed by cardiovascular surgeons. The symptoms disappeared within several days and no cerebral infarction developed. Although patients with AAD and neurological symptoms can show a fatal course when they receive tissue plasminogen activator (tPA), it is difficult to exclude patient with AAD as candidates for tPA treatment. Routine use of 3D CTA and CTP in the diagnosis of acute stroke may help overcome the above problem. PMID:25082322

Koseki, Hirokazu; Kuroi, Yasuhiro; Arai, Naoyuki; Ohbuchi, Hidenori; Hirota, Kengo; Hagiwara, Shinji; Tani, Shigeru; Sasahara, Atsushi; Kasuya, Hidetoshi

2014-08-01

106

Vertigo as Manifestation of Vertebral Artery Dissection after Chiropractic Neck Manipulations  

Microsoft Academic Search

We recently observed a case of vertebral artery (VA) dissection following chiropractic neck manipulations. The first manifestation was unusual; in the form of vertigo. Therefore, the patient was referred to the otoneurologist. A VA dissection should be suspected in a case of vertigo following chiropractic neck manipulations, and vestibular tests should be done carefully, avoiding Rose’s positions. In our case,

Dominique Vibert; Josette Rohr-Le Floch; Gèrard Gauthier

1993-01-01

107

[Postoperative dissection of the vertebral artery in two steps].  

PubMed

The diagnosis of perioperative vertebral artery dissection can be difficult because of non-specific clinical signs. We report a case revealed by a tegmento-thalamic stroke after an abdominal second surgical look. The interest of this observation is related to a particular evolution in two steps separated by a 2-month-interval and an intercurrent cervical manipulation. After the second anesthesia, neck pain associated with a third cranial nerve palsy and a supranuclear ophtalmoplegia revealed a tegmento-thalamic ischemic stroke due to vertebral artery dissection. We discuss here the different factors possibly involved in the pathophysiology of postoperative vertebral artery dissection: positioning, cervical manipulation, subclavian central venous access and cisplatin toxicity. Vertebral artery dissection should be discussed in case of postoperative neck pain, especially with non-typical symptomatology. PMID:25447780

Bien, J-Y; Morel, J; Demasles, S; Abboud, K; Molliex, S

2014-12-01

108

Sequential multiple visceral arteries dissections without aortic involvement.  

PubMed

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

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

2013-05-01

109

"Dissection" of a Hair Dryer  

ERIC Educational Resources Information Center

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…

Eisenstein, Stan; Simpson, Jeff

2008-01-01

110

Thoracic aortic aneurysm and dissection.  

PubMed

Aortic dissection is the most devastating complication of thoracic aortic disease. In the more than 250 years since thoracic aortic dissection was first described, much has been learned about diseases of the thoracic aorta. In this review, we describe normal thoracic aortic size; risk factors for dissection, including genetic and inflammatory conditions; the underpinnings of genetic diseases associated with aneurysm and dissection, including Marfan syndrome and the role of transforming growth factor beta signaling; data on the role for medical therapies in aneurysmal disease, including beta-blockers, angiotensin receptor blockers, and angiotensin-converting enzyme inhibitors; prophylactic surgery for aneurysm; surgical techniques for the aortic root; and surgical and endovascular management of aneurysm and dissection for different aortic segments. PMID:25323262

Goldfinger, Judith Z; Halperin, Jonathan L; Marin, Michael L; Stewart, Allan S; Eagle, Kim A; Fuster, Valentin

2014-10-21

111

Automatic Dissection Of Plantlets  

NASA Astrophysics Data System (ADS)

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)

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

1989-03-01

112

Vertebral Artery Dissection as a Cause of Cervical Radiculopathy  

PubMed Central

The acute onset of neck pain and arm weakness is most commonly due to cervical radiculopathy or inflammatory brachial plexopathy. Rarely, extracranial vertebral artery dissection may cause radiculopathy in the absence of brainstem ischemia. We describe a case of vertebral artery dissection presenting as cervical radiculopathy in a previously healthy 43-year-old woman who presented with proximal left arm weakness and neck pain aggravated by movement. Cervical magnetic resonance imaging (MRI) and angiography revealed dissection of the left vertebral artery with an intramural hematoma compressing the left C5 and C6 nerve roots. Antiplatelet treatment was commenced, and full power returned after 2 months. Recognition of vertebral artery dissection on cervical MRI as a possible cause of cervical radiculopathy is important to avoid interventions within the intervertebral foramen such as surgery or nerve root sleeve injection. Treatment with antithrombotic agents is important to prevent secondary ischemic events. PMID:24353851

Khangure, Mark; Silbert, Peter Linton

2013-01-01

113

Endovascular Treatment of Acute Type B Dissection Complicating Aortic Coarctation  

PubMed Central

Surgical treatment poses a high risk to patients with concomitant aortic coarctation and dissection, and an interventional approach could be an alternative. We describe the case of a 52-year-old man with a long history of untreated hypertension and aortic coarctation who emergently presented at our institution with an acute Stanford type B dissection. The patient's elevated serum creatinine level, perfusion deficit in the right lower limb, and hypertension did not respond to medical therapy, and he did not consent to surgery. By endovascular means, we used a self-expandable stent-graft to cover the entry point of the dissection; then, we deployed a balloon-expandable bare-metal stent to correct residual stenosis. To our knowledge, this is the first report of the endovascular treatment of aortic coarctation complicated by type B dissection. PMID:23678217

Kassaian, Seyed Ebrahim; Abbasi, Kyomars; Mousavi, Mehdi; Sahebjam, Mohammad

2013-01-01

114

A 346 Case Analysis for Laparoscopic Spleen-Preserving No.10 Lymph Node Dissection for Proximal Gastric Cancer: A Single Center Study  

PubMed Central

Purpose This study was designed to formulate a model that efficiently predicts splenic hilar lymph node metastasis (SHLNM) in patients with proximal gastric cancer and to assess indications for laparoscopic spleen-preserving no.10 lymph node dissection (LSPNo.10LND) based on this model. Methods Patients (N?=?346) with proximal gastric cancer who underwent LSPNo.10LND from January 2010 to October 2013 were prospectively enrolled and retrospectively evaluated. Groups of patients with and without SHLNM were compared, and independent risk factors for SHLNM determined. An optimal predictive model of SHLNM in patients with proximal gastric cancer was well established. Results Of the 346 patients with proximal gastric cancer, only 35 (10.1%) were diagnosed with SHLNM. Depth of invasion, tumor location and metastases to No.7 and No.11 lymph nodes (LNs) were independent risk factors for SHLNM (p<0.0001 each). A model involving depth of invasion, tumor location and metastasis to No.7 and 11 LNs yielded a lowest Akaike’s information criterion (AIC) of ?913.535 and a highest area under the ROC curve (AUC) of 0.897(95%CI:0.851–0.944). Stratification analysis showed no SHLNMs in the absence of serosal invasion of the lesser curvature and metastases at No.7 and No.11 LNs (T2-3?0/87, 95% CI: 0.00–4.15). Conclusions A model including depth of invasion, tumor location and metastases at No.7 and No.11 LNs was found optimal for predicting SHLNM for proximal gastric cancers. LSPNo.10LND may be avoided when tumors on the lesser curvature did not show serosal invasion or metastases at No.7 and No.11 LNs. PMID:25264673

Huang, Chang-Ming; Zhang, Jun-Rong; Zheng, Chao-Hui; Li, Ping; Xie, Jian-Wei; Wang, Jia-Bin; Lin, Jian-Xian; Lu, Jun; Chen, Qi-Yue

2014-01-01

115

Efficacy and safety of endoscopic submucosal dissection in treating gastric subepithelial tumors originating in the muscularis propria layer: a single-center study of 144 cases.  

PubMed

OBJECTIVE. Subepithelial tumors (SETs) in the stomach are usually considered benign. However, some do have potential for malignant transformation, especially when originating in the muscularis propria (MP). Our study aimed to evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for gastric SETs originating in MP. MATERIAL AND METHODS. A total of 145 gastric MP SETs in 144 patients were treated by ESD between September 2008 and December 2012. Characteristics of patients and SETs, therapeutic outcomes, pathologic characteristics, complications and follow-up outcomes were evaluated. RESULTS. Among the 144 patients, 104 were female (72.22%) and 40 were male (27.78%), and the mean age was 55.75 ± 11.29 years (range 18-78 years). The mean size of the tumors determined by endoscopic ultrasound (EUS) was 15.14 ± 9.70 mm (range 3-50 mm). En bloc complete resection was achieved in 134 of 145 tumors, giving a complete resection rate of 92.41%. The final histopathologic diagnoses included 52 leiomyomas, 89 gastrointestinal stromal tumors, 3 neurogenic tumors and 1 lipoma. Perforations occurred in 21 patients (14.48%) and were endoscopically repaired with clips or nylon bands. Intraoperative bleeding occurred in seven patients (4.83%) and was corrected with argon plasma coagulation (APC) or hot biopsy forceps. No local recurrence or distant metastasis was detected during a mean follow-up of 19.14 ± 10.29 months (range 3-51 months). CONCLUSIONS. ESD appears to be an effective and safe treatment for gastric SETs originating in MP. PMID:24131359

He, Zhankun; Sun, Chao; Wang, Jiang; Zheng, Zhongqing; Yu, Qingxiang; Wang, Tao; Chen, Xin; Liu, Wentian; Wang, Bangmao

2013-12-01

116

Spontaneous type B aortic dissection in antepartum gemellary pregnancy and endovascular repair  

PubMed Central

Background: It has been found that 50% of all aortic dissections can be attributable to pregnancy in women younger than 45 years of age. An estimated 30% of cases are type B, with half occurring in the antepartum period. To date type B aortic dissection has rarely been reported in gemellary pregnancies. Case: A 24-year-old primigravida at 36 weeks of gemellary gestation presented symptoms of severe and persistent chest pain for 1 day, before suffering the acute type B aortic dissection. The primigravida was treated with immediate cesarean section and endovacular stent graft placement. Conclusion: Aortic dissection is a rare complication of pregnancy, especially in gemellary pregnancies. Pregnancy is considered an independent risk factor for aortic dissection and endovascular repair may be an ideal option for the treatment of complicated type B aortic dissection during pregnancy, with reduced maternal and fetal mortality.

Gu, Xudong; Liu, Hongmei; Li, Yusheng; Fei, Libo; Shao, Danbing; Mao, Jianhua; Nie, Shinan

2014-01-01

117

Vertebral Artery Dissection in Children: A Comprehensive Review  

Microsoft Academic Search

Vertebral artery dissection (VAD) has been infrequently recognized in children. The authors have reviewed 68 reported cases of VAD in children in the existing literature. An association between routine types of neck movement in sports and the evolution of VAD was recognized in half of the reported cases. Boys outnumbered girls by a ratio of 6.6 to 1, in contrast

Izhar Hasan; Simon Wapnick; Michael S. Tenner; William T. Couldwell

2002-01-01

118

[Aortic aneurysms and aortic dissection: epidemiology, pathophysiology and diagnostics].  

PubMed

Aortic aneurysms and aortic dissection represent a significant health risk due to the demographic developments and current life styles. The mortality of ruptured aortic aneurysms is up to 80 % and the prevalence of aneurysms varies depending on the localization (thoracic or abdominal). Most commonly affected is the infrarenal abdominal aorta; however, there is evidence that the prevalence is diminishing but in contrast the incidence of thoracic aortic aneurysms is increasing. Aortic dissection is often fatal and is the most common acute aortic disease but the incidence is presumed to be underestimated. The pathogenesis of aortic aneurysms is manifold and is based on an interplay between degenerative, proteolytic and inflammatory processes. An aortic dissection arises from a tear in the intima which results in a separation of the aortic wall layers with infiltration of bleeding and the danger of aortic rupture. Various genetic disorders of connective tissue promote degeneration of the aortic media, most notably Marfan syndrome. Risk factors for aortic aneurysms and aortic dissection are nicotine abuse, arterial hypertension, age and male gender. Aortic aneurysms initially have an uneventful course and as a consequence are mostly discovered incidentally. The clinical course and symptoms of aortic dissection are very much dependent on the section of the aorta affected and the manifestations are manifold. Acute aortic dissection is in 80 % of cases first manifested as sudden extremely severe pain. The diagnostics and subsequent course control can be achieved by a variety of imaging procedures but the modality of choice is computed tomography. PMID:23558776

Baumann, F; Makaloski, V; Diehm, N

2013-05-01

119

Improved results for dissecting aneurysms. Intraluminal sutureless prosthesis.  

PubMed

Surgical therapy for dissection of the thoracic aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. A method of treatment with an intraluminal prosthesis that requires no end-to-end anastomosis has been developed. We have used this method in 14 patients, of whom eight had acute thoracic aortic dissections and six had chronic dissections. We assembled our own prosthesis in the first five cases but, more recently, we have utilized an intraluminal prosthesis provided by USCI. Eight of the patients had type 1 dissection, of whom five required concomitant aortic valve replacement and three coronary artery bypass grafting; one had a type II dissection and five had type III dissections. The age range was 31 to 71 years with a mean of 58. There were 12 men and 2 women. There were no intraoperative deaths, but one patient died 10 days postoperatively of a perforated ulcer and another died at 6 months of empyema. Follow-up has been from 9 to 51 months with a mean of 22 months. There has been no evidence of compromise of the aortic lumen and no prosthetic problems, such as erosion, migration, or thrombosis. This technique provides a safe and simple way to repair dissecting aneurysms of the thoracic aorta and has provided long-term reliability. We have subsequently used this graft for 11 patients with aneurysm of the aorta with favorable results. We presently recommend this technique for dissecting, atherosclerotic, and Marfanoid aneurysms of the thoracic aorta. PMID:6977074

Lemole, G M; Strong, M D; Spagna, P M; Karmilowicz, N P

1982-02-01

120

Extensive bilateral vertebral artery remodeling following treatment of dissection using pipeline embolic device  

PubMed Central

Background Cerebral artery dissection remains a significant cause of stroke, and the mainstay of treatment has been medical management with anticoagulation, although flow-diverting stents have been used in some cases of arterial dissection resistant to medical management. Methods We present a case report of bilateral vertebral artery stenting using pipeline embolic device flow-diverting stents, after failed medical management of the dissection. Results This case demonstrated substantial subsequent vertebral arterial remodeling and good clinical outcome with maintenance of posterior circulation. The patient did not suffer any further strokes or posterior circulation symptoms following vertebral artery remodeling. Conclusion In cases where traditional management of arterial dissection has not been efficacious, flow-diverting stents may be useful in treating dissections of the posterior cerebral circulation, even with bilateral involvement.

Mitchell, Bartley; Momin, Eric; Jou, Liang-Der; Shaltoni, Hashem; Morsi, Hesham; Mawad, Michel

2014-01-01

121

Congenital Incomplete Fusion of Superior Mesenteric Artery Mimicking Dissection  

PubMed Central

Patient: Male, 62 Final Diagnosis: Superior mesenteric artery anatomic variant Symptoms: Abdominal pain • diarrhea • transcient ischemic attacks Medication: — Clinical Procedure: CT of abdomen and pelvis Specialty: Surgery Objective: Congenital defects/diseases Background: Both spontaneous SMA dissection and anatomical variants of GIT vasculature are well known entities. We present a case initially diagnosed as an SMA dissection on CT, but upon detailed review of the imaging findings was considered to be incompletely fused ventral segmental arteries – a rare anatomic variant not well described before. This finding is clinically significant, as it can mimic a vascular dissection and such a wrong diagnosis will lead to unnecessary investigation and intervention. Case Report: A 62-year-old male patient presented with abdominal pain of uncertain etiology. The initial CT revealed an abnormal appearance of the superior mesenteric artery (SMA) which was diagnosed as SMA dissection. However, the appearance of this ‘dissection’ was unusual and there was a mismatch between the clinical presentation and radiological findings. The scan was reviewed and a 3D reconstruction of the abdominal aortal and visceral arteries was performed. The abnormal appearance of the SMA was deemed to be from a congenital anatomical variant. A review of the embryological origin of gut vasculature provides a likely explanation for this appearance. Conclusions: Ours is an unusual case of a developmental variant that has not been well described hitherto. Attention to the ancillary radiological signs and understanding the embryological origin of the abdominal vasculature is important to distinguish such variants from pathology. PMID:25623118

Sharma, Vasu Keshav; H’ng, Martin Weng Chin

2015-01-01

122

Isolated Unilateral Hypoglossal Nerve Palsy Due to Vertebral Artery Dissection  

PubMed Central

We report the case of a patient with unilateral tongue weakness secondary to an isolated lower motor neuron hypoglossal nerve palsy that was caused by a right vertebral artery dissection in the lower neck. The patient had a boggy tongue with a deviation to the right side but an otherwise normal neurological examination. Magnetic resonance angiography showed a narrow lumen of the right vertebral artery in the neck. After initially treating the patient with aspirin in the emergency room and later with warfarin for three months, there was complete recanalization of the right vertebral artery. Only one other case of vertebral artery dissection and twelfth nerve palsy has been reported before. PMID:22031481

Mahadevappa, Karthik; Chacko, Thomas; Nair, Anil K.

2012-01-01

123

Infective Left Atrial Dissecting Flap after Cardiac Surgery  

PubMed Central

Left atrial dissection (LatD), defined as the forced separation of the left atrial (LA) wall layers by blood, is a rare and severe complication of cardiac surgery. It is most frequently associated with atrioventricular junction injuries. We report a case of infected LatD after coronary artery bypass graft, mitral valve replacement, aortic valve replacement and ascending aortic root replacement. The patient was presented with septicemia and disseminated intravascular coagulation. To the best of our knowledge, this is the first case report of LA dissecting flap concomitant with attached infective vegetations identified by transesophageal echocardiography. PMID:25309695

Tabiban, Sasan; Ghaemian, Ali; Bagheri, Babak; Shokri, Mojtaba

2014-01-01

124

Concomitant Reconstruction of Arch Vessels during Repair of Aortic Dissection  

PubMed Central

Surgery for acute aortic dissection is challenging, especially in cases of cerebral malperfusion. Should we perform only the aortic repair, or should we also reconstruct the arch vessels when they are severely affected by the disease process? Here we present a case of acute aortic dissection with multiple tears that involved the brachiocephalic artery and caused cerebral and right upper-extremity malperfusion. The patient successfully underwent complete replacement of the brachiocephalic artery and the aortic arch during deep hypothermic circulatory arrest, with antegrade cerebral protection. We have found this technique to be safe and reproducible for use in this group of patients. PMID:25120398

Nezic, Dusko; Vukovic, Petar; Jovanovic, Marko; Lozuk, Branko; Jagodic, Sinisa; Djukanovic, Bosko

2014-01-01

125

Endovascular treatment of spontaneous isolated common and external iliac artery dissections with preservation of pelvic blood flow.  

PubMed

Spontaneous isolated dissection of iliac arteries is very rare, with few reports in the literature. Medical, surgical, and endovascular treatment modalities have all been used to manage iliac artery dissections. We report a case of symptomatic, isolated, spontaneous dissection of the common iliac and external iliac arteries. Both dissections were successfully treated by separate percutaneous stent-graft placement, preserving hypogastric artery flow. This technique is interesting because it provides adequate sealing of proximal and distal dissection sites while preserving hypogastric artery and pelvic flow. PMID:25305424

Yoshida, Ricardo de Alvarenga; Kolvenbach, Ralf; Vieira, Paulo Roberto Bahdur; Moura, Regina; Jaldin, Rodrigo Gibin; Yoshida, Winston Bonetti

2015-01-01

126

Revised earthquake hazard of the Hat Creek fault, northern California: A case example of a normal fault dissecting variable-age basaltic lavas  

E-print Network

Revised earthquake hazard of the Hat Creek fault, northern California: A case example of a normal ABSTRACT Normal faults in basalt have distinctive surface-trace morphologies and earthquake evidence be applied to any normal-faulted basalt envi- ronment. Applied to the Hat Creek fault, we estimate

Kattenhorn, Simon

127

Beware of arteria lusoria during lymph node dissection of the right paratracheal fossa for lung cancer surgery  

PubMed Central

An asymptomatic elderly woman presented with a solitary right upper lobe mass revealed to be non-small cell lung cancer following routine surveillance post mastectomy. Upon review of CT with contrast in preparation for rigid bronchoscopy and right upper lobectomy, we noticed that the patient had a rare case of arteria lusoria. This is the presence of an aberrant right subclavian artery extending from the left side of the aortic arch, crossing posteriorly across the midline to supply the upper limb. We suggest that with a documented 100% diagnostic sensitivity on 64 multislice computed tomography, the presence of arteria lusoria within the posterior paratracheal fossa may cause life-threatening complications in the unaware during systematic lymph node dissection for non-small cell lung cancer (NSCLC). PMID:25590005

Pan, Daniel; Cufari, Maria Elena

2014-01-01

128

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

PubMed

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

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

2012-01-01

129

Dissecting aortic aneurysm in computed tomography.  

PubMed

The dissecting aortic aneurysm (DAA) is an emergency, and because of that it requires urgent diagnosis and treatment. Many methods may by used to diagnose dissection, including aortography, CT, MRI, traditional and transesophageal ultrasonography. The computed tomography is often used in diagnostic of DAA, thus the knowledge of morphological characteristic of dissection is very important. The most important features of dissection in CT are presence of dissection of intima and two lumens, true and false. Nevertheless, the CT pictures of dissection not always appears like this, and sometimes the two lumens are identified only by their different rates of opacification with contrast material. PMID:15314960

Pas?awski, Marek; Z?omaniec, Janusz; Ruci?ska, Eulalia; Horbaczewska, Anna

2003-01-01

130

Isolated dissections and dissecting aneurysms of the posterior inferior cerebellar artery: topic and literature review.  

PubMed

Isolated dissections of the posterior inferior cerebellar artery (PICA) are rare. Thus, no large series of cases have been reported in the literature. Due to limited knowledge regarding the natural history of these lesions and the lack of high-quality evidence supporting various treatment options, management is controversial and practice parameters are ill defined. In order to offer a comprehensive reference for the diagnosis and management of isolated PICA dissections, the authors reviewed the National Library of Medicine from 1966 to October 2001. Twenty-seven patients averaging 43.6 years of age and including 14 males and 13 females were reported. Subarachnoid hemorrhage occurred in 20 patients, and two died. Dissections were located in the proximal PICA in 22 patients and were three times more common on the left side (left:right=3:1). Six patients were managed conservatively, and four with endovascular techniques. Seventeen had open surgery: five underwent resection, two went through trapping, and two had proximal clipping. Wrapping with muscle was performed in two patients, encasement with Sundt clips in two, and four had occipital artery (OA)-PICA bypass surgery. A meticulous analysis of reported cases with regard to clinical and pathological features, management strategies, and outcomes is presented. PMID:12845546

Tawk, Rabih G; Bendok, Bernard R; Qureshi, Adnan I; Getch, Christopher C; Srinivasan, Jayashree; Alberts, Mark; Russell, Eric J; Batjer, H Hunt

2003-07-01

131

Micro-dissection testicular sperm extraction as an alternative for sperm acquisition in the most difficult cases of Azoospermia: Technique and preliminary results in India  

PubMed Central

CONTEXT: Non-obstructive azoospermia (NOA) is an unfavorable prognostic condition for male infertility since spermatogenesis is disrupted. Sperm retrieval (SR) coupled with intracytoplasmic sperm injection (ICSI) is the only option for men with NOA who seek fertility. Among the SR techniques, microdissection testicular sperm extraction (micro-TESE) has been applied with encouraging results. AIMS: We describe how we implemented the micro-TESE procedure and present initial micro-TESE experience in a group of men with NOA and poor prognosis for SR. SETTINGS AND DESIGN: Case series of men with NOA treated in a tertiary healthcare center. MATERIALS AND METHODS: An Assisted Reproductive Technology (ART) facility was setup to perform SR using microsurgery. Fourteen men with NOA and previous failed retrievals or unfavorable histologic results underwent micro-TESE while their female partners received ovarian stimulation for oocyte pickup (OCP). Micro-TESE was performed the day prior to OCP and testicular sperm were used for sperm injections. We assessed retrieval rates and ICSI outcomes. STATISTICAL ANALYSIS: Outcomes of SR and ICSI were analyzed descriptively. Mann-Whitney and Fisher exact test were used to compare characteristics of men with successful and failed SR. RESULTS: The success of micro-TESE was 50.0% with no major complications. A clear microscopic distinction between enlarged and collapsed seminiferous tubules was seen in 35.7% of the cases, and sperm were retrieved in all but one of these cases. Patients with successful and failed retrieval did not differ with respect to baseline characteristics, use of medical therapy, presence of varicocele, and testicular histology. Sperm injections resulted in normal fertilization and embryo cleavage of 64% and 75%, respectively. A total of five transfers with an average of 1.5 embryos resulted in a cumulative clinical pregnancy rate per ICSI cycle of 28.6%, with an implantation rate of 33.3%. CONCLUSIONS: We were successful in integrating the micro-TESE procedures to the in vitro fertilization (IVF) laboratory. Our initial experience with micro-TESE applied to the most difficult cases of azoospermia is reassuring. PMID:24082652

Ashraf, Mohamed C; Singh, Sankalp; Raj, Dharma; Ramakrishnan, Sujatha; Esteves, Sandro C

2013-01-01

132

Dissect Your Squid and Eat It Too!  

ERIC Educational Resources Information Center

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)

McGinnis, Patricia

2001-01-01

133

Bilateral renal artery dissections: unusual complication of polyarteritis nodosa.  

PubMed

A case of polyarteritis nodosa with the acute complications of multiple bilateral real artery dissection, perirenal haemorrhage and kidney infarction is described. The diagnosis of polyarteritis nodosa was established on the basis of angiographical and clinical findings. Follow-up arteriograms and CT-findings after prednisone therapy are discussed. PMID:6144545

Hekali, P E; Pajari, R I; Kivisaari, M L; Haapanen, E J; Leirisalo, M

1984-02-01

134

Delayed left atrial wall dissection after mitral valve replacement.  

PubMed

We report two unusual cases of left atrial wall dissection creating a left atrial pseudoaneurysm associated with regurgitation a few months after mitral valve replacement. We emphasize the important role of transesophageal echocardiography in the diagnosis. The two patients successfully underwent surgery. PMID:10978990

Idir, M; Deville, C; Roudaut, R

2000-04-01

135

Surgery for three-channeled aortic dissection  

Microsoft Academic Search

Among aortic dissections, three-channeled aortic dissection, in which two parallel false lumens are present, is relatively rare. We surgically treated 26 patients with this type of dissection, they accounted for 7.4% of all 349 patients with aortic dissection surgically treated between 1978 and May 1997. Their ages ranged from 24 to 77 years (mean 45 years). The male\\/female ratio was

Motomi Ando; Shinichi Takamoto; Yutaka Okita; Tetsuro Moroto

1998-01-01

136

Treatment of ruptured intracranial dissecting aneurysms in Hong Kong  

PubMed Central

Background: Data suggests that hemorrhagic presentations occur in 20% of internal carotid artery dissections and 50% of vertebral artery dissections. A Finnish study has reported favorable outcomes in only 32% of patients. We aimed to review the epidemiology and management outcomes in a Chinese population. Methods: We reviewed the aneurysmal subarachnoid hemorrhage registry of patients who presented with intracranial dissecting aneurysms at a neurosurgical center in Hong Kong over a five-year period. Results: A total of 23 patients with intracranial dissecting aneurysms were identified, accounting for 8% of all spontaneous subarachnoid hemorrhage patients. Forty-eight percent of the patients identified were treated by main trunk occlusion and 39% were treated by embolization or stent-assisted embolization or stent alone. Thirteen percent were managed by craniotomy and trapping or wrapping. Favorable outcomes at six months were achieved in 67%. Conclusions: Patients with intracranial dissecting aneurysms account for a significant proportion of the cases of spontaneous subarachnoid hemorrhage in our population. Carefully selected endovascular and microsurgical treatments can lead to management outcomes similar to patients with saccular aneurysms. PMID:21206536

Wong, George Kwok Chu; Tang, Hoi Bun; Poon, Wai Sang; Yu, Simon Chun Ho

2010-01-01

137

Dissection & Science Fairs. [Information Packet.  

ERIC Educational Resources Information Center

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,…

National Anti-Vivisection Society, Chicago, IL.

138

Animal Rights Activism Threatens Dissection.  

ERIC Educational Resources Information Center

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)

Holden, Constance

1990-01-01

139

Adult-onset dysphagia lusoria secondary to a dissecting aberrant right subclavian artery associated with type B acute aortic dissection  

PubMed Central

The case of a 78-year-old African American woman who presented at the Mount Sinai Medical Center (Chicago, USA) with excruciating backache is presented. Computed tomography of the chest at the time of admission showed dissection of the aortic arch, descending aorta and dissection of an aberrant right subclavian artery. She was managed medically for Stanford type B acute aortic dissection. The patient was asymptomatic at presentation, but started complaining of new-onset dysphagia during her stay in the hospital. An esophagogram was performed and suggested posterior impingement of the esophagus, a classic sign of an aberrant right subclavian artery. Because the patient had multiple underlying comorbidities and the dysphagia was mild and intermittent, surgery was deferred. The patient was discharged home after complete stabilization and was scheduled for a follow-up appointment. PMID:18209773

Singh, Sarabjeet; Grewal, Puneet Dhillon; Symons, John; Ahmed, Aziz; Khosla, Sandeep; Arora, Rohit

2008-01-01

140

Simultaneous endovascular stent and renal stent placement for acute type B aortic dissection with malperfusion of kidney  

PubMed Central

Acute aortic dissection frequently causes life-threatening organ ischemia. The optimal therapy for acute type-B aortic dissection is still controversial. Surgery for acute dissection with organ malperfusion is known to carry a high morbidity and mortality; however endovascular treatment is becoming an alternative form of treatment. We report a clinical case of emergency percutaneous thoracal aorta endovascular stenting and renal artery stenting in a patient who had renal malperfusion and acute renal failure due to acute type-B dissection. The present case is a fundamental examples of collaboration between the cardiologist and cardiovascular surgeon in a hybrid procedure. PMID:23960684

Dagdelen, Sinan; Ayd?n, Ebuzer; Karabulut, Hasan

2012-01-01

141

Management Strategy of Isolated Spontaneous Dissection of the Superior Mesenteric Artery  

PubMed Central

Objective: Isolated spontaneous dissection of the superior mesenteric artery (SMA) is very rare among of the visceral artery dissection and its treatment is not established. In this paper we present our experiences and consider the treatment of isolated SMA dissection. Methods: A retrospective review of our cases from 2005 was performed. Clinical symptoms, radiologic findings and results were evaluated. There were 14 cases of visceral artery dissection, in which all cases were with SMA dissection. There were 12 males and 2 females with a mean age of 57 years (range 41–78 years). Results: We categorized SMA dissection into the six types according to the Sakamoto’s and Zerbib’s classification. One patient with type VI underwent emergent endovascular surgery with stent. One patient with type VI received thrombectomy and intimectomy with open surgery. One patient with type II underwent aneurysmectomy due to enlarged dissected SMA 3 months later from onset. The other eleven patients were managed conservatively. At follow-up, the diameter of SMA did not enlarged and the length of the dissection significantly decreased to 20.7 ± 15.7 mm from 38.0 ± 15.1 mm at onset (p <0.01). After treatment, imaging indicated the following changes in classification: type I, one patient; type II, 4 patients; type IV, 4 patients; complete remodeling, one patient, all without any event during the follow-up period of 5–82 months. Conclusion: Most patients with isolated visceral artery dissection occurred in superior mesenteric artery and can be treated conservatively; however, endovascular or surgical procedures including laparotomy are indicated when there is suspicion of severe mesenteric ischemia. Because the dissection configuration will change, long term follow-up is necessary. (*English translation of Jpn J Vasc Surg 2013; 22: 695-701) PMID:25298823

Takase, Shinya; Seto, Yuki; Yokoyama, Hitoshi; Gotoh, Mitsukazu; Kogure, Michihiko; Midorikawa, Hirofumi; Saito, Tomiyoshi; Maehara, Kazuhira

2014-01-01

142

Reversible cerebral vasoconstriction syndrome and bilateral vertebral artery dissection presenting in a patient after cesarean section  

PubMed Central

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by sudden-onset thunderclap headache and focal neurologic deficits. Once thought to be a rare syndrome, more advanced non-invasive imaging has led to an increase in RCVS diagnosis. Unilateral vertebral artery dissection has been described in fewer than 40% of cases of RCVS. Bilateral vertebral artery dissection has rarely been reported. We describe the case of a patient with RCVS and bilateral vertebral artery dissection presenting with an intramedullary infarct treated successfully with medical management and careful close follow-up. This rare coexistence should be recognized as the treatment differs. PMID:23354867

Mitchell, Lex A; Santarelli, Justin G; Singh, Inder Paul; Do, Huy M

2013-01-01

143

Use of covered stent devices for false lumen embolization in chronic dissection: a novel approach.  

PubMed

Thoracic endovascular aortic repair (TEVAR) is effective in treating acute complicated dissection, but in the chronic state it is frequently complicated by persistent retrograde false lumen perfusion that results in treatment failure. We describe a novel endovascular technique and present an illustrative case of a patient with chronic dissection for which covered stent devices were used as an adjunct to TEVAR to occlude the distal thoracic false lumen and interrupt retrograde perfusion. The case demonstrates that this strategy promotes remodeling when used in addition to stent grafting the true lumen for chronic dissection. PMID:25087811

Roselli, Eric E; Idrees, Jahanzaib; Reside, Joshua; Shafii, Susan

2014-08-01

144

Type A aortic dissection in a patient on dabigatran: hemostasis post circulatory arrest.  

PubMed

We present a successful case of prevention of postoperative hemorrhage in a 70-year-old male on dabigatran, who developed an acute type A aortic dissection and subsequently underwent an emergent ascending aortic replacement. PMID:25468095

Ashikhmina, Elena; Tomasello, Nicole; Connors, Jean Marie; Jahanyar, Jama; Davidson, Michael; Mizuguchi, K Annette

2014-12-01

145

Endovascular Management of Complete Vertebral Artery Dissection Presenting with Subarachnoid Haemorrhage  

PubMed Central

Summary Spontaneous vertebral artery (VA) dissection may involve the intradural segment of the VA and result in subarachnoid haemorrhage (SAH). These lesions are frequently associated with recurrent SAH, and have a high mortality. Prior to the development of endovascular techniques the majority of these lesions were treated surgically. In cases where the dissection involved the posterior inferior cerebellar artery (PICA) origin surgery was associated with significant complications including recurrent SAH from retrograde VA flow into the dissected segment above the surgical clip. We describe two cases of complete VA dissection in which the entire intradural VA was sacrificed to prevent recurrent SAH. The first case tolerated planned left PICA occlusion without developing a significant neurological deficit. The second case had infarcted the right PICA territory at presentation. PMID:20670506

Lenthall, R.K.; White, B.D.; Mcconachie, N.S.

1999-01-01

146

Spontaneous Subclavian Artery Dissection Causing Ischemia of the Arm: Diagnosis and Endovascular Management  

SciTech Connect

Spontaneous subclavian artery dissections are rare, with very few cases described in the literature. We report an unusual case of a 62-year-old female who presented with ischemia of the left arm secondary to spontaneous dissection of the first part of the left subclavian artery. We describe the imaging findings on both aortic arch angiogram and CT angiogram and discuss management by endovascular means.

Ananthakrishnan, Ganapathy, E-mail: ganapathy.ananthakrishnan@nhs.net; Bhat, Rajesh; Zealley, Ian [Ninewells Hospital and Medical School, Department of Radiology (United Kingdom)

2009-03-15

147

Netfrog: The Interactive Frog Dissection  

NSDL National Science Digital Library

This tutorial on frog dissection contains an introduction and sections on preparation, skin incisions, muscle incisions, and internal organs. The purpose of this lab activity is to help students learn the anatomy of a frog and provide them with a better understanding of the anatomy of vertebrate animals in general, including humans. This site provides still and motion visuals of preserved and pithed (severed spinal cord) frogs to demonstrate incisions, in addition to text.

Kinzie, Mable

148

[Progressive carotid artery dissection causing tinnitus and one-sided head and neck pain].  

PubMed

Carotid artery dissection, one of the most common causes of stroke in patients younger than 40 years of age, may develop spontaneously or after trauma. In 85% of cases, central neurological signs such as stroke, transient ischemic attack and amarozis fugax are seen, while headache and cranial nerve paralysis can be the presenting symptoms in the rest of cases. In this case report, a 35-year of age young male patient who had a progressive carotid artery dissection accompanied by complaints of left sided tinnitus and ipsilateral head and neck pain. The patient was admitted to the clinic with the diagnosis of carotid artery dissection and cerebral angiography (CA) was planned. During the CA performed the day after, three stents were placed in the dissection area. Improvement was observed in all complaints of the patient who was followed up in the clinic for 10 days. The patient was discharged in a healthy condition to return after three months for a control. PMID:21762057

Karada?, Omer; Ipekdal, Ilker Hüseyin; Meteo?lu, Ali; Gül, Levent Hakan

2011-01-01

149

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

PubMed

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

Kim, Myeong-Soo

2013-06-01

150

Aortic Dissection and Renal Failure in a Patient with Severe Hypothyroidism  

PubMed Central

Acute aortic dissection (AAD) is a life-threatening condition associated with high morbidity and mortality. The most important recognized acquired cause that leads to dissection is chronic arterial hypertension. With respect to the anuria and renal failure, aortic dissection is not something that is always considered and is still not a very common presentation unless both renal arteries come off the false lumen of the dissection. However, when present, preoperative renal failure in patients with acute type B dissection has been noted to be an independent predictor of mortality. Early recognition and diagnosis is the key and as noted by previous studies as well, almost a third of these patients are initially worked up for other causes until later when they are diagnosed with aortic dissection. Here we present a case of a patient presenting with severe hypothyroidism, long-standing hypertension, and anuria. Through the case, we highlight the importance of having aortic dissection as an important differential in patients presenting with anuria who have a long standing history of uncontrolled hypertension. Pathophysiology relating to severe hypothyroidism-induced renal dysfunction is also discussed. PMID:22829842

Brooke, Valerie; Goswami, Sangeeta; Mohanty, Arpan; Kasi, Pashtoon Murtaza

2012-01-01

151

Coronary ostial involvement in acute aortic dissection: detection with 64-slice cardiac CT.  

PubMed

A 41-year-old man collapsed after lifting weights at a gym. Following admission to the emergency department, a 64-slice cardiac computed tomography (CT) revealed a Stanford Type A aortic dissection arising from a previous coarctation repair. Multiphasic reconstructions demonstrated an unstable, highly mobile aortic dissection flap that extended proximally to involve the right coronary artery ostium. Our case is an example of the application of electrocardiogram-gated cardiac CT in directly visualizing involvement of the coronary ostia in acute aortic dissection, which may influence surgical management. PMID:19857809

Ryan, E Ronan; Martos, Ramon; O'Neill, Ailbhe; Mc Creery, Charles; Dodd, Jonathan D

2009-01-01

152

Spontaneous Coronary Artery Dissection in a Male Patient with Takayasu's Arteritis and Antiphospholipid Antibody Syndrome  

PubMed Central

We present a case of a 34-year-old male who presented to the emergency ward with fever and abdominal pain. The diagnosis of Takayasu's arteritis and also antiphospholipid syndrome was made during an imaging workup of deep-vein thrombosis. A spontaneous coronary artery dissection was revealed in coronary CT angiography requested for chest pain and dyspnea. The patient was treated medically and discharged on close followup. The concurrence of spontaneous coronary artery dissection with antiphospholipid syndrome and Takayasu's arteritis has not been reported in the previous literature. The possibility of a spontaneous coronary artery dissection should be considered in patients presenting with both diseases. PMID:23956914

Gerede, Demet Menek?e; Yüksel, Ba?dagül; Tutar, Eralp; Küçük?ahin, Orhan; Uzun, Ça?lar; Atasoy, Kayhan Çetin; Düzgün, Nur?en; Bengisun, U?ur

2013-01-01

153

Successful Aorta-osteal Stenting after Iatrogenic Acute Type-A Aortic Dissection during Primary Percutaneous Coronary Intervention  

PubMed Central

Background: Iatrogenic acute dissection of the ascending aorta following coronary angiography and percutaneous intervention is rare. This complication, if not managed urgently, can have critical results. Case Report: We present the case of a 70 year-old woman who was treated by primary percutaneous coronary intervention (PCI) of the right coronary artery (RCA) for acute inferior myocardial infarction; however, the procedure was complicated by anterograde dissection of the RCA with a simultaneous retrograde propagation to the proximal part of the ascending aorta. Successful stenting of the entry point was able to heal the RCA and restrict the retrograde propagation to the ascending aorta. The aortic dissection was monitored by means of computerised tomography and the dissection repaired itself spontaneously within a day. Conclusion: Treatment of the aorta coronary dissection (ACD) by urgent osteal stenting is a less invasive treatment compared with surgical treatment in appropriate cases. We demonstrated that immediate osteal stenting should be performed in ACD.

Bekler, Adem; Özeren, Ali; Gazi, Emine; Temiz, Ahmet; Altun, Burak

2014-01-01

154

Catheter-induced left main coronary artery dissection resulting in abrupt closure and cardiac arrest: successful stenting during resuscitation.  

PubMed

Catheter-induced left main coronary artery dissection is an uncommon but devastating complication of coronary angiography and percutaneous coronary intervention. We present a case of left main coronary artery dissection induced with a guide catheter, which resulted in acute occlusion and cardiac arrest. Survival and complete functional recovery were achieved with bailout stenting. PMID:17404412

Ozdol, Cagdas; Oral, Dervis; Tutar, Eralp

2007-04-01

155

Rotastenting in an anomalously arising right coronary artery after an ugly dissection  

PubMed Central

Rotational atherectomy is contraindicated in dissected coronary arteries since it can lead to progression of the dissection or perforation. In our case, the right coronary artery (RCA) arose anomalously from the left coronary sinus. The lesion in the RCA was an undilatable calcified one. There was a dissection in the RCA due to high pressure balloon dilatation. Since the patient was hemodynamically unstable and there were no options besides rotablation, we proceeded with caution. Rotablation and stenting were successfully done. Our case report highlights the importance of the need for good guide catheter support even in the presence of anomalously arising arteries and the rotablation option for unyielding calcified coronary lesions, even in the setting of a dissection. PMID:23993013

Mehta, Ashwin B.; Desai, Ajit; Mehta, Nihar

2013-01-01

156

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

...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...

2010-09-15

157

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Regulatory Commission [Docket No. PR09-5-003] Lee 8 Storage Partnership; Notice of Motion for Extension...Filing Deadline Take notice that on June 27, 2011, Lee 8 Storage Partnership (Lee 8) filed a request for an extension consistent...

2011-07-07

158

Aortic arch dissection: a controversy of classification.  

PubMed

Aortic dissections originating in the ascending aorta and descending aorta have been classified as type A and type B dissections, respectively. However, dissections with intimal flap extension into the aortic arch between the innominate and left subclavian arteries are not accounted for adequately in the widely used Stanford classification. This gap has been the subject of controversy in the medical and surgical literature, and there is a tendency among many radiologists to categorize such arch dissections as type A lesions, thus making them an indication for surgery. However, the radiologic perspective is not supported by either standard dissection classification or current clinical management. In this special report, the origin of dissection classification and its evolution into current radiologic interpretation and surgical practice are reviewed. The cause for the widespread misconception about classification and treatment algorithms is identified. Institutional review board approval and waiver of informed consent were obtained as part of this HIPAA-compliant retrospective study to assess all aortic dissection studies performed at the University of Maryland Medical Center, Baltimore between 2010 and 2012 to determine the prevalence of arch dissections. Finally, a unified classification system that reconciles imaging interpretation and management implementation is proposed. PMID:24617732

Lempel, Jason K; Frazier, Aletta Ann; Jeudy, Jean; Kligerman, Seth J; Schultz, Randall; Ninalowo, Hammed A; Gozansky, Elliott K; Griffith, Bartley; White, Charles S

2014-06-01

159

Beyond Dissection: Innovative Tools for Biology Education.  

ERIC Educational Resources Information Center

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,…

Larson, Sandra, Ed.

160

Objecting To Dissection: A College Student's Handbook.  

ERIC Educational Resources Information Center

In a number of states, students from kindergarten through high school have won the right to refuse to dissect or kill animals and the right to substitute an alternative project. This booklet was designed to help college science students take an ethical stand by refusing to participate in dissection exercises. The booklet begins with an overview of…

National Anti-Vivisection Society, Chicago, IL.

161

Quick Dissection of the Segmental Bronchi  

ERIC Educational Resources Information Center

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…

Nakajima, Yuji

2010-01-01

162

Surgery for Three-Channeled Aortic Dissection.  

PubMed

Among aortic dissections, three-channeled aortic dissection, in which two parallel false lumens are present, is relatively rare. We surgically treated 26 patients with this type of dissection, they accounted for 7.4% of all 349 patients with aortic dissection surgically treated between 1978 and May 1997. Their ages ranged from 24 to 77 years (mean 45 years). The male/female ratio was 1:1. Marfan's syndrome was present in 15 patients and Bentall's-type operation had been performed in 12 patients. Pain at different times was observed in 19 patients. For preoperative diagnosis, computed tomography (CT) and magnetic resonance imaging (MRI) were useful. The morphology of the 1st and 2nd false lumens was Stanford type A + type B in 11 patients, type B + type B in 12, type A + type A in 2, and localized abdominal dissection in 1. Reentry of the second false lumen was observed in only 3 patients. Descending aortic replacement was performed in 13 patients, thoracoabdominal aortic replacement in 6, ascending aortic replacement in 3, and others in 4. Seven patients died in the hospital. There were 4 late deaths during follow-up for 10-158 months (mean, 58 months). When pain recurred in patients with aortic dissection, three-channeled dissection should be suspected. The incidence of this dissection is high in patients with Marfan's syndrome. PMID:9716796

Ando; Takamoto; Okita; Moroto

1998-08-01

163

Left atrial dissection: an almost unknown entity.  

PubMed

Left atrial dissection is an exceedingly rare but potentially fatal complication of cardiac surgery. It is most commonly associated with mitral valve surgery, including both replacement and repair, with a reported incidence rate of 0.16%. However, other cardiac surgical or catheter-based interventional procedures are also known as potential predisposing factors. The time of presentation from the cause of dissection varies extremely, ranging from immediate occurrence up to 20 years later. The dissection forms a large cavity between the endocardium and epicardium of the left atrium, causing obliteration of the left atrial cavity and resultant haemodynamic compromise, which almost always requires immediate surgical intervention. In contrast, left atrial dissection without haemodynamic instability can often be managed non-operatively with satisfactory outcomes. This article reviews this rare but relevant clinical entity to further elucidate the incidence, pathogenesis, clinical course, management and outcome of left atrial dissection. PMID:25260895

Fukuhara, Shinichi; Dimitrova, Kamellia R; Geller, Charles M; Hoffman, Darryl M; Tranbaugh, Robert F

2015-01-01

164

Evaluation of the efficacy of a novel radical neck dissection preserving the external jugular vein, greater auricular nerve, and deep branches of the cervical nerve  

PubMed Central

Background Conventional radical neck dissection often causes a variety of complications. Although the dissection method has been improved by retaining some tissues to reduce complications, the incomplete dissection may cause recurrence of disease. In the present study, we developed a novel radical neck dissection, which preserves the external jugular vein, the greater auricular nerve, and the deep branches of the cervical nerve, to effectively reduce complications and subsequently, to promote the postoperative survival quality. Methods A total of 100 cases of radical neck dissection were retrospectively analyzed to evaluate the efficacy, rate of complication, and postoperative dysfunction of patients treated with the novel radical neck dissection. Data analysis was performed using the Chi-square test. Results Compared with conventional radical neck dissection, the novel radical neck dissection could significantly reduce complications and promote postoperative survival quality. Particularly, the preservation of the external jugular vein reduced the surgical risk (ie, intracranial hypertension) and complications (eg, facial edema, dizziness, headache). Preservation of the deep branches of the cervical nerve and greater auricular nerve resulted in relatively ideal postoperative functions of the shoulders and ear skin sensory function (P < 0.05), while the two types of dissection procedures showed no differences in the recurrence rate (P > 0.05). Conclusion Our novel radical neck dissection procedure could effectively reduce the complications of intracranial hypertension, shoulder dysfunction, and ear sensory disturbances. It can be used as a regular surgical approach for oral carcinoma radical neck dissection. PMID:23596353

Li, Yadong; Zhang, Jinsong; Yang, Kai

2013-01-01

165

Thymectomy in central lymph node dissection for papillary thyroid cancer  

PubMed Central

Background: Central lymph node dissection (CND) has been proposed in the treatment of patients affected by papillary thyroid cancer (PTC) with clinically negative neck lymph nodes. The procedure allows pathologic staging of lymph nodes of the central compartment and treatment of the micrometastases. By comparing bilateral and unilateral thymectomy during total thyroidectomy with central lymph node dissection for postoperative complications in sonographically node-negative papillary thyroid carcinomas, we aimed to determine the optimal extent of prophylactic central lymph node dissection. Methods: Patients were divided into two study groups: Group 1, total thyroidectomy plus unilateral thymectomy during the CND; Group 2, total thyroidectomy associated with bilateral thymectomy (both upper poles) during the CND. Primary endpoints of the study were evaluated by comparing the postoperative complications between the two groups. Results: The only significant result found when comparing the two groups was the rate of transient hypocalcemia. (Group 1: 13.7%, Group 2: 52.4%, p<0.01). A total of five cases of papillary thymic metastases were found in this study. And final pathology confirmed that all cases of thymic metastases were lymph node micrometastases of PTC, only situated in the ipsilateral thymus upper pole. Conclusions: Bilateral thymectomy during the CND did not provide a better carcinologic resection, as no contralateral thymic metastases were found. The unilateral thymectomy with total thyroidectomy during the CND may represent an effective strategy for reducing the rate of postoperative hypocalcemia. PMID:24955195

Huang, Du-Ping; Ye, Xiao-He; Xiang, You-Qun; Zhang, Xiao-Hua

2014-01-01

166

What Lies behind the Ischemic Stroke: Aortic Dissection?  

PubMed Central

Introduction. Some cases with aortic dissection (AD) could present with various complaints other than pain, especially neurological and cardiovascular manifestations. AD involving the carotid arteries could be associated with many clinical presentations, ranging from stroke to nonspecific headache. Case Report. A 71-year-old woman was admitted to emergency department with vertigo which started within the previous one hour and progressed with deterioration of consciousness following speech disorder. On arrival, she was disoriented and uncooperative. Diffusion magnetic resonance imaging (MRI) of brain was consistent with acute ischemia in the cerebral hemisphere. Fibrinolytic treatment has been planned since symptoms started within two hours. Echocardiography has shown the dilatation of ascending aorta with a suspicion of flap. Computed tomography (CT) angiography has been applied and intimal flap has been detected which was consistent with aortic dissection, intramural hematoma of which was reaching from aortic arch to bilateral common carotid artery. Thereafter, treatment strategy has completely changed and surgical invention has been done. Conclusion. In patients who are admitted to the emergency department with the loss of consciousness and stroke, inadequacy of anamnesis and carotid artery involvement of aortic dissection should be kept in mind.

Deniz, Turgut; Dag, Ersel; Tulmac, Murat; Azapoglu, Burcu; Alp, Caglar

2014-01-01

167

Spontaneous coronary artery dissection: a neglected cause of acute myocardial ischaemia and sudden death.  

PubMed Central

Spontaneous coronary artery dissection is a rare cause of acute myocardial ischaemia. Eight consecutive fatal cases which occurred in women aged 34-54 years (mean 43) are described. The dissection involved the left anterior descending coronary artery in four, the left main trunk in two, the right coronary artery in one, and both left anterior descending and circumflex arteries in one. The clinical presentation was sudden death in six cases, and acute myocardial infarction in two. Diagnosis was made at necropsy in every case but one, in which coronary dissection was diagnosed during life by selective coronary angiography. The only ascertained risk factor was hypertension in one patient; none of the women was in the puerperium, and Marfan syndrome was excluded in all. Histology showed a haematoma between the coronary tunica media and adventitia, that flattened and occluded the lumen; a coronary intimal tear was detected in only two cases. Unusual histological findings were cystic medial necrosis in one case, eosinophilic inflammatory infiltrates in four, and angiomatosis of the tunica adventitia in one. Patients dying of spontaneous coronary dissection are usually middle aged women, with no coronary atherosclerosis and apparently no risk factors. Spontaneous coronary artery dissection is unpredictable, and sudden death is the usual mode of clinical presentation. Prompt diagnosis and life saving treatment is far from being achieved. Images PMID:8665336

Basso, C.; Morgagni, G. L.; Thiene, G.

1996-01-01

168

Calcineurin A versus NS5A-TP2/HD domain containing 2: a case study of site-directed low-frequency random mutagenesis for dissecting target specificity of peptide aptamers.  

PubMed

We previously identified a peptide aptamer (named R5G42) via functional selection for its capacity to slow cell proliferation. A yeast two-hybrid screen of human cDNA libraries, using R5G42 as "bait," allowed the identification of two binding proteins with very different functions: calcineurin A (CnA) (PP2B/PPP3CA), a protein phosphatase well characterized for its role in the immune response, and NS5A-TP2/HD domain containing 2, a much less studied protein induced subsequent to hepatitis C virus non-structural protein 5A expression in HepG2 hepatocellular carcinoma cells, with no known activity. Our objective in the present study was to dissect the dual target specificity of R5G42 in order to have tools with which to better characterize the actions of the peptide aptamers toward their individual targets. This was achieved through the selection of random mutants of the variable loop, derived from R5G42, evaluating their specificity toward CnA and NS5A-TP2 and analyzing their sequence. An interdisciplinary approach involving biomolecular computer simulations with integration of the sequence data and yeast two-hybrid binding phenotypes of these mutants yielded two structurally distinct conformers affording the potential molecular basis of the binding diversity of R5G42. Evaluation of the biological impact of CnA- versus NS5A-TP2-specific peptide aptamers indicated that although both contributed to the anti-proliferative effect of R5G42, CnA-binding was essential to stimulate the nuclear translocation of nuclear factor of activated T cells, indicative of the activation of endogenous CnA. By dissecting the target specificity of R5G42, we have generated novel tools with which to study each target individually. Apta-C8 is capable of directly activating CnA independent of binding to NS5A-TP2 and will be an important tool in studying the role of CnA activation in the regulation of different signaling pathways, whereas Apta-E1 will allow dissection of the function of NS5A-TP2, serving as an example of the usefulness of peptide aptamer technology for investigating signaling pathways. PMID:23579184

Dibenedetto, Silvia; Cluet, David; Stebe, Pierre-Nicolas; Baumle, Véronique; Léault, Jérémie; Terreux, Raphaël; Bickle, Marc; Chassey, Benoit D E; Mikaelian, Ivan; Colas, Pierre; Spichty, Martin; Zoli, Michele; Rudkin, Brian B

2013-07-01

169

Calcineurin A versus NS5A-TP2/HD Domain Containing 2: A Case Study of Site-directed Low-frequency Random Mutagenesis for Dissecting Target Specificity of Peptide Aptamers*  

PubMed Central

We previously identified a peptide aptamer (named R5G42) via functional selection for its capacity to slow cell proliferation. A yeast two-hybrid screen of human cDNA libraries, using R5G42 as “bait,” allowed the identification of two binding proteins with very different functions: calcineurin A (CnA) (PP2B/PPP3CA), a protein phosphatase well characterized for its role in the immune response, and NS5A-TP2/HD domain containing 2, a much less studied protein induced subsequent to hepatitis C virus non-structural protein 5A expression in HepG2 hepatocellular carcinoma cells, with no known activity. Our objective in the present study was to dissect the dual target specificity of R5G42 in order to have tools with which to better characterize the actions of the peptide aptamers toward their individual targets. This was achieved through the selection of random mutants of the variable loop, derived from R5G42, evaluating their specificity toward CnA and NS5A-TP2 and analyzing their sequence. An interdisciplinary approach involving biomolecular computer simulations with integration of the sequence data and yeast two-hybrid binding phenotypes of these mutants yielded two structurally distinct conformers affording the potential molecular basis of the binding diversity of R5G42. Evaluation of the biological impact of CnA- versus NS5A-TP2-specific peptide aptamers indicated that although both contributed to the anti-proliferative effect of R5G42, CnA-binding was essential to stimulate the nuclear translocation of nuclear factor of activated T cells, indicative of the activation of endogenous CnA. By dissecting the target specificity of R5G42, we have generated novel tools with which to study each target individually. Apta-C8 is capable of directly activating CnA independent of binding to NS5A-TP2 and will be an important tool in studying the role of CnA activation in the regulation of different signaling pathways, whereas Apta-E1 will allow dissection of the function of NS5A-TP2, serving as an example of the usefulness of peptide aptamer technology for investigating signaling pathways. PMID:23579184

Dibenedetto, Silvia; Cluet, David; Stebe, Pierre-Nicolas; Baumle, Véronique; Léault, Jérémie; Terreux, Raphaël; Bickle, Marc; Chassey, Benoit D. E.; Mikaelian, Ivan; Colas, Pierre; Spichty, Martin; Zoli, Michele; Rudkin, Brian B.

2013-01-01

170

Animal Rights Groups Target High School Dissection.  

ERIC Educational Resources Information Center

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)

Trotter, Andrew

1992-01-01

171

Postoperative adjuvant chemoradiotherapy in D2-dissected gastric cancer: Is radiotherapy necessary after D2-dissection?  

PubMed Central

Studies from the Far East have demonstrated that D2-dissection is superior to D0/1-dissection. The effect of postoperative chemoradiotherapy (CRT) after D2-dissection has not been accepted due to the lack of D2-dissection in Western countries, as well as the potential harmful effect of radiotherapy. In the current NCCN guideline, adjuvant chemotherapy alone is recommended in D2-dissected patients. However, three recent prospective randomized controlled trials in South Korea and China (ARTIST, NCC and Multicenter IMRT Trials) demonstrated that adjuvant CRT can be safely administered to D2-dissected patients with notable benefits. To identify the role of radiotherapy (RT) in the D2-dissected postoperative setting, clinical research attempts should include (1) identification of high-risk patients for loco-regional recurrence who might benefit from CRT; (2) modification of RT target volume based on the findings that failure patterns should be different after D1- and D2-dissection; and (3) integration of new RT techniques to decrease treatment-related toxicity. The present paper is a review of recent studies addressing these fields. Well-designed prospective randomized studies are needed to clearly define the role of adjuvant CRT in D2-dissected gastric cancer, however, future clinical studies should also focus on answering these questions. PMID:25278687

Chang, Jee Suk; Koom, Woong Sub; Lee, Youngin; Yoon, Hong In; Lee, Hyung Sik

2014-01-01

172

Postoperative adjuvant chemoradiotherapy in D2-dissected gastric cancer: is radiotherapy necessary after D2-dissection?  

PubMed

Studies from the Far East have demonstrated that D2-dissection is superior to D0/1-dissection. The effect of postoperative chemoradiotherapy (CRT) after D2-dissection has not been accepted due to the lack of D2-dissection in Western countries, as well as the potential harmful effect of radiotherapy. In the current NCCN guideline, adjuvant chemotherapy alone is recommended in D2-dissected patients. However, three recent prospective randomized controlled trials in South Korea and China (ARTIST, NCC and Multicenter IMRT Trials) demonstrated that adjuvant CRT can be safely administered to D2-dissected patients with notable benefits. To identify the role of radiotherapy (RT) in the D2-dissected postoperative setting, clinical research attempts should include (1) identification of high-risk patients for loco-regional recurrence who might benefit from CRT; (2) modification of RT target volume based on the findings that failure patterns should be different after D1- and D2-dissection; and (3) integration of new RT techniques to decrease treatment-related toxicity. The present paper is a review of recent studies addressing these fields. Well-designed prospective randomized studies are needed to clearly define the role of adjuvant CRT in D2-dissected gastric cancer, however, future clinical studies should also focus on answering these questions. PMID:25278687

Chang, Jee Suk; Koom, Woong Sub; Lee, Youngin; Yoon, Hong In; Lee, Hyung Sik

2014-09-28

173

Carotid artery dissection: a challenging diagnosis.  

PubMed

Spontaneous extracranial internal carotid artery dissection (ICAD) is a rare vascular event. Even in the presence of existing signs and symptoms, the diagnosis can be missed by experienced clinicians of all specialties. This is a report of a patient who presented with symptomatic bilateral dissection manifested as partial Horner's syndrome. The diagnosis was made after several clinical evaluations with the use of duplex ultrasound and angiography. PMID:9949691

Aburahma, A F; Burns, W; Mullins, D A

1999-01-01

174

Pulmonary hypertension and pulmonary artery dissection  

PubMed Central

Pulmonary artery dissection is a fatal complication of long-standing pulmonary hypertension, manifesting as acute, stabbing chest pain, progressive dyspnea, cardiogenic shock, or sudden death. Its incidence has been underestimated, and therapeutic options are still scarce. In patients with pulmonary hypertension, new chest pain, acute chest pain, or cardiogenic shock should raise the suspicion of pulmonary artery dissection, which can result in sudden death. PMID:23670510

Corrêa, Ricardo de Amorim; Silva, Luciana Cristina dos Santos; Rezende, Cláudia Juliana; Bernardes, Rodrigo Castro; Prata, Tarciane Aline; Silva, Henrique Lima

2013-01-01

175

Acute ileofemoral artery thromboembolism due to left ventricle thrombi with spontaneous coronary artery dissection  

PubMed Central

Spontaneous coronary artery dissection (SCAD) is a very rare cause of peripheral artery thromboembolism. It is especially rare to show symptoms of acute limb ischemia without chest symptoms during a hospital visit. In this case, a rare case of SCAD led to left heart failure and caused left ventricle thrombi, which in turn caused peripheral thromboembolism. PMID:25553326

Jun, Heungman; Jung, Cheol-Woong

2015-01-01

176

Failure of stent-assisted endovascular treatment for ruptured dissecting aneurysms of the basilar artery  

Microsoft Academic Search

We report two instructive cases of ruptured dissecting aneurysm of the basilar artery. Although stent-assisted endovascular treatment was successful, recurrent bleeding occurred 4 h after the procedure in one patient, and the other's basilar artery occluded 6 days after the procedure. These cases suggest that the high porosity of currently available stents may be insufficient to induce intraluminal thrombosis and

Y. Kaku; S. Yoshimura; H. Yamakawa; N. Sakai

2003-01-01

177

Vertebral artery dissection after neck extension in an adult patient with Klippel-Feil syndrome.  

PubMed

The association between Klippel-Feil syndrome and vertebral artery dissection is quite rare. We report an adult patient with vertebral artery dissection and Klippel-Feil syndrome, to our knowledge only the third reported case of its kind. A 45-year-old woman with a known history of Klippel-Feil syndrome presented with occipital head and neck pain following forced neck extension. Diagnostic cerebral angiography revealed a high grade vertebral artery stenosis, consistent with vertebral artery dissection. Following 6 months of medical management, a repeat diagnostic angiogram revealed complete healing of the vessel. While cervical fusion, as seen in Klippel-Feil syndrome, has previously been shown to cause neurologic injury secondary to hypermobility, the association with vertebral artery dissection is incredibly rare. We hypothesize that this hypermobility places abnormal shear force on the vessel, causing intimal injury and dissection. Patients with seemingly spontaneous vertebral artery dissection may benefit from cervical spine radiography, and this predisposition to cerebrovascular injury strongly suggests further evaluation of vascular injury following trauma in patients with Klippel-Feil syndrome or other cervical fusion as clinically warranted. PMID:24156906

Dornbos, David; Ikeda, Daniel S; Slivka, Andrew; Powers, Ciaran

2014-04-01

178

Direct and Transapical Central Cannulation for Acute Type A Aortic Dissection  

PubMed Central

Objective: The choice of cannulation site for the treatment of acute Stanford type A aortic dissection is much debated. We believe that central cannulation is quick to perform, easy to use, and safe to manage acute type A aortic dissection. Materials and Methods: We retrospectively investigated 26 cases of acute aortic dissection performed using two different central cannulation methods between April 2011 and March 2012. Direct ascending aortic cannulation was performed using the Seldinger technique in 20 patients, and transapical ascending aortic cannulation was performed in six patients in whom puncture was difficult. Results: Patients were 21–86 years old (mean age, 67 years). The surgical techniques used to treat aortic dissection were hemiarch repair in 21 patients and total arch replacement in 5 patients. The mean length of surgery was 393 min. One death (3.8%) was attributed to intestinal ischemia. Conclusion: During surgery for acute aortic dissection, central cannulation using either transapical or direct puncture can be performed quickly and safely, and satisfactory short-term outcomes can be obtained. Because acute aortic dissection can present with various conditions, there is no single perfect surgical or cannulation method; therefore, the choice of surgical procedure should be individualized for each patient. PMID:25298831

Matsumura, Hitoshi; Minematsu, Noritoshi; Amako, Mau; Nishimi, Masaru; Tashiro, Tadashi

2014-01-01

179

Endovascular Treatment of Intracranial Artery Dissection: Clinical and Angiographic Follow-Up  

PubMed Central

Background. Intracranial artery dissections are rare and many controversies exist about treatment options. The aim of this study was to evaluate the efficacy and safety of the endovascular approach in patients with an intracranial dissection presenting with different symptoms. Methods. We prospectively evaluated the clinical features and treatment outcomes of 30 patients who had angiographically confirmed nontraumatic intracranial dissections over 4 years. Patients were followed up for 17 months, and their final outcomes were assessed by the modified Rankin Score (mRS) and angiography. Results. Sixteen (53.3%) patients had a dissection of the anterior circulation, whereas 14 (46.7%) had a posterior circulation dissection. Overall, 83.3% of the patients suffered a subarachnoid hemorrhage (SAH). Grade IV Hunt and Hess score was seen in 32% of the SAH presenting cases. Parent artery occlusion (PAO) with coil embolization was used in 70% of the cases. The prevalence of overall procedural complications was 23.3%, and all were completely resolved at the end of follow-up. No evidence of in-stent occlusion/stenosis or rebleeding was observed in our cases during follow-up. Angiography results improved more frequently in the PAO with coil embolization group (100%) than in the stent-only-treated group (88.9%) (P = 0.310) and the unruptured dissection group (5/5, 100%) in comparison with the group that presented with SAH (95.8%) (P = 0.833). Conclusion. Favorable outcomes were achieved following an endovascular approach for symptomatic ruptured or unruptured dissecting aneurysms. However, the long-term efficacy and durability of these procedures remain to be determined in a larger series. PMID:23970969

Taheraghdam, Ali Akbar; Sharifipour, Ehsan; Mansourizadeh, Reza; Pashapour, Ali; Shimia, Mohammad; Shokouhi, Ghaffar; shakeri, Moslem; Hashemzadeh, Ali

2013-01-01

180

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

PubMed

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. Anat Sci Educ 8: 45-52. © 2014 American Association of Anatomists. PMID:24799441

Nwachukwu, Chika; Lachman, Nirusha; Pawlina, Wojciech

2015-01-01

181

Cystic adventitial disease of the common femoral artery at a previous surgical dissection site.  

PubMed

Cystic adventitial disease (CAD) is a rare vascular disorder associated with nonatherosclerotic peripheral vessel disease and occurs when mucoid cysts in the adventitia compress the blood vessel. The underlying etiology and pathogenesis of CAD remain debatable as various theories have been suggested. This case is interesting because the cyst developed from the previous common femoral artery (CFA) dissection site. To our knowledge, this is the first report of CAD developed at a previous operation site. Thus, we report herein a case of CAD arising from a previous embolectomy dissection site in the CFA that was successfully treated with surgery. PMID:25463335

Park, Sun Jin; Park, Won Seo; Min, Sun Young; Kwon, Se Hwan; Park, Min Soo; Ahn, Hyung Joon

2015-02-01

182

[Risk evaluation of type B aortic dissection: importance for treatment of acute aortic syndrome].  

PubMed

Acute aortic syndrome (AAS) is a modern term used to describe interrelated emergency aortic conditions with similar clinical characteristics and challenges including aortic dissection, intramural hematoma (IMH) and penetrating aortic ulcer (PAU). Population-based studies suggest that the incidence of aortic dissection ranges from 2.6 to 3.5 cases per 100,000 inhabitants per year; hypertension and a variety of genetic disorders with altered connective tissue are the most prevalent risk conditions. In general, open surgical repair is recommended when dissection involves the ascending aorta, whereas medical management and endovascular stent graft repair is the best option when the ascending aorta is spared. Pathological conditions involving the aortic arch may be treated using a hybrid approach combining debranching of supra-aortic vessels and stent graft placement. Stent graft-induced remodeling of a dissected aorta seems to have long-term benefits in complicated and so-called uncomplicated type B dissections as almost every case reveals a risk profile and one in eight patients diagnosed with acute type B aortic dissection has either an IMH or a PAU. Pain is the most commonly presenting symptom of AAS and should prompt immediate attention including diagnostic imaging modalities, such as multislice computed tomography, transesophageal ultrasound and magnetic resonance imaging. A specific therapeutic approach is necessary for IMH and PAU because without treatment they have a very poor outcome, are unpredictable in evolution and can be more severe than acute aortic dissection. All patients must receive the best medical treatment available at admission. High-risk but asymptomatic patients with IMH and PAU can probably be monitored without interventions. All symptomatic patients will need treatment. In many of these patients a direct surgical approach is often prohibitive due to age and multiple comorbidities. Endovascular treatment offers superior results and is becoming a recognized indication for such patients. Irrespective of the treatment modality close surveillance is mandatory in order to monitor disease progression. PMID:25200627

Divchev, D; Aboukoura, M; Weinrich, M; Rehders, T; Tillwich, F; Richartz, B; Clough, R E; Nienaber, C A

2014-09-01

183

Acute Fatal Coronary Artery Dissection Following Exercise-related Blunt Chest Trauma.  

PubMed

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

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

2015-01-01

184

Palliative stent graft placement combined with subsequent open surgery for retrograde ascending dissection intra-thoracic endovascular aortic repair  

PubMed Central

Thoracic endovascular aortic repair (TEVAR) is an effective strategy for type B dissection. Retrograde ascending dissection (RAD) intra-TEVAR is a rare complication on clinic. In this case, a 48-year-old Chinese man with Stanford type B aortic dissection suffered acute RAD during the TEVAR. And palliative stent grafts placement was performed in a local hospital, which earned the time for transfer and subsequent total arch replacement surgery in Zhongshan Hospital Fudan University. This report suggests that the palliative strategy may be an option for RAD in some specific situation.

Zhu, Kai; Guo, Changfa; Li, Jun

2014-01-01

185

[The value and limitation of two-dimensional transesophageal echocardiography in diagnosis of dissecting aortic aneurysm].  

PubMed

The diagnostic value of two-dimensional transesophageal echocardiography (TEE) was evaluated in 29 patients with dissecting aortic aneurysm (DeBakey type I; 4, type II; 1, type IIIa; 6, type IIIb; 18) who were studied consecutively from May 1987 to August 1988. An intimal flap was demonstrated in all 29 cases. DeBakey type classification could be recognized in 26 of 29 patients (89.7%). The entry of aortic dissection could be identified in 26 of 29 patients (89.7%). The differentiation between true and false lumen could be performed in all 29 cases. The introduction of color Doppler and pulsed Doppler echocardiography has opened up an additional possibility, in particular an analysis of flow pattern of the lumen was valuable in differentiation between true and false lumen. TEE was also valuable in evaluation of operative procedure by means of intraoperative-TEE. The capability to visualize the lesion of descending aorta was superior to any other conventional diagnostic method such as CT, MRI, AOG. However, there were difficulties in scanning the distal part of the ascending aorta and aortic arch, and in identifying the reentry of arotic dissection except for DeBakey type IIIa dissection. Since transthoracic echocardiography was valuable in diagnosis of cardiac tamponade, aortic regurgitation, and DeBakey type I dissection, the diagnostic method of a combination of transthoracic and transesophageal echocardiography seems to be more valuable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2625562

Sasaki, S; Matsui, Y; Gouda, T; Sakuma, M; Yasuda, K; Sakai, K; Tanabe, T

1989-12-01

186

Rapid retraction of a post-infarction intramyocardial dissecting hematoma.  

PubMed

A 60-year-old male with a recent anterior myocardial infarction (MI) was referred to our hospital for implantable cardioverter defibrillator (ICD) implantation. He was on the 42nd day of MI and clinically stable on admission. Electrocardiography showed right bundle branch block with QS pattern on anterior leads. Transthoracic echocardiographic examination revealed an ejection fraction of 25% with akinesis of the apex and mid-apical segments of anterior and septal walls. In the apical-septal region, a pulsatile cavity with systolic expansion surrounded by a thin endomyocardial border was visualized. Color-Doppler interrogation did not demonstrate any flow within that structure. These findings suggested an intramyocardial dissecting hemorrhage formed after MI. Cardiac magnetic resonance imaging also confirmed an intramyocardial hematoma in the mid-apical anteroseptal region. A conservative approach was assumed as the patient was hemodynamically stable. The planned ICD implantation was postponed due to the high risk of perforation. Subsequently, oral anticoagulant therapy with warfarin was initiated against risk of intracardiac thrombus formation. The existing dual antiplatelet therapy was also continued. One week after hospital discharge, he was rehospitalized due to a very high INR of 6.3. The repeated transthoracic echocardiography revealed an almost complete resolution of the intramyocardial dissecting hematoma and adhesion of the surrounding myocardial layers. Oral anticoagulant therapy was discontinued. Echocardiographic examinations showed no change compared to the last examination during hospitalization. This case illustrates a conservatively managed intramyocardial dissecting hematoma case, in which anticoagulant and antiaggregant therapy yielded a rapid retraction without any complication. PMID:24899483

Özpelit, Ebru; Badak, Özer; Özpelit, Mehmet Emre; Kozan, Ömer

2014-06-01

187

Prevention of complications in neck dissection  

PubMed Central

Background The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option into an elective setting, in part promoted by efforts to reduce its morbidity. Objectives This review will consider the potential complications of neck dissection and on the basis of the available evidence describe both their management and prevention. Conclusion Although the neck dissection continues to provide clinicians with a method of addressing cervical disease, its reliability and safety can only be assured if surgeons remain cognisant of the potential complications and aim to minimise such morbidity by appropriate management in the peri-operative period. PMID:19822010

Kerawala, Cyrus J; Heliotos, Manolis

2009-01-01

188

Surgical treatment of acute ascending aortic dissection.  

PubMed Central

Since adopting a policy of immediate operation on patients with acute dissection of the ascending aorta, 42 men and 6 women (ages 18-67 years) have been managed surgically. Thirty-two patients had graft replacement of the ascending aorta and resuspension of the incompetent aortic valve. One of these had a coronary graft. There were five deaths in this group. Eight patients required aortic valve replacement because of a diseased aortic valve as well as grafting of the ascending aorta, with one death. Three patients had resuspension of the aortic valve and primary repair of their dissection without mortality. Two patients were managed successfully with an intraluminal prosthesis and resuspension of the aortic valve. Another patient had successful repair with a valved conduit and reimplantation of the coronaries. Two patients dissected 4 and 6 years after aortic valve replacement and neither survived operative repair. Of the surviving patients, one required dialysis, one a femoral-femoral bypass graft, and one an axillo-femoral bypass graft. One patient required a pacemaker for heart block, and two underwent successful repair of suture line aneurysms, both occurring three years after operation. On the basis of this experience, prompt surgical intervention for acute ascending aortic dissection is the treatment of choice. A variety of techniques are available to repair the dissected aorta. Long-term results for resuspension of the aortic valve in acute ascending aortic dissection have been excellent and emphasize that valve replacement should be reserved for those patients found at operation to have a primary abnormality of the aortic valve. PMID:6222709

Wolfe, W G; Oldham, H N; Rankin, J S; Moran, J F

1983-01-01

189

The nature of dissection: Exploring student conceptions  

NASA Astrophysics Data System (ADS)

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.

York, Katharine

190

[Surgery of aortic dissection: for which patient?].  

PubMed

In the acute stage (less than two weeks), surgery is indicated for Stanford type A aortic dissections. With respect to the initial work-up, surgery consists in replacing the ascending aorta, sometimes the aortic arch (with supra aortic vessels reimplantation), and aortic valve replacement (valve replacement, Bentall valved tube or valve sparing Tyron David technique). Ischemic visceral complications must be searched for and treated by endovascular techniques or surgery. Aneurismal evolution of chronic dissections must be treated surgically. Replacement can encompass the entire aorta. PMID:21146353

Verhoye, Jean-Philippe; Abouliatim, Issam; Larralde, Antoine; Beneux, Xavier; Heautot, Jean-François

2011-01-01

191

Intracranial Vertebral Artery Dissections: Evolving Perspectives  

PubMed Central

Summary Intracranial vertebral artery dissection (VAD) represents the underlying etiology in a significant percentage of posterior circulation ischemic strokes and subarachnoid hemorrhages. These lesions are particularly challenging in their diagnosis, management, and in the prediction of long-term outcome. Advances in the understanding of underlying processes leading to dissection, as well as the evolution of modern imaging techniques are discussed. The data pertaining to medical management of intracranial VADs, with emphasis on anticoagulants and antiplatelet agents, is reviewed. Surgical intervention is discussed, including, the selection of operative candidates, open and endovascular procedures, and potential complications. The evolution of endovascular technology and techniques is highlighted. PMID:23217643

Ali, M.S.; Amenta, P.S.; Starke, R.M.; Jabbour, P.M.; Gonzalez, L.F.; Tjoumakaris, S.I.; Flanders, A.E.; Rosenwasser, R.H.; Dumont, A.S.

2012-01-01

192

Politics & Prejudice: Dissection in Biology Education. Part II.  

ERIC Educational Resources Information Center

The issues, roles, dynamics, rationales and events embroiled in the dissection controversy are discussed. Insights into where the politics of biology education without speciesism or dissection are likely to take science education in the future are provided. (KR)

Gilmore, David R.

1991-01-01

193

Optical coherence tomography-guided bifurcation stenting of a coronary artery dissection.  

PubMed

Periprocedural guide wire-induced coronary artery dissection is a rare but potentially serious complication of percutaneous coronary intervention. Immediate stenting of the entry point is one of the therapeutic options but engaging the guide wire in the true lumen might be challenging. We report a case of a 55-year-old woman with a guide wire-induced coronary dissection that occurred during treatment of a bifurcation lesion. Optical coherence tomography was instrumental in distinguishing true from false lumen and thereby guide correct positioning of the guide wire to successfully treat the lesion using a dedicated bifurcation stent. PMID:24975190

van Ditzhuijzen, Nienke S; Ligthart, Jurgen; Tu, Shengxian; van der Linden, Marc; Regar, Evelyn

2014-08-01

194

Single incision thoracoscopic right upper lobectomy with systematic lymph node dissection  

PubMed Central

Video-assisted thoracic surgery (VATS) provides less postoperative pain, preservation of the immune response and shorter recovery period, compared with thoracotomy. However, many patients complain of postoperative pain and paresthesia because VATS requires 3 or 4 incisions including a utility incision of 3–5 cm. To overcome this problem, single incision thoracoscopic surgery has emerged; this technique has been adopted for lung cancer surgery since 2010. Complete mediastinal lymph node dissection is the major role of lung cancer surgery. We describe a case of a right upper lobectomy with complete mediastinal lymph node dissection via single incision thoracosopic surgery. PMID:24708717

2014-01-01

195

Pictorial review of colonic polyp and mass distortion and recognition with the CT virtual dissection technique.  

PubMed

Virtual dissection is a three-dimensional (3D) display technique for CT colonography that could potentially reduce interpretation times. With virtual dissection, the 3D model of the colon is "sliced" open along a centerline trace, rendering a 360° view of the endoluminal mucosa as a rectangular image. However, one must be familiar with several pitfalls and limitations to avoid errors in interpretation. One of the main limitations is the anatomic distortion that results. Polyp shape and colonic folds can be distorted and colonic or polyp mobility can lead to mischaracterization of polyps. Distorted folds, which frequently occur at flexures, can mimic polyps. Annular constricting masses can lead to skip areas, where the abnormality is not displayed. Various entities including diverticula and stool can mimic polyps at virtual dissection. Finally, technical errors such as an inadequate centerline trace can render a polyp occult. The purpose of this review is to demonstrate the spectrum of appearances of polyps at virtual dissection, with an emphasis on more difficult to detect polyps. In addition, 10 interactive virtual dissection quiz cases are presented along with corresponding two-dimensional and 3D endoluminal fly-through views. PMID:20622191

Christensen, Kevin N; Fidler, Jeff L; Fletcher, Joel G; Maccarty, Robert; Johnson, C Daniel

2010-09-01

196

Open repair of chronic complicated type B aortic dissection using the open distal technique  

PubMed Central

Aim The present study aimed to analyze early and late outcomes after open repair of chronic type B aortic dissection. Methods We retrospectively reviewed our cases of open descending thoracic aortic aneurysm (DTAA) with chronic dissection from 1991-2013. Long-term survival and aortic reinterventions were analyzed and patient comorbidities were evaluated in order to determine the risk of adverse outcomes. Furthermore, the technique for “distal first approach” is described. Results Between 1991 and 2013, 240 (40%) descending thoracic aortic repairs with associated chronic dissection were performed. Mean age is 59 years and 178 (74%) are men. The majority of patients (218, 91%) underwent repair using the adjunct of distal aortic perfusion with cerebral spinal fluid drainage. Early mortality was 8.3% (20/240). Permanent neurologic deficit occurred in 1.3% (3/240). Stroke occurred in 2.9% (7/240), and dialysis on discharge in 6% (12/240). 5-, 10-, 15-, and 20-year survival was 72%, 60%, 45%, and 39%, respectively. Freedom from reoperation on the operated segment was 97%, 94%, 94% and 94% at 5, 10, 15 and 20 years. Conclusions Open repairs of chronic descending thoracic dissections can be performed with respectable morbidity and mortality. Risk of neurologic deficit remains low with use of adjuncts, and risk of reintervention on the involved aortic segment is also low. These results allow comparison with endovascular repair for chronic aortic dissection. PMID:25133100

Sandhu, Harleen; Afifi, Rana O.; Azizzadeh, Ali; Charlton-Ouw, Kristofer; Miller, Charles C.; Safi, Hazim J.

2014-01-01

197

Spontaneous coronary artery dissection during hemodialysis in the post-abortion period.  

PubMed

Spontaneous coronary dissection (SCAD) is an unusual cause of acute myocardial infarction with complex pathophysiology. We present a case of acute inferior myocardial infarction resulting from spontaneous coronary artery dissection of the right coronary artery in a 33-year-old woman during the hemodialysis due to a recent abortion and consequent curettage at first trimester of her pregnancy. This report describes a previously healthy woman without traditional cardiovascular risk factors who presented with an acute inferior myocardial infarction. Spontaneous coronary artery dissection (SCAD) should be considered as a cause of the acute myocardial infarction in young patients without traditional risk factors for coronary artery disease, in females in the both peri-partum and post-abortion period. PMID:17467825

Iltumur, Kenan; Karahan, Zulkuf; Ozmen, Sehmus; Danis, Ramazan; Toprak, Nizamettin

2008-07-01

198

Cerebellar hemorrhage after embolization of ruptured vertebral dissecting aneurysm proximal to PICA including parent artery  

PubMed Central

Background: Some complications related to vertebral artery occlusion by endovascular technique have been reported. However, cerebellar hemorrhage after vertebral artery occlusion in subacute phase is rare. In this report, we describe a patient who showed cerebellar hemorrhage during hypertensive therapy for vasospasm after embolization of a vertebral dissecting aneurysm. Case Description: A 56-year-old female with a ruptured vertebral dissecting aneurysm proximal to the posterior inferior cerebellar artery developed cerebellar hemorrhage 15 days after embolization of the vertebral artery, including the dissected site. In this patient, the preserved posterior inferior cerebellar artery fed by retrograde blood flow might have been hemodynamically stressed during hypertensive and antiplatelet therapies for subarachnoid hemorrhage, resulting in cerebellar hemorrhage. Conclusion: Although cerebellar hemorrhage is not prone to occur in the nonacute stage of embolization of the vertebral artery, it should be taken into consideration that cerebellar hemorrhage may occur during hypertensive treatment. PMID:24872921

Tamase, Akira; Kamide, Tomoya; Mori, Kentaro; Kitamura, Yoshihisa; Shima, Hiroshi; Seki, Shunsuke; Nomura, Motohiro

2014-01-01

199

Global Distribution of Dissected Duricrust on Mars  

NASA Technical Reports Server (NTRS)

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.

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

2000-01-01

200

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

Warner, Sally

201

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

Warner, Sally

202

Physical injuries in the dissecting room.  

PubMed

Dissection of human cadavers remains an important element of learning anatomy in many medical and dental schools. During this activity, students are introduced to the safe handling of surgical instruments. The frequency, type, and mechanism of associated injuries are unknown. We undertook a retrospective cohort analysis of dissecting-room accidents during a 6-year period (2001-2006). Injury rates were adjusted to account for exposure risk. A total of 55 injuries, all minor, were recorded in 53 students, representing an overall injury rate of less than 4 injuries per 1,000 hr of dissection. Twenty-four injuries were documented in third-year medical students, 13 in second-year medical students, 10 in second-year dental students, and 8 in third-year science students. There was a statistically significant difference in injury rates between the groups due to a higher than expected rate among second-year medical students and a lower than expected rate among third-year medical students (P < 0.01). At least 38 (69%) injuries were from a scalpel blade. A further three injuries were from bone spicules. All except two injuries affected the hand. In conclusion, it is unusual for students to injure themselves in the dissecting room. Injuries tend to be minor and largely related to scalpel blades. A greater awareness of hazards due to sharps and safe handling techniques may reduce the risks of minor injury and better prepare students for future clinical practice. PMID:18058901

Cornwall, Jon; Stringer, Mark D

2008-01-01

203

A COMPARATIVE PRIMATE ANATOMY Dissection Manual  

E-print Network

is used as a reference species against which we compared the anatomy of the non-human primates. It alsoA COMPARATIVE PRIMATE ANATOMY Dissection Manual Edited by: Rebecca Rogers Ackermann Version 1 Anatomy taught jointly by Professors J Cheverud, G Conroy, and J Phillips-Conroy, at Washington University

Ackermann, Rebecca Rogers

204

Pythagoras and the Dissection of Polygons.  

ERIC Educational Resources Information Center

Provides examples of proofs of the Pythagorean result. These proofs fall into three categories: using ratios, using dissection, and using other forms of transformation. Shows that polygons of equal area are equidecomposable and that the approach taken (via squares) is a new approach. (JN)

Mortimer, M. E.; Ball, R. W.

1984-01-01

205

Ownership and control: dissecting the pyramid  

Microsoft Academic Search

Pyramids, cross-ownership, rings and other complex features are frequent in the European and Japanese industrial world. The dissection of these structures requires a proper measurement of indirect shareholdings. While some authors use the (generally overestimated) data coming from legal ownership declarations, Ellerman (1991) and Flath (1992), Baldone et al. (1997) use the input-output matrix technology applied to raw ownership data.

Ariane Chapelle; Ariane Szafarz

2002-01-01

206

Dissection of the Mammalian Midbody Proteome Reveals  

E-print Network

, and chromosome segregation (6­9). Mammalian midbody isolation. We iso- lated midbodies from Chinese hamster ovaryDissection of the Mammalian Midbody Proteome Reveals Conserved Cytokinesis Mechanisms Ahna R. Skop is the essential process that partitions cellular contents into daugh- ter cells. To identify and characterize

Meyer, Barbara

207

Cow's Eye Dissection in the Physics Lab.  

ERIC Educational Resources Information Center

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)

Lapp, David R.; Keenan, James E.

1991-01-01

208

Squid Dissection: From Pen to Ink.  

ERIC Educational Resources Information Center

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)

Brown, Cindy; Kisiel, Jim

2003-01-01

209

Post-traumatic dissection of the internal carotid artery associated with ipsilateral facial nerve paralysis: diagnostic and forensic issues.  

PubMed

Traumatic internal carotid artery dissection may result from a direct blow to anterolateral aspect of the neck, or an extreme extension and rotation of the neck. Traumas involved are variable ranging from high speed motor vehicle accident to trivial traumas. The most frequent presentations of carotid artery dissection are stroke, Hörner syndrome, and paralysis of a cranial nerve. Time of ischemic signs onset is very variable too, diverging from immediate to several months delay. We report the case of a 60-year-old woman, who was assaulted by a young man. Immediately, she complained of headache and posterior cervical pain. Three months later she developed a left hemifacial paralysis. MRI and MRA showed a dissection of the left internal carotid artery. The causal relationship between the trauma and the carotid artery dissection as well as forensic issues are discussed. PMID:24112338

Makhlouf, F; Scolan, V; Detante, O; Barret, L; Paysant, F

2013-10-01

210

Course review: the 4th bob huffstadt upper and lower limb flap dissection course.  

PubMed

The Bob Huffstadt course is a 2-day upper and lower limb flap dissection course held in Groningen, the Netherlands. The course is in English, with an international faculty of senior consultants from the Netherlands, Belgium, and United Kingdom. Faculty to participant ratio is 2:1, with 2 participants at each dissection table. The course is aimed at trainees in plastic surgery of all levels, and a comprehensive DVD is provided before the course, which demonstrates dissection of 35 flaps, ensuring those with little experience to have an understanding before dissection.This course offered a comprehensive overview with plenty of practical application. The course can greatly develop operative and theoretical knowledge, while also demonstrating a commitment for those wishing to pursue a career in plastic surgery. Longer courses are available; however, the 2-day course can already provide an excellent introduction for junior trainees. There are few flap courses in the United Kingdom and senior trainees may have difficulty acquiring a place as they book up well in advance. With reductions in operating time, trainees may welcome further experience and development of techniques in the dissection room.Most of both days were spent in the dissection room, raising flaps and receiving teaching from the faculty. Dissections included Foucher, Moberg, Becker, radial forearm, anterolateral thigh, and fibula flaps. Dissection specimens were fresh-frozen preparation, and 9 upper limb flaps were raised on the first day and 5 lower limb flaps on the second day. The faculty provided live demonstrations of perforator dissection, use of the hand-held Doppler, and tips and tricks. The last 2 hours of each day were spent with 2 lectures, including topics from the history of flaps and developments to challenging cases and reconstructive options.The course fee was 1000 euros, including a 5-course dinner, lunch on both days, and a drinks reception on the final evening. I would recommend this course unreservedly to trainees new to flaps, or those with greater experience. The course was supportive, friendly, and provided an excellent basis to develop reconstructive skills. There is a world-class faculty who can improve the knowledge and techniques of any trainee in attendance. PMID:24135639

Dunne, Jonathan A

2014-12-01

211

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

PubMed Central

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

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

2014-01-01

212

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

ERIC Educational Resources Information Center

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…

Akpan, Joseph; Strayer, Jeremy

2010-01-01

213

Anesthesia Management in Aortic Dissection in Patients Undergoing Kidney Transplant.  

PubMed

Kidney transplant is a last resort to increase the life expectancy and quality of life in patients with renal failure. Aortic dissection is a disease that requires emergency intervention; it is characterized by sudden life-threatening back or abdominal pain. In the case described, constant chest pain that increased with respiration was present on examination of a 28-year-old man (85 kg, 173 cm) who presented at our emergency department complaining of severe back pain. He had undergone a kidney transplant in 2004 from his mother (live donor). He was diagnosed with acute Type II aortic dissection and was scheduled for emergent surgery. Because there were no surgical or anesthetic complications, the patient with 79 and 89 minutes aortic cross-clamping and cardiopulmonary bypass durations was sent, intubated, to intensive care unit. When nephrotoxic agents are avoided and blood flow is stabilized, cardiovascular surgery with cardio-pulmonary bypass may be performed seamlessly in patients who have undergone a kidney transplant. PMID:25375956

Ucar, Muharrem; Erdil, Feray; Sanl?, Mukadder; Aydogan, Mustafa Said; Durmus, Mahmut

2014-11-01

214

Current evidence for thoracic aorta type B dissection management.  

PubMed

Aortic dissection is a devastating cardiovascular condition and represents the most common aortic emergency. Outcome is determined by the type and extent of dissection and the presence of associated complications requiring early diagnosis and treatment. Aortic dissection is defined as acute within 14 days from onset and chronic after that time period. The natural course of type B dissection is determined by 2 elements, early and chronic complications. An uncomplicated acute type B dissection is less frequently lethal but it is not totally benign. Some peculiar issues must be taken into account, such as the high probability of complications development in a dissected aorta and the poor long-term prognosis on medical treatment alone. Then, it would be helpful to identify which patients with uncomplicated type B dissection will have a poorest aortic prognosis over time in order to apply an early intervention. PMID:24043474

Capoccia, Laura; Riambau, Vicente

2014-12-01

215

Acute Thoracic Aortic Dissection (Stanford Type B) Complicated with Acute Renal Failure  

PubMed Central

We report a recent case and review some literatures of acute aortic dissection (AAD) Stanford type B complicated with late onset of acute renal failure. The patient underwent preoperational peritoneal dialysis followed by thoracic endovascular aortic repair (TEVAR) and was fully recovered and discharged soon after surgery. We conclude that an AAD case is difficult to achieve a timely diagnosis, but with attention to systemic symptoms and dedication thorough treatment plan, a full recovery and positive prognosis are expected. PMID:24324913

Cui, JiaSheng; Zhu, Huaqi; Zhang, Wan; Li, Ming

2013-01-01

216

Aortic dissection in the presence of an aberrant right subclavian artery.  

PubMed

The presence of an aberrant right subclavian artery arising from the proximal descending aorta is a relatively common anomaly of the aortic arch. These vessels may be involved in aortic dissections, either as the site of the primary intimal tear or as a dissected aortic branch, subject to flow limitation and future aneurysmal degeneration. In this report, we review our experience in treating these lesions in the endovascular era. In two cases, the dissected aorta was treated with an endovascular approach, whereas in two others, proximal open surgical repair was followed by distal stent grafting. The ostium of the aberrant vessel was covered in all cases. Preservation of antegrade flow into the right subclavian was obtained via extra-anatomic bypass. Creation of end-to-side bypasses as opposed to transpositions allowed transbrachial endovascular access to the aberrant right subclavian artery with the purpose of embolization while preserving the right vertebral artery. The hybrid approaches described here effectively address the aortic dissection and degenerative changes associated with an aberrant right subclavian artery while minimizing the need for extensive open repair. PMID:22794341

Guzman, Edgar D; Eagleton, Matthew J

2012-08-01

217

Evolution of a chronic dissecting aneurysm on magnetic resonance imaging in a pediatric patient.  

PubMed

Clinical and imaging manifestations of the so-called partially thrombosed aneurysm (PTA) are different from those of the classic intracranial saccular aneurysm. Given some of their peculiar imaging features, it had been hypothesized that some PTAs occur due to repeated intramural hemorrhages. The authors present a case of PTA that evolved from an acute dissecting aneurysm as shown by serial imaging. A previously healthy 5-year-old boy had a sudden onset of left hemiparesis. Initial MRI sequences showed a perforating vessel infarction in the right basal ganglia area secondary to an acute distal middle cerebral artery (MCA) dissection as demonstrated on conventional angiography. Conservative management with close observation of this dissection was chosen, and serial MRI studies revealed layering of blood of various ages within the wall of an aneurysmal outpouching of the MCA, thereby leading to the imaging appearance of a PTA. The findings in this case indicate that some PTAs may be caused by repeated or chronic dissections, with blood entering the wall through an endothelial defect. Understanding the pathological mechanism underlying the formation of these aneurysms will help inform appropriate treatment strategies. PMID:25479578

Chen, Long; Yau, Ivanna; deVeber, Gabrielle; Dirks, Peter; Armstrong, Derek; Krings, Timo

2014-12-01

218

Recurrent tamponade and aortic dissection in syphilis.  

PubMed

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

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

2013-11-01

219

Central compartment dissection in laryngeal cancer.  

PubMed

We report here a review of the literature intended to clarify the nomenclature and boundaries of the nodes in the "central compartment" of the neck, the frequency with which tumors from the different laryngeal sites metastasize to these nodes, and the indications for central compartment node dissection in the treatment of cancers of the larynx. From this review, we conclude that, until consensus is reached about grouping of the lymph nodes in this area, it is best to refer to these nodes by their anatomic location, ie, prelaryngeal, pretracheal, or paratracheal lymph nodes. It is also advisable to describe dissection of these nodes as selective neck dissection (SND) with an annotation about the specific lymph node groups removed. Metastases in prelaryngeal and paratracheal lymph nodes in patients with squamous cell carcinoma of the larynx are associated with increased tumor recurrence, more frequent metastases in lymph nodes of the lateral compartment of the neck, and decreased survival. If untreated, they may lead to the development of peristomal recurrence. Therefore, elective treatment of level VI nodes is recommended in patients with squamous cell carcinomas of the subglottic region, advanced glottis carcinomas with subglottic extension, and in certain advanced carcinomas of the supraglottic region. PMID:20652888

Medina, Jesus E; Ferlito, Alfio; Robbins, K Thomas; Silver, Carl E; Rodrigo, Juan P; de Bree, Remco; Rinaldo, Alessandra; Elsheikh, Mohamed N; Weber, Randal S; Werner, Jochen A

2011-05-01

220

Dissecting immunity by germline mutagenesis  

PubMed Central

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

Choi, Onjee; Rutschmann, Sophie

2012-01-01

221

76 FR 34974 - Cranberry Pipeline Corporation; Notice of Filing  

Federal Register 2010, 2011, 2012, 2013, 2014

...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...

2011-06-15

222

37 CFR 2.155 - Notice of publication.  

Code of Federal Regulations, 2010 CFR

...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...

2010-07-01

223

Spontaneous coronary artery dissection as a cause of myocardial infarction.  

PubMed

Spontaneous coronary artery dissection (SCAD) is a rare disease that is usually seen in young women in left descending coronary artery and result in events like sudden cardiac death and acute myocardial infarction. A 70-year-old man was admitted to the emergency department with chest pain which started 1 h ago during a relative's funeral. The initial electrocardiography demonstrated 2 mm ST-segment depression in leads V1-V3 and the patient underwent emergent coronary angiography. SCAD simultaneously in two different coronary arteries [left anterior descending (LAD) artery and left circumflex (LCx)] artery was detected and SCAD in LCx artery was causing total occlusion which resulted in acute myocardial infarction. Successful stenting was performed thereafter for both lesions. In addition to the existence of SCAD simultaneously in two different coronary arteries, the presence of muscular bridge and SCAD together at the same site of the LAD artery was another interesting point which made us report this case. PMID:25548620

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

2014-12-26

224

Unilateral shunt formation with thoracic aortic dissection in a whippet.  

PubMed

A three-year-old neutered male whippet was presented with intermittent, exercise-induced paraparesis. Femoral pulses were bilaterally absent. Neurologic examination was suggestive of a thoracolumbar myelopathy. Blood pressure measurements revealed hypotension in both pelvic limbs, hypertension in the right thoracic limb and it was immeasurable in the left thoracic limb. Echocardiography was within reference limits. A clear vascular pulsation was palpable on the right ventral abdominal wall. Computed tomographic angiography revealed a dissection of the aortic wall between the left subclavian artery and the brachiocephalic trunk with subsequent thrombus formation. A shunt between the right internal thoracic, cranial and caudal epigastric arteries to preserve blood flow to the pelvic limbs was visualized. Necropsy was declined by the owner. This is the first case report describing the formation of a unilateral vascular shunt following a thoracic aortic occlusion, which presented as exercise-induced paraparesis. PMID:24602076

Cornelis, I; Bosmans, T; Doom, M; Binst, D; Van der Vekens, E; Kromhout, K; Cornillie, P; Van Ham, L

2014-06-01

225

Open fenestration for complicated acute aortic B dissection.  

PubMed

Acute type B aortic dissection (ABAD) is a serious cardiovascular emergency in which morbidity and mortality are often related to the presence of complications at clinical presentation. Visceral, renal, and limb ischemia occur in up to 30% of patients with ABAD and are associated with higher in-hospital mortality. The aim of the open fenestration is to resolve the malperfusion by creating a single aortic lumen at the suprarenal or infrarenal level. This surgical procedure is less invasive than total aortic replacement, thus not requiring extracorporeal support and allowing preservation of the intercostal arteries, which results in decreased risk of paraplegia. Surgical aortic fenestration represents an effective and durable option for treating ischemic complications of ABAD, particularly for patients with no aortic dilatation. In the current endovascular era, this open technique serves as an alternative option in case of contraindications or failure of endovascular management of complicated ABAD. PMID:25133107

Trimarchi, Santi; Segreti, Sara; Grassi, Viviana; Lomazzi, Chiara; Cova, Marta; Piffaretti, Gabriele; Rampoldi, Vincenzo

2014-07-01

226

Open fenestration for complicated acute aortic B dissection  

PubMed Central

Acute type B aortic dissection (ABAD) is a serious cardiovascular emergency in which morbidity and mortality are often related to the presence of complications at clinical presentation. Visceral, renal, and limb ischemia occur in up to 30% of patients with ABAD and are associated with higher in-hospital mortality. The aim of the open fenestration is to resolve the malperfusion by creating a single aortic lumen at the suprarenal or infrarenal level. This surgical procedure is less invasive than total aortic replacement, thus not requiring extracorporeal support and allowing preservation of the intercostal arteries, which results in decreased risk of paraplegia. Surgical aortic fenestration represents an effective and durable option for treating ischemic complications of ABAD, particularly for patients with no aortic dilatation. In the current endovascular era, this open technique serves as an alternative option in case of contraindications or failure of endovascular management of complicated ABAD. PMID:25133107

Segreti, Sara; Grassi, Viviana; Lomazzi, Chiara; Cova, Marta; Piffaretti, Gabriele; Rampoldi, Vincenzo

2014-01-01

227

Spontaneous coronary artery dissection as a cause of myocardial infarction  

PubMed Central

Spontaneous coronary artery dissection (SCAD) is a rare disease that is usually seen in young women in left descending coronary artery and result in events like sudden cardiac death and acute myocardial infarction. A 70-year-old man was admitted to the emergency department with chest pain which started 1 h ago during a relative’s funeral. The initial electrocardiography demonstrated 2 mm ST-segment depression in leads V1-V3 and the patient underwent emergent coronary angiography. SCAD simultaneously in two different coronary arteries [left anterior descending (LAD) artery and left circumflex (LCx)] artery was detected and SCAD in LCx artery was causing total occlusion which resulted in acute myocardial infarction. Successful stenting was performed thereafter for both lesions. In addition to the existence of SCAD simultaneously in two different coronary arteries, the presence of muscular bridge and SCAD together at the same site of the LAD artery was another interesting point which made us report this case.

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

2014-01-01

228

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

PubMed Central

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

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

2014-01-01

229

Sentinel node biopsy and selective lymph node dissection in cutaneous melanoma patients.  

PubMed

Sentinel node biopsy allows an accurate selection of melanoma patients to be submitted to therapeutic dissection. From February 1994 to August 1998, at the National Cancer Institute, S. Pio X Hospital in Milan and Bufalini Hospital in Cesena, 580 sentinel node biopsies were performed in 540 stage I melanoma patients (242 males; 298 females; median age 47). Primary melanoma was located in the trunk in 201 patients, in lower limbs in 242 cases, in upper limbs in 80 cases and in head and neck in 17 patients. Injection of blue dye for sentinel node identification was performed in all cases; 372 patients were submitted to preoperative lymphoscintigraphy and in 272 cases an intraoperatory probe for a radioguided biopsy was utilized. Sentinel node identification rate was 91%. Sentinel node positivity rate was 15%. Frozen sections were examined in 199 cases. Distribution of positive cases according to primary thickness is the following: <1 mm: 1%; 1-1.99 mm: 5%; 2-2.99 mm: 18% and > or =3 mm: 27%. Sentinel node appeared to be the only metastatic node in 77% of patients submitted to dissection. The adoption of preoperative lymphoscintigraphy and the intraoperative use of the gamma probe contributed substantially in S.N. identification. No complications caused by the procedure were reported. Eight patients had a regional node relapse after a negative sentinel node biopsy and were submitted to therapeutic distant dissection. Currently 513 patients are alive with no evidence of disease. Present data confirm the feasibility and safety of sentinel node technique for selection of patients to be submitted to radical node dissection and to eventual adjuvant treatments. PMID:10374681

Lenisa, L; Santinami, M; Belli, F; Clemente, C; Mascheroni, L; Patuzzo, R; Gallino, G; Bergonzi, M; Rao, S; Polverelli, M; Morelli, R; Landi, G; Cascinelli, N

1999-03-01

230

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

NASA Astrophysics Data System (ADS)

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.

Milano, Regina Nicole

231

Internal carotid artery dissection caused by an elongated styloid process: usefulness of transoral ultrasonography.  

PubMed

We report a case of internal carotid artery (ICA) occlusion caused by arterial dissection triggered by an elongated styloid process. A 43-year-old man presented with a headache followed by speech disturbance. Magnetic resonance imaging and magnetic resonance angiography scans revealed acute infarction and right ICA occlusion. A T1-weighted magnetic resonance imaging scan revealed a hyperintensity in the occluded ICA, suggesting intramural hematoma. Computed tomographic angiography also revealed ICA occlusion and bilateral elongated styloid processes. We performed transoral carotid ultrasonography, which revealed the absence of flow signal in the double lumen of the dilated extracranial ICA. We diagnosed his condition as arterial dissection and treated him with antithrombotic drugs. Six months later, the occluded ICA recanalized spontaneously, and computed tomographic angiography at that time revealed a close relation between the tip of the styloid process and the recanalized ICA. This finding suggests that an elongated styloid process is involved in arterial dissection. In patients with ICA occlusion of unknown etiology, an evaluation for intramural hematoma and styloid process length are useful for the diagnosis of dissection and its etiology. PMID:22748713

Ohara, Nobuyuki; Sakaguchi, Manabu; Okazaki, Shuhei; Nagano, Keiko; Kitagawa, Kazuo

2012-11-01

232

A Blunt Chest Trauma Causing Left Anterior Descending Artery Dissection and Acute Myocardial Infarction Treated by Deferred Angioplasty  

PubMed Central

Traumatic coronary artery dissection is an uncommon cause of acute myocardial infarction (AMI). We report a case of blunt chest trauma resulting from a motorcycle collision causing ostial dissection of the left anterior descending (LAD) artery in a 31-year-old previously healthy male. The patient also suffered from compound comminuted fractures of the humerus and ulna and severe liver laceration, which hampered both percutaneous and surgical acute revasularization. After a stormy hospital course, a bare metal stent was implanted to seal the LAD artery dissection. The patient was discharged in a stable condition and was followed-up for rehabilitation. This case report underscores the multidisciplinary approach in facing challenges encountered after rare sequelae of chest trauma. PMID:22121464

Al-Aqeedi, Rafid Fayadh; Ali, Waleed Muhsin; Al-Ani, Fuad; Abdulrahman, Yassir S.; Alnabti, Abdulrahman

2011-01-01

233

Metabolic Signature of Electrosurgical Liver Dissection  

PubMed Central

Background and Aims High frequency electrosurgery has a key role in the broadening application of liver surgery. Its molecular signature, i.e. the metabolites evolving from electrocauterization which may inhibit hepatic wound healing, have not been systematically studied. Methods Human liver samples were thus obtained during surgery before and after electrosurgical dissection and subjected to a two-stage metabolomic screening experiment (discovery sample: N?=?18, replication sample: N?=?20) using gas chromatography/mass spectrometry. Results In a set of 208 chemically defined metabolites, electrosurgical dissection lead to a distinct metabolic signature resulting in a separation in the first two dimensions of a principal components analysis. Six metabolites including glycolic acid, azelaic acid, 2-n-pentylfuran, dihydroactinidiolide, 2-butenal and n-pentanal were consistently increased after electrosurgery meeting the discovery (p<2.0×10?4) and the replication thresholds (p<3.5×10?3). Azelaic acid, a lipid peroxidation product from the fragmentation of abundant sn-2 linoleoyl residues, was most abundant and increased 8.1-fold after electrosurgical liver dissection (preplication?=?1.6×10?4). The corresponding phospholipid hexadecyl azelaoyl glycerophosphocholine inhibited wound healing and tissue remodelling in scratch- and proliferation assays of hepatic stellate cells and cholangiocytes, and caused apoptosis dose-dependently in vitro, which may explain in part the tissue damage due to electrosurgery. Conclusion Hepatic electrosurgery generates a metabolic signature with characteristic lipid peroxidation products. Among these, azelaic acid shows a dose-dependent toxicity in liver cells and inhibits wound healing. These observations potentially pave the way for pharmacological intervention prior liver surgery to modify the metabolic response and prevent postoperative complications. PMID:24058442

von Schönfels, Witigo; von Kampen, Oliver; Patsenker, Eleonora; Stickel, Felix; Schniewind, Bodo; Hinz, Sebastian; Ahrens, Markus; Balschun, Katharina; Egberts, Jan-Hendrik; Richter, Klaus; Landrock, Andreas; Sipos, Bence; Will, Olga; Huebbe, Patrizia; Schreiber, Stefan; Nothnagel, Michael; Röcken, Christoph; Rimbach, Gerald; Becker, Thomas

2013-01-01

234

Retrograde Type B Aortic Dissection as a Complication of Standard Endovascular Aortic Repair.  

PubMed

Endovascular repair (EVAR) for abdominal aortic aneurysms (AAAs) is becoming the standard of practice in most vascular centers, even if some concerns remain about the occurrence of early and long-term failure and reintervention. A rare but potential catastrophic event is represented by retrograde type B aortic dissection (RTBAD). We report 2 cases of RTBAD after 425 standard EVARs performed in our institution. Both patients were treated for AAA without perioperative complication, and in both the patients, the presence of a preexisting disease of the thoracic aortic wall (ulcerated plaque in 1 case and aortic ectasia in the other) may have played an important role in the rapid evolution toward an early onset of the dissection. Only few cases of type B dissection after EVAR have been reported in literature, and the etiology of this complication remains uncertain. For the first time, our experience highlights the possible etiologic role of preexisting lesions of the thoracic aorta. In these cases, the only possible strategy may be to carefully study the entire aorta before an EVAR procedure, eventually switching the indication to an open surgical repair or carrying out a more aggressive management, treating the defects of the thoracic aorta. PMID:25304905

Sirignano, Pasqualino; Pranteda, Chiara; Capoccia, Laura; Menna, Danilo; Mansour, Wassim; Speziale, Francesco

2015-01-01

235

Contemporary inguinal lymph node dissection: minimizing complications  

Microsoft Academic Search

Objectives  This review describes the morbidity of inguinal lymph node dissection (ILND) performed as part of the management of penile\\u000a cancer as well as recent modifications that may reduce the incidence of complications.\\u000a \\u000a \\u000a \\u000a Methods  A review of the literature was conducted using Pubmed© for studies reporting complication outcomes of ILND for penile cancer. Furthermore, our contemporary results and patient\\u000a related morbidity associated

Philippe E. Spiess; Mike S. Hernandez; Curtis A. Pettaway

2009-01-01

236

miRNAs expression analysis in paired fresh/frozen and dissected formalin fixed and paraffin embedded glioblastoma using real-time pCR.  

PubMed

miRNAs are small molecules involved in gene regulation. Each tissue shows a characteristic miRNAs epression profile that could be altered during neoplastic transformation. Glioblastoma is the most aggressive brain tumour of the adult with a high rate of mortality. Recognizing a specific pattern of miRNAs for GBM could provide further boost for target therapy. The availability of fresh tissue for brain specimens is often limited and for this reason the possibility of starting from formalin fixed and paraffin embedded tissue (FFPE) could very helpful even in miRNAs expression analysis. We analysed a panel of 19 miRNAs in 30 paired samples starting both from FFPE and Fresh/Frozen material. Our data revealed that there is a good correlation in results obtained from FFPE in comparison with those obtained analysing miRNAs extracted from Fresh/Frozen specimen. In the few cases with a not good correlation value we noticed that the discrepancy could be due to dissection performed in FFPE samples. To the best of our knowledge this is the first paper demonstrating that the results obtained in miRNAs analysis using Real-Time PCR starting from FFPE specimens of glioblastoma are comparable with those obtained in Fresh/Frozen samples. PMID:22530056

de Biase, Dario; Visani, Michela; Morandi, Luca; Marucci, Gianluca; Taccioli, Cristian; Cerasoli, Serenella; Baruzzi, Agostino; Pession, Annalisa

2012-01-01

237

miRNAs Expression Analysis in Paired Fresh/Frozen and Dissected Formalin Fixed and Paraffin Embedded Glioblastoma Using Real-Time PCR  

PubMed Central

miRNAs are small molecules involved in gene regulation. Each tissue shows a characteristic miRNAs epression profile that could be altered during neoplastic transformation. Glioblastoma is the most aggressive brain tumour of the adult with a high rate of mortality. Recognizing a specific pattern of miRNAs for GBM could provide further boost for target therapy. The availability of fresh tissue for brain specimens is often limited and for this reason the possibility of starting from formalin fixed and paraffin embedded tissue (FFPE) could very helpful even in miRNAs expression analysis. We analysed a panel of 19 miRNAs in 30 paired samples starting both from FFPE and Fresh/Frozen material. Our data revealed that there is a good correlation in results obtained from FFPE in comparison with those obtained analysing miRNAs extracted from Fresh/Frozen specimen. In the few cases with a not good correlation value we noticed that the discrepancy could be due to dissection performed in FFPE samples. To the best of our knowledge this is the first paper demonstrating that the results obtained in miRNAs analysis using Real-Time PCR starting from FFPE specimens of glioblastoma are comparable with those obtained in Fresh/Frozen samples. PMID:22530056

Morandi, Luca; Marucci, Gianluca; Taccioli, Cristian; Cerasoli, Serenella; Baruzzi, Agostino; Pession, Annalisa

2012-01-01

238

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

Federal Register 2010, 2011, 2012, 2013, 2014

...A Multi-Center International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) The Federal...A multi-center international hospital-based case-control study of lymphoma in Asia (AsiaLymph) (NCI)''...

2012-03-01

239

A rare pattern of acute type A aortic dissection: circumferential intimal invagination.  

PubMed

A 59-year-old patient with chest pain was transferred to our emergency unit. Computed tomography depicted a dissection membrane limited to the aortic root and a seemingly normal ascending aorta. Further downstream stenosis of the descending aorta appeared. Intraoperatively, complete intimal absence in the ascending aorta with intussusception into the descending aorta was evident. Ascending aortic and hemiarch replacement was performed. This rare case should raise the surgeons' awareness that preoperative imaging can differ considerably from intraoperative findings. PMID:23143862

von Aspern, Konstantin; Etz, Christian D; Lehmkuhl, Lukas; Mohr, Friedrich W; Dohmen, Pascal M

2012-12-01

240

Management of isolated superior mesenteric artery dissection  

PubMed Central

AIM: To evaluate our experience of the clinical management of spontaneous isolated superior mesenteric artery dissection (ISMAD). METHODS: From January 2008 to July 2013, 18 patients with ISMAD were retrospectively analyzed, including 7 patients who received conservative therapy, 9 patients who received reconstruction with bare stents, and 2 patients who underwent surgical treatment. The decision to intervene was based on anatomic suitability, patient comorbidities and symptoms. RESULTS: Intestinal ischemia-related symptoms completely resolved in 7 patients who received conservative therapy. Stent placement was successful in 9 patients. Of the 9 patients who received endovascular stenting, abdominal pain was alleviated after the procedure and gradually disappeared within 3 d. Follow-up computed tomography and computed tomography angiography were available in all patients during the first month and the first year after the procedure, which revealed patent stent and patent involved superior mesenteric artery branches with complete obliteration of the dissection lesion. In the 2 patients who underwent surgical treatment, good clinical efficacy was also observed. CONCLUSION: ISMAD may be managed successfully in a variety of ways based on the clinical symptoms. ISMAD should be treated by conservative management as the ?rst-line option, however, in those with bowel necrosis or imminent arterial rupture during conservative therapy, endovascular or surgical therapy is indicated. PMID:25493033

Lv, Peng-Hua; Zhang, Xi-Cheng; Wang, Li-Fu; Chen, Zhao-Lei; Shi, Hai-Bin

2014-01-01

241

Molecular Mechanisms of Thoracic Aortic Dissection  

PubMed Central

Thoracic aortic dissection (TAD) is a highly lethal vascular disease. In many patients with TAD, the aorta progressively dilates and ultimately ruptures. Dissection formation, progression, and rupture cannot be reliably prevented pharmacologically because the molecular mechanisms of aortic wall degeneration are poorly understood. The key histopathologic feature of TAD is medial degeneration, a process characterized by smooth muscle cell depletion and extracellular matrix degradation. These structural changes have a profound impact on the functional properties of the aortic wall and can result from excessive protease-mediated destruction of the extracellular matrix, altered signaling pathways, and altered gene expression. Review of the literature reveals differences in the processes that lead to ascending versus descending and sporadic versus hereditary TAD. These differences add to the complexity of this disease. Although tremendous progress has been made in diagnosing and treating TAD, a better understanding of the molecular, cellular, and genetic mechanisms that cause this disease is necessary to developing more effective preventative and therapeutic treatment strategies. PMID:23856125

Wu, Darrell; Shen, Ying H.; Russell, Ludivine; Coselli, Joseph S.; LeMaire, Scott A.

2013-01-01

242

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

...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...

2011-01-25

243

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

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…

Akpan, Joseph Paul; Andre, Thomas

1999-01-01

244

Use of the pipeline embolization device to treat recently ruptured dissecting cerebral aneurysms.  

PubMed

The Pipeline embolization device (PED) is one of the flow-diverting stents approved for the treatment of unruptured large or wide-necked cerebral aneurysms in 2011(1). Its use has now been extended to the treatment of recently ruptured dissecting cerebral aneurysm, carotid pseudoaneurysm from radiation injury, and blister aneurysms(2,3). We aimed to evaluate the effectiveness of utilizing the PED as a primary treatment for ruptured dissecting intracranial aneurysms. A single center retrospective review was conducted for all patients primarily treated with PED for acute subarachnoid hemorrhage (SAH) from ruptured dissecting cerebral aneurysms between December 2010 and February 2013. Patients were followed up with CT angiogram (CTA) or digital subtraction angiogram (DSA). Eight patients with a total of eight dissecting aneurysms were identified. The mean duration from SAH to treatment was 2.5 days. Six of the aneurysms arose from vertebral arteries and two from the basilar artery. Immediate check-DSA confirmed satisfactory contrast stasis in all eight cases, and complete aneurysmal obliteration was achieved at six months. There were two (25%) procedure-related complications, but no major procedure-related complications, such as thromboembolic events or rebleeding from aneurysm were encountered. The PED is a feasible treatment option for ruptured dissecting cerebral aneurysms in acute phase. According to our experience, using PED as flow-diverters in acute SAH does not significantly increase the complication risks or mortality rate if the antiplatelet regime is carefully monitored. Future studies shall evaluate the optimal antiplatelet regimen for using the PED in the acute phase. PMID:25207906

Chan, Robert S K; Mak, Calvin H K; Wong, Alain K S; Chan, Kwong Yau; Leung, Kar Ming

2014-09-15

245

Impact of penile degloving and proximal ventral dissection on curvature correction in children with proximal hypospadias  

PubMed Central

Introduction: Penile degloving is an important step in orthoplasty. Although its role in correcting mild curvature in distal and midshaft hypospadias has been previously reported, its impact on ventral curvature (VC) correction in proximal defects warrants further investigation. Therefore, we sought to document the effect of degloving and proximal urethral dissection on VC correction in children with proximal hypospadias. Methods: We retrospectively reviewed the records of 137 patients who underwent proximal hypospadias repair between 1998 and 2006. VC, defined as mild (<30%), moderate (30%–45%), and severe (>45%), was recorded before penile degloving and after erection test. Percent improvement in VC and need for further treatment (beyond degloving and proximal dissection) based on preoperative degree of curvature were assessed. ANOVA test was used to compare improvement among the 3 groups. Results: Mean age at repair was 14 months (range: 6–24). Penile degloving associated with proximal urethral dissection when necessary was responsible for the improvement in the degree of curvature in 7 of 9 (77%) patients with mild VC, 23 of 44 (52%) with moderate and 35 of 84 (40%) with severe VC. Additionally, degloving alone was sufficient for VC correction in 7 of 9 (77%) mild cases, 14 of 44 (30%) moderate and only 2 of 84 (2%) severe cases. The difference among these 3 groups was statistically significant (p < 0.001). Conclusions: Penile degloving alone can correct VC. The percentage of improvement depends on the preoperative degree of curvature, with severe VC cases showing the least improvement. PMID:25553156

Weber, Bryce A.; Braga, Luis H.P.; Patel, Premal; Pippi Salle, Joao L.; Bägli, Darius J.; Khoury, Antoine E.; Lorenzo, Armando J.

2014-01-01

246

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Investigation No. 337-TA-865] Certain Balloon Dissection Devices and Products Containing...after importation of certain dissection balloons and products containing the same by reason...after importation of certain dissection balloons and products containing the same...

2013-01-31

247

Lateral lymph node dissection for lower rectal cancer.  

PubMed

The mainstay of surgical therapy for rectal cancer is colectomy (including lesions) with lymph node dissection. The lymphatic spread of rectal cancer can proceed in two directions: medially toward the origin of the inferior mesenteric artery or laterally toward the pelvis aslong the internal iliac artery. To prevent postoperative recurrence, lymph nodes situated along these two axes should be adequately dissected, leaving no residual cancer cells. In Japan, the standard procedure for advanced lower rectal cancer is mesorectal excision and lateral lymph node dissection with autonomic nerve preservation. In Europe and North America, lateral lymph node dissection used to be performed, but it led to increased blood loss, complications, and dysfunction, with no improvement in survival. Lateral lymph node dissection is thus no longer performed. Instead, multidisciplinary therapy combining mesorectal excision with preoperative chemoradiotherapy is now the standard treatment for advanced rectal cancer. Although lateral lymph node dissection decreases the rate of local recurrence similar to preoperative chemoradiotherapy, whether it contributes to improved survival remains unclear. In addition, it is unlikely that prophylactic lateral lymph node dissection is required in all patients with rectal cancer. Definition of the indications for lateral lymph node dissection is thus an important concern. PMID:23703637

Nakamura, T; Watanabe, M

2013-08-01

248

Surgical Delay for Acute Type A Dissection With Malperfusion  

Microsoft Academic Search

Background. An acute type A aortic dissection is considered a surgical emergency. Review of the risk factors for a type A dissection showed that preoperative malperfusion was associated with a 22% (2\\/9) intraoperative mortality and an 89% (8\\/9) hospital mortality. Intraoperative deaths were secondary to pulmonary failure resulting from capillary leak; the remaining patients died of multiorgan failure resulting from

G. Michael Deeb; David M Williams; Steven F Bolling; Leslie E Quint; Hilary Monaghan; Jennifer Sievers; Dean Karavite; Michael Shea

1997-01-01

249

Dissection Videos Do Not Improve Anatomy Examination Scores  

ERIC Educational Resources Information Center

In this quasi-experimental study, we describe the effect of showing dissection videos on first-year medical students' performance in terms of test scores during a gross anatomy course. We also surveyed students' perception regarding the showing of dissection videos. Two hundred eighty-seven first-year medical students at Rawalpindi Medical College…

Mahmud, Waqas; Hyder, Omar; Butt, Jamaal; Aftab, Arsalan

2011-01-01

250

A Modified Dissection Method to Preserve Neck Structures  

ERIC Educational Resources Information Center

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…

Hankin, Mark H.; Stoller, Jeremy L.

2009-01-01

251

Axillary artery cannulation in type a aortic dissection operations  

Microsoft Academic Search

Background: Femoral arteries are the preferred site of peripheral cannulation for arterial inflow in type A aortic dissection operations. The presence of aortoiliac aneurysms, severe peripheral occlusive disease, atherosclerosis of the femoral vessels, and distal extension of the aortic dissection may preclude their utilization. Axillary artery cannulation may represent a valid alternative in these circumstances. Methods: Between January 15, 1989,

Eugenio Neri; Massimo Massetti; Gianni Capannini; Enrico Carone; Enrico Tucci; Francesco Diciolla; Edvin Prifti; Carlo Sassi

1999-01-01

252

Alternatives To Animal Dissection in School Science Classes. ERIC Digest.  

ERIC Educational Resources Information Center

Until recently, one of the most expected and accepted experiences among students in biology classrooms of the United States has been the dissection of vertebrate animals, from frogs and mice to cats and fetal pigs. However, resistance to animal dissection has grown during the past decade with concerns ranging from inhumane treatment of animals by…

Haury, David L.

253

Controlled ultrasonic micro-dissection of thin tissue sections.  

PubMed

In order to obtain sufficient quantities of pure populations of cells or a single cell from surrounding tissue for analytical investigation, we have developed an ultrasonic microdissection system. The system utilizes a vision-based method for detecting the contact between the microdissection needle tip and a target surface. A multilayer stack piezoelectric actuator is employed to generate ultrasonic vibrations for histological isolation. Automated micro-dissection is also realized using visual feedback and vision-based control. Experimental results on tumor tissue sections show that the system has a high dissection accuracy and efficiency and is able to realize dissecting arbitrary shapes in specified locations on a tissue sample. Furthermore, effects in variations of vibration amplitude and frequency of ultrasonic micro-dissection as well as needle insertion depths on micro-dissection accuracy and speed were evaluated. PMID:24718707

Ru, Changhai; Liu, Jun; Pang, Ming; Sun, Yu

2014-08-01

254

Management and long-term outcome of aortic dissection.  

PubMed Central

All 163 patients admitted to one institution between 1975 and 1988 with aortic dissection were reviewed. Type I and type II patients received grafting of the ascending aorta, with an intraoperative mortality rate of 11%. For type III dissection, management was medical in 53 patients, while 19 required surgery for aortic rupture or expansion, with an intraoperative mortality rate of 11%. The 9- or 10-year survival rates were 29%, 46%, and 29% for types I, II, and III respectively. Of 135 patients with primary aortic dissection, 17 (13%) required subsequent aortic surgery. Cause of late death was other cardiovascular disease in 38%, rupture of another aortic segment in 18%, sudden death in 24%, and other medical conditions in 21%. Although operative therapy for types I and II dissections and reserving operation for selected type III dissections provides acceptable long-term survival, careful follow-up is necessary due to concurrent cardiovascular disease and residual aortic disease. Images Fig. 3. PMID:2064469

Glower, D D; Speier, R H; White, W D; Smith, L R; Rankin, J S; Wolfe, W G

1991-01-01

255

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

SciTech Connect

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.

Watkinson, A. F., E-mail: anthony.watkinson@rdeft.nhs.u [Royal Devon and Exeter Hospital and Peninsula Medical School (United Kingdom)

2009-07-15

256

Abdominal aortic endograft collapse due to false lumen radial force of an acute type B aortic dissection.  

PubMed

We report a case of abdominal endograft proximal collapse due to acute type B aortic dissection in a patient previously treated with endovascular repair (EVAR) for an infrarenal abdominal aortic aneurysm. Patient underwent axillobifemoral bypass grafting, in emergency. The postoperative computed tomography scan showed reexpansion of the occluded endograft. The patient died after 2 days with evidence of progression of the thrombosis of the false lumen and with involvement of renal, visceral, and medullar artery. EVAR collapse associated to acute type B aortic dissection is a challenging condition, which requires aggressive approach. PMID:25017771

Psacharopulo, Daniele; Ferrero, Emanuele; Viazzo, Andrea; Ferri, Michelangelo; Ripepi, Matteo; Nessi, Franco

2014-11-01

257

48 CFR 6101.2 - Filing cases; time limits for filing; notice of docketing; consolidation [Rule 2].  

Code of Federal Regulations, 2013 CFR

...2 Filing cases; time limits for filing...telephone number, facsimile machine number, and e-mail...telephone number, facsimile machine number, and e-mail...telephone number, facsimile machine number, and e-mail...Rule 30). (b) Time limits for filing...

2013-10-01

258

48 CFR 6101.2 - Filing cases; time limits for filing; notice of docketing; consolidation [Rule 2].  

Code of Federal Regulations, 2012 CFR

...2 Filing cases; time limits for filing...telephone number, facsimile machine number, and e-mail...telephone number, facsimile machine number, and e-mail...telephone number, facsimile machine number, and e-mail...Rule 30). (b) Time limits for filing...

2012-10-01

259

48 CFR 6101.2 - Filing cases; time limits for filing; notice of docketing; consolidation [Rule 2].  

Code of Federal Regulations, 2014 CFR

...2 Filing cases; time limits for filing...telephone number, facsimile machine number, and e-mail...telephone number, facsimile machine number, and e-mail...telephone number, facsimile machine number, and e-mail...Rule 30). (b) Time limits for filing...

2014-10-01

260

48 CFR 6101.2 - Filing cases; time limits for filing; notice of docketing; consolidation [Rule 2].  

Code of Federal Regulations, 2011 CFR

...2 Filing cases; time limits for filing...telephone number, facsimile machine number, and e-mail...telephone number, facsimile machine number, and e-mail...telephone number, facsimile machine number, and e-mail...Rule 30). (b) Time limits for filing...

2011-10-01

261

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

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…

Kariuki, Patrick; Paulson, Ronda

262

Frozen Elephant Trunk Repair for Descending Thoracic Aortic Dissection in a Man with a Hostile Left Pleural Cavity  

PubMed Central

The frozen elephant trunk procedure is a hybrid, single-staged alternative to conventional surgery for repairing diffuse pathologic conditions of the thoracic aorta. This approach is particularly advantageous in patients who have pathologic conditions of the left side of the chest, because the descending thoracic aorta can be repaired without entering a hostile pleural cavity. We present the case of a 67-year-old man who had undergone repair of acute type A aortic dissection. He presented with aneurysmal dilation of the descending thoracic aorta secondary to chronic dissection, a large acute dissection of the proximal ascending aorta, and a large paraesophageal hernia that made him a poor candidate for conventional, 2-staged open aortic repair. We describe the hybrid frozen elephant trunk technique that we used to repair the aorta, and its broader advantages. PMID:24955060

Kent, William D.T.; Manjunath, Adarsh

2014-01-01

263

Iatrogenic bidirectional dissection of the right coronary artery and the ascending aorta: the worst nightmare for an interventional cardiologist.  

PubMed

Although rare, iatrogenic aortocoronary dissection is one of the complications most dreaded by the interventional cardiologist. If not managed promptly, it can have redoubted and serious consequences. Herein, we present the case of a 70 year-old woman who was treated by stenting of the second segment of the right coronary artery (RCA) for recurrent angina but, unfortunately, the procedure was complicated by anterograde dissection of the RCA with a simultaneous retrograde propagation to the proximal part of the ascending aorta. Successful stenting of the entry point was able to recuperate the RCA and to limit the retrograde propagation to the ascending aorta, but there was an extension of the dissection to the aortic valve leaflets resulting in a massive aortic insufficiency. Therefore, surgical aortic valve replacement with prosthetic tube graft was performed [corrected]. PMID:22870087

Dahdouh, Ziad; Roule, Vincent; Lognoné, Thérèse; Sabatier, Rémi; Bignon, Mathieu; Malcor, Guillaume; Lemaitre, Adrien; Blanchart, Katrien; Wain-Hobson, Julien; Saplacan, Vladimir; Cutone, Fabio; Buklas, Dimitrios; Ivascau, Calin; Massetti, Massimo; Grollier, Gilles

2012-07-01

264

Cervical Artery Dissection: Emerging Risk Factors  

PubMed Central

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

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

2010-01-01

265

Prevention of esophageal strictures after endoscopic submucosal dissection.  

PubMed

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

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

2014-11-01

266

Postmastectomy/Axillary Node Dissection Chyloma: The Additional Value of SPECT/CT Lymphoscintigraphy  

PubMed Central

After mastectomy and axillary node dissection, chylous leakage is rare. However, considerable anatomical variation in the termination of the thoracic duct has been reported. Hence, during breast surgery, injury to the lateral terminating branch is not unlikely and might lead to retrograde chyle leak. Herein, we describe a patient who had a chylous leakage at her wound site after a left simple mastectomy and axillary node dissection and for whom lymphoscintigraphy with Tc-99m albumin nanocolloid was performed. In this case, additional hybrid single-photon emission computed tomography/computed tomography study was done, and has helped with the accurate identification of the chyle leakage site, thus aiding in surgical management. PMID:25320629

Thang, Sue Ping; Ng, David Chee Eng

2014-01-01

267

Emergency repair of acute aortic dissection in a patient with relapsing polychondritis.  

PubMed

Relapsing polychondritis (RP) is a rare, inflammatory, multiorgan disorder affecting cartilaginous structure and other connective tissue. Cardiovascular complications occur in 10%-52% of patients. We report a case of emergency surgery for an acute aortic dissection in a patient with RP. A 45-year-old female who had been taking corticosteroids (10 mg/day) for 2 years for RP presented at another hospital with dyspnea and severe chest and back pain. Acute aortic dissection was diagnosed, and we performed emergency replacement of the ascending aorta. We could not control the bleeding from suture holes of the native aorta because the vessel was so fragile. Thus, we performed a delayed sternal closure. The day after surgery, bleeding had decreased, and we could close the chest wall. Infection was well controlled, and the patient suffered minimal additional complications. She was discharged to home by herself 29 days after surgery and returned to normal life. PMID:22850093

Iida, Mitsuru; Orime, Yukihiko; Umeda, Tomofumi; Ishii, Yusuke; Shiono, Motomi

2013-04-19

268

Use of left ventricle assist device in a pregnant woman with acute aortic and coronary dissections.  

PubMed

We report the case of a 31-year-old female in her 32nd week of pregnancy, who experienced an acute type A aortic dissection resulting in severe aortic insufficiency, dissection of the left anterior descending coronary artery, and left ventricular infarct with ejection fraction of 20%. After a successful cesarean section, she underwent a Bentall operation and three-vessel coronary artery bypass grafting. Despite maximal inotropic support, her cardiovascular indices deteriorated postoperatively. On the first postoperative day she was started on mechanical circulatory support with the Levitronix CentriMag left ventricular assist device. Her myocardial function improved and she was successfully weaned from this mechanical support on post-implant day 14. She remains alive and well to date. PMID:20484409

Kolesar, Adrian; Sabol, Frantisek; Luczy, Jan; Bajmoczi, Milan

2010-08-01

269

Carotid artery dissection due to elongated styloid process: a self-stabbing phenomenon.  

PubMed

Elongated styloid process (ESP) is an anatomical variant that has been described as the cause of Eagle syndrome. Until recently, the styloid process has not been appreciated as a significant contributor to carotid artery dissection (CAD), which is not part of Eagle syndrome. We present a case of a 41-year-old male who presented with acute right middle cerebral artery occlusion and was found to have ESP projecting to and abutting the lateral wall of a dissected right internal carotid artery (ICA). Forced sustained head turning with maximal muscle contraction was the initiating event driving the styloid process into the wall of the ICA in a manner that can be likened to being stabbed with a pointed object. Knowing the association between ESP, Eagle syndrome, and CAD shall lead to increased awareness and appropriate diagnosis and treatment. PMID:23163559

Razak, Anmar; Short, Jody L; Hussain, Syed I

2014-01-01

270

Internal carotid dissection caused by an elongated styloid process (Eagle syndrome).  

PubMed

Eagle syndrome (symptoms associated with an elongated styloid process (SP)) is commonly divided into two presentations. First, the so-called classic Eagle syndrome where patients can present with unilateral sore throat, dysphagia, tinnitus, unilateral facial and neck pain and otalgia. Second, there is the vascular or stylocarotid form of Eagle syndrome in which the elongated SP is in contact with the extracranial internal carotid artery. We describe two cases of internal carotid artery dissection associated with an elongated SP. One is a patient with ischaemic stroke and another with transient ischaemic attacks caused by an elongated SP. A surgical resection of the SP was performed on the former patient. Both patients were treated with anticoagulation and recovered well. A literature search only revealed two prior descriptions of carotid dissection in the context of an elongated SP. PMID:23761567

Sveinsson, Olafur; Kostulas, Nikolaos; Herrman, Lars

2013-01-01

271

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

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.

Kos, Sebastian, E-mail: skos@gmx.de [University Hospital Basel, Division of Interventional Radiology, Institute of Radiology and Nuclear Medicine (Switzerland); Guerke, Lorenz [University Hospital Basel, Department of Vascular Surgery (Switzerland); Jacob, Augustinus L. [University Hospital Basel, Division of Interventional Radiology, Institute of Radiology and Nuclear Medicine (Switzerland)

2011-12-15

272

Endovascular interventional therapy and classification of vertebral artery dissecting aneurysms  

PubMed Central

The current study aimed to summarise the clinical features and classifications of vertebral artery dissecting aneurysms (VADAs) to optimise strategies for endovascular interventional therapy. The clinical features and results of 31 inpatients with VADA were retrospectively analysed. The aneurysms were classified according to their location and association between the aneurysm and posterior inferior cerebellar artery (PICA), and into subtypes according to the developmental state of the contralateral vertebral artery. Different endovascular interventional therapy strategies were selected for each classification. Three types of aneurysm with two subtypes each were identified. An aneurysm located distally to the PICA was termed type I (10/31 patients). Aneurysms with a contralateral vertebral artery were denoted as subtype a (type Ia, 6/31 patients) and aneurysms with hypoplasia of the contralateral vertebral artery were denoted as subtype b (type Ib, 4/31 patients). An aneurysm located at the origin of the PICA was termed type II (13/31 patients), with seven cases classified as IIa and six cases as IIb. An aneurysm located proximally to the PICA was termed type III (8/31 patients), with five cases classified as IIIa and three cases as IIIb. Among the 31 patients, 18 received stent-assisted coiling, two received coiling, 10 received coiling with parent artery occlusion and one patient received conservative treatment. Among the 31 patients with VADA, 21 were occluded completely, nine were partially occluded and one was not occluded. One patient developed a coma following coiling; however, the other 30 patients recovered well. Thus, the classification of an aneurysm based on its location and the developmental state of the contralateral vertebral arteries appears to be an effective and safe approach for the selection of appropriate endovascular interventional therapy strategies. PMID:25289031

WANG, YIHUA; ZHAO, CUIPING; HAO, XIAOGUANG; WANG, CHENGWEI; WANG, ZHIGANG

2014-01-01

273

Dissection by Ultrasonic Energy Versus Monopolar Electrosurgical Energy in Laparoscopic Cholecystectomy  

PubMed Central

Introduction: Laparoscopic cholecystectomy is the gold standard for management of symptomatic gallstones. Electrocautery remains the main energy form used during laparoscopic dissection. However, due to its risks, search is continuous for safer and more efficient forms of energy. This review assesses the effects of dissection using ultrasonic energy compared with monopolar electrocautery during laparoscopic cholecystectomy. Methods: A literature search of the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, and EMBASE was performed. Studies included were trials that prospectively randomized adult patients with symptomatic gallstone disease to either ultrasonic or monopolar electrocautery dissection during laparoscopic cholecystectomy. Data were collected regarding the characteristics and methodological quality of each trial. Outcome measures included operating time, gallbladder perforation rate, bleeding, bile leak, conversion rate, length of hospital stay and sick leave, postoperative pain and nausea scores, and influence on systemic immune and inflammatory responses. For metaanalysis, the statistical package RevMan version 4.2 was used. For continuous data, Weighted Mean Difference (WMD) was calculated with 95% confidence interval (CI) using the fixed effects model. For Categorical data, the Odds Ratio (OR) was calculated with 95% confidence interval using fixed effects model. Results: Seven trials were included in this review, with a total number of 695 patients randomized to 2 dissection methods: 340 in the electrocautery group and 355 in the ultrasonic group. No mortality was recorded in any of the trials. With ultrasonic dissection, operating time is significantly shorter in elective surgery (WMD ?8.19, 95% CI ?10.36 to ?6.02, P>0.0001), acute cholecystitis (WMD ?17, 95% CI ?28.68 to ?5.32, P=0.004), complicated cases (WMD ?15, 95% CI ?28.15 to ?1.85, P=0.03), or if surgery was performed by trainee surgeons who had performed >10 procedures (P=0.043). Gallbladder perforation risk with bile leak or stone loss is lower (OR 0.27, 95% CI 0.17 to 0.42, P>0.0001 and OR 0.13, 95% CI 0.04 to 0.47, P=0.002 respectively), particularly in the subgroup of complicated cases (OR 0.24 95% CI 0.09 to 0.61, P=0.003). Mean durations of hospital stay and sick leave were shorter with ultrasonic dissection (WMD ?0.3, 95% CI ?0.51 to ?0.09, P=0.005 and WMD ?3.8, 95% CI ?6.21 to ?1.39, P=0.002 respectively), with a smaller mean number of patients who stayed overnight in the hospital (OR 0.18, 95% CI 0.03 to 0.89, P=0.04). Postoperative abdominal pain scores at 1, 4, and 24 hours were significantly lower with ultrasonic dissection as were postoperative nausea scores at 2, 4, and 24 hours. Conclusion: Based on a few trials with relatively small patient samples, this review does not attempt to advocate the use of a single-dissection technology but rather to elucidate results that could be used in future trials and analyses. It demonstrates, with statistical significance, a shorter operating time, hospital stay and sick leave, lower gallbladder perforation risk especially in complicated cases, and lower pain and nausea scores at different postoperative time points. However, many of these potential benefits are subjective, and prone to selection, and expectation bias because most included trials are unblinded. Also the clinical significance of these statistical results has yet to be proved. The main disadvantages are the difficulty in Harmonic scalpel handling, and cost. Appropriate training programs may be implemented to overcome the first disadvantage. Cost remains the main universal issue with current ultrasonic devices, which outweighs the potential clinical benefits (if any), indicating the need for further cost-benefit analysis. PMID:20412640

2010-01-01

274

Neck dissection with cervical sensory preservation in thyroid cancer  

PubMed Central

Thyroid cancer is the most common endocrine malignancy. Recently, controversy has focused on the management of lymph node metastases, which represent approximately 90% of disease recurrences and may require considerable time, effort, and resources to diagnose and treat. Neck dissections play an essential role in the management of head and neck cancer. A modified radical neck dissection (MND) refers to resection of the lymph nodes in levels II through V and often including the central nodes in level VI. When performing modified neck dissection, we recommend to protect more reserved cervical plexus. The purpose is to better protect patient’s neck skin feeling. PMID:25083485

Xue, Shuai; Wang, Peisong

2013-01-01

275

Coil embolization of the false lumen in complicated type B aortic dissection.  

PubMed

A patent false lumen with persistent flow after endovascular repair of type B aortic dissection (TBAD) is associated with an ongoing risk of aortic dilation and rupture. We describe the case of a 64-year-old man who initially underwent thoracic endovascular aortic repair for acute complicated TBAD, but continued to have symptomatic retrograde aneurysm filling and dilatation because of a patent false lumen. Coil embolization of the patent false lumen successfully excluded the aneurysmal thoracic aorta from further perfusion, and led to a decease in aneurysm size on follow-up. Our case report is followed by a discussion on this management strategy and a review of literature. PMID:25304903

Hussain, Mohamad A; Lindsay, Thomas F; Tan, Kong T; Moloney, Tony

2015-01-01

276

Canal wall window mastoidectomy for extensive labyrinthine cholesteatoma: total dissection and hearing preservation.  

PubMed

This case report highlights outcomes of a 6-year-old patient who preserved functional hearing after complete dissection of an extensive labyrinthine cholesteatoma causing two semicircular canals fistulas with endolymph leak, tympanic and labyrinthine fallopian canal erosion of the facial nerve and internal auditory canal invasion with cerebrospinal fluid leak. The patient preserved 40 dB average of bone conduction threshold and 92% of speech discrimination score at 26 months postoperatively. This article reveals that canal wall window mastoidectomy might be an option even in cases of extensive cholesteatomatous labyrinthine fistula therefore avoiding hearing loss and long life cleaning of a canal wall down mastoid cavity. PMID:21605917

Bergeron, M; Saliba, I

2011-07-01

277

Syringomyelia Associated with Spinal Arachnoiditis Treated by Partial Arachnoid Dissection and Syrinx-Far Distal Subarachnoid Shunt  

PubMed Central

The authors describe a new modified surgical approach to minimize the postoperative recurrence of a syrinx after surgery to treat syringomyelia associated with spinal adhesive arachnoiditis in two cases. Both patients presented with progressive gait disturbance without any remarkable history, and spinal magnetic resonance imaging revealed a syrinx and broad irregular disappearance of the subarachnoid space and/or deformity of the cord. We successfully performed a partial arachnoid dissection and syrinx-far distal subarachnoid shunt for both cases. PMID:25232285

Iwatsuki, Koichi; Yoshimine, Toshiki; Ohnishi, Yu-Ichiro; Ninomiya, Koshi; Moriwaki, Takashi; Ohkawa, Toshika

2014-01-01

278

Horner’s syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck  

Microsoft Academic Search

PURPOSE: To report a case of Horner’s syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck.METHODS: Case report. A 44-year-old woman with no prior ocular or vascular history presented with severe right-sided head and neck pain, ptosis, and miosis following chiropractic treatment for a strained right shoulder muscle.RESULTS: Magnetic resonance angiography of the neck and

Bobbie L. Parwar; Amani A. Fawzi; Anthony C. Arnold; Steven D. Schwartz

2001-01-01

279

Syringomyelia associated with spinal arachnoiditis treated by partial arachnoid dissection and syrinx-far distal subarachnoid shunt.  

PubMed

The authors describe a new modified surgical approach to minimize the postoperative recurrence of a syrinx after surgery to treat syringomyelia associated with spinal adhesive arachnoiditis in two cases. Both patients presented with progressive gait disturbance without any remarkable history, and spinal magnetic resonance imaging revealed a syrinx and broad irregular disappearance of the subarachnoid space and/or deformity of the cord. We successfully performed a partial arachnoid dissection and syrinx-far distal subarachnoid shunt for both cases. PMID:25232285

Iwatsuki, Koichi; Yoshimine, Toshiki; Ohnishi, Yu-Ichiro; Ninomiya, Koshi; Moriwaki, Takashi; Ohkawa, Toshika

2014-01-01

280

The first cut is the deepest: reflections on the state of animal dissection in biology education  

Microsoft Academic Search

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 dissection. It suggests that the place, practice, and purpose of

Rian De Villiers; Martin Monk

2005-01-01

281

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

Microsoft Academic Search

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

Kathleen M. Allspaw

2008-01-01

282

GPM Dissects Typhoon Hagupit - Duration: 0:38.  

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...

283

[Malperfusion in aortic dissection: diagnostic problems and therapeutic procedures].  

PubMed

Malperfusion of the thoracoabdominal aorta and its side branches is a common complication of aortic dissection, often proving fatal. Vital organ malperfusion accompanying acute aortic dissection is a major cause of mortality and morbidity and requires timely reperfusion of the ischemic organs as well as adequate management of the aortic dissection. Ischemic damage to vital organs supplied by the thoracoabdominal aorta greatly increases the overall risk of aortic dissection. As initial symptoms may be subtle, malperfusion tends to be recognized late, and therefore accounts for a considerable percentage of fatalities.Effective reperfusion is not readily achieved by central aortic surgery alone in a certain number of patients. Various strategies have been used, including entry closure by central aortic surgery or stent grafting, surgical or catheter fenestration, bypass grafting and percutaneous stenting.Endovascular bare-metal stent placement is an attractive and promising treatment option since it is readily available, is less invasive and presents fewer risks to the patient. PMID:21858546

Jánosi, R A; Böse, D; Konorza, T; Eggebrecht, H; Tsagakis, K; Jakob, H; Erbel, R

2011-09-01

284

Dissection Videos Do Not Improve Anatomy Examination Scores  

NSDL National Science Digital Library

This article describes the effect and student perception of showing dissection videos on first-year medical students' performance in terms of test scores during a gross anatomy course. The article describes the methods and outcomes.

Waqas Mahmud (Rawalpindi Medical College Anatomy)

2011-01-03

285

Spontaneous Coronary Artery Dissection: Not Just a Heart Attack  

MedlinePLUS

Spontaneous Coronary Artery Dissection: Not Just a Heart Attack Updated:Jun 19,2014 Sometimes a heart attack is not just a ... the result of spontaneous tearing in the coronary artery wall. The artery wall has three layers and ...

286

A Vertebral Artery Dissection with Basilar Artery Occlusion in a Child  

PubMed Central

This paper presents the case report of an 11-year-old boy with an acute dissection with thrombosis of the left vertebral artery and thrombosis of the basilar artery. The patient was treated with acute systemic thrombolysis, followed by intra-arterial thrombolysis, without any clinical improvement, showing left hemiplegia, bilateral clonus, hyperreflexia, and impaired consciousness. MRI indicated persistent thrombosis of the arteria basilaris with edema and ischemia of the right brainstem. Heparinization for 72 hours, followed by a two-week LMWH treatment and subsequent oral warfarin therapy, resulted in a lasting improvement of the symptoms. Vertebral artery dissection after minor trauma is rare in children. While acute basilar artery occlusion as a complication is even more infrequent, it is potentially fatal, which means that prompt diagnosis and treatment are imperative. The lack of class I recommendation guidelines for children regarding treatment of vertebral artery dissection and basilar artery occlusion means that initial and follow-up management both require a multidisciplinary approach to coordinate emergency, critical care, interventional radiology, and child neurology services. PMID:25587466

Devue, Katleen; Van Ingelgem, Annemie; De Keukeleire, Katrien; De Leeuw, Marc

2014-01-01

287

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

SciTech Connect

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.

Buy, Xavier; Tok, Chung-Hong; Szwarc, Daniel; Bierry, Guillaume; Gangi, Afshin, E-mail: gangi@rad6.u-strasbg.f [University Hospital of Strasbourg, Department of Radiology B (France)

2009-05-15

288

Optogenetic dissection of medial prefrontal cortex circuitry  

PubMed Central

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

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

2014-01-01

289

Genetic dissection of drug resistance in trypanosomes.  

PubMed

The trypanosomes cause two neglected tropical diseases, Chagas disease in the Americas and African trypanosomiasis in sub-Saharan Africa. Over recent years a raft of molecular tools have been developed enabling the genetic dissection of many aspects of trypanosome biology, including the mechanisms underlying resistance to some of the current clinical and veterinary drugs. This has led to the identification and characterization of key resistance determinants, including transporters for the anti-Trypanosoma brucei drugs, melarsoprol, pentamidine and eflornithine, and the activator of nifurtimox-benznidazole, the anti-Trypanosoma cruzi drugs. More recently, advances in sequencing technology, combined with the development of RNA interference libraries in the clinically relevant bloodstream form of T. brucei have led to an exponential increase in the number of proteins known to interact either directly or indirectly with the anti-trypanosomal drugs. In this review, we discuss these findings and the technological developments that are set to further revolutionise our understanding of drug-trypanosome interactions. The new knowledge gained should inform the development of novel interventions against the devastating diseases caused by these parasites. PMID:23552488

Alsford, Sam; Kelly, John M; Baker, Nicola; Horn, David

2013-10-01

290

Dissecting the Milky Way disk with LAMOST  

NASA Astrophysics Data System (ADS)

The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST) survey has obtained over 3 million stellar spectra through its first two years of operations. This vast ensemble of bright star spectra is an unprecedented resource for detailed kinematical studies of the nearby Galactic disk. We detail recent results from LAMOST that uncover asymmetries in the vertical and radial (Galactocentric) velocity components of Milky Way disk stars. Using effective temperature as a proxy for stellar age, we have found that cooler stars in the extended Solar neighborhood appear to be in equilibrium, and that the velocity substructure is mostly present among warmer -- and thus younger -- stars. We detail our continued efforts to improve estimates of stellar distances and proper motions, which are vital to the process of disentangling complicated disk kinematics. With the huge number of spectra observed by LAMOST covering large contiguous sky areas, it is becoming possible to dissect the kinematical structure of the local disk in minute detail, while also reconstructing the larger-scale dynamics of the disk. This research was supported by NSF grants AST 09-37523 and AST 14-09421.

Carlin, Jeffrey L.; Newberg, Heidi Jo; Liu, Chao; Beers, Timothy C.; Chen, Xuelei; Grabowski, Kathleen; Guhathakurta, Puragra; Lepine, Sebastien; Liu, Xiaowei; Luo, A.-Li; Tian, Hai-Jun; Yanny, Brian; Yuan, Haibo; Zhang, Haotong; Zhao, Gang; Zhao, Yongheng; Zheng, Zheng

2015-01-01

291

Stroke prevention and treatment in patients with spontaneous carotid dissection  

Microsoft Academic Search

This review on spontaneous dissection of the internal carotid artery (sICAD) will discuss in the first part stroke prevention\\u000a and focus on vascular risk factors, antithrombotic therapy, and treatment of severe stenosis or occlusion, and dissecting\\u000a aneurysm. The second part of the review will summarize the treatment of acute ischemic stroke due to sICAD.

Ralf W. Baumgartner

292

Cadaver Dissection and the Ritual Transformation of Medical Students  

E-print Network

the cultural aspects of healing: birthing suites are becoming more comfortable and social, and prayer circles are increasingly part of the prescribed treatment for some disease in many communities. Increased understanding of the power of the placebo effect... badly, or of contracting diseases. Many physicians recall their cadaver dissection 3 sessions as significant life events, in addition to acknowledging their importance in knowledge acquisition (Lempp 2005, p. 319). Cadaver dissection can be viewed...

Laudermilk, Ryan

2011-12-31

293

Air leak seal for lung dissection plane with diode laser irradiation: an ex vivo study  

NASA Astrophysics Data System (ADS)

In order to seal air leak from lung dissection plane in thoracotomy, we studied diode laser irradiation (wavelength: 810nm) with surface stain of indocyanine green (ICG, peak absorption wavelength: 805nm) ex vivo. In general, this air leak is sealed by suturing with weak tension and large margin of parenchyma. This suturing requires surgeon's skill and takes long time. Moreover, lung ventilatory performance is significantly impaired. Since laser tissue welding is novel method to adhere living tissue with thin thermally denatured attachment layer, we propose to seal the lung dissection plane with laser irradiation. Our aim of this study is to investigate the sealing mechanism as well as optimum condition to develop reliable laser sealing method for dissected lung plane in surgery, using practical laser-dye combination. Compartment of extracted porcine lung was prepared as a lung model, which volume was approximately 60cm^3. ICG solution (2.5mg/ml) was applied to the dissection plane of this lung model with 1minute. The diode laser (power density: 8-40W/cm^2) irradiated to the plane, moving the laser spot with constant speed (v=1mm/s). The heat degeneration depth and smoothness of the laser irradiated surface were observed by a microscope. When power density was over 24W/cm^2, heat degeneration depth was over 1.5E-4 m. There were no pin holes on the surface and the air leak seemed to be sealed completely. We also evaluated the air leak by endotracheal pressure. In the case of above condition, the heat degeneration depth was the same that of previous reported result with CO2 laser.

Gotoh, Maya; Tokunaga, Hisako; Kaneko, Kenji; Arai, Tsunenori

2007-02-01

294

Planned neck dissection following chemo-radiotherapy in advanced HNSCC  

PubMed Central

Background Neck dissection has traditionally played an important role in the management of patients with regionally advanced head and neck squamous cell carcinoma (HNSCC) treated with radical radiotherapy alone. However, with the incorporation of chemotherapy in the therapeutic strategy for advanced HNSCC and resultant improvement in outcome the routine use of post chemo-radiotherapy neck dissection is being questioned. Methods Published data for this review was identified by systematically searching MEDLINE, CANCERLIT & EMBASE databases from 1995 until date with restriction to the English language. Results There is lack of high quality evidence on the role of planned neck dissection in advanced HNSCC treated with chemo-radiotherapy. A systematic literature search could identify only one small randomized controlled trial (Level I evidence) addressing this issue, albeit with major limitations. Upfront neck dissection followed by chemo-radiotherapy resulted in better disease-specific survival as compared to chemoradiation only. Several single arm prospective and retrospective reports were also identified with significant heterogeneity and often-contradictory conclusions. Conclusions Planned neck dissection after radical chemo-radiotherapy achieves a high level of regional control, but its ultimate benefit is limited to a small subset of patients only. Unless there are better non-invasive ways to identify residual viable disease, the role of such neck dissection shall remain debatable. A large randomized controlled trial addressing this issue is needed to clarify its role and provide evidence-based answers. PMID:15377383

Gupta, Tejpal; Agarwal, Jai Prakash

2004-01-01

295

Secondary Aortic Dissection after Endoluminal Treatment of an Intramural Hematoma of the Thoracoabdominal Aorta: Endovascular Extension with Two Stent Grafts and Scarce Distal Landing  

PubMed Central

Secondary dissection in the descending aorta after endovascular therapy may demand subsequent interventional procedures. This can set a particularly significant challenge for the endovascular specialist. When implanting an aortic prosthesis, a sufficient contact between the covered segment and the healthy vessel wall is advisable. However, our case shows that, in individual cases, it is indeed efficient to place an aortic stent graft on top of the distal end of the dissection. This is proven by a three-year follow-up CT-angiography. PMID:24368920

Kalmar, Peter I.; Oberwalder, Peter; Schedlbauer, Peter; Steiner, Jürgen; Portugaller, Rupert H.

2013-01-01

296

A patient-specific study of type-B aortic dissection: evaluation of true-false lumen blood exchange  

PubMed Central

Background Aortic dissection is a severe pathological condition in which blood penetrates between layers of the aortic wall and creates a duplicate channel – the false lumen. This considerable change on the aortic morphology alters hemodynamic features dramatically and, in the case of rupture, induces markedly high rates of morbidity and mortality. Methods In this study, we establish a patient-specific computational model and simulate the pulsatile blood flow within the dissected aorta. The k-? SST turbulence model is employed to represent the flow and finite volume method is applied for numerical solutions. Our emphasis is on flow exchange between true and false lumen during the cardiac cycle and on quantifying the flow across specific passages. Loading distributions including pressure and wall shear stress have also been investigated and results of direct simulations are compared with solutions employing appropriate turbulence models. Results Our results indicate that (i) high velocities occur at the periphery of the entries; (ii) for the case studied, approximately 40% of the blood flow passes the false lumen during a heartbeat cycle; (iii) higher pressures are found at the outer wall of the dissection, which may induce further dilation of the pseudo-lumen; (iv) highest wall shear stresses occur around the entries, perhaps indicating the vulnerability of this region to further splitting; and (v) laminar simulations with adequately fine mesh resolutions, especially refined near the walls, can capture similar flow patterns to the (coarser mesh) turbulent results, although the absolute magnitudes computed are in general smaller. Conclusions The patient-specific model of aortic dissection provides detailed flow information of blood transport within the true and false lumen and quantifies the loading distributions over the aorta and dissection walls. This contributes to evaluating potential thrombotic behavior in the false lumen and is pivotal in guiding endovascular intervention. Moreover, as a computational study, mesh requirements to successfully evaluate the hemodynamic parameters have been proposed. PMID:23829346

2013-01-01

297

Spontaneous vertebral dissection: Clinical, conventional angiographic, CT, and MR findings  

SciTech Connect

The purpose of this study was to determine if typical clinical and neuroradiologic patterns exist in patients with spontaneous vertebral artery (VA) dissection. The medical records and neuroradiologic examinations of 14 patients with spontaneous VA dissection were reviewed. The medical records were examined to exclude patients with a history of trauma and to record evidence of a nontratimatic precipitating event ({open_quotes}trivial trauma{close_quotes}) and presence of possible risk factors such as hypertension. All patients under-went conventional angiography, 13 either CT or MRI (II both CT and MRI), and 3 MRA. Conventional arteriograrris were evaluated for dissection site, evidence of fibromuscular dysplasia, luminal stenosis or occlusion, and pseudoaneurysm formation, CT examinations for the presence of infarction or subarachnoid hemorrhage, MR examinations for the presence of infarction or arterial signal abnormality, and MR angiograms for abnormality of the arterial signal column. Seven patients had precipitating events within 24 h of onset of symptoms that may have been causative of dissection and five had hypertension. At catheter angiography, two patients had dissections in two arteries (both VAs in one patient, VA and internal carotid artery in one patient), giving a total of 15 VAs with dissection. Dissection sites included V1 in four patients, V2 in one patient, V3 in three patients, V4 in six patients, and both V3 and V4 in one patient. Luminal stenosis was present in 13 VAs, occlusion in 2, pseudoaneurysm in 1, and evidence of fibromuscular dysplasia in 1. Posterior circulation infarcts were found on CT or MR in five patients. Subarachnoid hemorrhage was found on CT in two patients and by lumbar puncture alone in two patients. Abnormal periarterial signal on MRI was seen in three patients. MRA demonstrated absent VA signal in one patient, pseudoaneurysm in one, and a false-negative examination in one.

Provenzale, J.M.; Morgenlander, J.C. [Duke Univ. Medical Center, Durham, NC (United States)] [Duke Univ. Medical Center, Durham, NC (United States); Gress, D. [Univ. of California, San Francisco, CA (United States)] [Univ. of California, San Francisco, CA (United States)

1996-03-01

298

Extraesophageal saline during endoscopic submucosal dissection in a patient with early esophageal squamous cell carcinoma.  

PubMed

Saline submucosal injection (SSI) is an indispensable procedure before endoscopic submucosal dissection (ESD) in patients with early esophageal squamous cell carcinoma. Successful SSI should create a saline cushion in the submucosa rather than elsewhere. However, saline outside the esophagus was detected incidentally by endoscopic ultrasonography during ESD in a patient with early esophageal cancer. In this case, saline separated the esophageal adventitia from adjacent tissues, and there were no complications during or after ESD. This finding indicates that it is possible to use interventional extraesophageal saline injection to help differentiate advanced esophageal cancer of Stage T3 from Stage T4 by endoscopic ultrasonography. PMID:25441804

Li, Jian-jun; Shan, Hong-bo; He, Long-jun; Luo, Guang-yu; Chen, Li-ming; Xu, Guo-liang; Li, Yin; Zhang, Rong

2014-11-01

299

[Gastrointestinal hemorrhage after operation for dissecting aneurysm of the thoracic aorta].  

PubMed

We present the case of a 45-year-old man who underwent surgical repair of a dissecting aneurysm of the descending thoracic aorta. 25 days postoperatively, the patient unexpectedly developed hematemesis and hypovolemic shock. Emergency gastroscopy was performed and a suspected aortoesophageal fistula was diagnosed. Unfortunately, the patient died prior to emergency surgery. Aneurysms of the aorta or of aortic grafts occasionally lead to the development of fistulae to the upper gastrointestinal tract. Once this rare, but life-threatening complication is suspected, endoscopy must be performed immediately. Emergency surgery is associated with a high risk, but represents the only possibly chance of survival for the patient. PMID:9553205

Kirchgatterer, A; Punzengruber, C; Zisch, R; Balon, R; Knoflach, P

1998-02-13

300

Left lower sleeve lobectomy and systematic lymph node dissection by complete video-assisted thoracic surgery  

PubMed Central

Sleeve lobectomy for selected cases of central lung cancer has better functional outcomes comparing to pneumonectomy. With improved technology and increased experiences in complete video-assisted thoracic surgery (VATS) lobectomy, complete VATS sleeve lobectomy has been applied in major medical centers recently. A 64-year-old male patient with left lower central lung cancer underwent thoracoscopic sleeve lobectomy and systemic mediastinal lymph node dissection. The major incision, of four incisions in total, was a 4 cm mini-incision in the 4th intercostal space of anterior axillary line. The patient had recovered uneventfully after the surgery. PMID:25589982

Fan, Jun-Qiang; Chang, Zhi-Bo; Wang, Qi; Zhao, Bai-Qin

2014-01-01

301

Spontaneous coronary artery dissection associated with ?-HCG injections and fibromuscular dysplasia.  

PubMed

Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome predominantly affecting younger women. SCAD is often associated with predisposing arterial abnormalities and precipitating emotional, physical, and hormonal stressors. We previously showed that fibromuscular dysplasia is strongly associated with SCAD and may be a causative factor. Hormonal changes related to pregnancy and sex hormones have also been shown to be an important cause of SCAD. We describe the first case report, to our knowledge, of SCAD associated with ?-human growth hormone injections in a patient with concomitant FMD. PMID:24559539

Lempereur, Mathieu; Grewal, Jasmine; Saw, Jacqueline

2014-04-01

302

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

PubMed

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

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

2015-02-01

303

Five-year results of abdominopelvic lymph node dissection for carcinoma of the rectum  

Microsoft Academic Search

Summary and Conclusions  A series of 122 patients with adenocarcinoma of the rectum who had abdominopelvic lymph node dissection five or more years\\u000a ago is presented.\\u000a \\u000a Metastases to abdominopelvic extramesenteric lymph nodes which would not have been removed by the standard types of resection\\u000a of the rectum were found in 11 cases (9 per cent).\\u000a \\u000a \\u000a \\u000a There was 66 (54 per cent)

Maus W. Stearns; Michael R. Deddish

1959-01-01

304

Coronary accordion effect mimicking coronary dissection  

PubMed Central

The coronary “accordion” effect is a rare pseudo-complication of percutaneous coronary intervention (PCI). It is usually observed due to straightening and shortening of tortuous vessels with stiff guidewires during PCI. In this case report, we present an interesting case of the coronary accordion effect observed in a 52-year-old woman undergoing PCI. PMID:24570759

Balli, Mehmet; Akilli, Rabia Eker; Tekin, Kamuran; Cayli, Murat

2013-01-01

305

Digital dissection system for medical school anatomy training  

NASA Astrophysics Data System (ADS)

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.

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

2003-05-01

306

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

PubMed Central

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

2014-01-01

307

Extent of lymph node dissection: common hepatic artery lymph node dissection can be omitted for esophageal squamous cell carcinoma  

PubMed Central

Objectives Controversy persists regarding the adequate extent of lymph node (LN) dissection in thoracic esophageal cancer (EC) surgery. Oncologic efficacy should be balanced with the increased risk of postoperative complications after aggressive radical LN dissection. Here, we evaluate the effectiveness of common hepatic artery LN dissection in surgery for thoracic esophageal squamous cell carcinoma. Patients and methods Among a total of 1,563 EC patients who underwent surgery from May 2005 to December 2012 at the Fudan University Shanghai Cancer Center, 1,248 thoracic esophageal squamous cell carcinoma were selected for this study, including 682 patients who underwent esophagectomy with common hepatic artery LN dissection and 566 patients who underwent esophagectomy without common hepatic artery LN dissection. The clinical data of patients were retrospectively analyzed. In addition, the locoregional LN metastasis, relationship between metastatic rates of common hepatic artery LN and clinicopathological factors were analyzed. A propensity score match analysis were performed to control for potential differences in the characteristics of patients with EC cell carcinoma, and postoperative complications were analyzed after propensity score-matching. Results The metastatic rate of common hepatic LN was 3.5%. Logistic regression analysis revealed tumor diameter, N classification and pTNM stage were risk factors for common hepatic LN metastasis. Matching based on propensity scores produced 361 patients in each group. The overall incidence of postoperative complications was 32.70% and 35.45%, respectively, no significant difference was found (P=0.432). Conclusions The metastatic rate of common hepatic artery LN is low. For patients who undergo resection for Stage I thoracic esophageal squamous cell carcinoma, the dissection of common hepatic artery LN may be safely omitted. PMID:24876938

Ma, Xiao; Li, Bin; Yang, Su; Guo, Wei; Zhu, Xiaoli; Xiang, Jiaqing; Zhang, Yawei

2014-01-01

308

Treatment of a Persistent False Lumen with Aneurysm Formation Following Surgical Repair of Type A Dissection  

SciTech Connect

We describe the case of a 68-year-old man who developed aneurysmal dilatation of the proximal descending thoracic aorta 8 years after repair of a type A dissection. The aneurysm was due to an anastomotic leak at the distal end of the previous repair in the ascending aorta with antegrade perfusion of the false lumen. Surgical repair of the anastomotic leak partially obliterated the false lumen and computed tomography scan demonstrated thrombosis in a large proportion of the false lumen aneurysm. Follow-up with surveillance scans showed persistent filling of this aneurysm due to retrograde flow of blood within the false lumen. Coil embolization of the false lumen within the thoracic aorta was performed which successfully thrombosed the aneurysm with a reduction in diameter. Late aneurysm formation may complicate type A dissection repairs during follow-up due to a persistent false lumen, especially if there is an anastomotic leak. This case report describes a strategy to deal with this difficult clinical problem.

Jeganathan, Reubendra, E-mail: reubenj@hotmail.com; Kennedy, Peter; MacGowan, Simon [Royal Victoria Hospital, Department of Cardiac Surgery (United Kingdom)

2007-06-15

309

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

Federal Register 2010, 2011, 2012, 2013, 2014

...TRADE COMMISSION [Investigation No. 337-TA-865] Certain Balloon Dissection Devices and Products Containing Same; Commission...or sale in the United States after importation of certain balloon dissection devices and products containing same by reason...

2013-03-21

310

20 CFR 702.216 - Effect of failure to give notice.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 false Effect of failure to give notice...Notice § 702.216 Effect of failure to give notice...or in the case of a hearing loss, where the employer...report which indicates a loss of hearing. Failure to...

2014-04-01

311

20 CFR 702.216 - Effect of failure to give notice.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Effect of failure to give notice...Notice § 702.216 Effect of failure to give notice...or in the case of a hearing loss, where the employer...report which indicates a loss of hearing. Failure to...

2013-04-01

312

20 CFR 702.216 - Effect of failure to give notice.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Effect of failure to give notice...Notice § 702.216 Effect of failure to give notice...or in the case of a hearing loss, where the employer...report which indicates a loss of hearing. Failure to...

2011-04-01

313

20 CFR 702.216 - Effect of failure to give notice.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 false Effect of failure to give notice...Notice § 702.216 Effect of failure to give notice...or in the case of a hearing loss, where the employer...report which indicates a loss of hearing. Failure to...

2012-04-01

314

20 CFR 702.216 - Effect of failure to give notice.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Effect of failure to give notice...Notice § 702.216 Effect of failure to give notice...or in the case of a hearing loss, where the employer...report which indicates a loss of hearing. Failure to...

2010-04-01

315

Functional dissection and module swapping of fungal cyclooligomer depsipeptide synthetases.  

PubMed

BbBSLS and BbBEAS were dissected and reconstituted in Saccharomyces cerevisiae. The intermodular linker is essential for the reconstitution of the separate modules. Module 1 can be swapped between BbBEAS and BbBSLS, while modules 2 and 3 control the product profiles. BbBSLS is a flexible enzyme that also synthesizes beauvericins. PMID:23727842

Yu, Dayu; Xu, Fuchao; Gage, David; Zhan, Jixun

2013-07-14

316

Dissecting BitTorrent: Five Months in a Torrent's Lifetime  

E-print Network

Dissecting BitTorrent: Five Months in a Torrent's Lifetime M. Izal, G. Urvoy-Keller, E.W. Biersack as clients and servers. In this paper, we study BitTorrent, a new and already very popular peer- to-peer application that allows distribution of very large contents to a large set of hosts. Our analysis of BitTorrent

Rivière, Etienne

317

Blood Vessels of the Fetal Pig Dissection Posterior Vessels Protocol  

E-print Network

Blood Vessels of the Fetal Pig Dissection Posterior Vessels Protocol: 1. The blood vessels membrane is the peritoneum, the blood vessels are said to be retroperitoneal). In order to see the blood that supplies the stomach, liver and spleen with blood. This is the celiac artery. c. Just below where

Loughry, Jim

318

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...

319

The Influence of Emotion on Students' Performance in Dissection Exercises  

ERIC Educational Resources Information Center

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'…

Holstermann, Nina; Grube, Dietmar; Bogeholz, Susanne

2009-01-01

320

Familial Cervical Artery Dissections Clinical, Morphologic, and Genetic Studies  

Microsoft Academic Search

Background and Purpose—Genetic risk factors are thought to play a role in the etiology of spontaneous cervical artery dissections (CAD). However, familial CAD is extremely rare. In this study we analyzed patients with familial CAD and asked the question whether familial CAD has particular features. Methods—Seven families with 15 CAD patients were recruited. All patients were carefully investigated by a

Juan Jose Martin; Ingrid Hausser; Philippe Lyrer; Otto Busse; Ralf Schwarz; Rolf Schneider; Tobias Brandt; Manja Kloss; Markus Schwaninger; Stefan Engelter; Caspar Grond-Ginsbach

2010-01-01

321

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

ERIC Educational Resources Information Center

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.…

Lee, Yeung Chung

2004-01-01

322

INVESTIGATION Genetic Dissection of a Major Anthocyanin QTL  

E-print Network

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

Bradshaw, Toby

323

Exploring Dissections of Rectangles into Right-Angled Triangles  

ERIC Educational Resources Information Center

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…

Griffiths, Martin

2013-01-01

324

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-cycle control. However, cancer-associated mutations are almost exclusively found in RB, implying that RB has for cancer development; hence, the roles and regulation of RB have been intensively studied (reviewed

325

Dissection of epistasis in oligogenic Bardet-Biedl syndrome  

Microsoft Academic Search

Epistatic interactions have an important role in phenotypic variability, yet the genetic dissection of such phenomena remains challenging. Here we report the identification of a novel locus, MGC1203, that contributes epistatic alleles to Bardet-Biedl syndrome (BBS), a pleiotropic, oligogenic disorder. MGC1203 encodes a pericentriolar protein that interacts and colocalizes with the BBS proteins. Sequencing of two independent BBS cohorts revealed

Jose L. Badano; Carmen C. Leitch; Stephen J. Ansley; Helen May-Simera; Shaneka Lawson; Richard Alan Lewis; Philip L. Beales; Harry C. Dietz; Shannon Fisher; Nicholas Katsanis

2006-01-01

326

Dissecting SMS Malwares in Android Anoop Joseph Babu, Rahul Raveendranath,  

E-print Network

Dissecting SMS Malwares in Android Anoop Joseph Babu, Rahul Raveendranath, Venkiteswaran Rajamani of concept SMS malware is presented to analyze the working of most threatening SMS malwares in the wild Terms--Android; Security threats; Countermeasures; SMS Malware; Permissions. I. INTRODUCTION Smartphones

Gesbert, David

327

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

E-print Network

11CHAPTER Dissecting Oxygenic Photosynthesis: The Evolution of the "Z"-Scheme for Thylakoid and two photosystems are involved in oxygenic photosynthesis. This is then followed by the discovery Drop in Photosynthesis; Two Light Reactions; Two Photosystems; Z-Scheme of Photosynthesis #12

Govindjee

328

Lymph node dissection – understanding the immunological function of lymph nodes  

PubMed Central

Lymph nodes (LN) are one of the important sites in the body where immune responses to pathogenic antigens are initiated. This immunological function induced by cells within the LN is an extensive area of research. To clarify the general function of LN, to identify cell populations within the lymphatic system and to describe the regeneration of the lymph vessels, the experimental surgical technique of LN dissection has been established in various animal models. In this review different research areas in which LN dissection is used as an experimental tool will be highlighted. These include regeneration studies, immunological analysis and studies with clinical questions. LN were dissected in order to analyse the different cell subsets of the incoming lymph in detail. Furthermore, LN were identified as the place where the induction of an antigen-specific response occurs and, more significantly, where this immune response is regulated. During bacterial infection LN, as a filter of the lymph system, play a life-saving role. In addition, LN are essential for the induction of tolerance against harmless antigens, because tolerance could not be induced in LN-resected animals. Thus, the technique of LN dissection is an excellent and simple method to identify the important role of LN in immune responses, tolerance and infection. PMID:22861359

Buettner, M; Bode, U

2012-01-01

329

Dissection of Conformational Conversion Events during Prion Amyloid Fibril  

E-print Network

Dissection of Conformational Conversion Events during Prion Amyloid Fibril Formation Using Hydrogen A molecular understanding of prion diseases requires an understanding of the mechanism of amyloid fibril formation by the prion protein. In particular, it is necessary to define the sequence of the structural

330

Genetic Dissection of Behavioural and Autonomic Effects of D9  

E-print Network

Genetic Dissection of Behavioural and Autonomic Effects of D9 -Tetrahydrocannabinol in Mice Marijuana and its main psychotropic ingredient D9 -tetrahydrocannabinol (THC) exert a plethora -tetrahydrocannabinol in mice. PLoS Biol 5(10): e269. doi:10.1371/journal.pbio.0050269 Introduction Cannabinoids

Paris-Sud XI, Université de

331

Dissection of the Hyperadhesive Phenotype of Airway Eosinophils in Asthma  

E-print Network

Dissection of the Hyperadhesive Phenotype of Airway Eosinophils in Asthma Steven R. Barthel, Nizar, and Department of Medicine, University of Wisconsin­Madison, Madison, Wisconsin Asthma is characterized. Keywords: adhesion molecules; cell trafficking; eosinophils; human Asthma is an inflammatory syndrome

Mosher, Deane F.

332

Kendall Hunt Dissection of a Squid: Part 2  

NSDL National Science Digital Library

The purpose of this 9-minute video is to illustrate notable anatomical structures of the market squid (Loligo opalescens) to prepare teachers to lead a dissection of this species; however, this video is not meant to be viewed by students. Presented as a workshop at the NMEA Annual Conference, July 2010.

2012-01-01

333

Central Cannulation by Seldinger Technique: A Reliable Method in Type A Aortic Dissection Repairs  

PubMed Central

Background Extensive type A aortic dissections that involve peripheral great vessels can complicate the choice of a cannulation site for cardiopulmonary bypass. We started to employ direct cannulation of the true lumen on the concavity of the aortic arch by Seldinger technique and evaluated the efficacy of this access technique as an alternative arterial inflow target in aortic surgery. Material/Methods Twenty-four consecutive patients (mean age: 59±14 years) underwent type A aortic dissection repair using selective antegrade cerebral perfusion. Direct aortic cannulation was used in 14 cases, subclavian access in 6 patients, and femoral entry in 4 patients. Perioperative factors were evaluated to identify the reliability and eventual benefits of direct cannulation method at the aortic arch. Results There were no operative deaths and cumulative 30-day mortality rate was 25% (6). Permanent neurological deficits were not observed; in 1 patient transient changes occurred (4%). Time to reach circulatory arrest was the shortest in the direct access group, with mean 27±11 (CI: 20.6–33.3) min vs. 43±22 (28.0–78.0) min (p=0.058) and 32±8 (23.6–40.4) min (p=0.34) by femoral cannulation and subclavian entry, respectively. Direct arch cannulation resulted in the best renal function in the first 72 h after surgery and similar characteristics were observed in lactic acid levels. Conclusions Ultrasound-guided direct cannulation on the concavity of the aortic arch using a Seldinger technique is a reliable method in dissection repairs. Prompt antegrade perfusion provides not only cerebral but also peripheral organ and tissue protection, which is an advantage in this high-risk group of patients. PMID:25416498

Göbölös, Laszlo; Ugocsai, Peter; Foltan, Maik; Philipp, Alois; Thrum, Andrea; Miskolczi, Szabolcs; Malvindi, Pietro G.; di Gregorio, Vincenzo; Pousios, Dimitrios; Navaratnarajah, Manoraj; Ohri, Sunil K.

2014-01-01

334

Systematic review of outcomes of combined proximal stent-grafting with distal bare stenting for management of aortic dissection  

PubMed Central

Objective Available data on outcomes of combined proximal stent-grafting with distal bare stenting for management of aortic dissection are limited. The objective of this study was to provide a systematic review of outcomes of this approach. Methods Studies involving combined proximal stent-grafting with distal bare stenting for management of aortic dissection were systematically searched and reviewed through MEDLINE databases. Results A total of four studies were included: 108 patients treated for management of acute (n=54) and chronic (n=54) aortic dissection. The technical success rate was 95.3% (range, 84-100%). The 30-day mortality rate was 2.7% (range from 0% to 5%). The morbidity rate occurring within 30 days was 51.8% (range from 0% to 65%) and included stroke (2.7%), paraplegia (2.7%), retrograde dissection (1.8%), renal failure (14.8%), severe cardiopulmonary complications (5.5%) and bowel ischemia (0.9%). The incidence of type I endoleak was 9.2% (10/108). During follow-up, 5 (4.6%) deaths were related to aortic rupture or aortic repair. Mean re-intervention rate was 12.9%. Two cases (1.9%) of delayed retrograde type A dissection and one case of aortobronchial fistula (0.9%) were reported. The most common delayed complication was thoracic stent-graft migration (4.7%). The rate of device failure was 9.2%. Favorable aortic remodeling was observed: studies reporting midterm follow-up of the true lumen demonstrated a high rate of both false lumen regression and true lumen expansion. At 12 months, complete false lumen thrombosis was observed at the thoracic level in 70.4% and at the abdominal level in 13.5% of patients. Conclusions Combined proximal stent-grafting with distal bare stenting appears to be a feasible approach for the management of Type B aortic dissection. Although this approach clearly improved true lumen perfusion and diameter, it failed to completely suppress false lumen patency. However, it should be acknowledged that contemporary data on this approach is limited to small studies with variable results. PMID:24967161

Faure, Elsa Madeleine; Ozdemir, Baris Ata; Alric, Pierre; Thompson, Matt

2014-01-01

335

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

ERIC Educational Resources Information Center

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…

De Villiers, Rian; Monk, Martin

2005-01-01

336

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

ERIC Educational Resources Information Center

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…

Carlin, Joel L.

2010-01-01

337

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

ERIC Educational Resources Information Center

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…

Fancovicova, Jana; Prokop, Pavol; Leskova, Andrea

2013-01-01

338

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

ERIC Educational Resources Information Center

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…

Milano, Regina Nicole

2010-01-01

339

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

ERIC Educational Resources Information Center

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…

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

2010-01-01

340

Outcomes of a rotational dissection system in gross anatomy.  

PubMed

At the University of Texas Houston Medical School, a rotational dissection system was introduced to improve coordination between the Gross Anatomy and the Introduction to Clinical Medicine (ICM) courses. Six students were assigned to each cadaver and divided into two teams. For each laboratory, one team was assigned to dissect and the other to attend ICM or study independently. For the next laboratory, the assignments were reversed. At the start of the session, the team that had dissected previously spent 30 minutes teaching the other team. In 2012, the students were given three traditional practical examinations with 50 questions drawn equally from each laboratory. Students also completed three mid-course evaluations. There were no significant differences in overall performance between the two teams. Nevertheless, we wanted to determine how well individual students identified structures they had dissected compared with those they had not. For dissected structures, the mean percent correct was 80.0?±?13.0 (mean?±?standard deviation), and for undissected structures, it was 78.3?±?14.1. The difference was small, but statistically significant (P?=?0.0007). Although this result validated the concerns expressed by some students, it did not appear that a change in the system was justified. Students were generally enthusiastic about the opportunity to learn clinical skills in the first semester of medical school, and 91-96% of the students agreed that learning anatomy at the same time helped them understand the physical examination exercises in ICM. Anat Sci Educ. © 2014 American Association of Anatomists. PMID:25358463

Marshak, David W; Oakes, Joanne; Hsieh, Pei-Hsuan; Chuang, Alice Z; Cleary, Leonard J

2014-10-30

341

Possible extracardiac predictors of aortic dissection in Marfan syndrome  

PubMed Central

Background According to previous studies, aortic diameter alone seems to be insufficient to predict the event of aortic dissection in Marfan syndrome (MFS). Determining the optimal schedule for preventive aortic root replacement (ARR) aortic growth rate is of importance, as well as family history, however, none of them appear to be decisive. Thus, the aim of this study was to search for potential predictors of aortic dissection in MFS. Methods A Marfan Biobank consisting of 79 MFS patients was established. Thirty-nine MFS patients who underwent ARR were assigned into three groups based on the indication for surgery (dissection, annuloaortic ectasia and prophylactic surgery). The prophylactic surgery group was excluded from the study. Transforming growth factor-? (TGF-?) serum levels were measured by ELISA, relative expression of c-Fos, matrix metalloproteinase 3 and 9 (MMP-3 and ?9) were assessed by RT-PCR. Clinical parameters, including anthropometric variables - based on the original Ghent criteria were also analyzed. Results Among patients with aortic dissection, TGF-? serum level was elevated (43.78?±?6.51 vs. 31.64?±?4.99 ng/l, p?dissection in MFS. Based on these findings a new classification of MFS, that is benign or malignant is also proposed, which could be taken into consideration in determining the timing of prophylactic ARR. PMID:24720641

2014-01-01

342

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

SciTech Connect

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.

Palmowski, Moritz [Ruprecht Karls University, Department of Diagnostic Radiology (Germany)], E-mail: m.palmowski@dkfz.de; Kiessling, Fabian [German Cancer Research Center, Junior Group Molecular Imaging (Germany); Lopez-Benitez, Ruben; Kauffmann, Guenter Werner; Hallscheidt, Peter [Ruprecht Karls University, Department of Diagnostic Radiology (Germany)

2007-06-15

343

77 FR 19654 - Notice of Petition for Waiver of Sanyo E&E Corporation from the Department of Energy Residential...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Case No. RF-022] Notice of Petition for Waiver of Sanyo E&E Corporation from the Department of Energy Residential Refrigerator...This notice announces receipt of and publishes the Sanyo E&E Corporation (Sanyo) petition for waiver...

2012-04-02

344

Unusual bleeding from hepaticojejunostomy controlled by adult variable stiffness colonoscopy: report of a case and literature review.  

PubMed

Abstract We herein present a case of a 59-year-old man who had undergone pylorus preserving pancreaticoduodenectomy with regional lymph node dissection prior to episodes of melena. Series of conventional endoscopic investigations failed to identify the bleeding source. Enhanced computed tomography scan revealed complete obstruction of the main portal vein with numerous collateral veins running towards the hepatic hilus. Comprehensively, hemorrhage from the jejunal varices caused by postoperative portal hypertension was highly suspected. As the jejunal loop was out of reach, adult variable-stiffness colonoscope (AVSC) was utilized to solve the Roux-en-Y anatomy. Numerous telangiectasis and small varices at hepaticojejunostomy were observed and in the mean time, bleeding was noticed and endoclips were placed without any delay. Ectopic variceal bleeding in jejunal loop after pancreaticoduodenectomy is difficult to manage. We believe that AVSC is an alternative device when specialized jejunal endoscopy is not available. PMID:25216425

Baba, Hiroyuki; Wakabayashi, Mai; Oba, Atsushi; Baba, Hironobu; Mitsuoka, Akito; Nakamura, Hiroshi; Sanada, Takahiro; Kuwabara, Hiroshi; Nakajima, Kazumi; Goseki, Narihide; Ishida, Hideyuki

2014-01-01

345

20 CFR 802.307 - Notice of oral argument.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Notice of oral argument. 802.307 Section 802.307...PRACTICE AND PROCEDURE Procedure for Review Oral Argument Before the Board § 802.307 Notice of oral argument. (a) In cases where a...

2010-04-01

346

Naphazoline as a Confounder in the Diagnosis of Carotid Artery Dissection.  

PubMed

Diagnosing Horner Syndrome can be difficult in the setting of an incomplete triad. A 27-year-old man presented with unilateral eyelid droop and intermittent ipsilateral headaches, having already seen 7 physicians. Physical examination revealed unilateral ptosis but no pupillary miosis or facial anhidrosis. Inspection of his clinical photographs revealed elevation of the ipsilateral lower eyelid, suggesting sympathetic dysfunction. On further questioning, he admitted to naphazoline dependence. Reexamination after ceasing the naphazoline unveiled the anisocoria. Vascular imaging subsequently revealed carotid dissection, and the patient was started on anticoagulant and antiplatelet therapy. The ptosis persisted after conjunctival Müllerectomy. External levator resection was recommended, but patient declined. This case underscores the importance of clinical photography, meticulous medical record review, and complete medication history including over-the-counter preparations. Clinicians should meticulously inspect the lower eyelid in cases of atypical blepharoptosis and consider the effects of eye drops when inspecting pupils for miosis. PMID:24807801

Pemberton, John D; Macintosh, Peter W; Zeglam, Ahmaida; Fay, Aaron

2014-05-01

347

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

NASA Astrophysics Data System (ADS)

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.

Allspaw, Kathleen M.

348

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

PubMed Central

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

Holmes, AN; Williams, LE; Brosnan, SF

2013-01-01

349

Prediction of relapse after lymph node dissection for germ cell tumours: can salvage chemotherapy be avoided?  

PubMed Central

Salvage chemotherapy has been used by some oncology centres for patients with residual malignant or immature elements in retroperitoneal lymph node dissections removed for metastatic non-seminomatous germ cell tumours. However, surveillance of these patients shows that many are cured by surgery alone. 118 retroperitoneal lymph node dissections for metastatic non-seminomatous germ cell tumours were reviewed and the morphology seen within them was quantified. 28 of these had immature or malignant elements and had been treated by surveillance before administration of further chemotherapy. The proliferation rate in these cases was assessed by immunochemistry. The proliferation index and the amount of embryonal carcinoma (EC) were both predictors of recurrence and therefore the need for further chemotherapy. Patients with greater than 25% of EC had an 84% chance of relapse and those with a Ki-67 index of greater than 50% had a 71% chance of relapse. The two tests had a positive predictive value of 83% and 71%, respectively. Patients with such a high risk of recurrence could be considered for post-operative adjuvant therapy at this point whilst others would be suitable for a watchful waiting approach. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11161398

Berney, D M; Shamash, J; Hendry, W F; Arora, A; Jordan, S; Oliver, R T

2001-01-01

350

An Extensive Stanford Type A Aortic Dissection Involving Bilateral Carotid and Iliac Arteries  

PubMed Central

We present a rare case of continuous, extensive aortic dissection (AD) involving the bilateral common carotid arteries, the ascending, thoracic, and abdominal aorta, and bifurcation of the right common iliac artery. A 61-year-old man with history of chronic hypertension presented with a one-day history of chest pain, vertigo, left facial drooping, and left hemiparesis. Despite the presence of bilateral carotid bruits, doppler ultrasound of the neck was postponed, and the patient was treated with thrombolytic therapy for a presumed ischemic stroke. The patient's symptoms began to resolve within an hour of treatment, at which time treatment was withheld. Ultrasound performed the following day showed dissection of bilateral common carotid arteries, and CT angiography demonstrated extensive AD as described earlier. The patient subsequently underwent cardiovascular surgery and has been doing clinically well since then. AD has a myriad of manifestations depending on the involvement of aortic branches. Our paper illustrates the importance of having a high index of suspicion for AD when a patient presents with a picture of ischemic stroke, since overlapping signs and symptoms exist between AD and stroke. Differentiating between the two conditions is central to patient care as thrombolytic therapy can be helpful in stroke, but detrimental in AD. PMID:23401833

Lee, E. W.; Jourabchi, N.; Sauk, S. C.; Lanum, D.

2013-01-01

351

[Neck dissection for Head and Neck cancers: state of the art and classification].  

PubMed

The purposes of this article are to review the history and evolution of neck dissections, including an update on node levels and their anatomical landmark. A number of classification systems were proposed and subsequently established for neck dissection procedures. The system most often employed was published in 1991 by the American Head and Neck Society and American Academy of Otolaryngology- Head and Neck Surgery and revised in 2002 and 2008. According to this classification, neck dissections are grouped into four broad categories: radical neck dissection (RND), modified radical neck dissection (MRND), selective neck dissection (SND) and extended neck dissection (ERND). The choice between different surgeries depends on type and site of head and neck tumor as well nodal involvement. PMID:21453600

Pezzullo, L; Chiofalo, M G; Di Cecilia, M L; Marone, U

2011-03-01

352

Cardiac transplantation for spontaneous coronary artery dissection  

PubMed Central

We report a 49-year old female who presented with ST elevation myocardial infarction, in whom thrombolysis and coronary angioplasty failed to perfuse the myocardium. She was unsuitable for emergency coronary artery bypass grafting surgery due to the interval elapsed between the myocardial infarction, thrombolysis and large infracted myocardium. Ventricular-assisted device support for a bridge to recovery or transplantation is a widely accepted treatment modality; however, in this case, it was unadvisable due to the extent of the infarcted myocardium and the risk of suturing outflow ports into the infracted myocardium. The patient's condition was stabilized with cardiac inotropic support, intra-aortic balloon counter pulsation and extracorporeal membrane oxygenation as a last resort until a heart became available for transplantation. The patient received successful orthotopic heart transplantation 4 days after her initial presentation and her postoperative recovery was uneventful. PMID:23049079

Bashir, Mohamad; Mustafa, Hanif; Singh, Harjot; Bonser, Robert

2013-01-01

353

Giant, Dissecting, High-Pressure Pulmonary Artery Aneurysm  

PubMed Central

We report the rare subchronic clinical course of a giant, dissecting pulmonary artery aneurysm in an oligosymptomatic middle-aged woman who had idiopathic pulmonary hypertension. Diagnosis was simple with the use of echocardiography and multislice computed tomography. Conversely, deciding on the treatment was difficult, because prominent surgeons declined to perform surgical repair of the aneurysm and recommended heart–lung transplantation. Therefore, we were forced to treat our patient medically. She survived for 1 year, including 8 months of treatment with sildenafil, and then died suddenly while awaiting transplantation. Our patient, who had a dissecting, high-pressure pulmonary artery aneurysm, had an unexpectedly stable and uneventful clinical course for 1 year, which, under more favorable circumstances, might have provided enough time for heart–lung transplantation to be performed. PMID:16429912

Smalcelj, Anton; Brida, Vojtjeh; Samarzija, Miroslav; Matana, Ante; Margetic, Eduard; Drinkovic, Niksa

2005-01-01

354

Management of Acute Aortic Syndrome and Chronic Aortic Dissection  

SciTech Connect

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.

Nordon, Ian M., E-mail: inordon@sgul.ac.uk; Hinchliffe, Robert J.; Loftus, Ian M.; Morgan, Robert A.; Thompson, Matt M. [St George's Hospital, St. George's Vascular Institute, St. James' Wing (United Kingdom)

2011-10-15

355

Femtosecond laser dissection in C. elegans neural circuits  

NASA Astrophysics Data System (ADS)

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.

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

2006-02-01

356

The role of imaging in aortic dissection and related syndromes.  

PubMed

Aortic aneurysm and acute aortic syndrome are not uncommon conditions. Management of acute aortic dissection and related syndromes requires a multidisciplinary approach with input from the patient, clinician, imager, surgeon, and anesthesiologist. This requires an integrated evaluation of pathophysiology, anatomy, and severity to enable appropriate therapy. This review includes discussion of essential anatomy of the aortic valve and the aorta that determines the candidacy for surgical repair. It also includes discussion of various imaging modalities, particularly echocardiography, cardiac computed tomography, and cardiac magnetic resonance angiography. The relative benefits and demerits of each of these techniques are reviewed. This paper is intended to help guide management decisions for patients with acute aortic dissection and related syndromes. PMID:24742892

Baliga, Ragavendra R; Nienaber, Christoph A; Bossone, Eduardo; Oh, Jae K; Isselbacher, Eric M; Sechtem, Udo; Fattori, Rossella; Raman, Subha V; Eagle, Kim A

2014-04-01

357

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

PubMed Central

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.

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

2015-01-01

358

Postoperative peri-axillary seroma following axillary artery cannulation for surgical treatment of acute type A aortic dissection  

PubMed Central

The arterial cannulation site for optimal tissue perfusion and cerebral protection during cardiopulmonary bypass (CPB) for surgical treatment of acute type A aortic dissection remains controversial. Right axillary artery cannulation confers significant advantages, because it provides antegrade arterial perfusion during cardiopulmonary bypass, and allows continuous antegrade cerebral perfusion during hypothermic circulatory arrest, thereby minimizing global cerebral ischemia. However, right axillary artery cannulation has been associated with serious complications, including problems with systemic perfusion during cardiopulmonary bypass, problems with postoperative patency of the artery due to stenosis, thrombosis or dissection, and brachial plexus injury. We herein present the case of a 36-year-old Caucasian man with known Marfan syndrome and acute type A aortic dissection, who had direct right axillary artery cannulation for surgery of the ascending aorta. Postoperatively, the patient developed an axillary perigraft seroma. As this complication has, not, to our knowledge, been reported before in cardiothoracic surgery, we describe this unusual complication and discuss conservative and surgical treatment options. PMID:20500837

2010-01-01

359

Patterns of brain infarctions in internal carotid artery dissections  

Microsoft Academic Search

In 15 patients with internal carotid artery (ICA) dissections, patterns of brain infarctions visible on CT were categorized according to a pathogenetically oriented classification system. This differentiated ischemic brain damage due to low flow from thromboembolic infarctions. Simultaneously, cerebral hemodynamic reserve was evaluated by means of both CO2-dependent vasomotor reactivity and HMPAO- and 99 mTc-RBC-SPECT. Six out of 11 patients

Cornelius Weiller; Wolfgang Müllges; E. Bernd Ringelstein; Udalrich Buell; Werner Reiche

1991-01-01

360

Science Sampler: Frog dissection--An alternative model  

NSDL National Science Digital Library

Local dollar stores can be a treasure-trove of inexpensive items that are ideal for hands-on activities in the science classroom. This article describes one such activity in which a model frog that costs less than a dollar was used to allow students to perform a simulated dissection. It was designed as a teacher-directed activity in order for students to practice reading, following complex directions, and using critical-thinking skills.

Sanders, June

2007-02-01

361

Saphenous Vein Sparing Superficial Inguinal Dissection in Lower Extremity Melanoma  

PubMed Central

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

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

2014-01-01

362

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

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…

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

2014-01-01

363

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

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)

Bernstein, Penny L.

2000-01-01

364

Use of multimedia technology to provide solutions to existing curriculum problems: Virtual frog dissection  

NASA Astrophysics Data System (ADS)

The objective of this research was to determine whether currently available multimedia technology can resolve existing problems in the K--12 science curriculum. There are several practical and ethical problems relating to the classroom use of animal dissection and this led to the selection of hands-on frog dissection as the curriculum activity where the use of multimedia was investigated. The major finding was that multimedia-based virtual dissection was more effective than hands-on dissection in helping students learn about frog anatomy. Moreover, this result was achieved when the time available for the virtual dissection was approximately 44% less than that available for hands-on dissection. Examination of possible relationships between student characteristics and achievement revealed that students' attitudes to educational uses of animal dissection and their computer experience were positively correlated with their achievement scores. No relationships were found between either student gender or dissection experience and achievement test outcomes. Students rated virtual dissection as the easier of the two types of dissection, though they gave equivalent ratings for their enjoyment of virtual and hands-on dissection. Despite favorable feedback on the virtual dissection, a significant majority of students stated that they felt they would be "missing-out" on a valuable experience if they were not given the opportunity to perform a hands-on frog dissection. Comparing how students spent their time during each type of dissection showed that students spent a significantly larger proportion of their time On-Task when using the multimedia-based virtual dissection. In particular, the average increase in the proportion of time spent on activities directly related to the subject matter was over 36%. Time spent On-Task had a significant positive relationship with achievement for hands-on dissection. It may play a similar role for achievement with virtual dissection, but the small deviation in time On-Task data for virtual dissection prevented confirming this intuition. The teacher who participated in the research found that the use of a multimedia, inquiry-based computer application did limit his insight into students' classroom progress. However, he did not feel this to be a problem, nor did it in any way reduce his control over class activities.

Youngblut, Christine

365

Bluetongue virus: dissection of the polymerase complex  

PubMed Central

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

Roy, Polly

2009-01-01

366

24 CFR 35.910 - Notices and pamphlet.  

Code of Federal Regulations, 2011 CFR

In cases where evaluation or hazard reduction or both are undertaken as part of federally funded rehabilitation, the grantee or participating jurisdiction shall provide a notice to occupants in accordance with §...

2011-04-01

367

COPYRIGHT NOTICE: Elias Kiritsis: String Theory in a Nutshell  

E-print Network

COPYRIGHT NOTICE: Elias Kiritsis: String Theory in a Nutshell is published by Princeton University picture is only appropriate at large volume ( -expansion). In the case of type-II string theory, vacua

Landweber, Laura

368

Use of endovascular stents for acute aortic dissection: an experimental study.  

PubMed

This study was designed to evaluate the potential obliteration of an experimental aortic dissection using an intravascular stent introduced via the femoral artery. Twenty-two adult dogs were divided into four groups: in group A (n = 6) a thoracoabdominal aortic dissection was surgically created to observe the natural course of this lesion; in group B (n = 6) a nitinol coil graft was introduced into the aorta via the femoral artery; in group C (n = 3) a nitinol coil graft was introduced via the femoral artery into a dissected aorta in an attempt to obliterate the dissection; and in group D (n = 7) an expandable intraluminal vascular graft (Palmaz stent) was introduced via the femoral artery into a dissected aorta in an attempt to obliterate the dissection. Arteriographic evaluation was performed postoperatively and again 6 weeks later before the aortas were explanted. Gross and light microscopic examinations were performed on all explanted aortas. In group A dissection was achieved and a postoperative aortogram demonstrated evidence of aortic dissection in all animals. Autopsy revealed persistence of dissection with a reentry tear near the celiac axis in five animals. In group B there was incomplete expansion of the nitinol coil graft in five dogs, resulting in aortic thrombosis in one. In group C the nitinol coil graft failed to obliterate the aortic dissection in all animals and resulted in aortic thrombosis in two. In group D placement of a balloon-expandable intraluminal stent solely at entry and reentry sites resulted in only partial obliteration of the dissection (n = 3), but when the entire length of the dissected aorta was treated, the dissection was completely obliterated (n = 3). PMID:7811581

Marty-Ané, C; Serres-Cousiné, O; Laborde, J C; Costes, V; Alauzen, M; Mary, H

1994-09-01

369

Combination of water-jet dissection and needle-knife as a hybrid knife simplifies endoscopic submucosal dissection  

Microsoft Academic Search

Background  The safety and efficacy of endoscopic submucosal dissection (ESD) is very dependent on an effective injection beneath the\\u000a submucosal lamina and on a controlled cutting technique. After our study group demonstrated the efficacy of the HydroJet in\\u000a needleless submucosal injections under various physical conditions to create a submucosal fluid cushion (Selective tissue\\u000a elevation by pressure = STEP technique), the next step was

Tobias Lingenfelder; Klaus Fischer; Moritz G. Sold; Stefan Post; Markus D. Enderle; Georg F. B. A. Kaehler

2009-01-01

370

MET-Amplified Intramucosal Gastric Cancer Widely Metastatic after Complete Endoscopic Submucosal Dissection.  

PubMed

Intramucosal gastric cancer (IGC) is associated with a very low risk of lymph node metastasis; thus it is the main candidate for minimally invasive surgical procedures, such as endoscopic submucosal dissection (ESD). Herein, we document an extraordinary case of IGC, which showed a very aggressive clinical course. A 66-year-old female underwent ESD for early gastric cancer. Histologically, the tumor consisted mainly of moderately differentiated adenocarcinoma measuring 1.6 cm in diameter, and the tumor was confined to the mucosa. Despite annual esophagogastroduodenoscopic follow-up, the tumor recurred, with wide metastasis to multiple lymph nodes and bones throughout the body after three years. Fluorescence in situ hybridization study demonstrated MET gene amplification as well as low grade polysomy 7 in both original and recurrent tumors. The clinical characteristics of metastatic IGCs and the implication of MET amplification are discussed. PMID:25152190

Lee, Dakeun; Kim, Young Chul; Lee, Kee Myung; Yoon, Joon-Kee; Kim, Young-Bae

2015-01-01

371

Successful treatment of a gastric plasmacytoma using a combination of endoscopic submucosal dissection and oral thalidomide.  

PubMed

We report a rare case of a gastric plasmacytoma treated with endoscopic resection and oral thalidomide therapy. A 70-year-old man was admitted to our hospital with indigestion. He had no specific medical history and unremarkable laboratory results. Gastroendoscopic findings revealed a focal, erythematous, flat elevated lesion in the anterior wall of the stomach antrum. A biopsy revealed atypical lymphocytes. Endoscopic submucosal dissection (ESD) with an insulation-tipped knife was performed 45 days after diagnosis. Radiological and hematological evaluations, including a bone marrow biopsy, were performed and showed no involvement of other organs. The patient was diagnosed with extramedullary gastric plasmacytoma. Follow-up gastroendoscopy was performed three times during a 2-year period and showed nonspecific ESD scarring. The patient's condition was found to be stable. PMID:25505724

Park, Se Young; Moon, Hee Seok; Seong, Jae Kyu; Jeong, Hyun Yong; Yoon, Beum Yong; Hwang, Se Woong; Song, Kyu Sang

2014-11-01

372

Esophageal dissection and hematoma associated with obstruction in an Indian elephant (Elephas maximus indicus).  

PubMed

A 42-year-old female Indian elephant (Elephas maximus indicus) developed a sudden onset of excessive salivation and dysphagia. Esophageal obstruction was suspected; possibly related to palm frond ingestion. Esophageal endoscopy revealed a mat of plant material in the distal esophagus. An initial attempt at relieving the obstruction was unsuccessful, but subsequent use of custom-made instruments along with insufflation and hydropulsion enabled partial removal of the material. Postimmobilization care included aggressive intravenous and rectal fluids, anti-inflammatory and antibiotic administration, and fasting. Despite treatment, the dysphagia persisted and the elephant was euthanized due to lack of improvement and grave prognosis. Postmortem examination revealed remaining plant material in the esophagus, complicated by an esophageal dissection, mural hematoma, and secondary bacterial infection. Iatrogenic trauma may have contributed to the extent of esophageal injury. Although treatment was ultimately unsuccessful, the supportive care employed could potentially aid recovery in cases of less severe esophageal trauma. PMID:25000713

Phair, Kristen A; Sutherland-Smith, Meg; Pye, Geoffrey W; Pessier, Allan P; Clippinger, Tracy L

2014-06-01

373

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

SciTech Connect

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.

Wolf, Michael M. (University of Illinois at Urbana-Champaign, Urbana, IL); Chevalier, Cedric; Boman, Erik Gunnar

2008-12-01

374

Rb-Sr and Sm-Nd isotopic variations in dissected crustal xenoliths  

NASA Technical Reports Server (NTRS)

The effect of magma-xenolith interaction on the Rb-Sr and Sm-Nd isotopic systematics was investigated by studying the Rb-Sr and Sm-Nd variations in dissected crustal xenoliths sampled from different localities across Scotland. The Nd isotopic compositions were found to be virtually uniform across each xenolith, but significant variations were found in Rb, Sr, and REE concentrations, as well as in Rb/Sr and Sm/Nd ratios and Sr isotopic composition. Most of these variations appear to be inherited from the protolith, but, in one case, they have been modified by melt infiltration from the host magma. The results lend confidence to the interpretation of the isotopic and chemical compositions of xenoliths transported in basaltic magmas as reflecting their source regions, but they also highlight the potential problems of interpreting Sm-Nd model ages from metamorphic rocks.

Lee, Der-Chuen; Halliday, Alex N.; Hunter, Robert H.; Holden, Peter; Upton, Brian G. J.

1993-01-01

375

Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection as Treatments for Early Gastrointestinal Cancers in Western Countries  

PubMed Central

Early gastrointestinal cancers are defined as lesions limited to the mucosa or submucosa without invading the muscularis propria, regardless of the presence of lymph node metastases. Although the natural history of these diseases is basically alike worldwide, its management is quite different between the East and West; aggressive surgery is frequently adopted by Western surgeons, while less invasive techniques are adopted by Asian colleagues. These techniques include endoscopic mucosal resection and endoscopic submucosal dissection which are now accepted as treatments for early gastrointestinal cancers in selected cases. Recent advances in endoscopic detection and treatment techniques, especially in Japan and Korea, have prompted Western endoscopists to learn these techniques. This review addresses recent advances regarding endoscopic resections of early gastrointestinal cancers, which promoted its use in Western countries. In addition, prospective studies on endoscopic resection in Western countries are also described. PMID:20485653

Coda, Sergio; Lee, Sun-Young

2007-01-01

376

MET-Amplified Intramucosal Gastric Cancer Widely Metastatic after Complete Endoscopic Submucosal Dissection  

PubMed Central

Intramucosal gastric cancer (IGC) is associated with a very low risk of lymph node metastasis; thus it is the main candidate for minimally invasive surgical procedures, such as endoscopic submucosal dissection (ESD). Herein, we document an extraordinary case of IGC, which showed a very aggressive clinical course. A 66-year-old female underwent ESD for early gastric cancer. Histologically, the tumor consisted mainly of moderately differentiated adenocarcinoma measuring 1.6 cm in diameter, and the tumor was confined to the mucosa. Despite annual esophagogastroduodenoscopic follow-up, the tumor recurred, with wide metastasis to multiple lymph nodes and bones throughout the body after three years. Fluorescence in situ hybridization study demonstrated MET gene amplification as well as low grade polysomy 7 in both original and recurrent tumors. The clinical characteristics of metastatic IGCs and the implication of MET amplification are discussed. PMID:25152190

Lee, Dakeun; Kim, Young Chul; Lee, Kee Myung; Yoon, Joon-Kee; Kim, Young-Bae

2015-01-01

377

Influence of cardiac rehabilitation in Primigravida with spontaneous coronary artery dissection during postpartum  

PubMed Central

Background The physical exercise consists of trainable physical abilities such as strength and endurance. It can be inferred that the individual cardiac patient is dependent on it as an associated therapy to the drug treatment for a rapid and lasting improvement of their overall clinical status Case presentation The patient – with Spontaneous Coronary Artery Dissection Postpartum period – was subjected to 21 sessions of cardiac rehabilitation. A physical evaluation was performed, before and after the treatment period, for data collection: anthropometric values, flexibility, aerobic capacity and strength of grip. Conclusion The patient had a positive response in aerobic capacity, flexibility and grip strength and the anthropometric values were kept in short term rehabilitation. PMID:24829614

2014-01-01

378

Isolated dissection of the superior mesenteric artery treated using open emergency surgery  

PubMed Central

Background Isolated dissection of the superior mesenteric artery (IDSMA) remains a rare diagnosis. However, new diagnostic means such as computed tomography makes it possible to detect even asymptomatic patients. If patients present symptomatic on admission, the risk of bowel infarction makes immediate therapy necessary. Today, endovascular techniques are often successfully used; however, open surgery remains important for special indications. In this paper, we present two cases with IDSMA and show why open surgical repair is still important in current treatment concepts. Methods Two cases with ISDMA that presented in our department from January 1, 2014 to June 1, 2014 are described. Data collection was performed retrospectively. Additionally, a review of articles which reported small cases series on patients with IDSMA within the past five years is provided. Results Both patients underwent open surgical repair following interdisciplinary consultation. Both patients were transferred to the intensive care unit after surgical repair and needed bowel rest, nasogastric suction and intravenous fluid therapy. CT scans were performed within the first week after operation. Platelet aggregation inhibitors were used in both cases as postoperative medication. Both patients survived and are able to participate in everyday activities. Conclusion Open surgical repair remains important in cases of anatomic variants of visceral arteries and suspected bowel infarction. Therefore, it is important that knowledge about open surgical techniques still be taught and trained. PMID:25140196

2014-01-01

379

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

PubMed Central

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

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

380

Towards safer and appropriate application of endoscopic submucosal dissection for T1 colorectal carcinoma as total excisional biopsy: Future perspectives.  

PubMed

According to the Japanese Society for Cancer of the Colon and Rectum Guidelines 2014 for the Treatment of Colorectal Cancer, cases with T1 colorectal carcinoma should be considered for additional colectomy with lymph node dissection when histologically complete en bloc resection is endoscopically carried out and when one of the four risk factors listed below is present. These four risk factors are: (i) submucosal (SM) invasion depth ?1000??m; (ii) positive vascular invasion; (iii) poorly differentiated adenocarcinoma, signet ring cell carcinoma, or mucinous carcinoma; and (iv) grade 2/3 budding at the deepest part of SM invasion. However, the probability of lymph node metastasis is extremely low if none of these risk factors are present, with the exception of SM invasion depth ?1000??m. Consequently, it is assumed that there will be an increasing number of cases where no additional surgery is done, or cases of moderate invasive carcinoma in which endoscopic treatment is carried out to achieve an excisional biopsy, for which complete resection is applicable. In these cases, the preoperative diagnosis, resection techniques such as endoscopic submucosal dissection, features of resected specimens, and the accuracy of pathological diagnosis are all extremely important. PMID:25040773

Tanaka, Shinji; Asayama, Naoki; Shigita, Kenjiro; Hayashi, Nana; Oka, Shiro; Chayama, Kazuaki

2015-01-01

381

An electrical dissecting method of AC branch with FACTS for ancillary service assessment  

Microsoft Academic Search

This paper presents a new electrical dissecting method of AC branch installed with phase-shifter, which satisfies basic principles and laws of electric power network. With this method, the deep-seated electrical information between sources and flows, such as the contribution information of sources and flows, can be obtained. The dissected sub-branches are equivalent to the initial branch, and the dissecting procedure

Tang Yi; Yu Ji-Lai; Liu Xian Linz

2004-01-01

382

Charcoal-Induced Granuloma That Mimicked a Nodal Metastasis on Ultrasonography and FDG-PET/CT after Neck Dissection.  

PubMed

Charcoal can be used for preoperative localization of metastatic lymph nodes in the neck. Charcoal remains stable without causing foreign body reactions during as hort period. However, foreign body reactions may develop if charcoal is left in situ for more than 6 months. We reported a case of charcoal granuloma mimicking local recurrence on fluorodeoxyglucose-positron emission tomography/computed tomography and ultrasonography in a 47-year-old woman who had cervical lymph node dissection due to metastatic invasive ductal carcinoma of the breast. PMID:25598690

Choi, Jin Woo; Moon, Won-Jin; Choi, Nami; Roh, Hong Gee; Kim, Mi Young; Kim, Na Ra; Moon, Sung Gyu; Chung, Hyun Woo; Lim, So Dug; Yang, Jung-Hyun

2015-01-01

383

Intralesional Steroid Injection to Prevent Stricture after Near-Circumferential Endosopic Submucosal Dissection for Superficial Esophageal Cancer  

PubMed Central

Stricture frequently occurs after endoscopic submucosal dissection (ESD) for superficial esophageal carcinoma with near- or whole-circumferential mucosal defects, and post-ESD stricture is difficult to treat and usually requires multiple sessions of endoscopic balloon dilatation. Intralesional steroid injection has previously been used to prevent stricture; however, there have been few experiences with this method after near- or whole-circumferential ESD. We present a case of a single session of intralesional steroid injection performed immediately after near-circumferential ESD to prevent post-ESD stricture. After a follow-up period of 6 months, the patient showed good outcome without dysphagia. PMID:24340258

Lee, Wook Jin; Kim, Do Hoon; Lee, Jeong Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Kim, Jin-Ho

2013-01-01

384

Charcoal-Induced Granuloma That Mimicked a Nodal Metastasis on Ultrasonography and FDG-PET/CT after Neck Dissection  

PubMed Central

Charcoal can be used for preoperative localization of metastatic lymph nodes in the neck. Charcoal remains stable without causing foreign body reactions during as hort period. However, foreign body reactions may develop if charcoal is left in situ for more than 6 months. We reported a case of charcoal granuloma mimicking local recurrence on fluorodeoxyglucose-positron emission tomography/computed tomography and ultrasonography in a 47-year-old woman who had cervical lymph node dissection due to metastatic invasive ductal carcinoma of the breast.

Choi, Jin Woo; Choi, Nami; Roh, Hong Gee; Kim, Mi Young; Kim, Na Ra; Moon, Sung Gyu; Chung, Hyun Woo; Lim, So Dug; Yang, Jung-Hyun

2015-01-01

385

Lower-extremity lymphedema following neck dissection--an uncommon complication after cervical ligation of the thoracic duct.  

PubMed

Thoracic duct injuries and chylous fistula are well-known complications of neck dissection, occurring in 1-2% of cases. Management of these injuries can be conservative or operative. Conservative treatment consists of fat restricted diet or total parenteral nutrition reducing the volume of chyle production. Operative management includes exploration of the neck or if necessary open thoracotomy to ligate the thoracic duct. Following cervical thoracic duct ligation only few complications like chylothorax or chylous ascites are described in the literature. To the best authors knowledge, this is the first report in the english literature describing lower-extremity lymphedema following cervical thoracic duct ligation. PMID:17418615

Raguse, Jan D; Pfitzmann, Robert; Bier, Jürgen; Klein, Martin

2007-09-01

386

Cell-type Specific Optogenetic Mice for Dissecting Neural Circuitry Function  

E-print Network

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 ...

Zhao, Shengli

387

Multidetector computed tomography angiography: Application in vertebral artery dissection  

PubMed Central

Background and Purpose: Multidetector computed tomography angiography (MDCTA) is a minimally invasive radiological technique providing high-resolution images of the arterial wall and angiographic images of the lumen. We studied the radiological features of vertebral artery dissection (VAD) in a consecutive series of patients investigated for acute stroke and subarachnoid hemorrhage (SAH) in order to confirm and define the diagnostic features of VAD on MDCTA. Patients and Methods: Review of patients identified prospectively over a 4-year period with VAD assessed by MDCTA was conducted. Radiological features of VAD on MDCTA were reanalyzed utilising previously reported criteria for VAD. Results: Thirty-five patients (25 males, mean age 49.6 years) with a total of 45 dissected vertebral arteries were reviewed. MDCTA features of VAD included increased wall thickness in 44/45 (97.7%) arteries and increased total vessel diameter in 42/45 arteries (93.3%). All dissected arteries had either lumen stenosis (21/45) or associated segmental occlusion (24/45). An intimal flap was detected in 6/45 (13.3 %) vessels. Twenty-five patients had follow-up imaging, 14/32 vessels returned to normal, 4 showed improvement in stenosis but did not return to normal and 14 demonstrated no change. The majority of non-occluded vessels became normal or displayed improved patency. Only 4/17 occluded arteries demonstrated re-establishment of flow. No adverse effects were recorded. Conclusions: MDCTA is a safe and reliable technique for the diagnosis of VAD. Increased wall thickness (97.7%) and increased vessel wall diameter (93.3%) were the most frequently observed features. PMID:21633613

Teasdale, Evelyn; Zampakis, Peter; Santosh, Celestine; Razvi, Saif

2011-01-01

388

Clinical Characteristics of Symptomatic Vertebral Artery Dissection. A Systematic Review  

PubMed Central

Background Vertebral artery dissection (VAD) is an important cause of stroke in the young. It can present nonspecifically and may be misdiagnosed with adverse consequences. We assessed the frequency of head/neck pain, other neurological symptoms, and cerebrovascular events in symptomatic VAD. Methods We conducted a systematic review of observational studies, searching electronic databases (MEDLINE, EMBASE) for English-language manuscripts with >5 subjects with clinical or radiological features of VAD. Two independent reviewers selected studies for inclusion; a third adjudicated differences. Studies were assessed for methodological quality and clinical data were abstracted. Pooled proportions were calculated. Results Of 3996 citations, we screened 511manuscripts and selected 75 studies describing 1,972 VAD patients. The most common symptoms were dizziness/vertigo (58%), headache (51%) and neck pain (46%). Stroke was common (63%), especially with extracranial dissections (66% vs. 32%, p<0.0001), while TIA (14%) and subarachnoid hemorrhage (SAH) (10%) were uncommon. SAH was seen only with intracranial dissections (57% vs. 0%, p=0.003). Fewer than half of the patients had obvious trauma, and only 7.9% had a known connective tissue disease. Outcome was good (modified Rankin scale (mRS) 0-1) in 67% and poor (mRS 5-6) in 10%. Conclusion VAD is associated with nonspecific symptoms such as dizziness, vertigo, headache, or neck pain. Ischemic stroke is the most common reported cerebrovascular complication. VAD should be considered in the diagnostic assessment of patients presenting with dizziness or craniocervical pain, even in the absence of other risk factors. Future studies should compare clinical findings as predictors in well-defined, undifferentiated populations of clinical VAD suspects. PMID:22931728

Gottesman, Rebecca F.; Sharma, Priti; Robinson, Karen A.; Arnan, Martinson; Tsui, Megan; Ladha, Karim; Newman-Toker, David E.

2013-01-01

389

Extensive Operation as One of the Solution for Patients with the Insufficient Proximal Landing Zone for TEVAR in Aortic Dissection – short term results  

PubMed Central

Objective: In our study we wanted to showed the safety, feasibility, efficacy and way how to solve the problems of endovascular repair for aortic dissection with insufficient proximal Landing Zone. Methods: The clinical data of all the patients with insufficient proximal Landing Zone (PLZ) for endovascular repair for aortic aneurism and dissection Stanford type B for the period from October 2013 to June 2014 was prospectively reviewed. According to the classification proposed by Mitchell et al, aortic Zone 0 was involved in 3 cases, Zone 1 in 1 case, Zone 2 in 9 cases and Zone 3 in 6 cases (19 patients in total). A hybrid surgical procedure of supraortic debranching and revascularization, with direct anastomosed truncus brachiocephalicus and left common carotid artery, were performed to obtain an adequate aortic PLZ. Revascularization of the left subclavian artery was carried out on the patient with dissection Stanford type B and short PLZ 2. Results: There was no significant difference of risk factors between Zone 0, Zone 1, and Zone 2 (Table 1.), but the length of the PLZ significantly differed between groups (p<0.01) and there is no significant difference in technical and clinical success rate among the groups. Conclusion: The procedure of extending insufficient PLZ for endovascular repair for aortic arch pathology is feasible and relatively safe. The TEVAR applicability in such aortic disorders could be extended.

Kacila, Mirsad; Vranic, Haris; Straus, Slavenka

2014-01-01

390

In utero release of constriction amniotic bands via blunt dissection.  

PubMed

Therapeutic techniques for in utero release of amniotic bands have relied on transecting instruments. We present an additional technique, blunt dissection, to release a constriction band in utero. The lower extremity that had detectable abnormalities during prenatal ultrasound had improved outcome after blunt in utero release of the amniotic band compared to the contralateral (control) leg. These findings support two conjectures: first, the degree of band adherence to the fetus is an important factor influencing the surgical approach to in utero lysis of the bands; second, that in utero release of constriction bands can result in improvement in outcome. PMID:22017664

Assaf, Raymen; Llanes, Arlyn; Chmait, Ramen

2012-02-01

391

Aortoesophageal fistula after repair of descending aortic dissection.  

PubMed

The development of aortoesophageal fistula after aortic repair is rare. We describe a patient who presented with hematemesis 4 months after emergent repair of a descending thoracic aortic dissection using a prosthetic graft. Diagnosis was supported by computed tomographic, angiographic, and endoscopic findings. Resection of the involved graft was performed through a left thoracotomy after placement of an ascending aorta-to-abdominal aorta conduit through an anterior approach. The patient died of uncontrollable bleeding a few hours after the procedure. Surgical intervention offers the potential for cure in this otherwise uniformly fatal condition. But like medical therapy, operative management has thus far been associated with 100% mortality. PMID:8694638

Wong, R S; Champlin, A; Temes, R T; Wernly, J A

1996-08-01

392

Improving the run time and quality of nested dissection ordering  

SciTech Connect

When performing sparse matrix factorization, the ordering of matrix rows and columns has a dramatic impact on the factorization time. This paper describes an approach to the reordering problem that produces significantly better orderings than prior methods. The algorithm is a hybrid of nested dissection and minimum degree ordering, and combines an assortment of different algorithmic advances. New or improved algorithms are described for graph compression, multilevel partitioning, and separator improvement. When these techniques are combined, the resulting orderings average 39% better than minimum degree over a suite of test matrices, while requiring roughly 2.7 times the run time of Liu`s multiple minimum degree.

Hendrickson, B. [Sandia National Labs., Albuquerque, NM (United States)] [Sandia National Labs., Albuquerque, NM (United States); Rothberg, E. [Silicon Graphics, Inc., Mountain View, CA (United States)] [Silicon Graphics, Inc., Mountain View, CA (United States)

1998-09-01

393

Dissection Technique for Abdominoplasty: A Prospective Study on Scalpel versus Diathermocoagulation (Coagulation Mode)  

PubMed Central

Background: The purpose of this study was to evaluate the effect of the dissection technique on outcomes and complications after a full abdominoplasty, comparing 2 different techniques used to raise the abdominal flap: the steel scalpel and the diathermocoagulation device on coagulation mode. Methods: A prospective study was performed at a single center from January 2009 to December 2011 of patients submitted to abdominoplasty with umbilical transposition. Two groups were identified: group A, abdominoplasty performed with steel scalpel/knife; and group B, abdominoplasty performed with diathermocoagulation on coagulation mode. Several variables were determined: general characteristics, time until drain removal, daily and total volume of drain output, length of hospital stay, operative time, readmission, reoperation, emergency department visits, and local and systemic complications. Results: A total of 119 full abdominoplasties were performed in women (group A, 39 patients; group B, 80 patients). There were no statistically significant differences between groups with respect to general characteristics, except for body mass index, comorbidities, and weight of the surgical specimen; there were no differences for operative time, systemic complications, hematoma, and necrosis incidence. The scalpel group had a highly significant reduction of 54.56% on total drain output, and a 2.65 day reduction on time to drain removal and no reported cases of seroma or healing problems (difference of 81.25% and 90.00%, respectively, between the 2 groups). Conclusions: Performing abdominal dissection with scalpel had a beneficial effect on patient recovery, as it reduced time requested for drain removal, total drain output, and incidence of seroma and wound healing problems. PMID:25674380

Martins, Apolino; Silva, Álvaro; Vásconez, Luis O.; Amarante, José; Costa-Ferreira, António

2015-01-01

394

47 CFR 51.327 - Notice of network changes: Content of notice.  

Code of Federal Regulations, 2010 CFR

... 2010-10-01 false Notice of network changes: Content of notice. 51...Exchange Carriers § 51.327 Notice of network changes: Content of notice. (a) Public notice of planned network changes must, at a minimum,...

2010-10-01

395

Dissection of human vitreous body elements for proteomic analysis.  

PubMed

The vitreous is an optically clear, collagenous extracellular matrix that fills the inside of the eye and overlies the retina. (1,2) Abnormal interactions between vitreous substructures and the retina underlie several vitreoretinal diseases, including retinal tear and detachment, macular pucker, macular hole, age-related macular degeneration, vitreomacular traction, proliferative vitreoretinopathy, proliferative diabetic retinopathy, and inherited vitreoretinopathies. (1,2) The molecular composition of the vitreous substructures is not known. Since the vitreous body is transparent with limited surgical access, it has been difficult to study its substructures at the molecular level. We developed a method to separate and preserve these tissues for proteomic and biochemical analysis. The dissection technique in this experimental video shows how to isolate vitreous base, anterior hyaloid, vitreous core, and vitreous cortex from postmortem human eyes. One-dimensional SDS-PAGE analyses of each vitreous component showed that our dissection technique resulted in four unique protein profiles corresponding to each substructure of the human vitreous body. Identification of differentially compartmentalized proteins will reveal candidate molecules underlying various vitreoretinal diseases. PMID:21304469

Skeie, Jessica M; Mahajan, Vinit B

2011-01-01

396

Popliteal lymph node dissection for metastases of cutaneous malignant melanoma  

PubMed Central

Popliteal lymph node dissection is performed when grossly metastatic nodal disease is encountered in the popliteal fossa or after microscopic metastasis is found in interval sentinel nodes during clinical staging of cutaneous malignant melanoma. Initially, an S-shaped incision is made to gain access to the popliteal fossa. A careful en bloc removal of fat tissue and lymph nodes is made to preserve and avoid the injury of peroneal and tibial nerves as well as popliteal vessels, following the previous recommendations. This rare surgical procedure was successfully employed in a patient with cutaneous malignant melanoma and nodal metastases at the popliteal fossa. The technique described by Karakousis was reproduced in a step-by-step fashion to allow anatomical identification of the neurovascular structures and radical resection with no post-operative morbidity and prompt recovery. Popliteal lymph node dissection is a rarely performed operative procedure. Following a lymphoscintigraphic examination of the popliteal nodal station, surgeons can be asked to explore the popliteal fossa. Detailed familiarity of the operative procedure is necessary, however, to avoid complications. PMID:24886058

2014-01-01

397

Cat dissection and human cadaver prosection versus sculpting human structures from clay: A comparison of alternate approaches to human anatomy laboratory education  

NASA Astrophysics Data System (ADS)

Dissection and vivisection are traditional approaches to biology laboratory education. In the case of human anatomy teaching laboratories, there is a long tradition of using human and animal cadaver specimens in the classroom. In a review of the literature comparing traditional dissection and vivisection lessons to alternative lessons designed to reduce the time spent dissecting or the numbers of animals used, we conclude that it is difficult to come to any conclusion regarding the efficacy of different approaches. An analysis of the literature is confounded because many studies have very low statistical power or other methodological weaknesses, and investigators rely on a wide variety of testing instruments to measure an equally varied number of course objectives. Additional well designed studies are necessary before educators can reach any informed conclusions about the efficacy of traditional versus alternative approaches to laboratory education. In our experiments, we compared a traditional cat dissection based undergraduate human anatomy lesson to an alternative where students sculpted human muscles onto plastic human skeletons. Students in the alternative treatment performed significantly better than their peers in the traditional treatment when answering both lower and higher order human anatomy questions. In a subsequent experiment with a similar design, we concluded that the superior performance of the students in the alternative treatment on anatomy exams was likely due to the similarity between the human anatomy representation studied in lab, and the human anatomy questions asked on the exams. When the anatomy questions were presented in the context of a cat specimen, students in the traditional cat dissection treatment outperformed their peers in the alternative treatment. In a final experiment where student performance on a human anatomy exam was compared between a traditional prosected human cadaver treatment and the alternative clay sculpting treatment, no significant difference were detected, suggesting that the complexity or simplicity of the anatomy representation is less important than the similarity between the learning experience and the testing experience.

Waters, John R.

398

Fetal Pig Digestive System Dissection 1. Begin by placing the fetal pig on its side in your dissecting tray. Peel the skin back from the  

E-print Network

Fetal Pig Digestive System Dissection Protocol: 1. Begin by placing the fetal pig on its side of the digestive tract. First, locate the esophagus, the collapsible tube lying underneath the trachea. 10. Trace

Loughry, Jim

399

Students' Physical and Psychological Reactions to Forensic Dissection: Are There Risk Factors?  

ERIC Educational Resources Information Center

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…

Sergentanis, Theodoros N.; Papadodima, Stavroula A.; Evaggelakos, Christos I.; Mytilinaios, Dimitrios G.; Goutas, Nikolaos D.; Spiliopoulou, Chara A.

2010-01-01

400

Can the principles of evidence-based medicine be applied to the treatment of aortic dissections?  

Microsoft Academic Search

Surgical treatment of patients with acute type A aortic dissections has improved early survival from 10–20 to approximately 80%. Data supporting several other treatment recommendations in patients with aortic dissection, however, are less convincing. We hypothesized that applying strict principles of evidence-based medicine would invalidate most of the recommendations in these published papers. We conducted a literature search asking three

Truls Myrmel; David T. M. Lai; D. Craig Miller

2004-01-01

401

Preservation of the aortic valve in acute type A dissection complicated by aortic regurgitation  

Microsoft Academic Search

Background. The aim of the present study was to verify the efficacy of preserving the aortic valve in patients with acute type A aortic dissection complicated by significant aortic regurgitation.Methods. From January 1979 to December 1996, 178 patients (125 males; mean age 57 ± 9 years) underwent emergency surgery for acute type A aortic dissection, with an overall operative mortality

Renzo Pessotto; Francesco Santini; Peppino Pugliese; Giuseppe Montalbano; Giovanni Battista Luciani; Giuseppe Faggian; Paolo Bertolini; Alessandro Mazzucco

1999-01-01

402

GCSE Students' Attitudes to Dissection and Using Animals in Research and Product Testing.  

ERIC Educational Resources Information Center

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,…

Lock, Roger

1995-01-01

403

Platelet dysfunction in acute type A aortic dissection evaluated by the laser light-scattering method  

Microsoft Academic Search

ObjectivesPlatelet dysfunction contributes to bleeding tendency in acute type A aortic dissection. Particle counting by new laser light-scattering methods more accurately quantifies changes in the number of different-sized platelet aggregates than do conventional optical density methods. We studied platelet aggregation kinetics and patterns of aggregation deficiency in acute-phase aortic dissection with laser light scattering.

Masashi Tanaka; Koji Kawahito; Hideo Adachi; Takashi Ino

2003-01-01

404

The discovery of the body: human dissection and its cultural contexts in ancient Greece.  

PubMed Central

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

von Staden, H.

1992-01-01

405

Aortoesophageal fistula as a late complication of type B aortic dissection.  

PubMed

We present a patient with aortoesophageal fistula that occurred years after an acute type B aortic dissection that was treated medically. This patient developed aneurysmal dilatation of the chronically dissected aorta, which finally eroded into the esophagus. Endovascular management with the placement of a stent graft was performed, but the patient ultimately died of multiorgan failure and possible myocardial infarction. PMID:21489929

Vasquez, Julio C; Delarosa, Jacob; Leon, Juan J

2011-02-01

406

Association of Cervical Artery Dissection with Connective Tissue Abnormalities in Skin and Arteries  

Microsoft Academic Search

Spontaneous cervical artery dissections (sCAD) often occur in otherwise healthy individuals without known risk factors for stroke and frequently develop spontaneously without relevant trauma. An underlying arteriopathy leading to a so-called ’weakness of the vessel wall’ and predisposing certain individuals to dissection has often been postulated. Therefore, the morphology of connective tissue, a main component of vessel wall and environment,

T. Brandt; M. Morcher; I. Hausser

2005-01-01

407

Endovascular Aortic Repair Of A Post-Dissecting1 Thoracoabdominal Aneurysm Using Intraoperative2  

E-print Network

1 Endovascular Aortic Repair Of A Post-Dissecting1 Thoracoabdominal Aneurysm Using Intraoperative2 of "Fusion Imaging" to facilitate the treatment of a post-dissection6 thoracoabdominal aneurysm The endovascular aortic repair of complex aortic aneurysms with fenestrated or branched2 grafts requires accurate

Paris-Sud XI, Université de

408

The dead center of the dental curriculum: changing attitudes of dental students during dissection.  

PubMed

The purpose of this study was to investigate changes in dental students' perceptions of professionalism, knowledge, and emotion over the period of dissection in a human anatomy course. Whether human dissection needs to be a part of the modern dental curriculum is often called into question, particularly with the plethora of electronic and other aids available to support the learning of anatomy. The influence of the dissection process on development of professional attitudes and emotional maturity has been studied in medical students, but how dental students react to this part of their education is less well known. To investigate this question, a survey was administered before and after the dissection course to two sequential year groups of dental students. It was found that these students had high levels of understanding of professional values before commencing dissection and continued to value the role of teamwork in aiding their learning over the survey period. The majority of students coped well with the assimilation of knowledge and developed coping mechanisms to handle the emotional aspects of dissection. The students remained excited by and interested in dissection, and the majority valued it as the most positive aspect of their anatomy course. The students increasingly valued the use of prosected specimens as an aid to learning. This study confirmed that significant changes occur in dental students' attitudes during the period of dissection, which we believe contribute to the development of more empathetic and caring practitioners. PMID:22012777

Redwood, Christopher J; Townsend, Grant C

2011-10-01

409

Transoesophageal echocardiography as the sole diagnostic investigation in patients with suspected thoracic aortic dissection.  

PubMed Central

OBJECTIVES--To assess the value and limitations of using transoesophageal echocardiography as the sole diagnostic test in patients with suspected thoracic aortic dissection. DESIGN--Retrospective data review over a two year period. SETTING--A regional cardiothoracic centre. PATIENTS--Data were compiled from admission records, surgical records, and lists of patients undergoing diagnostic investigations in the hospital. Patient's notes were used to identify presentation, management, and outcome. INTERVENTIONS--Patients were managed according to the policy of our unit, which is to treat patients with dissection affecting the ascending aorta by an operation. Patients with uncomplicated dissection sparing the ascending aorta are initially managed medically. MAIN OUTCOME MEASURES--In hospital and two year follow-up of patients who were investigated by transoesophageal echocardiography alone. RESULTS--Of 48 patients referred, 45 underwent transoesophageal echocardiography. Dissection was confirmed in 22 patients. Transoesophageal echocardiography showed the proximal extent of the dissection in 21/22 (96%) and only one patient required a further diagnostic investigation. Ten patients with dissection of the ascending aorta underwent graft replacement of the ascending aorta; operative mortality was 10% and their two year survival was 80%. Of the eight patients with dissection of the descending aorta, six were discharged home, and five were alive at two years. No patient without evidence of dissection on their initial transoesophageal echocardiographic examination required re-investigation into possible dissection in the two years after discharge. CONCLUSIONS--In patients with suspected thoracic dissection transoesophageal echocardiography rapidly and safely gives all the necessary diagnostic information. Further investigations, including coronary angiography, before surgery are unnecessary. Images PMID:7818964

Banning, A P; Masani, N D; Ikram, S; Fraser, A G; Hall, R J

1994-01-01

410

Complications Related to Gastric Endoscopic Submucosal Dissection and Their Managements  

PubMed Central

Endoscopic submucosal dissection (ESD) for early gastric cancer is a well-established procedure with the advantage of resection in an en bloc fashion, regardless of the size, shape, coexisting ulcer, and location of the lesion. However, gastric ESD is a more difficult and meticulous technique, and also requires a longer procedure time, than conventional endoscopic mucosal resection. These factors naturally increase the risk of various complications. The two most common complications accompanying gastric ESD are bleeding and perforation. These complications are known to occur both intraoperatively and postoperatively. However, there are other rare but serious complications related to gastric ESD, including aspiration pneumonia, stenosis, venous thromboembolism, and air embolism. Endoscopists should have sufficient knowledge about such complications and be prepared to deal with them appropriately, as successful management of complications is necessary for the successful completion of the entire ESD procedure. PMID:25324997

Saito, Itaru; Tsuji, Yosuke; Sakaguchi, Yoshiki; Niimi, Keiko; Ono, Satoshi; Kodashima, Shinya; Yamamichi, Nobutake; Koike, Kazuhiko

2014-01-01

411

Using Isotopic Tools to Dissect and Quantitate Parallel Metabolic Pathways  

PubMed Central

4-hydroxyacids are ubiquitous in human physiology. They are derived from the drugs of abuse ?-hydroxybutyrate (GHB), ?-hydroxypentanoate(GHP), in addition to the omnipresent lipid peroxidation product 4-Hydroxy-2-(E)-nonenal (4-HNE). Previously we reported that 4-hydroxyacids are catabolized through two parallel pathways. In this report we detail two isotopic tools that have allowed the dissection of this catabolic process, and illustrate how these tools can be used to quantify the relative flux down each pathway. We found that 4-hydroxynonanoate (a 4-hydroxyacid derived from 4-HNE) is primarly catabolized through a pathway that phosphorylates the C-4 hydroxyl and isomerizes it to a C-3 hydroxy compound, which is catabolized through ?-oxidation. PMID:20408520

Sadhukhan, Sushabhan; Han, Yong; Zhang, Guo-Fang; Brunengraber, Henri; Tochtrop, Gregory P

2010-01-01

412

Dissecting functional connectivity of neuronal microcircuits: experimental and theoretical insights.  

PubMed

Structure-function studies of neuronal networks have recently benefited from considerable progress in different areas of investigation. Advances in molecular genetics and imaging have allowed for the dissection of neuronal connectivity with unprecedented detail whereas in vivo recordings are providing much needed clues as to how sensory, motor and cognitive function is encoded in neuronal firing. However, bridging the gap between the cellular and behavioral levels will ultimately require an understanding of the functional organization of the underlying neuronal circuits. One way to unravel the complexity of neuronal networks is to understand how their connectivity emerges during brain maturation. In this review, we will describe how graph theory provides experimentalists with novel concepts that can be used to describe and interpret these developing connectivity schemes. PMID:21459463

Feldt, Sarah; Bonifazi, Paolo; Cossart, Rosa

2011-05-01

413

Recommended sedation and intraprocedural monitoring for gastric endoscopic submucosal dissection.  

PubMed

Endoscopic submucosal dissection is associated with a longer treatment time and a higher risk of patient discomfort than conventional procedures. Adequate, safe sedation is therefore essential. Sedation can cause adverse effects such as hypoxemia and hypotension, requiring continuous intraoperative and postoperative monitoring of blood pressure, use of the electrocardiogram, and arterial blood oxygen saturation by pulse oximetry. A physician and a nurse solely responsible for sedating and monitoring the patient should be present during treatment.A combination of benzodiazepines and analgesics are generally used for sedation, but new sedatives such as propofol and dexmedetomidine hydrochloride are expected to be useful agents. Endoscopists should become more familiar with sedatives, analgesics, and emergency procedures in the future. PMID:23406354

Sasaki, Tohru; Tanabe, Satoshi; Ishido, Kenji; Azuma, Mizutomo; Katada, Chikatoshi; Higuchi, Katsuhiko; Koizumi, Wasaburo

2013-03-01

414

Desirable training of endoscopic submucosal dissection: further spread worldwide  

PubMed Central

Endoscopic submucosal dissection (ESD) is an excellent treatment because of its high curative resection rate and low local recurrence rate. However, its technical difficulty prevents from its permeation worldwide. For further permeation of ESD, the establishment of an appropriate training system is essential. In Japan, trainee endoscopists who have had prerequisites for ESD, that is to say, basic knowledge and skills, start ESD in accordance with a stepwise training system under close supervision by experts. The trainers select an appropriate lesion in human for each step of developments in ESD techniques. In Western countries there are few ESD experts at present, so an ex vivo animal model training must play a major role in the training system. It is desirable that these training systems should be constructed by some authorized organizations such as Japan Gastroenterological Endoscopy Society (JGES). PMID:25333003

Fujishiro, Mitsuhiro; Kodashima, Shinya; Niimi, Keiko; Ono, Satoshi; Yamamichi, Nobutake; Koike, Kazuhiko

2014-01-01

415

Tenascin C protects aorta from acute dissection in mice  

NASA Astrophysics Data System (ADS)

Acute aortic dissection (AAD) is caused by the disruption of intimomedial layer of the aortic walls, which is immediately life-threatening. Although recent studies indicate the importance of proinflammatory response in pathogenesis of AAD, the mechanism to keep the destructive inflammatory response in check is unknown. Here, we report that induction of tenascin-C (TNC) is a stress-evoked protective mechanism against the acute hemodynamic and humoral stress in aorta. Periaortic application of CaCl2 caused stiffening of abdominal aorta, which augmented the hemodynamic stress and TNC induction in suprarenal aorta by angiotensin II infusion. Deletion of Tnc gene rendered mice susceptible to AAD development upon the aortic stress, which was accompanied by impaired TGF? signaling, insufficient induction of extracellular matrix proteins and exaggerated proinflammatory response. Thus, TNC works as a stress-evoked molecular damper to maintain the aortic integrity under the acute stress.

Kimura, Taizo; Shiraishi, Kozoh; Furusho, Aya; Ito, Sohei; Hirakata, Saki; Nishida, Norifumi; Yoshimura, Koichi; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Ikeda, Yasuhiro; Miyamoto, Takanobu; Ueno, Takafumi; Hamano, Kimikazu; Hiroe, Michiaki; Aonuma, Kazutaka; Matsuzaki, Masunori; Imaizumi, Tsutomu; Aoki, Hiroki

2014-02-01

416

Vertebral artery dissection after a chiropractor neck manipulation.  

PubMed

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

Jones, Jeremy; Jones, Catherine; Nugent, Kenneth

2015-01-01

417

Vertebral artery dissection after a chiropractor neck manipulation  

PubMed Central

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

Jones, Jeremy; Nugent, Kenneth

2015-01-01

418

Murine Model of Surgically Induced Acute Aortic Dissection Type A  

PubMed Central

Objectives This study aimed at developing a murine model of surgically induced acute aortic dissection type A (AAD) for investigation of the formation and progression of AAD, and to test whether this system could be used for biomarker discovery. Methods Adult fibrillin-1 deficient, Fbn1C1039G/+ mice and wild-type mice were anesthetized, ventilated and the ascending aorta exposed via hemisternotomy. We hypothesized that AAD could be induced either by injecting autologous blood into the aortic wall or by injury to the wall with aortic clamping. Echocardiography was done preoperatively, and serum samples collected before and 30 minutes after surgery, and analyzed by ELISA. Results Echocardiography revealed larger aortic root diameters in Fbn1C1039G/+ compared with wild-type mice (P=0.001). Histology showed that aortic clamp injury but not injection of blood leads to large intimal tears, disruption of aortic wall structures and localized dissection of the aortic media in Fbn1C1039G/+ mice. AAD developed in 4 out of 5 Fbn1C1039G/+ mice versus 0 out of 5 wild-type mice after aortic clamping (P<0.01). Elastin staining showed higher elastic fiber fragmentation and disarray in Fbn1C1039G/+ compared with wild-type mice. ELISA analysis revealed elevated circulating TGF?1 concentrations after inducing AAD in Fbn1C1039G/+ mice (P=0.02, 150±61 ng/ml vs. 456±97 ng/ml), but not in wild-type or sham-operated mice. Conclusions Aortic clamp injury can induce AAD in Fbn1C1039G/+, but not in wild-type mice. This murine model of surgically induced AAD is highly reproducible and non-lethal in the short-term. Using this system, we revealed that circulating TGF?1 is a promising biomarker for AAD. PMID:19910001

Matt, Peter; Huso, David L.; Habashi, Jennifer; Holm, Tammy; Doyle, Jeff; Schoenhoff, Florian; Liu, Guosheng; Black, James; Van Eyk, Jennifer E.; Dietz, Harry C.

2010-01-01

419

Common variation in PHACTR1 is associated with susceptibility to cervical artery dissection.  

PubMed

Cervical artery dissection (CeAD), a mural hematoma in a carotid or vertebral artery, is a major cause of ischemic stroke in young adults although relatively uncommon in the general population (incidence of 2.6/100,000 per year). Minor cervical traumas, infection, migraine and hypertension are putative risk factors, and inverse associations with obesity and hypercholesterolemia are described. No confirmed genetic susceptibility factors have been identified using candidate gene approaches. We performed genome-wide association studies (GWAS) in 1,393 CeAD cases and 14,416 controls. The rs9349379[G] allele (PHACTR1) was associated with lower CeAD risk (odds ratio (OR) = 0.75, 95% confidence interval (CI) = 0.69-0.82; P = 4.46 × 10(-10)), with confirmation in independent follow-up samples (659 CeAD cases and 2,648 controls; P = 3.91 × 10(-3); combined P = 1.00 × 10(-11)). The rs9349379[G] allele was previously shown to be associated with lower risk of migraine and increased risk of myocardial infarction. Deciphering the mechanisms underlying this pleiotropy might provide important information on the biological underpinnings of these disabling conditions. PMID:25420145

Debette, Stéphanie; Kamatani, Yoichiro; Metso, Tiina M; Kloss, Manja; Chauhan, Ganesh; Engelter, Stefan T; Pezzini, Alessandro; Thijs, Vincent; Markus, Hugh S; Dichgans, Martin; Wolf, Christiane; Dittrich, Ralf; Touzé, Emmanuel; Southerland, Andrew M; Samson, Yves; Abboud, Shérine; Béjot, Yannick; Caso, Valeria; Bersano, Anna; Gschwendtner, Andreas; Sessa, Maria; Cole, John; Lamy, Chantal; Medeiros, Elisabeth; Beretta, Simone; Bonati, Leo H; Grau, Armin J; Michel, Patrik; Majersik, Jennifer J; Sharma, Pankaj; Kalashnikova, Ludmila; Nazarova, Maria; Dobrynina, Larisa; Bartels, Eva; Guillon, Benoit; van den Herik, Evita G; Fernandez-Cadenas, Israel; Jood, Katarina; Nalls, Michael A; De Leeuw, Frank-Erik; Jern, Christina; Cheng, Yu-Ching; Werner, Inge; Metso, Antti J; Lichy, Christoph; Lyrer, Philippe A; Brandt, Tobias; Boncoraglio, Giorgio B; Wichmann, Heinz-Erich; Gieger, Christian; Johnson, Andrew D; Böttcher, Thomas; Castellano, Maurizio; Arveiler, Dominique; Ikram, M Arfan; Breteler, Monique M B; Padovani, Alessandro; Meschia, James F; Kuhlenbäumer, Gregor; Rolfs, Arndt; Worrall, Bradford B; Ringelstein, Erich-Bernd; Zelenika, Diana; Tatlisumak, Turgut; Lathrop, Mark; Leys, Didier; Amouyel, Philippe; Dallongeville, Jean

2015-01-01

420

Novel method to prevent gastric antral strictures after endoscopic submucosal dissection: using triamcinolone.  

PubMed

Endoscopic submucosal dissection (ESD) of large gastric lesions often leads to severe gastric strictures, especially in cases of large ESD in the antrum of the stomach. It has recently been reported that balloon dilation, mucosal incision, and local steroid injections can successfully treat gastric strictures. However, there are some complications with existing methods and decreasing the quality of life. We have developed a novel method to prevent severe gastric strictures that does not involve balloon dilation, mucosal incision, or steroid injections after circumferential ESD. Our original method involves the submucosal injection of a mixed solution composed of triamcinolone acetonide and a general solution of glycerol, hyaluronic acid, and a small amount of indigo carmine and epinephrine during the ESD procedure; this mixture is called a mixed solution of triamcinolone (MST). According to standard ESD procedures, several milliliters of MST are injected into the submucosal layer for the purpose of elevating the submucosa during ESD resulting in prevention of severe strictures. Our method using MST take several advantages such as MST method suppress inflammation in ulcer from initial phase, prevention of stricture without obstructive symptoms, and does not require several ballooning. Therefore, MST method is safe and gentle, shorten the hospitalization duration. Here, we described two cases in which we prevented severe strictures of the gastric antrum after completing a circumferential ESD using MST without any complications. PMID:25206299

Nishiyama, Noriko; Mori, Hirohito; Kobara, Hideki; Rafiq, Kazi; Fujihara, Shintaro; Matsunaga, Tae; Ayaki, Maki; Yachida, Tatsuo; Oryu, Makoto; Masaki, Tsutomu

2014-09-01

421

Virtual, on-line, frog dissection vs. conventional laboratory dissection: A comparison of student achievement and teacher perceptions among honors, general ability, and foundations-level high school biology classes  

NASA Astrophysics Data System (ADS)

Dissecting animal specimens has long been a tradition in biology classes. Objections by students, based on religious or ethical grounds, have been raised regarding the dissections of animals in classroom laboratories. A number of states now have legal proceedings or statewide policies requiring that alternatives to the actual dissection of laboratory animal specimens be permitted in their school districts. Alternatives to actual dissections have been developed in recent years. For a variety of reasons, performing an actual or conventional animal dissection may not be a desirable option. The purpose of this study was to investigate how a virtual On-line frog dissection compares with an actual laboratory dissection. What were the perceptions of the teacher's using it? How does student achievement compare among three the different ability levels on a pre and posttest regarding basic frog anatomy? Is a virtual On-line dissection a suitable alternative for students who, for whatever reason, do not participate in the actual laboratory experience? The subjects consisted of 218 biology students among three different ability levels, in a Northeastern suburban high school. Approximately half of the student groups participated in a virtual On-line dissection, the other half in an actual laboratory dissection. A pretest of basic frog anatomy was administered to the students two days before and the posttest one day after their dissection experience. Data were analyzed using matched pairs t-Tests, Analysis of Variance, Tukey HSD, and Squared Curvilinear Coefficients. Survey questionnaires were administered to the teachers after the dissection experiences were completed. There were no significant differences found in achievement between the virtual and conventional dissection groups. There were significant differences found in achievement score means among the three ability levels. There was no significant interaction between gender and achievement. Perceptions of the teacher's facilitating the two instructional methods varied. The main area of agreement among them was that a virtual On-line frog dissection was a viable alternative for students who objected to doing a conventional dissection.

Kopec, Ronald H.

2002-09-01

422

Outcome analysis of laporoscopic D1 and D2 dissection in patients 70 years and older with gastric cancer  

PubMed Central

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

Emir, Seyfi; Sözen, Selim; Bali, ?lhan; Gürdal, Sibel Özkan; Turan, Bünyamin Cüneyt; Y?ld?r?m, Oguzhan; Yeti?yi?it, Tarkan

2014-01-01

423

Probing cell mechanics with subcellular laser dissection of actomyosin networks in the early developing Drosophila embryo.  

PubMed

Laser dissection is a useful tool in developmental biology to probe mechanical forces from the subcellular to the tissue/embryo scale. During tissue morphogenesis, cells are equipped with networks of actomyosin that generate forces. Here we present a technique based on near-infrared (NIR) femtosecond (fs) pulsed laser dissection that allows subcellular ablation of actomyosin networks. This technique allows to selectively ablate actomyosin networks while preserving cell plasma membrane. The resulting relaxation of the remaining network after laser dissection is imaged and analyzed to deduce local forces responsible for tissue morphogenesis in the developing Drosophila embryo. PMID:25245696

Rauzi, M; Lenne, P-F

2015-01-01

424

Cutting Edge Controversy: The Politics of Animal Dissection and Responses to Student Objection  

NASA Astrophysics Data System (ADS)

This mixed methods study investigated the experiences and perspectives of former Ontario high school students and current Ontario science and biology teachers toward animal dissection, objection to dissection, and choice policies that grant students the right to opt out of dissection and use an alternative instead. Data was collected via a student questionnaire (n=311), a teacher questionnaire (n=153), and interviews with eight students and nine teachers. Quantitative and qualitative data analyses and reporting techniques were employed within a humane education and critical pedagogy framework to explore the experiences and perspectives of both groups.

Oakley, Jan

2011-12-01

425

JOINT NOTICE OF PRIVACY PRACTICES  

E-print Network

JOINT NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY disclosure of your immunization data to the Wisconsin Immunization Registry. A request for restriction should

426

The Quality of Reports on Cervical Arterial Dissection following Cervical Spinal Manipulation  

PubMed Central

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

Wynd, Shari; Westaway, Michael; Vohra, Sunita; Kawchuk, Greg

2013-01-01

427

Experience with a new device for pathological assessment of colonic endoscopic submucosal dissection.  

PubMed

Endoscopic submucosal dissection (ESD) is gaining popularity worldwide in the treatment of neoplastic lesions of the gastrointestinal tract. However, the experience in Western countries is quite limited and restricted to large or academic centers. Besides, this approach requires an optimal pathological assessment. The aim of this study was to report our experience with colonic ESD using a new device that allows complete handling of the resected specimens and especially of lateral margins, for pathological analysis. In a 1-year period, 14 patients (6 men, 8 women, age range 50-82 years) underwent colonic ESD in a non-academic hospital. The endoscopic procedure was carried out successfully en bloc in more than 90 % of cases. Perforation requiring surgery occurred in one patient (7 %). Pathological assessment with the new device allowed entire and complete examination of both the deep and lateral margins of the excised specimens. Colonic ESD is a viable option for non-surgical treatment of large bowel lesions even in relatively small centers and in non-academic settings. The new device allows good handling of the specimens, and it seems to be useful for the entire examination of the resection margins. PMID:25214205

Trecca, A; Marinozzi, G; Villanacci, V; Salemme, M; Bassotti, G

2014-11-01

428

Management of esophageal stricture after complete circular endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma  

PubMed Central

Background Endoscopic submucosal dissection (ESD) permits removal of esophageal epithelial neoplasms en bloc, but is associated with esophageal stenosis, particularly when ESD involves the entire circumference of the esophageal lumen. We examined the effectiveness of systemic steroid administration for control of postprocedural esophageal stricture after complete circular ESD. Methods Seven patients who underwent wholly circumferential ESD for superficially extended esophageal squamous cell carcinoma were enrolled in this study. In 3 patients, prophylactic endoscopic balloon dilatation (EBD) was started on the third post-ESD day and was performed twice a week for 8 weeks. In 4 patients, oral prednisolone was started with 30 mg daily on the third post-ESD day, tapered gradually (daily 30, 30, 25, 25, 20, 15, 10, 5 mg for 7 days each), and then discontinued at 8 weeks. EBD was used as needed whenever patients complained of dysphagia. Results En bloc ESD with tumor-free margins was safely achieved in all cases. Patients in the prophylactic EBD group required a mean of 32.7 EBD sessions; the postprocedural stricture was dilated up to 18 mm in diameter in these patients. On the other hand, systemic steroid administration substantially reduced or eliminated the need for EBD. Corticosteroid therapy was not associated with any adverse events. Post-ESD esophageal stricture after complete circular ESD was persistent, requiring multiple EBD sessions. Conclusions Use of oral prednisolone administration may be an effective treatment strategy for reducing post-ESD esophageal stricture after complete circular ESD. PMID:21542926

2011-01-01

429

Biomechanical roles of medial pooling of glycosaminoglycans in thoracic aortic dissection  

PubMed Central

Spontaneous dissection of the human thoracic aorta is responsible for significant morbidity and mortality, yet this devastating biomechanical failure process remains poorly understood. In this paper, we present finite element simulations that support a new hypothesis for the initiation of aortic dissections that is motivated by extensive histopathological observations. Specifically, our parametric simulations show that the pooling of glycosaminoglycans/proteoglycans that is singularly characteristic of the compromised thoracic aorta in aneurysms and dissections can lead to significant stress concentrations and intra-lamellar Donnan swelling pressures. We submit that these localized increases in intramural stress may be sufficient both to disrupt the normal cell-matrix interactions that are fundamental to aortic homeostasis and to delaminate the layered microstructure of the aortic wall and thereby initiate dissection. Hence, pathologic pooling of glycosaminoglycans/proteoglycans within the medial layer of the thoracic aortic should be considered as a possible target for clinical intervention. PMID:23494585

Roccabianca, Sara; Ateshian, Gerard A.; Humphrey, Jay D.

2013-01-01

430

Pitfalls in diagnosis of aortic dissection by angiography: algorithmic approach utilizing CT and MRI.  

PubMed

Dissection of the thoracic aorta is a life-threatening event requiring imaging studies to define the level of the tear and the intimal flap. The "gold standard" has been angiography. This method may fail to demonstrate the dissection, however, due to overlap of the true and false lumens or a very thin flap that is imaged en face rather than tangentially. Computed tomography has a diagnostic accuracy of 95%, but can fail to image the dissection due to technical factors or a thrombosed false lumen. Magnetic resonance imaging requires a hemodynamically stable and cooperative patient. A diagnostic algorithm is proposed for diagnosis of aortic dissection based on renal function and the surgeon's imaging modality preference. PMID:1773416

Mast, H L; Gordon, D H; Kantor, A M

1991-01-01

431

Cell type–specific channelrhodopsin-2 transgenic mice for optogenetic dissection of neural circuitry function  

E-print Network

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 ...

Zhao, Shengli

432

J Physiol 580.3 (2007) pp 961975 961 Pharmacological dissection of the human gastro-  

E-print Network

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

Brasseur, James G.

433

A Perspective Review on Numerical Simulations of Hemodynamics in Aortic Dissection  

PubMed Central

Aortic dissection, characterized by separation of the layers of the aortic wall, poses a significant challenge for clinicians. While type A aortic dissection patients are normally managed using surgical treatment, optimal treatment strategy for type B aortic dissection remains controversial and requires further evaluation. Although aortic diameter measured by CT angiography has been clinically used as a guideline to predict dilation in aortic dissection, hemodynamic parameters (e.g., pressure and wall shear stress), geometrical factors, and composition of the aorta wall are known to substantially affect disease progression. Due to the limitations of cardiac imaging modalities, numerical simulations have been widely used for the prediction of disease progression and therapeutic outcomes, by providing detailed insights into the hemodynamics. This paper presents a comprehensive review of the existing numerical models developed to investigate reasons behind tear initiation and progression, as well as the effectiveness of various treatment strategies, particularly the stent graft treatment. PMID:24672348

Wan Ab Naim, Wan Naimah; Ganesan, Poo Balan; Hashim, Shahrul Amry

2014-01-01

434

["Aquatic" dissection of the facial nerve for the surgery of acoustic neurinoma].  

PubMed

We describe a procedure facilitating dissection of the facial nerve from acoustic neuromas, consisting of a pulsed irrigation of serum. This seems to minimize nerve manipulation and thus surgical trauma. PMID:9765710

Tran Ba Huy, P; Lot, G; Herman, P

1998-02-01

435

Laser zona dissection using short-pulse ultraviolet lasers  

NASA Astrophysics Data System (ADS)

The interaction of pulsed ultraviolet radiation with the zona pellucida of human oocytes which had failed to fertilize in standard IVF cycles, was investigated. Two lasers were studied: a 100 ps pulsed Nd:YAG with a nonlinear crystal emitting light at 266 nm, and a 15 ns XeCl excimer laser with 308 nm radiation. Incisions in the zona were made by aiming the beam tangentially to the oocyte. The results indicate superior, high precision performance by the excimer laser creating trenches as narrow as 1 micrometers and as shallow as 1 micrometers . The incision size was found to be sensitive to the laser's energy and to the position of the microscope's objective focal plane, but relatively insensitive to the laser pulse repetition rate. Once the minimum spot size was defined by the system parameters, the laser beam was used to curve out any desired zona shape. This laser microsurgery technique as applied to partial zone dissection or zona drilling could prove very useful as a high-precision, non-contact method for treatments of low fertilization rate and for enhancing embryo implantation rates in patients undergoing IVF treatments.

Neev, Joseph; Tadir, Yona; Ho, Peter D.; Whalen, William E.; Asch, Richardo H.; Ord, Teri; Berns, Michael W.

1992-06-01

436

Dissecting the Role of COPI Complexes in Influenza Virus Infection  

PubMed Central

As an obligate pathogen, influenza virus requires host cell factors and compartments to mediate productive infection and to produce infectious progeny virus. Recently, several small interfering RNA (siRNA) knockdown screens revealed influenza virus host dependency proteins, all of which identified at least two subunits of the coat protein I (COPI) complex. COPI proteins oligomerize to form coated vesicles that transport contents between the Golgi apparatus and the endoplasmic reticulum, and they have also been reported to mediate endosomal trafficking. However, it remains unclear which steps in the influenza virus infection cycle rely on the COPI complex. Upon systematic dissection of the influenza virus infection cycle, from entry to progeny virion production, we found that prolonged exposure to COPI complex disruption through siRNA depletion resulted in significant defects in virus internalization and trafficking to late endosomes. Acute inhibition of COPI complex recruitment to the Golgi apparatus with pharmacological compounds failed to recapitulate the same entry defects as observed with the COPI-depleted cells but did result in specific decreases in viral membrane protein expression and assembly, leading to defects in progeny virion production. Taken together, our findings suggest that COPI complexes likely function indirectly in influenza virus entry but play direct roles in viral membrane protein expression and assembly. PMID:23255804

Sun, Eileen; He, Jiang

2013-01-01

437

Dissecting specific and global transcriptional regulation of bacterial gene expression  

PubMed Central

Gene expression is regulated by specific transcriptional circuits but also by the global expression machinery as a function of growth. Simultaneous specific and global regulation thus constitutes an additional—but often neglected—layer of complexity in gene expression. Here, we develop an experimental-computational approach to dissect specific and global regulation in the bacterium Escherichia coli. By using fluorescent promoter reporters, we show that global regulation is growth rate dependent not only during steady state but also during dynamic changes in growth rate and can be quantified through two promoter-specific parameters. By applying our approach to arginine biosynthesis, we obtain a quantitative understanding of both specific and global regulation that allows accurate prediction of the temporal response to simultaneous perturbations in arginine availability and growth rate. We thereby uncover two principles of joint regulation: (i) specific regulation by repression dominates the transcriptional response during metabolic steady states, largely repressing the biosynthesis genes even when biosynthesis is required and (ii) global regulation sets the maximum promoter activity that is exploited during the transition between steady states. PMID:23591774

Gerosa, Luca; Kochanowski, Karl; Heinemann, Matthias; Sauer, Uwe

2013-01-01

438

Zebrafish as a Novel Vertebrate Model To Dissect Enterococcal Pathogenesis  

PubMed Central

Enterococcus faecalis is an opportunistic pathogen responsible for a wide range of life-threatening nosocomial infections, such as septicemia, peritonitis, and endocarditis. E. faecalis infections are associated with a high mortality and substantial health care costs and cause therapeutic problems due to the intrinsic resistance of this bacterium to antibiotics. Several factors contributing to E. faecalis virulence have been identified. Due to the variety of infections caused by this organism, numerous animal models have been used to mimic E. faecalis infections, but none of them is considered ideal for monitoring pathogenesis. Here, we studied for the first time E. faecalis pathogenesis in zebrafish larvae. Using model strains, chosen isogenic mutants, and fluorescent derivatives expressing green fluorescent protein (GFP), we analyzed both lethality and bacterial dissemination in infected larvae. Genetically engineered immunocompromised zebrafish allowed the identification of two critical steps for successful establishment of disease: (i) host phagocytosis evasion mediated by the Epa rhamnopolysaccharide and (ii) tissue damage mediated by the quorum-sensing Fsr regulon. Our results reveal that the zebrafish is a novel, powerful model for studying E. faecalis pathogenesis, enabling us to dissect the mechanism of enterococcal virulence. PMID:24002065

Renshaw, Stephen A.; Ogryzko, Nikolay V.; Foster, Simon J.; Serror, Pascale

2013-01-01

439

Dissection of miRNA pathways using Arabidopsis mesophyll protoplasts.  

PubMed

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

Martinho, Cláudia; Confraria, Ana; Elias, Carlos Alexandre; Crozet, Pierre; Rubio-Somoza, Ignacio; Weigel, Detlef; Baena-González, Elena

2014-10-24

440

Dissection of miRNA Pathways Using Arabidopsis Mesophyll Protoplasts.  

PubMed

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

Martinho, Cláudia; Confraria, Ana; Elias, Carlos Alexandre; Crozet, Pierre; Rubio-Somoza, Ignacio; Weigel, Detlef; Baena-González, Elena

2015-02-01

441

Dissecting a complex chemical stress: chemogenomic profiling of plant hydrolysates  

PubMed Central

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

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

442

Urethral pseudodiverticulum secondary to penile fracture and complete urethra dissection.  

PubMed

A 22-year-old man reported cracking sound and acute pain during sexual intercourse followed by rapid penile detumescence and ecchymosis. He experienced more pain because he could not urinate and had a palpably full bladder. Moreover, his urethra was bleeding. Physical examination revealed swollen, ecchymotic and deviated penis and penis ultrasonography showed an injury of the tunica albuginea and Buck's fascia with an expanding hematoma. Suprapubic catheter was positioned. Surgical exploration revealed a tear of tunica albuginea of both corpora cavernosa and complete urethral dissection. End-to-end urethral anastomosis and suture of corpora cavernosa lesion were performed. Vescical catheter was mantained for 6 days and suprapubic catheter for 3 months to allow a complete urethral healing. A pseudodiverticulum was found at anastomosis level on the urethrocistography 1 month after surgery. It disappeared by allowing micturition via the suprapubic catheter. The patient presented regular urinary flow and physiological erections 30 days later. In our experience, prompt surgical repair preserved erectile function and keeping the suprapubic catheter protected the urethra; this was the correct management for repairing the urethral lesion. PMID:23766837

Di Pierro, Giovanni B; Iannotta, Luca; Innocenzi, Michele; Caterina, Gulia; Grande, Pietro; Cristini, Cristiano; Gentile, Vincenzo

2013-01-01

443

Dissecting impulsivity and its relationships to drug addictions.  

PubMed

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 support 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

Jentsch, J David; Ashenhurst, James R; Cervantes, M Catalina; Groman, Stephanie M; James, Alexander S; Pennington, Zachary T

2014-10-01

444

Pulse energy dependence of subcellular dissection by femtosecond laser pulses  

NASA Technical Reports Server (NTRS)

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.

Heisterkamp, A.; Maxwell, I. Z.; Mazur, E.; Underwood, J. M.; Nickerson, J. A.; Kumar, S.; Ingber, D. E.

2005-01-01

445

Copper phenotype in Alzheimer’s disease: dissecting the pathway  

PubMed Central

Alzheimer’s disease (AD) is the most common form of dementia. Several hypotheses have been put forward to explain the basis of disease onset and progression. Unfortunately, none of these seems to clarify the complexity of the pathogenesis. In fact, diverse and independent pathogenetic pathways can be disrupted at the same time, and each contributes to disease etiology. In recent years, researchers have begun studying biometals more deeply. A number of studies have shown that metal dyshomeostasis may enhance AD onset and progression. Specifically, different authors have hypothesized that alterations in metal metabolism are associated with an increased in metal-related oxidative stress and beta-amyloid oligomer formation and precipitation. Studies conducted in vivo, in vitro, in living patients and in silico studies have demonstrated that local and systemic defects in copper metabolism are characteristic signs of AD. This strongly supports the hypothesis that copper pathways may be disrupted by the disease. More specifically, a copper phenotype can be proposed for AD, based on defects found in genes involved in copper metabolism. In this review, we describe copper dyshomeostasis in AD patients and attempt to explain the basis of the AD copper phenotype. Dissecting copper pathways, we highlight mechanisms which may be at the basis of the disease. We also discuss various associated translation outcomes. PMID:23844331

Squitti, Rosanna; Polimanti, Renato

2013-01-01

446

Dissection of Filamentous Growth by Transposon Mutagenesis in Saccharomyces Cerevisiae  

PubMed Central

Diploid Saccharomyces cerevisiae strains starved for nitrogen undergo a developmental transition from growth as single yeast form (YF) cells to a multicellular form consisting of filaments of pseudohyphal (PH) cells. Filamentous growth is regulated by an evolutionarily conserved signaling pathway that includes the small GTP-binding proteins Ras2p and Cdc42p, the protein kinases Ste20p, Ste11p and Ste7p, and the transcription factor Ste12p. Here, we designed a genetic screen for mutant strains defective for filamentous growth (dfg) to identify novel targets of the filamentation signaling pathway, and we thereby identified 16 different genes, CDC39, STE12, TEC1, WHI3, NAB1, DBR1, CDC55, SRV2, TPM1, SPA2, BNI1, DFG5, DFG9, DFG10, BUD8 and DFG16, mutations that block filamentous growth. Phenotypic analysis of dfg mutant strains genetically dissects filamentous growth into the cellular processes of signal transduction, bud site selection, cell morphogenesis and invasive growth. Epistasis tests between dfg mutant alleles and dominant activated alleles of the RAS2 and STE11 genes, RAS2(Val19) and STE11-4, respectively, identify putative targets for the filamentation signaling pathway. Several of the genes described here have homologues in filamentous fungi, where they also regulate fungal development. PMID:9055077

Mosch, H. U.; Fink, G. R.

1997-01-01

447

Molecular dissection of segment formation in the developing hindbrain.  

PubMed

Although many components of the genetic pathways that provide positional information during embryogenesis have been identified, it remains unclear how these signals are integrated to specify discrete tissue territories. Here, we investigate the molecular mechanisms underlying the formation of one of the hindbrain segments, rhombomere (r) 3, specified by the expression of the gene krox20. Dissecting krox20 transcriptional regulation has identified several input pathways: Hox paralogous 1 (PG1) factors, which both directly activate krox20 and indirectly repress it via Nlz factors, and the molecular components of an Fgf-dependent effector pathway. These different inputs are channelled through a single initiator enhancer element to shape krox20 initial transcriptional response: Hox PG1 and Nlz factors define the anterior-posterior extent of the enhancer's domain of activity, whereas Fgf signalling modulates the magnitude of activity in a spatially uniform manner. Final positioning of r3 boundaries requires interpretation of this initial pattern by a krox20 positive-feedback loop, orchestrated by another enhancer. Overall, this study shows how positional information provided by different patterning mechanisms is integrated through a gene regulatory network involving two cis-acting elements operating on the same gene, thus offering a comprehensive view of the delimitation of a territory. PMID:25516974

Labalette, Charlotte; Wassef, Michel Adam; Desmarquet-Trin Dinh, Carole; Bouchoucha, Yassine Xavier; Le Men, Johan; Charnay, Patrick; Gilardi-Hebenstreit, Pascale

2015-01-01

448

Endoscopic submucosal dissection for colorectal neoplasms: A review.  

PubMed

The introduction of colorectal endoscopic submucosal dissection (ESD) has expanded the application of endoscopic treatment, which can be used for lesions with a low metastatic potential regardless of their size. ESD has the advantage of achieving en bloc resection with a lower local recurrence rate compared with that of piecemeal endoscopic mucosal resection. Moreover, in the past, surgery was indicated in patients with large lesions spreading to almost the entire circumference of the rectum, regardless of the depth of invasion, as endoscopic resection of these lesions was technically difficult. Therefore, a prime benefit of ESD is significant improvement in the quality of life for patients who have large rectal lesions. On the other hand, ESD is not as widely applied in the treatment of colorectal neoplasms as it is in gastric cancers owing to the associated technical difficulty, longer procedural duration, and increased risk of perforation. To diversify the available endoscopic treatment strategies for superficial colorectal neoplasms, endoscopists performing ESD need to recognize its indications, the technical issues involved in its application, and the associated complications. This review outlines the methods and type of devices used for colorectal ESD, and the training required by endoscopists to perform this procedure. PMID:25473168

Sakamoto, Taku; Mori, Genki; Yamada, Masayoshi; Kinjo, Yuzuru; So, Eriko; Abe, Seiichiro; Otake, Yosuke; Nakajima, Takeshi; Matsuda, Takahisa; Saito, Yutaka

2014-11-21

449

Amplification of multiple genomic loci from single cells isolated by laser micro-dissection of tissues  

Microsoft Academic Search

BACKGROUND: Whole genome amplification (WGA) and laser assisted micro-dissection represent two recently developed technologies that can greatly advance biological and medical research. WGA allows the analysis of multiple genomic loci from a single genome and has been performed on single cells from cell suspensions and from enzymatically-digested tissues. Laser micro-dissection makes it possible to isolate specific single cells from heterogeneous

Dan Frumkin; Adam Wasserstrom; Shalev Itzkovitz; Alon Harmelin; Gideon Rechavi; Ehud Shapiro

2008-01-01

450

Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head-and-Neck Squamous Cell Carcinoma  

SciTech Connect

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