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1

Superior mesenteric artery dissection: Case report  

Microsoft Academic Search

Spontaneous dissections of the superior mesenteric artery are exceptional events because only 26 reports have been published. We present a new case, revealed with an acute abdominal syndrome. Computed tomographic angiography and arteriography allowed a rapid diagnosis and urgent surgical intervention. Progress in imagery makes diagnosis and follow-up examination easier. Surgery is indicated for acute symptomatic forms with suspicion of

Yann Gouëffic; Alain Costargent; Marie-Françoise Heymann; Philippe Chaillou; Philippe Patra

2002-01-01

2

Superior mesenteric artery dissection: case report.  

PubMed

Spontaneous dissections of the superior mesenteric artery are exceptional events because only 26 reports have been published. We present a new case, revealed with an acute abdominal syndrome. Computed tomographic angiography and arteriography allowed a rapid diagnosis and urgent surgical intervention. Progress in imagery makes diagnosis and follow-up examination easier. Surgery is indicated for acute symptomatic forms with suspicion of mesenteric ischemia. In the other cases, a simple follow-up examination may be appropriate. PMID:12021719

Gouëffic, Yann; Costargent, Alain; Dupas, Benoît; Heymann, Marie-Françoise; Chaillou, Philippe; Patra, Philippe

2002-05-01

3

[Open submucosal dissection: first case described].  

PubMed

Endoscopic submucosal dissection is a new treatment, basically for the management of early gastric cancer, it is also a good option for large benign lesions if a "una pieza" resection needs to be performed. However this technique requires not only gastroenterologist with proven technical skill, but also some special devices not necessarily disposables in our country. The present paper describes the case of a patient with a large hyperplastic polyp located in the upper third of the stomach who underwent an open endoscopic submucosal dissection to resect the lesion owing to its size and characteristics. According our knowledge this is the first case in the medical literature describing the use of this technique during an open surgery. PMID:18183281

Portanova, Michel; Vesco, Eduardo; Morales, Domingo

2007-01-01

4

Spontaneous isolated superior mesenteric artery dissection - Report of two cases.  

PubMed

Two cases of isolated superior mesenteric artery dissection diagnosed by contrast enhanced 64 slice CT are reported. In both, the dissection was seen extending along the entire length of the artery with one of them showing partially thrombosed false lumen. One case was associated with dissection of left renal artery with consequent renal infarcts. Although superior mesenteric artery dissection is a rare phenomenon, it should be considered in the differential diagnosis of abdominal angina. PMID:22470682

Srinivasan, Kaliappan Gurusamy; Srividya, Saravanan; Ushanandhini, Premnath; Ramprabananth, Sivanandan

2009-01-01

5

A case report on asymptomatic ascending aortic dissection  

PubMed Central

Aortic dissection is a relatively rare but dreadful illness, often presenting with tearing chest pain and acute hemodynamic compromise. Early and accurate diagnosis and treatment are essential for survival. In the present review, a rare case of an asymptomatic ascending aortic dissection is reported. The general clinical manifestations, diagnosis and management of aortic dissection will also be reviewed.

Cohen, Ronny; Mena, Derrick; Carbajal-Mendoza, Roger; Arole, Olugbenga; Mejia, Jose O

2008-01-01

6

Virtual temporal bone dissection: a case study  

Microsoft Academic Search

The Temporal Bone Dissection Simulator is an ongoing research project for the construction of a synthetic environment suitable for virtual dissection of human temporal bone and related anatomy. Funded by the National Institute on Deafness and Other Communication Disorders (NIDCD), the primary goal of this project is to provide a safe, robust, and cost-effective virtual environment for learning the anatomy

Jason Bryan; Don Stredney; Gregory J. Wiet; Dennis Sessanna

2001-01-01

7

Functional neck dissection: an evaluation and review of 843 cases.  

PubMed

After briefly reviewing the principles, indications, and merits of functional neck dissection, the results of 1200 neck dissections performed on 843 patients in the period 1961-1979 are presented. They compare very favorably with those reported for classic (radical) neck dissection by other leading authors; however, a retrospective analysis of data derived from material of different origin is hardly possible and has a disputable value. Therefore, we decided to compare our data on functional neck dissections (FND) with those of classic neck dissections (CND) performed by the same surgical team at the same clinic in the period 1948-1960. The clinical material was largely the same in both cases, and the data were collected and analyzed using the same criteria. In both series, neck dissections were divided into elective and curative. It could be demonstrated that the number of neck recurrences observed in the dissected necks is the same for FND and CND in curative dissections, while it is considerably lower for FND in elective neck dissections. This of course does not prove improved radicality in FND, but only proves that a systematic bilateral elective neck dissection in N0 cases affords improved cancerological safety. This radical bilateral approach to regional lymph nodes is made possible routinely by FND which avoids the problems of unnecessary mutilation. The figures produced speak in favor of a wider adoption of FND especially for expanding the indications to elective treatment of regional lymph nodes in cancer of the head and neck. Elective neck dissection is made practically harmless by this newer technique and averts the dreadful appearance of late metastases in N0 cases. PMID:6738274

Bocca, E; Pignataro, O; Oldini, C; Cappa, C

1984-07-01

8

Isolated dissection of the celiac artery--a case report.  

PubMed

Isolated arterial dissection, which occurs with the absence of aortic dissection, has been reported in carotid and renal arteries but rarely in visceral arteries. A case of isolated celiac artery dissection is reported here. A healthy 58-year-old man experienced sudden upper abdominal pain, which continued for several days. A body computed tomogram (CT) showed a multiple low-density wedge-shaped area in the spleen, which was diagnosed as splenic infarction, and an aneurysm with thrombus in the celiac artery. A selective angiogram showed dilatation of the celiac artery with wall irregularity, and proximal occlusion of the hepatic artery. The distal hepatic artery was fed by collateral arteries from the superior mesenteric artery. Splenic infarction was probably due to the embolism from the thrombus in the dissected celiac artery. The absence of other vascular lesions and causes or risks for the arterial dissection would suggest the occurrence of spontaneous dissection. The dissection of visceral arteries should be considered in diagnosing acute abdominal pain. PMID:10917586

Matsuo, R; Ohta, Y; Ohya, Y; Kitazono, T; Irie, H; Shikata, T; Abe, I; Fujishima, M

2000-07-01

9

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.

2014-01-01

10

Spontaneous Celiac Artery Dissection Case Report and Literature Review  

PubMed Central

Symptomatic spontaneous celiac artery dissection is a rare condition that is being detected more often with the use of advanced imaging techniques. There is no consensus as to whether surgical or endovascular treatment is more appropriate. We describe the case of a 41-year-old hypertensive woman who presented with the sudden onset of sharp, persistent, right-upper-quadrant abdominal and epigastric pain. Magnetic resonance angiography of the abdomen revealed celiac artery dissection, with a flap compressing the lumen approximately 17 mm from the artery's origin at the aorta. Because of the patient's persistent epigastric pain, endovascular celiac artery stent implantation was performed with the use of 2 overlapping balloon-expandable stents. Twelve months after the procedure, the patient remained asymptomatic, and the stents were patent. This case and others in the medical literature suggest that endovascular treatment can be feasible in symptomatic patients with isolated spontaneous celiac artery dissection.

Obon-Dent, Mauricio; Shabaneh, Bahaeddin; Dougherty, Kathryn G.; Strickman, Neil E.

2012-01-01

11

Three-Dimensional CT in Isolated Dissecting Aneurysm of the Superior Mesenteric Artery: A Case Report  

Microsoft Academic Search

Isolated dissecting aneurysm of the superior mesenteric artery (SMA) without aortic dissection is a rare condition. We report a case of isolated dissecting aneurysm of the SMA incidentally detected by postcontrast abdominal computed tomography (CT). Three-dimensional CT using helical scanning was helpful for the evaluation of dissecting aneurysmal structures such as the intimal flap, true lumen, and false lumen with

Takao Sagiuchi; Yuuji Asano; Hisashi Yanaihara; Yuki Aoki; Reiko Woodhams; Kazushige Hayakawa

12

Dissection Dissected.  

ERIC Educational Resources Information Center

Discusses the role of dissection in science courses, examining essential lessons students can learn (such as developing an abiding respect for all forms of life, including the animal being dissected). Also presents a list of tips related to classroom dissection and comments on formaldehyde and formalin substitutes. (JN)

Berman, William

1984-01-01

13

A case report of postpartum acute coronary artery dissection  

Microsoft Academic Search

Spontaneous coronary artery dissection (SCAD) which was first described by Pretty in 1931 is rare but significant cause of myocardial infarction and sudden cardiac death. The incidence of this condition in general population is between 0.28% and 1.1%, however in pregnant population it accounts for 27% of all MI cases.1 Mode of presentation is variable and can range from asymptomatic

A Abouelela Morsy; S Meti

2010-01-01

14

Spontaneous Coronary Artery Dissection: Case Report and Review of Literature  

PubMed Central

Spontaneous coronary artery dissection (SCAD) is an unusual cause of acute coronary syndrome or sudden cardiac death. SCAD has most frequently been described as presenting as an acute coronary syndrome in females during the peripartum period. It may also be associated with autoimmune and collagen vascular diseases, Marfan's syndrome, chest trauma, and intense physical exercise. The most common presentation of SCAD is the acute onset of severe chest pain associated with autonomic symptoms. This condition has a high mortality rate if not identified and treated promptly. Here, we present a case of SCAD presenting with stroke, followed by a brief review.

Biswas, Monodeep; Sethi, Arjinder; Voyce, Stephen J.

2012-01-01

15

Dissecting Dissection.  

ERIC Educational Resources Information Center

This journal features articles covering various aspects of dissection. "Biology--The Study of Life" (George Russell) offers students experiments that do not require using invasive procedures. "Animal Cruelty--Behind the Scenes" (Zoe Weil) describes sources of laboratory animals. "Doing without Dissection" (Juliana Texley) discusses objections over…

AV Magazine, 1996

1996-01-01

16

Acute dissecting aortic aneurysm: community hospital experience in 20 cases.  

PubMed

Of 20 patients with dissecting aortic aneurysm managed at our community hospital, 16 had type A (ascending) dissection and four had type B (descending) dissection. Twelve of the patients with type A dissection were operated on; six of them survived and six died postoperatively. The remaining four patients with type A dissection had cardiopulmonary arrest and died before surgical intervention was attempted. All four patients with type B dissection were treated medically and all survived. Although acute aortic dissection is not commonly seen at community hospitals, expedient management of such patients can have a major impact on their survival. Patients at extreme risk are those with type A dissection, particularly those with cardiopulmonary arrest. PMID:2371604

Salem, B I; Selke, K; Gowda, S; Haikal, M; Coordes, C; Leidenfrost, R

1990-07-01

17

Spontaneous dissection of the superior mesenteric artery and the right hepatic artery: a case report  

Microsoft Academic Search

INTRODUCTION: Isolated spontaneous dissection of the superior mesenteric artery is a very rare condition. Endovascular stent placement has been proposed recently for selected cases, which has led to some good clinical results. CASE PRESENTATION: We report a case of spontaneous dissection of the superior mesenteric artery spreading to the origin of a right hepatic artery in a 48-year-old Chinese man.

Nicolas C Buchs; Pierre Charbonnet; Frank Schwenter; Christoph D Becker; Philippe Morel; Sylvain Terraz

2010-01-01

18

[Isolated spontaneous dissection of the superior mesenteric artery in two cases treated with conservative therapy].  

PubMed

We report two cases of isolated spontaneous dissection of the superior mesenteric artery (SMA). Both patients complained of abdominal pain with sudden onset and were given diagnoses of dissection of the SMA based on abdominal CT scanning. CT showed dissention of the SMA with thrombosis of the false lumen and narrowing of the true lumen. Therefore there were no symptoms of bowel ischemia, and after hospitalization both cases received conservative therapy with anticoagulation and antiplatelet therapy. Spontaneous dissection of the SMA without aortic dissection is very rare, and only 53 cases have been recorded in Japan. PMID:19578311

Furukawa, Daisuke; Dowaki, Shoichi; Izumi, Hideki; Okamoto, Yuichi; Imaizumi, Toshihide; Makuuchi, Hiroyasu

2009-07-01

19

Spontaneous renal artery dissection complicated by renal infarction: A case report and review of the literature  

PubMed Central

Introduction Renal artery dissection is a rare cause of abdominal pain. The renal arteries are the commonest site of primary dissection involving visceral vessels but spontaneous bilateral dissection is extremely rare. Presentation of case We present a case of spontaneous bilateral renal artery dissection in a previously fit 43-year-old man who presented with right iliac fossa pain. He was treated conservatively with anticoagulation for 6 months, with resolution of the dissections on imaging at 6-month follow-up. Discussion The presentation of spontaneous renal artery dissection is non-specific, making it a diagnostic challenge. Computed Tomography angiography is now the gold standard for diagnosis and follow-up of these patients. Conclusion This case highlights the importance of considering other causes of abdominal pain in a young man with normal initial investigations and the role of conservative management.

Katz-Summercorn, A.C.; Borg, C.M.; Harris, P.L.

2012-01-01

20

Alpha1Antitrypsin Deficiency-Associated Cervical Artery Dissection: Report of Three Cases  

Microsoft Academic Search

The pathogenesis of cervical artery dissection is poorly understood. Deficiency of the elastase inhibitor alpha-1-antitrypsin may represent a predisposing condition. Biochemical and genetic analyses in a series of 12 consecutive patients with spontaneous dissection of the neck vessels showed 3 cases associated to alpha-1-antitrypsin deficiency, in combination with transient precipitating factors. A disequilibrium between proteolytic enzymes and protease inhibitors may

Alessandro Pezzini; Mauro Magoni; Luciano Corda; Lara Pini; Daniela Medicina; Mario Crispino; Marco Pavia; Alessandro Padovani; Vittorio Grassi

2002-01-01

21

Isolated spontaneous dissection of the superior mesenteric artery treated by percutaneous stent placement: case report.  

PubMed

Acute ischemia due to spontaneous dissections of the superior mesenteric artery are uncommon events, with sporadic reports. Therapeutic options include clinical management, direct artery repair, bowel resection, and more recently, endovascular stenting. We present a case of abdominal pain due to superior mesenteric artery spontaneous isolated dissection treated with stent placement and with a favorable 31-month follow-up period. PMID:18178474

Casella, Ivan B; Bosch, Maria A; Sousa, Wilson O

2008-01-01

22

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

PubMed Central

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

Carlson, M; Silberbach, M

2007-01-01

23

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

PubMed Central

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.

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

2014-01-01

24

Carotid artery dissection secondary to seatbelt trauma: case report.  

PubMed

A postmortem report of a patient with traumatic internal carotid artery dissection, along with evidence strongly suggestive of a car seatbelt as a causative factor, is presented. In this 5-foot subject, the shoulder harness could have been high, over the anterior cervical area. The authors feel this mechanism deserves consideration as one of the important causes of traumatic carotid dissection. If supported by further studies, remedial measures in the form of changes in seatbelt design, or the use of alternate protective measures may be warranted. PMID:2342151

Reddy, K; Furer, M; West, M; Hamonic, M

1990-05-01

25

Case report on vertebral artery dissection in mixed martial arts.  

PubMed

A 41-year-old man presented to the ED with severe vertigo 2 days after a grappling injury while training in mixed martial arts. Imaging revealed a cerebellar infarct with complete occlusion of the right vertebral artery secondary to dissection. Management options are discussed as is the ongoing controversy regarding the safety of the sport. PMID:22487672

Slowey, Michael; Maw, Graeme; Furyk, Jeremy

2012-04-01

26

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.

Kang, Ung Rae; Lee, Young-Hwan

2013-01-01

27

Vertebral artery dissection presenting as a Brown-S?quard syndrome: a case report  

PubMed Central

Introduction Vertebral artery dissection has become increasingly recognized as an important cause of stroke. It usually presents with posterior headache or neck pain followed within hours or days by signs of posterior circulation stroke. To the best of our knowledge, the clinical presentation of a Brown-Séquard syndrome with a vertebral artery dissection has been reported only once before. Case presentation An otherwise healthy 35-year-old man presented with acute left-sided weakness. He had experienced left-sided posterior neck pain after a 4-hour flight 4 weeks previously. Physical examination was consistent with a left Brown-Séquard syndrome. Magnetic resonance angiography showed evidence of left vertebral artery dissection. He improved after therapy with anticoagulants. Conclusion We report a case of an unusual presentation of a relatively uncommon condition. This diagnosis should be considered early in relatively young patients with stroke-like symptoms or unexplained neck pain, because missing a dissection can result in adverse outcomes.

2009-01-01

28

Spontaneous coronary artery dissection in a young man - case report.  

PubMed

A 31 year old man with a 17-year-history of drug abuse (heroine and cannabis) was admitted with recurrent chest pain over a period of about three weeks. Chest discomfort severely worsened during the 5 hours before hospital admission. Electrocardiography revealed poor R-wave progression and non specific repolarization abnormalities. Echocardiography showed extensive left ventricular anterior and apical wall motion abnormalities and a ventricular thrombus located at the apex of the left ventricle was present. Subsequently, a diagnosis of acute coronary syndrome was made. Coronary angiography revealed spontaneous coronary artery dissection of the left anterior descending (LAD) artery with Thrombolysis In Myocardial Infarction (TIMI) flow 2 to 3. We managed the patient conservatively. The clinical course was uneventful and repeated angiography on day 4 demonstrated spontaneous healing of large parts of the dissection with TIMI 3 flow in the LAD. PMID:21371317

Schmid, Julia; Auer, Johann

2011-01-01

29

[Dissection of the ascending aorta in pregnancy. Apropos of a case and review of the literature].  

PubMed

Dissection of ascendant aorta is infrequent during pregnancy. Given this low prevalence, diagnosis is often delayed or even unrecognized. This delay in diagnosis can have a highly jeopardizing effect on vital maternal prognosis. In this study, we report a case of ascendant aorta dissection in the 3rd trimester of pregnancy with maternal and fetal survival through combined surgery of a cesarean section and replacement of the ascendant aorta. PMID:9417470

Bercau, G; Castaigne, V; Mihaileanu, S; Couetil, J P; Freund, M; Sauvanet, E

1997-01-01

30

Isolated, spontaneous superior mesenteric and celiac artery dissection: case report and review of literature.  

PubMed

Spontaneous, isolated dissection of the superior mesenteric artery (SMA) and celiac artery (CA) is rare. Although there are known risk factors, there is no particular mechanism that is common to vascular dissections. The objectives of this study were to review the current literature on diagnosis and treatment of isolated SMA and CA dissection, and to review aortic complications in giant cell arteritis, Takayasu arteritis, and polyarteritis nodosa. Giant cell arteritis, Takayasu arteritis, and polyarterteritis nodosa are vasculitides that are associated with SMA and CA dissection. An interesting aspect of this case is that the patient was a healthy person before presentation, and ultimately, did not have an underlying etiology to explain the dissection. In addition, the patient was successfully managed without operative intervention. Although there are known risk factors in patients who present with isolated, spontaneous SMA and CA dissection, the pathogenesis is still unclear. The prognosis has improved significantly with the early use of computed tomography angiography to diagnosis this entity. Although most cases require surgical intervention, there are some, as in this case, that are managed non-operatively. PMID:18996673

Kang, Tarina Lee; Teich, Douglas L; McGillicuddy, Daniel C

2011-02-01

31

[Traumatic dissection of the internal carotid artery by a safety belt: a report of two cases].  

PubMed

Traumatic internal carotid artery dissection secondary to blunt trauma is a rare event accounting for 0.08 to 0.4% of all traumatic lesions. The spectrum of traumatic lesions that can affect the internal carotid artery includes minor lesions like spasm, intimal tears, or mural contusions and serious lesions like pseudoaneurysms and complete occlusion. Delayed clinical presentation is typical and can include headache, hemiparesis, partial Horner's syndrome, and cranial nerve palsy. Embolization secondary to the dissection can have devastating effects because it may cause ischemic stroke. Traumatic internal carotid artery dissection after safety belt trauma is very rare; it is usually due to direct cervical trauma on the side of the shoulder fixation point, which causes external bruising along the pathway of the safety belt. We present two cases of traumatic internal carotid artery dissection with concomitant cerebral infarcts caused by safety belts; we discuss the clinical, diagnostic, and therapeutic aspects of this lesion. PMID:19828398

López-Sánchez, M; Ballesteros-Sanz, M A; Pérez-Ceballos, A; González-Fernández, C; López-Espadas, F

2009-10-01

32

Paraplegic Neurodeficit Management Post Endovascular Graft: A Rare Case of Aortic Dissection  

PubMed Central

Acute aortic dissection is a catastrophic episode that usually presents as a sudden, painful, ripping sensation in the chest or back. It is associated with neurologic sequelae in as many as one-third of patients. We report a case of aortic dissection, presenting as acute paraplegia. A 50-year-old patient presented to us with chief complaints of paraplegia and back pain. On examination, strength was 5/5 in both upper extremities and 0/5 in both lower extremities. Deep tendon reflexes were absent in her legs. CT angiogram of aorta Aortic Dissection Stanford type B / De-Bakey type –III. Patient was treated with endovascular graft for aortic dissection, paraplegia recovered completely.

Kanse, Vilas Yadavarao; Chongtham, Dhanaraj Singh; Nemichandra, S C; Salam, Kenny Singh

2013-01-01

33

Delayed presentation of carotid dissection, cerebral ischemia, and infarction following blunt trauma: two cases  

Microsoft Academic Search

Carotid artery dissection followed by cerebral infarction as a result of blunt trauma can occur in a number of forensically relevant situations. We describe two such cases. In the first case, a 19-year-old female was involved in a road traffic accident, when her car crashed into the rear of another car. Initially, the young woman presented a minor head injury

J Blanco Pampin; N Morte Tamayo; R Hinojal Fonseca; J. J Payne-James; P Jerreat

2002-01-01

34

Isolated Spontaneous Dissection of the Celiac Artery: Report of Two Cases  

PubMed Central

Isolated spontaneous dissection of the celiac artery (DCA) is extremely rare and its therapeutic strategy is still not established. We report two cases of DCA, in which 58-year-old and 43-year-old male patients with right hypogastralgia and back pain, respectively, were diagnosed by enhanced computed tomography and treated conservatively with antihypertensive agents. They were doing well under circumspect medical management without recurrence of symptoms or progression of dissection after 3.5 years and 3 months, respectively, after detection of DCA. Conservative treatment with blood pressure control and careful surveillance is considered to be applicable in most cases of DCA.

2014-01-01

35

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

36

Spontaneous dissection of the superior mesenteric artery as a rare cause of acute abdomen: report of two cases.  

PubMed

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare condition. Here we report 2 cases of spontaneous SMA dissection causing acute abdomen. Bowel infarction did not occur in either case despite total occlusion or severe stenosis of the SMA;we successfully managed isolated SMA dissection without surgical intervention. Our nonoperative management regimen for spontaneous SMA dissection consisted of intestinal rest with fasting, administration of a vasodilator, and blood pressure control. Surgical intervention should be unnecessary unless complications, such as intestinal infarction and abdominal angina, occur. PMID:19571903

Totsugawa, Toshinori; Kuinose, Masahiko; Ishida, Atsuhisa; Tamaki, Takahiko; Yoshitaka, Hidenori; Tsushima, Yoshimasa

2009-06-01

37

[The dissecting aortic aneurysm associated with polymyalgia rheumatica: a case report].  

PubMed

We report a patient with a dissecting aortic aneurysm associated with polymyalgia rheumatica (PMR). The patient is a 55-year-old Japanese man without a history of hypertension, diabetes mellitus and syphilis. He was admitted to an emergency hospital because of severe back pain, and was diagnosed as having a dissecting aneurysm of the descending aorta. After the admission, he began to notice severe muscle pain in his bilateral shoulder. Although his back pain gradually improved, his muscle pain progressively worsened, and his lower extremities were also involved. Then, he was introduced to our hospital. On neurological examination, he was alert and oriented. His cranial nerves were all intact. There was no muscle weakness nor sensory disturbance. Laboratory studies revealed that his erhythrocyte sedimentation rate was extremely high without elevation of the serum level of creatine phoshpokinase, rheumatoid factors and c-reactive protein. He was diagnosed as having PMR, and oral administration of prednisolone++ was started. Within several days, his muscle pain dramatically disappeared. As is known, there is a close relationship between PMR and temporal arteritis of giant cell arteritis. In general, PMR is a benign disease and responds well to steroid therapy, and prevalence of the giant cell arteritis is low in Japanese people. However, it should be kept in mind that the dissecting aneurysm is a relevant, severe complication of PMR because arteritis can be latently present in PMR. PMID:10654301

Iroi, A; Miwa, H; Iijima, M; Fukae, J; Hatori, K; Tanaka, S; Yano, T; Mizuno, Y

1999-12-01

38

Surgical treatment of spontaneous dissection of the superior mesenteric artery: a case report.  

PubMed

A case of a 46-year-old man with spontaneous dissection of the superior mesenteric artery (SMA) demonstrated by ultrasonography is presented. He was successfully treated by emergency aorto-SMA bypass surgery, but complicated with bilateral internal iliac aneurysm. The patient has remained asymptomatic with full employment. PMID:10748364

Iha, K; Nakasone, Y; Nakachi, H; Horikawa, Y; Gushiken, M; Matsuda, H

2000-02-01

39

Dissection of the left main coronary artery after blunt thoracic trauma: Case report and literature review  

PubMed Central

Blunt chest trauma is commonly encountered by surgeons and is rarely associated with cardiac injuries. The incidence of cardiac injury is rare but can be rapidly fatal, requiring prompt recognition and treatment. We review the case of a 37 year-old male who was involved in a head-on motor vehicle collision at highway speed and was found to have an isolated left main coronary artery dissection. We then review the supporting literature for evaluation of blunt cardiac injuries and the treatment options for traumatic coronary dissection.

2010-01-01

40

A case of an aortic dissection in a young adult: a refresher of the literature of this "great masquerader"  

PubMed Central

Aortic dissection is often misdiagnosed, especially among young patients, and it is associated with a high mortality rate. We present here a case of fatal acute aortic dissection in a young man who was misdiagnosed with pericarditis. We reviewed the literature of acute aortic dissection in young people and we focused particularly on clinical presentations, outcomes and investigations of aortic dissection. We report a case of a 33-year-old man with a history of uncontrolled hypertension with acute pleuretic chest pain who was transferred to our hospital for suspected pulmonary embolism and died of acute hemorragic pericardial effusion from an ascendant aortic dissection. We should never rule out aortic dissection off our differential diagnosis on the sole basis of a patient’s young age.

Pineault, Jerome; Ouimet, Denis; Pichette, Vincent; Vallee, Michel

2011-01-01

41

Pregnancy-related Spontaneous Coronary Artery Dissection: Two Case Reports and a Comprehensive Review of Literature  

PubMed Central

Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome, particularly seen in women during pregnancy or in the puerperium. It has a high acute phase mortality. The etiology is uncertain. Hormonal changes during pregnancy, hemodynamic stress and changes in the autoimmune status have been considered as possible etiological factors. A timely diagnosis and institution of appropriate treatment is important for a successful outcome. There is no consensus of opinion for optimal treatment. Conservative management, coronary artery bypass graft surgery, and percutaneous coronary intervention, all have been described in the literature as possible therapeutic options. Spontaneous coronary artery dissection should be considered as a differential in any young woman presenting with chest pain associated with pregnancy. We report two cases of pregnancy-associated spontaneous coronary artery dissection, both successfully managed, along with a comprehensive review of the previously published literature.

Sheikh, Azeem S; O'Sullivan, Michael

2012-01-01

42

[A case of spontaneous dissection of the superior mesenteric artery treated by percutaneous stent placement].  

PubMed

Acute mesenteric ischemia can result from emboli, arterial and venous thrombi or vasoconstriction secondary to low-flow states. Isolated spontaneous dissection of the superior mesenteric artery is a rare cause of acute mesenteric ischemia. The mortality rates of acute mesenteric ischemia averages 71% with a range of 59-93%. Diagnosis before the occurrence of intestinal infarction is the most important factor in improving survival rate for patients with acute mesenteric ischemia. A 68-year-old female presented with postprandial epigastric pain, and a dissection of the superior mesenteric artery and a gallbladder polyp were shown in abdominal computed tomographic scan. After the percutaneous metalic stent placement and laparoscopic cholecystectomy, her symptoms improved. We report a case of spontaneous dissection of main trunk of the superior mesenteric artery which was successfully treated by percutaneous stent placement with a review of literature. PMID:16498285

Ko, Geun Jun; Han, Ki Jun; Han, Seo Goo; Hwang, Sang Yon; Choi, Chang Hwan; Gham, Chang Woo; Cho, Hyeon Geun; Song, Soon-Young; Jung, Jin Ho

2006-02-01

43

Dissecting peripheral superior cerebellar artery aneurysms: Report of two cases and review of the literature  

PubMed Central

Background: Only a limited number of dissecting aneurysms of the peripheral cerebellar arteries have been previously described, and very few of these cases involve the superior cerebellar artery (SCA). Due to the rarity of these lesions, there is little consensus regarding prognosis and management. We describe our experience with two cases of complex peripheral SCA dissecting aneurysms and review the existing literature on this fascinating entity. Case Description: Two patients, both with SCA dissecting aneurysms not amenable to endovascular treatment underwent microsurgical clipping, one with the associated removal of a tentorial meningioma. In each procedure a combined subtemporal, presigmoidal approach was performed. Surgical clips were utilized to reconstruct the aneurysms, and both patients were discharged without complication. Surgical management of complex distal SCA fusiform aneurysm is challenging and options include wrap/clip reconstruction, proximal occlusion, trapping, and distal outflow occlusion. When possible, preservation of the parent artery is preferred to mitigate the risk of brainstem infarction. If proximal occlusion or trapping are employed, we have advocated for the use of combined distal revascularization techniques to prevent permanent ischemic damage of the brainstem and cerebellar hemisphere. Conclusions: Peripherally dissecting aneurysm of the SCA is an uncommon entity. Management of these lesions is best handled by an experienced neuro-endovascular team combined with a neurovascular surgeon skilled in skull base approaches.

Nussbaum, Eric S.; Defillo, Archie; Zelensky, Andrea; Stoller, Richard; Nussbaum, Leslie

2011-01-01

44

Concurrent basilar artery double fenestration with aneurysm and vertebral artery dissection: case report and literature review of rare cerebrovascular abnormalities.  

PubMed

Many disorders can cause aneurysm and/or dissection of the cerebral arteries, including fibromuscular dysplasia (FMD), connective tissue disorders, cerebral vasculitis, infection, and vascular malformations. Arterial fenestration is a rare congenital finding that can also cause aneurysms, and can rarely dissect and bleed. Treatment of aneurysm and dissection with subarachnoid hemorrhage can be very complicated, and requires case-by-case analysis of the risks and benefits of antithrombotic therapy. To the authors' knowledge, no case of double fenestration of the basilar artery has been reported. This report presents a case of concurring vertebral artery dissection and double fenestration of the basilar artery with aneurysm. The fenestration and FMD are considered possible main contributing causes of this presentation. A literature review of cerebrovascular fenestration and FMD is provided and the relationship between the 2 is considered. Lastly, the use of antithrombotic therapy in the setting of subarachnoid hemorrhage, dissection, and stent placement is discussed. PMID:23548267

Stark, Madeline M; Skeik, Nedaa; Delgado Almandoz, Josser E; Crandall, Benjamin M; Tubman, David E

2013-05-01

45

A Case of Acute Ischemic Duodenal Ulcer Associated with Superior Mesenteric Artery Dissection After Transarterial Chemoembolization for Hepatocellular Carcinoma  

SciTech Connect

We report a case of transarterial chemoembolization (TACE)-related acute ischemic duodenal ulcer that developed in association with dissection of the superior mesenteric artery. We conclude that the acute duodenal ulcer was developed by ischemia related to superior mesenteric artery dissection during TACE. TACE should be conducted carefully with continuous observation of abdominal arteries.

Jang, Eun Sun; Jeong, Sook-Hyang, E-mail: jsh@snubh.org; Kim, Jin Wook; Lee, Sang Hyub [Seoul National University Bundang Hospital, Department of Internal Medicine, College of Medicine (Korea, Republic of); Yoon, Chang Jin; Kang, Sung Gwon [Seoul National University Bundang Hospital, Department of Radiology (Korea, Republic of)

2009-03-15

46

Natural history of a spontaneous dissecting aneurysm of the proximal superior mesenteric artery: Report of a case  

Microsoft Academic Search

We report herein the case of a 44-year-old man in whom an asymptomatic dissecting aneurysm was found in the proximal part of the superior mesenteric artery (SMA) during a preoperative evaluation for colon cancer. The patient was managed conservatively with blood pressure control during the perioperative period of the colon resection as the false lumen of the dissecting aneurysm was

Katsutoshi Nakamura; Mutsumi Nozue; Yuzuru Sakakibara; Kenmei Kuramoto; Masato Satoh; Sei Kobayashi; Hiromasa Kashimura; Hisayuki Fukutomi; Takeshi Todoroki; Katashi Fukao

1997-01-01

47

A Case of Acute Ischemic Duodenal Ulcer Associated with Superior Mesenteric Artery Dissection After Transarterial Chemoembolization for Hepatocellular Carcinoma  

Microsoft Academic Search

We report a case of transarterial chemoembolization (TACE)-related acute ischemic duodenal ulcer that developed in association with dissection of the superior mesenteric artery. We conclude that the acute duodenal ulcer was developed by ischemia related to superior mesenteric artery dissection during TACE. TACE should be conducted carefully with continuous observation of abdominal arteries.

Eun Sun Jang; Sook-Hyang Jeong; Jin Wook Kim; Sang Hyub Lee; Chang Jin Yoon; Sung Gwon Kang

2009-01-01

48

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

49

Isolated dissection of the superior mesenteric artery after living donor liver transplantation: a case report.  

PubMed

Isolated dissection of the superior mesenteric artery (SMA) not associated with aortic dissection is rare, particularly after living donor liver transplantation (LDLT). We experienced a case of isolated dissection of the SMA after LDLT performed in a 56-year-old man diagnosed with hepatitis B virus-related cirrhosis and hepatocellular carcinoma within the Milan criteria. He had no past history of hypertension or diabetes mellitus. At 6 days after LDLT, the patient underwent an emergency portal vein thrombectomy with ligation of a huge left gastric vein shunt. Thereafter anticoagulant and antiplatelet therapy were initiated. At 12 days after LDLT, a contrast-enhanced computer assisted tomography (CT) scan revealed the presence of a thrombus in a false lumen and a thin flap enlarged in the SMA. Because he presented neither abdominal pain nor biochemical data suggesting mesenteric ischemia, he was treated with antihypertensive agents in addition to anticoagulant and antiplatelet therapy. The thrombus in the false lumen was reduced and the intimal flap in the SMA disappeared according to the results of a CT scan 4 months after LDLT. He has remained free of symptoms for 4 years. The strategy to treat isolated SMA dissection is not well established. Urgent surgery is indicated for acute symptomatic forms with a suspicion of mesenteric ischemia; conservative treatment is indicated for patients with minimal, resolving, or no pain, but requires close follow-up. PMID:22410076

Kokai, H; Sato, Y; Yamamoto, S; Oya, H; Kobayashi, T; Watanabe, T; Miura, K; Hatakeyama, K

2012-03-01

50

MRI-GUIDED DISSECTION OF THE NONHUMAN PRIMATE BRAIN: A CASE STUDY  

PubMed Central

Numerous biochemical as well as electrophysiological techniques require tissue that must be retrieved very quickly following death in order to preserve the physiological integrity of the neuronal environment. Therefore, the ability to accurately predict the precise locations of brain regions of interest (ROI) and to retrieve those areas as quickly as possible following the brain harvest is critical for subsequent analyses. One way to achieve this objective is the utilization of high resolution MRI scans to guide the subsequent dissections. In the present study, individual MRI scans of the brains of rhesus and cynomolgus macaques that had chronically self-administered ethanol were employed in order to determine which blocks of dissected tissue contained specific ROIs. MRI-guided brain dissection of discrete brain regions was completely accurate in 100% of the cases. In comparison, approximately 60–70% accuracy was achieved in dissections that relied on external landmarks alone without the aid of MRI. These results clearly demonstrate that the accuracy of targeting specific brain areas can be improved with high-resolution MR imaging.

Daunais, James Bernard; Kraft, Robert Arthur; Davenport, April Teresa; Burnett, Elizabeth J; Vicki Moser Maxey, A.S.; Kendall Thomas, Szeliga; Rau, Andrew Ryan; Graham Stallard, Flory; Hemby, Scott Edwards; Christopher David, Kroenke; Grant, Kathleen Alice; Friedman, David Paul

2009-01-01

51

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.

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

2013-01-01

52

Is it renal colic or ruptured dissecting aneurysm of renal artery?: A case report  

PubMed Central

Introduction The dissecting aneurysm of renal artery is a form of renal artery occlusive disease that is infrequently recognized in the literature. However, when encountered, it is of great clinical significance because symptoms related to aneurysm are rarely seen and there is risk of its rupture. Case Presentation The present case was a 30 year old Indian male, who presented with recurrent episodes of pain mimicking renal colic, which turned out to be a ruptured dissecting aneurysm of renal artery on exploration. The patient could not be salvaged due to delay in the diagnosis. Conclusion This report highlights that rupture of renal artery aneurysm is a rare but potentially lethal clinical entity and should be considered as one of the differential diagnosis in patients with severe and persistent renal colicky type of pain in the absence of obvious findings on routine investigations.

2009-01-01

53

The pitfalls of premature closure: clinical decision-making in a case of aortic dissection  

PubMed Central

Premature closure is a type of cognitive error in which the physician fails to consider reasonable alternatives after an initial diagnosis is made. It is a common cause of delayed diagnosis and misdiagnosis borne out of a faulty clinical decision-making process. The authors present a case of aortic dissection in which premature closure was avoided by the aggressive pursuit of the appropriate differential diagnosis, and discuss the importance of disciplined clinical decision-making in the setting of chest pain.

Kumar, Bharat; Kanna, Balavenkatesh; Kumar, Suresh

2011-01-01

54

[Isolated spontaneous dissection of the superior mesenteric artery: a case report].  

PubMed

We report the case of a 38-year-old man admitted at the emergency department for abdominal pain of abrupt onset. Computed tomographic examination revealed a spontaneous isolated dissection of the superior mesenteric artery and an anevrysm of the coeliac artery caused by the arcuate ligament. Outcome was favorable under conservative medical treatment and a three months follow-up was uneventful. This observation offers the opportunity to present recent insights concerning this pathology. PMID:18308290

Ghuysen, A; Meunier, P; Van Damme, H; Creemers, E; D'orio, V

2008-08-01

55

An isolated dissecting: aneurysm of the superior mesenteric artery: report of a case  

Microsoft Academic Search

We report herein the case of a 56-year-old man found to have an isolated dissecting aneurysm of the superior mesenteric artery (SMA) after he presented with a 3-day history of postprandial epigastralgia of sudden onset. An echogram showed marked dilatation of the SMA and a high level of peripheral echoes in a linear fashion within its lumen. A thin-section contrast

Takafumi Ambo; Yoshikazu Noguchi; Hiroyuki Iwasaki; Jiro Kondo; Akihiko Matsumoto; Hideaki Suzuki; Yutaro Takamura

1994-01-01

56

Endovascular management for isolated spontaneous dissection of the superior mesenteric artery: report of two cases and literature review.  

PubMed

The clinical course and treatment strategies of isolated superior mesenteric artery (SMA) dissection have not been fully investigated. Two cases of uncontrolled abdominal pain caused by isolated SMA dissection were successfully treated with percutaneous endovascular stent placement. At follow-up 6 months later, computed tomography confirmed that the lesions had stabilized. The patients remained symptom free at 14- and 13-month follow-up, respectively. The present report describes these two cases of isolated SMA dissection treated successfully with percutaneous endovascular stent placement, along with a review of the related literature. PMID:21801996

Lim, Eun-Hye; Jung, Sung Woo; Lee, Seung Hwa; Kwon, Bo Sung; Park, Jae Youn; Koo, Ja Seol; Yim, Hyung Joon; Lee, Sang Woo; Choi, Jai Hyun

2011-08-01

57

Extensive intracranial involvement with multiple dissections in a case of giant cell arteritis.  

PubMed

A 56-year-old man presented with weight loss, articular pain and minor neurological symptoms progressing over 1 month. Neurosonological evaluation suggested occlusion in intracranial segments of the left vertebral artery (VA) and of both internal carotid arteries (ICA) and hypoechoic halo sign in both superficial temporal arteries. The diagnosis of giant cell arteritis was supported by inflammatory markers and confirmed by biopsy. Despite early steroid initiation, he manifested fluctuant vascular deficits and became lethargic. Brain MRI indicated watershed infarcts and intracranial dissections of left VA and both ICA. The patient was stabilised with the association of prednisolone 2 mg/kg, methotrexate and oral anticoagulation. Since then he has been neurologically asymptomatic and control imaging showed only residual intracranial left VA stenosis, with no signs of temporal artery inflammation or new vascular lesions. This is to the best of our knowledge, the first reported clinical case with such an extensive intracranial involvement with multiple dissections. PMID:24728901

Parra, Joana; Domingues, Joana; Sargento-Freitas, João; Santana, Isabel

2014-01-01

58

[A case of superficial esophageal basaloid squamous cell carcinoma resected by endoscopic submucosal dissection].  

PubMed

A woman in her 70s visited our hospital to undergo endoscopy. Esophagogastroduodenoscopy showed a white submucosal tumor-like lesion in the upper esophagus. Analysis of a biopsy specimen revealed that the tumor was a basaloid squamous cell carcinoma. A superficial squamous cell carcinoma was also revealed near the basaloid squamous cell carcinoma before endoscopic submucosal dissection. Curative en bloc resection was successfully performed. Histopathological examination revealed that the basaloid and superficial squamous cell carcinomas had invaded the lamina propria (pT1a-LPM) and epithelium (pT1a-EP), respectively. In addition, the basaloid squamous cell carcinoma had two different components in terms of malignancy and differentiation. Here we report a rare case of esophageal basaloid squamous cell carcinoma resected by endoscopic submucosal dissection. PMID:24898489

Nosaka, Takuto; Suto, Hiroyuki; Matsuda, Hidetaka; Takahashi, Kazuto; Ohtani, Masahiro; Hiramatsu, Katsushi; Nemoto, Tomoyuki; Imamura, Yoshiaki; Nakamoto, Yasunari

2014-06-01

59

A surgical case of paraclinoid carotid aneurysm associated with ipsilateral cervical internal carotid artery dissection.  

PubMed

This report presents a 60-year-old with a large paraclinoid carotid aneurysm associated with cervical interal carotid artery (ICA) dissection (CICAD). She had a fall while riding a bicycle and hit her head on the ground. Computed tomography scan done at another facility showed a round mass lesion near the sella. Her medical history revealed gradual decrease in left eye vision since two years. Left carotid artery digital subtraction angiography demonstrated a CICAD with an intimal flap and a large paraclinoid aneurysm (15.5 mm in size). She underwent a high-flow bypass with a so-called double-insurance bypass and proximal ligation of the cervical ICA and the postoperative course was uneventful. She was discharged without any new neurological deficits. We suggest that the possible nature of carotid artery dissection (CAD)-related hemodynamic changes should be taken into consideration in cases of intracranial aneurysm associated with CAD. PMID:23135031

Takeuchi, Satoru; Wada, Kojiro; Sakakibara, Fumihiro; Mori, Kentaro

2012-01-01

60

Intraoperative thrombectomy for occluded carotid arteries in patients with acute aortic dissection: report of two cases.  

PubMed

The present study describes two cases in which intraoperative thrombectomy was performed for occluded or severely stenosed carotid arteries in patients with acute aortic dissection complicated by cerebral malperfusion. A Fogarty catheter was inserted into the true lumen of the occluded branch under hypothermic circulatory arrest, and thrombi within the false lumen were removed. The arch vessels were patent on subsequent computed tomographic imaging, and no neurological complications were found postoperatively. In these cases, the choice of appropriate management strategies took into consideration the brain ischemic time and the presence or absence of cerebral infarction. This technique represents a useful option for the management of this clinical scenario. PMID:23463538

Igarashi, Takashi; Takahashi, Shoichi; Takase, Shinya; Yokoyama, Hitoshi

2014-06-01

61

A case of vertebral artery dissection associated with morning blood pressure surge.  

PubMed

We report a case of a middle-aged man who suffered a cerebral infarction resulting from dissection of a vertebral artery associated with morning blood pressure surge. A 56-year-old man was transferred to our hospital with dizziness and vomiting in the early morning on a cold day in winter. He reported that he had been standing in front of the sink after bathing when he suddenly felt dizzy and fell down. He did not lose consciousness, and by the time he reached the hospital by ambulance, his dizziness had subsided, but he complained of severe headache and vomited 3 times. On admission, he was alert, and there were no neurological or radiological abnormalities (CT, MR angiography) in the brain. However, infarction in the left cerebellar hemisphere was detected by brain MRI on the 5th day of hospitalization. String sign of the left vertebral artery was noted by angiography, confirming the diagnosis of dissection of the left vertebral artery. Ambulatory blood pressure monitoring was performed after discharge. Although the mean 24-h blood pressure was in the normal range, a marked morning blood pressure rise was observed. We speculated that the acute rise of blood pressure in the early morning might have contributed to the dissection of the vertebral artery. PMID:16471179

Eguchi, Kazuo; Tachikawa, Yuichi; Kashima, Ryuichi; Shinohara, Michi; Fukushima, Fumiya; Sato, Takashi; Takeda, Akira; Numao, Toshio; Numao, Toshiro; Kario, Kazuomi; Shimada, Kazuyuki

2005-10-01

62

Endovascular Management for Isolated Spontaneous Dissection of the Superior Mesenteric Artery: Report of Two Cases and Literature Review  

Microsoft Academic Search

The clinical course and treatment strategies of isolated superior mesenteric artery (SMA) dissection have not been fully investigated. Two cases of uncontrolled abdominal pain caused by isolated SMA dissection were successfully treated with percutaneous endovascular stent placement. At follow-up 6 months later, computed tomography confirmed that the lesions had stabilized. The patients remained symptom free at 14- and 13-month follow-up,

Eun-Hye Lim; Sung Woo Jung; Seung Hwa Lee; Bo Sung Kwon; Jae Youn Park; Ja Seol Koo; Hyung Joon Yim; Sang Woo Lee; Jai Hyun Choi

2011-01-01

63

Endovascular management of a spontaneous dissecting aneurysm of the superior mesenteric artery: case report and discussion of treatment options.  

PubMed

Spontaneous dissection of the superior mesenteric artery represents a rare cause of abdominal angina. Conservative or more aggressive treatments such as surgery or endovascular therapy depend on the symptoms. We present a case report of acute mesenteric ischemia due to spontaneous dissection of the superior mesenteric artery successfully treated by endovascular stent placement. In the discussion we review the different alternatives of treatment presented in the literature. PMID:19467830

Baldi, Sebastián; Zander, Tobias; Rabellino, Martín; Maynar, Manuel

2009-01-01

64

A Case of Acute Ischemic Duodenal Ulcer Associated with Superior Mesenteric Artery Dissection After Transarterial Chemoembolization for Hepatocellular Carcinoma  

Microsoft Academic Search

We report a case of transarterial chemoembolization (TACE)-related acute ischemic duodenal ulcer that developed in association\\u000a with dissection of the superior mesenteric artery. We conclude that the acute duodenal ulcer was developed by ischemia related\\u000a to superior mesenteric artery dissection during TACE. TACE should be conducted carefully with continuous observation of abdominal\\u000a arteries.

Eun Sun Jang; Sook-Hyang Jeong; Jin Wook Kim; Sang Hyub Lee; Chang Jin Yoon; Sung Gwon Kang

2009-01-01

65

Percutaneous endovascular treatment for isolated spontaneous superior mesenteric artery dissection: report of two cases and literature review.  

PubMed

Isolated spontaneous superior mesenteric artery (SMA) dissection is a rare and sporadically reported condition. Therapeutic options include medical treatment, surgery, and endovascular treatment. However, the optimal treatment strategy has still not been established. We herein present two patients with acute abdomen due to isolated spontaneous SMA dissection, in whom symptoms remained despite initial anticoagulation therapy. Percutaneous endovascular treatment with stenting of the dissected main trunk to achieve complete coverage of the entry site and balloon angioplasty for the distally involved side branches were performed successfully and resulted in complete resolution of the symptoms. According to our experience and previous case reports, early (within 1 week) elective percutaneous endovascular intervention with background anticoagulation therapy is a feasible and effective treatment strategy for symptomatic patients with isolated SMA dissection. PMID:19156877

Wu, Xue-Ming; Wang, Tzung-Dau; Chen, Ming-Fong

2009-02-01

66

Isolated, Spontaneous Superior Mesenteric and Celiac Artery Dissection: Case Report and Review of Literature  

Microsoft Academic Search

Spontaneous, isolated dissection of the superior mesenteric artery (SMA) and celiac artery (CA) is rare. Although there are known risk factors, there is no particular mechanism that is common to vascular dissections. The objectives of this study were to review the current literature on diagnosis and treatment of isolated SMA and CA dissection, and to review aortic complications in giant

Tarina Lee Kang; Douglas L. Teich; Daniel C. McGillicuddy

2011-01-01

67

Dissecting Pseudoaneurysm of the Proper Hepatic Artery Repaired by Primary Anastomosis: A Case Report  

PubMed Central

Background. Although rare, visceral artery pseudoaneurysms often present as surgical emergencies with a specific mortality rate as high as 35% related to aneurysmal rupture. Risk factors for the development of iatrogenic pseudoaneurysms include anticoagulation, female gender, obesity, and vessel calcification. Case Report. We present a case of an elderly female who developed a dissecting pseudoaneurysm of the proper hepatic artery after undergoing routine surgery to resect a large duodenal adenoma. Surgical repair comprised of resection and primary anastomosis was employed resulting in a favourable outcome. Discussion/Conclusion. Surgical management reduces the risk of hepatic ischemia, biliary complications, and abscess formation. Although stenting, coil embolization, and thrombin injection are all plausible options for management, we propose that surgical reconstruction be considered seriously as a treatment for such spontaneous pseudoaneurysms.

Razik, Roshan; Fallah, Aria; Sandroussi, Charbel; Wei, Alice C.; McGilvray, Ian D.

2012-01-01

68

Spontaneous dissection of the superior mesenteric artery in four cases treated with anticoagulation therapy.  

PubMed

Reports of spontaneous dissection of the superior mesenteric artery are rare. Diagnosis in the acute stage has been considered difficult, but we encountered four cases from November 1998 to November 2001. All four cases were diagnosed using abdominal CT scanning in the acute stage and could be treated conservatively. All patients were provided anticoagulation therapy upon fasting. The mean period of continuous abdominal pain was 10.2 days, the mean period of fasting was 27.2 days, and the mean number of in-hospital days was 44.5. There is no established opinion on treatment, but conservative treatment is considered possible if there are no symptoms or if it has not been aggravated. PMID:15283182

Nagai, Takayuki; Torishima, Ryutaro; Uchida, Akihiro; Nakashima, Hiroshi; Takahashi, Kenji; Okawara, Hitoshi; Oga, Masatoshi; Suzuki, Koji; Miyamoto, Shinji; Sato, Ryugo; Murakami, Kazunari; Fujioka, Toshio

2004-06-01

69

Ultrasound of the sural nerve: normal anatomy on cadaveric dissection and case series.  

PubMed

The sural nerve is a small sensory nerve innervating the lateral aspect of the ankle and foot. Clinical symptoms of pathology may present as atypical sensory changes in this region. We present the normal anatomy and ultrasound technique for examination of the sural nerve based on an anatomical dissection, as well as imaging in a normal volunteer. We also present a case series (n=10) of different conditions of the sural nerve that we encountered based on a review of interesting cases from 4 institutions. The pathological conditions included neuropathy related to stripping or venous laser surgery, compression by abscess, Lyme disease, nerve tumors, traumatic transsection, and encasement by fibrous plaque and edema. Ultrasound with its exquisite resolution is the preferred imaging method for examining the sural nerve in patients with unexplained sensory changes at the lateral aspect of the ankle and foot. PMID:23809918

Belsack, Dries; Jager, Tjeerd; Scafoglieri, Aldo; Vanderdood, Kurt; Van Hedent, Eddy; Vanhoenacker, Filip; Marcelis, Stefaan; De Maeseneer, Michel

2013-11-01

70

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.

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

2013-01-01

71

Spontaneous dissection of the celiac trunk: a rare cause of abdominal pain--case report and review of the literature.  

PubMed

Spontaneous dissection of the celiac trunk is uncommon and rarely considered in patients presenting with acute onset of epigastric pain. We report the case of a 48-year old male, diagnosed with a spontaneous dissection of the celiac trunk extending towards the common hepatic artery. He was treated conservatively and remained asymptomatic after two years of follow-up. Conservative treatment seems justified in the absence of bowel ischemia or signs of hemorrhage. Initial Computed Tomography angiography revealed the presence of a dissection with a pseudoaneurysm that remained stable and regressed towards a normal Computed Tomography angiography after 7 months of follow-up. Radiologic follow-up is warranted as progression of the dissection and/or total occlusion with or without symptoms can occur. The risk factors, the natural course and optimal treatment remain unclear due to the rarity of the disorder. Our patient had no predisposing cardiovascular risk factors. Nevertheless, we observed a hypertrophic ligamentum arcuatum on Computed Tomography, possibly facilitating the evolution towards a dissection. Next to the case report, we provide a review of the available literature. PMID:24261029

Schrijvers, Rik; Van De Mierop, Frank; De Schepper, Bart; Sprengers, Dirk; Dero, Isabel; D'Archambeau, Olivier; Botelberge, Thomas

2013-09-01

72

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

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; Lee, Yoon-Soo; Suh, Sang-Jun; Lee, Jeong-Ho; Ryu, Kee-Young; Kang, Dong-Gee

2014-06-01

73

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.

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

2014-01-01

74

Vocal cord paralysis secondary to spontaneous internal carotid dissection: case report and systematic review of the literature  

PubMed Central

Objectives To present a rare case of unilateral vocal cord paralysis (VCP) secondary to spontaneous internal carotid artery dissection and to perform a literature review. Case report A 35-year-old male presented to the emergency department with acute onset hoarseness and dysphagia. History, physical exam and laryngoscopy revealed left sided VCP without obvious cause. Magnetic Resonance Imaging (MRI) demonstrated a left internal carotid artery dissection of unknown etiology. Neurovascular surgery was consulted and treatment with aspirin was initiated. The dysphagia and hoarseness resolved in 12 weeks with long-term neurosurgery follow-up as the management plan. Methods Systematic literature review was conducted by 3 independent reviewers. Since 1988 only 9 cases of VCP due to internal carotid artery dissection have been reported. These were reviewed for: demographics, diagnostic method, treatment and vocal cord function. Results 7 patients had unilateral while 2 had bilateral VCP. MRI was used for diagnosis in 7 cases and 5 cases utilized a type of angiography. All received antithrombotic treatment with 5 out of the 9 patients experiencing vocal cord recovery in an average of 7.2 weeks. Conclusion MRI is crucial in the work-up of idiopathic VCP. If an ipsilateral internal carotid artery dissection is found, antithrombotic treatment is initiated with an expectation that vocal cord mobility is likely to return.

2013-01-01

75

Recurrent Spontaneous Esophageal Dissection  

PubMed Central

Introduction: Spontaneous esophageal dissection is a rare disorder of the esophagus. Case Description: We present what is believed to be the first reported case of recurrent esophageal dissection in a previously healthy 33-year-old man with chronic eosinophilic esophagitis. He had two episodes of spontaneous dissection of the midesophagus separated by a 5-month interval. Both episodes responded to treatment with endoscopic intervention. He has remained free of additional recurrences after definitive endoscopic therapy and oral steroid therapy. A complete description of the case, relevant radiologic imaging, and a review of the relevant literature are provided. Discussion: Endoscopic therapy is an option for the management of recurrent esophageal dissection.

Stephens, Nicholas A.; Walker, Peter A.; Jayanty, Vikram; Raijman, Isaac; Khalil, Kamal

2014-01-01

76

Chylorrhea following laparoscopy assisted distal gastrectomy with D1+ dissection for early gastric cancer: A case report?  

PubMed Central

INTRODUCTION Chylorrhea is a form of lymphorrhea involving digested lipid products absorbed in the small intestine. Here we report a rare case of chylorrhea after laparoscopy-assisted distal gastrectomy (LADG) with D1+ dissection that resolved following administration of a low-fat diet. PRESENTATION OF CASE A 35-year-old woman with early gastric cancer underwent LADG with D1+ dissection, and on postoperative day 4, the drain output increased and the fluid with a high triglyceride level (740 mg/dL) changed from clear to milky. On postoperative day 6, oral intake of a low-fat diet was initiated after a 2-day fast, and the daily drain output decreased from postoperative day 9. The drain tube was withdrawn on postoperative day 15, and the patient was discharged on postoperative day 17. DISCUSSION D1+ dissection does not typically cause injury to the lymphatic trunks, cisterna chyli, or thoracic duct. The maximum output of chylous ascites was minimal, and thus, we assumed that chylorrhea occurred from slightly injured lymphatics with anatomical variation. CONCLUSION Chylorrhea after LADG with D1+ dissection is very rare. The fasting of our case followed by a low-fat diet without TPN would be an effective therapy. As a result, our case recovered favorably without further therapy.

Yamada, Takanobu; Jin, Yasuyuki; Hasuo, Kimiatsu; Maezawa, Yukio; Kumazu, Yuta; Rino, Yasushi; Masuda, Munetaka

2013-01-01

77

A type A aortic dissection missed by non-cardiac gated contrast-enhanced computed tomography due to an aortic root dissection flap masquerading as an aortic valve apparatus: a case report  

PubMed Central

Introduction Though computed tomographic angiography has very high sensitivity and specificity to diagnose acute aortic dissection, false-negative studies can occur and secondary tests may be required to make the diagnosis. Case presentation We report the case of a 57-year-old Caucasian man with a typical presentation for acute type A aortic dissection in whom the initial non-cardiac gated computed tomographic angiogram was negative, leading to a delay in surgical management. Transesophageal echocardiography and post hoc 3D reconstruction of the original computed tomographic scan revealed a dissection flap confined to the aortic root, immediately superior to the sinuses of Valsalva and masquerading as part of the aortic valve apparatus. Conclusion This case demonstrates that false-negative computed tomographic angiograms taken to rule out type A aortic dissection can occur and that secondary imaging tests, such as echocardiography, should be performed in cases in which the pre-test probability of aortic dissection is high. Cardiac gating of computed tomographic angiograms to exclude aortic dissection may enhance diagnostic accuracy.

2013-01-01

78

Endovascular stent placement for isolated spontaneous dissection of the superior mesenteric artery: report of a case.  

PubMed

Spontaneous dissection of the superior mesenteric artery (SMA) is rare and has been reported only sporadically. The therapeutic options are either a surgical approach, which is the most frequently adopted, or simple observation. We present a patient with acute abdominal pain due to superior mesenteric artery dissection who was successfully treated by percutaneous endovascular stent placement. PMID:16485545

Miyamoto, Noriyuki; Sakurai, Yasuo; Hirokami, Mitsugu; Takahashi, Kuniyuki; Nishimori, Hiroyuki; Tsuji, Kunihiko; Kang, Jong-Hon; Maguchi, Hiroyuki

2005-11-01

79

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.

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

2014-01-01

80

Fatal Aortic Dissection in a Patient with Giant Cell Arteritis: A Case Report and Review of the Literature  

PubMed Central

Giant cell arteritis may lead to catastrophic, large-vessel complications from chronic vascular wall inflammation without prompt diagnosis and treatment. We describe a rare case of acute aortic dissection without preceding aneurysm secondary to histologically confirmed giant cell arteritis (GCA) in an 85-year-old female with a four-year history of polymyalgia rheumatica and temporal arteritis diagnosed per biopsy six months prior to presentation. The literature is reviewed and the clinical implications of this case are discussed.

Nayar, Anjeli K.; Casciello, Michael; Slim, Jennifer N.; Slim, Ahmad M.

2013-01-01

81

Traumatic internal carotid artery dissection associated with playing soccer: a case report.  

PubMed

Soccer, one of the most popular sports worldwide among young men, can result in a wide range of orthopedic injuries. Although vascular injuries such as dissection occur rarely, they can cause significant mortality if left undiagnosed. We report herein a 31-year-old male who suffered a large middle cerebral artery infarction due to traumatic internal carotid artery dissection after a ball struck his head and neck. He recovered with mild neurologic deficit after decompressive surgery. PMID:21935841

Ta?c?lar, Nida; Ozen, Banu; Aç?kgöz, Mustafa; Ekem, Süreyya; Ac?man, Esra; Gül, Sanser

2011-07-01

82

A Case Report of Aneuysmectomy after Thrombo-Intimectomy for Spontaneous Isolated Superior Mesenteric Artery Dissection  

PubMed Central

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.

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

2012-01-01

83

Brainstem ischemic stroke without permanent sequelae during the course of spontaneous internal carotid artery dissection - case 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.

Nesteruk, Tomasz; Nesteruk, Marta; Bulik-Pasinska, Marta; Boroszko, Dariusz; Ostrowska, Monika

2012-01-01

84

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

PubMed

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

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

2014-03-01

85

[Acute aortic dissection induced by autonomic dysreflexia; report of a case].  

PubMed

Autonomic dysreflexia can occur in patients with spinal cord injury and lead to excessive hypertension. A 61-year-old man who had been treated for spinal cord injury 28 years before in an accidental fall, was admitted with an acute aortic dissection and underwent replacement of ascending aorta. He had been injured the 6th cervical neurologic level and he had not been given regular medical care. His incident of aortic dissection during defecation might related to the elevation of blood pressure due to autonomic dysreflexia. PMID:23917059

Ono, Kimiyo; Kuroda, Hiroaki

2013-06-01

86

A case of severe acute pancreatitis and ischemic gastropathy caused by acute aortic dissection.  

PubMed

A 49-year-old man presented with chest pain and was given a diagnosis of aortic dissection based on computed tomography (CT) findings. Two days later the dissection reached the origin of the celiac artery and there was poor blood flow from the body to the tail of the pancreas and fundus of the stomach wall. Severe acute pancreatitis developed. Endoscopy showed a near-circumferential gastric ulcer in the gastric cardia and we diagnosed ischemic gastropathy. A fistula between the area of infected pancreatic necrosis and the stomach had formed spontaneously and the necrotic tissue was draining into the stomach. His recovery was uneventful. PMID:21212601

Umeda, Ikumi; Hayashi, Tsuyoshi; Ishiwatari, Hirotoshi; Yoshida, Makoto; Miyanishi, Kouji; Sato, Yasushi; Kofune, Masayoshi; Takimoto, Risyu; Kato, Junji; Meguro, Makoto; Hirata, Kouichi

2011-01-01

87

A Case of Effective Cerebrospinal Fluid Drainage for Paraplegia Caused by Acute Aortic Dissection  

PubMed Central

A 65-year-old man with sudden back pain was transferred to our hospital by ambulance, who also complained of sensory and motor disorder of bilateral legs on arrival. The neurological disorder was gradually aggravated and paraplegia below the level of Th10 was manifested. Computed tomography demonstrated DeBakey IIIb acute aortic dissection; therefore, the paraplegia was thought to be due to spinal cord ischemia caused by the acute aortic dissection. Emergent cerebrospinal fluid drainage was performed, and it was very effective for the relief from paraplegia. The hospital course after the drainage was uneventful and he was discharged on the 39th day after the onset of symptoms.

Hayatsu, Yukihiro; Nagaya, Koichi; Sakuma, Kei; Nagamine, Susumu

2011-01-01

88

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

89

Extracapsular dissection of pleomorphic adenoma in the parotid gland: A case report and review of the literature  

PubMed Central

Salivary gland tumors comprise of less than 3% of all tumors of the head and neck region. Pleomorphic adenoma represents 45 to 74% of all these salivary gland tumors and 65% of them occur in the parotid gland. Owing to the close proximity of this tumor to the facial nerve, there have been various techniques for surgical management of this tumor in the literature. Extracapsular dissection of pleomorphic adenoma is a conservative treatment modality which spares the handling of facial nerve. We are reporting a case of extracapsular dissection of pleomorphic adenoma in the lower pole of the superficial lobe of the parotid gland in a 22 year-old Indian male with a 1-year follow-up.

Gupte, Shreyas; Sorathia, Rakesh; Shetye, Angad; Shinde, Swapnil

2014-01-01

90

A Case of Right Sinus of Valsalva Rupture with Dissection into Interventricular Septum Causing Left Ventricular Outflow Tract Obstruction  

PubMed Central

Sinus of Valsalva aneurysm (SVA) is an uncommon anomaly of the aorta. Rupture of SVA often precipitates dramatic clinical complications, including heart failures. Right SVAs are the most common type, and when they rupture, they usually rupture into the right ventricle or right atrium. Rupture into left ventricle or interventricular septum is rare. Herein, we report a case of right SVA rupture with dissection into interventricular septum, which produced significant left ventricular outflow tract obstruction and aortic regurgitation. The case was successfully treated by surgical operation.

Lee, Dong Hyun; Kang, Eun-Ju; Park, Tae-Ho; Woo, Jong Soo; Hong, Sook Hee

2013-01-01

91

Surgical intervention for isolated dissecting aneurysm of the superior mesenteric artery--a case report.  

PubMed

A 44-year-old man with abdominal pain was diagnosed as having a spontaneous isolated dissection of the superior mesenteric artery. The patient was successfully treated with endoaneurysmorrhaphy 5 months after the onset and has been symptom free 15 months after surgery. In view of the excellent surgical outcome in the literature, surgical intervention for this rare pathology should be considered. PMID:15490047

Tsuji, Yoshihiko; Hino, Yutaka; Sugimoto, Koji; Matsuda, Hitoshi; Okita, Yutaka

2004-01-01

92

Prevalence of Post-tonsillectomy Bleeding as Day-case Surgery with Combination Method; Cold Dissection Tonsillectomy and Bipolar Diathermy Hemostasis  

PubMed Central

Objective Post-tonsillectomy hemorrhage remains an important factor in determining the safety of performing tonsillectomy as a day case procedure. The aim of this study was to determine the safety of day case tonsillectomy by using combination method, cold dissection tonsillectomy and bipolar diathermy hemostasis. Methods A prospective randomized clinical study conducted on the patients who had undergone day case tonsillectomy (DCT). There were two groups (DCT and control group) each group consisting of 150 cases. Tonsillectomy was performed by using combination method; cold dissection and hemostasis was achieved by ligation of vessels with bipolar electerocautery. Findings We found 3 cases of post-tonsillectomy bleeding in DCT group and 4 cases in the control group. There was no statistically significant difference in the rate of post-operative hemorrhage between the two groups. Conclusion The findings suggest the safety of the combination of cold dissection tonsillectomy and bipolar diathermy hemostasis as day case tonsillectomy.

Faramarzi, Abolahassan; Heydari, Seyed Taghi

2010-01-01

93

Vertebral artery dissection caused by swinging a golf club: case report and literature review.  

PubMed

Vertebral artery (VA) dissection caused by swinging a golf club is extremely rare, and the mechanism of the dissection has not been elucidated. A 39-year-old man suddenly felt sharp neck pain and dizziness when he swung a driver while playing golf and visited our clinic. Imaging studies showed acute right cerebellar infarction and complete occlusion of the right VA at the C2 (axis) level. After 1 month of 100 mg aspirin treatment, the occluded right VA was completely recanalized and the patient became totally asymptomatic. Professional golfers look at the position of the ball on the ground or tee until completion of their follow-through. However, some amateur golfers look in the direction that the ball travels at the beginning of their follow-through. It is hypothesized that this rapid disproportionate head rotation produces VA elongation and distortion, mainly at the C2 level, causing stenosis or occlusion of the artery. PMID:24056473

Yamada, Shoko M; Goto, Yoshiaki; Murakami, Mineko; Hoya, Katsumi; Matsuno, Akira

2014-03-01

94

A case of effective cerebrospinal fluid drainage for paraplegia caused by acute aortic dissection.  

PubMed

A 65-year-old man with sudden back pain was transferred to our hospital by ambulance, who also complained of sensory and motor disorder of bilateral legs on arrival. The neurological disorder was gradually aggravated and paraplegia below the level of Th10 was manifested. Computed tomography demonstrated DeBakey IIIb acute aortic dissection; therefore, the paraplegia was thought to be due to spinal cord ischemia caused by the acute aortic dissection. Emergent cerebrospinal fluid drainage was performed, and it was very effective for the relief from paraplegia. The hospital course after the drainage was uneventful and he was discharged on the 39th day after the onset of symptoms. PMID:23555433

Hayatsu, Yukihiro; Nagaya, Koichi; Sakuma, Kei; Nagamine, Susumu

2011-01-01

95

Management of spontaneous isolated dissection of the superior mesenteric artery: Case report and literature review  

Microsoft Academic Search

Background and method  The aim of this study was to assess retrospectively the clinical presentation, management and outcome of three patients with\\u000a isolated SMA dissection encountered at Okinawa Prefectural Chubu Hospital, Japan from 2005 to 2006, along with a review of\\u000a the literature. We follow up the patient's clinical symptoms and the image by using enhanced dynamic CT at 1 week,

Morihiro Katsura; Hidemitsu Mototake; Hiroaki Takara; Kazuhide Matsushima

2011-01-01

96

[Acute type a aortic dissection with birt-hogg-dubé syndrome;report of a case].  

PubMed

We describe a 76-year-old woman with cardiac tamponade who was admitted to our hospital. She underwent ascending and partial arch aortic replacement to treat acute type A aortic dissection. However, postoperative respiratory failure developed and a chest X-ray revealed right lung pneumothorax. The lung was finally expanded after difficulties with prolonged tube drainage. Chest computed tomography(CT) showed multiple cystic changes in the bilateral lungs. Her sister and her daughter also had a history of spontaneous pneumothorax. We finally diagnosed Birt-Hogg-Dube syndrome after deoxyribonucleic asid(DNA)sequencing of folliculin( FLCN) gene. PMID:24917291

Sakaguchi, Masayuki; Gotou, Hirohisa; Nakahara, Takashi; Fuke, Megumi; Nishimura, Kazunori; Kuraishi, Hiroshi; Furuya, Mitsuko

2014-05-01

97

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.

Grant, Rhode I.

98

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

99

Spontaneous Dissection of the Superior Mesenteric Artery  

Microsoft Academic Search

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection [1]. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of

Patrick J. Sheldon; James B. Esther; Elana L. Sheldon; Steven R. Sparks; David P. Brophy; Steven B. Oglevie

2001-01-01

100

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

PubMed Central

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

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

2014-01-01

101

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

PubMed

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

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

2014-01-20

102

Endoscopic submucosal dissection for early gastric cancer in cases preoperatively contraindicated for endoscopic treatment  

PubMed Central

Background and study aims Endoscopic submucosal dissection (ESD) is an optimal treatment for early gastric cancer (EGC) with negligible risk of lymph node metastasis; however, ESD is sometimes performed to treat lesions preoperatively contraindicated for the procedure due to various reasons. Here we aim to evaluate the treatment outcomes of ESD for lesions that were preoperatively contraindicated for ESD. Patients and methods Clinicopathological data of 104 EGC lesions in 104 patients were reviewed retrospectively. The demographic characteristics of patients, reasons for ESD, treatment results, complications, and outcomes were assessed. Results The major reasons for undergoing ESD included advanced age, desire to undergo ESD, and the existence of comorbidities. En-bloc and complete resection rates were 97 and 71%, respectively. Perforation and postoperative bleeding rates were 13 and 9%, respectively. Resection was beyond the expanded Japanese criteria for endoscopic treatment of EGC in 87 patients (84%), 41 (47%) of whom underwent additional therapy, including subsequent gastrectomy (29 patients) and photodynamic therapy (12 patients). The median follow-up period was 47 months, during which seven patients died from recurrent disease. The 5-year overall and disease-specific survival rates were 70 and 91.5%, respectively. Conclusions ESD is a technically demanding procedure for lesions preoperatively contraindicated for endoscopic resection. The curative resection rate was low, but the 5-year disease-specific survival rate of 91.5% was favourable. In experienced hands, ESD may be a treatment option for patients not suitable for radical surgery, and the relevant risk of complications must be considered before treatment.

Hagiwara, Tomoko; Tanaka, Masaki; Sawai, Hiroaki; Kawata, Noboru; Takizawa, Kohei; Imai, Kenichiro; Takao, Toshitatsu; Hotta, Kinichi; Yamaguchi, Yuichiro; Matsubayashi, Hiroyuki; Ono, Hiroyuki

2013-01-01

103

Paper dissection  

NSDL National Science Digital Library

Students are provided with a dinosaur article from a popular magazine (e.g. Discover or Natural History) or the journal Science. Their task is to dissect the article distinguishing evidence from interpretation. They need to recognize the various hypotheses presented and also evaluate the strength of these ideas. Then during classroom discussion, they explore the implications of their dissections. For example they would address some of the following questions: Are other interpretations possible? Where have the authors over interpreted the evidence? What are the strongest interpretations? How could the ideas be further tested? What type of evidence would be sufficient to falsify or further support the interpretations of the papers?

Varricchio, David

104

A case of endovascular treatment for followed by side to side bypass for vertebral artery dissecting aneurysms involved posterior inferior cerebellar artery.  

PubMed

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; Yoon, Byul Hee; Park, Moon Sun; Kim, Seong Min

2014-01-01

105

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.

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

2014-01-01

106

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

107

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).

Wood, Olga

2012-06-27

108

Spontaneous Dissection of the Superior Mesenteric Artery  

SciTech Connect

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection [1]. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of SMA dissection [2-5]. We present two recent cases of spontaneous SMA dissection in which enhanced spiral CT was instrumental in following the disease process and guiding clinical decision making.

Sheldon, Patrick J. [Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States); Esther, James B. [Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, CC308E, One Deaconess Road, Boston, MA 02215 (United States); Sheldon, Elana L. [Department of Medicine, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States); Sparks, Steven R. [Department of Surgery, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States); Brophy, David P. [Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, CC308E, One Deaconess Road, Boston, MA 02215 (United States); Oglevie, Steven B. [Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 (United States)

2001-09-15

109

Spontaneous dissection of the superior mesenteric artery.  

PubMed

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection [1]. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of SMA dissection [2-5]. We present two recent cases of spontaneous SMA dissection in which enhanced spiral CT was instrumental in following the disease process and guiding clinical decision making. PMID:11815839

Sheldon, P J; Esther, J B; Sheldon, E L; Sparks, S R; Brophy, D P; Oglevie, S B

2001-01-01

110

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

PubMed

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

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

2010-04-15

111

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.

Plotnick, Roy

112

Dissection of the left main coronary artery after blunt thoracic trauma: Case report and literature review  

Microsoft Academic Search

Blunt chest trauma is commonly encountered by surgeons and is rarely associated with cardiac injuries. The incidence of cardiac injury is rare but can be rapidly fatal, requiring prompt recognition and treatment. We review the case of a 37 year-old male who was involved in a head-on motor vehicle collision at highway speed and was found to have an isolated

Mollie M James; Marnix Verhofste; Cass Franklin; Greg Beilman; Charles Goldman

2010-01-01

113

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

ERIC Educational Resources Information Center

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

Koichu, Boris; Kontorovich, Igor

2013-01-01

114

An Unusual Case of Traumatic Internal Carotid Artery Dissection during Snowboarding  

PubMed Central

The presentation of Horner’s syndrome following blunt trauma is uncommon, but is of important clinical significance. Identification of the constellation of signs of Horner’s syndrome should, therefore, prompt urgent neuro-radiologic imaging. Early diagnosis and initiation of appropriate treatment can lead to excellent outcomes in the majority of cases and prevent devastating cerebral ischaemic damage. A progressive case of Horner’s syndrome following blunt injury to the neck in an amateur snowboarder is presented. Key points Blunt injury to the neck can result in Horner’s syndrome. Horner’s syndrome should alert clinicians to the possibility of a silent ICAD. MRI and MRA of the head and neck constitute the imaging modality of choice to look for ICAD. The treatment of choice for ICAD is anticoagulation for 3-6 months.

Kalantzis, George; Georgalas, Ilias; Chang, Bernard Y.P.; Ong, Chin; El-Hindy, Nabil

2014-01-01

115

An Unusual Case of Traumatic Internal Carotid Artery Dissection during Snowboarding.  

PubMed

The presentation of Horner's syndrome following blunt trauma is uncommon, but is of important clinical significance. Identification of the constellation of signs of Horner's syndrome should, therefore, prompt urgent neuro-radiologic imaging. Early diagnosis and initiation of appropriate treatment can lead to excellent outcomes in the majority of cases and prevent devastating cerebral ischaemic damage. A progressive case of Horner's syndrome following blunt injury to the neck in an amateur snowboarder is presented. Key pointsBlunt injury to the neck can result in Horner's syndrome.Horner's syndrome should alert clinicians to the possibility of a silent ICAD.MRI and MRA of the head and neck constitute the imaging modality of choice to look for ICAD.The treatment of choice for ICAD is anticoagulation for 3-6 months. PMID:24790504

Kalantzis, George; Georgalas, Ilias; Chang, Bernard Y P; Ong, Chin; El-Hindy, Nabil

2014-05-01

116

Three cases of Spontaneous Vertebral Artery Dissection (SVAD), resulting in two cases of Wallenberg syndrome and one case of Foville syndrome in young, healthy men.  

PubMed

First patient, presented with sudden onset of headache, left hypoacusia and right hemiparesis, posteriorly developing gaze-evoked nystagmus and worsening right-sided weakness. Diagnosis of vertebral artery dissection and Foville Syndrome were made through clinical assessment and CT-carotid angiogram-MR angiography. Second patient, presented with four episodes of pain over left side of the nose and left eye pain over 1 month; admitted for acute facial pain without limb weakness. During admission, tingling over V1/V2 facial territory, vertigo, hypotension, uvula deviation and right lower limb numbness. CT-carotid angiogram confirmed vertebral artery with dissection. MRI revealed left lateral medullary infarct. Third patient, presented with sudden onset of left facial numbness and right upper limb weakness; 1 day after, right arm and leg hypoesthesia with hoarseness. MRA revealed dissection of left distal vertebral artery and MRI showed infarction in lower medulla oblongata. PMID:24777086

Canepa Raggio, Carlo; Dasgupta, Aban

2014-01-01

117

Case of isolated lateral lymph node recurrence occurring after TME for T1 lower rectal cancer treated with lateral lymph node dissection: report of a case.  

PubMed

We experienced a rare case of isolated lateral lymph node (LLN) recurrence after laparoscopic intersphincteric resection with total mesorectal excision for T1 lower rectal cancer that was successfully treated using LLN dissection with en bloc resection of the left superior vesical artery, the left ovary and the left obturator nerve, artery and vein. There are no guidelines for treating patients with isolated LLN recurrence because isolated LLN recurrence is rare, especially in patients with T1 rectal cancer. However, in patients with pT1N0 lower rectal cancer, follow-up examinations of the pelvis should be performed periodically. Patients with isolated LLN recurrence treated with surgery might have good long-term prognoses. Therefore, for such patients, surgical resection should be considered as a curative treatment only. PMID:22832928

Sueda, Toshinori; Noura, Shingo; Ohue, Masayuki; Shingai, Tatsushi; Imada, Shinya; Fujiwara, Yoshiyuki; Ohigashi, Hiroaki; Yano, Masahiko; Tomita, Yasuhiko; Ishikawa, Osamu

2013-07-01

118

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.

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

2014-01-01

119

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

PubMed Central

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

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

2007-01-01

120

[Paraplegia associated with acute aortic dissection complicated with pulmonary embolism and re-dissection].  

PubMed

Paraplegia associated with acute aortic dissection is one of the most serious complications. We experienced a case of Stanford type A acute aortic dissection with paraplegia and cardiac tamponade because the dissection was already thrombosed, conservative therapy was chosen. After drainage of pericardial effusion, a spinal drainage tube was inserted. Eleven days later, pulmonary embolism and re-dissection occurred, and an emergency operation was performed. Although the operation was successful, paraplegia did not improve. Even if type A acute aortic dissection is complicated with paraplegia, early surgical repair of aortic dissection should be considered, when paraplegia does not improve rapidly in spite of treatment. PMID:19999086

Murakami, H; Makuuchi, H; Chikada, M; Kobayashi, T; Suzuki, T; Ando, T; Oono, M; Ono, H; Chiba, K; Nagata, T

2009-12-01

121

Intraarterial thrombolysis and stent placement in the acute phase of blunt internal carotid artery trauma with subocclusive dissection and thromboembolic complication: case report and review of the literature.  

PubMed

The case of a patient with blunt traumatic internal carotid artery dissection associated with subocclusive stenosis and thromoboembolic complication is presented. The patient suffered fluctuant neurological abnormalities and several open and closed fractures of the left limb. The vascular lesion and its complication were successfully treated with intraarterial thrombolysis and stent placement during the acute phase, prior to the open surgical treatment of the fractures. PMID:15864475

Fateri, F; Groebli, Y; Rüfenacht, D A

2005-05-01

122

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

123

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.

2013-01-01

124

Traumatic internal carotid artery dissection.  

PubMed

Traumatic internal carotid artery dissection is a serious condition that may cause ischemic stroke in young patients. It has been under-diagnosed in the past. We present three cases of traumatic internal carotid artery dissection. The clinical manifestations include hemicrania, hemiparesis, partial Horner's syndrome and cranial nerve palsy. Diagnosis is with carotid color Doppler ultrasound, CT angiography of the neck and conventional angiography. The outcome may be poor with hemiparesis, persistent vegetative state and death. We review the literature and discuss the clinical presentation, diagnosis, grading and treatment choices for traumatic internal carotid artery dissection and stroke. PMID:16410213

Yang, Shun-Tai; Huang, Yin-Cheng; Chuang, Chi-Cheng; Hsu, Peng-Wei

2006-01-01

125

[Coronary artery dissection after blunt chest trauma: subacute and chronic phase assessment by intravascular ultrasonography: a case report].  

PubMed

A 35-year-old man sustained a steering wheel injury in a motor vehicle accident. Initial electrocardiography showed ST-segment elevation. Coronary angiography revealed a dissection of the right coronary artery and perfusion delay in the left anterior descending artery. Coronary stents were inserted into the left anterior descending artery. One month later, coronary angiography and intravascular ultrasonography showed that the dissection of the right coronary artery was still present. Coronary stents were inserted from the aorto-ostial lesion to the mid portion of the right coronary artery. Six months later, coronary angiography and intravascular ultrasonography revealed diffuse neointimal hyperplasia inside all of the stents, and the aorto-ostial stent had severe stenosis with perfusion delay. Severe neointimal hyperplasia was found inside the stents used for repair of the coronary artery dissection. PMID:15188611

Fujii, Noriyuki; Hase, Mamoru; Tsuchihashi, Kazufumi; Nishizato, Kimio; Kurimoto, Yoshihiko; Asai, Yasufumi; Shimamoto, Kazuaki

2004-05-01

126

[Intravascular echocardiography (ICUS) diagnosis of post-traumatic coronary dissection involving the common trunk. A case report and review of the literature].  

PubMed

A case is reported in which a 31-years-old man experienced coronary artery dissection with an acute anterior myocardial infarction following blunt chest trauma in a car accident. Due to ECG signs of acute myocardial infarction a coronary angiography was performed showing an abrupt occlusion of the mid part of the left anterior descending artery and a linear filling defect in the proximal portion of the vessel. Additional detailed intravascular ultrasound was performed, revealing a long intimal tear involving the left anterior descending artery and the left main. The patient underwent immediate coronary artery bypass surgery. Two vein grafts were made from aorta to the left anterior descending artery and the circumflex artery, respectively. Repeat angiography was performed early after the operation; dissection of the left main and the left anterior descending artery was still visible and the grafts to the left descending artery and the circumflex were patent. PMID:10514963

Morocutti, G; Spedicato, L; Vendrametto, F; Bernardi, G

1999-09-01

127

Traditional electrosurgery and a low thermal injury dissection device yield different outcomes following bilateral skin-sparing mastectomy: a case report  

PubMed Central

Introduction Although a skin- and nipple-sparing mastectomy technique offers distinct cosmetic and reconstructive advantages over traditional methods, partial skin flap and nipple necrosis remain a significant source of post-operative morbidity. Prior work has suggested that collateral thermal damage resulting from electrocautery use during skin flap development is a potential source of this complication. This report describes the case of a smoker with recurrent ductal carcinoma in situ (DCIS) who experienced significant unilateral skin necrosis following bilateral skin-sparing mastectomy while participating in a clinical trial examining mastectomy outcomes with two different surgical devices. This unexpected complication has implications for the choice of dissection devices in procedures requiring skin flap preservation. Case presentation The patient was a 61-year-old Caucasian woman who was a smoker with recurrent DCIS of her right breast. As part of the clinical trial, each breast was randomized to either the standard of care treatment group (a scalpel and a traditional electrosurgical device) or treatment with a novel, low thermal injury dissection device, allowing for a direct, internally controlled comparison of surgical outcomes. Post-operative follow-up at six days was unremarkable for both operative sites. At 16 days post-surgery, the patient presented with a significant wound necrosis in the mastectomy site randomized to the control study group. Following debridement and closure, this site progressively healed over 10 weeks. The contralateral mastectomy, randomized to the alternative device, healed normally. Conclusion We hypothesize that thermal damage to the subcutaneous microvasculature during flap dissection may have contributed to this complication and that the use of a low thermal injury dissection device may be advantageous in select patients undergoing skin- and nipple-sparing mastectomy.

2011-01-01

128

Spontaneous Dissection of the Superior Mesenteric Artery  

Microsoft Academic Search

Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic\\u000a dissection [1]. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the\\u000a natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis\\u000a of

Patrick J. Sheldon; James B. Esther; Elana L. Sheldon; Steven R. Sparks; David P. Brophy; Steven B. Oglevie

2001-01-01

129

[Isolated spontaneous dissection of visceral arteries].  

PubMed

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

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

2014-01-01

130

[Traumatic internal carotid artery dissection associated with triathlon: a rare differential diagnosis].  

PubMed

Most cervical artery dissections occur spontaneously, but traumatic mechanisms can occasionally be identified. Traumatic internal carotid artery dissection has been attributed with several sports, but there are no reports of its occurrence in thriathlon. We report the case of a 63-year-old semi-professional triathlete, who noticed right-sided neck pain and parietooccipital headache after a triathlon competition. Neurological examination revealed an incomplete right Horner's syndrome. MRI and MR-angiography demonstrated a right-sided internal carotid artery dissection with segmental loss of flow-signal and a mural haematoma in the vessel wall. In this case two pathophysiological mechanisms may be considered. Our patient reported receiving several blows to the neck in a congested 50-metre pool during the triathlon swimming stage. Furthermore, the hyperextended position of the neck during the subsequent cycling stage may have contributed, to a large extent, to the arterial dissection. The risk factors, presenting symptoms, diagnosis of internal carotid artery dissection are reviewed. PMID:16369912

Sparing, R; Hesse, M D; Schiefer, J

2005-12-01

131

Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature.  

PubMed

Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases. PMID:24967021

Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

2014-02-01

132

Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature  

PubMed Central

Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases.

Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

2014-01-01

133

Aortic dissection associated with penetration of a spinal pedicle screw: a case report and review of the literature.  

PubMed

A 30-year-old male underwent a corrective posterior instrumented spinal fusion for scoliosis. Six years later, he was found to have an aortic dissection after aortic penetration of a spinal pedicle screw. We review the literature, including diagnostic modalities, and treatment decision-making for this unusual complication. doi: 10.1111/jocs.12327 (J Card Surg 2014;29:377-381). PMID:24707982

Pillai, Saila T; Schoenhagen, Paul; Subrahmanyan, Lakshman; Mukherjee, Sandip K; McNamara, Robert L; Elefteriades, John; Svensson, Lars Georg

2014-05-01

134

Subarachnoid hemorrhage after an ischemic attack due to a bacterial middle cerebral artery dissecting aneurysm: case report and literature review.  

PubMed

A 78-year-old woman suffered sudden-onset left hemiparesis. There were no remarkable infectious findings. Computed tomography (CT) demonstrated a low-intensity area supplied by the right middle cerebral artery (MCA). The diagnosis was cerebral ischemia and she was conservatively treated with hyperosmotic fluids. Two days after the ischemic stroke she suddenly became comatose. CT showed diffuse subarachnoid hemorrhage (SAH) in the basal cistern associated with a right intra-Sylvian and a right frontal subcortical hematoma. Three-dimensional (3D)-CT angiography demonstrated occlusion of the M2 portion of the right MCA. Four days after the ischemic onset she died of brain herniation. Autopsy revealed arterial dissection in the intermediate membrane of the right MCA bifurcation and occlusion of the M2 portion of the thrombosed right MCA. Gram staining showed remarkable bacterial infection in the thrombus. SAH after an ischemic attack due to MCA dissection is extremely rare. We suspect that bacterial infection was involved in the formation of her fragile dissecting aneurysm. PMID:24140774

Saito, Atsushi; Kawaguchi, Tomohiro; Hori, Emiko; Kanamori, Masayuki; Nishimura, Shinjitsu; Sannohe, Seiya; Kaimori, Mitsuomi; Sasaki, Tatsuya; Nishijima, Michiharu

2014-01-01

135

[Neurological signs in aortic dissection].  

PubMed

A substantial number of patients suffering from aortic dissection will show neurological signs. These can dominate the clinical picture and hinder an accurate diagnosis of this life-threatening disease. We present a case of lower extremity pain and a case of transient global amnesia caused by aortic dissection. A third patient suffered from acute cerebral ischemia accompanied by hypotension and back pain, suggestive of aortic dissection. In this third case, aortic dissection was excluded before systemic thrombolytic therapy was administered, for the patient could have suffered disastrous complications caused by this emergency stroke therapy. Clinicians should be aware that a wide range of cerebral, spinal and peripheral neurological signs can be caused by aortic dissection. An unusual combination of symptoms can be a clue for underlying aortic disease. High-risk clinical features are predisposing factors in medical history, typical acute onset back or chest pain, and pulse deficit, blood pressure asymmetry or a new cardiac murmur on physical examination. These features should be explicitly evaluated in patients with an acute neurological deficit. If neurological symptoms and a high-risk clinical feature are present, immediate aortic imaging should be considered since early detection can be life saving. PMID:24330794

Walma, Rinske A; Vermeij, Frederique H; Bakker, Stef L M

2013-01-01

136

Weight Lifting and Aortic Dissection: More Evidence for a Connection  

Microsoft Academic Search

Background\\/Aims: In 2003, we reported on a small number of patients in whom acute aortic dissection appeared to be causally related to intense weight lifting. If additional cases could be identified, the phenomenon of weight lifting induced aortic dissection would be further substantiated. We now report a substantially larger number of cases in which aortic dissection is associated with intense

I. Hatzaras; M. Tranquilli; M. Coady; P. M. Barrett; J. Bible; J. A. Elefteriades

2007-01-01

137

Osteogenesis imperfecta and aortic dissection.  

PubMed

Osteogenesis imperfecta (OI) is a group of autosomal dominant disorders affecting Type I collagen synthesis with the predominant clinical manifestations in skeleton, skin, eyes, and teeth. Valvular cardiac manifestations and aortic root changes have long been reported. However, aortic dissection and repair were not described until 1993, with only 3 more proximal aortic dissections and repair noted. We report a fifth case and the first distal dissection. Surgeons performing vascular operations will in all probability never have encountered vascular repair in those with OI. The reports and this case are strong evidence that special efforts are required because of the fragility of tissues and propensity for bleeding. Reinforcement of any vascular suture line should be considered to reduce failure and bleeding. PMID:18626241

Byra, Paul; Chillag, Shawn; Petit, Scott

2008-07-01

138

[A case with traumatic internal carotid artery dissection in which the extent of the pseudolumen was defined by MR angiography].  

PubMed

We report a 29-year-old male with traumatic internal carotid artery (ICA) dissection who presented with cerebral ischemia developed after removal of a left acute subdural hematoma and external decompression. CT scans 4 days after the operation showed infarctions of the distribution of the bilateral cerebral hemispheres. Cerebral angiography on the 11th hospital day demonstrated narrowing of the extracranial internal carotid artery at C1-C2 vertebral levels. Slight arterial dilatation and retention of the contrast medium were found just above the narrowing segment, which was suspected to be a pseudolumen. Three D time-of flight MRA showed an intramural hematoma corresponding to the narrowing on the angiography. Original axial MRA images showed that narrowing of the lumen was surrounded by a crescent hematoma and that two flow velocity areas were in the area distal to the narrowing. High flow seemed to be ordinary artery flow rate. The low flow area, including turbulent flow, led to the retention of contrast medium mimicking a pseudolumen. Precise MRA imaging will bring us an accurate diagnosis of extracranial carotid dissections. PMID:10535076

Okuchi, K; Nagata, K; Fujioka, M; Maeda, Y; Yokota, H; Nishioka, T; Kagoshima, T

1999-10-01

139

[Isolated dissection of the superior mesenteric artery].  

PubMed

Isolated spontaneous dissection of the superior mesenteric artery is uncommon. We report a case complicated by arterial rupture and discuss diagnostic imaging work-up. Diagnosis is usually made by conventional arteriography. But, dissection can also be diagnosed noninvasively by computed tomography angiography and ultrasound. PMID:12910178

Gomez, M-A; Tchokonte, M; Delhommais, A; Bretagnol, F; Bleuet, F; Besson, M; Roger, R; Alison, D

2003-06-01

140

Marquette University Neuroanatomical Dissection  

NSDL National Science Digital Library

This website provides information regarding Marquette University' Neuroanatomical Dissection Summer Course. The focus of the course is an intensive review of the brain and spinal cord. Participants will spend a portion of the course dissecting a cadaver.

Marquette University (Marquette University)

2012-07-24

141

Dissecting Classroom Ethics.  

ERIC Educational Resources Information Center

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

Allchin, Douglas

1991-01-01

142

[The use of negative pressure wound therapy to treat wound necrosis and groin lymphorrhea after inguinal lymph nodes dissection: a case report].  

PubMed

Wound necrosis and groin lymphorrhea after inguinal lymph nodes dissection are serious complications. But treatment options for these complications are somewhat controversial. We report a patient who underwent an inguinal lymph node dissection for a regional metastasized squamous cell carcinoma of penis. Unfortunately, a extensive wound necrosis occurred with lymphorrhea (300 cc daily). After operative debridement, negative pressure wound therapy was started. We had used the instrument "V.A.C. (Vacuum Assisted Closure) ATS Therapy System" (KCI U.S.A.). After 11 days of negative pressure wound therapy, the good formation granulation tissue was observed and the lymphatic leakage was prominently decreased. This therapy was performed without serious complications but tolerable localized pain due to negative pressure. There were only seven reports that gave the description of an approach using negative pressure wound therapy for the less invasive treatment of lymphocutaneous fistulas and evaluated the efficacy of this therapy as an alternative medical procedure for treating lymphorrhea. This case suggested that negative pressure wound therapy could not only promote wound healing but also improve intractable lymphorrhea. PMID:22568166

Ito, Hiroki; Arao, Masayuki; Ishigaki, Hanako; Shirai, Akira; Yamasaka, Tomomi; Hirai, Kotaro

2012-01-01

143

Traumatic bilateral vertebral artery dissection.  

PubMed

Traumatic vertebral artery dissection is not often seen by forensic pathologists, and cases investigated are scarce in the forensic literature. We present the case of a 40-year-old woman cyclist who was struck by a car while wearing a helmet, and was neurologically near normal immediately thereafter at Emergency. She presented 48 h later with acute right hemiparesis, decreasing level of consciousness, and unsteadiness. CT revealed massive cerebellar infarction. CT angiography was normal. The patient died in coma 7 days after injury and autopsy revealed bilateral edematous cerebellar infarction and bilateral vertebral artery dissection. Rotational neck injury and mural tear in the wall of the Atlantic parts of both vertebral arteries is suggested as the possible mechanism of the arterial injury. Head and neck injuries are reported as a precipitating cause of vertebral artery injury. The possible influence of trauma may be further underestimated if longer intervals between vessel dissection and ischemia occur. The current case illustrates that "talk-and-die" syndrome may be due to occult vertebral artery dissection, possibly bilateral. In forensic cases of delayed death after mild trauma to the head and neck, the vertebral arteries should be examined for the cause of death. PMID:21798679

Galtés, Ignasi; Borondo, Juan Carlos; Cos, Mònica; Subirana, Mercè; Martin-Fumadó, Carles; Martín, Carles; Castellà, Josep; Medallo, Jordi

2012-01-10

144

Asymptomatic spontaneous coronary artery dissection.  

PubMed

Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia that could present as angina, acute myocardial infarction, or even sudden death. It occurs more commonly in women and it has been associated with autoimmune and collagen vascular diseases. The management and prognosis in these patients depend on the initial clinical presentation and the extent of dissection. In this article, we report 2 cases of asymptomatic SCAD that were diagnosed on routine preoperative evaluation. The management options and clinical implications are discussed. PMID:20641110

Dakik, Habib A; Nader, Gilbert Abou; Arja, Wajih A; Sawaya, Jaber; Gharzuddine, Walid

2010-07-01

145

[Leg amputation for severe lower limb ischemia caused by type a acute aortic dissection;report of a case].  

PubMed

A 41-year-old man underwent total arch replacement and aorto-bifemoral bypass owing to type A acute aortic dissection complicated by ischemia of both lower extremities. Just after the operation, he developed myonephropathic metabolic syndrome due to severe ischemia of the right leg, and hemodiafiltration was performed. However, the serum potassium was elevated to an uncontrollable level. Ligation of the right femoral artery and the right branch of the bypass graft was performed one hour after the transfer to intensive care unit (ICU), and the serum potassium dropped to a normal level. He underwent amputation of the right lower limb above the knee on the 13th postoperative day, and was discharged after long-term rehabilitation. PMID:24917407

Watanabe, Suguru; Minagawa, Tadanori; Fujiwara, Hidenori; Kanda, Keisuke; Miura, Makoto; Tabayashi, Koichi

2014-06-01

146

Spondyloarthritis associated with acne conglobata, hidradenitis suppurativa and dissecting cellulitis of the scalp: a review with illustrative cases.  

PubMed

To review and highlight the association of acne conglobata, hidradenitis suppurativa, and dissecting cellulitis of the scalp with inflammatory arthritic conditions, we report five illustrative patients with this association, and a review of the literature. All our patients were African-American males, and their skin disease present before the onset of arthritis. Both asymmetric peripheral arthritis and axial disease can occur. The arthritis is usually insidious and lacks association with rheumatoid factor and HLA-B27. Imaging of peripheral joints can reveal erosions, periosteal bone reaction and new bone formation. When the axial skeleton is involved, imaging can reveal sacroiliitis, syndesmophyte formation. NSAIDs, oral and intra-articular steroids, DMARDs and TNF alpha antagonists have all been used with success. Controlled trials with larger numbers of patients are needed to assess which treatment options are the most effective for this group of patients. PMID:23771559

Lim, Debbie T; James, Neena M; Hassan, Sobia; Khan, Muhammad A

2013-08-01

147

The Problems of Dissection.  

ERIC Educational Resources Information Center

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

Davis, Pat

1997-01-01

148

Tricuspid regurgitation resulting from acute type a aortic dissection.  

PubMed

Proximal extension of acute type A aortic dissection can affect the aortic valve but seldom affects the tricuspid valve. We report the case of an octogenarian who underwent successful surgical repair of an aortic dissection that was accompanied by tricuspid regurgitation. We believe that the tricuspid regurgitation was attributable to displacement of the valve resulting from aortic dissection. PMID:24996748

Kurisu, Kazuhiro; Baba, Hironori; Nakashima, Hidehiko; Kajiwara, Takashi; Hisahara, Manabu; Joo, Kunihiko; Ochiai, Yoshie

2014-07-01

149

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

Federal Register 2010, 2011, 2012, 2013

...Louisiana Intrastate) LLC ; Notice of Motion for Extension of Rate Case Filing Deadline...Louisiana Intrastate) LLC (AMLI) filed a motion requesting an extension consistent with...participate in this proceeding must file a motion to intervene or to protest this...

2012-03-05

150

Negative results - Vascular thoracic Retrograde aortic dissection after a stent graft repair of a type B dissection: how to improve the endovascular technique  

Microsoft Academic Search

To date, endovascular repair of thoracic dissections is a reality, associated with acceptable morbidity and mortality. We present the case of a 72-year-old woman presenting a retrograde aortic dissection at the postoperative day 12, after an endovascular repair for a 60-mm thoracic dissecting aneurysm. Two years earlier, she had presented an uncomplicated thoracoabdominal type B aortic dissection between the isthmic

Sylvain Rubin; Aurelie Bayle; Anne Poncet; Bernard Baehrel

151

Eyelid lymphedema following neck dissection and radiotherapy.  

PubMed

Chronic eyelid lymphedema following neck dissection and radiotherapy is rare with 1 report in the literature. The authors report 3 cases and review the literature. Two cases had bilateral neck dissection and developed bilateral eyelid lymphedema and 1 case had unilateral neck dissection (left side) and developed ipsilateral lymphedema. Two patients underwent surgical debulking of lymphedema with significant improvement in symptoms. One patient declined surgical intervention, and the lymphedema remained unchanged. Chronic eyelid lymphedema following neck dissection and radiotherapy occurs where predominant lymphatic drainage to the submandibular and deep cervical lymph node basin is removed. Lymphedema tends to persist when it occurs and in selected cases appearance can be effectively improved by debulking and excision of festoons. PMID:23446298

Sagili, Suresh; Selva, Dinesh; Malhotra, Raman

2013-01-01

152

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

Federal Register 2010, 2011, 2012, 2013

...Energy Regulatory Commission [Docket No. PR09-32-003] DCP Raptor Pipeline, LLC; Notice of Motion for Extension of Rate Case Filing Deadline Take notice that on November 30, 2011, DCP Raptor Pipeline, LLC (Raptor) filed a request for an...

2011-12-08

153

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

Federal Register 2010, 2011, 2012, 2013

...Overland Trail Transmission, LLC; Notice of Motion for Extension of Rate Case Filing Deadline...participate in this rate proceeding must file a motion to intervene or to protest this filing...must file a notice of intervention or motion to intervene, as appropriate. Such...

2011-12-08

154

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

Federal Register 2010, 2011, 2012, 2013

...WesTex Transmission, LLC; Notice of Motion for Extension of Rate Case Filing Deadline...participate in this rate proceeding must file a motion to intervene or to protest this filing...must file a notice of intervention or motion to intervene, as appropriate. Such...

2010-11-18

155

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

Federal Register 2010, 2011, 2012, 2013

...North Texas Pipeline, L.P.; Notice of Motion for Extension of Rate Case Filing Deadline...participate in this rate proceeding must file a motion to intervene or to protest this filing...must file a notice of intervention or motion to intervene, as appropriate. Such...

2011-01-07

156

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

Federal Register 2010, 2011, 2012, 2013

...Mexico Gas Company, Inc.; Notice of Motion for Extension of Rate Case Filing Deadline...participate in this rate proceeding must file a motion to intervene or to protest this filing...must file a notice of intervention or motion to intervene, as appropriate. Such...

2011-08-19

157

Spontaneous bilateral internal carotid artery dissection  

PubMed Central

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.

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

2009-01-01

158

Dissecting aneurysm of the hepatic artery caused by an isolated spontaneous celiac trunk dissection.  

PubMed

Dissecting hepatic artery aneurysm caused by an isolated spontaneous celiac artery dissection is a life-threatening condition with only 5 cases reported previously. We report a successful resection and revascularization of all affected arteries with an inferior mesenteric vein graft in a 59-year-old asymptomatic man with a large dissecting common and proper hepatic artery aneurysm (diameter, 4.2 cm) due to a spontaneous dissection from the celiac trunk to the proximal splenic artery and the right hepatic artery. Our case suggests that intervention should not be delayed in cases of hepatic aneurysm and a long dissection extending to the proper hepatic artery because of the difficulty in restoring hepatic circulation and preventing rupture. PMID:24365084

Higashiyama, Hiroshi; Ishii, Masayuki; Fujimoto, Koji; Oka, Yurika; Uehara, Tetsuya; Kumada, Kaoru; Yamamoto, Masayuki

2014-07-01

159

Effects of Gastric Irrigation on Bacterial Counts before Endoscopic Submucosal Dissection: A Randomized Case Control Prospective Study  

PubMed Central

Objective The antiseptic effect of gastric irrigation before endoscopic submucosal dissection (ESD) has not yet been reported. The aim of the randomized prospective study is to evaluate the antiseptic effects of gastric irrigation of saline solution before ESD by evaluating bacterial count. Methods This prospective randomized controlled trial included 50 patients diagnosed with early gastric cancer who were randomly divided into 2 groups (25 patients in each group) by using the opaque envelope method: the clean group (irrigation with 2 L saline solution before ESD) and the regular group (no irrigation). The gastric juice was collected and cultured before ESD. The entire stomach was irrigated using a water jet attached to an endoscope. After ESD with resection and removal of the tumor specimen, a postoperative culture of the gastric juice was obtained using the same method as the preoperative culture. Results The mean log bacterial count of the post-gastric irrigation gastric juice was 5.08±0.75 in the regular group and 1.86±0.86 in the clean group. The difference in the bacterial counts was significant between the groups (P?=?0.0004). The difference in the white blood cells (WBC) count on POD 1 was significant (P?=?0.044). WBC count on POD 2 did not significantly differ between the groups (P?=?0.3). The difference in the body temperature (BT) on POD 1 was significant (P?=?0.017), On POD 2 the BT was not significant between the groups (P?=?0.5). On POD 1, 88% of the patients in the regular group and 16% of the patients in the clean group had mild to moderate spontaneous pain (P?=?0.0026). On POD 2 the proportion with mild to moderate spontaneous pain was 36% and 24% in the regular group and the clean group, respectively (P?=?0.1). Conclusion Pre-ESD gastric irrigation with saline solution is effective and feasible for suppressing infection during the ESD procedure with favorable clinical outcomes. Trial registration information The university hospital medical information network (UMIN) #000008691.

Mori, Hirohito; Kobara, Hideki; Rafiq, Kazi; Nishiyama, Noriko; Fujihara, Shintaro; Oryu, Makoto; Masaki, Tsutomu

2013-01-01

160

Isolated dissection of superior mesenteric artery.  

PubMed

Isolated dissection of the superior mesenteric artery is a rare occurrence with a hitherto unknown exact etiology. Patients may present with abdominal symptoms or hemodynamic instability.We herein present a case of spontaneous isolated superior mesenteric artery dissection in a 48-year-old man, who was admitted with epigastric pain. Due to an undiagnosed paced rhythm on the electrocardiogram, he was given fibrinolysis treatment for acute myocardial infarction. On further evaluation, angiography revealed that the cause of pain was the dissection of the superior mesenteric artery. The patient's symptoms were diminished with conservative management, obviating the need for the angioplasty of the superior mesenteric artery. PMID:23304184

Taherkhani, Maryam; Hashemi, Seyyed Reza; Nikpoor, Shahryar

2012-08-01

161

Isolated Dissection of Superior Mesenteric Artery  

PubMed Central

Isolated dissection of the superior mesenteric artery is a rare occurrence with a hitherto unknown exact etiology. Patients may present with abdominal symptoms or hemodynamic instability. We herein present a case of spontaneous isolated superior mesenteric artery dissection in a 48-year-old man, who was admitted with epigastric pain. Due to an undiagnosed paced rhythm on the electrocardiogram, he was given fibrinolysis treatment for acute myocardial infarction. On further evaluation, angiography revealed that the cause of pain was the dissection of the superior mesenteric artery. The patient’s symptoms were diminished with conservative management, obviating the need for the angioplasty of the superior mesenteric artery.

Taherkhani, Maryam; Hashemi, Seyyed Reza; Nikpoor, Shahryar

2012-01-01

162

TEVAR for type B aortic dissection in Japan.  

PubMed

TEVAR is a new strategy for treating both acute and chronic type B aortic dissection. The JSC guidelines classify TEVAR as a Class I recommendation for cases of complicated acute type B dissection and a Class IIa recommendation for cases of chronic type B aortic dissection. While TEVAR has been primarily applied to treat complicated acute type B aortic dissection in Europe and the USA, the procedure remains an off-label treatment strategy for aortic dissection in Japan. The current state of TEVAR for type B aortic dissection in Japan from 2001 to 2011 is estimated in the annual reports of the Japanese Association for Thoracic Surgery. The number of acute type B aortic dissection patients treated with transluminal stent grafting increased rapidly after 2008, from 10 cases in 2001 to 76 cases in 2010. Meanwhile, the number acute type B aortic dissection patients treated with any type of surgery has increased gradually, from 100 cases in 2001 to 194 cases in 2009. The number of chronic type B aortic dissection patients treated with transluminal stent grafting increased abruptly in 2010, reaching 346 cases, which accounted for one-third of all surgical procedures for chronic type B aortic dissection. Furthermore, the number of open surgeries for chronic type B aortic dissection has also increased gradually, from 401 cases in 2001 to 947 cases in 2011. At present, open surgery, TEVAR and hybrid procedures are available to treat patients with type B aortic dissection. The use of a multidisciplinary team approach is mandatory when selecting the appropriate surgical strategy. PMID:24317874

Usui, Akihiko

2014-05-01

163

Science teachers' learning to notice from video cases of the enactment of cognitively demanding instructional tasks  

NASA Astrophysics Data System (ADS)

Members of a profession develop a professional vision that enables them to see and understand complex situations in particular ways. This study focuses on developing science teachers' professional vision by supporting their learning to attend to particular classroom interactions and make sense of them in particular ways. Specifically, this study investigated high school biology teachers' learning to notice in a professional development (PD) setting from video cases that depict classroom interactions during the enactment of high-level, cognitively demanding science tasks. A seven-session, video-based PD intervention in which teachers analyzed short video clips that illustrated students' engagement with cognitively demanding tasks was designed and implemented. The findings focused on changes in teacher noticing from pre- to post-PD as revealed through the analysis of two sets of baseline and exit interviews with each individual teacher as well as the analysis of particular PD sessions. According to the findings, there were mostly significant changes in what teachers attended to in the video cases and how they made sense of what they saw. In addition, there was a shift towards connecting the specifics of what they noticed in the video cases to the level or kind of student thinking as outlined in the Task Analysis Guide in Science framework. The findings are promising in terms of developing science teachers' professional vision of classroom interactions during the enactment of cognitively demanding tasks. The study findings provide implications for designing effective PD programs to support teachers' professional vision.

Kisa, Miray Tekkumru

164

Renal artery dissection.  

PubMed Central

Renal artery dissections are stenotic or occlusive lesions most often observed in hypertensive patients with underlying atherosclerosis or fibromuscular disease. Acute dissections may present spontaneously, as a complication of diagnostic or therapeutic angiography or as an agonal event associated with overwhelming systemic illness. Chronic dissections may produce renovascular hypertension or be entirely asymptomatic. Fourteen renal artery dissections have been encountered in nine patients treated at Vanderbilt University Medical Center during the past decade. Eleven dissections have been found in seven patients with renovascular hypertension. Seven of these dissections were chronic (six functional, one silent) and four acute (two spontaneous, two secondary to angiography). Three agonal dissections were found in two additional patients postmortem: one at autopsy and bilateral dissections found at the time of cadaveric donor nephrectomy. Ten bypass procedures, including five complex branch reconstructions of which three were performed ex vivo, have been performed with 100% immediate patency and maintenance or improvement of renal function. Long-term follow-up of these patients has shown sustained patency of the reconstructed renal arteries, excellent blood pressure control, and normal renal function in all. Nephrectomy has not been required and there have been no associated deaths. Seventy-seven additional renal artery dissections in 72 patients collected from previous reports have been analyzed. Patient survival (55/72, 76.4%) and preservation of the involved kidney in surviving patients (26/55, 47.3%) were low in these earlier series. In addition, renal failure was associated with 59% of the deaths. The lethality of renal artery dissections and the ease and success of revascularization, which preserves renal function and ameliorates associated renovascular hypertension, emphasize the need for an aggressive approach to the recognition and treatment of this entity. Therapy should be directed toward arterial reconstructions and the preservation of functioning renal tissue. Images FIG. 1A. FIG. 2A. FIG. 5. FIG. 6. FIG. 7. FIG. 9. FIG. 10. FIG. 11.

Smith, B M; Holcomb, G W; Richie, R E; Dean, R H

1984-01-01

165

Hemi-Fontan or Bidirectional Cavopulmonary Shunt for Right Ventricular Failure after Mitral Valve Replacement and Acute Ascending Aortic Dissection: Report of Two Cases  

PubMed Central

Right ventricular failure due to right coronary artery disease, right ventricular hypertrophy, stunning, abnormal septal motion, myocardial infarction, or non-homogeneous distribution of cardioplegia is an uncommon but serious complication of open heart surgery. We report a patient with severe right ventricular hypertrophy secondary to severe mitral valve stenosis and another patient with detachment of the right coronary artery due to the dissection of the ascending aorta. The patients developed right ventricular failure, which persisted after surgery and rendered weaning from cardiopulmonary bypass unsuccessful. Through a hemi-Fontan, or bidirectional cavopulmonary shunt, and an intra-aortic balloon pump, the patients were successfully weaned from cardiopulmonary bypass. This shunt may be an alternative to a right ventricular assist device in some patients with right ventricular failure. The long-term outcome and the indication of bi-directional cavopulmonary shunt has not been confirmed, although it is believed to be effective for saving the life of patients with low cardiac output and acute right ventricular failure. In our cases, six months following the operation, there was some degree of recovery of the right ventricular function. In long-term follow-up, however, it would be interesting for the authors to know if the improved right ventricular function, with better antegrade pulsatile flow in the pulmonary artery, in any way interferes with the functioning of the bidirectional cavopulmonary shunt.

Teimouri, Hassan; Sabzi, Feridoun; Nasiri, Babak

2013-01-01

166

A modified root reinforcement technique for acute aortic dissection with a weakened aortic root: a modified Florida sleeve technique and two cases report.  

PubMed

Despite marvelous advances in repair for acute type A aortic dissection over past decades, it remains challenging to repair the aortic root when aortic dissection extended to the sinuses causes the fragile root because of its thinner layers, which are susceptible to suture trauma. Here, we describe a modified Florida sleeve technique to strengthen the weakened aortic root. After mobilization of the aortic root and the coronary arteries, a designed Dacron tube graft was wrapped outside the sinuses as neo-adventitia to reinforce the dissected weakened wall. During surgery for aortic dissection, our technique is easy and effective to reinforce a weakened root and avoid bleeding. Furthermore, this might be an alternative technique to restore and maintain the geometry of the aortic root. PMID:24172158

Heo, Woon; Min, Ho-Ki; Kang, Do Kyun; Jun, Hee Jae; Hwang, Youn-Ho; Choi, Jin Ho; Wi, Jin Hong

2013-01-01

167

Successful right common iliac to superior mesenteric artery bypass for mesenteric ischemia associated with acute aortic dissection: Report of a case  

Microsoft Academic Search

Mesenteric ischemia caused by obstruction of the superior mesenteric artery associated with acute aortic dissection was successfully treated by surgery in a 74-year-old man. The vein graft was effectively bypassed between the right common iliac artery and superior mesenteric artery on the day of onset of acute DeBakey type III b aortic dissection. He is currently well 1 year postoperatively

Shigetoh Odagiri; Shirosaku Koide; Kenji Ariizumi; Ichirou Suzuki; Kazuo Kamabuchi; Shunichi Inamura; Akira Shoutsu

1993-01-01

168

Introduction to Dissection  

NSDL National Science Digital Library

Many health science students do not enroll in undergraduate dissection-based anatomy courses during their pre-professional education. As a result, they are not familiar with dissection instruments and the mechanics of dissection, and are poorly prepared for medical, dental, and allied health science anatomy courses. Thus, the first dissections are very challenging and require extensive help from instructors. This program is designed to alleviate those deficits. It serves as an introduction to dissection in a human gross anatomy course for first-year medical and other health science students. It can be used either as a component of a structured classroom session, or, independently by individual students. The content is presented in a series of video clips arranged in two sections, each containing multiple chapters. Section #1 is a guide to the selection of proper dissection instruments. Section #2 is an overview of how to begin the first dissection in the course, including the use of dissection tools. The program is menu-driven, allowing viewing of the entire content in sequence, or, selected chapters in any order. Student and faculty surveys indicate the program prepares students well for and improves time management during the first dissections. It is available as a web-based download and as a CD-ROM. This work was supported in part by NIH P03 1B040107 and G12-RR 03034. Note: The files must be downloaded, unzipped, extracted, and saved to your local system. Download a stand-alone Flash player from Adobe.com.

Wineski, Lawrence

2007-11-20

169

[Lymphorrhea after neck dissection].  

PubMed

In this publication lymphorrhea was described as one of possible complications after the neck dissection surgery of Crile-Jawdy?ski procedurae. The matter of this complication is rise of pressure in lymph system. 4 women with this complication after neck dissection, the best treatment is drainage of the operated area. In one patient, because of the failure of conservative treatment, another surgical intervention was preformed. The full treatment of lymphorrhea was after 4-6 weeks. PMID:10481496

Nowaczyk, M T

1999-01-01

170

Postpartum coronary artery dissection.  

PubMed Central

A 27-year-old woman experienced anterior myocardial infarction three weeks after the delivery of her second child. Coronary arteriography subsequently showed primary dissection of the left coronary artery. This patient is believed to be the second reported survivor of angiographically proven peripartal left coronary artery dissection and the only such patient to achieve and maintain asymptomatic status for a prolonged period without operative intervention. Images

Shaver, P J; Carrig, T F; Baker, W P

1978-01-01

171

Iatrogenic left main artery dissection: A catastrophic complication.  

PubMed

Iatrogenic left main artery (LM) dissection is a catastrophic complication of coronary angiography and angioplasty that requires prompt management using stenting. Although LM dissection can be prevented, it cannot always be avoided and has a reported incidence rate of 0.02%. In the present report, a case of iatrogenic LM dissection that was successfully treated with multiple stents is presented and followed by a brief review of the literature. PMID:23592948

Namazi, Mohammad Hassan; Rostami, Reza Tajik; Mohammadi, Afsaneh; Amini, Abdol Latifi; Safi, Morteza; Saadat, Habibollah; Vakili, Hosein; Motamedi, Mohammad Reza; Movahed, Mohammad Reza

2012-01-01

172

Iatrogenic left main artery dissection: A catastrophic complication  

PubMed Central

Iatrogenic left main artery (LM) dissection is a catastrophic complication of coronary angiography and angioplasty that requires prompt management using stenting. Although LM dissection can be prevented, it cannot always be avoided and has a reported incidence rate of 0.02%. In the present report, a case of iatrogenic LM dissection that was successfully treated with multiple stents is presented and followed by a brief review of the literature.

Namazi, Mohammad Hassan; Rostami, Reza Tajik; Mohammadi, Afsaneh; Amini, Abdol Latifi; Safi, Morteza; Saadat, Habibollah; Vakili, Hosein; Motamedi, Mohammad Reza; Movahed, Mohammad Reza

2012-01-01

173

[Minocycline sclerotherapy for lymphorrhea following neck dissection].  

PubMed

Postoperative cervical lymphorrhea is a complication uncommonly encountered following neck dissection for which several treatment modalities have been described in the literature. We managed 8 cases of lymphorrhea after neck dissection by injecting Minocycline through a drainage tube. We attempted this procedure for lymph discharge that had continued despite pressure dressing and systemic management with nutritional modification for about 1 week. This treatment rapidly resolved lymph discharge in 6 of the 8 cases. No patient required surgical intervention. Minocycline sclerotherapy has typically been used to treat pleural effusion, ascites, pneumothorax, and other cystic diseases of the liver, pancreas, and kidney. In many cases, this therapy brings rapid resolution. This inefficiency is due to the acidity and toxicity of Minocycline. No major adverse effects have been reported. We believe that Minocycline sclerotherapy is effective for rapidly resolving lymphorrhea following neck dissection and use of this therapy should be attempted before surgical intervention. PMID:12692958

Koda, Hiroko; Gotsu, Kazuo; Sugimoto, Taro; Ishikawa, Norihiko; Kishimoto, Seiji

2003-02-01

174

Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy  

PubMed Central

Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year-old female who developed two spontaneous coronary dissections while on topical hormonal replacement therapy. The patient had no other risk factors for coronary dissection. After withdrawal from topical hormonal therapy, our patient has done well and has not had recurrent coronary artery dissections over a one-year follow-up period. The potential contributory role of topical hormonal therapy as a cause of spontaneous coronary dissection should be recognized.

Pan, Alexander L.; Fergusson, David; Hong, Robert; Badawi, Ramy A.

2012-01-01

175

Recurrent cotyledonoid dissecting leiomyoma of the uterus.  

PubMed

Cotyledonoid dissecting leiomyoma is a benign smooth muscle neoplasm with an unusual growth pattern that is characterized by intramural dissection within the uterine corpus and often a placental-like appearance macroscopically in its extrauterine component that may be alarming to the surgeon. All cases reported to date have been nonaggressive. We report a case in a 33-yr-old woman who had a history of prolonged uterine bleeding. She was operated upon for uterine leiomyomas, and the diagnosis of cotyledonoid dissecting leiomyoma was made at the time of intraoperative consultation. To maintain fertility, the intrauterine tumor was resected by myomectomy and the extrauterine tumor by excision. However, persistent uterine bleeding that eventually became intractable and continued growth of the neoplasm in the uterus necessitated hysterectomy 5 yr later. She was living and well 2.5 yr after hysterectomy with no evidence of disease. PMID:23370645

Roth, Lawrence Max; Kirker, James A; Insull, Mark; Whittaker, John

2013-03-01

176

Spontaneous celiac artery dissection and its management.  

PubMed

Spontaneous visceral artery dissection is an uncommon event with an unpredictable natural history with superior mesenteric artery being the most common affected artery. It is most often asymptomatic and usually diagnosed at autopsy. Pre-disposing factors are not specific but have been suggested to be pre-existing vascular disease, hypertension and pregnancy. Spontaneous resolution, definitive occlusion of the artery, and formation of an aneurysm with associated complications are some other possible outcomes. Isolated dissection of the celiac artery (CA) is rare and there are only a few cases reported in the literature. We present a case of a 65 year old male with spontaneous celiac artery dissection and provide a review of the current literature about imaging findings and management of this entity. PMID:22470724

Vaidya, Sandeep; Dighe, Manjiri

2010-01-01

177

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

178

Traumatic internal carotid artery dissections caused by blunt softball injuries  

Microsoft Academic Search

This report describes recently treated patients with carotid artery dissection caused by blunt softball injuries, as well as the results of a study of carotid artery trauma in a community. Data obtained through the medical records linkage system used for epidemiologic studies in Olmsted County, MN were used to identify all cases of traumatic internal carotid artery dissection diagnosed from

Wouter I Schievink; John L. D Atkinson; J. D Bartleson; Jack P Whisnant

1998-01-01

179

Traumatic Axillary Artery Dissection with Radial Artery Embolism  

SciTech Connect

This report describes a case of pathologically proven traumatic arterial dissection, presenting as complete occlusion of the axillary artery with radial artery embolism. Occlusion of the axillary artery by traumatic dissection mimicked transection and radial artery embolism mimicked congenital absence of the radial artery on the initial angiogram, but these were correctly diagnosed with the following sonogram.

Chung, Hwan-Hoon; Cha, Sang Hoon, E-mail: shcha123@naver.com; Cho, Sung Bum; Kim, Jung Hyuck; Lee, Seung Hwa [Ansan Hospital, Korea University College of Medicine, Department of Radiology (Korea, Republic of); Shin, Jae Seung [Ansan Hospital, Korea University College of Medicine, Department of Thoracic and Cardiovascular Surgery (Korea, Republic of); Park, Sang Woo [KonKuk University Hospital, Department of Radiology (Korea, Republic of)

2006-04-15

180

Isolated Spontaneous Celiac Artery Dissection in a 47-Year-Old Man with von Willebrand Disease  

PubMed Central

Isolated spontaneous dissection of the celiac artery is rare, and its occurrence without aortic dissection is even rarer. The typical symptom of this dissection is acute-onset abdominal pain. Complications of the condition include aneurysm formation, rupture, and abdominal-organ ischemia or infarction, especially in the liver or spleen. We report the case of a 47-year-old man with von Willebrand disease who had an isolated spontaneous dissection of the celiac artery. We used computed tomography and computed tomographic angiography in the diagnosis and characterization of the dissection. To our knowledge, this is the first report of celiac artery dissection in a patient with von Willebrand disease.

Rehman, Aziz Ur; Nadella, Srikanth; Sohail, Umair

2014-01-01

181

Isolated spontaneous celiac artery dissection in a 47-year-old man with von Willebrand disease.  

PubMed

Isolated spontaneous dissection of the celiac artery is rare, and its occurrence without aortic dissection is even rarer. The typical symptom of this dissection is acute-onset abdominal pain. Complications of the condition include aneurysm formation, rupture, and abdominal-organ ischemia or infarction, especially in the liver or spleen. We report the case of a 47-year-old man with von Willebrand disease who had an isolated spontaneous dissection of the celiac artery. We used computed tomography and computed tomographic angiography in the diagnosis and characterization of the dissection. To our knowledge, this is the first report of celiac artery dissection in a patient with von Willebrand disease. PMID:24955061

Rehman, Aziz Ur; Almanfi, Abdelkader; Nadella, Srikanth; Sohail, Umair

2014-06-01

182

76 FR 52969 - In the Matter of Certain Protective Cases and Components Thereof Notice of Commission...  

Federal Register 2010, 2011, 2012, 2013

...Determination Granting Complainant's Motion To Amend the Complaint and Notice of Investigation...Order No. 3) granting Complainant's motion to amend the complaint and notice of investigation...On July 19, 2011, Otter filed a motion under Commission Rule...

2011-08-24

183

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.

184

Spontaneous coronary artery dissection.  

PubMed

Spontaneous coronary artery dissection (SCAD) is an infrequent condition that is underdiagnosed. There is a predilection for young women without traditional cardiovascular risk factors, and it is increasingly diagnosed in women who are not peripartum. We discovered an association between SCAD and fibromuscular dysplasia (FMD), in which most women with nonatherosclerotic SCAD were found to have FMD in another vascular territory. We suspect that these seemingly healthy patients have underlying coronary FMD that predisposed them to coronary dissection. Medical treatment of SCAD includes antiplatelet therapy and ?-blockade. Revascularization of SCAD patients might be challenging, and the recommendation for stenting or surgery depends on their clinical status and the dissected coronary anatomy. The long-term outcome of patients who survived their SCAD event is generally good, however, they are at risk for recurrent dissection and major cardiovascular events, and thus should be closely monitored by cardiovascular specialists. This review summarizes the epidemiology, associated etiology, diagnosis, management, and outcome of patients with SCAD. PMID:23498840

Saw, Jacqueline

2013-09-01

185

Spontaneous dissection of the hepatic artery  

Microsoft Academic Search

Two cases of spontaneous dissection of hepatic arteries are described. Presentation and management of these two patients are distinctly different. The first patient presented with mild back pain and mild abnormal liver function tests and was treated conservatively. The second patient presented with hemoperitoneum and shock and was treated surgically.

M. F. Miiller; D. Kim

1995-01-01

186

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

Federal Register 2010, 2011, 2012, 2013

...Calpine Texas Pipeline, L.P.; Notice of Motion for Extension of Rate Case Filing Deadline...Pipeline, L.P. (Calpine Texas) filed a motion to extend the date for filing its next...participate in this rate proceeding must file a motion to intervene or to protest this...

2010-11-29

187

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

188

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

Microsoft Academic Search

Iatrogenic arterial dissection leading to the development of dissecting pseudoaneurysms of the superior mesenteric artery (SMA) is a rare complication of angiography. Surgical and endovascular treatment options exist for this important condition. We report a case of bare stent implantation in dissecting pseudoaneurysm of the SMA that developed after angiography in a patient with acute mesenteric ischemia. Although it is

Ramazan Kutlu; Cengiz Ara; Kaya Sarac

2007-01-01

189

Dudeney Dissection of Polygons  

Microsoft Academic Search

\\u000a Given an equilateral triangle A and A Square B of the same area, Henry E. Dudeney introduced A partition of A into parts that tan be reassembled in some way, without turning over the surfaces, to form B. An examination of Dudeney’s method of partition motivates us to introduce the notion of Dudeney dissections of various polygons\\u000a to other polygons.

Jin Akiyama; Gisaku Nakamura

1998-01-01

190

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

191

Shark Dissection Webcast  

NSDL National Science Digital Library

View this Webcast dissection of four shark species conducted last August at the Birch Aquarium and narrated by Dr. Jeffrey Graham of the Scripps Institution of Oceanography. This is a rare opportunity to learn from a marine biologist as he examines the internal organs of these sharks for the audience. The site also has several short text sections offering life history and behavioral information for those users interested in learning more about sharks in general.

2001-01-01

192

Aortic dissection during pregnancy.  

PubMed Central

Aortic dissection occurred in a nineteen year old woman during the thirty seventh week of pregnancy. Immediate elective delivery of a normal baby by caesarean section was followed by aortic root replacement 48 hours later. It was decided not to proceed immediately to operation on the aortic root because it was believed that the anticoagulation necessary for cardiopulmonary bypass might provoke dangerous haemorrhage from the raw placental site. Images Fig. 1 Fig. 2

Pumphrey, C W; Fay, T; Weir, I

1986-01-01

193

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.

2007-01-01

194

Spontaneous dissection of the superior mesenteric artery.  

PubMed

We describe a case of spontaneous dissection and thrombosis of the superior mesenteric artery in a 54-year-old man who presented with new onset of hypertension and epigastric pain. Initial unsuccessful treatment with catheter-directed thrombolysis was followed by surgical intervention. In cases in which an extensive intimectomy is performed, early institution of antiplatelet therapy or anticoagulation may be necessary to preserve vessel patency due to the presence of a prothrombotic surface and compromised outflow. PMID:20142003

Hwang, Christopher K; Wang, Jeffrey Y; Chaikof, Elliot L

2010-02-01

195

Endovascular management of chronic post-dissection aneurysms.  

PubMed

Open repair is still the gold standard in acute type A dissection. Endovascular repair is advocated for complicated acute type B dissections. Recent evidence also supports the role of endovascular repair in a larger proportion of uncomplicated acute type B dissections. The role of endovascular repair in chronic post-dissection aneurysms, however, is still unclear. Most commonly, post-dissection aneurysms involve the thoracoabdominal aorta, making the use of fenestrated/branched stent-grafts to achieve complete aneurysm exclusion mandatory. These fenestrated/branched stent-grafts have been used with success in atherosclerotic thoracoabdominal aortic aneurysms (TAAAs). In chronic post-dissection aneurysms, however, additional technical challenges arise. The usually narrow true lumen makes the use of branches more tedious and overall planning difficult. A second technical challenge relates to the fact that visceral branches can also originate from the false lumen. In such cases, perforation of the stiff chronic dissection flap is required to obtain access to the vessel. During the period January 2010 to November 2013, 17 patients (13 males, mean age 65±7.8 years) with chronic thoracoabdominal aneurismal degeneration following acute dissection were treated in our department with the use of fenestrated/branched stent-grafts. Technical success was achieved in all cases (100%). Perioperative mortality was two (11.8%) patients. One patient died due to multiple organ failure and one due to cardiac failure. No case of paraplegia was observed. During a 12-month median follow-up (range, 4-28 months) no aneurysm-related deaths were observed. Reintervention was required in three cases to repair a type Ib endoleak from a side branch. Endovascular treatment with fenestrated/branched stent-grafts is feasible for chronic post-dissection aneurysms. Standard thoracic stent-grafting is an option in a minority of patients, when the aneurysm is limited to the thoracic segment. Fenestrated and branched devices can successfully be used for aneurysms extending to the thoracoabdominal aorta. PMID:24967171

Oikonomou, Kyriakos; Katsargyris, Athanasios; Ritter, Wolfgang; Spinelli, Domenico; Seto, Yuki; Verhoeven, Eric L

2014-05-01

196

Endovascular management of chronic post-dissection aneurysms  

PubMed Central

Open repair is still the gold standard in acute type A dissection. Endovascular repair is advocated for complicated acute type B dissections. Recent evidence also supports the role of endovascular repair in a larger proportion of uncomplicated acute type B dissections. The role of endovascular repair in chronic post-dissection aneurysms, however, is still unclear. Most commonly, post-dissection aneurysms involve the thoracoabdominal aorta, making the use of fenestrated/branched stent-grafts to achieve complete aneurysm exclusion mandatory. These fenestrated/branched stent-grafts have been used with success in atherosclerotic thoracoabdominal aortic aneurysms (TAAAs). In chronic post-dissection aneurysms, however, additional technical challenges arise. The usually narrow true lumen makes the use of branches more tedious and overall planning difficult. A second technical challenge relates to the fact that visceral branches can also originate from the false lumen. In such cases, perforation of the stiff chronic dissection flap is required to obtain access to the vessel. During the period January 2010 to November 2013, 17 patients (13 males, mean age 65±7.8 years) with chronic thoracoabdominal aneurismal degeneration following acute dissection were treated in our department with the use of fenestrated/branched stent-grafts. Technical success was achieved in all cases (100%). Perioperative mortality was two (11.8%) patients. One patient died due to multiple organ failure and one due to cardiac failure. No case of paraplegia was observed. During a 12-month median follow-up (range, 4-28 months) no aneurysm-related deaths were observed. Reintervention was required in three cases to repair a type Ib endoleak from a side branch. Endovascular treatment with fenestrated/branched stent-grafts is feasible for chronic post-dissection aneurysms. Standard thoracic stent-grafting is an option in a minority of patients, when the aneurysm is limited to the thoracic segment. Fenestrated and branched devices can successfully be used for aneurysms extending to the thoracoabdominal aorta.

Oikonomou, Kyriakos; Katsargyris, Athanasios; Ritter, Wolfgang; Spinelli, Domenico; Seto, Yuki

2014-01-01

197

Spontaneous isolated dissection of the abdominal aorta.  

PubMed

Isolated spontaneous dissection of the abdominal aorta is such a rare entity and there are only a few cases reported in literature up to date. A 42-year old male was admitted to the hospital with mild pain in the lower abdomen and back that had began seven days prior to admission together with the sudden onset of the ischemic symptoms of the left leg (ischemic ulcers of the calf gangrenous toe and pallor foot). Patient denied any trauma, hypertension history was negative, while he was active cigarette smoker. MSCT and digital subtracted angiography have shown a dissection of the abdominal aorta approximately two centimeters below the origin of the inferior mesenteric artery extending in the left common iliac artery, with no sign of the aneurysmatic dilatation of the abdominal aorta. Emergent surgery was performed with aorto-biiliacal bypass graft interposition, amputation of the left toe and necrectomy of the left calf Postoperative follow up and local vascular condition were satisfied. Even though is rare entity, isolated abdominal aorta dissection accounts for approximately 2-4% of all aortic dissection. Nowadays therapeutic regimen includes endovascular, open surgery or conservative treatment. PMID:24611358

Ivkosi?, Ante; Budincevi?, Hrvoje; Krstonijevi?, Zoran; Bari?, Marko; Lojo, Nermin; Trajbar, Dubravka; Gorski, Dinko; Suknai?, Slaven; Suci?, Tena

2013-12-01

198

Acute aortic dissection in a patient receiving gemcitabine and cisplatin.  

PubMed

Acute aortic dissection is often a fatal condition with in-hospital mortality rates of 27%. The incidence of acute aortic dissection is low at around 3 cases per 100,000 person-years. There is a strong relationship between hypertension and aortic dissection. 72% of patients in the International Registry of Acute Aortic Dissection had a history of hypertension. The inciting event is an intimal tear extending into the media with resultant dissection of blood along the laminar planes of the media. Cisplatin, a commonly used platinum-based chemotherapy drug, is associated with the development of hypertension on long-term follow up studies. This knowledge should prompt clinicians to screen for the development of hypertension and to be aware of its potential complications in patients treated with cisplatin-containing chemotherapy. Despite the known vascular complications of chemotherapy, there is a paucity of data on the association of aortic dissection with active cancer or chemotherapy. We present an unusual case of an extensive, acute aortic dissection in a relatively young male patient receiving gemcitabine and cisplatin for advanced metastatic pancreatic adenocarcinoma. PMID:23344098

Madden, George W; Ishaq, Muhammad K; Gupta, Raghav

2014-01-01

199

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

200

[Complications of colpohysterectomy with lymph node dissection in the cervix carcinoma at the Cancer Institute of Dakar: report of 412 cases].  

PubMed

The wertheim complications are dominated by the urinary dysfonction and the lymphocele which are linked at this procedure. This study reported 412 Wertheim associated to the radiotherapy. The purpose was to evaluate the complications among patients who underwent the Wertheim and to analyse the differents factors promotions the complications. The diagnosis was always late and the disease stage was advanced. The stages II, III and IV represented more than 80%. We found 86 complications (20.87%) distributed as follow: 17 urinary (19.76%), 30 secondary infections (34.88%), 8 colonic fistula (9.30%), 7 hemorrage (8.13%), 6 lymphedema (6.97%), 3 occlusions (3.48%), 1 phlebitis (1.16%), 1 lymphocele (1.16%). among all patients, 17 died, the mortality rate was 4.12%. A very good dissection preceded by radiotherapy may reduce the complications rate. PMID:15773155

Dem, A; Kasse, A A; Diop, M; Fall-Gaye, M C; Diop, P S; Dotou, C; Ciss, M L; Toure, P

2001-01-01

201

Unilateral right occipital condyle to C2 level spinal cord infarction associated with ipsilateral vertebral artery stenosis and contralateral vertebral artery dissection: a case report  

PubMed Central

Objectives To illustrate the clinical presentation, diagnosis, management, and outcome of unilateral right occipital condyle to C2 level spinal cord infarction. Setting A teaching hospital in Taiwan. Findings A 37-year-old man presented with acute-onset severe right neck pain before weakness developed in both right limbs. Early diagnosis was delayed due to mild intervertebral herniation of the C4–C5 disk. Magnetic resonance imaging revealed unilateral right occipital condyle to C2 level infarction. Angiography showed stenosis of the right vertebral artery (foraminal and intradural segments), and dissection of the left vertebral artery at the C1–C2 level. At discharge, he walked with assistance; 2 weeks later, he walked independently. Conclusions An early diagnosis is difficult but important, as it facilitates appropriate treatment for better functional and survival outcomes. Accurate early diagnosis can be made with adequate knowledge of spinal cord infarction and high index of suspicion for this condition.

Wang, Chin-Man; Tsai, Wei-Lun; Lo, Yang-Lan; Chen, Ji-Yih; Wong, Alice M-K

2011-01-01

202

Principles of Quality Controlled Endoscopic Submucosal Dissection with Appropriate Dissection Level and High Quality Resected Specimen  

PubMed Central

Endoscopic submucosal dissection (ESD) has enabled en bloc resection of early stage gastrointestinal tumors with negligible risk of lymph node metastasis, regardless of tumor size, location, and shape. However, ESD is a relatively difficult technique compared with conventional endoscopic mucosal resection, requiring a longer procedure time and potentially causing more complications. For safe and reproducible procedure of ESD, the appropriate dissection of the ramified vascular network in the level of middle submucosal layer is required to reach the avascular stratum just above the muscle layer. The horizontal approach to maintain the appropriate depth for dissection beneath the vascular network enables treatment of difficult cases with large vessels and severe fibrosis. The most important aspect of ESD is the precise evaluation of curability. This approach can also secure the quality of the resected specimen with enough depth of the submucosal layer.

Nishino, Eisei; Man-i, Mariko; East, James E.; Azuma, Takeshi

2012-01-01

203

Pseudo-dissection of ascending aorta in inferior myocardial infarction  

PubMed Central

Acute aortic dissection is a cardiac emergency which can present as inferior myocardial infarction. It has high morbidity and mortality requiring prompt diagnosis and treatment. Rapid advances in non-invasive imaging have facilitated the early diagnosis of this condition and in ruling out this potentially catastrophic illness. We report an interesting case of a 57-year old man who presented with inferior myocardial infarction requiring thrombolysis and temporary pacing wire for complete heart block. An echocardiogram was highly suspicious of aortic dissection. CT scan confirmed that the malposition of the temporary pacing wire through the aorta mimicked aortic dissection.

Attar, Muhammad Nadeem; Elmahy, Hossam; Goode, Grahame K.

2011-01-01

204

Aortic dissection: the flood tide sign.  

PubMed

Aortic dissection is a challenging medical and surgical problem. Its evolution depends on size and location of its intimal tears. We describe a case of contrast enhanced MD-CT with low out flow of the false lumen for an unbalanced between the entry and the reentry tears. This determined a delayed filling up of the false lumen on the arterial phase that was complete on the venous one. PMID:24268122

Rossi, Umberto G; Seitun, Sara; Cariati, Maurizio

2013-01-01

205

Fatal hemopericardium caused by retrograde acute abdominal aortic dissection: An autopsy report and morphological consideration  

Microsoft Academic Search

A case of acute aortic dissection in which entry is formed at the abdominal aorta is unusual. In addition, an autopsy case of cardiac tamponade caused by spontaneous acute retrograde abdominal aortic dissection is extremely rare and such a report has never previously been published to our knowledge. We herein present an autopsy case of sudden unexpected death due to

Takashi Chiba; Naoki Nishida; Maki Ohtani; Ichiro Suzuki; Naofumi Yoshioka

2006-01-01

206

"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

207

Flip-flop phenomenon and dissection of extracranial carotid artery  

SciTech Connect

A case of extracranial carotid artery dissection investigated both by conventional brain imaging and by arteriography is presented. The radionuclide angiogram showed a flip-flop phenomenon on the left hemisphere. The implications, including clinical features, pathogenesis, diagnosis, and treatment are discussed. Dissection of extracranial carotid artery is a cause of carotid hypoactivity, and this phenomenon is associated directly with a flip-flop phenomenon on brain imaging.

Verreault, J.; Cote, C.

1986-04-01

208

Delayed aortic dissection after transcatheter aortic valve implantation.  

PubMed

In selected high-risk patients with aortic stenosis, transcatheter aortic valve implantation (TAVI) can provide comparable functional improvement and early survival after surgical aortic valve replacement. However, the long-term outcome after TAVI is still to be determined and the occurrence of aortic dissection has not been systematically reported. Herein, a case is presented of delayed aortic dissection and rupture several months after an uneventful TAVI in a patient with bicuspid aortic valve stenosis. PMID:24383384

Al-Attar, Nawwar; Himbert, Dominique; Barbier, François; Vahanian, Alec; Nataf, Patrick

2013-09-01

209

Intramural esophageal dissection associated with esophageal perforation.  

PubMed

Intramural esophageal dissection (IED) is a rare clinical entity involving a mucosal injury and creation of a true and false lumen within the esophagus. We report on a case of IED caused by repeated vomiting due to a small bowel obstruction associated with a small amount of pneumomediastinum on CT. IED has traditionally been believed not to be associated with esophageal perforation. Our case adds to the few reported instances where IED has been associated with extraluminal air leakage, the mildest form of esophageal perforation and demonstrates imaging not previously published in the radiology literature. Our case was successfully managed conservatively. PMID:23819141

Monu, Nicholas C; Murphy, Brian L

2013-01-01

210

Rapidly Aggravated Dissecting Flap by Angiography during Percutaneous Stent Placement for Acute Isolated Superior Mesenteric Artery Dissection  

PubMed Central

Acutely aggravated dissecting flap and consequent occlusion of the superior mesenteric artery (SMA) by simple contrast passage during initial angiography for percutaneous stent placement is a uncommon event, which usually is not reported. After analysis of many factors that underlie development of such complications, we present herein one case of successful treatment of isolated SMA dissection and its complications with favorable outcomes during 25 months follow-up after percutaneous stent placement.

Yang, Hye Jin; Son, Tae Jun; Jung, Yoon Young; Choi, Seung A; Lee, Suk Hoon

2011-01-01

211

An Electrosurgical Endoknife with a Water-Jet Function (Flushknife) Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc  

PubMed Central

Background. Previously, we reported that the Flushknife (electrosurgical endoknife with a water-jet function) could reduce the operation time of colorectal endoscopic submucosal dissection (ESD) however, suitable situation for the Flushknife was obscure. This subgroup analysis of a prospective randomized controlled trial was aimed to investigate the suitable situation for the Flushknife. Methods. A total of 48 superficial colorectal neoplasms that underwent ESD using either the Flexknife or the Flushknife in a referral center were enrolled. The differences of operation time between the Flexknife and the Flushknife groups in each subgroup (tumor size, location, and macroscopic type) were analyzed. Results. Median (95% CI) operation time calculated using survival curves was significantly shorter in the Flushknife group than in the Flexknife group (55.5?min [41, 78] versus 74.0 [57, 90]?min; P = 0.039, Hazard Ratio HR: 0.53; 95% CI (0.29–0.97)). In particular, the HR in patients with laterally spreading tumors-nongranular type (LST-NG) in the Flushknife group was significantly smaller than in the Flexknife group (HR: 0.165?0.17; 95% CI (0.04–0.66)). There was a trend of decreasing HRs according to larger lesion size. Conclusions. The Flushknife proved its merits in colorectal ESD especially for the lesions which should be removed en bloc (LST-NG and large lesion).

Takeuchi, Yoji; Ishihara, Ryu; Iishi, Hiroyasu; Hanaoka, Noboru; Higashino, Koji; Uedo, Noriya

2013-01-01

212

Vertebral Artery Dissect Injury with Brown-S?quard Syndrome by a Neural Foramen Penetrated Electric Screw Driver Bit : A Case Report  

PubMed Central

There are few reports in the literature of complete obstruction of the vertebral artery (VA) due to an electric screw driver bit penetration through the neural foramen into the spinal canal with Brown-Séquard syndrome (BSS). A 25-year-old man was admitted to the emergency department with a penetrated neck injury by an electric screw driver bit after a struggle. The patient presented the clinical features of BSS. Computed tomography scan revealed that the electric screw driver bit penetrated through the right neural foramen at the level of C3-4, and it caused an injury to the right half of the spinal cord. Emergent angiography revealed VA dissection, which was managed by immediate coil embolization at both proximal and distal ends of the injury site. After occlusion of the VA, the electric screw driver bit was extracted under general anesthesia. Bleeding was minimal and controlled without difficulties. No postoperative complications, such as wound dehiscence, CSF leakage, or infection, were noted. Endovascular approaches for occlusion of vertebral artery lesions are safe and effective methods of treatment.

Oh, Chang Hyun; Kim, Min Soo; Noh, Sung Hyun; Ji, Gyu Yeul

2013-01-01

213

Vertebral artery dissect injury with brown-séquard syndrome by a neural foramen penetrated electric screw driver bit : a case report.  

PubMed

There are few reports in the literature of complete obstruction of the vertebral artery (VA) due to an electric screw driver bit penetration through the neural foramen into the spinal canal with Brown-Séquard syndrome (BSS). A 25-year-old man was admitted to the emergency department with a penetrated neck injury by an electric screw driver bit after a struggle. The patient presented the clinical features of BSS. Computed tomography scan revealed that the electric screw driver bit penetrated through the right neural foramen at the level of C3-4, and it caused an injury to the right half of the spinal cord. Emergent angiography revealed VA dissection, which was managed by immediate coil embolization at both proximal and distal ends of the injury site. After occlusion of the VA, the electric screw driver bit was extracted under general anesthesia. Bleeding was minimal and controlled without difficulties. No postoperative complications, such as wound dehiscence, CSF leakage, or infection, were noted. Endovascular approaches for occlusion of vertebral artery lesions are safe and effective methods of treatment. PMID:24891861

Oh, Chang Hyun; Kim, Min Soo; Noh, Sung Hyun; Shin, Dong Ah; Ji, Gyu Yeul

2013-12-01

214

Management of Posterior Fossa Dissecting Aneurysms  

PubMed Central

Summary Treatment and prognosis of 14 patients of posterior fossa arterial dissections (AD) and dissecting aneurysms (DA) in one institution was reviewed. Internal trapping of aneurysm was performed for six patients presenting with SAH (three Vertebral, one posterior cerebral, one posterior inferior cerebellar, one anterior inferior cerebellar DA). The patency of the parent arteries was preserved in four DA patients with SAH (two Vertebral, two Basilar DA), 1 incidental vertebral DA, and one DA patient with brainstem infarction using stents and coils (four patients) or coils only (two patient). Proximal occlusion of parent artery was performed in a vertebral DA with SAH. One patient with a superior cerebellar DA presented with a midbrain infarct developed SAH with spontaneous occlusion of the aneurysm two weeks later. Of the 14 cases, ten were angiographically stable or cured during a follow up period of four to 70 months. one spontaneously resolved and two recurred. There was one death.

Winston Chong, W. K.

2008-01-01

215

Thoracic aortic dissection associated with cocaine abuse.  

PubMed

Cardiovascular complications of cocaine abuse include myocardial ischemia and infarction, dysrhythmias, cardiomyopathies and aortic dissection. The case in point pertains to a 26-year-old, Caucasian male, substance abuser who suffered a thoracic aortic dissection following the use of crack cocaine. The autopsy and histological findings showed a connective tissue abnormality including a focal microcystic medial necrosis and a fragmentation of the elastic fibers in the arterial walls. Blood concentrations of cocaine and benzoylecgonine, taken individually, were considered to be within a potentially toxic range. Blood concentrations of methadone also indicated use of this drug at the same time. The small amounts of morphine found in the blood and urine were compatible with heroine or morphine use more than 24 h before death. PMID:15062953

Palmiere, Cristian; Burkhardt, Sandra; Staub, Christian; Hallenbarter, Myriam; Paolo Pizzolato, Gian; Dettmeyer, Reinhard; La Harpe, Romano

2004-05-10

216

Radical lymph node dissection for gallbladder cancer: indications and limitations.  

PubMed

Radical lymph node dissection provides survival benefit for patients with pT2 or more advanced gallbladder carcinoma tumors only if potentially curative resection is feasible; it must always be considered when planning a resection or re-resection for robust patients with pT2 or more advanced gallbladder carcinoma tumors. The degree of radical lymphadenectomy depends on clinically assessed nodal status: portal lymph node dissection is limited to cN0 disease; extended portal nodal dissection is indicated for cN0 and a modest degree of cN1 disease; peripancreatic lymph node dissection with pancreaticoduodenectomy is indicated for selected cases of evident peripancreatic nodal disease and/or direct organ involvement. Extended resection with extensive lymphadenectomy should be limited to expert surgeons because it may cause serious morbidity and mortality. PMID:17336245

Shirai, Yoshio; Wakai, Toshifumi; Hatakeyama, Katsuyoshi

2007-01-01

217

Vertebral artery dissection as a cause of cervical radiculopathy.  

PubMed

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

Silbert, Benjamin Isaac; Khangure, Mark; Silbert, Peter Linton

2013-12-01

218

Complicated Postpartum Type B Aortic Dissection and Endovascular Repair  

PubMed Central

BACKGROUND Fifty percent of aortic dissections in women younger than 40 years occur in association with pregnancy. Of these, half of type B dissections occur in the postpartum period. CASE A 30-year-old woman was status post spontaneous vaginal delivery at 30 weeks of gestation for fetal death, complicated by an eclamptic seizure. On post-partum day 4, she suffered an acute, complicated type B aortic dissection treated with endovascular stent graft placement. CONCLUSION Endovascular repair may be an attractive option for the treatment of complicated type B aortic dissections in pregnancy and the peripartum period, with reduced maternal and fetal mortality. This may allow the fetus to remain in situ and avoid the risks of surgery and possible cardiopulmonary bypass, with little radiation risk to the fetus.

Rosenberger, Laura H.; Adams, Joshua D.; Kern, John A.; Tracci, Margaret C.; Angle, J. Fritz; Cherry, Kenneth J.

2012-01-01

219

Dissecting Aneurysm of the Superior Mesenteric Artery Successfully Treated by Endovascular Stent-Graft Placement  

Microsoft Academic Search

Spontaneous and isolated dissecting aneurysm of the superior mesenteric artery is a rare event that has been successfully treated by surgery in several reported cases. To our knowledge, we present the first case of a patient with spontaneous and isolated dissecting aneurysm of the superior mesenteric artery that was successfully treated by endovascular stent-graft placement.

Masaki Ishida; Noriyuki Kato; Tadanori Hirano; Tomoaki Suzuki; Yu Shomura; Isao Yada; Kan Takeda

2003-01-01

220

Biomedicine: an ontological dissection.  

PubMed

Though ubiquitous across the medical social sciences literature, the term "biomedicine" as an analytical concept remains remarkably slippery. It is argued here that this imprecision is due in part to the fact that biomedicine is comprised of three interrelated ontological spheres, each of which frames biomedicine as a distinct subject of investigation. This suggests that, depending upon one's ontological commitment, the meaning of biomedicine will shift. From an empirical perspective, biomedicine takes on the appearance of a scientific enterprise and is defined as a derivative category of Western science more generally. From an interpretive perspective, biomedicine represents a symbolic-cultural expression whose adherence to the principles of scientific objectivity conceals an ideological agenda. From a conceptual perspective, biomedicine represents an expression of social power that reflects structures of power and privilege within capitalist society. No one perspective exists in isolation and so the image of biomedicine from any one presents an incomplete understanding. It is the mutually-conditioning interrelations between these ontological spheres that account for biomedicine's ongoing development. Thus, the ontological dissection of biomedicine that follows, with particular emphasis on the period of its formal crystallization in the latter nineteenth and early twentieth century, is intended to deepen our understanding of biomedicine as an analytical concept across the medical social sciences literature. PMID:18802784

Baronov, David

2008-01-01

221

Genetic Dissection of SLE  

PubMed Central

Genetic dissection of lupus pathogenesis in the NZM2410 strain has recently revealed that Sle1 is a potent locus that triggers the formation of IgG anti-histone/DNA antibodies, when expressed on the B6 background as a congenic interval. B6.lpr mice, in contrast, exhibit distinctly different cellular and serological phenotypes. Both strains, however, do not usually exhibit pathogenic autoantibodies, or succumb to lupus nephritis. In this study, we show that the epistatic interaction of Sle1 (in particular, Sle1/Sle1) with FASlpr leads to massive lymphosplenomegaly (with elevated numbers of activated CD4 T cells, CD4?CD8? double negative (DN) T cells, and B1a cells), high levels of IgG and IgM antinuclear (including anti-ssDNA, anti-dsDNA, and anti-histone/DNA), and antiglomerular autoantibodies, histological, and clinical evidence of glomerulonephritis, and >80% mortality by 5–6 mo of age. Whereas FASlpr functions as a recessive gene, Sle1 exhibits a gene dosage effect. These studies indicate that Sle1 and FASlpr must be impacting alternate pathways leading to lymphoproliferative autoimmunity.

Shi, Xiaoyan; Xie, Chun; Kreska, Desi; Richardson, James A.; Mohan, Chandra

2002-01-01

222

Experience with parametric binary dissection  

NASA Technical Reports Server (NTRS)

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

Bokhari, Shahid H.

1993-01-01

223

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

PubMed Central

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

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

2013-01-01

224

Endoscopic submucosal dissection of gastric ectopic pancreas  

PubMed Central

Patients with gastric tumors usually present with symptoms of discomfort or pain in the epigastrium, regurgitations, nausea, vomiting or melena. Treatment options include open and laparoscopic total or partial gastrectomy and recently endoscopic mucosal resection. A case of successful endoscopic submucosal dissection is described with the unusual pathological finding of heterotopic pancreatic tissue forming a gastric tumor. The 67-year-old male patient was operated on due to the initial diagnosis of gastro-intestinal stromal tumor of the gastric trunk. Two intra-operative biopsies were negative for cancer cells. Submucosal endoscopic dissection was performed with IT and Hook knives (Olympus). A literature review was performed. The operative time was 180 min with hospital stay of 6 days. During the injection of the carmine dye and the air insufflation pneumoperitoneum occurred and remained clinically silent during the observation period. The pathology result showed a heterotopic pancreatic tissue type 2 according to Heinrich's classification with microfoci of intestinal metaplasia. Preoperative diagnostics of gastric masses might be misleading and such tumors not necessarily should be excised. There are several surgical options with endoscopic submucosal dissection being probably the safest one and a non-disabling approach. Patients tolerate that kind of surgery well with good postoperative functional outcomes.

Makarewicz, Wojciech; Dubowik, Michal; Kosinski, Adam; Jastrzebski, Tomasz; Jaskiewicz, Janusz

2013-01-01

225

"Ostrich sign" indicates bilateral vertebral artery dissection.  

PubMed

Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms. Magnetic resonance angiography examinations of axially oriented slices of bilateral VADs resemble the face of an ostrich. This observation is similar to the "puppy sign," in which bilateral internal carotid artery dissections resemble the face of a dog. Craniocervical dissections of either the carotid or vertebral arteries have the potential to form an aneurysm, cause artery-to-artery embolism, or completely occlude the parent artery, resulting in an ischemic stroke. Because bilateral VADs in axial magnetic resonance angiographic sections stand out like the eyes of an ostrich, and because the fast identification of VADs is so critical, we eponymize this image the "ostrich sign." PMID:21440457

Rose, David Z; Husain, M Rizwan

2012-11-01

226

Endoscopic submucosal dissection of gastric ectopic pancreas.  

PubMed

Patients with gastric tumors usually present with symptoms of discomfort or pain in the epigastrium, regurgitations, nausea, vomiting or melena. Treatment options include open and laparoscopic total or partial gastrectomy and recently endoscopic mucosal resection. A case of successful endoscopic submucosal dissection is described with the unusual pathological finding of heterotopic pancreatic tissue forming a gastric tumor. The 67-year-old male patient was operated on due to the initial diagnosis of gastro-intestinal stromal tumor of the gastric trunk. Two intra-operative biopsies were negative for cancer cells. Submucosal endoscopic dissection was performed with IT and Hook knives (Olympus). A literature review was performed. The operative time was 180 min with hospital stay of 6 days. During the injection of the carmine dye and the air insufflation pneumoperitoneum occurred and remained clinically silent during the observation period. The pathology result showed a heterotopic pancreatic tissue type 2 according to Heinrich's classification with microfoci of intestinal metaplasia. Preoperative diagnostics of gastric masses might be misleading and such tumors not necessarily should be excised. There are several surgical options with endoscopic submucosal dissection being probably the safest one and a non-disabling approach. Patients tolerate that kind of surgery well with good postoperative functional outcomes. PMID:24130642

Makarewicz, Wojciech; Bobowicz, Maciej; Dubowik, Michal; Kosinski, Adam; Jastrzebski, Tomasz; Jaskiewicz, Janusz

2013-09-01

227

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

PubMed

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

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

2014-03-01

228

Giant Aortic Pseudoaneurysm with Stanford Type A Aortic Dissection after Aortic Valve Replacement  

PubMed Central

Giant pseudoaneurysm of the ascending aorta is a rare but dreadful complication occurring several months or years after aortic surgery. Thoracic aortic aneurysms tend to be asymptomatic and were previously often diagnosed only after a complication such as dissection or rupture. We present a rare case of giant ascending aneurysm with Stanford type A aortic dissection occurring 6 years after aortic valve replacement and also illustrate the potential dimensions the ascending aorta may reach by a pseudoaneurysm and dissection after AVR.

Boran, Mertay; Parlar, Ali Ihsan; Boran, Ertay

2012-01-01

229

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

SciTech Connect

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

Papadopoulos, Dimitris P., E-mail: jimpapdoc@yahoo.com; Moyssakis, Ioannis; Perakis, Alexandros; Athanasiou, Andreas [Department of Cardiology (Greece); Anagnostopoulou, Sophia [University of Athens Medical School, Department of Anatomy (Greece); Benos, Ioannis; Votteas, Vassilios E. [Department of Cardiology (Greece)

2004-09-15

230

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

Microsoft Academic Search

Iatrogenic arterial dissection leading to the development of dissecting pseudoaneurysms of the superior mesenteric artery\\u000a (SMA) is a rare complication of angiography. Surgical and endovascular treatment options exist for this important condition.\\u000a We report a case of bare stent implantation in dissecting pseudoaneurysm of the SMA that developed after angiography in a\\u000a patient with acute mesenteric ischemia. Although it is

Ramazan Kutlu; Cengiz Ara; Kaya Sarac

2007-01-01

231

[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

232

Pneumococcal Meningitis, Cerebral Venous Thrombosis, and Cervical Arterial Dissection  

PubMed Central

Background: Pneumococcal meningitis in adults is widely associated with intracranial complications, which occur in up to 74.7% of the patients. Method: Case report. Results: We report the case of a 40-year-old white female with pneumococcal meningitis after a sinus surgery, who developed a concomitant cerebral venous thrombosis and multiple cervical artery dissections. Following treatment with antibiotics and intravenous heparin, she had complete neurological recovery. Conclusions: Vascular complications should always be remembered and adequately treated in patients with bacterial meningitis. Cervical arterial dissections should be investigated as potential embolic sources of intracranial ischemic lesions.

Panicio, Mauricio Isaac; Foresto, Renato Demarchi; Mateus, Lucas; Monzillo, Paulo Helio; Alves, Monique Bueno; Silva, Gisele Sampaio

2013-01-01

233

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.

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

2012-01-01

234

Aortic Dissection in Turner Syndrome  

PubMed Central

Purpose of review Turner syndrome (TS) is a relatively common disorder of female development with cardinal features of short stature and congenital cardiovascular defects (CHD). TS is the most common established cause of aortic dissection in young women, but has received little attention outside of pediatric literature. This review focuses on emerging knowledge of the characteristics of aortic disease in TS in comparison with Marfan-like syndromes and isolated aortic valve disease. Recent findings The incidence of aortic dissection is significantly increased in individuals with TS at all ages, highest during young adult years and in pregnancy. Pediatric patients with dissection have known CHD, but adults often have aortic valve and arch abnormalities detected only by screening cardiac MR (CMR). Thoracic aortic dilation in TS must be evaluated in relation to body surface area (BSA). Dilation is most prominent at the ascending aorta similar to the pattern seen in non-syndromic bicuspid aortic valve (BAV), is equally prevalent (20-30%) in children and adults, and does not seem to be rapidly progressive. Cardiovascular anomalies and risk for aortic dissection in TS are strongly linked to a history of fetal lymphedema, evidenced by the presence of neck webbing and shield chest. Summary Risk for acute aortic dissection is increased by more than 100-fold in young and middle-aged women with TS. Monitoring frequency and treatment modalities are decided on an individual basis until more information on outcomes becomes available.

Bondy, Carolyn A.

2009-01-01

235

Spontaneous isolated dissection of the superior mesenteric artery.  

PubMed

A case of a 63-year-old man with isolated dissection of the superior mesenteric artery (SMA), demonstrated by enhanced computed tomography (CT) and abdominal angiography, was admitted to our hospital. The severity of this disease varies from mild to severe; the severe cases require surgery. But the mild cases, like the one presented here, only need conservative therapy. This case demonstrated the usefulness of anticoagulation therapy and the indications for surgical and radiological intervention. PMID:12322798

Takayama, Hideo; Takeda, Shinhiro; Saitoh, Sabine Kyoko; Hayashi, Hiromitsu; Takano, Teruo; Tanaka, Keiji

2002-09-01

236

Treatment optimization of aortocoronary dissection as a complication after heart catheterization using coronary computerized tomographic angiography.  

PubMed

We present the case of a 71-year-old patient with a chronic total occlusion of the right coronary artery (RCA) resulting in a retrograde aortic dissection as a complication of coronary intervention. Acute therapy consisted of coronary stent implantation into the proximal RCA to cover the dissection's entry. One day after, computed tomography-guided angiography revealed a progression of the intramural aortic hematoma with a residual dissection at the RCA ostium. Recurrent coronary angiography was performed to implant another stent covering the entry. Imaging at follow-up demonstrated complete coverage of the Dunning dissection and regression of the intramural aortic hematoma. PMID:24882545

Baumann, Stefan; Huseynov, Aydin; Behnes, Michael; Frambach, Daniel; Böcker, Christian; Becher, Tobias; Henzler, Thomas; Lehmann, Ralf; Borggrefe, Martin; Akin, Ibrahim

2014-06-01

237

[Endovascular therapy of acute traumatic vascular peripheral dissections using self-expandable stents].  

PubMed

Percutaneous peripheral and coronary interventions as well as surgical procedures can be complicated by dissections and traumatic lesions of peripheral arteries. Posttraumatic peripheral dissections can be threatening for the extremities and often their management might be a challenge. Open surgery requires wide exposure and dissection of posttraumatic tissues. Endovascular techniques using selfexpandable stents gains popularity because of high efficiency, safety and good results. This technique is associated with decreased trauma, no requirements for anesthesia, short hospital stay. We present two cases of posttraumatic iliac dissections treated with self expandable stents. PMID:15587738

Petrov, I; Chervenkov, V; Dzhorgova, Iu; Grozdinski, L; Zakhariev, T; Chirkov, A

2003-01-01

238

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

239

Traditional electrosurgery and a low thermal injury dissection device yield different outcomes following bilateral skin-sparing mastectomy: a case report  

Microsoft Academic Search

Introduction  Although a skin- and nipple-sparing mastectomy technique offers distinct cosmetic and reconstructive advantages over traditional\\u000a methods, partial skin flap and nipple necrosis remain a significant source of post-operative morbidity. Prior work has suggested\\u000a that collateral thermal damage resulting from electrocautery use during skin flap development is a potential source of this\\u000a complication. This report describes the case of a smoker

Richard E Fine; Joshua G Vose

2011-01-01

240

Symptomatic Internal Carotid Artery Dissecting Pseudoaneurysm: Endovascular Treatment by Stent-Graft  

SciTech Connect

Dissecting pseudoaneurysm of the extracranial portion of the internal carotid artery (ICA) is a usually benign complication of spontaneous ICA dissection. We report a case in which pseudoaneurysm volume enlarged progressively and new clinical symptoms developed 9 months following disease onset. Placement of a coronary stent-graft resulted in immediate complete resolution of clinical symptoms and radiologic restoration of normal flow.

Heye, Sam, E-mail: sam.heye@uz.kuleuven.ac.be; Maleux, Geert [University Hospitals Gasthuisberg, Department of Radiology (Belgium); Vandenberghe, Rik [University Hospitals Gasthuisberg, Department of Neurology (Belgium); Wilms, Guido [University Hospitals Gasthuisberg, Department of Radiology (Belgium)

2005-05-15

241

Symptomatic internal carotid artery dissecting pseudoaneurysm: endovascular treatment by stent-graft.  

PubMed

Dissecting pseudoaneurysm of the extracranial portion of the internal carotid artery (ICA) is a usually benign complication of spontaneous ICA dissection. We report a case in which pseudoaneurysm volume enlarged progressively and new clinical symptoms developed 9 months following disease onset. Placement of a coronary stent-graft resulted in immediate complete resolution of clinical symptoms and radiologic restoration of normal flow. PMID:15959696

Heye, Sam; Maleux, Geert; Vandenberghe, Rik; Wilms, Guido

2005-01-01

242

Traumatic Vertebral Artery Dissection in a Child with Brachial Plexus Injury  

Microsoft Academic Search

Traumatic vertebral artery dissection is an unusual event in children, but early recognition and treatment are important to prevent neurological deficits. The authors present a case of a 4-year-old boy with a traumatic extracranial vertebral artery dissection, who suffers from left arm monoplegia due to brachial plexus injury.

Seong-Hyun Park; Joo-Kyung Sung; Sung-Kyoo Hwang

2005-01-01

243

Surgical treatment of superior mesenteric artery dissecting aneurysm and simultaneous celiac artery compression  

Microsoft Academic Search

Spontaneous dissections of visceral arteries are rare, but when they do occur, they most commonly involve the superior mesenteric artery (SMA). We present a case of intestinal ischemia caused by a spontaneous dissection of the SMA in a patient with simultaneous celiac artery occlusion. The patient was a 45-year-old woman who presented with intestinal angina of sudden onset. Arteriography revealed

Maurice M. Solis; Tim J. Ranval; David R. McFarland

1993-01-01

244

Stenting of a spontaneous dissection of the superior mesenteric artery: a new therapeutic approach?  

PubMed

Spontaneous dissection of the superior mesenteric artery (SMA) is rare and has been reported only sporadically. Therapeutic options are either a surgical approach, which is the more frequently adopted, or a simple observation. We report a case of spontaneous dissection of the SMA with a review of the literature and present a new therapeutic approach. PMID:15461979

Froment, P; Alerci, M; Vandoni, R E; Bogen, M; Gertsch, P; Galeazzi, G

2004-01-01

245

Stenting of a Spontaneous Dissection of the Superior Mesenteric Artery: A New Therapeutic Approach?  

Microsoft Academic Search

Spontaneous dissection of the superior mesenteric artery (SMA) is rare and has been reported only sporadically. Therapeutic options are either a surgical approach, which is the more frequently adopted, or a simple observation. We report a case of spontaneous dissection of the SMA with a review of the literature and present a new therapeutic approach.

P. Froment; M. Alerci; R. E. Vandoni; M. Bogen; P. Gertsch; G. Galeazzi

2004-01-01

246

Self-limited spontaneous dissection of the main trunk of the superior mesenteric artery  

Microsoft Academic Search

Spontaneous dissection of the splanchnic arteries is rare and reportedly carries a high risk of mortality. Two cases with spontaneous dissection of the main trunk of the superior mesenteric artery followed by a self-limited clinical course are presented. Current management strategies, including bypass operation, patch angioplasty, and conservative treatments, are discussed. Emphasis is placed on the role of nonsurgical management

Hiroshi Yasuhara; Hiroshi Shigematsu; Tetsuichiro Muto

1998-01-01

247

Stenting of a Spontaneous Dissection of the Superior Mesenteric Artery: A New Therapeutic Approach?  

SciTech Connect

Spontaneous dissection of the superior mesenteric artery (SMA) is rare and has been reported only sporadically. Therapeutic options are either a surgical approach, which is the more frequently adopted, or a simple observation. We report a case of spontaneous dissection of the SMA with a review of the literature and present a new therapeutic approach.

Froment, P. [Ospedale San Giovanni, Department of Surgery (Switzerland)], E-mail: froment_philippe@bluewin.ch; Alerci, M. [Ospedale San Giovanni, Department of Radiology (Switzerland); Vandoni, R.E.; Bogen, M.; Gertsch, P. [Ospedale San Giovanni, Department of Surgery (Switzerland); Galeazzi, G. [Ospedale San Giovanni, Department of Radiology (Switzerland)

2004-09-15

248

``Dissection'' of a Hair Dryer  

NASA Astrophysics Data System (ADS)

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 discover how engineers solve problems such as how to vary between low and high heat and fan speed by simply moving the position of a single switch. Principles of alternating versus direct current, series and parallel circuits, electrical safety, voltage dividing, ac rectification, power, and measurement of resistance and continuity all come in to play.

Eisenstein, Stan; Simpson, Jeff

2008-12-01

249

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.

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

2013-01-01

250

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

251

Stereotactic excision of additional lesions detected with intraoperative ultrasound examination during radiofrequency dissecting sealar (habib®) assisted hepatic metastasectomy: report of 4 cases.  

PubMed

Intraoperative ultrasound has been using to achieve a proper resection strategy in patients undergoing a hepatic colorectal metastasectomy. This study aims to describe and reveal the place of stereotactic metastasectomy in nonpalpable colorectal liver metastases (CLM). A chart review was initiated for all patients underwent resection for CLM between 2006 and 2011. The data concerning perioperative data and intraoperative strategy were abstracted. Among the 58 patients, who underwent a resection for CLM, 4 (6.9 %) (all men, median age 65.5, range 49-72, years) necessitated a stereotactic metastasectomy. Preoperative evaluations showed 1 (n?=?1), 2 (n?=?2), or 3 (n?=?1) lesions, and intraoperative ultrasound (IUS) found an additional lesion in a case. Stereotactic marking was performed for nonpalpable lesions located in segments IVA, II, and VI and at the junction of segments V and VI. The margins were negative for all lesions both resected with conventional and stereotactic techniques. The examinations of the stereotactic resection materials revealed metastatic adenocarcinoma (patients n?=?2), focal nodular hyperplasia (n?=?1), and abnormal benign liver histology probably induced by chemotherapy (n?=?1). The median (range) operation and hospitalization periods were 217.5 (150-310) minutes and 5.5 (2-9) days. No complications were observed except biliary fistula in a case, which spontaneously disappeared within 2 weeks. A patient died due to systemic disease including hepatic metastases 33 months after the liver surgery. Stereotactic metastasectomy may be feasible for the removal of nonpalpable CLM. Further evaluations are necessitated to understand the accurate place of this novel technique. PMID:24799786

Altuntas, Yunus E; Unel, Sacide; Gezen, Fazl? C; Aksakal, Nihat; Civil, Osman; Vural, Selahattin; Ozates, Mustafa; Oncel, Mustafa

2014-02-01

252

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.

253

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

254

Insights into acute aortic dissection  

Microsoft Academic Search

Aortic dissection represents one of the most catastrophic and complex cardiovascular diseases. Its origin is related to an intimal tear with course of blood flow into the aortic wall and division of the aortic lumen into two different lumens, defined as the true and false lumen, separated by a septum or intimal flap. Based on the location of the entry

S. Trimarchi

2012-01-01

255

Traumatic internal carotid artery dissection presenting as delayed hemilingual paresis.  

PubMed

A case of internal carotid artery dissection presenting as delayed right hemilingual paresis after blunt craniocervical trauma is presented. Diagnosis is discussed with emphasis on MR and MR angiographic findings. Mechanisms of injury and lower cranial nerve palsy are also briefly discussed. PMID:8770254

Pica, R A; Rockwell, B H; Raji, M R; Dastur, K J; Berkey, K E

1996-01-01

256

Aortic dissection of Kommerell's diverticulum in Marfan's syndrome.  

PubMed

We report a surgical case of chronic aortic dissection with an entrance tear on Kommerell's diverticulum, a rare embryologic anomaly, with an extension to the arteria lusoria, in a patient with Marfan's syndrome. The operation consisted of aortic root and arch replacement with reimplantation of the right subclavian artery in the right carotid artery under circulatory arrest and deep hypothermia. PMID:10320273

Braunberger, E; Mercier, F; Fornes, P; Julia, P L; Fabiani, J N

1999-04-01

257

Robotic-assisted inguinal lymph node dissection: A preliminary report  

PubMed Central

Penile cancer with inguinal lymph node metastasis is a common cancer in India. Open inguinal lymphadenectomy is the gold standard treatment of metastatic inguinal lymph nodes. We report our experience and technique of robotic assisted inguinal lymph node dissection in two patients presented with palpable inguinal lymph nodes, which to our knowledge is the first reported case series from India.

Dogra, P. N.; Saini, Ashish Kumar; Singh, Prabhjot

2011-01-01

258

Nutcracker phenomenon: An unusual presentation of acute aortic dissection  

PubMed Central

We report a case of acute aortic dissection leading to compression of the left renal vein (LRV), thereby resulting in the nutcracker phenomenon. A 49-year-old previously healthy woman presented with intermittent gross hematuria and mild left flank pain of five days' duration. Laboratory examinations were within normal limits, except for the elevated C-reactive protein. Cystoscopy revealed bleeding from the left ureteral orifice. Contrast-enhanced computed tomography demonstrated acute Type B aortic dissection and compression of LRV between the enlarged aorta and superior mesenteric artery with an associated dilatation of the left gonadal vein as a collateral circulation.

Kodama, Koichi; Noda, Toru; Motoi, Isamu

2013-01-01

259

Multiparity and Spontaneous Coronary Artery Dissection in the Postpartum Period  

PubMed Central

Spontaneous coronary artery dissection (SCAD) is a deadly cause of myocardial infarction (MI) that mainly affects otherwise healthy, young females. Forty percent of patients die suddenly or within a few hours of symptom onset. We examine the case of a young female who presented with chest pain. She developed ST elevations in anterolateral leads mimicking ST elevation MI. Cardiac catheterization was done and showed a middle left anterior descending (LAD) dissection. The patient underwent primary percutaneous transluminal coronary angioplasty with coronary stent placed in the LAD.

Asker, Muntecep; Asker, Selvi; Gursu, Ozgur

2012-01-01

260

Hi-Tech Alternatives to Dissection.  

ERIC Educational Resources Information Center

The debate on the educational value of dissection versus the value of animal life is examined. Interactive videodisc (IVD) technology is described in light of its potential for laboratory simulations. The design of the IVD-based dissection simulation, The Interactive Frog Dissection, is presented. (KR)

Strauss, Richard T.; Kinzie, Mable B.

1991-01-01

261

Isolated dissection of the superior mesenteric artery  

Microsoft Academic Search

Dissection of the superior mesenteric artery (SMA) not associated with aortic dissection is rare. The purpose of this study is to describe the computed tomographic (CT) findings of this condition. We studied the CT findings of six patients with isolated dissection of the SMA. CT demonstrated thrombosis of the false lumen or intramural hematoma ( n = 4) and\\/or intimal

S. Suzuki; S. Furui; H. Kohtake; T. Sakamoto; M. Yamasaki; A. Furukawa; K. Murata; R. Takei

2004-01-01

262

Traumatic internal carotid artery dissections caused by blunt softball injuries.  

PubMed

This report describes recently treated patients with carotid artery dissection caused by blunt softball injuries, as well as the results of a study of carotid artery trauma in a community. Data obtained through the medical records linkage system used for epidemiologic studies in Olmsted County, MN were used to identify all cases of traumatic internal carotid artery dissection diagnosed from 1987 through 1994. Four patients with traumatic internal carotid artery dissections were identified during the 8-year period under study. In two patients (50%) the carotid dissection was a result of the direct impact of a softball. A 39-year-old-man, who developed transient cerebral ischemic symptoms, and a 35-year-old woman, who developed a painful Horner's syndrome, were struck by a softball on the anterolateral aspect of the neck. Both patients had a low carotid bifurcation. These data suggest that internal carotid artery dissections may be underrecognized sequelae of direct softball injuries to the anterolateral neck. A low carotid bifurcation may be a risk factor for such injuries. PMID:9517699

Schievink, W I; Atkinson, J L; Bartleson, J D; Whisnant, J P

1998-03-01

263

Central neck dissection in differentiated thyroid cancer: technical notes.  

PubMed

Differentiated thyroid cancers may be associated with regional lymph node metastases in 20-50% of cases. The central compartment (VIupper VII levels) is considered to be the first echelon of nodal metastases in all differentiated thyroid carcinomas. The indication for central neck dissection is still debated especially in patients with cN0 disease. For some authors, central neck dissection is recommended for lymph nodes that are suspect preoperatively (either clinically or with ultrasound) and/or for lymph node metastases detected intra-operatively with a positive frozen section. In need of a better definition, we divided the dissection in four different areas to map localization of metastases. In this study, we present the rationale for central neck dissection in the management of differentiated thyroid carcinoma, providing some anatomical reflections on surgical technique, oncological considerations and analysis of complications. Central neck dissection may be limited to the compartments that describe a predictable territory of regional recurrences in order to reduce associated morbidities. PMID:24711677

Giugliano, G; Proh, M; Gibelli, B; Grosso, E; Tagliabue, M; De Fiori, E; Maffini, F; Chiesa, F; Ansarin, M

2014-02-01

264

Acute Type A Aortic Dissection in a 36-Week Pregnant Patient  

PubMed Central

Aortic dissection is a relatively rare yet often fatal condition. Early recognition and treatment are crucial for survival. While the majority of patients who present with aortic dissection are older than 50 years of age and have a history of hypertension, younger patients with connective tissue disease, bicuspid aortic valves, and a family history of aortic dissection are also at an increased risk for developing this condition. A review of the literature revealed a paucity of published cases describing the successful, emergent repair of acute type A aortic dissections in third- trimester gravid patients. We present the case of the successful diagnosis and surgical repair of a 41-year-old female who presented to the emergency department with an acute type A aortic dissection at 36 weeks of gestation.

Jwayyed, Sharhabeel; Bhalla, Mary Colleen

2013-01-01

265

Spontaneous Dissection of Internal Carotid Artery Masquerading as Angioedema  

PubMed Central

Spontaneous dissection of the internal carotid artery usually presents with stroke-like symptoms secondary to ischemia in its vascular territory, as well as local signs and symptoms, which may include head, face or neck pain, Horner’s syndrome, pulsatile tinnitus, and cranial nerve palsies. We report a case of a 44-year-old healthy white male who presented with tongue swelling mimicking angioedema as an unusual manifestation of spontaneous dissection of the internal carotid artery. Two weeks after the initial presentation, the patient returned with similar symptoms and slurred speech. Upon physical examination, he was noted to have isolated left-sided hypoglossal nerve palsy. Subsequent diagnostic imaging revealed segmental narrowing of the left internal carotid artery. The appearance was consistent with the presence of a spontaneous internal carotid artery dissection with associated pseudoaneurysm formation.

Abhishek, Kumar; Sofi, Umar

2008-01-01

266

Concurrent hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum in a 16-year-old boy.  

PubMed

We report the case of a 16-year-old boy who presented to our clinic with concomitant hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum. Recent reports describe the co-occurrence of pyoderma gangrenosum, acne, and hidradenitis suppurativa. This case further expands the spectrum of concomitant pyoderma gangrenosum and dissecting cellulitis of the scalp. PMID:24118007

Koshelev, Misha V; Garrison, Paige A; Wright, Teresa S

2014-01-01

267

Use of Multidetector-row CT with Multiplanar Reconstruction to Diagnose Isolated Dissection of the Superior Mesenteric Artery  

Microsoft Academic Search

Dissection of the superior mesenteric artery not associated with aortic dissection is rare. We describe our experience of multidetector -row computed tomography with multiplanar recon- struction in two cases. Axial and oblique sagittal reconstructed images clearly illustrate the intimal flap in the proximal superior mesenteric artery. In both cases, the involved portions of the arteries are concomitantly enlarged in diameter.

CHENG-ANG C HANG; SHIUN JAW; WEI-CHEN L IN; TSY H-JYI HSIEH; Tsyh-Jyi Hsieh

2007-01-01

268

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

269

Seizure as Initial Manifestation of Aortic Dissection Type A  

PubMed Central

Background Seizure as the initial manifestation of aortic dissection is rare. Case report An 88-year-old female experienced a first generalized tonic clonic seizure, which was terminated with midazolam. Acute cerebral magnetic resonance imaging and angiography were non-informative. After awaking she complained about cramping pain in the right upper extremity, which was accompanied by involuntary flexion movements of the right upper extremity. Blood pressure was initially normal. Blood gases revealed metabolic acidosis and blood chemical investigations a markedly increased D-dimer. Consecutively blood pressure declined and transthoracic echocardiography showed pericardial effusion. A computed tomography scan of the thorax revealed an aortic dissection type A. The patient died 16 hours after admission after cardiothoracic surgeons had refused surgical treatment. Conclusion This case shows that a generalized tonic-clonic seizure may be the initial manifestation of an aortic dissection type A in the absence of thoracic chest pain and that brachyalgia may not develop earlier than with progression of the dissection.

Finsterer, Josef; Frank, Marlies; Keller, Hans; Bastowanski, Adam

2010-01-01

270

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

271

Clinical Utility of Magnetic Resonance Imaging in the Follow-up of Chronic Aortic Type B Dissection.  

PubMed

Several imaging modalities are utilised in the assessment of disease progression in chronic aortic dissection. We present the case of a 66 year-old male who underwent ascending aorta repair for Stanford type A aortic dissection. On follow-up the persisting dissection of the descending thoracic aorta was observed to regress on magnetic resonance imaging (MRI). MRI has several advantages over computed tomography (CT) scanning and echocardiography in the follow-up phase of this disease. PMID:24735714

Sherrah, Andrew G; Vallely, Michael P; Grieve, Stuart M; Jeremy, Richmond W; Hendel, Paul N; Puranik, Rajesh

2014-07-01

272

Endoscopic submucosal tunnel dissection salvage technique for ulcerative early gastric cancer  

PubMed Central

Endoscopic submucosal dissection is an effective treatment modality for early gastric cancer (EGC), though the submucosal fibrosis found in ulcerative EGC is an obstacle for successful treatment. This report presents two cases of ulcerative EGC in two males, 73- and 80-year-old, with severe fibrosis. As endoscopic ultrasonography suggested that the EGCs had invaded the submucosal layer, the endoscopic submucosal tunnel dissection salvage technique was utilized for complete resection of the lesions. Although surgical gastrectomy was originally scheduled, the two patients had severe coronary heart disease, and surgeries were refused because of the risks associated with their heart conditions. The endoscopic submucosal tunnel dissection salvage technique procedures described in these cases were performed under conscious sedation, and were completed within 30 min. The complete en bloc resection of EGC using endoscopic submucosal tunnel dissection salvage technique was possible with a free resection margin, and no other complications were noted during the procedure. This is the first known report concerning the use of the endoscopic submucosal tunnel dissection salvage technique salvage technique for treatment of ulcerative EGC. We demonstrate that endoscopic submucosal tunnel dissection salvage technique it is a feasible method showing several advantages over endoscopic submucosal dissection for cases of EGC with fibrosis.

Choi, Hyuk Soon; Chun, Hoon Jai; Seo, Min Ho; Kim, Eun Sun; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang

2014-01-01

273

Superior mesenteric artery spontaneous and isolated dissection diagnosed by using MDCTA.  

PubMed

We report the case of a 49-year-old man admitted to our Institute because he suffered acute abdominal pain induced by eating. Sonography don't revealed pathological findings. Then underwent a multi-detector row computed tomography angiography (MDCTA) that revealed an intimal flap separating true and false lumens that was located 2 cm from the origin of the superior mesenteric artery (SMA) and with an extension of 8 cm. Since the dissection was limited without occlusion of the SMA and the mesenteric marginal artery served as a collateral vessel on the distal side of the SMA, the treatment has been conservative. Improved CT technology facilitates the diagnosis of superior mesenteric artery dissection. Prompt diagnosis and treatment result in the lowest mortality rate and minimize the prevalence of intestinal infarction. Only 107 cases (including the present case) of isolated spontaneous SMA dissection without associated aortic dissection were identified from the literature. PMID:20391965

Saba, L; Sanfilippo, R; Atzeni, M; Ribuffo, D; Montisci, R; Mallarini, G

2010-03-01

274

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

Federal Register 2010, 2011, 2012, 2013

...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

275

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

Federal Register 2010, 2011, 2012, 2013

...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

276

Vertebral artery dissection associated with sildenafil abuse.  

PubMed

We present a 49-year-old male who suffered a cerebellar infarction due to a vertebral artery dissection. The patient had taken sildenafil daily for at least 2 years for sexual enhancement. There was no sexual intercourse or traumatic event prior to symptom onset. Sildenafil intake has been associated with aortic dissection and, in the light of this report, we suggest that chronic sildenafil intake could be a risk factor for arterial dissection. PMID:23454143

Dersch, Rick; Anastasopoulos, Constantin; Hader, Claudia; Stich, Oliver

2013-05-01

277

Delayed chronic type A dissection with a functional midline crossing right internal thoracic artery after CABG: surgical approach to an ascending aorta without dissecting the midline crossing internal thoracic artery.  

PubMed

We successfully treated chronic type A dissection and coronary artery disease with a functional midline crossing right internal thoracic artery (RITA) after coronary artery bypass grafting (CABG). A 68-year-old man was incidentally diagnosed as chronic type A dissection by follow-up cardiac catheterization after CABG, with 90% stenosis in the right coronary artery (RCA) No. 2. The dissecting aneurysm (max. 6 cm in diameter) was localized at the right portion of the ascending aorta with a functional RITA to the left anterior descending coronary artery. The dissecting aneurysm was treated with patch closure and the RCA was revascularized with a right gastroepiploic artery and saphenous vein composite graft through combined right antero-axillar thoracotomy and lower mini-sternotomy without RITA dissection. Treatment of chronic type A dissection following CABG becomes more challenging with a functional midline crossing RITA. It is important that a safe and less invasive surgical strategy be implemented for such complicated case. PMID:15008703

Yamauchi, Takashi; Miyamoto, Yuji; Takano, Hiroshi; Sawa, Yoshiki; Matsumiya, Goro; Sakaki, Masayuki; Matsuda, Hikaru

2004-02-01

278

Traumatic Bilateral Common Carotid Artery Dissection Due to Strangulation  

PubMed Central

Summary We report a case of bilateral common carotid artery dissection due to strangulation successfully treated by stent placement, with a review of the literature. A 61-year-old woman was strangled by an apron strap. She was admitted to our hospital with tetraparesis, because of spinal cord injury. On the next day, her left hemiparesis aggravated and left facial palsy newly appeared. Diffusion weighted magnetic resonance imaging (MRI) showed new ischemic lesions in the right cerebral hemisphere. Aortography revealed bilateral common carotid artery dissection. Moreover, thrombus or intimal flap was recognized in the right common carotid artery. The right common carotid dissection was fixed with deployment of self expanding stents to prevent the aggravation of ischemic stroke at that time. The contralateral lesion was also treated ten days later because small ischemic lesions were newly recognized in the left hemisphere on MRI. No new neurological deficit appeared after bilateral carotid artery stenting. Her paraparesis completely improved two months after the spinal cord injury. Carotid artery stenting using self expanding stents was especially effective as the treatment for bilateral carotid artery dissection.

Chokyu, I.; Tsumoto, T.; Miyamoto, T.; Yamaga, H.; Terada, T.; Itakura, T.

2006-01-01

279

Axillary lymph node dissection for breast cancer utilizing Harmonic Focus®  

PubMed Central

Background For patients with axillary lymph node metastases from breast cancer, performance of a complete axillary lymph node dissection (ALND) is the standard approach. Due to the rich lymphatic network in the axilla, it is necessary to carefully dissect and identify all lymphatic channels. Traditionally, these lymphatics are sealed with titanium clips or individually sutured. Recently, the Harmonic Focus®, a hand-held ultrasonic dissector, allows lymphatics to be sealed without the utilization of clips or ties. We hypothesize that ALND performed with the Harmonic Focus® will decrease operative time and reduce post-operative complications. Methods Retrospective review identified all patients who underwent ALND at a teaching hospital between January of 2005 and December of 2009. Patient demographics, presenting pathology, treatment course, operative time, days to drain removal, and surgical complications were recorded. Comparisons were made to a selected control group of patients who underwent similar surgical procedures along with an ALND performed utilizing hemostatic clips and electrocautery. A total of 41 patients were included in this study. Results Operative time was not improved with the use of ultrasonic dissection, however, there was a decrease in the total number of days that closed suction drainage was required, although this was not statistically significant. Complication rates were similar between the two groups. Conclusion In this case-matched retrospective review, there were fewer required days of closed suction drainage when ALND was performed with ultrasonic dissection versus clips and electrocautery.

2011-01-01

280

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.

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

2012-01-01

281

Management of symptomatic spontaneous isolated visceral artery dissection: is emergent intervention mandatory?  

PubMed

Spontaneous dissection of a visceral artery without associated aortic dissection is rare, although more cases have recently been reported because of the advancement of diagnostic techniques. The risk factors, causes, and natural history of spontaneous isolated visceral artery dissection are unclear. Treatment with open surgery, endovascular stenting, or anticoagulation therapy has been proposed; however, there is no consensus on the optimal management. We present three cases of spontaneous and isolated dissection of visceral arteries. Dissection involved the superior mesenteric artery in one and the celiac artery in two. All three patients presented with acute abdominal pain but lacked any peritoneal irritation. The patients were treated nonoperatively with anticoagulants or antiplatelets. No surgical or endovascular intervention was performed. Follow-up imaging studies demonstrated improvement of the dissection in two patients and no change in one patient. All patients were symptom-free over a mean follow-up of 17 months. Nonoperative treatment with close observation is an acceptable strategy in the management of spontaneous isolated dissection of visceral arteries. Emergent intervention is not mandatory in symptomatic patients without evidence of acute bowel ischemia or hemorrhage. PMID:18774686

Zhang, Wayne W; Killeen, J David; Chiriano, Jason; Bianchi, Christian; Teruya, Theodore H; Abou-Zamzam, Ahmed M

2009-01-01

282

Paediatric tonsillectomy: radiofrequency-based plasma dissection compared to cold dissection with sutures  

PubMed Central

Summary Aim of this study was to compare post-operative recovery over 14 days in children submitted to tonsillectomy using a bipolar radiofrequency-based plasma device (Coblation®, Evac 70, ArthroCare Corp, Sunnyvale, CA, USA) to cold dissection. Paediatric patients (n = 42) aged 5-16 years old with chronic tonsillitis underwent tonsillectomy using cold dissection with suture ligatures or a plasma device (Evac 70, ArthroCare Corp, Sunnyvale, CA, USA). Pain intensity on the first day, use of analgesics, type of diet, and days of pain, fever, nausea, and absence from school were determined. Groups were compared using time-to-event (Kaplan-Meier) curves and statistically evaluated using the Breslow (generalized Wilcoxon) test. Children undergoing plasma tonsillectomy reported significantly less pain on the first post-operative day (1.2 ± 0.9 vs. 3.5 ± 1.5, p < 0.001), fewer days of pain (4.8 ± 1.5 vs. 9.4 ± 1.2, p < 0.001), pain medication withdrawal (2.6 ± 1.3 vs. 4.5 ± 1.3, p < 0.001) and earlier use of liquid diet (5.1 ± 1.4 vs. 8.5 ± 2.1, p < 0.001), and fewer school days lost (5.3 ± 1.7 vs. 8.9 ± 1.5, p < 0.001). After completing this study, plasma tonsillectomy was adopted for the majority of cases. Benefits of the plasma device include the possibility both to excise tissue and coagulate bleeding vessels using the same device whilst improving quality of post-operative recovery over cold dissection with suture ligatures.

Di Rienzo Businco, L; Coen Tirelli, G

2008-01-01

283

Type B aortic dissection after standard endovascular repair of abdominal aortic aneurysm.  

PubMed

Dissection of the aorta is a rare yet potentially serious complication following endovascular abdominal aortic aneurysm (EVAR). These can lead to visceral branch hypoperfusion, compromise of aneurysm exclusion, arterial dilation or rupture. Intimal injury and dissection in the context of EVAR may be associated with a number of risk factors that include adverse infrarenal neck morphology, device oversizing, barbed fixation and wire manipulation in the proximal aorta. Herein, we describe three cases of type B aortic dissection following EVAR and discuss possible causes. As the applicability of endovascular technology widens, clinicians are reminded of the importance of early recognition and detection of unusual sequelae following EVAR. PMID:23667216

Khanbhai, Mustafa; Ghosh, Jonathan; Ashleigh, Raymond; Baguneid, Mohammed

2013-01-01

284

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.

Gerede, Demet Menekse; Yuksel, Bagdagul; Tutar, Eralp; Kucuksahin, Orhan; Uzun, Caglar; Atasoy, Kayhan Cetin; Duzgun, Nursen; Bengisun, Ugur

2013-01-01

285

Isolated dissection of the superior mesenteric artery: conservative approach in a selected patient.  

PubMed

The authors present the case report of effective conservative treatment in a patient with spontaneous, self-limiting, non-atherosclerotic dissection of the superior mesenteric artery (SMA) without fixed obstruction of the vessel lumen and signs of intestinal ischemia. Treatment with both anti-coagulant and anti-hypertensive agents succeeded in limiting the progression of intimal dissection and in preventing the potential dramatic sequelae of this rare clinical condition. Conservative treatment of spontaneous SMA dissection may be an alternative to surgery, if residual blood flow is maintained. PMID:20029364

Rispoli, P; Casella, F; Lorenzati, B; Guerzoni, V; Gruden, G; Conforti, M; Varetto, G

2009-12-01

286

Acute Gallbladder Necrosis in a Patient with Acute Type B Aortic Dissection  

PubMed Central

Although vascular complications induced by acute aortic dissection are varied and common, gallbladder necrosis induced by acute aortic dissection is rare. We experienced the case of a 42-year-old woman who suffered from acute gallbladder necrosis that occurred the following day after the onset of acute type B aortic dissection. Contrasted computed tomography, which showed the thickened wall of the gallbladder and the pericholecystic fluid, as well as the occluded celiac artery, was an effective diagnostic procedure. We performed cholecystectomy and revascularization of the celiac artery using autologous saphenous vein. Her postoperative course was uneventful, and she was discharged after 20 postoperative days.

2013-01-01

287

Bilateral chylothorax following neck dissection: a new method of treatment.  

PubMed

Chylothorax is a serious condition with a high rate of morbidity that may lead to death. Although it is encountered more frequently with certain thoracic procedures, it is considered to be a rare complication of neck dissection. Different forms of management have been postulated; however, no consensus of treatment has been achieved. A case of severe bilateral chylothorax that developed after bilateral neck dissection in a patient with laryngeal carcinoma is presented. Somatostatin injection was successful after total parenteral nutrition failed to control the chylothorax. On the basis of this case and the review of the literature discussed here, we advocate the use of somatostatin with other conservative measures in the management of chylothorax. PMID:11307917

Al-Sebeih, K; Sadeghi, N; Al-Dhahri, S

2001-04-01

288

Acute Aortic Dissection and Stroke in Multivessel Fibromuscular Dysplasia  

PubMed Central

Fibromuscular dysplasia is a rare, nonatherosclerotic, noninflammatory vascular disease that typically affects women between the ages of 20 and 60 years. Although any artery can be affected, fibromuscular dysplasia most commonly affects the renal and carotid arteries. Fibromuscular dysplasia of the renal arteries usually presents with hypertension, while carotid or vertebral artery disease causes transient ischemic attacks, strokes, or dissection. Fibromuscular dysplasia of the brachial arteries is extremely uncommon. It can induce extremity ischemia, nerve compression, or both—causing coldness, discoloration, pain, ulceration or gangrene of the fingers, paresthesias, or paralysis. We report a rare case of multivessel fibromuscular dysplasia manifested by acute stroke in association with type I aortic dissection, which progressed rapidly to ascending aortic false aneurysmal development that necessitated arch replacement. Outcomes of aortic arch replacement in this setting are currently unknown. Therefore, our case might well offer some insight.

Kar, Subrata; Gopaldas, Raja R.; Kumar, Arun

2013-01-01

289

Acute aortic dissection and stroke in multivessel fibromuscular dysplasia.  

PubMed

Fibromuscular dysplasia is a rare, nonatherosclerotic, noninflammatory vascular disease that typically affects women between the ages of 20 and 60 years. Although any artery can be affected, fibromuscular dysplasia most commonly affects the renal and carotid arteries. Fibromuscular dysplasia of the renal arteries usually presents with hypertension, while carotid or vertebral artery disease causes transient ischemic attacks, strokes, or dissection. Fibromuscular dysplasia of the brachial arteries is extremely uncommon. It can induce extremity ischemia, nerve compression, or both-causing coldness, discoloration, pain, ulceration or gangrene of the fingers, paresthesias, or paralysis. We report a rare case of multivessel fibromuscular dysplasia manifested by acute stroke in association with type I aortic dissection, which progressed rapidly to ascending aortic false aneurysmal development that necessitated arch replacement. Outcomes of aortic arch replacement in this setting are currently unknown. Therefore, our case might well offer some insight. PMID:23467036

Kar, Subrata; Gopaldas, Raja R; Kumar, Arun

2013-01-01

290

Aortic dissection detected 40 days after mitral valve replacement.  

PubMed

We report a case of a 61-year-old man with aortic dissection, which was detected after mitral valve replacement. The presenting manifestation was a moderate, dull and steady pain in his right scapular region, which started on the 40th postoperative day and irradiated to the back and lower limbs. The dissection and its extent was diagnosed on transthoracic echocardiography and CT scanning and the patient improved on conservative management with beta blockers. The main purpose of reporting this case is to emphasize challenges involved with early diagnosis of this ominous condition due to nonspecific symptoms and unreliable clinical examination, and to highlight the role of the imaging studies to confirm the diagnosis of this entity. PMID:21798138

dos Santos, Vitorino Modesto; Martins, Rosane Rodrigues; dos Santos Barcelos, Maria; Andrade, Loana Márquez; Silva Paz, Bruno César; Soares, Liliane Aparecida

2011-08-01

291

Spontaneous Cervical Artery Dissection: The Borgess Classification  

PubMed Central

Background and Purpose: The pathogenesis of spontaneous cervical artery dissections (sCAD) and its best medical treatment are debated. This may be due to a lack of clear classification of sCAD. We propose the new Borgess classification of sCAD, based on the presence or absence of intimal tear as depicted on imaging studies and effect on blood flow. Materials and Methods: This is a single-center investigator-initiated registry on consecutive patients treated for sCAD. In the Borgess classification, type I dissections have intact intima and type II dissections have an intimal tear. Results: Forty-four patients and 52 dissected arteries were found. Forty-nine of 52 dissections (93%) were treated with dual anti-platelet therapy. Twenty-one of 52 dissections were type I; 31 were type II. Type I dissections were more likely to present with ischemic symptoms [stroke, transient ischemic attack (TIA)] (p?=?0.001). More type I dissections occurred in the vertebral artery, while more type II dissections occurred in the internal carotid artery (p?dissections were more likely to heal than type II (p?dissection types in the Borgess classification appear to relate to clinical presentation and rate of healing, making the classification useful in clinical management. Dual anti-platelet therapy for sCAD seems to have a very low risk of subsequent stroke; however, a large prospective study is needed to investigate the best treatment.

Al-Ali, Firas; Perry, Brandon C.

2013-01-01

292

Acute mesenteric ischemia caused by spontaneous isolated dissection of the superior mesenteric artery: treatment by percutaneous stent placement  

Microsoft Academic Search

.   Spontaneous and isolated dissection of the superior mesenteric artery is a rare and often fatal event which has been successfully\\u000a treated by surgery in several reported cases. We present a patient with acute mesenteric ischemia due to superior mesenteric\\u000a artery dissection who was successfully treated by percutaneous endovascular placement of a Wallstent.

D. A. Leung; E. Schneider; R. Kubik-Huch; B. Marincek; T. Pfammatter

2000-01-01

293

Acute mesenteric ischemia caused by spontaneous isolated dissection of the superior mesenteric artery: treatment by percutaneous stent placement.  

PubMed

Spontaneous and isolated dissection of the superior mesenteric artery is a rare and often fatal event which has been successfully treated by surgery in several reported cases. We present a patient with acute mesenteric ischemia due to superior mesenteric artery dissection who was successfully treated by percutaneous endovascular placement of a Wallstent. PMID:11305570

Leung, D A; Schneider, E; Kubik-Huch, R; Marincek, B; Pfammatter, T

2000-01-01

294

A sneeze: an unusual trigger for aortic dissection.  

PubMed

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

Upadhyaya, Subramanya G N; Large, A

2013-01-01

295

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.

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

2013-01-01

296

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

PubMed

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

297

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. © RSNA, 2014. 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

298

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.

299

Modeling the propagation of arterial dissection  

Microsoft Academic Search

Arterial dissections are frequently observed in clinical practice and during road traffic accidents. In particular, the lamellarly arrangement of elastin, collagen, in addition to smooth muscle cells in the middle arterial layer, the media, favors dissection failure. Experimental studies and related biomechanical models are rare in the literature. Finite strain kinematics is employed, and the discontinuity in the displacement field

T. Christian Gasser; Gerhard A. Holzapfel

2006-01-01

300

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.

301

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

302

Cardiovascular magnetic resonance of acute myocardial infarction following traumatic coronary artery dissection.  

PubMed

Traumatic coronary artery dissection is a very rare cause of myocardial infarction. Occurrence of this condition late in the posttraumatic period is extremely uncommon. We present a case of a young patient with acute myocardial infarction 4 weeks after blunt chest trauma. Coronary angiography showed left anterior descending artery dissection as well as thrombus formation, and multiple small infarctions were shown by cardiovascular magnetic resonance. PMID:20686414

Mahmod, Masliza; Wage, Rick; Alpendurada, Francisco; Pennell, Dudley J

2013-09-01

303

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

SciTech Connect

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

Jeon, Yong Sun, E-mail: radjeon@korea.com; Cho, Soon Gu [Inha University College of Medicine, Department of Radiology (Korea, Republic of); Hong, Ki Cheon [Inha University College of Medicine, Department of Surgery (Korea, Republic of)

2009-03-15

304

Neurological Outcome and Quality of Life after Stroke due to Vertebral Artery Dissection  

Microsoft Academic Search

Background: Vertebral artery dissection is a well-recognized cause of posterior circulation stroke for which there is relatively little information on long-term outcomes. Quality of life (QOL) is an important patient-centred outcome measure. Methods: Stroke due to vertebral artery dissection was conservatively defined by neuroimaging documentation. Thirty sequential cases were identified based on a retrospective database and chart review with prospective

Diana Czechowsky; Michael D. Hill

2002-01-01

305

Self-limited spontaneous dissection of the main trunk of the superior mesenteric artery.  

PubMed

Spontaneous dissection of the splanchnic arteries is rare and reportedly carries a high risk of mortality. Two cases with spontaneous dissection of the main trunk of the superior mesenteric artery followed by a self-limited clinical course are presented. Current management strategies, including bypass operation, patch angioplasty, and conservative treatments, are discussed. Emphasis is placed on the role of nonsurgical management with careful follow-up with the use of new technologies such as duplex and computed tomography scanning. PMID:9576098

Yasuhara, H; Shigematsu, H; Muto, T

1998-04-01

306

Large thoracic aortic aneurysm and dissection with rare complication.  

PubMed

Thoracic aortic aneurysms can be found incidentally, however, patients can also present with acute dissection and or rupture that can be fatal. Symptoms that might indicate dissection include chest and back pain as well as lightheadedness. The diagnosis can be made with imaging studies such as computed tomography or magnetic resonance angiogram and sometimes transesophageal echocardiogram. Management is based on the aneurysmal size, location, extension, and the presence of complications. Although smaller localized and slow growing aneurysms can be monitored, larger and or complicated ones may warrant immediate repair. Less-common complications include compression over anatomic structures in the vicinity including vessels and the mediastinum. We report a unique case of a 71-year-old man who presented with a very large thoracic aortic aneurysm with dissection causing compression over the brachiocephalic veins and the mediastinum leading to facial and upper extremity swelling, dysphagia, and cough. This case represents a rare but significant complication of thoracic aortic aneurysm and emphasizes the challenges of its management. PMID:24509371

Skeik, Nedaa; Ahmed, Aisha K; Schumacher, Clark W; Decker, Troy; Sullivan, Timothy M

2014-05-01

307

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

PubMed Central

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

2014-01-01

308

Successful repair of intraoperative aortic dissection detected by transesophageal echocardiography.  

PubMed

Aortic dissection is a rare but devastating complication of cardiac surgery. Early intraoperative diagnosis and management are essential for a favorable outcome. We describe the case of a 69-year-old man with worsening dyspnea who was admitted for mitral valve replacement having previously had a mitral valve repair. Precardiopulmonary bypass transesophageal echocardiography confirmed mitral regurgitation and showed mild atherosclerotic changes in the descending aorta. Following successful replacement of the mitral valve, an attempt to wean from cardiopulmonary bypass failed. This was characterized by acute onset hypovolemia. The transesophageal echocardiography showed the presence of features of acute aortic dissection involving only the descending aorta without identifying the entry point. The tear was successfully repaired by direct suture within the lumen. PMID:11899959

Varghese, David; Riedel, Bernhard J C J; Fletcher, S Nicholas; Al-Momatten, Mohammed I; Khaghani, Asghar

2002-03-01

309

Emergent treatment of aortic rupture in acute type B dissection  

PubMed Central

Massive left hemothorax is a rare and dramatic complication of acute type B aortic dissection. The primary endpoint is to treat the aortic rupture, stop the bleeding and stabilize the hemodynamic status, with the aim to prevent mortality and major cardiac, cerebral, visceral and renal complications. Thoracic endovascular repair (TEVAR) is the most frequent management, although its planning, in these emergent patients, may be very difficult and sub-optimal imaging may result at post-operative examination (CT and MRI). In case of TEVAR is not the definitive treatment of the aortic disease, a second stage surgical management can be performed in elective status, in a patient with a total clinical recover. In acute and dramatic circumstances, like ruptured type B dissection, TEVAR is a valid and suitable bridge procedure to open surgery, reducing the overall risk for mortality and major complications.

Segreti, Sara; Grassi, Viviana; Lomazzi, Chiara; de Vincentiis, Carlo; Rampoldi, Vincenzo

2014-01-01

310

Radioembolization Complicated by Dissection of the Common Femoral Artery  

PubMed Central

The common femoral artery is the most frequently used access site for angiographic procedures in interventional radiology. Potential complications of common femoral arteriotomy include hematoma formation, pseudoaneurysm, uncontrolled groin or retroperitoneal bleeding, acute arterial occlusion, dissection, and arteriovenous fistula formation. In a case such as the one described here, with a common femoral artery dissection with intraluminal thrombus and vessel occlusion, the complication may have occurred at the time of access or at the time of closure, with both procedure-associated and patient-specific risk factors affecting the overall risk of complications. Though some studies have shown an increased risk of complications with the use of arterial closure devices, others have found no increase. In any patient with symptoms following a femoral arteriotomy, rapid diagnosis and treatment is necessary to avoid further complications. Both patient-specific and procedure-associated risk factors should be considered prior to arteriotomy and usage of an arterial closure device.

Deitch, Sarah G.; Gupta, Ramona

2011-01-01

311

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

PubMed

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

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

2013-11-01

312

Spontaneous intracranial arterial dissection in the young: diagnosis by CT angiography  

PubMed Central

Background Spontaneous carotid artery dissections have been rarely reported in children. Diagnosis has traditionally been confirmed by catheter arteriography. More recently diagnosis has been made by magnetic resonance imaging and magnetic resonance angiography; however the sensitivity of these techniques has yet to be determined. The authors are unaware of reports of carotid dissection confirmed by dynamic computed tomography (computerized tomographic arteriography) in the young. Case presentation We recently evaluated a fourteen year-old male following the development of transient neurologic symptoms. There was no antecedent illness or trauma. Dynamic computed tomography revealed an intracranial dissection involving the supraclinoid segment of the left internal carotid artery (confirmed by catheter arteriography). Studies for vasculitis, pro-thrombotic states, and defects of collagen were negative. Conclusion Spontaneous carotid artery dissection is a potential cause of transient neurological symptoms and ischemic stroke in the pediatric population. Dynamic computed tomography appears to be a reliable diagnostic tool which can lead to early diagnosis.

Robertson, William C; Given, Curtis A

2006-01-01

313

[Isolated spontaneous dissection of superior mesenteric artery: treated by percutaneous endovascular stent placement].  

PubMed

Isolated spontaneous dissection of the superior mesenteric artery (SMA) without aortic dissection is a rare cause of acute mesenteric ischemia. A sudden decrease of intestinal blood flow can lead to fatal complications such as ischemic necrosis, shock, and death. Therefore, early diagnosis and therapeutic approach before the occurrence of intestinal infarction are the most important factor to determine the patients prognosis. A 52-year-old male presented with postprandial periumbilical pain, and isolated spontaneous dissection of the superior mesenteric artery with mural thrombus was detected by abdominal computed tomography with contrast enhancement. By the percutaneous implantation of vascular metallic stent via femoral artery, he was treated successfully. We report a case of isolated spontaneous dissection of the SMA treated by a percutaneous endovascular stent replacement with a review of literature. PMID:20098068

Kwak, Jae Wuk; Paik, Chang Nyol; Lee, Kang Moon; Chung, Woo Chul; Jung, Sung Hoon; Kim, Ji Eun; Baik, Jun Hyun; Yang, Jin Mo

2010-01-01

314

First report of elective selective neck dissection in the management of squamous cell carcinoma of the maxillary sinus.  

PubMed

Controversy remains about management of the neck in squamous cell carcinoma (SCC) of the maxillary sinus and we know of no reports of the use of elective selective neck dissection for management in this site. We retrospectively reviewed 18 consecutive patients with SCC of the maxillary sinus who were managed by primary operation with curative intent. A total of 13 patients had an elective selective neck dissection, which was invaded in one case 8%. Four patients had regional metastases, two with positive nodal disease confirmed after elective selective neck dissection, and two who developed regional recurrence (both after elective selective neck dissections which were negative (pN0)). A review of other published articles in the English language showed no cases of elective selective neck dissections reported. The mean regional recurrence rate was 12% (range 0-26%) and total mean regional metastases rate 21% (range 5-36%). Elective selective neck dissection did not contribute to an improved rate of neck control with regional recurrence of 11% (2/18) compared with 12% in the review. There is no evidence in this report to indicate that elective selective neck dissections for maxillary sinus SCC will result in better disease control. Future research may indicate fewer radiotherapy fields for necks with pathologically clear nodes after elective selective neck dissection. PMID:22578881

Brown, James S; Bekiroglu, Fazilet; Shaw, Richard J; Woolgar, Julia A; Triantafyllou, Asterios; Rogers, Simon N

2013-03-01

315

Type A aortic dissection with cold agglutinin disease.  

PubMed

Cold agglutinin disease is an uncommon condition characterized by hemagglutination and microvascular thrombosis of red blood cells at low temperatures during cardiopulmonary bypass. We report the rare case of an ambulatory 74-year-old woman with a relatively high thermal amplitude for antibody activation. We performed aortic arch repair for type A aortic dissection using moderately hypothermic cardiopulmonary bypass and warm blood cardioplegia in a retrograde manner. This case report provides evidence that these are safe and suitable techniques for selected aortic arch repair patients with cold agglutinin disease. PMID:21801929

Osada, Hiroaki; Nakajima, Hiroyuki; Shimizu, Atsushi; Nagasawa, Atsushi; Ogino, Hitoshi

2011-08-01

316

Ruptured Valsalva Sinus Aneurysm to Pericardium Simulated Aortic Root Dissection  

PubMed Central

Ruptured valsalva sinus aneurysm to pericardium is a rare condition. Here, we described a case presented with tamponade. Initially, hemopericardium was partially drained and then, imaging evaluations were done. Transesophageal echocardiography showed limited dissection of aortic sinus and CT angiography of the ascending aorta showed deformed dilated right coronary sinus. Besides, surgery showed that windsock tract of the right coronary sinus had ruptured into the pericardium with avulsed right coronary aortic cusp. This case indicated a rare cause of cardiac tamponade and insufficiency of imaging modalities for making an accurate diagnosis.

Davarpasand, Tahereh; Hosseinsabet, Ali; Abassi, Kumars; Arzhan, Sorya

2014-01-01

317

CT imaging findings and endovascular management of isolated spontaneous dissecting aneurysm of celiac artery  

PubMed Central

Isolated spontaneous dissecting aneurysm of celiac artery without concomitant involvement of aorta is a rare entity and only a few cases are reported in the literature. More cases are being detected recently with greater advancements in CT technology. Clinicians and emergency physicians should be aware of this condition and should include it in the differential diagnosis of patients who present with refractory postprandial epigastric pain, particularly in middle-aged men. We present a case of a 45-year-old male with isolated spontaneous dissecting celiac artery aneurysm, with special emphasis on CT findings and the role of endovascular management.

Rama Krishnan, RS; Murali, K; Madan, R; Francis, G

2013-01-01

318

Training in endoscopic submucosal dissection.  

PubMed

Endoscopic submucosal dissection (ESD) represents an important advancement in the therapy of early neoplastic gastrointestinal lesions by providing higher en-bloc curative resection rate with lower recurrence compared to endoscopic mucosal resection (EMR) and by sparing the involved organ and protecting patient's quality of life. Despite these advantages ESD is associated with long procedure times and a higher rate of complications, making ESD a challenging procedure which requires advanced endoscopic skills. Thus, there has been a recognized need for structured training system for ESD to enhance trainee experience and, to reduce the risks of complications and inadequate treatment. ESD has a very flat learning curve. However, we do not have uniformly accepted benchmarks for competency. Nevertheless, it appears that, in Japan, more than 30 supervised gastric ESD procedures are required to achieve technical proficiency and minimize complications. A number of training algorithms have been proposed in Japan with the aim to standardize ESD training. These algorithms cannot be directly applied in the West due to substantial differences including the availability of highly qualified mentors, the type of pathology seen, choice of devices, and trainee's background. We propose a training algorithm for Western physicians which integrates both hands-on training courses, animal model work as well as visits to expert centers. No specific preceptor training programs have been yet developed but there is a consensus that these programs are important for permeation of ESD worldwide. PMID:23951392

Coman, Roxana M; Gotoda, Takuji; Draganov, Peter V

2013-08-16

319

Dissecting Motivational Circuitry to Understand Substance Abuse  

PubMed Central

Summary An important goal of cocaine addiction research is to understand the neurobiological mechanisms underlying this disease state. Here, we review studies from our laboratory that examined nucleus accumbens (NAc) cell firing and rapid dopamine signaling using electrophysiological and electrochemical recordings in behaving rodents. A major advantage of these techniques is that they allow for the characterization of NAc activity and rapid dopamine release during specific phases of motivated behavior. Moreover, each approach enables an examination of the dynamic nature of NAc signaling as a function of factors such as hedonics and associative learning. We show that NAc neurons differentially respond to rewarding and aversive stimuli and their predictors in a bivalent manner. This differential responding is modifiable and can be altered by the presentation of other natural rewards or cocaine. Likewise, the dynamic nature of NAc cell firing is also reflected in the differential activation of distinct populations of NAc neurons during goal-directed behaviors for natural versus drug rewards, and the heightened activation of some NAc neurons following cocaine abstinence. Our electrochemical data also show that rapid dopamine signaling in the NAc reflects primary rewards and their predictors and appears to modulate specific NAc neuronal responses. In some cases, these influences are observed in a regionally specific manner that matches previous pharmacological manipulations. Collectively, these findings provide critical insight into the functional organization of the NAc that can be used to guide additional studies aimed at dissecting the neural code underlying compulsive drug-seeking behavior.

Wheeler, Robert A.; Carelli, Regina M.

2009-01-01

320

A New Idea for Dissecting Tray  

ERIC Educational Resources Information Center

A method of preparing a special dissecting tray to be used with transmitted light as well as reflected light is presented. It may also be used with an overhead projector to illustrate some skeletal structures in vertebrates. (Author/EB)

Branham, Arthur

1976-01-01

321

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

322

Unreliability of aortic size index to predict risk of aortic dissection in a patient with Turner syndrome  

PubMed Central

Aortic size index (ASI) has been proposed as a reliable criterion to predict risk for aortic dissection in Turner syndrome with significant thresholds of 20-25 mm/m2. We report a case of aortic arch dissection in a patient with Turner syndrome who, from the ASI thresholds proposed, was deemed to be at low risk of aortic dissection or rupture and was not eligible for prophylactic surgery. This case report strongly supports careful monitoring and surgical evaluation even when the ASI is < 20 mm/m2 if other significant risk factors are present.

Nijs, Jan; Gelsomino, Sandro; Luca, Fabiana; Parise, Orlando; Maessen, Jos G; Meir, Mark La

2014-01-01

323

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.

Dibenedetto, Silvia; Cluet, David; Stebe, Pierre-Nicolas; Baumle, Veronique; Leault, Jeremie; Terreux, Raphael; Bickle, Marc; Chassey, Benoit D. E.; Mikaelian, Ivan; Colas, Pierre; Spichty, Martin; Zoli, Michele; Rudkin, Brian B.

2013-01-01

324

Spontaneous coronary artery dissection and acute myocardial infarction during pregnancy.  

PubMed

Spontaneous coronary artery dissection is a rare cause of infarction in the general population, but a common cause of myocardial infarction during pregnancy, and even nowadays carries a high risk of mortality. We describe the case of a 31-year-old primigravida who presented during the 34th week of pregnancy with the chief complaint of chest pain and was found to suffer from myocardial infarction. She was otherwise healthy and had no known risk factors for coronary artery disease. The patient was treated conservatively with nitrates, aspirin, heparin and beta-blockers, eventually sustained a large myocardial infarction and, after an initial period of instability, remained asymptomatic. A week later she delivered 3 healthy babies. A coronary angiogram performed 3 months after the initial event revealed an extensive obstructive dissection of the circumflex coronary artery. The decision whether to pursue percutaneous coronary intervention, surgical revascularisation or appropriate medical therapy, is based on clinical presentation, the extent of the dissection, and the amount of ischaemic myocardium at risk. Cardiologists must be aware of this rare entity during pregnancy or postpartum, since early diagnosis and treatment are crucial for the survival of the mother and the foetus. PMID:20118050

Vogiatzis, Ioannis; Hadjimiltiades, Stavros; Sachpekidis, Vasilios; Parcharidis, Georgios

2010-01-01

325

Endovascular Treatment of Iatrogenic and Traumatic Carotid Artery Dissection  

SciTech Connect

This paper reports on the early and midterm results of endovascular treatment of acute carotid artery dissections, its specific problems, and its limitations. We encountered seven patients with symptomatic extracranial carotid artery dissection, three cases of which occurred after carotid endarterectomy, two after carotid angioplasty and stenting, and two after trauma. Balloon-expandable and self-expanding stents were placed using a transfemoral approach. Success in restoring the carotid lumen was achieved in all patients. No procedure-related complications occurred. All patients experienced significant clinical improvement while in the hospital and achieved complete long-term recovery. At follow-up (mean, 22.4 months), good luminal patency of the stented segments was observed. In conclusion, in this small series, primary stent-supported angioplasty seems to be a safe and effective strategy in the treatment of selected patients having acute traumatic extracranial carotid artery dissection, with excellent early and midterm results. Larger series and longer-term follow-up are required before definitive recommendations can be made.

Schulte, Stefan; Donas, Konstantinos P., E-mail: k.donas@gmx.at; Pitoulias, Georgios A.; Horsch, Svante [Hospital Porz am Rhein, Academic Teaching Hospital of the University of Cologne, Department of Vascular Surgery (Germany)

2008-09-15

326

Sharp Dissection versus Electrocautery for Radial Artery Harvesting  

PubMed Central

Radial arteries have been increasingly used during the last decade as conduits for coronary artery revascularization. Although various harvesting techniques have been described, there has been little comparative study of arterial damage and patency. A radial artery graft was used in 44 consecutive patients, who were randomly divided into 2 groups. In the 1st group, the radial artery was harvested by sharp dissection and in the 2nd, by electrocautery. These groups were compared with regard to radial artery free flow, harvest time, number of clips used, complications, and endothelial damage. Radial artery free flow before and after intraluminal administration of papaverine was significantly greater in the electrocautery group (84.3 ± 50.7 mL/min and 109.7 ± 68.5 mL/min) than in the sharp-dissection group (52.9 ± 18.3 mL/min and 69.6 ± 28.2 mL/ min) (P =0.003). Harvesting time by electrocautery was significantly shorter (25.4 ± 4.3 min vs 34.4 ± 5.9 min) (P =0.0001). Electrocautery consumed an average of 9.76 clips, versus 22.45 clips consumed by sharp dissection. The 2 groups were not different regarding postoperative complications, except for 3 cases of temporary paresthesia of the thumb in the electrocautery group; histopathologic examination found no endothelial damage. We conclude that radial artery harvesting by electrocautery is faster and more economical than harvesting by sharp dissection and is associated with better intraoperative flow and good preservation of endothelial integrity.

Marzban, Mehrab; Arya, Reza; Mandegar, Mohammad Hossein; Karimi, Abbas Ali; Abbasi, Kiomars; Movahed, Namvar; Abbasi, Seyed Hesameddin

2006-01-01

327

Incomplete nested dissection for solving n by n grid problems  

NASA Technical Reports Server (NTRS)

Nested dissection orderings are known to be very effective for solving sparse positive definite linear systems which arise from n by n grid problems. In this paper we consider incomplete nested dissection, an ordering which corresponds to the premature termination of nested dissection. Analyses of the arithmetic and storage requirements for incomplete nested dissection are given and the ordering is shown to be competitive with nested dissection with regard to arithmetic operations and superior to that ordering in storage requirements.

George, A.; Poole, W. G., Jr.; Voigt, R. G.

1978-01-01

328

Pulmonary embolism due to biological glue after repair of type A aortic dissection.  

PubMed

Biological glue is increasingly used in cardiac surgery. We report a case of type A aortic dissection repair that was complicated by subsequent pulmonary embolism due to BioGlue(®) (Cryolife Inc, Hennesaw, GA, USA). To our knowledge this is the first report of a case with this complication. PMID:21273252

Rubio Alvarez, Jose; Sierra Quiroga, Juan; Martinez de Alegria, Anxo; Delgado Dominguez, Cristian

2011-04-01

329

Quadruple spontaneous cervical artery dissection following aneurysm embolization: a rare posttreatment complication.  

PubMed

We present a unique case of multiple sCADs occurring after a ruptured intracranial aneurysm embolization. We discuss the impact of head extension during embolization as the prevailing factor in multiple artery dissections in this case and point out another cause of new-onset neurologic deficit in patients with aneurysmal SAH. PMID:20110376

Papagiannaki, C; Cottier, J P; Barbier, C; Bibi, R; Herbreteau, D

2011-01-01

330

Spontaneous, self-limited, non-atherosclerotic dissection of the superior mesenteric artery.  

PubMed

A case of spontaneous, non-atherosclerotic dissection of the superior mesenteric artery is described. The patient presented with severe abdominal pain. An initial computed tomography scan did not disclose any pathology, namely the major mesenteric arteries were perfused. The patient's initial symptoms resolved during the first 48 h under conservative treatment. Sagittal reconstruction from a follow-up computed tomography scan disclosed a 7 cm long dissection of the proximal superior mesenteric artery with thrombosis of the false lumen and residual blood flow through the true lumen. There were no signs of transmural infarction of the bowel. Anticoagulation with heparin and later with phenprocoumon was initiated and the patient is well after 6 months. Together with several other cases reported recently, and in contrast to previous experience, this case adds evidence that conservative treatment of spontaneous, non-atherosclerotic dissection of the superior mesenteric artery may be an alternative to surgery if residual blood flow is maintained. PMID:12655268

Lamprecht, Georg; Trabold, Tobias; Gregor, Michael; Lamberts, Regina

2003-04-01

331

Migraine, Migraine Aura, and Cervical Artery Dissection: A Systematic Review and Meta-Analysis  

PubMed Central

Objective We evaluated the current evidence on the association between migraine including aura status and cervical artery dissection. Methods We performed a systematic review and meta-analysis of studies investigating the association between migraine or migraine subtypes (e.g. migraine with aura) and cervical artery dissection published until October 2010. Results We identified five case-control studies investigating the association between migraine and cervical artery dissection. In pooled analysis, migraine doubled the risk of cervical artery dissection (pooled odds ratio [OR]=2.06, 95% CI 1.33–3.19). All studies allowed evaluation of migraine aura status. While the effect estimate for migraine without aura (pooled OR=1.94, 95% CI 1.21–3.10) was similar to overall migraine, the association was weaker for migraine with aura (pooled OR=1.50, 95% CI 0.76–2.96) However, there is no evidence that aura status significantly modifies the association between migraine and cervical artery dissection (meta-regression on aura status p=0.58). The risk does not appear to differ between women and men; however, only few studies presented gender-specific data. Heterogeneity among studies was low to moderate. Conclusion In this meta-analysis migraine is associated with a two-fold increased risk of cervical artery dissection. This risk does not appear to significantly differ by migraine aura status or gender.

Rist, Pamela M.; Diener, Hans-Christoph; Kurth, Tobias; Schurks, Markus

2011-01-01

332

Live dissection of Drosophila embryos: streamlined methods for screening mutant collections by antibody staining.  

PubMed

Drosophila embryos between stages 14 and 17 of embryonic development can be readily dissected to generate "fillet" preparations. In these preparations, the central nervous system runs down the middle, and is flanked by the body walls. Many different phenotypes have been examined using such preparations. In most cases, the fillets were generated by dissection of antibody-stained fixed whole-mount embryos. These "fixed dissections" have some disadvantages, however. They are time-consuming to execute, and it is difficult to sort mutant (GFP-negative) embryos from stocks in which mutations are maintained over GFP balancer chromosomes. Since 2002, our group has been conducting deficiency and ectopic expression screens to identify ligands for orphan receptors. In order to do this, we developed streamlined protocols for live embryo dissection and antibody staining of collections containing hundreds of balanced lines. We have concluded that it is considerably more efficient to examine phenotypes in large collections of stocks by live dissection than by fixed dissection. Using the protocol described here, a single trained individual can screen up to 10 lines per day for phenotypes, examining 4-7 mutant embryos from each line under a compound microscope. This allows the identification of mutations conferring subtle, low-penetrance phenotypes, since up to 70 hemisegments per line are scored at high magnification with a 40X water-immersion lens. PMID:20040910

Lee, Hyung-Kook Peter; Wright, Ashley P; Zinn, Kai

2009-01-01

333

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.

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

2013-01-01

334

Stroke, cerebral artery dissection, and cervical spine manipulation therapy.  

PubMed

Stroke represents an infrequent adverse reaction associated with cervical spine manipulation therapy. Attempts to identify the patient at risk and the type of manipulation most likely to result in these complications of manipulation have not been successful. A retrospective review of 64 medical legal cases of stroke temporally associated with cervical spine manipulation was performed to evaluate characteristics of the treatment rendered and the presenting complaints in patients reporting these complications. These files included records from the practitioner who administered the manipulation therapy, post stroke testing and treatment records usually by a neurologist, and depositions of the patient and the practitioner of manipulation as well as expert and treating physicians. A retrospective review of the files was carried out by three (two in 11 cases) researchers using the same data abstraction instrument to independently assess each case. These independent reviews were followed by a consensus review in which all reviewers reached agreement on file content. Ninety two percent of cases presented with a history of head and/or neck pain and 16 (25 %) cases presented with sudden onset of new and unusual headache and neck pain often associated with other neurological symptoms that may represent a dissection in progress. The strokes occurred at any point during the course of treatment. Certain patients reporting onset of symptoms immediately after first treatment while in others the dissection occurred after multiple manipulations. There was no apparent dose-response relationship to these complications. These strokes were noted following any form of standard cervical manipulation technique including rotation, extension, lateral flexion and non-force and neutral position manipulations. The results of this study suggest that stroke, particularly vertebrobasilar dissection, should be considered a random and unpredictable complication of any neck movement including cervical manipulation. They may occur at any point in the course of treatment with virtually any method of cervical manipulation. The sudden onset of acute and unusual neck and/or head pain may represent a dissection in progress and be the reason a patient seeks manipulative therapy that then serves as the final insult to the vessel leading to ischemia. PMID:12195461

Haldeman, Scott; Kohlbeck, Frank J; McGregor, Marion

2002-08-01

335

Student injuries in the dissecting room.  

PubMed

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

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

2013-01-01

336

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

ERIC Educational Resources Information Center

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

Oakley, Jan

2012-01-01

337

Superficial femoral artery transposition repair for isolated superior mesenteric artery dissection.  

PubMed

Isolated dissection of the superior mesenteric artery is an uncommon event, but many new cases have been reported recently, reflecting the progress of imaging and suggesting that this pathology is not as rare as previously thought. Here we report a case of superior mesenteric artery dissection where we performed, after failure of conservative medical management, an original surgical technique for mesenteric revascularization using a superficial femoral artery transposition. To the best of our knowledge, this is the first report of the use of this technique for complex mesenteric revascularization. PMID:16242570

Picquet, Jean; Abilez, Oscar; Pénard, Julien; Jousset, Yann; Rousselet, Marie Christine; Enon, Bernard

2005-10-01

338

Internal carotid artery redundancy and dissection in a young cocaine abuser.  

PubMed

Carotid artery redundancies are common findings on routine imaging studies and are usually considered to be benign variants. We present a case of a 40-year-old man, with a history of cocaine abuse, who was diagnosed with dissection of the right internal carotid artery and looping of the bilateral internal carotid arteries. This report attempts to highlight the possible association between carotid artery redundancy and dissection, especially in the context of vascular injury such as cocaine abuse, as in our case. PMID:23539068

Meghani, M; Siddique, M N; Bhat, T; Samarneh, M; Elsayegh, S

2013-03-27

339

Minor trauma may lead to traumatic internal carotid artery dissection.  

PubMed

A farmer's wife was slapped by her cow's tail during milking. There was no obvious injury, but afterward she first developed unusual headaches of unknown origin and then a severe stroke 7 days later. Further diagnostics, including magnetic resonance imaging techniques, revealed a dissection of the carotid artery to be the reason for the stroke, probably caused by being hit by the cow's tail. This case demonstrates that persisting unusual headaches, even after minor trauma, should lead to further diagnostic procedures and then therapeutic intervention for stroke prevention if necessary. PMID:16377840

Huber, Roman; Kassubek, Jan

2005-01-01

340

Management of isolated spontaneous dissection of superior mesenteric artery  

Microsoft Academic Search

Purpose  Our objectives were to clarify the management of isolated spontaneous dissection of the superior mesenteric artery (DSMA).\\u000a \\u000a \\u000a \\u000a Methods  We reviewed seven patients diagnosed as having DSMA from 2002 to 2007 (group A). Simultaneously, we analyzed 50 cases of DSMA\\u000a previously reported in the literature between 2000 and 2008 (group B). In each group, clinical presentation, Sakamoto’s classification,\\u000a imaging appearances, need for

Philippe Zerbib; Céline Perot; Marc Lambert; Mohamad Seblini; François René Pruvot; Jean Pierre Chambon

2010-01-01

341

Spontaneous dissection with rupture of the superior mesenteric artery from segmental arterial mediolysis.  

PubMed

Spontaneous dissection of the superior mesenteric artery (SMA) is rare. We report a case of rupture of the SMA after spontaneous dissection in a 51-year-old male who presented with acute onset of abdominal pain and hypotension. The patient was initially treated with intravenous fluid resuscitation and endovascular intervention followed by open surgery. No identifiable cause for dissection was found. The patient was diagnosed as having segmental arterial mediolysis (SAM). The patients' presentation, treatment, outcome, and all relevant imaging, pathologic, and laboratory studies were reviewed. The relevant features of the case and SAM are presented herein. In addition, a review of all available published literature on SAM to date is presented. PMID:21276678

Tameo, Michael N; Dougherty, Matthew J; Calligaro, Keith D

2011-04-01

342

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

343

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

Ozpelit, Ebru; Badak, Ozer; Ozpelit, Mehmet Emre; Kozan, Omer

2014-06-01

344

Percutaneous treatment of spontaneous left main coronary artery dissection extending to the left anterior descending and circumflex arteries possibly triggered by thrombolytic therapy  

PubMed Central

Spontaneous coronary artery dissection is a rare cause of myocardial infarction and the role of thrombolytic therapy in this setting is not known. A case of acute ST elevation myocardial infarction is presented, with initial positive response to thrombolytic therapy and subsequent marked worsening of ST elevation due to extensive dissection, possibly triggered by thrombolytic therapy, which was successfully treated with percutaneous coronary intervention.

Saadat, Habib; Taherkhani, Maryam; Safi, Morteza; Vakili, Hosein; Namazi, Mohammad Hassan; Poorhoseini, Hamid Reza; Movahed, Mohammad Reza

2009-01-01

345

Acute mesenteric ischemia caused by spontaneous isolated dissection of the superior mesenteric artery: Treatment by intra-arterial thrombolysis and percutaneous stent placement  

Microsoft Academic Search

Spontaneous and isolated dissection of the superior mesenteric artery is a rare event with a high mortality. It has been successfully treated by surgery and in a few cases by percutaneous stent placement. We present a patient with acute mesenteric ischemia due to superior mesenteric artery dissection who was successfully treated by intra-arterial thrombolysis and endovascular stent placement.

Soenke Langner; Inga Kobarg; Ralf Puls; Ulrich Sill; Jens Kuem; Norbert Hosten

2007-01-01

346

[An efficient way in mouse brain dissection].  

PubMed

Laboratory mice are common experimental animals in biological, medical, pharmacological and psychological researches primarily because they are easy to maintain and reproduce quickly. The protection of the welfare of experimental animals is gaining greater attention during the application of a large number of mice. It's therefore essential to consider how to reduce the unnecessary use of animals and fully exploit each experimental animal. We report, in this article, an efficient way to dissect various brain regions from a mouse for protein immunoblot and/or neuronal culture, providing technical reference information for minimizing the number of animals used in projects, and refining methods and procedures to quick brain dissection. PMID:24777412

Wang, Jin-Zhao; Long, Cheng; Yang, Li

2014-04-25

347

Stenting for vertebrobasilar dissection: a possible treatment option for nonhemorrhagic vertebrobasilar dissection  

Microsoft Academic Search

Introduction  It has been reported that stent placement may improve compromised blood flow resulting from vertebrobasilar dissection. In\\u000a this study the technical feasibility, safety, as well as short-term outcome of stent placement for the treatment of nonhemorrhagic\\u000a vertebrobasilar dissection was retrospectively investigated.\\u000a \\u000a \\u000a \\u000a Methods  Ten patients (eight men, two women; age range 36 to 45 years) with nonhemorrhagic vertebrobasilar dissection were treated\\u000a by stenting.

Yong Sam Shin; Ho Sung Kim; Sun Yong Kim

2007-01-01

348

37 CFR 2.155 - Notice of publication.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 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...

2013-07-01

349

Laparoscopic Cystogastrotomy by Ultrasonic Dissection after Pylorus-Preserving Pancreaticoduodectomy  

PubMed Central

Background and Objectives: Symptomatic pancreatic pseudocysts can be drained using open, endoscopic, and laparoscopic techniques. Little is written on the role of laparoscopic drainage techniques after major abdominal operations. We describe a case of laparoscopic cystgastrotomy after pancreaticoduodenecomy. Case Report: A 55-year-old female with a prior history of open pylorus-preserving pancreaticoduodenectomy presented with multiple symptomatic pancreatic pseudocysts in the setting of alcohol-induced chronic pancreatitis. Methods: After preoperative planning with contrast-enhanced computed tomography, the patient successfully underwent laparoscopic cystgastrotomy with ultrasonic dissection. Conclusion: This case report illustrates that laparoscopic cystenteric drainage of pancreatic pseudocysts can be performed safely after major open abdominal operations. Further investigation is needed.

Titus, Jessica; Pan, Jenny; Cruz Pico, Christian X.; Guerron, Alfredo D.

2012-01-01

350

Spontaneous triple coronary artery dissection in a 78-year-old woman resolved angiographically with anticoagulation and medical management.  

PubMed

A 78-year-old woman who presented with chest pain, on a background of hypertension and varicose veins, was found to have a non-ST segment elevation myocardial infarction with coronary angiography demonstrating dissections of all three major arteries distally. She was treated medically, with anticoagulation and risk factor management as the primary therapies. This is the first reported case of triple spontaneous coronary artery dissection treated medically, along with angiographic follow-up demonstrating complete resolution. PMID:23880400

Backman, Warren David; Bakhai, Ameet

2013-01-01

351

Type I acute aortic dissection accompanied by ischemic enterocolitis due to blood flow insufficiency in the superior mesenteric artery  

Microsoft Academic Search

We report a case of acute type I aortic dissection with ischemic enterocolitis due to blood flow insufficiency in the superior\\u000a mesenteric artery. The patient was a 52-year-old man who visited the hospital with major complaints of sudden low back pain\\u000a and melena. Mesenteric ischemia was suspected, and angiography revealed type I aortic dissection with accompanying blood flow\\u000a insufficiency in

Mikio Ninomiya; Haruo Makuuchi; Yoshihiro Naruse; Toshiya Kobayashi; Takeshi Sato

1999-01-01

352

Dissection of the pulmonary ligament during upper lobectomy: is it necessary?  

PubMed

A best evidence topic was written according to a structured protocol. The question addressed was whether dissection of the pulmonary ligament during an upper lobectomy would result in improved outcomes. A total of 85 articles were found using the reported search, of which eight represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results are tabulated. Reported measures were complications associated with dissection (atelectasis, bronchial stenosis, bronchial obstruction and bronchial deformation) and preservation (insufficient lung expansion, pooling of effusion and atelectasis) of the pulmonary ligament, ratio (%) of dead space in longitudinal axis (movement of nonoperated lobes), change in the angle (degrees) of main bronchus on the operated side, overall morbidity and mortality, overall survival and conversion rates. In a randomized control trial, the dissection of the pulmonary ligament revealed no significant difference in the dead space ratio or change in the angle of the main bronchus when compared with preservation. Dissection of the ligament, in theory, reduces the free space in the upper thorax by increasing the mobility of the residual lobes. Dissection of the ligament may lead to bronchial deformation, stenosis, obstruction or lobar torsion. Preservation of the ligament may prevent this complication by suppressing the upward movement of residual lobes. However, this may result in pleural effusion in the free thoracic space that may potentially become infected resulting in an empyema or bronchial fistula. Five large case series were analysed; three routinely dissected the pulmonary ligament and two did not. There was no observed difference in clinical outcomes between the two groups. There is no convincing evidence that dissection of the pulmonary ligament in an upper lobectomy significantly improves outcomes and reduces complications. PMID:23628653

Khanbhai, Mustafa; Dunning, Joel; Yap, Kok Hooi; Rammohan, Kandadai S

2013-08-01

353

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

SciTech Connect

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

Yao Min [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]. E-mail: min-yao@uiowa.edu; Hoffman, Henry T.; Funk, Gerry F. [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Chang, Kristi [Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Smith, Russell B. [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Tan Huaming [Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA (United States); Clamon, Gerald H. [Department of Medical Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Dornfeld, Ken [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Buatti, John M. [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)

2007-07-01

354

Conservative Management of Chronic Aortic Dissection with Underlying Aortic Aneurysm  

PubMed Central

Aortic dissection is one of the most common aortic emergencies affecting around 2000 Americans each year. It usually presents in the acute state but in a small percentage of patients aortic dissections go unnoticed and these patients survive without any adequate therapy. With recent advances in medical care and diagnostic technologies, aortic dissection can be successfully managed through surgical or medical options, consequently increasing the related survival rate. However, little is known about the optimal long-term management of patients suffering from chronic aortic dissection. The purpose of the present report is to review aortic dissection, namely its pathology and the current diagnostic tools available, and to discuss the management options for chronic aortic dissection. We report a patient in which chronic aortic dissection presented with recurring episodes of vomiting and also discuss the management plan of our patient who had a chronic aortic dissection as well as an underlying aortic aneurysm.

Yusuf Beebeejaun, Mohammad; Malec, Aleksandra; Gupta, Ravi

2013-01-01

355

Genetics Home Reference: Familial thoracic aortic aneurysm and dissection  

MedlinePLUS

... literature OMIM Genetic disorder catalog Conditions > Familial thoracic aortic aneurysm and dissection (often shortened to familial TAAD ) On ... February 2011 What is familial TAAD? Familial thoracic aortic aneurysm and dissection (familial TAAD) is a disorder that ...

356

Carotid artery dissection causing hypoglossal nerve palsy  

PubMed Central

A 45-year-old man was admitted with a 4 day history of right facial pain and on examination, there was atrophy of the right side of the tongue. Magnetic resonance angiography demonstrated carotid artery dissection and aspirin was commenced.

Epstein, Elliot; Khan, Muhammed Azeem; Francis, David; Sada, Priyo; Thuse, Makarand

2012-01-01

357

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

358

[Arteriovenous dissection for branch retinal vein occlusion].  

PubMed

Arteriovenous dissection (AVD) is a surgical maneuver to separate the retinal artery and vein at the crossing site in patients with branch retinal vein occlusion (BRVO). The published studies showed an evidence level 3. AVD seems to be maintainable in patients with recent onset of BRVO and decimal visual acuity < or =0.4. PMID:18317778

Feltgen, N; Hattenbach, L-O; Mirshahi, A; Hansen, L

2008-04-01

359

Microvascular Reconstruction After Previous Neck Dissection  

Microsoft Academic Search

Background: Microvascular reconstruction of defects in the head and neck is more challenging in patients who have undergone a previous neck dissection, owing to prior resection of potential cervical recipient blood vessels used for free flap perfusion. Objective: To evaluate the reliability and safety of free flap reconstruction in patients with previous neck dis- section. Patients and Methods: Sixty free

Christian Head; Joel A. Sercarz; Elliot Abemayor; Thomas C. Calcaterra; Jeffrey D. Rawnsley; Keith E. Blackwell

2002-01-01

360

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

361

Postpartum Four-Vessel Cervical Artery Dissection  

PubMed Central

A postpartum four-vessel cervical artery dissection with no stroke is reported. This transient vasculopathy took place in the autoimmune context of the HELLP syndrome combined with the reversible posterior leucoencephalopathy syndrome. Correlations between the clinical, radiological and biological entities are discussed.

Barroso, Bruno; Demasles, Stephanie

2013-01-01

362

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

363

The etiology of cervical artery dissection  

PubMed Central

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

Haneline, Michael T.; Rosner, Anthony L.

2007-01-01

364

Spontaneous dissection of the splanchnic arteries.  

PubMed

Three patients had severe abdominal pain of sudden onset. Computed tomography showed localized dissection in the superior mesenteric artery in two patients and in the celiac artery in one. With conservative therapy abdominal symptoms were self-remitted. All patients were successfully treated with medication and have been doing well during follow-up. PMID:20071446

Ozaki, Nobuchika; Wakita, Noboru; Yamada, Akitoshi; Tanaka, Yosuke

2010-04-01

365

Use of neutral plasma coagulation in groin node dissection for vulvar malignancy: a novel technique  

PubMed Central

Vulvar cancer is an uncommon disease with approximately 1000 cases reported annually in the UK. Lymph node involvement is an important prognostic indicator. Vulvectomy and bilateral groin node dissection are the preferred surgical treatments for early disease and increase survival. However, significant morbidity with lymphocyst formation and wound breakdown has been reported in more than 50% of cases. We report the first case following use of the PlasmaJet® neutral argon coagulation system to reduce postoperative lymphocyst formation.

Madhuri, Thumuluru Kavitha; Tailor, Anil; Butler-Manuel, Simon

2011-01-01

366

Unusual Manifestations of Bilateral Carotid Artery Dissection: Dysphagia and Hoarseness  

Microsoft Academic Search

Dissection of the carotid artery can occur intracranially or extracranially, although dissections tend to affect extracranial\\u000a segments of the arteries much more commonly than intracranial segments. Carotid artery dissection (CAD) is most common in\\u000a middle-aged women. Although not completely known, the main risk factors related to carotid artery dissection are genetic and\\u000a environmental factors, traumatic events, cervical manipulation, migraine, recent

Huseyin Isildak; Emin Karaman; Ahmet Ozdogan; Metin Ibrahimov; Mehmet Yilmaz

2010-01-01

367

Aortic dissection of Kommerell’s diverticulum in Marfan’s syndrome  

Microsoft Academic Search

We report a surgical case of chronic aortic dissection with an entrance tear on Kommerell’s diverticulum, a rare embryologic anomaly, with an extension to the arteria lusoria, in a patient with Marfan’s syndrome. The operation consisted of aortic root and arch replacement with reimplantation of the right subclavian artery in the right carotid artery under circulatory arrest and deep hypothermia.

Eric Braunberger; Frederic Mercier; Paul Fornes; Pierre L Julia; Jean-Noël Fabiani

1999-01-01

368

The non-syndromic familial thoracic aortic aneurysms and dissections maps to 15q21 locus  

Microsoft Academic Search

BACKGROUND: Thoracic aortic aneurysms and dissections (TAAD) is a critical condition that often goes undiagnosed with fatal consequences. While majority of the cases are sporadic, more than 20% are inherited as a single gene disorder. The most common familial TAA is Marfan syndrome (MFS), which is primarily caused by mutations in fibrillin-1 (FBN1) gene. Patients with FBN1 mutations are at

Ali R Keramati; Anita Sadeghpour; Maryam M Farahani; Gurangad Chandok; Arya Mani

2010-01-01

369

Surgical Repair and Stent Positioning for Type A Acute Aortic Dissection: A Step Forward?  

Microsoft Academic Search

We report two cases of type A acute aortic dissection in which the traditional ascending aorta replacement was completed by aortic arch stenting to achieve a complete treatment and to avoid the risks that are connected to aortic arch replacement. Correct deployment of the stent was evaluated through an endoscope inserted in the transverse arch, which avoided fluoroangiography and the

Stefano Saccani; Marzio Busi; Claudio Fragnito; Andrea Agostinelli; Bruno Borrello; Francesco Nicolini; Tiziano Gherli

2005-01-01

370

Management of hemorrhagic dissecting vertebral artery aneurysms involving posterior inferior artery.  

PubMed

We reported 2 cases with hemorrhagic dissecting vertebral artery (VA) aneurysms involving posterior inferior cerebellar artery (PICA), and one was treated with aneurysm trapping and PICA-VA anastomosis, whereas another was treated with coil embolization and VA-to-PICA stent placement. We suggest both bypass surgery and VA-to-PICA stent placement are good options for PICA revascularization. PMID:24621719

Guo, Liemei; Wan, Jieqing; Qiu, Yongming; Zhang, Xiaohua

2014-03-01

371

Three-dimensional CT imaging of an isolated dissecting aneurysm of the superior mesenteric artery  

Microsoft Academic Search

.   A case of an isolated dissecting aneurysm of the superior mesenteric artey is presented with findings of three-dimensional\\u000a CT imaging. False lumen, intimal flap, entry, and re-entry are clearly identified on threedimensional CT imaging.

H. Hyodoh; K. Hyodoh; K. Takahashi; M. Yamagata; K. Kanazawa

1996-01-01

372

Blunt traumatic internal carotid artery dissection with delayed stroke in a young skydiver.  

PubMed

We describe a case of a 33-year-old skydiver who presented to the emergency department after a traumatic landing following a parachuting episode. He initially presented with right knee pain secondary to a tibial plateau fracture. There were no neurological symptoms or signs at the initial assessment. While he was still in the emergency department, he suddenly developed headache and left-sided hemiplegia. An urgent work-up showed right middle cerebral artery thrombosis with right internal carotid thrombosis and dissection. We have discussed some possible mechanism of injury in skydiving that may have predisposed to the occurrence of cervical dissection in our patient. PMID:23559649

Abbo, Michael; Hussain, Kosar; Ali, Mohammad Baqer Mohammad

2013-01-01

373

Successful treatment of growing basilar artery dissecting aneurysm by pipeline flow diversion embolization device.  

PubMed

We describe a case of successful management of a growing basilar artery dissecting aneurysm by the Pipeline flow diversion embolization device (PED). A 48-year-old woman presented with severe headache, neck pain, and altered consciousness. Computed tomography showed subarachnoid hemorrhage located in basal cisterns, with a pontine infarct shown on magnetic resonance imaging. Digital subtraction angiography showed dissecting aneurysm of the trunk of the basilar artery, with growth over time on repeated imaging. Repeated imaging demonstrated growth in size of the aneurysm. The aneurysm was treated with PED with complete obliteration of the basilar artery aneurysm. Subsequent follow-up demonstrated good clinical recovery. PMID:24389375

Gong, Dasen; Yan, Bernard; Dowling, Richard; Mitchell, Peter

2014-07-01

374

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.

2014-01-01

375

Spontaneous coronary artery dissection by intravascular ultrasound in a patient with myocardial infarction  

PubMed Central

Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome and sudden cardiac death. The incidence, causes, pathogenesis, and treatment have not been defined clearly, but spontaneous coronary artery dissection should be considered in young patients without major cardiovascular risk factors or in patients in the peripartum period who present with acute coronary syndrome. The treatment is often challenging. Medical treatment is usually considered, and percutaneous coronary intervention or coronary artery bypass surgery may be possible in some patients. We herein report two cases of middle-aged males with myocardial infarction who were treated with percutaneous coronary angioplasty.

Jang, Ji Hun; Kim, Dae Hyeok; Yang, Dong Hyuk; Woo, Seong Il; Kwan, Jun; Park, Keum Soo

2014-01-01

376

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

377

Chronic dissection and aneurysmal dilatation of a BioValsalva conduit.  

PubMed

The BioValsalva (Vascutek Terumo, Renfrewshire, Scotland, UK) conduit is the first commercially available prefabricated bioprosthetic aortic valved conduit. We present a case of chronic dissection of a BioValsalva valved conduit presenting as a 7.5-cm aortic root aneurysm 1 year after a Bentall operation. Intraoperatively, the conduit was found to have dissected from the annulus upward, and the coronary buttons were avulsed from the inner layers while remaining attached to the outer layer. Both the outer layer and the coronary buttons were grossly dilatated. PMID:23816079

Yigzaw, Yikuno A; Lau, Kelvin K W; Baig, Kamran; Uppal, Rakesh

2013-07-01

378

Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child  

PubMed Central

Aortic dissection (AD) is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS) without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated genetic or inherited risk factors.

Gera, D. N.; Ghuge, P. P.; Gandhi, S.; Vanikar, A. V.; Shrimali, J. D.; Kute, V. B.; Trivedi, H. L.

2013-01-01

379

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

SciTech Connect

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

Haesemeyer, Scott W.; Vedantham, Suresh [Washington University in St. Louis, Mallinckrodt Institute of Radiology (United States)], E-mail: vedanthams@mir.wustl.edu; Braverman, Alan [Washington University in St. Louis, Section of Cardiology (United States)

2005-01-15

380

Severe Limb Ischemia Related to Previous Abdominal Aortic Aneurysm Repair Induced by Acute Aortic Dissection  

PubMed Central

We described the first case of limb ischemia induced by acute aortic dissection in the patient with previous abdominal aortic aneurysm (AAA) repair. A 56-year-old male was referred for severe limb ischemia. He underwent AAA repair one month before the referral. Computed tomography (CT) scan revealed Stanford type B aortic dissection extended to the proximal anastomosis site of the AAA repair. The false lumen made the complete interruption of antegrade blood flow at the proximal anastomosis site of the AAA repair.

Umeda, Yukio; Imaizumi, Matsuhisa; Mori, Yoshio; Takiya, Hiroshi

2011-01-01

381

Extensive Iatrogenic Aortic Dissection During Renal Angioplasty: Successful Treatment with a Covered Stent-Graft  

SciTech Connect

An extensive iatrogenic aortic type B dissection during percutaneous transluminal renal angioplasty (PTRA) for bilateral renal artery stenosis was treated with a covered stent placed in the right renal artery. Control angiography confirmed closure of the entry. Postprocedural CT demonstrated a thick intramural hematoma (IMH) up to the left subclavian artery. CT follow-up at 8 months showed an almost complete resorption of the IMH. While medical treatment is the standard therapy for type B dissections, closure of the intimal tear with a covered stent may be an additional option in extensive cases during PTRA.

Rasmus, M.; Huegli, R.; Jacob, A.L. [University Hospital of Basel, Interventional Radiology (Switzerland); Aschwanden, M. [University Hospital of Basel, Department of Angiology (Switzerland); Bilecen, D. [University Hospital of Basel, Interventional Radiology (Switzerland)], E-mail: dbilecen@uhbs.ch

2007-06-15

382

Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child.  

PubMed

Aortic dissection (AD) is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS) without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated genetic or inherited risk factors. PMID:24339527

Gera, D N; Ghuge, P P; Gandhi, S; Vanikar, A V; Shrimali, J D; Kute, V B; Trivedi, H L

2013-11-01

383

Chimney technique for aortic dissection involving an aberrant right subclavian artery.  

PubMed

We report a case involving a ruptured acute type B aortic dissection originating from an aberrant right subclavian artery (ARSA). A thoracic stent-graft was deployed in the distal arch close to the origin of the ARSA; the entry site at the origin of the ARSA was embolized with metallic coils. Perfusion of the left subclavian artery was preserved without a surgical bypass by using a chimney graft. This procedure is a feasible and less invasive treatment for high-risk sternotomy patients and is an effective strategy for acute aortic dissections involving an ARSA. PMID:24384181

Samura, Makoto; Zempo, Nobuya; Ikeda, Yoshitaka; Kaneda, Yoshikazu; Suzuki, Kazuhiro; Tsuboi, Hidetoshi; Hamano, Kimikazu

2014-01-01

384

Pediatric tonsillectomy: post-operative morbidity comparing microsurgical bipolar dissection versus cold sharp dissection  

Microsoft Academic Search

A prospective single-blinded study was conducted to compare pediatric tonsillectomy using the traditional cold sharp dissection with ligation for securing hemostasis (CSDL) versus microsurgical bipolar dissection technique (MBCT). Sixty children aged between 2 and 14 years were sequentially assigned to each group. Blood loss and postoperative pain in the first hour were markedly decreased in the MBCT group (P<0.0001 and

Luis Lassaletta; Gonzalo Mart??n; Miguel Angel Villafruela; Caridad Bolaños; Juan José Álvarez-Vicent

1997-01-01

385

Osteogenesis Imperfecta, Multiple Intra-Abdominal Arterial Dissections and a Ruptured Dissecting-Type Intracranial Aneurysm  

PubMed Central

Summary We describe an adult patient with a ruptured dissecting-type superior cerebellar artery aneurysm and known osteogenesis imperfecta. He was successfully treated with coil embolization and intentional parent vessel sacrifice. During his hospital admission, he also suffered from abdominal distension. An incidental note was made of multiple intra-abdominal arterial dissections. These were managed conservatively. We review the rare association of osteogenesis imperfecta and intracranial aneurysms, as well as discuss management implications.

Matouk, C.C.; Hanbidge, A.; Mandell, D.M.; Terbrugge, K.G.; Agid, R.

2011-01-01

386

Is Endoscopic Submucosal Dissection the Option for Early Gastric Cancer Patients with Contraindication to Surgery?  

PubMed Central

Surgical therapy is the traditional approach for early gastric cancer. Patients with comorbidities cannot benefit from this treatment because of high surgical morbidities and mortalities. Endoscopic submucosal dissection is a new technique for complete en bloc resection of early gastric cancer. We report the case of a patient with severe cardiomyopathy who developed early gastric cancer without metastases present on CT scan. The patient underwent endoscopic submucosal dissection because of the high risk associated to surgery due to severe comorbidity. The patient had complete submucosal dissection with complete en bloc resection. The lateral and deep margins were free of cancerous cells based on histopathology study. The patient was controlled every 6 months for 30 months by endoscopy. Systematic biopsies were done. No recurrences were diagnosed. This report supports the application of endoscopic treatment for patients with early gastric cancer and at high risk for surgery due to comorbidities.

Farhat, Said; Coriat, Romain; Audard, Virginie; Leblanc, Sarah; Prat, Frederic; Chaussade, Stanislas

2010-01-01

387

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.

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

2014-01-01

388

Iatrogenic Ascending Aorta Dissection during Diagnostic Coronary Angiography: Rare but Life-Threatening  

PubMed Central

Dissection of the ascending aorta is a very rare but life-threatening complication during diagnostic angiography. We present a case of an elderly woman who underwent an elective diagnostic coronary angiography, complicated with an iatrogenic ascending aorta dissection that did not involve the coronary arteries but originated 4 cm distal of the aortic valve. The patient developed cardiogenic shock due to acute pericardial tamponade and so immediate, life-saving cardiac surgery with implantation of a supracoronary graft was successfully performed. A biopsy from the excised aorta showed loss of smooth muscle cells and accumulation of basophilic ground substance, clear features of cystic media necrosis. This is believed to be the underlying cause of the dissection besides a nonselective injection of the right coronary artery.

Haenen, Luc

2014-01-01

389

Severe splenic rupture after colorectal endoscopic submucosal dissection  

PubMed Central

Splenic rupture (SR) after colonoscopy is a very rare but potentially serious complication. Delayed diagnosis is common, and may increase morbidity and mortality associated. There is no clear relation between SR and difficult diagnostic or therapeutic procedures, but it has been suggested that loop formation and excessive torquing might be risk factors. This is a case of a 65-year-old woman who underwent endoscopic submucosal dissection (ESD) for lateral spreading tumor in the descending colon, and 36 h afterwards presented symptoms and signs of severe hypotension due to SR. Standard splenectomy was completed and the patient recovered uneventfully. Colorectal ESD is usually a long and position-demanding technique, implying torquing and loop formation. To our knowledge this is the first case of SR after colorectal ESD reported in the literature. Endoscopists performing colorectal ESD in the left colon must be aware of this potential complication.

Herreros de Tejada, Alberto; Gimenez-Alvira, Luis; Van den Brule, Enrique; Sanchez-Yuste, Rosario; Matallanos, Pilar; Blazquez, Esther; Calleja, Jose L; Abreu, Luis E

2014-01-01

390

The Difference of Each Angiographic Finding After Multiple Stent According to Stent Type in Bilateral Vertebral Artery Dissection  

PubMed Central

We report a case of spontaneous bilateral intracranial vertebral artery dissecting aneurysms with subarachnoid hemorrhage. One dissecting lesion was treated with a coronary balloon-mounted stent (BMS) technique; however, due to differences in access route tortuosity, the other lesion was treated with a self-expandable stent (SES) technique. After 2 months, the angiographic outcome showed complete healing of the dissected segment on the side that was treated with BMS; in contrast, the dissection lesion appeared to be re-growing on the side that was treated with SES. Complete treatment of the aggravated lesion was achieved by additional deployment of BMSs. Therefore, we have provided a discussion of the possible reasons for this difference in outcome according to the stent type.

Lee, Dong Hoon; Yoon, Woon Ki; Baik, Min Woo

2013-01-01

391

Impact of middle and lower jugular neck dissection on supraclavicular lymph node metastasis from endometrial carcinoma  

PubMed Central

Supraclavicular lymph node metastasis from endometrial carcinoma is considerably rarer than metastasis from uterine cervical cancer. To date, there have been no reported cases regarding systematic neck dissection as a salvage treatment. In this report, we describe the neck dissection procedure carried out on a 74-year-old woman with supraclavicular lymph node metastasis. Our objective was to histologically determine the origin of the metastasis while simultaneously providing appropriate treatment. The patient’s past medical history included two prior cases of cancer: rectal cancer 7?years earlier and endometrial adenocarcinoma 4?years earlier. We determined that middle and lower jugular neck dissection was appropriate in treating this case based on the results of our preoperative FDG-PET and tumor markers. This surgery provided histological evidence that metastasis occurred from endometrial carcinoma. Middle and lower jugular neck dissection was expected to improve the patient’s prognosis without impacting the patient’s active daily life. We have continued to monitor the patient closely over an extended period.

2012-01-01

392

Dissecting mammalian immunity through mutation  

PubMed Central

Although mutation and natural selection have given rise to our immune system, a well-placed mutation can also cripple it, and within an expanding population we are recognizing more and more cases of single-gene mutations that compromise immunity. These mutations are an ideal tool for understanding human immunology, and there are more ways than ever to measure their physiological effects. There are also more ways to create mutations in the laboratory, and to use these resources to systematically define the function of every gene in our genome. This review focuses on the discovery and creation of mutations in the context of mammalian immunity, with an emphasis on the use of genome-wide chemical and CRISPR/Cas9 mutagenesis to reveal gene function.

Siggs, Owen M

2014-01-01

393

Towards a fast implementation of spectral nested dissection  

NASA Technical Reports Server (NTRS)

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

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

1992-01-01

394

Endoscopic submucosal dissection and surgical treatment for gastrointestinal cancer  

PubMed Central

Endoscopic submucosal dissection (ESD) is widely used in Japan as a minimally invasive treatment for early gastric cancer. The application of ESD has expanded to the esophagus and colorectum. The indication criteria for endoscopic resection (ER) are established for each organ in Japan. Additional treatment, including surgery with lymph node dissection, is recommended when pathological examinations of resected specimens do not meet the criteria. Repeat ER for locally recurrent gastrointestinal tumors may be difficult because of submucosal fibrosis, and surgical resection is required in these cases. However, ESD enables complete resection in 82%-100% of locally recurrent tumors. Transanal endoscopic microsurgery (TEM) is a well-developed surgical procedure for the local excision of rectal tumors. ESD may be superior to TEM alone for superficial rectal tumors. Perforation is a major complication of ESD, and it is traditionally treated using salvage laparotomy. However, immediate endoscopic closure followed by adequate intensive treatment may avoid the need for surgical treatment for perforations that occur during ESD. A second primary tumor in the remnant stomach after gastrectomy or a tumor in the reconstructed organ after esophageal resection has traditionally required surgical treatment because of the technical difficulty of ER. However, ESD enables complete resection in 74%-92% of these lesions. Trials of a combination of ESD and laparoscopic surgery for the resection of gastric submucosal tumors or the performance of sentinel lymph node biopsy after ESD have been reported, but the latter procedure requires a careful evaluation of its clinical feasibility.

Asano, Michio

2012-01-01

395

Dissecting aortic aneurysm manifesting as acute pericarditis.  

PubMed

Two patients with coarctation of the aorta initially had acute idiopathic pericarditis with anterior pleuritic chest pain as the chief complaint. A pericardial friction rub was present in both patients. Both patients died suddenly. At autopsy, they were found to have a dissecting aneurysm of the ascending aorta with extension into the pericardial space; acute pericardial tamponade was the cause of death. We recommend that when a patient with coarctation of the aorta is admitted with pericarditis, aortic dissection should be considered and appropriate diagnostic procedures undertaken. In all young patients with acute pericarditis there should be careful palpation of the femoral pulses and review of the chest x-ray film for rib notching. PMID:760674

Greenberg, D I; Davia, J E; Fenoglio, J; McAllister, H A; Cheitlin, M D

1979-01-01

396

Altered Hemodynamics Associated with Pathogenesis of the Vertebral Artery Dissecting Aneurysms  

PubMed Central

The etiology of the vertebral dissecting aneurysms is largely unknown, and they frequently occurs in relatively healthy young men. Objectives and Methods. A series of 57 consecutive cases defined by angiography were evaluated with regard to deviation in the course of the affected and contralateral vertebral arteries. Division was into 3 types: Type I without any deviation, Type II with mild-to-moderate deviation but not over the midline; and Type III with marked deviation over to the contralateral side beyond the midline. Results. The most frequent type of VA running was Type III for the affected and Type I nonaffected side, with this being found in all 17 patients except one. All of the Type III dissections occurred just proximal to a tortuous portion, while in cases with Type-I- and Type-II-affected sides, the majority (33 of 39) occurred near the union of the vertebral artery. In 10 of 57, a non-dominant side was affected, all except one being of Type I or II. With 12 recent patients assessed angiographically in detail for hemodynamics, eleven patients showed contrast material retrograde inflowing into the pseudolumen from the distal portion of the dissection site. Turbulent blood flow was recognized in all of these patients with retrograde inflow. Conclusions. Turbulent blood flow is one etiology of vertebral artery dissection aneurysms, with the sites in the majority of the cases being just proximal to a tortuous portion or union of vessels. In cases with dissection proximal to the tortuous course of the vertebral artery, retrograde inflow will occur more frequently than antegrade, which should be taken into account in designing therapeutic strategies.

Kurata, Akira; Suzuki, Sachio; Iwamoto, Kazuhisa; Nakahara, Kuniaki; Abe, Katsutoshi; Inukai, Madoka; Niki, June; Sasaki, Makoto; Fujii, Kiyotaka; Konno, Shingo; Kan, Shinichi; Fukasaku, Kazuaki

2012-01-01

397

Donors' attitudes towards body donation for dissection  

Microsoft Academic Search

SummaryWe report a survey in the UK of potential whole-body donors for dissection. 218 people (age range 19-97 years) answered a postal questionnaire, giving information about themselves, their reasons for donation, attitudes towards the dead body, funeral preferences and medical giving and receiving. In addition to altruism, motives included the wish to avoid funeral ceremonies, to avoid waste, and in

R Richardson; B Hurwitz

1995-01-01

398

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

399

Laparoscopic Retroperitoneal Lymph Node Dissection: Extraperitoneal Approach  

Microsoft Academic Search

We review our early experience with laparoscopic retroperitoneal lymph node dissection (RPLND) via extraperitoneal approach\\u000a to assess the precise pathological status of retroperitoneal lymph nodes in early-stage testicular cancer. A total of 32 patients\\u000a (23 with stage I, 4 with stage IIa, and 5 with stage IIb) with testicular cancer underwent extraperitoneal laparoscopic RPLND\\u000a in the supine position. After developing

Makoto Satoh; Akihiro Ito; Yoichi Arai

400

Molecular Dissection of a Bifidobacterial Replicon  

Microsoft Academic Search

The 2.1-kb cryptic plasmid pCIBAO89 from Bifidobacterium asteroides harbors a 1.4-kb segment which is sufficient for its autonomous replication. The segment is divided into two parts, the presumed replication origin, ori89, and the rep gene encoding the putative 41-kDa Rep89 replication initiation protein. This minimal replication region of pCIBAO89 was functionally dissected by transcriptional analyses as well as by DNA-

Michelle Cronin; Moritz Knobel; Mary O'Connell-Motherway; Gerald F. Fitzgerald; Douwe van Sinderen

2007-01-01

401

Advanced endoscopic submucosal dissection with traction  

PubMed Central

Endoscopic submucosal dissection (ESD) has been established as a standard treatment for early stage gastric cancer (EGC) in Japan and has spread worldwide. ESD has been used not only for EGC but also for early esophageal and colonic cancers. However, ESD is associated with several adverse events, such as bleeding and perforation, which requires more skill. Adequate tissue tension and clear visibility of the tissue to be dissected are important for effective and safe dissection. Many ESD methods using traction have been developed, such as clip-with-line method, percutaneous traction method, sinker-assisted method, magnetic anchor method, external forceps method, internal-traction method, double-channel-scope method, outerroute method, double-scope method, endoscopic-surgical-platform, and robot-assisted method. Each method has both advantages and disadvantages. Robotic endoscopy, enabling ESD with a traction method, will become more common due to advances in technology. In the near future, simple, noninvasive, and effective ESD using traction is expected to be developed and become established as a worldwide standard treatment for superficial gastrointestinal neoplasias.

Imaeda, Hiroyuki; Hosoe, Naoki; Kashiwagi, Kazuhiro; Ohmori, Tai; Yahagi, Naohisa; Kanai, Takanori; Ogata, Haruhiko

2014-01-01

402

Advanced endoscopic submucosal dissection with traction.  

PubMed

Endoscopic submucosal dissection (ESD) has been established as a standard treatment for early stage gastric cancer (EGC) in Japan and has spread worldwide. ESD has been used not only for EGC but also for early esophageal and colonic cancers. However, ESD is associated with several adverse events, such as bleeding and perforation, which requires more skill. Adequate tissue tension and clear visibility of the tissue to be dissected are important for effective and safe dissection. Many ESD methods using traction have been developed, such as clip-with-line method, percutaneous traction method, sinker-assisted method, magnetic anchor method, external forceps method, internal-traction method, double-channel-scope method, outerroute method, double-scope method, endoscopic-surgical-platform, and robot-assisted method. Each method has both advantages and disadvantages. Robotic endoscopy, enabling ESD with a traction method, will become more common due to advances in technology. In the near future, simple, noninvasive, and effective ESD using traction is expected to be developed and become established as a worldwide standard treatment for superficial gastrointestinal neoplasias. PMID:25031787

Imaeda, Hiroyuki; Hosoe, Naoki; Kashiwagi, Kazuhiro; Ohmori, Tai; Yahagi, Naohisa; Kanai, Takanori; Ogata, Haruhiko

2014-07-16

403

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

404

Massive dissecting intramural duodenal haematoma following endoscopic haemostasis of a bleeding duodenal ulcer.  

PubMed

Intramural duodenal haematoma is a rare injury of the duodenum. Most reported cases are secondary to blunt trauma to the abdomen. Such injury following endoscopic intervention is even rarer, and there are no definite guidelines for its management. We report a case where endoscopic haemostasis of a bleeding duodenal ulcer resulted in a massive dissecting intramural duodenal haematoma with gastric outlet obstruction and obstructive jaundice. PMID:16644511

Lukman, Mohd Rashid; Jasmi, Ali Yaakub; Niza, S Shahrun

2006-04-01

405

Stent recanalization of carotid tonsillar loop dissection using the Enterprise vascular reconstruction device.  

PubMed

Although advances in endovascular techniques have permitted reconstruction of intimal dissections and related pseudoaneurysms of the extracranial cervical internal carotid artery, highly tortuous tonsillar loop anatomic variants still pose an obstacle to conventional extracranial self-expanding carotid stents. During a 12year period, nine of 48 cases with cervical carotid dissections were associated with a tonsillar loop. Five patients required endovascular treatment, which was performed using a microcatheter-based technique with the low-profile Enterprise vascular reconstruction device (Codman Neurovascular, Raynham, MA, USA). Technical, radiographic, and clinical outcomes were analyzed for each patient. Dissection etiology was spontaneous in three patients, iatrogenic in one, and traumatic in one. Four near-occlusive tonsillar loop dissections were successfully recanalized during the acute phase. Dissection-related stenosis improved from 90±22% to 31±13%, with tandem stents needed in three instances to seal the inflow zone. There were no procedure-related transient ischemic attacks (TIA), minor/major strokes, or deaths. Angiographic follow-up for a mean of 28.0±21.6months showed all stents were patent, with average stenosis of 25.2±12.2%. Focal ovalization and kinking of the closed-cell design was noted at the sharpest curve in one patient. Clinical outcome (follow-up of 28.1±21.5months) demonstrated overall improvement with no clinical worsening, new TIA, or stroke. Tonsillar loop-associated carotid dissections can be successfully and durably recanalized using the low-profile Enterprise stent with an excellent long-term patency rate and low procedural risk. The possibility of stent kinking and low radial force should be considered when planning reconstruction with this device. PMID:24642024

Rahal, Jason P; Gao, Bulang; Safain, Mina G; Malek, Adel M

2014-07-01

406

Student attitudes to whole body donation are influenced by dissection.  

PubMed

Given the important role that anatomical dissection plays in the shaping of medical student attitudes to life and death, these attitudes have not been evaluated in the context of whole body donation for medical science. First year students of anatomy in an Irish university medical school were surveyed by questionnaire before and after the initial dissection and again after 9 weeks of anatomical dissection. Analysis of student responses to the idea of whole body donation by an unrelated stranger, a family member, or by the respondent showed that a priori attitudes to donation by a stranger did not change with exposure to dissection. However, student opposition to donation by a family member was evident immediately after the initial dissection and was sustained throughout the duration of this study. Support for the idea of donating their bodies to medical science decreased significantly among respondents after exposure to dissection (31.5% before dissection, 19.6% after dissecting for 9 weeks) but not to levels reported in the general population in other studies. This study demonstrates that where dissection forms a part of anatomy teaching, students expect to learn anatomy by dissecting donors whom they do not know. As a potential donor population, students are reluctant to become emotionally involved in the donation process and are unwilling to become donors themselves. PMID:19177413

Cahill, Kevin C; Ettarh, Raj R

2008-01-01

407

Stimulated Recall as a Trigger for Increasing Noticing and Language Awareness in the L2 Writing Classroom: A Case Study of Two Young Female Writers  

ERIC Educational Resources Information Center

Appropriately timed Focus on Form can help in raising the learners' language awareness. In this paper we argue that the learner's own text composition progression can indicate when a learner is ready to notice a particular language form. Stimulated recall induced discussion was used to provoke explicit writer comments relating to noticing and…

Lindgren, Eva; Sullivan, Kirk P. H.

2003-01-01

408

Dissecting aneurysm of the superior mesenteric artery associated with transomental hernia of the small bowel: helical CT findings  

Microsoft Academic Search

We present a case of intestinal obstruction caused by a transomental hernia with an associated finding of a dissecting aneurysm\\u000a of the superior mesenteric artery. These two rare conditions both cause acute abdomen with similar symptoms. This case shows\\u000a the possible diagnostic pitfalls of transomental hernia.

Tadao Hiromura; Hiroyuki Ikeda; Tatsuzou Tanabe

2000-01-01

409

JAK2-Centered Interactome Hotspot Identified by an Integrative Network Algorithm in Acute Stanford Type A Aortic Dissection  

PubMed Central

The precise mechanisms underlying dissections, especially those without connective tissue diseases or congenital vascular diseases, are incompletely understood. This study attempted to identify both the expression profile of the dissected ascending aorta and the interactome hotspots associated with the disease, using microarray technology and gene regulatory network analysis. There were 2,737 genes differentially expressed between patients with acute Stanford type A aortic dissection and controls. Eight interactome hotspots significantly associated with aortic dissection were identified by an integrative network algorithm. In particular, we identified a JAK2-centered expression module, which was validated in an independent gene expression microarray data set, and which was characterized by over-expressed cytokines and receptors in acute aortic dissection cases, indicating that JAK2 may play a key role in the inflammatory process, which potentially contributes to the occurrence of acute aortic dissection. Overall, the analytical strategy used in this study offered the possibility to identify functional relevant network modules and subsequently facilitated the biological interpretation in the complicated disease.

Teschendorff, Andrew E.; Hong, Tao; Wang, Linyan; Qian, Mengjia; Wang, Chunsheng; Wang, Xiangdong

2014-01-01

410

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

411

77 FR 30999 - Notice of Submission for OMB Review; Office of Planning, Evaluation and Policy Development; Case...  

Federal Register 2010, 2011, 2012, 2013

...Case Studies of Current and Former Grantees under the Title III National Professional...Case Studies of Current and Former Grantees under the Title III National Professional...this study is to examine how a sample of grantees is implementing their grants with...

2012-05-24

412

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

Federal Register 2010, 2011, 2012, 2013

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

2012-03-01

413

Effectiveness of a new inflatable balloon device for gluing dissected layers in an experimental model of aortic dissection  

PubMed Central

OBJECTIVES: In the surgical treatment of acute aortic dissection, tissue glues are widely used to reinforce the adhesion between the dissected aortic layers. A new inflatable balloon device was developed to compress the dissected aortic wall during gluing to increase adhesion between the dissected layers. The present study used an ex vivo experimental animal model to test the hypothesis that this device is effective when gluing the true and false channels of dissected aortas. METHODS: In the ex vivo experimental model, aortic dissection was simulated surgically on 12 fresh bovine aorta samples. In six samples (group I), the inflatable balloon device was inserted into the aorta to reinforce and fuse the dissected layers during gluing. The other six fresh bovine aortic samples (group II) were compressed between the surgeon’s fingers during gluing. Aortic samples were evaluated and compared macroscopically and histologically. RESULTS: In group I, adhesion between the dissected layers was easily achieved during gluing. All false cavities were perfectly closed, with no deleterious effects related to the device. In group II, the adhesion between the dissected layers was not complete and some false cavities remained patent. CONCLUSIONS: The inflatable balloon device can increase the adhesive effect of tissue glues via homogenous compression of the dissected aortic layers. In addition, the balloon can prevent distal embolization of the glue.

Colak, Necmettin; Nazli, Yunus; Alpay, Mehmet Fatih; Akkaya, Ismail Olgun; Aksoy, Omer Nuri; Akgedik, Sukran; Cakir, Omer

2013-01-01

414

[Type A aortic dissection: the role of angiography in identifying morphologic features in comparison with autopsy and surgical findings].  

PubMed

To evaluate the reliability of cineangiography in identifying some morphologic characteristics of type A aortic dissection, the angiograms of 36 consecutive patients were retrospectively revised and compared with the surgical of necropsy findings. The following features were examined: site and extension of intimal tear (s); extension of the wall dissection; coronary and brachiocephalic arteries involvement; coexisting anuloaortic ectasia; aortic valve state. The angiographic diagnosis of site and extension of the intimal tear was correct in 97 (35/36) and 100% of cases respectively. In one case the presence of an intimal tear at the level of the aortic arch was missed because of the superimposition of the innominate artery. The extension of the wall dissection was correctly identified in 24 out of 25 patients. In one case the presence of distal false lumen thrombosis made the correct diagnosis impossible. The brachiocephalic arteries involvement was always correctly stated while the coronary involvement was suspected in 6 and confirmed in 5 (1 false positive). Anuloectasia was suspected in 12 and confirmed in 10 (2 false positives). In our experience the most challenging diagnosed were the presence of aortic arch tears and the aortic arch and coronary arteries involvement in the dissection. This study confirms that many morphologic features of type A aortic dissection can be adequately assessed by cineangiography. PMID:2055376

Giommi, L; Cavallini, C; Franceschini, E; Marton, F; Risica, G; Olivari, Z; Cuzzato, V

1991-01-01

415

Chronic pulmonary artery dissection associated with pulmonary arterial hypertension  

PubMed Central

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

2013-01-01

416

Seeing the invisible: painless aortic dissection in the emergency setting.  

PubMed

Acute dissection of the aorta can be one of the most dramatic cardiovascular emergencies. Classically, aortic dissection presents as sudden, severe chest, back, or abdominal pain that is characterised as ripping or tearing in nature. However, a timely diagnosis can be elusive in the event of an atypical presentation. In this report, the authors present two patients with painless aortic dissection who were misdiagnosed during their initial evaluation in the emergency department. PMID:16498148

Ayrik, C; Cece, H; Aslan, O; Karcioglu, O; Yilmaz, E

2006-03-01

417

Seeing the invisible: painless aortic dissection in the emergency setting  

PubMed Central

Acute dissection of the aorta can be one of the most dramatic cardiovascular emergencies. Classically, aortic dissection presents as sudden, severe chest, back, or abdominal pain that is characterised as ripping or tearing in nature. However, a timely diagnosis can be elusive in the event of an atypical presentation. In this report, the authors present two patients with painless aortic dissection who were misdiagnosed during their initial evaluation in the emergency department.

Ayrik, C; Cece, H; Aslan, O; Karcioglu, O; Yilmaz, E

2006-01-01

418

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.

von Schonfels, 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; Rocken, Christoph; Rimbach, Gerald; Becker, Thomas

2013-01-01

419

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

420

Molecular Dissection of a Bifidobacterial Replicon? †  

PubMed Central

The 2.1-kb cryptic plasmid pCIBAO89 from Bifidobacterium asteroides harbors a 1.4-kb segment which is sufficient for its autonomous replication. The segment is divided into two parts, the presumed replication origin, ori89, and the rep gene encoding the putative 41-kDa Rep89 replication initiation protein. This minimal replication region of pCIBAO89 was functionally dissected by transcriptional analyses as well as by DNA-binding studies, and the information obtained was exploited to create a number of Escherichia coli-Bifidobacterium shuttle vectors capable of transforming various bifidobacteria with an efficiency of up to 106 transformants/?g DNA.

Cronin, Michelle; Knobel, Moritz; O'Connell-Motherway, Mary; Fitzgerald, Gerald F.; van Sinderen, Douwe

2007-01-01

421

A Comparative Approach To Animal Dissections (A Phylogenic Study)  

NSDL National Science Digital Library

In this biology inquiry lab, students study evolutionary relationships by making observations of preserved animal specimens, developing a question, then investigating by dissecting the specimens provided.

422

Effects on seventh-grade students' achievement and science anxiety of alternatives to conventional frog dissection  

NASA Astrophysics Data System (ADS)

The purpose of this study in a suburban school district was to investigate and compare the level of learning and long-term retention of frog internal anatomy between seventh-grade students using an interactive CD tutorial, a desktop microworld, and conventional frog dissection. Students' anxiety toward science was also compared across the three treatment groups and between genders. Additional data on the students' preferred learning style were used to explore possible interaction effects with their respective instructional activity. Subjects participating in the study were all seventh-grade students in one junior-high school, numbering 280 in total. Classes were randomly assigned to the three modes of instruction for the dissection of a frog: a CD-tutorial dissection, a desktop microworld dissection, and a conventional dissection. The Conventional treatment was the traditional physical dissection using a preserved frog specimen and lab dissection tools. The CD-Tutorial treatment was the interactive tutorial Digital Frog from Digital Frog International. The Microworld treatment was a desktop microworld environment composed of Operation Frog on CD supplemented with other programs to provide additional avenues for learning. Data collection and testing occurred prior to treatment, one day after treatment, and three months after treatment. Data collected showed mixed results for all measures taken. The differences in achievement gained favoring the conventional treatment from pretest to both posttests appear to have leveled out somewhat over time. Although anxiety levels declined for both genders after treatment, females continued to report significantly higher science anxiety than males. There appears to be a relationship between treatment and gender in terms of effect on science anxiety. For all three measures taken--pretest, immediate posttest and delayed posttest--no significant difference in achievement by learning style was observed. Learning style alone does not appear to be related to achievement in this study. However, the interaction between learning style and treatment was significant in some cases. In looking at achievement defined as gain scores among the three achievement measures, only some cases within the microworld treatment proved to be significant.

Marszalek, Christine Susan

423

The Effects of Interactive Dissection Simulation on the Performance and Achievement of High School Biology Students.  

ERIC Educational Resources Information Center

A study of 61 high school biology students found that Interactive Video Disk (IVD) simulation was as effective as actual frog dissection in promoting student learning of frog anatomy and dissection procedures. When used as a preparation for dissection, IVD simulation helped students perform better dissections and learn more from doing dissections.…

Kinzie, Mable B.; And Others

1993-01-01

424

Dissection of the ascending aorta mimicking an acute coronary syndrome: usefulness of transthoracic echocardiography for the differential diagnosis.  

PubMed

We describe the case of 2 patients presenting with chest pain and electrocardiographic signs of myocardial ischemia, in whom a transthoracic echocardiogram, performed urgently at the bedside, allowed a diagnosis of dissection of the ascending aorta. Prompt recognition of this condition avoided inappropriate aggressive medical treatments and permitted emergency surgical intervention. Aortic dissection can mimic other conditions including an acute coronary syndrome. When the diagnosis is unclear it may be useful to perform a transthoracic echocardiogram before starting any aggressive medical treatment because in such cases thrombolytic or anticoagulant therapy and antithrombotic treatment with platelet glycoprotein IIb/IIIa receptor antagonists can results in serious side effects. On the other hand, transthoracic echocardiography can confirm the suspicion of an acute coronary syndrome or suggest other diagnoses such as aortic dissection. PMID:12407829

Scarabeo, Virginia; Di Marco, Attilio; Pantaleoni, Attilio; Contessotto, Francesco; Mantovani, Enzo; Piovesana, PierGiuseppe

2002-08-01

425

Dissection of Organs from the Adult Zebrafish  

PubMed Central

Over the last 20 years, the zebrafish has become a powerful model organism for understanding vertebrate development and disease. Although experimental analysis of the embryo and larva is extensive and the morphology has been well documented, descriptions of adult zebrafish anatomy and studies of development of the adult structures and organs, together with techniques for working with adults are lacking. The organs of the larva undergo significant changes in their overall structure, morphology, and anatomical location during the larval to adult transition. Externally, the transparent larva develops its characteristic adult striped pigment pattern and paired pelvic fins, while internally, the organs undergo massive growth and remodeling. In addition, the bipotential gonad primordium develops into either testis or ovary. This protocol identifies many of the organs of the adult and demonstrates methods for dissection of the brain, gonads, gastrointestinal system, heart, and kidney of the adult zebrafish. The dissected organs can be used for in situ hybridization, immunohistochemistry, histology, RNA extraction, protein analysis, and other molecular techniques. This protocol will assist in the broadening of studies in the zebrafish to include the remodeling of larval organs, the morphogenesis of organs specific to the adult and other investigations of the adult organ systems.

Gupta, Tripti; Mullins, Mary C.

2010-01-01

426

Molecular mechanisms of thoracic aortic dissection.  

PubMed

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

2013-10-01

427

Anterior ECG changes following iatrogenic dissection of the right coronary artery into the aortic root: exclusion of left coronary obstruction with transoesophageal echocardiography.  

PubMed

One of the most troublesome complications of percutaneous coronary intervention (PCI) or angiography is retrograde dissection of the artery into the aortic root. We report a case involving the right coronary artery (RCA) which was treated with prompt deployment of stents. Recurrent chest pain and ST segment elevation in V(2-4) mimicked the ECG appearance of acute anterior infarction and prompted concern that the dissection had extended to impair flow in the left coronary artery (LCA). Transoesophageal echocardiography (TOE) demonstrated that the aortic root dissection had been contained and that the LCA was not compromised. PMID:23182174

Burstow, Darryl; Poon, Karl; Bell, Brendan; Bett, Nicholas

2013-01-01

428

Spontaneous rupture of a middle colic artery aneurysm arising from superior mesenteric artery dissection: Diagnosis by color Doppler ultrasonography and CT angiography.  

PubMed

Both middle colic artery (MCA) aneurysm and spontaneous dissection of the superior mesenteric artery (SMA) are rare. We report the first case of concomitancy of both conditions, diagnosed by ultrasonography and CT angiography. A 56-year-old man with abrupt abdominal pain and hypovolemic shock was diagnosed initially with ruptured MCA aneurysm by color Doppler ultrasonography. Computed tomography and angiography confirmed MCA aneurysm and showed that it was arising from the false lumen of an SMA dissection and was probably associated with segmental arterial mediolysis. The MCA aneurysm was treated successfully by transcatheter coil embolization, and the SMA dissection was treated conservatively. PMID:22457222

Yoo, Bo Reum; Han, Hyun Young; Cho, Young Kwon; Park, Suk Jin

2012-05-01

429

Early recognition of acute thoracic aortic dissection and aneurysm  

PubMed Central

Background Thoracic aortic dissection (TAD) and aneurysm (TAA) are rare but catastrophic. Prompt recognition of TAD/TAA and differentiation from acute coronary syndrome (ACS) is difficult yet crucial. Earlier identification of TAA/TAD based upon routine emergency department screening is necessary. Methods A retrospective analysis of patients that presented with acute thoracic complaints to the ED from January 2007 through June 2012 was performed. Cases of TAA/TAD were compared to an equal number of controls which consisted of patients with the diagnosis of ACS. Demographics, physical findings, EKG, and the results of laboratory and radiological imaging were compared. P-value of?>?0.05 was considered statistically significant. Results In total, 136 patients were identified with TAA/TAD, 0.36% of patients that presented with chest complaints. Compared to ACS patients, TAA/TAD group was older (68.9 vs. 63.2 years), less likely to be diabetic (13% vs 32%), less likely to complain of chest pain (47% vs 85%) and head and neck pain (4% vs 17%). The pain for the TAA/TAD group was less likely characterized as tight/heavy in nature (5% vs 37%). TAA/TAD patients were also less likely to experience shortness of breath (42% vs. 51%), palpitations (2% vs 9%) and dizziness (2% vs 13%) and had a greater incidence of focal lower extremity neurological deficits (6% vs 1%), bradycardia (15% vs. 5%) and tachypnea (53% vs. 22%). On multivariate analysis, increasing heart rate, chest pain, diabetes, head & neck pain, dizziness, and history of myocardial infarction were independent predictors of ACS. Conclusions Increasing heart rate, chest pain, diabetes, head & neck pain, dizziness, and history of myocardial infarction can be used to differentiate acute coronary syndromes from thoracic aortic dissections/aneurysms.

2013-01-01

430

Interventional management for secondary intracranial extension of spontaneous cervical arterial dissection  

PubMed Central

Background: Spontaneous cervical artery dissection (sCAD) is an important etiology of stroke and subarachnoid hemorrhage (SAH) in young patients. Anticoagulation and platelet antiaggregant medications are the treatment of choice, while the indications of endovascular treatment are still to be defined. Case Description: We report two cases of medically refractory sCAD with intracranial extension treated successfully with multiple intra and extracranial stents. The patients were evaluated at 4 years and 1-year follow-up. Conclusion: Progressive, spontaneous cervical artery dissection with intracranial extension despite adequate medical therapy is rare and associated with worse prognosis. Given the rapid evolution of interventional technology and techniques, if we are better able to predict the cohort of patients that fail medical management, earlier endovascular therapy may be considered.

Smith, Michelle J.; Santillan, Alejandro; Segal, Alan; Patsalides, Athos; Gobin, Y. Pierre

2010-01-01

431

Emergent Repair of a Complex Dissecting Aneurysm in the Thoracic Aorta  

PubMed Central

Endovascular treatment of complex thoracic pathologic conditions involving the aortic arch can often be appropriate and safe; however, minimally invasive procedures are not always feasible, especially in emergent cases. We report the case of a 78-year-old woman who emergently presented in hemorrhagic shock with a ruptured chronic dissecting aneurysm that involved the aortic arch. Eight years earlier, she had undergone aortic valve replacement and plication of the ascending aorta, which was complicated a day later by Stanford type B dissection, malperfusion, and ischemia that required an axillobifemoral bypass. At the current admission, we successfully treated her surgically through a left thoracotomy, using moderate hypothermic extracorporeal circulation and advanced organ-protection methods. We discuss the surgical indications and our operative strategy in relation to open surgical repair versus endovascular treatment in patients with complex conditions.

Civilini, Efrem; Bertoglio, Luca; Mascia, Daniele; Bonis, Michele De; Chiesa, Roberto

2012-01-01

432

Color Doppler sonographic diagnosis of dissecting aneurysm of the superior mesenteric artery.  

PubMed

We report a case of dissecting aneurysm of the superior mesenteric artery (SMA) diagnosed on gray-scale and color Doppler sonography and confirmed on angiography. Spontaneous dissection of the SMA is rare, and there are few reported cases of the color Doppler sonographic findings. Gray-scale sonography revealed an aneurysmal dilatation of the SMA 3-4 cm from the SMA's origin, with an echogenic linear membrane (an intimal flap) within the aneurysm. Color Doppler sonography showed color flow within the aneurysm and showed that the intimal flap separated the aneurysm into 2 lumina. Spectral analysis revealed anterograde flow in the anterior (ie, true) lumen and retrograde flow in the posterior (ie, false) lumen. PMID:11323781

Wadhwani, R; Modhe, J; Pandey, K; Gujar, S; Sukthankar, R

2001-05-01

433

Extracranial carotid and vertebral artery dissection: a review.  

PubMed

Dissection of the extracranial carotid and vertebral arteries is increasingly recognized as a cause of transient ischemic attacks and stroke. The annual incidence of spontaneous carotid artery dissection is 2.5 to 3 per 100,000, while the annual incidence of spontaneous vertebral artery dissection is 1 to 1.5 per 100,000. Traumatic dissection occurs in approximately 1% of all patients with blunt injury mechanisms, and is frequently initially unrecognized. Overall, dissections are estimated to account for only 2% of all ischemic strokes, but they are an important factor in the young, and account for approximately 20% of strokes in patients less than 45 years of age. Arterial dissection can cause ischemic stroke either by thromboemboli forming at the site of injury or as a result of hemodynamic insufficiency due to severe stenosis or occlusion. Available evidence strongly favors embolism as the most common cause. Both anticoagulation and antiplatelet agents have been advocated as treatment methods, but there is limited evidence on which to base these recommendations. A Cochrane review on the topic of antithrombotic drugs for carotid dissection did not identify any randomized trials, and did not find that anticoagulants were superior to antiplatelet agents for the primary outcomes of death and disability. Healing of arterial dissections occurs within three to six months, with resolution of stenosis seen in 90%, and recanalization of occlusions in as many as 50%. Dissecting aneurysms resolve on follow-up imaging in 5-40%,decrease in size in 15-30%, and remain unchanged in 50-65%. Resolution is more common in vertebral dissections than in carotid dissections. Aneurysm enlargement occurs rarely. The uncommon patient presenting with acute hemodynamic insufficiency should be managed with measures to increase cerebral blood flow, and in this setting emergency stent placement to restore cerebral perfusion may be considered, provided that irreversible infarction has not already occurred. PMID:18574926

Redekop, Gary John

2008-05-01

434

Acute paraplegia in painless aortic dissection. Rich imaging with poor outcome  

Microsoft Academic Search

Study design:Case reportObjective:To describe the clinical and imaging findings of a patient with painless aortic dissection.Setting:University Neurology Department, Thessaloniki, GreecePatient, Methods, Results:A 46-year-old man was transferred to our Department for emergent evaluation of paraplegia, from the local hospital of the nearby town, where he was admitted complaining from sudden, painless, bilateral leg weakness, 24 h earlier. He presented complete flaccid

D Karacostas; G Anthomelides; P Ioannides; K Psaroulis; D Psaroulis

2010-01-01

435

Multi-detector computed tomography of an aortic dissection in a cat.  

PubMed

Contrast enhanced, multi-detector computed tomography (MDCT) is a useful diagnostic imaging modality that has become increasingly available in veterinary medicine. Multi-planar and three-dimensional reconstructions allow accurate and comprehensive assessment of cardiac and vascular lesions with short image acquisition times. ECG-gated, contrast enhanced MDCT was used to assess the lesion extent and therapeutic options in a case of aortic dissection diagnosed in a hypertensive cat. PMID:24485986

Scollan, Katherine; Sisson, David

2014-03-01

436

IVC filter limb penetration of the caval wall during retroperitoneal surgery/lymph node dissection.  

PubMed

Optional inferior vena cava (IVC) filters are being increasingly used for protection against pulmonary embolism in patients with deep vein thrombosis where anticoagulation is contraindicated. We describe two cases during retroperitoneal surgery where the IVC filters were found to have perforated the cava wall and were subsequently removed intra-operatively. Cava wall penetration by filter limbs poses a significant danger during retroperitoneal lymph node dissection and filters should be removed preoperatively. PMID:23210584

Goh, Gerard S; Slattery, Michael M; Given, Mark F; Little, David; Lee, Michael J

2012-12-01

437

Aortic dissection complicating pregnancy following prophylactic aortic root replacement in a woman with Marfan syndrome.  

PubMed

Prophylactic aortic root replacement is the main factor explaining the increase in median probability of survival in Marfan syndrome (MFS) patients. In women with MFS, earlier root replacement has been suggested as a strategy to facilitate safe pregnancy. However, in this case report a pregnant patient with MFS who sustained a Type B aortic dissection in her second trimester, with fatal outcome, despite having had a prophylactic aortic root replacement five months prior to conception is described. PMID:17175042

McDermott, Colleen D; Sermer, Mathew; Siu, Samuel C; David, Tirone E; Colman, Jack M

2007-09-01

438

Surgical repair and stent positioning for type A acute aortic dissection: a step forward?  

PubMed

We report two cases of type A acute aortic dissection in which the traditional ascending aorta replacement was completed by aortic arch stenting to achieve a complete treatment and to avoid the risks that are connected to aortic arch replacement. Correct deployment of the stent was evaluated through an endoscope inserted in the transverse arch, which avoided fluoroangiography and the involvement of a radiologic team. PMID:15854975

Saccani, Stefano; Busi, Marzio; Fragnito, Claudio; Agostinelli, Andrea; Borrello, Bruno; Nicolini, Francesco; Gherli, Tiziano

2005-05-01

439

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

440

Posttraumatic Intradural Internal Carotid Artery-Cavernous Sinus Fistula Associated with Ipsilateral Carotid Dissection  

PubMed Central

Summary We describe a relatively unusual case of traumatic direct carotid-cavernous fistula in association with a giant intradural venous pouch and ipsilateral carotid dissection, related to carotid artery fistula located in the supraclinoid segment just below the origin of posterior communicating artery. Endovascular therapy could be accomplished by use of detachable coils transarterially. Awareness of an unusual intradural origin of a carotid-cavernous sinus fistula and the possibility of an embolization should be kept in mind.

Oran, I.; Parildar, M.; Memis, A.; Dalbasti, T.

2004-01-01

441

Swallowing Function Following post Chemoradiotherapy Neck Dissection - Review of Findings and Analysis of Contributing Factors  

PubMed Central

Objective This study assesses swallowing function following chemoradiotherapy and neck dissection in head and neck cancer patients and investigates clinical, treatment and neck dissection factors associated with dysphagia. Study Design Case series with chart review Setting Tertiary Care Center Subjects and Methods 88 patients undergoing neck dissection after chemoradiotherapy for advanced head and neck cancer were reviewed. Dysphagia outcome measures included weight loss, diet, gastrostomy tube-dependency and video swallow findings of aspiration or stenosis. Additionally we created a Diet/GT Scale, score 1–5. Univariate and multivariate analysis of clinical, treatment or neck dissection factors potentially associated with dysphagia outcome measures was undertaken. Results Peak mean weight loss was 17% at 6 months after chemoradiotherapy. At 12 months a soft/regular diet was taken by 78/88 (89%) and only 1/88 (1%) of patients were nil per os. Gastrostomy tube-dependence at 6, 12, 24 months was 53%, 25%, and 10%. Diet/GT score was 5 (gastrostomy tube removed and soft/regular diet) for 47% at 6 months, 74% at 12 months and 89% at 24 months. Multivariate analyses revealed that higher tumor stage was associated with a lower Diet/GT score at 12 months (p=0.02) and gastrostomy-dependence at 12 (p=0.01) and 24 months (p=0.04). Conclusion Despite the addition of neck dissection to chemoradiotherapy, nearly all patients took a soft or regular diet, reached a Diet/GT score of 5 and only 1% remained nil per os. A higher tumor stage is associated with a lower Diet/GT score and gastrostomy tube-dependency beyond 12 months.

Chapuy, Claudia I; Annino, Donald J; Snavely, Anna; Li, Yi; Tishler, Roy B; Norris, Charles M; Haddad, Robert I; Goguen, Laura A.

2012-01-01

442

Student Attitudes toward Cadaveric Dissection at a UK Medical School  

ERIC Educational Resources Information Center

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

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

2011-01-01

443

Student Attitudes Toward Cadaveric Dissection at a UK Medical School  

NSDL National Science Digital Library

This article describes a survey conducted among first year medical students examining two main questions. One, attitudes toward the process of dissection and the personhood of the cadaver Two, the extent to which gender, anxiety, exposure to dissection, bereavement and prior experience of a dead body influenced these attitudes. Outcomes and suggestions on how to respond to first year dissectors are provided.

Thelma Quince (University of Cambridge Department of Public Health and Primary Care)

2011-06-08

444

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

445

An alternate dissection approach to the female urogenital triangle.  

PubMed

Traditional dissections of the female urogenital (UG) triangle can lead to early destruction of the erectile tissues, associated musculature, and neurovascular structures. Here, we present an alternate dissection of the female UG triangle. Rather than begin the female UG triangle dissection with the fatty tissue of the labia majora, we utilize an early identification of the suspensory ligament of the clitoris to organize the dissection. The suspensory ligament leads to the body of the clitoris, which can be palpated from distal to proximal to find the crura of the clitoris with overlying ischiocavernosus muscles. Once the crura have been defined, the bulbs of the vestibule with overlying bulbospongiosus muscles can be palpated medially and posteriorly. This dissection approach results in a clean dissection that well demonstrates homologies between male and female external genitalia. Through the use of this method, most student dissection attempts are able to demonstrate the erectile tissues and associated musculature that comprise the female UG triangle. This technique can also be used for male UG triangle dissections, encouraging identification of male and female homologies. PMID:23825011

Hall, Margaret I; Walters, Linda M

2013-09-01

446

Justifying the Dissection of Animals in Biology Teaching.  

ERIC Educational Resources Information Center

Presents the idea that several points should be considered in animal dissection: (1) ethics; (2) the animal's position; (3) the law; and (4) the actual benefits to society. Recommends that students be carefully prepared for animal dissection. Contains 21 references. (DDR)

Wheeler, Anthony G.

1993-01-01

447

Aortic Valve Conservation in Acute Type A Dissection  

Microsoft Academic Search

Background. We consider operative survival as the primary objective in acute type A dissection and believe that virtually all native aortic valves can be conserved. We sought to answer the question: “Does glue repair improve the long-term stability of proximal aortic repair?”Methods. We retrospectively studied 64 patients with an acute type A dissection, an ascending aortic tear, and aortic regurgitation

Stephen Westaby; Takahiro Katsumata; Edward Freitas

1997-01-01

448

Virtual temporal bone dissection: An interactive surgical simulator  

Microsoft Academic Search

Objective: Our goal was to integrate current and emerging technology in virtual systems to provide a temporal bone dissection simulator that allows the user interactivity and realism similar to the cadaver laboratory. Study Design: Iterative design and validation of a virtual environment for simulating temporal bone dissection. Setting: University otolaryngology training program with interdisciplinary interaction in a high-performance computer facility.

Gregory J. Wiet; Don Stredney; Dennis Sessanna; Jason A. Bryan; D. Bradley Welling; Petra Schmalbrock

2002-01-01

449

Therapy Insight: aortic aneurysm and dissection in Marfan's syndrome  

Microsoft Academic Search

Aortic dissection and aneurysm are common clinical problems with life-threatening consequences; they are also the hallmark of several genetic diseases, including Marfan's syndrome (MFS). In spite of clinical and surgical advances that have increased life expectancy for affected patients, cardiovascular manifestations remain significant contributors to morbidity and mortality in MFS. Dissecting aortic aneurysm in this disorder is accounted for by

Harry C Dietz; Francesco Ramirez

2004-01-01

450

Surgical treatment of 50 carotid dissections: Indications and results  

Microsoft Academic Search

Purpose: This article analyzes the course of 48 patients with 49 chronic carotid dissections (who were treated surgically at our institution after a median anticoagulation period of 9 months because of a persistent high-grade stenosis or an aneurysm) and the course of one additional patient with acute carotid dissection (who underwent early operative reconstruction 12 hours after onset because of

Barbara Theresia Müller; Bernd Luther; Waldemar Hort; Tobias Neumann-Haefelin; Albrecht Aulich; Wilhelm Sandmann