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1

Extracranial vertebral artery dissection: nine cases  

Microsoft Academic Search

Nine patients (six men, three women) with extracranial vertebral artery dissection are described. Their mean age was 39.1 years (range 17–66). In four cases dissection was “spontaneous”; in the other five cases there was a history of trivial trauma. Three patients had fibromuscular dysplasia, two were migraineurs, one had elastorrhexis. Treatment varied. Six received heparin, three acetylsalicylic acid or ticlopidine.

E. Josien

1992-01-01

2

Spontaneous dissecting aneurysm of the extracranial vertebral artery (20 cases)  

Microsoft Academic Search

Spontaneous dissecting aneurysm of the vertebral artery is an infrequent cause of vertebro basilar ischemic strokes. Previously reported cases concern essentially occlusion of the basilar artery. Only 14 cases of spontaneous dissecting aneurysm concern the extracranial vertebral artery among these eight were angiographically documented. In this study based upon 15 patients (20 dissecting aneurysms), the authors discuss etiological factors, such

J. Chiras; S. Marciano; J. Vega Molina; J. Touboul; B. Poirier; J. Bories

1985-01-01

3

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. PMID:22477421

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

2008-01-01

4

Coronary artery dissection following blunt chest trauma: a case report  

PubMed Central

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

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

2005-01-01

5

[Four cases of dissecting aneurysm of the aorta].  

PubMed

Four cases of dissecting aneurysm of the aorta are described. Attention is drawn to the difficulties of clinical diagnosis, the results of which will often be expressed in wide differences of prognosis and sometimes of treatment pattern, including surgical correction in suitable cases. A summary account of the literature data is used in expressing some views on the clinical and aetiopathogenetic position in the light of recent knowledge. PMID:17340830

Micheletti, P C; Tortarolo, E; Cardellino, G

1969-09-01

6

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

PubMed

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

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

2013-12-01

7

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

PubMed Central

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

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

2013-01-01

8

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

9

Spontaneous coronary artery dissection associated with cocaine use: A case report and brief review  

Microsoft Academic Search

Isolated, spontaneous dissection of the coronary arteries in the absence of trauma is an unusual but well-documented occurrence. Fewer than 50 cases have been reported in males in the English language literature, and only one case, nonfatal, was associated with cocaine use. We present the second overall and the first fatal case of cocaine-associated spontaneous coronary artery dissection and a

Jon R. Steinhauer; James B. Caulfield

2001-01-01

10

Spontaneous coronary artery dissection: a case series and literature review  

PubMed Central

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

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

2014-01-01

11

A Case of Acute Aortic Dissection Presenting with Chest Pain Relieved by Sublingual Nitroglycerin  

PubMed Central

Acute aortic dissection is an uncommon disorder which can have fatal results in the event of treatment delay or misdiagnosis. This case examines a 77-year-old woman presenting with chest pain relieved by nitroglycerin. She was referred to the emergency room with clinical suspicion of acute coronary syndrome (ACS). However, she was later diagnosed with acute aortic dissection and an emergency operation was performed with successful recovery. Aortic dissection may manifest in various ways depending on the site involved and may mimic other disorders such as ACS or pulmonary embolism. Therefore, clinicians must always be aware of aortic dissection and its different clinical manifestations must be understood. PMID:24340165

Kim, Hyun Joo; Lee, Hyun-Ki

2013-01-01

12

Dissection of the extracranial vertebral artery: report of four cases and review of the literature  

Microsoft Academic Search

Four cases of cervical vertebral artery (VA) dissection are reported. In three patients VA dissection was associated with neck trauma. All patients were young or middle-aged (range 27 to 49 years). In two there was a history of migraine. Pain preceded neurological symptoms from hours to six weeks. Three patients had neurological deficits including elements of the lateral medullary syndrome,

P Hinse; A Thie; L Lachenmayer

1991-01-01

13

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

14

Paediatric dissecting posterior cerebral aneurysms: report of two cases and review of the literature  

Microsoft Academic Search

Introduction  Intracranial aneurysms in the paediatric population are uncommon, accounting for 2% to 6% of all aneurysms, and spontaneous arterial dissection is rarely reported as the cause of aneurysms in children, especially in the posterior cerebral artery.Methods  Two cases of paediatric spontaneous posterior cerebral artery dissecting aneurysms are reported, one in a 33-month-old male child presenting with aneurysmal rupture and subarachnoid haemorrhage

Pedro Vilela; Augusto Goulão

2006-01-01

15

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

PubMed Central

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

Jalalian, Rozita; Saravi, Mehrdad; Banasaz, Bahar

2014-01-01

16

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. PMID:24298506

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

2013-01-01

17

Low Limb and Allograft Rescue With Iliofemoral Graft for External Iliac Artery Dissection: Case Report  

Microsoft Academic Search

The technical difficulties in performing a transplantation can often be joined by an accident that demands an urgent solutions, putting the life of the patient in serious risk. In our case we were forced to perform an iliofemoral PTFE graft substitution to save the vascularization of the right lower limb. The cause was constituted by a dissection in the external

E. Russo; D. Sciano; V. Cerbone; G. Valeriani; G. Barbato; P. De Rosa

2010-01-01

18

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

PubMed

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. PMID:20649988

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

2010-01-01

19

Spontaneous acute aortic dissection in pregnancy: report of a case devoid of known risk factors.  

PubMed

Acute aortic dissection in pregnancy is a rare condition with a potentially catastrophic outcome. The low rate of incidence together with variable presenting features in such circumstances makes diagnosis elusive. A high degree of clinical suspicion and diagnostic acumen is especially required in pregnant women without any history of connective tissue disorder, congenital aortic valvular malformation, or chronic hypertension. In this report, we present a case of aortic dissection with multiple aortic intimal tears in a medicolegal autopsy of a young pregnant woman who developed circulatory collapse and died during labor. PMID:23629391

Nath, Dhritiman; Vaideeswar, Pradeep; Rojekar, Amey; Vaz, Walter

2013-06-01

20

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. PMID:22919449

Sheikh, Azeem S; O'Sullivan, Michael

2012-01-01

21

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

22

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

23

Axillary Dissection in the Case of Positive Sentinel Lymph Nodes: Results of the Innsbruck Consensus Conference  

PubMed Central

The prognosis of breast cancer is most heavily influenced by the status of the axillary nodes. Until a few years ago, this knowledge was gained through radical axillary lymph node clearance. In the meantime, sentinel lymph node clearance has become an established part of the surgical treatment of breast cancer. With the development of this procedure, the morbidity caused by axillary dissection has been reduced significantly. Although comprehensive prospective, randomised data regarding the safe use of the sentinel concept are only now available, the focus currently, however, is on the question of whether in the case of positive sentinel lymph nodes, an axillary dissection can be done away with altogether without having any negative impact on the risk of loco-regional recurrence or on progression-free survival and overall survival. The results of the American ACOSOG-Z001 study have changed the fundamental perspective of this. In this study on the advantages of axillary dissection following the confirmation of tumour tissue in the sentinel lymph nodes, there were no statistically significant advantages from axillary dissection for women with a favourable overall risk profile who had received radiotherapy and systemic therapy. If this concept takes hold, the surgical treatment of node-positive breast cancer, at least in the axilla, would be reduced to a minimum, and the focus of treatment would in future lie more on the systemic treatment of this condition. As part of an interdisciplinary consensus meeting, a standardised approach for Austria with regard to this question was decided upon.

Hubalek, M.; Bartsch, R.; Gnant, M.; Kapp, K. S.; Lang, A.; Lax, S.; Lukas, P.; Neunteufel, W.; Pristauz, G.; Reitsamer, R.; Sandbichler, P.; Schrenk, P.; Singer, C.; Tamussino, K.; Tschmelitsch, J.; Zeimet, A. G.; Marth, C.

2012-01-01

24

A rare case of stenting of spontaneous dissection of Shepherd's Crook right coronary artery  

PubMed Central

BACKGROUND Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS) and sudden death. It usually occurs in young women during the peripartum period; however, it had also been reported in older aged males having risk factors for atherosclerotic coronary artery disease. CASE REPORT This case describes a 69-year-old male patient who presented with manifestations of ACS due to a spontaneous dissection of the Shepherd’s Crook right coronary artery (RCA), which was successfully managed with percutaneous coronary intervention (PCI) and stenting. At the 6th month follow-up, the patient remained chest pain free. CONCLUSION Patients with SCAD in the presence of ongoing ischemia can be treated with PCI and stenting. PMID:25161681

Dubey, Laxman

2014-01-01

25

Stenting for coronary intervention-related dissection of the left main coronary artery with extension to the aortic root: a case report.  

PubMed

Retrograde aortocoronary dissection is a rare but devastating complication of coronary angioplasty. It occurs most frequently in the right coronary artery, rarely in the left. This is a case report of an aortic dissection complicated by coronary angioplasty of the left circumflex artery. Stenting of the left main coronary artery successfully sealed the entry point of dissection. PMID:19088533

Cheng, Cheng-Chung; Tsao, Tien-Ping; Tzeng, Bing-Hsiean; Cheng, Shu-Meng; Yang, Shih-Ping

2008-11-01

26

Unilateral and Bilateral Vertebral Artery Dissection Following Motor Vehicle Injury—Two Cases and a Mini-Review  

Microsoft Academic Search

Vertebral artery dissection in two patients with traumatic brain and cervical spine injury was treated in the intensive care\\u000a unit. In both cases vertebral artery dissection was suspected solely by the presence of ischemic lesions on the cervical spine\\u000a and by magnetic resonance imaging of the brain, performed because of a failure to recover consciousness. In the intensive\\u000a care unit

Christina G. Mandila; Georgios V. Koukoulitsios; Georgios T. Stathopoulos; Ioannis Karampelas; Georgios Karydas; Andreas Karabinis

2005-01-01

27

A case of ascending aortic dissection and rupture caused by giant cell arteritis.  

PubMed

Giant cell arteritis (GCA) is an autoimmune disease characterized by granulomatous inflammation in the wall of medium-sized and large-sized arteries, and it usually occurs in patients over 50 years of age.(1)) Symptoms are nonspecific, and include fatigue, fever, and headache.(2)) It is occasionally combined with aortic complications, and ruptures resulting in death. These complications occur as late events, usually several years after diagnosis and often after other symptoms have subsided.(3)) Physicians should therefore be alert for complications of the large arteries in GCA. Here we present a case of GCA combined with ascending aortic dissection and rupture 3 weeks after diagnosis. PMID:25297504

Pak, Misun; Ito, Shimpei; Takeda, Masaki; Watanabe, Nobuhide; Sato, Hirotomo; Ito, Saki; Adachi, Tomoko; Sugamori, Takashi; Endo, Akihiro; Takahashi, Nobuyuki; Yoshitomi, Hiroyuki; Ishibashi, Yutaka; Tanabe, Kazuaki

2014-11-13

28

Dissecting Aneurysms of Bilateral Anterior Cerebral Artery Complicated by Subarachnoid Hemorrhage After Cerebral Infarction: A Case Report  

PubMed Central

Introduction Intracranial dissecting aneurysms have been increased due to recent advancements in diagnostic imaging. However there have been little article with subarachnoid hemorrhage and cerebral infarction occurring almost at the same time. We performed the surgical treatment and obtained good result. Case presentation A 47-year-old male presented to our hospital with chief complaints of sudden headache and mild paralysis of the left lower extremity. Brain imaging at admission revealed cerebral infarction in the right frontal lobe and subarachnoid hemorrhage in the frontal convexy and anterior interhemispheric fissure. The left and right internal carotid angiography showed a bulging cerebral aneurysm at the left A1–A2 junction and stenosis and arterial dissections in the peripheral of the bilateral anterior cerebral artery. Wrapping was performed for the dissecting aneurysm of the left anterior cerebral artery. For the right anterior cerebral artery, trapping was performed at the A2 segment without vascular anastomosis. The patient’s postoperative course was uneventful. Conclusion A consensus has not been reached on the treatment for intracranial dissecting aneurysms. Proximal trapping without vascular reconstruction was performed for the right anterior cerebral artery without vascular anastomosis to prevent rebleeding. However no symptoms of neurological deficiency were observed. Proximal trapping of dissecting aneurysm seems to be a good option when patient’s functional and life prognosis are taken into account in case that vascular reconstruction will be anticipated difficulty. PMID:24179355

Kurosu, Akihiro; Hatashita, Shizuo; Ueno, Hideo

2008-01-01

29

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

PubMed Central

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

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

2013-01-01

30

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

31

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

PubMed

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

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

2013-08-01

32

Follow up after spontaneous coronary artery dissection: a report of five cases.  

PubMed Central

Five cases of spontaneous coronary artery dissection (SCAD) are reported, three in women and two in men (mean age 44 years; range 28-65), all of whom suffered a myocardial infarction. Common risk factors for coronary artery disease were present in the two men; in the female group one patient was taking an oral contraceptive, one was in the postpartum period, and the third was a smoker. Only the three women received intravenous alteplase and their ejection fraction was normal; both men had impaired left ventricular function. Two patients had SCAD of the left anterior descending coronary artery and three of the right coronary artery. Only the two men had angiographic features of coronary atherosclerotic involvement. No patients required surgical revascularisation or percutaneous transluminal coronary angioplasty. At a mean follow up of 27 months (range 6 to 40) all patients were alive and all but one were asymptomatic. Images PMID:8673763

Zampieri, P.; Aggio, S.; Roncon, L.; Rinuncini, M.; Canova, C.; Zanazzi, G.; Fiorencis, R.; Zonzin, P.

1996-01-01

33

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. PMID:23668480

2013-01-01

34

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

PubMed

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

Bauer, Martin; Tatschner, Thomas; Patzelt, Dieter

2007-05-01

35

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. PMID:23533937

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

2013-01-01

36

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

PubMed

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

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

2013-12-01

37

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

PubMed

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

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

2014-08-01

38

Dissecting aneurysm of intracranial vertebral artery: case report and review of literature  

Microsoft Academic Search

A spontaneous dissecting aneurysm of the intracranial portion of the dominant right vertebral artery presented as massive subarachnoid hemorrhage, excruciating headache, and respiratory arrest in a 57-year-old white man with a history of systemic hypertension. He died on the 3rd day. Postmortem examination revealed a dissecting hemorrhage extending for 2.1 cm along the artery; rupture of the intima, media, and

H. J. Manz; A. J. Luessenhop

1983-01-01

39

Rapid Progression of Symptomatic Vertebrobasilar Artery Dissection on Magnetic Resonance Imaging: A Case Report  

PubMed Central

Spontaneous intracranial vertebrobasilar dissection can manifest with various clinical symptoms, including subarachnoid hemorrhage or ischemic symptoms from impaired posterior circulation. A 29-year-old woman came to our emergency department with a sudden onset of left sided mild motor weakness and headache. Initial magnetic resonance imaging (MRI) showed mild luminal irregularities in the vertebrobasilar arteries with an eccentric periluminal hematoma. Follow-up MRI obtained 3 days later showed a progression of vertebrobasilar dissection to multifocal stenoses with an increased intramural hematoma.

Kwak, Hyo-Sung; Hwang, Seung Bae; Chung, Gyung Ho

2014-01-01

40

Coronary artery dissection in Prader-Willi syndrome: case report and literature review.  

PubMed

Prader-Willi syndrome (PWS) is a syndrome characterized in babies by small birth weight, hypogonadism, flaccid muscle tone, and skeletal abnormalities, and in older children by intense food cravings leading to morbid obesity, hypoxemia, and right heart failure. To our knowledge, PWS has not been associated with coronary artery dissection. We report a 17-year-old woman with PWS who suffered an inferior myocardial infarction secondary to dissection of her right coronary artery. PMID:22857901

Jacob, Jason C; Armada, Penelope; Dhesi, Pavittarpaul; Elbash, Firas; Primiano, Charles; Estrada, Elizabeth D; Thompson, Paul D

2012-01-01

41

Ruptured dissecting cerebral aneurysms in young people: report of three cases  

Microsoft Academic Search

Intracranial arterial aneurysms in the pediatric population are rare. Among these, dissecting aneurysms are the most frequent,\\u000a followed by saccular, infectious, and posttraumatic. It is widely known that aneurysmal rupture is uncommon in the first two\\u000a decades of life. Spontaneous dissecting aneurysms (SDAs) of the middle cerebral artery (MCA) affecting young individuals most\\u000a frequently present as occlusive syndrome with ischemia,

Stefano Peron; Luis Jimenez-Roldán; Marta Cicuendez; Jose María Millán; Jose Ramón Ricoy; Ramiro D. Lobato; Rafael Alday; José F. Alén; Alfonso Lagares

2010-01-01

42

Dissection and Analysis of the Recent Cases on Employment Discrimination Under Title VII of the Civil Rights Act of 1964  

Microsoft Academic Search

This article begins with an overview of the existing law of employment discrimination under Title VII of the Civil Rights\\u000a Act of 1964, within which it explains disparate treatment discrimination, disparate impact discrimination, pregnancy discrimination\\u000a and sexual harassment. This article then dissects the recent U.S. Supreme Court and U.S. Courts of Appeal cases that have\\u000a interpreted and provided specificity to

Willis W. Hagen II

2011-01-01

43

Clam Dissection  

NSDL National Science Digital Library

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

Riedell, Kelly; District, Brookings S.

44

Vertebral-artery dissection following a judo session: a case report.  

PubMed

A few days after a judo session, an 11-year-old boy presented with an ischemic stroke with dizziness, aphasia and ataxia. CCT scan revealed a left thalamic infarct. Angiography showed a fibromuscular dysplasia (FMD) of the left vertebral artery probably complicated by dissection. Subsequent evolution was favorable. This observation points out the fact that the association of a cervical pain with neurological signs of vertebrobasilar stroke, especially occurring after a cervical trauma or rotatory motion, should alert to the possibility of vertebral-artery dissection. The diagnosis is mainly based on angiographic criteria. Accurate diagnosis has implications for prognosis and probably for acute medical treatment. PMID:8072674

Lannuzel, A; Moulin, T; Amsallem, D; Galmiche, J; Rumbach, L

1994-04-01

45

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

46

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. PMID:24808706

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

2014-01-01

47

Level V in therapeutic neck dissections for papillary thyroid carcinoma.  

PubMed

Neck dissection for papillary thyroid carcinoma (PTC) is the standard of care for patients with clinical evidence of regional metastases. However, the extent of neck dissection is debatable. The purpose of the current study was to develop evidence-based recommendations for when to include level V, or 1 of its sublevels, among patients with PTC undergoing neck dissection. A literature review of all studies evaluating the occurrence of metastases in level V in patients with regional metastases from PTC undergoing neck dissection was performed. Occurrence of metastases at level V is low in most series (5% to 10%), although a wide range was noticed. In cases in which metastases were found at level V, they occurred almost exclusively at sublevel VB. Sublevel VA was rarely, if ever, involved with metastatic lymph nodes. However, only recently have investigators begun to specify which sublevels of level V are at risk. Therapeutic dissection of level V is indicated when there is clinical evidence of disease involving this zone. Elective dissection of sublevel VB is indicated when there is involvement of level IV, or possibly multiple nodes at levels II and III. Under these circumstances, dissection of sublevel VB is indicated but sublevel VA may be spared. PMID:22287259

Khafif, Avi; Medina, Jesus E; Robbins, K Thomas; Silver, Carl E; Weber, Randal S; Rinaldo, Alessandra; Owen, Randall P; Shaha, Ashok R; Ferlito, Alfio

2013-04-01

48

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. PMID:23056702

Faramarzi, Abolahassan; Heydari, Seyed Taghi

2010-01-01

49

Antithrombotic therapy and outcomes of cervical arterial dissection in the trauma patient: a case series  

Microsoft Academic Search

BACKGROUND: The use of antithrombotic therapy (anticoagulants and\\/or antiplatelets) in the setting of traumatic cervical arterial dissection (CAD) for the prevention of stroke remains controversial. This issue is further complicated by the frequent co-existence of intracranial hemorrhage (ICH) and other intracranial injuries, and also the wide variability in treatment due to a lack of evidence-based guidance. To address these controversies,

Holly E Hinson; M JB Stallmeyer; Jon P Furuno; Karen L Yarbrough; John W Cole

2010-01-01

50

Idiopathic, serial coronary vessels dissection in a young woman with psychological stress: a case report and review of the literature.  

PubMed

Spontaneous coronary artery dissection (SCAD) is a very rare disease, associated with high mortality rate, whose etiology and pathogenesis are poorly understood. Its sporadic nature and the varied angiographic extent make firm recommendations regarding revascularization impossible. The case described is that of a young, otherwise healthy woman, without a known underlying condition which may lead to SCAD, but with a history of intense psychological stress. We managed the patient with a conservative approach based on watchful waiting, medical therapy, and plain old balloon angioplasty (POBA) with low inflation atmospheres. PMID:23133786

Arrivi, Alessio; Milici, Caterina; Bock, Carlo; Placanica, Attilio; Boschetti, Enrico; Dominici, Marcello

2012-01-01

51

Spontaneous retrograde dissection of ascending aorta from descending thoracic aorta--a case review.  

PubMed

A 56-year-old man with sudden onset chest pain, absent right lower limb pulses and ECG changes suggestive of inferior ST elevation MI underwent coronary angiogram through the right radial artery with a view to primary percutaneous coronary intervention (PCI). The left coronary angiogram demonstrated severe proximal stenotic disease in the left anterior descending and circumflex coronary arteries, but the right coronary artery could not be selectively cannulated. An ascending aortogram to visualise the right coronary artery not only failed to demonstrate it, but revealed, instead, a dissection flap in the ascending aorta, arch and descending thoracic aorta, with moderately severe aortic regurgitation. At operation, the patient was found to have an acute dissection of the ascending aorta, arch and descending aorta with an entry tear in the descending aorta below the left subclavian artery origin. Triple coronary artery bypass grafting with re-suspension of the aortic valve, supracoronary replacement of the ascending aorta and hemiarch and transaortic repair of the descending aortic tear was performed. The patient made an uncomplicated recovery, with the re-appearance of right limb pulses. A postoperative magnetic resonance (MR) scan revealed complete thrombosis of the false channel in the residual arch and a considerably shrunken false channel in the descending aorta and no aortic regurgitation. Retrograde dissection of the ascending aorta from the descending aorta has been reported infrequently in the past. We believe the scale of the problem has been underestimated because of the failure to adopt open distal anastomosis routinely in the past and, hence, failure to inspect the arch and the descending aorta routinely, particularly when the intimal tear was not identified in the ascending aorta. Retrograde dissection of the ascending aorta from an intimal tear in the descending aorta, when identified as such, has been managed, either on the principle of exclusion of the tear in the descending aorta by various elephant trunk procedures and their variants or, alternatively, on the principle of excision of the tear by extended one-stage aortic replacement, usually combined with an elephant trunk procedure. Neither of these procedures is widely adopted, owing to procedural, institutional and outcome considerations. We describe a transaortic repair of the intimal tear in the descending aorta with supracoronary interposition graft replacement of the ascending aorta and hemiarch with excellent clinical and radiological result. We also review the diagnostic and therapeutic approaches to this incompletely understood lethal disease. PMID:21247986

Kaul, Pankaj

2011-05-01

52

Vertebral Artery Dissection Associated with Generalized Convulsive Seizures: A Case Report  

PubMed Central

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

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

2013-01-01

53

Multiple strokes and bilateral carotid dissections: a fulminant case of newly diagnosed Ehlers-Danlos syndrome type IV.  

PubMed

Ehlers-Danlos Syndrome is a rare group of inheritable disorders resulting in abnormal collagen production, leading to skin fragility, joint hypermobility and easy bruising. Six major subtypes have been identified, of which Type IV most often leads to neurovascular complications, may lead to inner organ rupture and overall has the worst prognosis. Early recognition followed by genetic testing is key, since this diagnosis will guide decision making in the management of complications, influence the choice of antiplatelet medications versus anticoagulants and allow for potentially affected family members to be identified, undergo genetic testing and reproductive counseling. We here report the case of a 50 year old woman with a fulminant presentation of Ehlers Danlos Syndrome Type IV, including bilateral carotid and vertebral artery dissection, multiple strokes and liver rupture. Of note, this patient did not have a known history or obvious clinical features of connective tissue disease. Genetic testing confirmed the diagnosis. Review of her family history revealed multiple family members with a history of aortic dissection or aneurysm rupture. This case illustrates that Ehlers Danlos Syndrome Type IV is an important differential diagnosis even in adult patients without a known history of connective tissue disease and no prior complications. PMID:22559935

Dohle, C; Baehring, J M

2012-07-15

54

[Surgical management of a dissecting aneurysm of the thoracic aorta in a patient with Marfan's syndrome - Case report].  

PubMed

Marfan's Syndrome is a rare connective tissue disease whose surgical treatment presents several challenges. The existing criteria and recommendations on how and when to surgically approach this disease is almost exclusively confined to the root and ascending aorta, in contrast to the variability of indications on the involvement of the remaining segments of the thoracic and abdominal aorta, due to the multiplicity, morphology and topography of these involvements. This case report is related to a 39 year old woman with Marfan's syndrome, with a type B chronic dissection and a segmentar aneurysm of the proximal descending thoracic aorta with 6,1cm of maximum diameter. The clinical and imagiologic evaluation pointed out the absence of any disorder of the heart, root or ascending aorta. The patient underwent surgical management of the dissecting aneurysm through a transthoracic approach to the aneurysm, with fenestration of the distal aorta and exclusion of the aneurism and intercostal arteries. The efficacy and result of the procedure in addition to the rarity of the vascular pathology presented by the patient, even in the context of a Marfan, completely justify the presentation and disclosure of this clinical case. PMID:23560272

Dinis Da Gama, A; Marcelino, João Luís; Damião, Angélica; Evangelista, Ana; Ministro, Augusto

2011-01-01

55

Transrenal E-XL stenting prior to EVAR in the case of abdominal aortic aneurysm associated to proximal aortic neck dissection.  

PubMed

Chronic dissection of proximal aortic neck is a rare occurrence in patients with abdominal aortic aneurysm (AAA) and a gold standard therapy has not been defined so far. Herein we report two successful cases of an original adjunctive procedure involving the transrenal placement of a self-expanding nitinol stent (E-XL aortic stent, Jotec GmbH, Germany) in order to fix a dissection flap in the aortic neck wall prior to the deployment of the bifurcated endograft. Primary technical success and midterm clinical success was achieved in both cases with freedom from any early or late reintervention. Scheduled follow-up angio-CT scans did not show any Type I endoleak, graft migration or renal/visceral arteries complications. According to these findings, patients with an AAA, presenting with a proximal neck with chronic dissection, can be safely and effectively treated by pre-emptive transrenal E-XL stenting and endovascular aneurysm repair. PMID:24647316

Ventoruzzo, G; Chisci, E; Croce, S; Turini, F; Michelagnoli, S; Bellandi, G

2014-12-01

56

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

57

Acute aortic dissection related to crack cocaine  

Microsoft Academic Search

Background—Although single case reports have described acute aortic dissection in relation to cocaine use, this condition is not widely recognized, and the features of cocaine-related aortic dissection have not been defined. Methods and Results—We reviewed all available hospital charts from 1981 to 2001 with the ICD-9 diagnosis of aortic dissection. Among the 38 cases of acute aortic dissection, 14 (37%)

Priscilla Y. Hsue; Cynthia L. Salinas; Ann F. Bolger; Neal L. Benowitz; David D. Waters

2002-01-01

58

The role of base-level change in the dissection of alluvial fans: case studies from southeast Spain and Nevada  

NASA Astrophysics Data System (ADS)

Tectonics, climate and base level are the underlying controls of alluvial fan development. On many fans base level is stable, but where base-level change occurs it may itself be a response to tectonics or climatic change. Tectonically induced base-level change will be temporally independent of climatic change, and will show spatial variability depending on the rate of propagation of tectonically induced regional dissection. This is illustrated by the Tabernas fans, southeast Spain. The timing of climatically induced base-level change follows the timing of climatic change itself, and will show more consistency of spatial relationships within groups of fans affected. Alluvial fans which toe out in coastal zones or at lake shorelines may be influenced by climatically controlled base-level changes. Conventionally, a fall in base level would be expected to cause dissection of the distal fan zone. However, the reverse may occur, with fan progradation taking place in response to a base-level fall, and dissection occurring in response to a base-level rise. Two contrasted case studies are considered, based in part on previously published work, from dry-region alluvial fan zones, the coastal Cabo de Gata fans in southeast Spain and the Stillwater and Cold Springs fans in Nevada, USA. In these areas, base-level changes occurred in response to late Quaternary eustatic changes of sea level, and changes in the levels of pluvial lakes, respectively. Within both areas there are fans not affected by base-level change (Cabo de Gata, west-coast and inland fans; Cold Springs fans), and others where base-level change has been important in fan evolution (Cabo de Gata, east-coast fans; Stillwater fans). The differences in geomorphic regime between those fans influenced by base-level changes and those not are expressed in morphometric contrasts and different fan profile and plan characteristics. Within those fans influenced by base-level changes, the different mechanisms have influenced the location and elevation of the zone of incision. The differences can be attributed in part to the temporal interactions of base-level change with climatically induced changes in sediment supply, and in part to differences in gradients of the foreshore exposed by the falling sea or lake base levels.

Harvey, A. M.

2002-06-01

59

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

60

Presentation and therapy of spontaneous coronary artery dissection and comparisons of postpartum versus nonpostpartum cases.  

PubMed

Predisposing risk factors, clinical course, and prognosis of spontaneous coronary artery dissection (SCAD) remain poorly understood. We reviewed medical records and coronary angiograms of patients admitted to our institution with the diagnosis of SCAD from 1999 through 2010. A definite diagnosis of SCAD required the agreement of 2 blinded board-certified interventional cardiologists who reviewed all images separately. Baseline characteristics of patients (n = 23) included mean age 45 ± 11 years, female gender in all (100%), history of hypertension in 13 (57%), and postpartum in 7 (30%). Eleven (48%) had ST-segment elevation on initial electrocardiogram. SCAD involved the left main in 5 patients (21.7%), left anterior descending coronary artery in 16 (70%), left circumflex coronary artery in 8 (35%), and right coronary artery in 6 (26%). Four patients (17%) underwent coronary stenting and 6 (26%) required urgent bypass surgery. Comparison between postpartum and nonpostpartum patients revealed significant differences in mean peak troponin levels: 50 ± 34 ng/ml vs 21 ± 23, p = 0.04, mean left ventricular ejection fraction: 34 ± 6% vs 49 ± 9, p <0.01, proximal coronary segment distribution: 6 (86%) vs 3 (19%), p = 0.004, and left anterior descending coronary artery distribution: 7 (100%) vs 9 (56%), p = 0.04, respectively. Repeat coronary angiographies were performed in 11 patients (46%) during a mean follow-up of 39 ± 38 months and 10 (91%) were found to have healed SCAD, including those who had undergone bypass surgery. In conclusion, our patients with SCAD were characterized by female gender, absence of coronary risk factors, and a high rate of vascular healing without residual stenosis. Larger infarct was found in postpartum patients. PMID:21439531

Ito, Hiroki; Taylor, Lee; Bowman, Martha; Fry, Edward T A; Hermiller, James B; Van Tassel, James W

2011-06-01

61

Dissecting Light  

NSDL National Science Digital Library

White light is composed of the entire visible light spectrum, but how do you teach this to students in a hands-on way? The answer is simple: by using a spectroscope. This easy-to-make tool allows students to dissect light and in the process, develop an un

Proto, Christopher; Marek, Edmund A.

2000-04-01

62

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

63

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

64

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

65

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

PubMed

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

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

2014-05-01

66

Locked in and out: a case of emerging basilar artery obstruction secondary to vertebral artery dissection thrombolysed with intravenous rt-PA  

Microsoft Academic Search

The authors present a case in which intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) potentially saved a young man from locked-in syndrome or life threatening consequences. The patient presented with acute stroke secondary to vertebral artery dissection and was treated with intravenous rt-PA. There were no post thrombolysis complications and the patient left hospital with mild neurological symptoms. Our

Y H Al-Raweshidy; D M Sinha; L J Coward; P C Guyler; A O’Brien

2011-01-01

67

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

68

[Aortic root and arch replacement late after ascending aortic replacement for acute aortic dissection;report of a case].  

PubMed

Surgical treatment for acute type A aortic dissection remains controversial, especially when the aortic dissection extends to the aortic root and arch. A 73-year-old woman presented with palpitation. She had previously undergone ascending aorta replacement for acute type A aortic dissection with reinforcement of the proximal and distal aortic stumps using gelatin-resorcinol-formaldehyde (GRF) glue, conducted by a different surgical team 7 years ago. Echocardiography and computed tomography revealed dilatation of both ends of the reconstructed aorta, with aortic valve insufficiency. Hence, we performed Bentall procedure, partial aortic arch replacement, and coronary artery bypass grafting. The postsurgical course was uneventful. Redo operations may be avoidable, if, in the initial operation for acute type A aortic dissection with dissected aortic root and arch, surgery is performed without use of GRF glue for reinforcement of stumps. We recommend to perform the Bentall procedure, partial remodeling procedure, or valve-sparing aortic root replacement for reconstruction of the aortic root and arch replacement for repair of the aortic arch. PMID:25391475

Suzuki, Hiroyuki; Fujimatsu, Toshihiro; Teratani, Hiromitsu; Ogawa, Takanori; Akatsu, Tomonari; Takahashi, Kazuhiro

2014-11-01

69

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. PMID:24967021

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

2014-01-01

70

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

71

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

Federal Register 2010, 2011, 2012, 2013

...Docket No. PR09-8-005] Washington Gas Light Company; Notice of Motion for Extension of Rate Case Filing Deadline Take notice that on June 15, 2011, Washington Gas Light Company (Washington Gas) filed a request for an extension...

2011-06-23

72

Spontaneous bilateral carotid artery dissection following cervical manipulation.  

PubMed

We report an autopsy case of a bilateral carotid artery dissection, following cervical manipulation by a chiropractor. To establish the etiology of a cervical artery dissection is important in view of possible legal implications and to exclude hereditary disorders, since cervical artery dissection has been linked to several arteriopathies. The underlying arteriopathy in the presented case was an idiopathic cystic medial degeneration. This report emphasizes the role of the pathologist in defining the underlying arteriopathy in carotid artery dissection. PMID:22633562

Carprieaux, Marilyn; Michotte, Alex; Van Varenbergh, Dirk; Marichal, Miriam Pipeleers

2012-09-01

73

Endovascular Treatment of Huge Dissecting Aneurysms Involving the Basilar Artery  

PubMed Central

Summary Dissecting aneurysms involving the basilar artery (BA) are lesions with significant morbidity and mortality. Their management is controversial and often difficult. There is no generally approved strategy. Two cases of huge dissections involving the BA presented with subarachnoid hemorrhage in one case and mass effect in both cases. The dissection of case 1 involved the upper two thirds of the BA distal to the anterior inferior cerebellar arteries (AICA). Another dissection of case 2 involved the bilateral vertebral arteries (VA) distal to bilateral PICA and extended to upper third of the BA. After making a basket with coils inside the pseudoaneursym, proximal dissection was totally occluded in case 1. Dissection on the bilateral VA distal to the bilateral PICA and proximal BA was occluded in case 2 with a small residual dissection on the left VA. Case 1 had an excellent recovery with a durable image and clinical result. But recanalization and regrowth occurred in case 2, which might have originated from the residual dissection on the left VA, induced acute mass effect and sudden coma six weeks after the initial treatment. The residual and regrown dissection had to be occluded in a second intervention. The patient died two days later. BA occlusion is safe and efficient for dissections involving the BA as in our case and the literature. Proximal occlusion might be enough for huge and long lesions like ours. It seems that completely dense packing of proximal dissection is the key point to prevent recanalization. PMID:20566106

Yang, X.; Mu, S.; Lv, M.; Li, L.; Wu, Z.

2007-01-01

74

Postoperative hypertension following radical neck dissection  

PubMed Central

Baroreflex failure results in wide excursions of blood pressure and heart rate. We report two cases that developed severe postoperative hypertension after radical neck dissection. Carotid sinus denervation during neck dissection may be the cause of the reflex hypertension once general anesthesia-induced vasodilatation has ended. PMID:22345960

Prakash, Smita; Rapsang, Amy; Kumar, Suresh S; Bhatia, Parminder S; Gogia, Anoop R

2012-01-01

75

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

76

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

77

MRI in spontaneous dissection of vertebral and carotid arteries  

Microsoft Academic Search

Fifteen patients were observed between 1987 and 1990: there were six with angiographically confirmed vertebral artery dissection, and 9 with carotid artery dissection. Results showed concordance of MRI and angiographic findings, in all cases but one. The dissected portion consistently showed a semilunar hyperintensity narrowing the residual eccentric signal void of the lumen when the artery was not completely occluded.

F. Gelbert; E. Assouline; J. E. Hodes; D. Reizine; F. Woimant; B. George; M. Hagueneau; J. J. Merland

1991-01-01

78

Interactive Frog Dissection  

NSDL National Science Digital Library

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

79

Flower Dissection Lab  

NSDL National Science Digital Library

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

2007-12-27

80

Acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection.  

PubMed

Acute type B aortic dissection comprises approximately one-third of all aortic dissection cases. Although this catastrophic cardiovascular condition was first described in the medical literature over two centuries ago, data on the optimal diagnostic and treatment modalities for type B dissection was slow to evolve throughout the latter half of the twentieth century, even as newer diagnostic techniques and management strategies became commonplace. To further elucidate contemporary practice patterns and outcomes of aortic dissection, the International Registry of Acute Aortic Dissection (IRAD) was established in 1996. Over the past two decades, IRAD publications have steadily increased our knowledge and understanding about aortic dissection. Specifically in recent years, analyses of IRAD data have gone beyond simply characterizing the patient with acute type B aortic dissection and have attempted to identify the means by which the outcome of such a patient could be improved. Thus, we present herein three areas in which IRAD data has recently advanced our understanding of acute type B aortic dissection: temporal classification especially for the subacute time period, risk stratification for identifying complicated cases, and thoracic endovascular aortic repair (TEVAR). PMID:25133099

Patel, Akshar Y; Eagle, Kim A; Vaishnava, Prashant

2014-07-01

81

Spontaneous Arterial Dissection.  

PubMed

There is no controlled study for the best treatment or management of cervico-cerebral artery dissection (CAD). Rationale initial empiric treatment in acute CAD to prevent secondary embolism is partial thromboplastin time (PTT)-guided anticoagulation by intravenous heparin followed by anticoagulation with warfarin. Carotid surgery for treatment of CAD is not recommended anymore with the possible exception of persisting severe stenosis of the proximal internal carotid artery (ICA). There could be use of carotid angioplasty by balloon dilatation and stenting in selected cases of severe cerebral hemodynamic impairment by bilateral CAD. Duration of secondary prophylaxis by anticoagulation is best guided by Doppler sonography follow-up, and should be continued until normalization of blood flow or until at least 1 year after the vessel is occluded. There is no evidence that pseudoaneurysms increase the risk for embolic complication, and there is no evidence for surgery or continuation of anticoagulation in patients with pseudoaneurysms. Caution should be recommended for exercises that involve excessive head movements (eg, bungee jumping, trampoline jumping, and chiropractic maneuvers). The patient should be informed that recurrent rate is low in nonfamilial cases. Doppler sonography is a low-cost and high-sensitivity method for patients at risk. PMID:11487460

Brandt, Tobias; Caplan, Louis

2001-09-01

82

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

83

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

Federal Register 2010, 2011, 2012, 2013

...Docket No. PR09-17-003] Humble Gas Pipeline Company; Notice of Motion for Extension of Rate Case Filing Deadline Take notice that on April 15, 2011, Humble Gas Pipeline Company (HGPC) filed a request for an extension consistent with...

2011-04-28

84

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. 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

85

Ascending aorta dissection associated with bicuspid aortic valve  

Microsoft Academic Search

Aortic dissection etiology involve many factors that are difficult to identify clearly. We report a 47-year-old man who underwent\\u000a a Bentall operation with reattachment of bypass grafts for a dissecting aneurysm (De Bakey type II) 4 years after combined\\u000a triple coronary artery bypass grafting and mitral valve replacement. This case appeared to be associated with factors leading\\u000a to dissecting aneurysm

Atsushi Morishita; Tadayuki Shimakura; Masaki Nonoyama; Taiichi Takasaki; Masataka Yoda

2001-01-01

86

Unexpected limited chronic dissection of the ascending aorta  

PubMed Central

We report a rare case of a limited chronic dissection of the ascending aorta that was accidentally discovered at operation performed for severe aortic stenosis and moderate to severe dilatation of the ascending aorta. Preoperative investigations such as transoesophageal echocardiography and cardiac catheterization missed the diagnosis of dissection. Intraoperative findings included a 3.5 cm eccentric bulge of the ascending aorta and a 5 mm circular shaped intimal tear comunicating with a limited hematoma or small dissection of the media layer. (The rarety of the report is that the chronic dissection is limited to a small area (approximatively 3.5 × 2.5 cm) of the ascending aorta). PMID:18638403

Venturini, Andrea; Zoffoli, Giampaolo; Mangino, Domenico; Ascione, Raimondo; Terrini, Alberto; Asta, Angiolino; Angelini, Gianni; Polesel, Elvio

2008-01-01

87

Virtual Pig Dissection  

NSDL National Science Digital Library

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

Fleck, Earl W.

88

Facial nerve morbidity after retrograde nerve dissection in parotid surgery for benign disease: A 10-year prospective observational study of 136 cases  

Microsoft Academic Search

We evaluated the facial nerve function in 136 patients who had had retrograde nerve dissection during parotidectomy for benign disease. One week after the operation 90 patients (66%) had some weakness of the facial nerve. After 1 month 52 (38%) had facial nerve paresis. After 3 months 114 (84%) had recovered fully and 21 (16%) had minor nerve paresis. After

Barry O’Regan; Girish Bharadwaj; Satwant Bhopal; Victoria Cook

2007-01-01

89

Is dissection humane?  

PubMed Central

Dissection is being jeopardized in the modern medical education. It has unrelentingly faced the lashes of time and has been the scapegoat for numerous convenient curricula reforms and subjective biases. The cadaver is unparallel in establishing core knowledge among the medical community and it needs to be appreciated in a new light in the “cyber anatomy” realm of today. This article elucidates the medical and ethical validity of continuing human body dissection in medicine which outweighs all the prejudices associated with it. PMID:23908746

Hasan, Tabinda

2011-01-01

90

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.

91

Spontaneous coronary dissection associated with sleep deprivation presenting with acute myocardial infarction  

Microsoft Academic Search

Spontaneous coronary dissection is a rare cause of myocardial ischemia, myocardial infarction and sudden cardiac death. Idiopathic spontaneous coronary artery dissection (SCAD) occurs in patient without risk factors for coronary artery disease and without underlying pregnancy. We describe a case of idiopathic spontaneous coronary dissection after sleep deprivation presenting with acute myocardial infarction. A 40 year old woman presented to

Soon Yong Suh; Jin Won Kim; Cheol Ung Choi; Eung Ju Kim; Seung-Woon Rha; Chang Gyu Park; Hong Seog Seo; Dong Joo Oh

2007-01-01

92

Neck dissections: radical to conservative  

PubMed Central

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

Harish, K

2005-01-01

93

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

94

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

SciTech Connect

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

Kutlu, Ramazan [Inonu University School of Medicine, Department of Radiology (Turkey)], E-mail: rkutlu@inonu.edu.tr; Ara, Cengiz [Inonu University School of Medicine, Department of General Surgery (Turkey); Sarac, Kaya [Inonu University School of Medicine, Department of Radiology (Turkey)

2007-02-15

95

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

PubMed Central

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

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

2014-01-01

96

[Aortic dissection and carotid arteries dissection complicated by ischaemic stroke in a patient with cystic medial necrosis].  

PubMed

We present a case of a 62-year-old man who was admitted in grave condition to the Institute of Psychiatry and Neurology because of ischaemic stroke. Neurological examination re- vealed left-sided pyramidal hemiparesis. Computed tomography (CT) showed the ischaemic focus in the right cerebral hemisphere. Clinical examination and ultrasound examination revealed dissection of the aortic arch and extracranial arteries. Aortic dissection was confirmed in echocardiography and chest CT. The patient remained comatose and died after 7 days. Post-mortem examination identified dissection of the aortic arch, brachiocephalic truncus, common carotid arteries, internal carotid arteries and dissection extending along the whole aorta into both iliac arteries. This examination also showed a massive haemopericardium and a scar in the heart muscle after myocardial infarction. Microscopic examination identified cystic medial necrosis. This type of dissection is very rarely described. PMID:20054762

Jachi?ska, Katarzyna; Lipczy?ska-?ojkowska, Wanda; Kuran, W?odzimierz; Rozenfeld, Anna; Grochowska, Elzbieta; Szpak, Grazyna M; Lenart, Janusz

2009-01-01

97

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

PubMed

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

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

2014-08-01

98

Traumatic carotid artery dissection caused by bungee jumping.  

PubMed

Bungee jumping is a popular recreational activity in which participant experiences transient freefall while connected to a bungee cord. The rapid freefall and the resultant rebound force created by the bungee cord can result in a variety of bodily injuries. We report herein a case of traumatic carotid artery dissection caused by bungee jumping. The symptoms related to carotid artery dissection were successfully treated with anticoagulation. The etiology of carotid dissection related to bungee jumping is discussed. Physicians should be cognizant of this potential injury due to the force created by the freefall and rebound motion associated in this recreational sport. PMID:17980290

Zhou, Wei; Huynh, Tam T; Kougias, Panagiotis; El Sayed, Hosam F; Lin, Peter H

2007-11-01

99

"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

100

Medical management in type B aortic dissection  

PubMed Central

Medical management is generally the preferred treatment for uncomplicated type B acute aortic dissection cases. It is often centered on the use of antihypertensive agents, which alleviates hemodynamic stress on the damaged aortic wall. Methods of medical management and drug selection are still based mainly on personal experience, expert opinion and historical observational studies as randomized controlled studies are lacking. Guidelines from European (ESC), American (ACC/AHA) and Asian (Japan) societies in the last decade have made recommendations on use of medications, but also reaffirmed the lack of evidence for therapeutic approaches and targeted medical management. More recent evidence suggests that there may be type-selective benefits for antihypertensive medications. Here, we will discuss the present understanding of medical management of acute aortic dissection. PMID:25133106

Eagle, Kim A.; Bossone, Eduardo; Ballotta, Andrea; Froehlich, James B.; Isselbacher, Eric M.

2014-01-01

101

Endovascular treatment of acute type B dissection complicating aortic coarctation.  

PubMed

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

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

2013-01-01

102

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

103

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

PubMed Central

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

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

2014-01-01

104

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

105

"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

106

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

107

Dissecting aneurysms of the vertebrobasilar system. A comprehensive review on natural history and treatment options  

Microsoft Academic Search

Vertebral artery dissection has been recognized as an uncommon cause of ischemic stroke. However, it is less well known as\\u000a a cause of subarachnoid hemorrhage. Even if dissecting aneurysms of the vertebral artery are rare, their importance arise\\u000a from their high morbidity and mortality with rebleeding occurring more often than in cases of saccular aneurysms. Dissecting\\u000a aneurysms of the vertebrobasilar

Jorge Arturo Santos-Franco; Marco Zenteno; Angel Lee

2008-01-01

108

Dynamic aortic obstruction in a patient with acute type B dissection.  

PubMed

There are at least 7000 aortic dissections diagnosed in the United States each year. Type B dissections accounted for 38% of cases enrolled in the prospective International Registry of Aortic Dissection. We report a case of a 48-year-old hypertensive woman with an acute type B aortic dissection causing significant dynamic obstruction of the aorta. Intravascular ultrasound of her aorta revealed a mobile intimal flap nearly obliterating the true lumen with each systolic contraction. Simultaneous pressure tracings obtained from her ascending aorta and femoral artery demonstrated a systolic pressure gradient in excess of 100 mm Hg. The patient developed progressive renal failure and ultimately underwent successful operative replacement of the proximal descending thoracic aorta with a Dacron graft. In this case presentation, we highlight the unusual physiology exemplified by this case and explore contemporary management strategies for complicated type B aortic dissection, including surgery and catheter-based techniques. PMID:16628024

Mega, Jessica L; Opotowsky, Alexander R; Curillova, Zelmira; O'Gara, Patrick T

2006-01-01

109

Isolated Unilateral Hypoglossal Nerve Palsy Due to Vertebral Artery Dissection  

PubMed Central

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

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

2012-01-01

110

Infective Left Atrial Dissecting Flap after Cardiac Surgery  

PubMed Central

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

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

2014-01-01

111

Concomitant Reconstruction of Arch Vessels during Repair of Aortic Dissection  

PubMed Central

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

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

2014-01-01

112

Isolated spontaneous dissection of the celiac trunk in a patient with bicuspid aortic valve.  

PubMed

Isolated spontaneous dissection of celiac trunk is a rare entity. The spontaneous dissection of the visceral artery occurs without aortic dissection. The most consistent presenting symptom is acute onset abdominal pain. Complications consist of ischemia, aneurysm formation, and rupture. We report an exceptional case of an isolated spontaneous dissection of the celiac trunk which occurred in a 49 year old male with a previously undiagnosed bicuspid aortic valve (BAV). We also describe the classical appearance in different imaging modalities with a particular emphasis on multidetector computed tomography, and discuss the clinical manifestation and its relationship to BAV. PMID:20539840

Zeina, Abdel-Rauf; Nachtigal, Alicia; Troitsa, Anton; Admon, Gil; Avshovich, Nina

2010-01-01

113

Recurrent aortic dissection presenting with repeated transient ischemic attacks: a novel pathophysiology and successful endovascular treatment.  

PubMed

Aortic dissection is the most common and the most lethal event that can involve the aorta. Typically, aortic dissection presents with sharp, tearing, or ripping pain. Alternatively, the patients may suffer from possible extension of the dissecting aneurysm into the supra-aortic vessels resulting in syncope in 9.4 % of patients cerebrovascular accidents in 4.7 %. We present a case of recurrent aortic dissection, which presented with recurrent transient ischemic attacks (TIAs). The etiology of the neurological symptoms was attributed to a steal phenomenon. The right subclavian artery was supplied by retrograde flow from the right internal carotid artery through the false lumen of the dissection. To prevent further hemodynamic TIAs, we successfully occluded the proximal part of the false lumen of the dissection responsible for the steal phenomenon. PMID:23307261

Elshikh, S; Schumacher, M; Dohmen, A; Weber, J

2013-12-01

114

Acute dissection of the left anterior descending after contusio cordis.  

PubMed

Traumatic coronary artery dissection after blunt chest trauma is extremely rare. The diagnosis is often delayed and some are only diagnosed postmortem. We report a case of acute dissection of the left anterior descending (LAD) after contusio cordis that presented at our institution. In our case we performed the off pump coronary artery bypass operation (OPCAB) procedure with left internal mammary artery (LIMA) on LAD by a partial lower sternotomy approach. There were no operative or perioperative complications and the patient was discharged from hospital 6 days postoperatively. OPCAB operation through the partial lower sternotomy is a safe and effective technique for the treatment of patients with acute dissection of a coronary artery after blunt chest trauma. PMID:21460781

Monsefi, N; Moritz, A; Dzemali, O

2011-04-01

115

Talking about death: implementing peer discussion as a coping mechanism to overcome fears about dissection, death, and dying.  

PubMed

Many studies have reported on the perceptions of medical students toward dissection. It is important to understand the feelings and symptoms experienced during dissection so that they can be adequately handled. Prior to dissection, first year students are given lectures on aspects of dissection, death and dying, and death rituals in various cultures. Two separate questionnaires, one given during the first week of dissection and another given one month into the program were then completed anonymously by dissection groups. The questions were designed to be open-ended, thereby encouraging group discussion amongst students. The questionnaires were used to determine the perception of students to dissection and to discover if these perceptions change during the dissection program. The first questionnaire revealed that students do experience fears and anxiety prior to and at the beginning of dissection; however, most of these fears dissipated by the time of the second questionnaire. One month into dissection students cited talking to peers as their main coping mechanism and fewer students mentioned emotional detachment from their cadaver as a coping mechanism, as was the case in the first questionnaire. Dissection was perceived as a positive experience by our student cohort and most students cited the main advantage of dissection as the ability to visualize organs in three dimensions. The comprehensive answers received from the students indicated that thorough discussion of feelings amongst peers occurred, introducing students to an important coping mechanism at an early stage of their learning. PMID:23208957

Kotzé, Sanet Henriët; Mole, Calvin Gerald

2013-01-01

116

Syncope and cardiovocal syndrome as the result of a spontaneous innominate artery dissection.  

PubMed

Dissection of the innominate artery is extremely rare and is associated with a high in-hospital mortality rate. We present the case of a 44-year-old man who presented with syncope and cardiovocal syndrome as the result of a spontaneous innominate artery dissection with an extension to the right common carotid. PMID:19571766

Lampropoulos, Stelios; Theofilogiannakos, Efstratios K; Gkontopoulos, Argiris; Kadoglou, Nikos P; Mamalis, Vassilis; Kontaki, Theodosia; Kottas, George

2009-10-01

117

Successful treatment of acute dissection of the donor aorta after orthotopic heart transplantation  

Microsoft Academic Search

Acute aortic dissection is one of the rare aortic complications that occur after orthotopic heart transplantation. We report the second case of successful surgical treatment of aortic dissection confined to the donor aorta in a recipient of an orthotopic cardiac allograft. A 68-year-old patient was admitted with chest pain and shortness of breath 7 years after orthotopic heart transplantation. He

Ali Kubilay Korkut; Francis Wellens; Luc Foubert; Marc Goethals

2003-01-01

118

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

119

Extracapsular dissection of the parapharyngeal space for a pleomorphic adenoma: a 10-year review.  

PubMed

Pleomorphic adenomas of the parapharyngeal space are difficult to remove with a margin of normal tissue. We reviewed 29 cases of extracapsular dissection of a parapharyngeal pleomorphic adenoma and found that extracapsular dissection does not increase the probability of recurrence of the tumour. PMID:24768035

Guo, Yuxing; Guo, Chuanbin; Zhang, Lei; Yu, Guangyan

2014-07-01

120

Computed tomography manifestation of a triple-barreled aortic dissection: the Mercedes-Benz mark sign.  

PubMed

Computed tomographic (CT) findings of a rare case of triple-barreled aortic dissection was described. CT demonstrated the extent of dissection, a communication between two channels, and three lumens separated by the intimal flap and a thin undetached tunica media, resembling a Mercedes-Benz mark. PMID:3168525

Shin, M S; Zorn, G L; Ho, K J

1988-04-01

121

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

PubMed Central

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

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

2013-01-01

122

Keeping Dissection Alive for Medical Students  

NSDL National Science Digital Library

This article describes an experiential course with the goal of immersing medical students in a cadaver dissection course abroad. The course was developed because of a reduction in cadaver opportunities and a desire by medical students to gain dissection skills.

2009-11-01

123

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

124

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

125

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.

126

External iliac artery dissection causing early renal transplant dysfunction.  

PubMed

External iliac artery dissection after kidney transplantation is a rare, catastrophic but potentially reversible complication. Treatment which may save both the transplant and the patient requires clinical suspicion, timely imaging, and prompt intervention. This case report describes successful diagnosis of this complication and surgical intervention which saved the kidney and safeguarded blood supply to the patient's leg. PMID:24695666

Lee, Gwyn; Barlow, Adam; Doughman, Tahir; Nicholson, Michael L

2014-01-01

127

Vertebral artery dissection associated with viral meningitis  

PubMed Central

Background Vertebral artery dissection (VAD) is often associated with trauma or occurs spontaneously, inevitably causing some neurological deficits. Even though acute infection can be related to the development of spontaneous VAD (sVAD), VAD associated with viral meningitis has never been reported in the literature. Case presentation A 42-year-old man with fever, sore throat, and runny nose developed sudden onset of occipital headache, vertigo, transient confusion, diplopia, and ataxia. Brain stem encephalitis was diagnosed initially because the cerebrospinal fluid (CSF) study showed inflammatory changes. However, subsequent diffusion-weighted (DWI) magnetic resonance imaging of his brain demonstrated left lateral medullary infarction, and the digital subtraction angiography (DSA) confirmed VAD involving left V4 segment of the artery. Consequently, the patient was diagnosed as VAD accompanied by viral meningitis. Conclusion This case suggests that viral meningitis might lead to inflammatory injury of the vertebral arterial wall, even sVAD with multiple neurological symptoms. PMID:22909191

2012-01-01

128

Stanford type A aortic dissection. A new surgical approach.  

PubMed Central

We describe a new surgical technique adopted for the repair of Stanford type A aortic dissection. In order to minimize the risk of malperfusion caused by retrograde flow during cardiopulmonary bypass, we avoid femoral artery cannulation. On the hypothesis that it is best not to interfere with the hemodynamics of the dissection, we cannulate the dissected ascending aorta, in either the true or false lumen. We here report 2 cases of successful surgical treatment of Stanford type A aortic dissection. In both cases, the false lumen was cannulated under deep hypothermic circulatory arrest, without clamping the aorta. While the patient was cooling, a 10-mm GORE-TEX side arm was sutured to a Dacron graft prosthesis. Repair of the aortic arch was carried out 1st. The aortic cannula was inserted into the GORE-TEX side arm, the tubular prosthesis was cross-clamped, and cardiopulmonary bypass was reinstituted. After this, the aortic bulb was repaired as usual and the tubular prosthesis was sutured to the bulb. No postoperative cerebral complication occurred. Our experience must be confirmed by more cases and a longer follow up. Images PMID:9566066

Lijoi, A; Scarano, F; Dottori, V; Parodi, E; Casali, G; Bartolozzi, F

1998-01-01

129

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

130

Clinical analysis of vertebrobasilar dissection  

Microsoft Academic Search

Summary  Background. The natural history of vertebrobasilar artery dissection (VAD) is not fully known. The purpose of this study was to review\\u000a the clinical outcome of the patients with VAD, then to propose an appropriate management strategy for VAD.\\u000a \\u000a Method. From 1992 to 2004, 35 VAD patients admitted to our institutes were retrospectively reviewed. There were 28 men and 7 women,

C.-H. Kim; Y.-J. Son; S. H. Paek; M. H. Han; J. E. Kim; Y. S. Chung; B. J. Kwon; C. W. Oh; D. H. Han

2006-01-01

131

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

132

Management Strategy of Isolated Spontaneous Dissection of the Superior Mesenteric Artery  

PubMed Central

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

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

2014-01-01

133

Nonsyndromic genetic predisposition to aortic dissection: a newly recognized, diagnosable, and preventable occurrence in families.  

PubMed

The major diseases affecting the aorta are aortic aneurysms and dissections, with patients with acute dissections often presenting in the emergency department (ED). Recent studies demonstrate a strong genetic predisposition to thoracic aortic aneurysms and dissections, independent of syndromes traditionally considered to predispose to aortic disease (such as Marfan syndrome). Nonsyndromic familial thoracic aortic aneurysms and dissections are inherited in families as an autosomal dominant disorder and a variable age of onset of the aortic disease. The case reported here illustrates the critical importance of obtaining a family history of thoracic aortic aneurysms and dissections, along with unexplained sudden death, when assessing an individual with chest pain in the ED, regardless of age and in the absence of a known genetic syndrome. PMID:14707946

Hasham, Sumera N; Lewin, Matthew R; Tran, Van T; Pannu, Hariyadarshi; Muilenburg, Ann; Willing, Marcia; Milewicz, Dianna M

2004-01-01

134

Endoscopic submucosal tunnel dissection salvage technique for ulcerative early gastric cancer.  

PubMed

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. PMID:25083097

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

2014-07-21

135

[CT analysis of aortic cobwebs in aortic dissection].  

PubMed

Contrast-enhanced CT images in patients with acute or chronic aortic dissection were evaluated for the purpose of determining the clinical usefulness of "aortic cobwebs", which were originally reported by Williams et al. as an anatomical marker of the false lumen. Aortic cobwebs were detected in 13 of 44 cases (30%), demonstrating as low density structures in the false lumen continuing from the intimal flap. The aortic cobwebs were mainly linear in shape, and the size ranged from 5 x 1 to 15 x 3 mm (mean: 9 x 2 mm). Aortic cobwebs were more frequently demonstrated in chronic than in acute cases, and were more often detected in the abdominal aorta. Follow-up CT examinations of the cobwebs revealed no interval change in six cases, disappearance in three cases and thickening in one case. There was no significant correlation between the sequential changes in the cobwebs and dilatation or thrombus formation in the false lumen. Aortic cobwebs seem to represent partially residual bands of the aortic media incompletely sheared from the aortic wall during the initial processes of aortic dissection. These structures are considered to be a reliable anatomic marker and to be useful for CT identification of the false lumen in aortic dissection. PMID:7617466

Hayashi, H; Onda, M; Takagi, R; Kawamata, H; Watari, J; Ichikawa, T; Kumazaki, T

1995-05-01

136

Unusual presentation of aortic dissection: post-coital acute paraplegia with renal failure.  

PubMed

We report the case of a 45-year-old chronic smoker who presented with acute paraplegia occurring during coitus and subsequently developed acute renal failure (ARF) requiring dialysis. He had absent peripheral pulses in the lower limbs with evidence of acute ischemia. Doppler study showed dissecting aneurysm of thoracic aorta, thrombotic occlusion of the distal aorta from L1 level up to bifurcation and occlusion of the right renal artery by a thrombus that was confirmed by magnetic resonance imaging of the spine. He was not subjected to any vascular intervention as his lower limbs were not salvageable due to delay in the diagnosis. Post-coital aortic dissection and aortic dissection presenting with acute paraplegia and ARF are very rare. This is probably the first case report with post-coital acute aortic dissection presenting with paraplegia and ARF. This case emphasizes the importance of a careful examination of peripheral pulses in patients presenting with ARF and paraplegia. PMID:25193908

Galabada, Dinith P; Nazar, Abdul L M

2014-09-01

137

Noninvasive Detection ofVertebral Artery Dissection  

Microsoft Academic Search

Background andPurpose: We sought toidentify theuse ofduplexandtranscranial Dopplersonography inthenoninvasive diagnosis ofvertebral dissection. Methods: Tenpatients with adiagnosis ofsymptomatic vertebral artery dissection confirmed bycerebral angiography were retrospectively analyzed. Results: Computed tomographic scanning andmagnetic resonance imaging together delineated lateral medullary or cerebellar infarcts in7patients. Angiography documented a total of21vertebral artery lesions (16stenoses and5occlusions), with7of10patients havingmultiple sites ofvertebral artery dissection. Vertebral Doppler was abnormal

Michael Hoffmann; Ralph L. Sacco; Stephen Chan; P. Mohr

138

Optimal Diagnostic Imaging of Aortic Dissection  

PubMed Central

Without prompt diagnosis and treatment, aortic dissection is rapidly fatal. While standard chest radiography may give clues to the diagnosis of aortic dissection, suspected dissection can be confirmed by only 4 imaging techniques: aortography, echocardiography, computed tomography, and magnetic resonance imaging. The following review discusses each of these methods. It also explains why aortography, the previous diagnostic benchmark, has been replaced by newer techniques and why magnetic resonance imaging has become the diagnostic method of choice for imaging aortic dissection. (Texas Heart Institute Journal 1990;17:271-8) Images PMID:15227519

Wilbers, Christopher R.H.; Carrol, Clark L.; Hnilica, Mark A.

1990-01-01

139

[Hybrid operative intervention for DeBakey type III aortic dissection with the relay stent graft].  

PubMed

Determining the exact incidence of aortic dissection is highly conjectural because many cases of the disease remain undiagnosed. According to the autopsy findings, the incidence rate of the pathology concerned varies within the range from 0.2 to 0.8%. In clinical practice, aortic dissection is the cause of sudden death in 1.1% of the patients involved. However, aortic dissection should by no means be considered a rare disease. According to Borst et ah, ruptures in thoracic-portion aortic dissections are encountered 2-3 times more often than tears occurring in abdominal aortic aneurysms. The prognosis for patients presenting with a chronic aortic dissection is unfavourable. The commonest complications of the natural course of the disease include the development of a secondary dissection, formation of an aneurysm, progression of aortic regurgitation and circulatory insufficiency, occlusion of the aortic branches, and a late aortic rupture being the immediate cause of death in 30% of patients suffering from chronic dissection. With the recent advent of stent grafts, there appeared a possibility in the majority of cases involving a chronic type B dissection by the Stanford classification to substantially avoid an otherwise inevitably traumatic and typically prolonged reconstructive operation. Unfortunately, in some patients, owing to anatomical peculiarities, it is not always possible to deploy an endograft, thus requiring a major surgical intervention to perform instead. The authors describe herein a case of endovascular prosthetic reconstruction of the aortic arch and the descending portion in a patient who was found to have a type III aortic dissection according to the DeBakey classification and treated with the Relay stent graft. PMID:20635727

Cherniavski?, A M; Karpenko, A A; Cherniavski?, M A; Starodubtsev, V B; Edemski?, A G

2010-01-01

140

Spontaneous resolution of iatrogenic dissection of the left main coronary artery extending to the thoracic and abdominal aorta  

PubMed Central

Iatrogenic coronary artery dissection extending to the ascending aorta is a rare complication of percutaneous coronary interventions. Coronary stent implantation is usually sufficient to control the injury. In this report we describe an unusual case of spontaneous resolution of both left main coronary artery and aortic wall dissection. The patient was not operated on due to the location of the initial tear in the distal part of the left main coronary artery. Moreover, in computed tomography (CT) thrombus formation in the false lumen of the dissected aorta was seen. The in-hospital course was uneventful. The last follow-up CT showed complete resolution of dissection. PMID:24570718

Lesiak, Maciej; Jemielity, Marek

2013-01-01

141

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

PubMed

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

Kim, Myeong-Soo

2013-06-01

142

Acute gallbladder necrosis in a patient with acute type B aortic dissection.  

PubMed

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. PMID:24386028

Ito, Toshiro; Yasuda, Naomi; Kuroda, Yohsuke; Sugawara, Motoshi; Koyanagi, Tetsuya; Higami, Tetsuya

2013-01-01

143

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. PMID:24386028

2013-01-01

144

[Dissection is still important when learning anatomy].  

PubMed

Dissection and prosection require a donation programme of cadavers for education and research. The importance of maintaining the donation programme and the significance of dissection as a teaching method when learning anatomic structures and obtaining surgical skills are evaluated. PMID:23697565

Knudsen, Britt Mejer; Søe, Niels H; Jensen, Nina Vendel; Langebæk, Rikke; Dahlin, Lars B

2013-05-20

145

Aortic arch dissection: a controversy of classification.  

PubMed

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

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

2014-06-01

146

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

147

Spontaneous coronary artery dissection as a cause of sudden cardiac death in the peripartum period  

PubMed Central

Spontaneous coronary artery dissection is a rare cause of acute coronary syndromes and can be potentially fatal. The authors describe a case of multi-vessel coronary artery dissection occurring in a young postpartum mother. The diagnosis was established by coronary artery angiography. However, the patient died following a cardiac arrest. The authors discuss the methods of investigation available and the different treatment options. PMID:22798305

Pabla, Jatinder Singh; John, Lawrence; McCrea, William A

2010-01-01

148

A Simple and Safe Technique for Manipulation of Retrosternal Dissection in the Nuss Procedure  

PubMed Central

Objective: The Nuss procedure has become the first choice for repairing the pectus excavatum because of the advantages of the technique including minimal invasiveness and short operative duration. Although this technique appears simple and easy, life-threatening complications during dissection such as intraoperative cardiac perforation have been reported. We developed a new approach for safer dissection of retrosternal space. Methods: We use a dissector that is commonly used for laparoscopic operation, instead of the Nuss introducer. The dissector goes through the same skin incision where the Nuss bar will be inserted. The major difference is the position of dissector insertion, which is set up more dorsally than usual, and the use of a laparoscopic dissector instead of the Nuss introducer. In this new approach, the direction of dissection is from dorsal toward the anterior thoracic wall, which allows us to visually follow the tip of the dissector throughout the surgery. Moreover using the dissector that has better manipulation capability enables us the fine dissection and also is able to precisely determine both the layer and the area of the dissection level. Results: We have treated more than 150 patients using this technique without any complications since 2008. In all the cases, safer dissection of the retrosternal space was performed with good results. Conclusion: We believe every surgeon can easily apply this procedure to patients with pectus excavatum, and this procedure can reduce the stress during the dissection. PMID:24570769

Noguchi, Masahiko; Kondoh, Shoji; Fujita, Kenya

2014-01-01

149

Bilateral Carotid Artery Dissection after High Impact Road Traffic Accident  

PubMed Central

A 58 year old man was involved in a high impact road traffic incident and was admitted for observation. Asymptomatic for the first 24 hours, he collapsed with symptoms and signs consistent with a cerebrovascular accident. Computed tomography angiogram (CTA) and Magnetic resonance angiogram (MRA) demonstrated bilateral internal carotid artery dissections and a left middle cerebral artery infarct. It was not considered appropriate to attempt stenting or other revascularistation. The patient was treated with heparin prior to starting warfarin. He made a partial recovery and was discharged to a rehabilitation facility. This case is a reminder of carotid dissection as an uncommon but serious complication of high speed motor vehicle accident, which may be silent initially. Literature Review suggests risk stratification before relevant radiological screening at risk patients. Significant advances in CTA have made it the diagnostic tool of choice, but ultrasound is an important screening tool. PMID:22470607

Srivastava, Ankur; Bradley, Marcus; Kelly, Michael

2008-01-01

150

A proposed dissection procedure for vertebral arteries in forensic pathology.  

PubMed

Vertebral artery removing constitutes a significant forensic pathology challenge. Dissection techniques during head-neck autopsy are based on anterior approach, a difficult method, which is unable to assess the transverse part of the artery. This work presents an original and simple method for dissecting vertebral arteries by a posterior approach, opening the vertebroarterial canal through the spinal canal without any special equipment. Once the spinal cord is removed, the transversarium foramens are opened by an internal cut at the pedicle and an external cut at the transverse process. This enables us to visualize vertebral arteries in its entirety. The method improves both the examination of the upper extracranial segment of the vertebral artery and the neuropathological study when arterial injury is suspected. Applying this method routinely is both feasible and useful in suspected cases of vertebral artery trauma and could contribute to assess more precisely the actual incidence of this injury. PMID:21827482

Galtés, Ignasi; Rodríguez-Baeza, Alfonso; Subirana, Mercè; Barbería, Eneko; Castellà, Josep; Medallo, Jordi

2012-01-01

151

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

152

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

PubMed Central

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

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

1996-01-01

153

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. PMID:24936486

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

2014-01-01

154

Ruptured valsalva sinus aneurysm to pericardium simulated aortic root dissection.  

PubMed

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. PMID:24936486

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

2014-04-01

155

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

156

Training in endoscopic submucosal dissection  

PubMed Central

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

2013-01-01

157

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

158

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

PubMed Central

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

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

2014-01-01

159

Managing Dissections of the Thoracic Aorta  

PubMed Central

Thoracic aortic dissection is associated with substantial morbidity and mortality, and it requires timely and accurate diagnosis and treatment. Long-term antihypertensive therapy remains critical for the treatment of this disease. Surgical intervention, although still a formidable undertaking, has evolved to better address both acute and chronic dissection, and the results have improved. Basic and clinical research, as well as technological advances, have increased our understanding of this challenging disease state. PMID:18481490

WONG, DANIEL R.; LEMAIRE, SCOTT A.; COSELLI, JOSEPH S.

2010-01-01

160

78 FR 2437 - Corrected: Certain Cases For Portable Electronic Devices; Notice of Receipt of Complaint...  

Federal Register 2010, 2011, 2012, 2013

...within the United States after importation of certain cases for portable electronic devices. The complaint names as respondents Global Digital Star Industry, Ltd. of China; JWIN Electronics Corp., (d/b/a iLuv) of NY; Project Horizon,...

2013-01-11

161

78 FR 116 - Certain Cases for Portable Electronic Devices: Notice of Receipt of Complaint; Solicitation of...  

Federal Register 2010, 2011, 2012, 2013

...within the United States after importation of certain cases for portable electronic devices. The complaint names as respondents Global Digital Star Industry, Ltd. of China; JWIN Electronics Corp., (d/b/a iLuv) of NY; Project Horizon,...

2013-01-02

162

77 FR 66632 - Certain Protective Cases and Components Thereof; Notice of the Commission's Final Determination...  

Federal Register 2010, 2011, 2012, 2013

...China (``Guangzhou Evotech''); Hard Candy Cases LLC of Sacramento, California (``Hard Candy''); Hoffco Brands, Inc. of Wheat Ridge...complaint: One Step Up, InMotion, Hard Candy, DHGate.com, Alibaba.com, A.G....

2012-11-06

163

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

164

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

PubMed Central

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

Dibenedetto, Silvia; Cluet, David; Stebe, Pierre-Nicolas; Baumle, 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

165

The Effect of Animal Dissections on Student Acquisition of Knowledge of and Attitudes toward the Animals Dissected.  

ERIC Educational Resources Information Center

A conflict exists over the use of animals in the classroom. One aspect of this use involved the dissection of animals. Animal protection advocates report that dissections constitute abuse of the animals dissected. The advocates state that what is learned by dissection could be more effectively learned by other means. Some science educators state…

McCollum, Terry L.

166

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. PMID:21511950

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

2011-01-01

167

Direct and Transapical Central Cannulation for Acute Type A Aortic Dissection  

PubMed Central

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

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

2014-01-01

168

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

PubMed Central

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

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

2013-01-01

169

Endovascular Coil Trapping of a Ruptured Dissecting Aneurysm of the Vertebral Artery Using Detachable Coils and Micro-Tornado(R) Coils  

PubMed Central

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

2013-01-01

170

Outbreaks of salmonellosis at elementary schools associated with dissection of owl pellets.  

PubMed

Salmonella enterica serotype Typhimurium outbreaks occurred at two elementary schools after science club students dissected owl pellets. Forty primary cases were identified (26 culture-confirmed). At the first school, pellets were dissected on a cafeteria table, concurrent with after-school child care in the cafeteria. Subsequently, the table was not sanitized before use by after-school care students for snack, or before the next school lunch. At the second school, pellets were dissected in a dedicated science room, and fewer cases occurred. Pellets in both outbreaks originated from a single captive barred owl. The outbreak pulsed-field gel electrophoresis subtype of S. Typhimurium was isolated from the owl's pellets and feces, and from four frozen chicks from a batch used to feed the owl. PMID:16011429

Smith, Kirk E; Anderson, Fred; Medus, Carlota; Leano, Fe; Adams, Jennifer

2005-01-01

171

Carotid and vertebral artery dissection syndromes  

PubMed Central

Cervicocerebral arterial dissections (CAD) are an important cause of strokes in younger patients accounting for nearly 20% of strokes in patients under the age of 45 years. Extracranial internal carotid artery dissections comprise 70%–80% and extracranial vertebral dissections account for about 15% of all CAD. Aetiopathogenesis of CAD is incompletely understood, though trauma, respiratory infections, and underlying arteriopathy are considered important. A typical picture of local pain, headache, and ipsilateral Horner's syndrome followed after several hours by cerebral or retinal ischaemia is rare. Doppler ultrasound, MRI/MRA, and CT angiography are useful non-invasive diagnostic tests. The treatment of extracranial CAD is mainly medical using anticoagulants or antiplatelet agents although controlled studies to show their effectiveness are lacking. The prognosis of extracranial CAD is generally much better than that of the intracranial CAD. Recurrences are rare in CAD. PMID:15937204

Thanvi, B; Munshi, S; Dawson, S; Robinson, T

2005-01-01

172

Scope on Safety: Dissection--Don't cut out safety  

NSDL National Science Digital Library

In June 2005, the NSTA Board of Directors adopted a revised position statement, Responsible Use of Live Animals and Dissection in the Science Classroom. Under the "Dissection" section, NSTA calls for more research to determine the effectiveness of animal dissection activities and alternatives, and the extent to which these activities should be integrated into the science curriculum. Until research indicates the effectiveness of alternatives to dissection, many teachers will continue including dissections in their classrooms. Those that do need to make sure they are addressing related safety issues to ensure a successful learning experience. This month's Scope on Safety features NSTA's safety recommendations for safe and ethical dissection practices.

Roy, Ken

2007-02-01

173

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

174

Surgical treatment of acute ascending aortic dissection.  

PubMed Central

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

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

1983-01-01

175

Intracranial Vertebral Artery Dissections: Evolving Perspectives  

PubMed Central

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

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

2012-01-01

176

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. PMID:24179638

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

2013-01-01

177

Combined subgaleal/myocutaneous technique for temporalis muscle dissection.  

PubMed

Background?The frontal branch of the facial nerve (FBFN) is the most susceptible neural structure to injury during frontotemporal craniotomies. The balance between adequate temporalis muscle mobilization and frontal branch protection with minimal anatomical alteration is the philosophy behind our approach to temporalis muscle dissection. Objective?To describe a combined subgaleal/myocutaneous technique for dissection and mobilization of the temporalis muscle in anterolateral cranial approaches. Methods?Interdisciplinary literature review of the anatomical course of the FBFN was performed. Retrospective analysis of anterolateral craniotomies performed at our institution in which the combined subgaleal/myocutaneous (CSGMC) technique was performed. Results?A total of 71 cases of anterolateral craniotomies (excluding full variant orbitozygomatic) were performed with the successful application of a CSGMC technique (36 pterional, 31 orbitopterional, and 4 fronto-orbital). Partial frontalis weakness was transient in one case. Conclusion?The CSGMC technique provides sufficient protection for the FBFN and allows for adequate mobilization for a variety of skull base exposures while minimally violating myofascial anatomy. This is the first reported technique that allows both adequate temporalis muscle mobilization with performance of the one-piece orbitofrontal and orbitopterional approaches, without disruption of the superficial/deep temporalis fascia and fat-pad complex. PMID:24294555

Youssef, A Samy; Ahmadian, Amir; Ramos, Edwin; Vale, Fernando; van Loveren, Harry R

2012-12-01

178

A COMPARATIVE PRIMATE ANATOMY Dissection Manual  

E-print Network

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

Ackermann, Rebecca Rogers

179

Chemistry & Biology Chemical Dissection of the Link  

E-print Network

for dynamic intracellular protein O-glycosylation. We have used galacto-streptozotocin to chemically dissect for streptozotocin, suggesting the need for using more specific inhibitors to study protein O proteins in higher eukaryotes (Zachara and Hart, 2006; Hart et al., 2007). O-GlcNAcylation has been shown

van Aalten, Daan

180

Dissecting the pressure field in tidal flow  

E-print Network

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

Warner, Sally

181

Dissecting the pressure field in tidal flow  

E-print Network

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

Warner, Sally

182

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

183

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

PubMed

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. PMID:21792333

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

2011-01-01

184

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. PMID:21792333

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

2011-01-01

185

Clinical perceptions of the risk of vertebral artery dissection after cervical manipulation  

Microsoft Academic Search

Background context: The growing recognition of cervical manipulation as a treatment of neck pain and cervicogenic headaches has lead to increased interest in potential complications that may result from this treatment approach. Recent surveys have reported that many neurologists will encounter cases of vertebral artery dissection that occur at various times after cervical manipulation, whereas most practitioners of spinal manipulation

Scott Haldeman; Paul Carey; Murray Townsend; Costa Papadopoulos

2002-01-01

186

Aortic valve preservation in acute type a dissection: Is it sound?  

Microsoft Academic Search

A series of 200 consecutive patients with acute Stanford type A dissection (157 men, 78%; 43 women, 22%) was analyzed to assess the validity of aortic valve preservation or repair. Indication for the operation in most cases was based on echocardiographic examination alone, to reduce the delay. In the majority of patients (111\\/200, 56%) the aortic valve was preserved or

Ludwig K. von Segesser; Enrico Lorenzetti; Mario Lachat; Urs Niederhäuser; Mariette Schönbeck; Paul R. Vogt; Marko I. Turina

1996-01-01

187

Traumatic dissection of the left circumflex artery after a fall from height.  

PubMed

The authors present the case of a healthy 40-year-old man who developed a myocardial infarction because of traumatic dissection of the left circumflex coronary artery following a fall from height. To our knowledge, this is the first time that a traumatic lesion of the left circumflex artery is being reported after a fall. PMID:18388049

Dounis, George B; Rentoukas, Elias I; Mandila, Christina G; Papanikolaou, John G; Matsakas, Evangelos P; Karabinis, Andreas P

188

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

189

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. PMID:24339527

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

2013-01-01

190

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

PubMed Central

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

Thang, Sue Ping; Ng, David Chee Eng

2014-01-01

191

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

192

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

193

A Novel Approach to the Dissection of the Human Knee  

NSDL National Science Digital Library

This article describes an alternate technique to dissecting the human knee in a cadaver lab. The purpose behind the procedure is to allow for maximal visualization of intra-articular structures that are typically removed early in dissection. This technique modernizes the dissection to allow for students to visualize structures that they would see during a knee replacement surgery.

Michael Schumaker (Youngstown Orthopedics)

2009-02-01

194

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

PubMed Central

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

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

2014-01-01

195

Young male survivor of a spontaneous left main coronary artery dissection treated with surgery  

PubMed Central

Spontaneous dissection of the coronary arteries is a rare disease with a wide range of clinical presentations ranging from angina to myocardial infarction (MI); its pathophysiology has not yet been fully established. In this paper, we present the case of a 31-year-old male with an acute coronary syndrome. The initial results of the electrocardiogram and cardiac enzymes were consistent with MI. However, a coronary angio-tomography revealed a dissection of the left main coronary artery and the patient underwent emergent surgery with coronary artery bypass grafting. The treatment of spontaneous dissection of the coronary arteries depends on the anatomical location and the patient's clinical presentation. Coronary revascularization is associated with good results. PMID:24964467

Endara, Santiago A.; Ayala, Andres V.; Davalos, Gerardo A.; Moscoso, Juan; Montero, R. Alejandra

2013-01-01

196

Delayed retrograde type A aortic dissection after endografting of descending thoracic aorta.  

PubMed

We report a case of a delayed retrograde dissection occurred after endovascular repair of ruptured type B aortic dissection. A 75-year-old male, presented with acute hemothorax and aortic arch fissuration. He was successfully treated with descending aorta and aortic arch stenting. After six days, he developed retrograde type A dissection with aortic root involvement and aortic valve incompetence. The entire ascending aorta and the ventral part of the arch were successfully replaced by a composite graft; in addition, aortic valve was replaced with prosthesis. Patient had an uncomplicated course and radiologic follow-up at one month revealed a sealed fissuration and no signs of endoleak. Endovascular repair of acute ruptured aorta, although life saving may be associated with potentially lethal complications, and it requires close monitoring with prolonged hospital stay to recognize and treat promptly these fatal complications. PMID:21485604

Tiwari, K K; Mariani, M; Murzi, M; Glauber, M

2010-01-01

197

Shoulder function after selective and superselective neck dissections: clinical and functional outcomes.  

PubMed

The aim of this work is to assess the clinical and functional outcome of patients who underwent different types of neck dissection, with special regards to the spinal accessory nerve, trapezius muscle and shoulder function. From February 2008 to July 2010, we evaluated 17 cases of neck dissection in patients affected by laryngeal carcinoma clinically staged N0. We performed selective neck dissection (IIA-IIBIII- IV) in 11 cases (group A) and superselective neck dissection in 6 cases (group B). All patients underwent clinical examination before surgery to evaluate shoulder function. They also underwent functional evaluation of the spinal accessory nerve through electromyography (study of muscular activity) and electroneurography (study of motor action potential). Patients were evaluated before surgery (T0), 8 days after surgery (T1) and 21 days after surgery (T2). In all cases, at the end of surgery it was possible to assess the integrity of the spinal accessory nerve. The average value of the MAP was 13.06 in group A and 10.98 in group B at T0. Eight days after surgery (T1) the value of MAP was reduced to 1.35 in group A and 6.15 in group B. Electromyography evaluation showed signs of denervation in 6 cases in group A and in 2 cases in group B. Voluntary activity was not detectable in 6 cases in group A, while it was present, even if reduced, in all cases in group B. At 21 days after surgery (T2), we found a value of MAP of 1.03 in group A and 6.43 in group B. Electromyography showed signs of denervation in 10 patients in group A and in 3 cases in group B. Voluntary activity was not detectable in 10 cases in group A, while it was present in all cases in group B. The arm abduction test was 2.5 in group A and 4.0 in group B. Neck dissection quality of life questionnaire showed a value of 24.17 in group A and a value of 25.5 in group B. Our data thus confirm that surgical manipulation of the nerve may be associated with severe impairment of nerve conduction when sublevel IIB is involved in the dissection. PMID:23349556

Giordano, L; Sarandria, D; Fabiano, B; Del Carro, U; Bussi, M

2012-12-01

198

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

ERIC Educational Resources Information Center

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

Akpan, Joseph; Strayer, Jeremy

2010-01-01

199

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. PMID:24518983

Siggs, Owen M

2014-01-01

200

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

PubMed

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

Dunne, Jonathan A

2014-12-01

201

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

PubMed Central

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

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

2014-01-01

202

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

203

Mutations in TGFBR2 gene cause spontaneous cervical artery dissection.  

PubMed

Mutations in the genes encoding transforming growth factor ? receptors 1 and 2 (TGFBR1 and TGFBR2) have recently been associated with hereditary connective tissue disorders with widespread vascular involvement, including arterial dissection. To determine whether mutations in these genes cause spontaneous cervical artery dissection (sCAD), all coding exons of TGFBR1 and TGFBR2 were sequenced in 56 consecutive patients with sCAD. Novel TGFBR2 disease causing mutations were found in two patients. The two mutations were the pK327R substitution affecting the kinase domain of TGFBR2 and the pC138R substitution falling in the extracellular domain of the protein, involved in TGF? binding and signalling. No TGFBR1 mutation was found. The findings indicate that TGFBR2 gene mutations are responsible for sCAD in 3.6% (95% CI 0.0 to 8.4) of cases, have implications in understanding the role of TGF? signalling in the pathogenesis of sCAD and emphasise the importance of considering molecular characterisation of the TGFBR2 gene in these patients, regardless of the presence of clinical features suggestive of hereditary connective tissue disorders. PMID:21270064

Pezzini, Alessandro; Drera, Bruno; Del Zotto, Elisabetta; Ritelli, Marco; Carletti, Monica; Tomelleri, Gianpaolo; Bovi, Paolo; Giossi, Alessia; Volonghi, Irene; Costa, Paolo; Magoni, Mauro; Padovani, Alessandro; Barlati, Sergio; Colombi, Marina

2011-12-01

204

Student attitudes toward cadaveric dissection at a UK medical school.  

PubMed

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 cadaver and secondly, the extent to which gender, anxiety, exposure to dissection, bereavement and prior experience of a dead body influenced these attitudes. Attitudes toward dissection were assessed by of levels of agreement toward eleven statements and by selection of adjectives describing possible feelings toward dissection. Students were asked about recent bereavement, whether they had seen a dead body prior to starting their course and exposure to dissection when completing the questionnaire. Validated instruments were used to measure disposition toward generalized anxiety (Hospital Anxiety and Depression Scale) and toward death anxiety (Collett-Lester Death Anxiety Scale). Between 60% and 94% of students held positive attitudes toward the process of dissection and over 70% of students selected 2 or fewer negative adjectives. Students' attitudes toward the personhood of the cadaver were more disparate. Disposition toward anxiety (particularly death anxiety), and exposure to dissection, influenced attitudes. Female gender and recent bereavement exerted a negative influence. Students with higher levels of anxiety experienced more negative feelings and those recently bereaved were less enthusiastic about dissection. Anticipation of dissection may be worse than reality. Sensitive preparation of students prior to entering the dissecting room for the first time may be beneficial. PMID:21656918

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

2011-01-01

205

CRITICAL NOTICES 227 Critical Notices  

E-print Network

CRITICAL NOTICES 227 Critical Notices Critical Scientific Realism. ILKKA NIINILUOTO. Oxford: Oxford, there remain problems for realists to tackle if they are to demonstrate that the position is coherent. Critical

Chakravartty, Anjan

206

Complex intimal flaps in acute aortic dissection  

Microsoft Academic Search

A 43-year-old man was emergently admitted and diagnosed as acute aortic dissection (Stanford type A). While being prepared\\u000a for emergent operation he fell into hemodynamic hazard with repeated ventricular fibrillation and loss of consciousness. Massive\\u000a aortic regurgitation and coronary disturbance due to a back-and-forth movement of an intimal flap through the aortic valve\\u000a were the causes of the cardiogenic catastrophy.

Shinji Akishima; Junichi Sakurai; Tomoaki Jikuya

2003-01-01

207

Block data distribution for parallel nested dissection  

SciTech Connect

In this paper, we consider the problem of data partitioning for block sparse Cholesky factorization on distributed memory MIMD computers. We propose a preprocessing algorithm which computes and distributes a column block partition based on an initial partition induced by a nested dissection ordering. This preprocessing algorithm works by optimizing load balancing under precedence constraints and communication traffic. It can be performed in linear time and space complexities.

Charrier, P.; Facq, L.; Roman, J. [Universite Bordeaux, Talence (France)

1995-12-01

208

NOTICE: This paper, Intersection homology with field coefficients: K-Witt spaces and K-Witt bordism, contains an error in the characteristic 2 case. A copy of the Corrigendum  

E-print Network

NOTICE: This paper, Intersection homology with field coefficients: K-Witt spaces and K-Witt bordism, contains an error in the characteristic 2 case. A copy of the Corrigendum and follow-up work in K-Witt homology with field coefficients: K-Witt spaces and K-Witt bordism Greg Friedman Texas Christian University

Friedman, Greg

209

Open fenestration for complicated acute aortic B dissection  

PubMed Central

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

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

2014-01-01

210

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. PMID:23940445

Colak, Necmettin; Nazli, Yunus; Alpay, Mehmet Fatih; Akkaya, Ismail Olgun; Aksoy, Omer Nuri; Akgedik, Sukran; Cakir, Omer

2013-01-01

211

Metabolic Signature of Electrosurgical Liver Dissection  

PubMed Central

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

von 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

212

MRI and MR angiography of vertebral artery dissection  

Microsoft Academic Search

A review of 4,500 angiograms yielded 11 patients with dissection of the vertebral arteries who had MRI and (in 4 patients)\\u000a MR angiography (MRA) in the acute phase of stroke. One patient with incidental discovery at arteriography of asymptomatic\\u000a vertebral artery dissection and two patients with acute strokes with MRI and MRA findings consistent with vertebral artery\\u000a dissection were included.

M. Mascalchi; M. C. Bianchi; S. Mangiafico; G. Ferrito; M. Puglioli; E. Marin; S. Mugnai; R. Canapicchi; N. Quilici; D. Inzitari

1997-01-01

213

Orientation to dissection: Assisting students through the transition.  

PubMed

Human dissection continues to be strongly argued for teaching human anatomy to medical students and is technically and emotionally demanding. An orientation to dissection and the laboratory are provided for students before beginning their work because students' and families' reactions to dissection are often complex. This study explored medical students' experiences of attending an orientation to human dissection and the anatomy laboratory. Students' reactions, feelings, and thoughts were enquired about 1 year after beginning dissection at the University of Auckland, New Zealand. Qualitative research methods, specifically one-on-one semistructured interview were utilized. Third-year medical students self-selected into the study and were interviewed 1 year after entering the laboratory. Transcribed audiotapes of the interviews were analyzed for themes across the interviews. One year after dissection students have vivid memories with differing ways of viewing the body that may help or hinder with dissection. The themes presented include orientation, student anticipation, psychological approach to the body, normalizing-continuing disquiet, and social reference. The orientation eases student entry into the laboratory. There can be ongoing feelings of ambivalence regards the body for some students. Novel findings include that students not only have their own feelings to deal with but also those of friends and family who question them and may feel uncomfortable with the idea of them dissecting. Even one year after beginning dissection, students may emotionally struggle with their work and may require further support, including how they talk about sensitive topics with other people. PMID:21815220

Lamdin, R; Weller, J; Kerse, N

2012-03-01

214

20 CFR 404.904 - Notice of the initial determination.  

Code of Federal Regulations, 2013 CFR

...SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE...notice will explain in simple and clear language what we have determined and the reasons...notice also will contain in understandable language a statement of the case setting...

2013-04-01

215

20 CFR 404.904 - Notice of the initial determination.  

...SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE...notice will explain in simple and clear language what we have determined and the reasons...notice also will contain in understandable language a statement of the case setting...

2014-04-01

216

20 CFR 404.904 - Notice of the initial determination.  

Code of Federal Regulations, 2011 CFR

...SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE...notice will explain in simple and clear language what we have determined and the reasons...notice also will contain in understandable language a statement of the case setting...

2011-04-01

217

20 CFR 404.904 - Notice of the initial determination.  

Code of Federal Regulations, 2010 CFR

...SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE...notice will explain in simple and clear language what we have determined and the reasons...notice also will contain in understandable language a statement of the case setting...

2010-04-01

218

20 CFR 404.904 - Notice of the initial determination.  

Code of Federal Regulations, 2012 CFR

...SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE...notice will explain in simple and clear language what we have determined and the reasons...notice also will contain in understandable language a statement of the case setting...

2012-04-01

219

76 FR 34974 - Cranberry Pipeline Corporation; Notice of Filing  

Federal Register 2010, 2011, 2012, 2013

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

2011-06-15

220

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

NASA Astrophysics Data System (ADS)

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

Milano, Regina Nicole

221

Spontaneous post-partum cervical carotid artery dissection in a patient with reversible cerebral vasoconstriction syndrome.  

PubMed

Post-partum cervicocephalic artery dissection (pp-CAD) is a rare and poorly understood condition. To our knowledge, only 21 cases have been reported. Reversible cerebral segmental vasoconstriction (RCSV) was first described by Call and Fleming in 1988, and its association with pp-CAD has only been reported in three cases. However, in those cases it is unclear whether the pp-CAD may have been caused by straining during labor and therefore merely coincidental to the intracranial arteriopathy. We describe a 41-year-old right-handed African-American woman who developed the syndrome of pp-CAD (headaches, trace subarachnoid hemorrhage and diffuse cerebral arteriopathy on angiogram) two weeks after delivery. In this unique case, the patient had fortuitously undergone an MR study twice over a four day period which included the carotid bifurcations. During that time the patient was an inpatient, on bed rest and subject to continuous cardiac monitoring. The interval studies documented a true spontaneous right internal carotid artery dissection occurring without obvious cause. The patient had noted moderate right neck pain developing between the two MR studies but experienced no neurological deficits. Subsequent conventional angiography confirmed the presence of postpartum cerebral arteriopathy and the cervical dissection. The patient was managed conservatively with antiplatelet medication and had an otherwise uneventful course. We hypothesize whether transient arterial wall abnormalities, postpartum hormonal changes or subtle connective tissue aberrations play a similar role in the pathogenesis of these two associated conditions. PMID:22192555

Soltanolkotabi, Maryam; Ansari, S A; Shaibani, A; Singer, T B; Hurley, M C

2011-12-01

222

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

PubMed

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

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

2014-10-31

223

Molecular Mechanisms of Thoracic Aortic Dissection  

PubMed Central

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

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

2013-01-01

224

Imaging Characteristics of Symptomatic Vertebral Artery Dissection: A Systematic Review  

PubMed Central

Background Vertebral artery dissection (VAD) is an important cause of stroke in the young. VAD can present with a range of imaging findings. We sought to summarize the diagnostic value of various imaging findings in patients with symptomatic VAD. Methods We conducted a systematic review of observational studies, searching electronic databases (MEDLINE, EMBASE) for English-language manuscripts with >5 subjects with clinical or radiological features of VAD. Two independent reviewers selected studies for inclusion; a third adjudicated differences. Studies were assessed for methodological quality and imaging data were abstracted. Pooled proportions were calculated. Results Of 3996 citations, we screened 511 manuscripts and selected 75 studies describing 1,972 VAD patients. Most studies utilized conventional angiography or magnetic resonance angiography (MRA) to diagnose VAD; CT angiography (CTA) and Doppler ultrasonography were described less frequently. Imaging findings reported were vertebral artery stenosis (51%), string and pearls (48%), arterial dilation (37%), arterial occlusion (36%), and pseudoaneurysm, double lumen, and intimal flap (22% each). In cases where conventional angiography was the reference standard, CTA was more sensitive (100%) than either MRA (77%) or Doppler ultrasonography (71%) (p=0.001). Conclusions Imaging findings vary widely in patients with VAD, with no single radiographic sign present in the majority of VAD patients. Non-specific radiographic signs predominate. CTA probably has greater sensitivity for dissection than MRA or ultrasound relative to conventional angiography. Higher quality studies on imaging techniques and radiographic criteria in subjects with VAD are needed. Future studies should compare imaging techniques in well-defined, undifferentiated populations of clinical VAD suspects. PMID:22931729

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

2013-01-01

225

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

PubMed Central

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

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

2012-01-01

226

[Familial thoracic aortic aneurysms and dissections can be divided into three different main categories].  

PubMed

Thoracic aortic aneurysms and dissections (TAAD) can be divided into three different main categories. 1. Inherited syndromes predisposing to TAAD such as Marfan syndrome, Ehlers-Danlos syndrome type IV and Loeys-Dietz syndrome (less than 5% of all TAAD). 2. Familial TAAD (FTAAD) with more than one affected family member (20 % of all TAAD). Inheritance shows an autosomal dominant pattern and there are no features of known syndromes. 3. Sporadic forms of TAAD with no family history or features of syndromic forms. FTAAD present earlier in life and dissections occur in smaller diameter than in sporadic cases. The underlying genetic cause can be found in about 20 % of the inherited cases. The pathogenesis seems to be an involvement of the transforming growth factor ? (TGF?) signaling pathway or a dysfunction of the smooth muscle cell contraction. The role of ?-blockers for aneurysm prevention is uncertain and there are on-going studies comparing angiotensin receptor blockers and ?-blockers. PMID:24570135

Hannuksela, Matias; Stattin, Eva-Lena; Nyberg, Peter; Carlberg, Bo

227

Acute type B aortic dissection and coarctation: open stent-graft elephant trunk.  

PubMed

We describe a case of acute type B dissection associated with coarctation of the aorta. An intimal tear was located just distal to the coarctation. Aortic dilatation started below the coarctation and extended to the level of the diaphragm. We performed descending aorta replacement from the distal aortic arch to the level of the 9(th) intercostal arteries, and implanted a stent-graft elephant trunk through a left posterior lateral thoracotomy in the 5(th) intercostal space off-pump. PMID:22718727

Sun, Hongtao; Qian, Xiangyang; Chang, Qian

2012-06-01

228

[Carotid dissection during angioplasty for vasospasm induced by subarachnoid haemorrhage. The use of multimodal cerebral monitoring].  

PubMed

We report the case of a 54-year-old woman presenting subarachnoid haemorrhage. She experienced multiple vasospasms and treatment included triple-H (hypervolaemia, hypertension, and haemodilution) and endovascular therapies. Right internal carotid dissection complicated angioplasty of the right middle cerebral artery. Combined brain tissue partial pressure of oxygen monitoring and transcranial echo-Doppler could have facilitated early diagnosis. Despite successful revascularization of right internal carotid by stenting, this complication caused acute stroke with refractory intracranial hypertension. PMID:19945247

Bordes, J; Boret, H; Prunet, B; Montcriol, A; Goutorbe, P

2009-12-01

229

Silent Pulmonary Artery Dissection in a patient with old Pulmonary Balloon Valvuloplasty  

PubMed Central

Percutaneous pulmonary balloon valvuloplasty (PBV) remains the treatment of choice for pulmonary stenosis (PS). This procedure is effective, safe and gives excellent results. Pulmonary artery (PA) dissection is a rare complication of PBV. This report is a case of an asymptomatic 17-year-old male with a history of PBV due to severe PS dating back to fifteen years ago. During recent echocardiography, an intimal flap was detected in the main PA and entry site was clearly seen by contrast study.

Nikparvar, Marzieh; Parsaee, Mozhgan; Maleki, Majid; Alizadehasl, Azin; Azarfarin, Rasoul

2014-01-01

230

Right aortic arch and Kommerell's diverticulum associated with acute aortic dissection and pericardial tamponade  

PubMed Central

The right-sided aorta associated with an aberrant left subclavian artery is a rare anomaly of the aortic branches in the upper mediastinum. We present a 62-year-old patient suffering from an acute dissection of the ascending aorta associated with hemopericardium. In this case, there was also aneurysmal dilatation of the origin of the left subclavian artery, known as diverticulum of Kommerell. PMID:23986854

Ebner, Lukas; Huber, Andreas; Christe, Andreas

2013-01-01

231

Hemolytic anemia after operation for aortic dissection using teflon felt strips.  

PubMed

We report three cases of hemolytic anemia caused by anastomotic stenosis after surgical treatment for aortic dissection in which internal and external Teflon (DuPont, Wilmington, DE) felt strips were used for reinforcement of the aortic stump. To detect this complication, laboratory findings typical of red cell fragmentation syndrome as well as appropriate imaging modalities are necessary. As a precaution, it is necessary to be meticulous when stitching the internal felt strip. PMID:18442587

Nakamura, Yuki; Ogino, Hitoshi; Matsuda, Hitoshi; Minatoya, Kenji; Sasaki, Hiroaki; Kitamura, Soichiro

2008-05-01

232

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

ERIC Educational Resources Information Center

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

Akpan, Joseph Paul; Andre, Thomas

1999-01-01

233

Cerebral Dissecting Aneurysms in Patients with Essential Thrombocythemia  

PubMed Central

The etiologies of intracranial artery dissection are various, the exogenous as well as inherited connective tissue disorders. We report on a patient who presented with diffuse subarachnoid hemorrhage who had been suffered from essential thrombocythemia. He was diagnosed to multiple dissecting aneurysms of left superior cerebellar artery, left posterior inferior cerebellar artery and right pericallosal artery and treated with endovascular coil embolization. PMID:25368771

Baek, Jin Wook

2014-01-01

234

Dissection Videos Do Not Improve Anatomy Examination Scores  

ERIC Educational Resources Information Center

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

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

2011-01-01

235

Geographic Dissection of the Twitter Network Juhi Kulshrestha Farshad Kooti  

E-print Network

Geographic Dissection of the Twitter Network Juhi Kulshrestha Farshad Kooti Max Planck Institute interactions occur online via social net- working sites like Twitter and Facebook, users can in- teract in online social networks? In this paper, we attempt to address this question by dissecting the Twitter so

Gummadi, Krishna P.

236

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

237

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

238

Supraomohyoid neck dissection in cancer of the oral cavity  

Microsoft Academic Search

Background: In oral cavity cancer, supraomohyoid neck dissection (SOHND) is becoming more popular for patients with N0 and N1 disease in the neck. The aim of this study was to assess the value of this surgical procedure.Methods: The study included 237 previously untreated patients with oral cavity cancer. The neck treatment consisted of SOHND or functional neck dissection (FND). One

Claire Majoufre; Alain Faucher; Carine Laroche; Camille De Bonfils; François Siberchicot; Jean-Louis Renaud-Salis; Jacques Pinsolle

1999-01-01

239

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

240

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. PMID:21493276

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

241

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

ERIC Educational Resources Information Center

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

Franklin, Sue; Peat, Mary; Lewis, Alison

2002-01-01

242

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

Federal Register 2010, 2011, 2012, 2013

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

2013-01-31

243

Pancreatic dissection in the procedure of pancreaticoduodenectomy (with videos).  

PubMed

The procedure of pancreaticoduodenectomy consists of three parts: resection, lymph node dissection, and reconstruction. A transection of the pancreas is commonly performed after a maneuver of the pancreatic head, exposing of the portal vein or lymph node dissection, and it should be confirmed as a safe method for pancreatic transection for decreasing the incidence of pancreatic fistula. However, there are only a few clinical trials with high levels of evidence for pancreatic surgery. In this report, we discuss the following issues: dissection of peripancreatic tissue, exposing the portal vein, pancreatic transection, dissection of the right hemicircle of the peri-superior mesenteric artery including plexus and lymph nodes, and dissection of the pancreatic parenchyma. PMID:22076671

Yamaue, Hiroki; Tani, Masaji; Kawai, Manabu; Hirono, Seiko; Okada, Ken-ichi; Miyazawa, Motoki

2012-03-01

244

Stent-coil treatment of a distal internal carotid artery dissecting pseudoaneurysm on a redundant loop by use of a flexible, dedicated nitinol intracranial stent.  

PubMed

Treatment of dissecting pseudoaneurysms of the distal cervical internal carotid artery with preservation of the parent artery by using stents or coils has become routine. Tortuosity remains a significant obstacle to successful endovascular treatment in some cases. We report the use of a stent-coil technique to treat a nonhealing dissecting pseudoaneurysm and associated stenosis with anatomic preservation of a redundant loop involving the stented arterial segment. This was accomplished by using a Neuroform dedicated intracranial stent. PMID:14970042

Pride, G Lee; Replogle, Robert E; Rappard, George; Graybeal, Christopher L Taylor Dion; White, Jonathan; Purdy, Phillip

2004-02-01

245

Conservative Management in a Young Woman Affected by Isolated Left Subclavian Artery Dissection  

PubMed Central

Subclavian Artery Dissection (SAD) is a rare condition, generally due to arterial catheterization, blunt trauma or connective tissue disease. Spontaneous or minimally traumatic cases have also been reported. Clinical manifestations are usually chest and/or back pain, pulse loss and paresthesia, whereas nausea, dizziness and vomiting are present in case of involvement of the vertebral artery. We report an unusual case of a young woman presenting isolated left SAD after traffic accident, minimally symptomatic, and treated with medical therapy alone. A conservative management and a closed follow-up appear to be a safe approach in patients affected by uncomplicated SAD without other comorbidities.

Alberto Pegorer, Matteo; Bissacco, Daniele; Di Gregorio, Sara; Dallatana, Raffaello; Settembrini, Piergiorgio

2014-01-01

246

PBS Learning Media: Cow's Eye Dissection  

NSDL National Science Digital Library

This video-based interactive activity gives users a close-up and fascinating view of the anatomy of a real cow eye as it is dissected by a teenage narrator. You'll get a view of the cornea, watch light refract through the extracted lens, see the retina from the inside, and more. The Flash movies are divided into 12 segments which may be stopped/started interactively. Each segment contains text information with vocabulary definitions in hover-over format. The resource also provides a diagram of the eye and detailed illustrations of how the eye refracts light and sends messages to the optic nerve. PBS Learning Media is a growing collection of 10,000+ free educational resources compiled by researchers and experienced teachers to promote the use of digital resources in the classroom.

2009-06-12

247

Endoscopic submucosal dissection for colorectal neoplasms  

PubMed Central

Endoscopic submucosal dissection (ESD) is an established therapeutic technique for the treatment of gastrointestinal neoplasms. Because it is typically completed as en bloc resection, this technique provides a complete specimen for precise pathological evaluation. On the other hand, ESD is not as widely applied in treating colorectal neoplasms as with gastric cancers, due to its technical difficulty, longer procedure time, and increased risk of perforation. However, some devices that facilitate ESD and improve the safety of the procedure have been recently reported, and the use of the technique has gradually spread worldwide. Endoscopists who begin to perform ESD need to recognize the indications of ESD, the technical issue involved in this procedure, and its associated complications. This review outlines the methods and certain types of devices used for colorectal ESD. PMID:25333002

Takamaru, Hiroyuki; Mori, Genki; Yamada, Masayoshi; Kinjo, Yuzuru; So, Eriko; Abe, Seiichiro; Otake, Yosuke; Nakajima, Takeshi; Matsuda, Takahisa; Saito, Yutaka

2014-01-01

248

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

ERIC Educational Resources Information Center

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

Kariuki, Patrick; Paulson, Ronda

249

Endovascular treatment of a carotid dissecting pseudoaneurysm in a patient with Ehlers-Danlos syndrome type IV with fatal outcome.  

PubMed

We present a patient with Ehlers-Danlos syndrome type IV (EDS IV) with a carotid dissecting pseudoaneurysm causing severe carotid stenosis. This lesion was treated endovascularly. Unfortunately, the patient died of remote vascular catastrophes (intracranial hemorrhage and abdominal aortic rupture). This unique case illustrates the perils of endovascular treatment of EDS IV patients and the need for preoperative screening for concomitant lesions. It also shows that a dissecting pseudoaneurysm can feasibly be treated with a covered stent and that closure is effective using Angioseal in patients with EDS IV. PMID:17687602

Lim, Siok Ping; Duddy, Martin J

2008-01-01

250

Left main coronary artery ostial repair with autologous ring-shaped aortic patch for iatrogenic aortic dissection.  

PubMed

Iatrogenic left main coronary artery and aortic root dissection are rare complications during coronary catheterization. A case of catheter-induced left main coronary artery dissection with subsequent retrograde progression into the ascending aorta wall is reported. The patient was surgically managed with an ascending aorta replacement and left coronary ostial repair with an autologuos aortic wall ring-shaped patch in the paraostial position in order to seal the intimal tear. doi: 10.1111/jocs.12446 (J Card Surg 2014;29:821-823). PMID:25269622

Barbero, Cristina; Di Rosa, Elio; Devotini, Roger; Attisani, Matteo; Rinaldi, Mauro

2014-11-01

251

Prevention of esophageal strictures after endoscopic submucosal dissection  

PubMed Central

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

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

2014-01-01

252

78 FR 17470 - Proposed Collection: Comment Request for Notice 2006-83  

Federal Register 2010, 2011, 2012, 2013

...concerning Notice 2006-83, Chapter 11 Bankruptcy Cases. DATES: Written comments should...SUPPLEMENTARY INFORMATION: Title: Chapter 11 Bankruptcy Cases. OMB Number: 1545-2033. Notice...2006-83. Abstract: The IRS needs bankruptcy estates and individual chapter 11...

2013-03-21

253

75 FR 5851 - Proposed Collection: Comment Request for Notice 2006-83  

Federal Register 2010, 2011, 2012, 2013

...concerning Notice 2006-83, Chapter 11 Bankruptcy Cases. DATES: Written comments should...SUPPLEMENTARY INFORMATION: Title: Chapter 11 Bankruptcy Cases. OMB Number: 1545-2033. Notice...2006-83. Abstract: The IRS needs bankruptcy estates and individual chapter 11...

2010-02-04

254

Iatrogenic Bidirectional Dissection of the Right Coronary Artery and the Ascending Aorta: The Worst Nightmare for an Interventional Cardiologist  

PubMed Central

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

Roule, Vincent; Lognone, Therese; Sabatier, Remi; Bignon, Mathieu; Malcor, Guillaume; Lemaitre, Adrien; Blanchart, Katrien; Wain-Hobson, Julien; Saplacan, Vladimir; Cutone, Fabio; Buklas, Dimitrios; Ivascau, Calin; Massetti, Massimo; Grollier, Gilles

2012-01-01

255

Endovascular Repair as a Bridge to Surgical Repair of an Aortobronchial Fistula Complicating Chronic Residual Aortic Dissection  

PubMed Central

Endovascular and open surgical repair have been used in patients with descending thoracic aortic dissection; however, the appropriate treatment is debated. We describe the case of a 60-year-old woman who had a symptomatic, chronic, residual, descending thoracic aortic dissection that was complicated by an aortobronchial fistula. She underwent emergent thoracic endovascular stent-grafting but remained symptomatic. Computed tomographic angiograms showed a contained rupture into the lower lobe of the left lung. The patient underwent definitive surgery to remove the stents, reconstruct the aorta, and resect the nonviable lung tissue. The remainder of her postoperative course was uneventful, and she was discharged from the hospital 13 days after the 2nd operation. Results of genetic testing confirmed an earlier presumptive diagnosis of Marfan syndrome. In an emergency, the best initial option for patients with a complicated descending thoracic aortic dissection might be thoracic endovascular aortic repair, which could serve as a bridge to definitive open repair. PMID:24808784

Matos, Jesus M.; de la Cruz, Kim I.; Ouzounian, Maral; Preventza, Ourania; LeMaire, Scott A.; Coselli, Joseph S.

2014-01-01

256

Training methods and models for colonoscopic insertion, endoscopic mucosal resection, and endoscopic submucosal dissection.  

PubMed

Colonoscopic examination is considered an effective examination for the detection of colorectal cancers. Additionally, early colorectal cancers can be resected using endoscopic techniques such as endoscopic mucosal resection and endoscopic submucosal dissection. However, those examinations and treatments need special techniques. Various training methods are practiced to acquire such endoscopic techniques throughout the world. In clinical cases, magnetic positioning devices help endoscopic insertion by less experienced endoscopists. There is a physical model made by polyvinyl chloride and a virtual simulator for training of colonoscopic insertion. Various techniques including a method to apply pressure to the abdomen and consideration for patient's pain can be trained using these models. In view of extensive training of endoscopic mucosal resection and endoscopic submucosal dissection, animal models are useful and actually used. Live animal models of minipig, which entails blood flow, are ideal and used frequently, but are cumbersome to prepare. On the other hand, ex vivo animal models using intestine of porcine and bovine are convenient for preparation and less expensive. Unique ex vivo animal models with blood flow have been developed recently and techniques for hemostasis can be practiced. With respect to a method of training for colorectal endoscopic submucosal dissection, a stepwise system has been adopted throughout the world. Thus, first they observe the expert's technique, then practice training of animal models, and finally, they perform clinical rectal cases. The system is useful for a safe and definite procedure. In this review, we reveal various training methods for colonoscopic examinations and treatments. PMID:25102984

Yoshida, Naohisa; Fernandopulle, Nilesh; Inada, Yutaka; Naito, Yuji; Itoh, Yoshito

2014-09-01

257

Is elective neck dissection indicated during salvage surgery for head and neck squamous cell carcinoma?  

PubMed

Among patients with head and neck squamous cell carcinoma with a negative neck who are initially treated with (chemo)radiotherapy, a number of cases will recur locally without obvious neck recurrence. There is little information available as to the most efficacious management of the neck in these cases. We have reviewed the literature to see what conclusions can be drawn from previous reports. We conducted a bibliography search on MEDLINE and EMBASE databases. Studies published in the English language and those on squamous cell carcinoma of the oral cavity, nasopharynx, oropharynx, larynx and hypopharynx were included. Data related to neck management were extracted from the articles. Twelve studies satisfied the inclusion criteria. Five studies reported only one treatment plan (either neck dissection or observation), while the others compared neck dissection to observation. The rate of occult metastases ranged from 3.4 to 12 %. The studies included a variable distribution of primary sites and stages of the recurrent primary tumors. The risk of occult neck node metastasis in a clinically rN0 patient correlated with tumor site and T stage. Observation of the neck can be suggested for patients with T1-2 glottic tumors, who recurred with less advanced tumors (rT1-2). For patients with more advanced laryngeal recurrences or recurrence at other high-risk sites, neck dissection could be considered for the rN0 patient, particularly if the neck was not included in the previous radiation fields. PMID:24515917

Sanabria, Alvaro; Silver, Carl E; Olsen, Kerry D; Medina, Jesus E; Hamoir, Marc; Paleri, Vinidh; Mondin, Vanni; Rinaldo, Alessandra; Rodrigo, Juan P; Suárez, Carlos; Boedeker, Carsten C; Hinni, Michael L; Kowalski, Luiz P; Teymoortash, Afshin; Werner, Jochen A; Takes, Robert P; Ferlito, Alfio

2014-12-01

258

[Carotid dissecting aneurysm due to blunt (rubbing) injury of the Kendo protector].  

PubMed

A case of dissecting aneurysm of the cervical internal carotid artery due to rare mechanism by non-penetrating injury is described. A 45-year-old right-handed man had complaints of the right lateral neck pain during exercise of KENDO wearing a tight headneck protector. Following sudden dysarthria and left hemiplegia, he developed loss of consciousness and generalized convulsion. Five hours after admission, he became alert and had no neurological deficits. Four days after these episodes, he loss visual acuity of the right eye, and a few days later he showed left hemiplegia, hypotension, hypersomnia and right-sides Horner's syndrome. Right retrograde brachial angiography revealed so-called "string sign" in the right extracranial internal carotid artery and delayed circulation in the right cerebral hemisphere. He was diagnosed as having traumatic dissecting aneurysm due to blunt (rubbing) injury. He was treated with STA-MCA anastomosis 3 weeks after the accident. Usually, carotid dissecting aneurysm due to blunt injury is produced by hyperextension and contralateral rotation of the neck or direct blow to the neck, but our case shows a possible mechanism of rubbing injury such as simple anteroposterior flexion under tight neck fixation. PMID:3951667

Sakai, H; Kaneko, D; Yuki, K; Nakamura, N

1986-01-01

259

[Cervical cord infarction associated with unilateral vertebral artery dissection due to golf swing].  

PubMed

A-68-year-old man experienced nuchal pain and bilateral shoulder weakness that occurred suddenly after he performed a golf swing. He was conscious. His cranial nerves were normal, but bilateral deltoid and biceps muscle strengths weakened. Magnetic resonance image (MRI) showed no brain stem infarctions or cervical epidural hematoma. We tentatively diagnosed him with concussion of the spinal cord because of mild recovery of his bilateral upper limb weakness after several hours; he was later discharged. The next day, he suddenly developed serious tetraplegia and was admitted to the emergency department. His breathing was controlled by a respirator as he had expectoration difficulty and respiratory muscle paralysis. A lesion in the cervical cord became apparent on MRI; the right vertebral artery was not detected on magnetic resonance angiography. Cervical MRI showed the intimal flap and a lack of flow void in the right vertebral artery. These findings revealed a right vertebral artery dissection. Cervical cord infarction due to unilateral vertebral artery dissection is rarer than posterior cerebral infarction due to the same pathogenesis; however, some such cases have been reported. We consider the present case to be caused by cervical cord infarction associated with unilateral vertebral artery dissection resulting from golf swing. PMID:24583591

Tokumoto, Kazuki; Ueda, Nobuhiko

2014-01-01

260

Raising the thinker: new concept for dissecting the cystic pedicle during laparoscopic cholecystectomy.  

PubMed

Imprecise dissection due to poor visualization of anatomic structures is among the major causes of biliary injuries during laparoscopic cholecystectomy. Developing new illustrational and rendering techniques represents an important part in decreasing visual deception and subsequent bile duct injuries. We use the model of one of the most well-known pieces of art, Rodin's The Thinker, to visualize the gallbladder and cystic pedicle structures. This minimizes visual deception before dissection, especially in cases with obscured structures. Our method, raising The Thinker, is based on the remarkable similarity between the sculpture and the topographic anatomy of the gallbladder. The method can be used not only for better orientation and visualization during laparoscopic cholecystectomy but also as a tool to complement the teaching of laparoscopic biliary anatomy to surgical residents and medical students. PMID:22184309

Neychev, Vladimir; Saldinger, Pierre F

2011-12-01

261

Spontaneous coronary artery dissection causing acute coronary syndrome in a young patient without risk factors  

PubMed Central

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction that is more common in younger patients (under age 50) and in women. Although the etiology is not known, some predisposing conditions to SCAD are well known and include Marfan syndrome, pregnancy and peripartum state, drug abuse, and some anatomical abnormalities of the coronary arteries such as aneurysms and severe kinking. We describe a case of SCAD in a young woman who presented with sudden onset of chest pain and was admitted for the treatment of acute coronary syndrome. The coronary angiography showed dissection of the left anterior descending artery. The patient underwent successful percutaneous transluminal coronary angioplasty and stent placement.

Chevli, Parag; Kelash, Fnu; Gadhvi, Pragnesh; Grandhi, Sreeram; Syed, Amer

2014-01-01

262

Aortic dissection type A after right atrial cryoablation during port access mitral valve surgery.  

PubMed

The case of a 63-year-old woman who underwent minimal invasive mitral and tricuspid valve repair and a concomitant CryoMaze is described. During creation of the last lesion of the right-sided maze procedure, dissection of the ascending aorta occurred that necessitated emergency sternotomy, replacement of the ascending aorta, and aortocoronary bypass grafting to the right coronary artery (RCA) because of detachment of the RCA from the aortic annulus. Repair of this complication was successful; nevertheless, the patient died 5 days after the operation because of multiorgan failure. The cause of this complication can only be speculated, but a relation to the CyroMaze is obvious. Because of the restricted incision with impaired vision especially in the area of the right atrial appendage, the cryoprobe could have come into contact with the orifice of the RCA during the last lesion, with subsequent detachment of the RCA from the aorta, which could subsequently have caused dissection. PMID:23274873

Fleck, Tatjana; Dworschak, Martin; Wisser, Wilfried

2012-01-01

263

[Spontaneous intramural intracranial artery dissection and ischemic stroke].  

PubMed

Spontaneous intracranial artery dissection (SIAD), leading to occlusion or stenosis of arterial lumen is a frequent but less studied cause of ischemic stroke especially in young adults. We studied 17 patients (10 men, 7 women, mean age 27.5 +/- 8.5 years) with SIAD. All the patients have undergone magnetic resonance imaging of the head, magnetic resonance angiography (MRA) (in 16 patients--follow-up MRA), 1 patient--conventional cerebral angiography. SIAD was located in the middle cerebral artery (MCA, 14 patients); posterior cerebral artery (PCA, 2 patients) and basilar artery (BA, 1 patient). Fifteen patients (88%) with SIAD developed ischemic stroke, 2 patients (12%)--a transient ischemic attack (TIA). The appearance of the local brain ischemia symptoms was combined with headache in 93% cases. The course of ischemic stroke was favorable in most cases with complete or good functional recovery in 66% of patients. A fatal outcome was observed in 1 patient (7%) with massive brain infarct. The initial cerebral angiography carried out in most cases (76%) within 3 weeks after the disease onset revealed occlusion (71%) or stenosis (29%) of corresponding cerebral arteries (MCA, PCA, BA). The last cerebral angiography conducted in 90% cases 4,5 months or later showed positive dynamics--appearance or improvement of the blood flow in these arteries--in 82% patients. The factors provoking SIAD were alcohol, contraceptive drugs and less frequent recent infection. None of patients had atherosclerosis, vasculitis or arterial hypertension. Clinical manifestations of connective tissue weakness were in 71% of patients, hypotension--65%, mitral valve prolapse--46%. In conclusion, SIAD is one of the causes of ischemic stroke and TIA in young adults and characteristic clinical manifestations and follow-up MRA have a great diagnostic importance. The development of SIAD appears to be related to weakness of connective tissue of arterial wall. PMID:18196622

Kalashnikova, L A; Konovalov, R N; Krotenkova, M V

2006-01-01

264

Endovascular interventional therapy and classification of vertebral artery dissecting aneurysms  

PubMed Central

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

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

2014-01-01

265

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

Federal Register 2010, 2011, 2012, 2013

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

2011-01-25

266

Aortic dissection one year after aortic valve replacement.  

PubMed

Acute aortic dissection after aortic valve replacement is rare. A 57-year-old man presented with an acute type A aortic dissection 1 year after aortic valve replacement, which originated from the previous aortotomy site. He underwent a Bentall procedure. Postoperatively, he developed complete heart block requiring permanent pacemaker implantation. During aortic valve replacement, risk factors for aortic dissection (diameter of the aorta and fragility and thinness of the aortic wall) should be assessed. Prophylactic aortic root replacement should be undertaken if the aortic root is more than 45?mm in diameter. PMID:24887849

Behranwala, Ali Asgar; Handa, Shyam R; Mehta, Nihar P

2014-11-01

267

Neck dissection with cervical sensory preservation in thyroid cancer  

PubMed Central

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

Xue, Shuai; Wang, Peisong

2013-01-01

268

A patient with altered mental status and possible seizure reveals an atypical aortic dissection upon workup.  

PubMed

Aortic dissection occurs when a tear occurs in the inner muscle wall lining of the aorta, allowing blood to split the muscle layers of the aortic wall apart. It is classically characterized by pain that starts in the upper chest, which then radiates to the upper back and is tearing or ripping in quality. Our objective is to present a case followed by a brief literature review of aortic dissection and uncommon but important features that may be demonstrated. In this report, we present the case of a 57-year-old woman who was transported to the emergency department with an acute episode of altered mental status, presenting as a possible stroke with possible seizures. The patient's only complaint was mild low back pain. Physical examination revealed disorientation to time with no other neurologic deficits or abnormal findings. Results from initial noncontrast head computed tomography, chest radiograph, and laboratory studies were all normal, except for an elevated D-dimer and serum creatinine. Chest computed tomography with contrast demonstrated a type A aortic dissection. The patient was taken emergently to the operating room where the aortic valve and a portion of the ascending aorta were replaced. The patient did well and was discharged from the hospital 5 days later without any permanent sequalae. Aortic dissection is both rare and life threatening and may present with atypical signs. It is important to note that patients may show no signs of typical features or may even display other symptoms based on other branches from the aorta that have been occluded. PMID:24360026

Lawal, Olufolahan J; Dhindsa, Harinder S; Loyd, Joshua W

2014-05-01

269

[Familial aortic dissection of non-Marfan syndrome with mutations in the transforming growth factor-beta receptor type 1 genes].  

PubMed

Marfan syndrome is an inherited connective tissue disorder with ocular, skeletal and cardiovascular systems and often causes acute aortic dissection. Interestingly, there have been several reports of familial thoracic aortic dissection in patients with autosomal dominant diseases without Marfan syndrome. Variation of the transforming growth factor-beta receptor (TGFBR) gene is reported to be one of the causes. We report a case of a familial aortic dissection not associated with Marfan syndrome, with mutation of TGFBR type 1. Hereditary aortic dissection of the non-Marfan syndrome that does not have clinical manifestations is not uncommon. Thus, the existence of familial aortic aneurysm should be in mind in diagnosis and treatment. PMID:21387612

Suzuki, Ryo; Mikamo, Akihito; Kurazumi, Hiroshi; Sato, Masafumi; Ikeda, Yoshitaka; Shirasawa, Bungo; Hamano, Kimikazu

2011-02-01

270

Cervical artery dissection goes frequently undiagnosed.  

PubMed

Cervical artery dissection (CeAD) is a frequent cause of stroke among young patients. It is unclear how many CeADs occur asymptomatically or cause subtle and unspecific clinical symptoms. We hypothesize that CeAD remains often unrecognized. Accordingly, the incidence of CeAD might be higher and the stroke risk lower than generally assumed. Lack of CeAD-indicating clinical symptoms is regarded as the main cause of missed diagnoses. We further hypothesize that underrepresentation of asymptomatic and oligosymptomatic patients in CeAD studies may have biased the association between ischemia and local symptoms in CeAD patients as well as the associations of CeAD with risk factors or co-morbidities. We finally hypothesize that symptomatic CeAD may be preceded by an initial asymptomatic phase. According to this final hypothesis, the time of onset of CeAD should be considered uncertain. The issue of unrecognized CeAD is relevant, as it may affect the associations between CeAD and putative risk factors. Furthermore, the existence of clinically silent CeADs may explain why recurrent and familial CeAD have been rarely observed. PMID:23562286

Grond-Ginsbach, Caspar; Metso, Tiina M; Metso, Antti J; Pezzini, Alessandro; Tatlisumak, Turgut; Hakimi, Maani; Grau, Armin J; Kloss, Manja; Lichy, Christoph

2013-06-01

271

Blunt scissors stromal dissection technique for deep anterior lamellar keratoplasty  

PubMed Central

Objective We describe a modified technique for performing lamellar dissection in deep anterior lamellar keratoplasty after failure to achieve a “big bubble” detachment of Descemet’s membrane (DM) with deep intrastromal pneumatic injection. Methods The technique utilizes blunt lamellar dissection with blunt-tipped corneal mini scissors as an alternative to a crescent blade, which can be difficult for surgeons to master and is associated with a high risk of perforation. Results Other techniques of blunt dissection, such as the Melles technique, cannot be utilized after failure to achieve a big bubble, as emphysema in the stroma prevents visualization of the spatula. In contrast, our blunt scissors lamellar dissection technique takes advantage of the emphysema and microdetachments of DM created by the pneumatic injection. Conclusion This technique provides deep anterior lamellar keratoplasty surgeons with a simple, alternative method of baring DM or achieving a pre-DM plane with minimal residual stroma, after failure to achieve a big bubble. PMID:25258506

Anwar, Didar S; Kruger, Matthew M; Mootha, V Vinod

2014-01-01

272

Dissection Videos Do Not Improve Anatomy Examination Scores  

NSDL National Science Digital Library

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

Waqas Mahmud (Rawalpindi Medical College Anatomy); Omar Hyder (Rawalpindi Medical College Obstetrics and Gynecology); Jamaal Butt (Rawalpindi Medical College Anatomy); Arsalan Aftab (Rawalpindi Medical College Anatomy)

2011-01-03

273

Evaluation of characteristics, associations and clinical course of isolated spontaneous renal artery dissection  

PubMed Central

Background Spontaneous renal artery dissection (SRAD) is a rare entity of unknown etiology. We aimed to study the clinical course and outcomes and compare the characteristics of patients with SRAD with those of the general population. Methods All cases of isolated renal artery dissection diagnosed at the University of Michigan Hospitals between January 2000 and July 2012 were identified by the ICD-9 code. Cases were matched by age, gender and race with individuals from the 2009–2010 National Health and Nutrition Examination Survey (NHANES). Characteristics and awareness of comorbid conditions were compared. Information about the clinical course after diagnosis was retrieved from the case group to ascertain their outcomes. Results Overall, 17 patients with SRAD with a mean age of 38.6 years (SD = 8.3) were identified. Eleven patients were male and 14 were white. The most common presenting symptom was excruciating sudden-onset flank pain ipsilateral to the site of dissection. Fibromuscular dysplasia, Ehlers–Danlos and polyarteritis nodosa were present in 4, 4 and 1 patients, respectively. After adjusting in a multivariable model, the case group was more likely to report history of hypertension, cancer and connective tissue disorders (P < 0.001), and less likely to have obesity (BMI ?30 kg/m2) compared with the general population. Supportive medical treatment, endovascular intervention and surgery were required in 8, 5 and 4 cases, respectively. After discharge from the hospital, hypertension was adequately controlled in all the patients but one. Conclusion SRAD may be part of a syndrome having multi-organ involvement. With appropriate medical or surgical management, long-term clinical outcome appears favorable. PMID:23563282

Afshinnia, Farsad; Sundaram, Baskaran; Rao, Panduranga; Stanley, James; Bitzer, Markus

2013-01-01

274

Reassessment of the coronal incision and subgaleal dissection for foreheadplasty.  

PubMed

Thirty years ago, the aging upper face was generally ignored by surgeons performing facial rejuvenation surgery. Ultimately, the coronal incision forehead lift technique became an accepted procedure, with most surgeons raising the forehead flap at the subgaleal plane. These surgeons found the subgaleal plane to be the "natural" or most accessible dissection plane to use, and it continues to be the most commonly used dissection plane for foreheadplasty today. However, some surgeons have begun to advocate using the subperiosteal plane, and controversy surrounds the question of which dissection plane is more surgically sound for raising a forehead flap. On the basis of 25 fresh cadaver dissections and more than 20 years of clinical experience with foreheadplasty, the author concludes that dissection done at the subperiosteal rather than the subgaleal plane provides greater benefit to the patient. Although both subgaleal and subperiosteal planes can provide relative ease of dissection, elevation of the forehead flap at the subperiosteal plane can maximally preserve blood supply for the forehead flap and predictably preserve long-term frontoparietal scalp sensation. The deep division of the supraorbital nerve, which provides sensation to the frontoparietal scalp, is placed at risk for transection with subgaleal elevation of the forehead flap. The skin incision approach chosen for the forehead flap can also affect postoperative frontoparietal scalp sensation. The deep division of the supraorbital nerve will always be transected by a coronal incision approach for forehead flap elevation, with dissection done at either the subgaleal or the subperiosteal level. Only limited scalp incisions placed to avoid the course of the deep division of the supraorbital nerve can avoid transecting this nerve, and only subperiosteal dissection of the forehead flap can predictably preserve this nerve while elevating the forehead flap. PMID:9703089

Knize, D M

1998-08-01

275

Surgery for aortic dissection associated with congenital bicuspid aortic valve  

Microsoft Academic Search

Congenital bicuspid aortic valve is a relatively rare malformation. It is reported that the presence of this anomaly predisposes\\u000a the patient to the development of dissecting aortic aneurysms. Between 1981 and October 1997, 7 patients with aortic dissection\\u000a associated with congenital bicuspid aortic valve underwent surgical treatment at our institution. The patients consisted of\\u000a six males and one female. The

Motomi Ando; Yutaka Okita; Ritsu Matsukawa; Shinichi Takamoto

1998-01-01

276

The surgical treatment for acute aortic dissection —A retrospective study from the statistics of affiliated hospital of a medical school—  

Microsoft Academic Search

A retrospective study was conducted for the surgical treatment on acute aortic dissection among the cardiovascular services\\u000a of 5 affiliated hospital of a medical school. The total of 74 cases were operated for the last 5 yers period from Jan., 1991\\u000a to Dec, 1995, in which 64 cases were classified as Type A and 10 for Type B. The average

Nobuyuki Nakajima; Hiroshi Watanabe; Yoshiharu Takahara; Shigeaki Uemura; Hirokazu Murayama; Shigeyasu Takeuchi

1998-01-01

277

Dissecting Aneurysm of Vertebral Artery Manifestating as Contralateral Abducens Nerve Palsy  

PubMed Central

Isolated abducens nerve paresis related to ruptured vertebral artery (VA) aneurysm is rare. It usually occurs bilaterally or ipsilaterally to the pathologic lesions. We report the case of a contralateral sixth nerve palsy following ruptured dissecting VA aneurysm. A 38-year-old man was admitted for the evaluation of a 6-day history of headache. Abnormalities were not seen on initial computed tomography (CT). On admission, the patient was alert and no signs reflecting neurologic deficits were noted. Time of flight magnetic resonance angiography revealed a fusiform dilatation of the right VA involving origin of the posterior inferior cerebellar artery. The patient suddenly suffered from severe headache with diplopia the day before the scheduled cerebral angiography. Neurologic examination disclosed nuchal rigidity and isolated left abducens nerve palsy. Emergent CT scan showed high density in the basal and prepontine cistern compatible with ruptured aneurismal hemorrhage. Right vertebral angiography illustrated a right VA dissecting aneurysm with prominent displaced vertebrobasilar artery to inferiorly on left side. Double-stent placement was conducted for the treatment of ruptured dissecting VA aneurysm. No diffusion restriction signals were observed in follow-up magnetic resonance imaging of the brain stem. Eleven weeks later, full recovery of left sixth nerve palsy was documented photographically. In conclusion, isolated contralateral abducens nerve palsy associated with ruptured VA aneurysm may develop due to direct nerve compression by displaced verterobasilar artery triggered by primary thick clot in the prepontine cistern. PMID:23634273

Jeon, Jin Sue; Son, Young-Je; Chung, Young Seob

2013-01-01

278

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

SciTech Connect

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

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

2009-05-15

279

A Method of Transoral Finger Dissection for a Giant Epiglottic Lipoma  

PubMed Central

Background. Subcutaneous lipomas that occur in the trunk and proximal extremities are commonly dissected by low-invasive method. However, a standard surgical method for lipomas of the epiglottis has been absent. Microscopic laryngeal surgery is appropriate to extirpate small epiglottic lipomas. However, microscopic laryngeal surgery may be insufficient for giant epiglottic lipomas because there is restricted visualization of the operating field of the tumor under the microscope. Furthermore, microscopic surgical instruments are very small to manipulate giant lipomas, and it would be excessive to approach these lipomas via external cervical incisions. Case Presentation. A 57-year-old female presented with a giant lipoma on the lingual surface of the epiglottis. Following a tracheotomy, microscopic surgery was inadequate to manipulate the epiglottic lipoma. Instead, we performed macroscopic surgery in which the epiglottic lipoma was pulled into the oral cavity with forceps and then separated from the surrounding tissues using the surgeon's finger to dissect the tumor en bloc. Conclusion. The low-invasive method of transoral finger dissection enabled the giant lipoma to be extirpated without leaving any remnants or causing excessive epiglottic damage.

Yane, Katsunari; Yamanaka, Toshiaki; Kitahara, Tadashi

2014-01-01

280

Classic Dissection of Thoracic Aorta Complicated by Ascending Aortic Intramural Hematoma: Promt Diagnosis and Successful Endovascular Repair  

PubMed Central

We reported a case of 68-year-old man, with a previous history of hypertension. Patient was admitted to our institution for evaluation of a severe, constant, tearing anterior chest pain radiated to the neck with suspicion of acute aortic dissection. A multidetector computed tomography scan of thorax and abdomen demonstrated a dissection starting from the middle part of aortic arch and extending downward to the descending aorta till the middle part of the thoracic aorta. The dissection was classified as Stanford A, De Bakey I. Surgical treatment of patient was started with bypass graft from the right common carotid artery to the left common carotid with subsequent revascularization of left subclavian artery. Lower parts of above-mentioned arteries were ligated. At the second stage an emergent prosthetic stent-graft was placed distally from the truncus brachiocephalicus up to the proximal part of the descending aorta. We reported a case report to present diagnostic and possible interventional treatment for patient with acute aortic type A dissection. PMID:22291714

Rackauskas, Gediminas; Mataciunas, Mindaugas; Misonis, Nerijus; Zakarkaite, Diana; Gutauskas, Marijus; Bilkis, Valdas; Tamosiunas, Algirdas Edvardas; Serpytis, Pranas; Laucevicius, Aleksandras

2012-01-01

281

Differential findings in post-factum dissections of medieval Korean mummies exhibiting similar preservation patterns on computerized tomography images.  

PubMed

In our previous CT and post-factum dissection studies on medieval Korean mummies, well preserved internal organs generally were found to have been displaced to the dorsal side of the body cavity. This movement seems to have been caused by the effect of gravitational force exerted over long burial durations. However, when we recently examined a newly discovered medieval Korean mummy (SN1-2) by CT, most of the mummified organs were found to have remained in their natural positions. Our post-factum dissection of SN1-2 showed that the organs might have undergone expansion by posthumous gas formation, after which they hardened into a stone-like state, which mitigated against their displacement. Similar CT findings were made in the case of a second Korean mummy (KU-1). Since the internal organs within the thoracic cavity were discovered to be in their natural positions, we suspected that they, like those in the case of SN1-2, had also been changed into stony structures. However, the post-factum dissection showed that the internal organs of KU-1 had neither hardened nor been displaced to the back wall of the thoracic cavity, owing possibly to the presence of a pleural adhesion. Overall, our results indicated that CT alone might be inadequate for correct estimation of the preservation status of internal organs in Korean mummies. This calls for further accumulation of dissection data, against which CT diagnoses can be compared and by which they can be improved. PMID:21444196

Oh, Chang Seok; Lee, Sang Yoon; Lee, In Sun; Kim, Yi-Suk; Koh, Ki Seok; Shin, Dong Hoon

2011-12-20

282

Open surgical repair for chronic type B aortic dissection: a systematic review  

PubMed Central

Background The treatment of chronic type B aortic dissection (CBAD) remains complicated. Thoracic endovascular aortic repair (TEVAR) has supplanted open surgical repair (OSR) as the preferred surgical treatment for CBAD. Despite TEVAR’s superior short-term results, much less is understood about its long-term outcomes. As much of the understanding of OSR originates from historical report, contemporary series, with modern surgical techniques and technologies, may present an alternative to TEVAR. The present systematic review will assess the short- and long-term outcomes of historic and contemporary series of OSR for CBAD. Methods Electronic searches were performed using six databases from their inception to March 2014. Relevant studies with OSRs for chronic type B dissection were identified. Data were extracted by two independent reviewers and analyzed according to predefined clinical endpoints. Studies were sub-classified into the pre-endovascular (historic series) and endovascular era (contemporary series) depending on whether the majority of cases were performed after 1999. Results Nineteen studies were identified for inclusion for quantitative analysis. Pooled short-term mortality was 11.1% overall, and 7.5% in the nine contemporary studies. Stroke, spinal cord ischemia, renal dysfunction, and reoperation for bleeding were 5.9%, 4.9%, 8.1%, and 8.1%, respectively, for the contemporary series. Absolute late reintervention was identified in 13.3% of patients overall, and in 11.3% of patients in the contemporary series. Aggregated survival at 1-, 3-, 5-, and 10-years of all patients were 82.1%, 74.1%, 66.3%, and 50.8%, respectively. Conclusions OSR for chronic type B dissection in the contemporary era offers acceptable results. Management approaches should be considered carefully, taking into account both short-term and long-term complications. More research is required to clarify specific indications for OSR and TEVAR in chronic type B dissections. PMID:25133097

Tian, David H.; De Silva, Ramesh P.; Wang, Tom

2014-01-01

283

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

NASA Astrophysics Data System (ADS)

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

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

2007-02-01

284

[Intramammary lymph node sentinel metastasis without metastasis in axilla. Axillary lymph node dissection or conservative surgery?].  

PubMed

The sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM) sentinel lymph node (SLN) occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation. PMID:23288226

Vieira, René Aloisio da Costa; Viviani, Dionísio Nepomuceno; Ferreira, Suellen Strada; Bailão, Antônio; Kerr, Ligia Maria; Matthes, Angelo Gustavo Zucca; Moriguchi, Sonia Marta

2012-10-01

285

Clinical stage B non-seminomatous germ cell testis cancer: The Indiana University experience (1965–1989) using routine primary retroperitoneal lymph node dissection  

Microsoft Academic Search

Between 1965 and 1989, 1180 patients at Indiana University, U.S.A., underwent retroperitoneal lymph node dissection (RPLND) for non-seminomatous germ cell (NSGC) testis cancer of whom 638 cases had primary RPLND. A subset of 174 cases were considered clinical stage B (or II) before surgery (retroperitoneal nodal metastases by clinical staging). Surgery revealed that 23% (n = 41) had pathological stage

J. P. Donohue; J. A. Thornhill; R. S. Foster; R. G. Rowland; R. Bihrle

1995-01-01

286

Long-term outcomes in thoracoabdominal aortic aneurysm repair for chronic type B dissection  

PubMed Central

Introduction Open repair for chronic aortic dissection remains a challenging surgical option. Different centers report diverse experiences and outcomes pertaining to thoracoabdominal aortic aneurysm repair (TAAAR) for chronic type B dissection. We highlight our center’s experience and results on a background of published literature and current evidence. Methods We reviewed 214 open TAAAR performed between October 1998 and February 2014. Of these, chronic type B dissection was present in 62 (29.0%) patients. We reviewed these patients in terms of demographics, operative characteristics and outcomes. Thirteen (21.0%) patients had surgery on the descending thoracic aorta [Category A =2 (3.2%), B =0 (0%), C =11 (17.7%)] and 49 (79.0%) in the thoracoabdominal thoracic aorta [Crawford extent I =5 (8.1%), extent II =39 (62.9%), extent III =4 (6.5%), extent IV =1 (1.6%)]. Left heart bypass was used in 12 (19.4%) patients. Results The composite in-hospital endpoint, adverse outcome—defined as operative death, renal failure necessitating dialysis at discharge, stroke, or permanent paraplegia or paraparesis—occurred after 28 (45.2%) procedures. There were 14 (22.6%) operative deaths. In-hospital mortality was seven (16.3%) out of 43 elective patients, and increased to seven (36.8%) of the 19 non-elective ones. Permanent paraplegia or paraparesis occurred after two (3.2%) cases, stroke occurred after seven (11.3%) and renal failure requiring dialysis occurred after 16 (25.8%). Mean follow-up time was 3.2 years and actuarial 5-year mortality was 27.4% [nine (14.5%) elective and eight (12.9%) non-elective patients]. Conclusions TAAAR in chronic type B dissection carries a substantial risk of early adverse outcomes. The results could be well alleviated with cases directed towards specialized regional and supra-regional centers. Although the endovascular approaches offer relatively low mortality and morbidity, there is a lack of long-term data and guidelines on their use. There is a need for a multidisciplinary international registry on the management of thoracoabdominal aortic aneurysms and dissection. This would provide a degree of guidance on relevant clinical and surgical judgments and outcomes. PMID:25133101

Bashir, Mohamad; Shaw, Matthew; Fok, Matthew; Harrington, Deborah; Field, Mark; Kuduvalli, Manoj

2014-01-01

287

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

SciTech Connect

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

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

1996-03-01

288

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

PubMed Central

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

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

2013-01-01

289

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

PubMed Central

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

2013-01-01

290

Computed Tomography of Aortic Wall Calcifications in Aortic Dissection Patients  

PubMed Central

Objectives To investigate the frequency of aortic calcifications at the outer edge of the false lumen and the frequency of fully circular aortic calcifications in a consecutive series of patients with aortic dissection who underwent contrast-enhanced CT. Methods The study population compromised of 69 consecutive subjects aged 60 years and older with a contrast-enhanced CT scan demonstrating an aortic dissection. All CT scans were evaluated for the frequency of aortic calcifications at the outer edge of the false lumen and the frequency of fully circular aortic calcifications by two experienced observers. Between observer reliability was evaluated by using Cohen’s Kappa. Differences between groups were tested using unpaired T test and Chi-square test. Results Presumed media calcifications were observed in 22 (32%) patients of 60 years and older and were found more frequently in chronic aortic dissection (N?=?12/23, 52%) than in acute aortic dissection (N?=?10/46, 22%). Conclusion As the intima has been torn away by the aortic dissection it is highly likely that CT scans can visualize the calcifications in the tunica media of the aorta. PMID:25003993

de Jong, Pim A.; Hellings, Willem E.; Takx, Richard A. P.; Isgum, Ivana; van Herwaarden, Joost A.; Mali, Willem P. Th. M.

2014-01-01

291

Left main coronary artery compression syndrome and spontaneous coronary artery dissection: coincidence or pathologic association?  

PubMed

Left main coronary artery compression syndrome (LMCS) in patients with severe pulmonary arterial hypertension (PAH) is an unusual, and often a missed cause of exertional angina. Spontaneous coronary dissection (SCD) is a rare cause of acute coronary syndrome of unknown etiology, with predilection to women in the 20s-40s. Weather the co-presence of LMCS and SCD in certain patients is a coincidence or of pathological significance is not known. The optimal management strategy of each of these conditions remains controversial. We report a case of SCD in a patient with PAH and LMCS, successfully treated with conservative medical therapy. PMID:24751338

Alkhouli, Mohamad; Huda, Nazmul; Bashir, Riyaz; Patil, Pravin; O'Murchu, Brian

2014-01-01

292

Painless hypoglossal palsy as an isolated symptom of spontaneous carotid dissection.  

PubMed

Spontaneous internal carotid artery dissection (sICAD) occurs annually in 2.5 to 3 per 100,000 presenting with signs of ischemic events in the majority of cases. In contrast, lower cranial nerve palsy due to peripheral nerve affection is seldom the presenting clinical sign. In symptomatic cases (>90%), sICAD is most commonly accompanied by local pain. We report a case of a 49-year old woman with a left sICAD presenting with isolated ipsilateral hypoglossal palsy as the sole clinical sign. Compared to other cases, local pain was absent and other cranial nerves were not affected. Further, sICAD could not be detected in repeated Doppler-/Duplex-sonography, but magnetic resonance imaging and MR-angiography only. PMID:24794948

Hennings, J M; Hoehn, D; Schumann-Spaeth, E; Weber, F

2014-08-01

293

The Relationship between Tension and Length of the Aortic Adventitia Resected from the Aortic Wall of Acute Aortic Dissection  

PubMed Central

Objective: To our knowledge, no previous study has described the measurement of the tensile strength of the human aortic adventitia. In the present study, we examined the relationship between the tension and length of the aortic adventitia resected from the aortic wall of patients with acute aortic dissection. Methods: We obtained rectangular specimens from the aortic adventitia that was resected in patients with acute aortic dissection during surgery. The specimens were placed on a tension meter (Digital Force Gauge FGS-10, SHIMPO, Kyoto, Japan) within 15 min after resection and stretched until they were pulled apart, and the tension and length were recorded. Results: We obtained 18 specimens during surgery from 11 cases of acute aortic dissection. When the specimen was being pulled apart, the mean tension recorded was 10.2 ± 4.9 N/cm specimen width, whereas the mean elongated length recorded was 4.2 ± 1.1 mm/cm specimen length. Discussion: We determined that the aortic adventitia is elastic and expandable up to 140% of its original length. This indicates that dilation of the aorta to >4.2 cm in diameter may result in a rupture if the original aortic diameter prior to dissection was 3 cm. (*English translation of J Jpn Coll Angiol 2013; 53: 77-81) PMID:25298826

Kitano, Mitsuru; Teranishi, Hiroo; Kudo, Masahumi; Matsuura, Makoto

2014-01-01

294

[Formaldehyde exposure levels and exposure control measures during an anatomy dissecting course].  

PubMed

The evaporation of formaldehyde from cadavers can produce high exposures among students and instructors. A possible causal role for formaldehyde has been considered likely for tumor of the nasopharynx and the nasal cavities in human beings. Due to this reason, Japan Ministry of Education, Culture, Sports, Science and Technology (MEXT) has set a guideline, which includes--decrease in gaseous formaldehyde in gross anatomy dissection laboratories and a guide to medical students about the toxicity of formaldehyde and protective method to avoid damages to skin, mucous, membrane, etc, in 2002. To understand what effective plans should be regarding the awareness of students about this notification, this study measured the gaseous formaldehyde concentrations in the anatomy dissection room and also analyzed the formaldehyde-related symptoms, and frequency of using protective measures. The study was conducted over a period of 3 months during the anatomy dissection exercise. We found that immediately after removing the cadavers' plastic covering, formaldehyde concentrations in the dissection room increased sharply. The concentration reached a peak point of 0.62 ppm after 10 minutes of starting of the class. This was much above the recommended level of 0.5 ppm set by Japan Society for Occupational Health. After 30 minutes of achieving the peak the formaldehyde level started decreasing gradually to a level of 0.11 ppm. Formaldehyde-related symptoms were observed in 59% of students. They had experienced symptoms of irritation of eyes, nose, throat, airways, skin, and headache during the course. Ocular discomfort was found significantly higher in the contact lenses users compared to the spectacle users or the normal eye sight group. Although, the guidelines about toxicity of formaldehyde and its protective measures to prevent damages to skin, mucous membrane etc. were informed to every student, only 52% of the students used both the mask containing activated carbon and the rubber gloves in every practical class without fail. Environmental Health Criteria 89 of International Program of Chemical Safety states, "It must be regarded that formaldehyde fluid is not absorbed directly into tissues through the skin". So the students may be allowed in some cases to touch the cadaver, treated by formaldehyde content fixative, by bare hands to understand the feel of certain organs and tissues. These results support that the rules of health supervision including necessity to use of protective measures, monitoring of indoor air formaldehyde etc. should be adhered by students and instructors in anatomy dissection room during the practical class. PMID:12833854

Tanaka, Kazuko; Nishiyama, Keiji; Yaginuma, Hiroyuki; Sasaki, Akihiko; Maeda, Takahumi; Kaneko, Sin-ya; Onami, Tetsuo; Tanaka, Masatoshi

2003-06-01

295

Acute subdural hematoma following halo pin tightening in a patient with bilateral vertebral artery dissection.  

PubMed

We report the first case of acute subdural hematoma (SDH) developing after tightening the halo of an osteoporotic 61-year-old woman on warfarin therapy for bilateral traumatic vertebral artery dissection. We discuss literature relevant to this case with an emphasis on identifying warning signs, including recurrent pin loosening, especially in patients with compromised bone structure and high risk of bleeding. Our 61-year-old patient presented to neurosurgery clinic for a 2-month follow-up of a type-III odontoid fracture sustained in a motor vehicle accident. The patient had repeatedly loosened halo pins, and shortly after the pins were tightened, the patient had a syncopal event and struck her head. An emergent computed tomography scan revealed acute SDH requiring emergent craniotomy and evacuation. SDH following pin penetration in a patient with bilateral vertebral artery dissection, osteoporosis, and anticoagulation has not been reported as a complication of the use of the halo vest for stabilization of the cervical spine. The risk of this serious complication can be minimized by giving special consideration to patients with comorbidities and by repositioning problematic pins. This case demonstrates the importance of special attention to bone strength, bleeding risk, and recurrent minor complaints with use of the halo vest. PMID:22989701

Medhkour, A; Massie, L; Horn, M

2012-12-01

296

The birth and evolution of neuroscience through cadaveric dissection.  

PubMed

Although interest in the art of dissection and vivisection has waxed and waned throughout the ages, the past century has seen it accepted as commonplace in medical schools across the country. No other practice in medicine has contributed more to the understanding of neuroanatomy and the neurosciences as dissection of the human cadaver, the origins of which are widely documented to have been in Alexandrian Greece. This article chronicles the fascinating and often controversial use of dissection and vivisection in these fields through the ages, beginning with Herophilus of Alexandria, among the first systematic dissectors in the history of Western medicine. The authors comment on its role in the development of modern neurosurgery and conclude with remarks about use of this educational tool today in the United States. PMID:20657312

Moon, Karam; Filis, Andreas K; Cohen, Alan R

2010-09-01

297

Digital dissection system for medical school anatomy training  

NASA Astrophysics Data System (ADS)

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

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

2003-05-01

298

Spontaneous coronary artery dissection in a patient with bacterial meningitis.  

PubMed

A 40-year-old man was admitted to our hospital because of the acute onset of fever and headache, which were attributed to bacterial meningitis. Antibiotic treatment was initiated and his condition gradually improved. On day 5 after admission, immediately after masturbation, he developed abrupt onset of severe chest pain and cold sweat and the ECG suggested acute anterior myocardial infarction. Immediate coronary angiography revealed spontaneous dissection of the left anterior descending artery. After conservative management, his cardiac function improved. Acute coronary syndrome may be rarely caused by spontaneous coronary artery dissection. Sepsis was considered as a probable trigger for spontaneous coronary artery dissection, possibly through vascular damage from increased nitric oxide and sympathetic nervous over-activation. PMID:24194165

Kinoshita, Kensuke; Tsunoda, Yoshiya; Watanabe, Shigeyuki; Tokuda, Yasuharu

2013-01-01

299

Lymph node dissection in radical resection for carcinoma of the head of the pancreas and periampullary region.  

PubMed

Resected specimens from 41 cases of carcinoma of the head of the pancreas or the periampullary region and autopsy specimens from 16 patients with recurrence were examined for lymph node metastasis. Evidence demonstrating the need for dissection and removal of specific lymph node groups in pancreatoduodenectomy or total pancreatectomy was discussed. These include the common hepatic and celiac groups, the superior mesenteric group, the jejunal group located in the mesentery of the proximal portion of the jejunum, and the retropancreatic group located behind the uncinate process. Metastasis to these groups was found even in cases where the carcinoma was considered small. In carcinoma of the head of the pancreas, metastasis to the peripancreatic lymph nodes was seen more widely. Therefore, total pancreatectomy with lymph node dissection is desirable for this disease. PMID:6887557

Ozaki, H; Kishi, K

1983-06-01

300

Adjustable dissection and surgical table as an aid to teaching.  

PubMed

An adjustable dissection and surgical table for teaching residents, fellows, staff, and other medical and allied health personnel about anatomy and simulated techniques of surgery in the laboratory setting is described. The table can be attached to a standard House-Urban temporal bone dissection bench. The temporal bone laboratory can thus serve a dual purpose in teaching ear and soft tissue anatomy and surgical techniques of the head and neck. In this setting such a dual purpose laboratory can often include basic and clinical research activities as a third function. PMID:3339939

Work, W P

1988-02-01

301

Questionable necessity to remove the submandibular gland in neck dissection.  

PubMed

Saliva is of major importance in taste, speech, swallowing, and protection against dental caries. Neck dissection surgery and/or radiotherapy may impair the function of the submandibular glands. Over the years, there has been a trend toward more conservative approaches to neck dissection. Metastasis to the submandibular gland itself is extremely rare and if removal of the lymph nodes of sublevel IB is imperative, it seems feasible to preserve the submandibular gland, unless it is involved by direct tumor extension of the primary tumor or the adjacent metastatic lymph nodes. Clinical studies to validate this concept are needed. PMID:20629090

Takes, Robert P; Robbins, K Thomas; Woolgar, Julia A; Rinaldo, Alessandra; Silver, Carl E; Olofsson, Jan; Ferlito, Alfio

2011-05-01

302

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

Federal Register 2010, 2011, 2012, 2013

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

2013-03-21

303

Evaluation of MorphologyNet as a Virtual Dissection Experience  

Microsoft Academic Search

As technological developments in the field of medical imaging increase at an exponential rate, literally hundreds of researchers and clinicians are generating three- dimensional visualizations of anatomical structures for use in research and disease diagnosis. But virtual dissection experiences (VDEs) can also be valuable for and appealing to the current video-game generation of K-16 students, and may well stimulate student

Jennifer Leopold; Anne Maglia

304

Rectilinear Glass-Cut Dissections of Rectangles to Squares  

E-print Network

Rectilinear Glass-Cut Dissections of Rectangles to Squares Jurek Czyzowicz§ czyzowic is made using only rectilinear glass-cuts, i.e., vertical or horizontal straight-line cuts separating pieces into two. 1 Introduction A glass-cut of a rectangle is a cut by a straight-line segment

Urrutia, Jorge

305

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

E-print Network

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

Govindjee

306

Fibromuscular Dysplasia May Herald Symptomatic Recurrence of Cervical Artery Dissection  

Microsoft Academic Search

Background: The prevalence of fibromuscular dysplasia (FMD) in patients with cervical artery dissection (CAD) is unknown. Our objectives were to assess the risk of CAD recurring as a stroke or a transient ischemic attack and the association of these events with FMD. Methods: We prospectively included and followed 103 consecutive patients who had been admitted for a CAD. The median

J. M. de Bray; G. Marc; V. Pautot; B. Vielle; A. Pasco; P. Lhoste; F. Dubas

2007-01-01

307

Prototyping Dissection Puzzles with Layered Manufacturing Carlo H. Squin  

E-print Network

Deposition Modeling (FDM) machine. 2. Helicoidal Dissections In the fall of 2011, I decided to experiment be used to train students' spatial understanding and to teach geometrical modeling as well as some used as class exercises in a graduate course on computer-aided solid modeling: Helicoidal sectioning

Sequin, Carlo H.

308

The Effect of Ultrasound Dissection in Thyroid Surgery  

Microsoft Academic Search

Background: One of the most important aspects of thyroid surgery is hemostasis. The ultrasonically activated scalpel is described as a very useful instrument in thyroid surgery for the dissection and sealing of vessels. Our study compares the short-term results of endocrine surgery, with and without the use of ultrasonic devices. Methods: In a prospectively randomized trial, 96 patients with endemic

K. Witzel; B. H. A. von Rahden; H. J. Stein

2009-01-01

309

Gastric Wall Dissection as a Complication of Percutaneous Gastrostomy  

SciTech Connect

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

Reimer, Wolfgang; Farres, Maria Teresa; Lammer, Johannes [Department of Radiology, Division of Angiography and Interventional Radiology, University of Vienna, AKH, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

1996-04-15

310

Photoreceptor degeneration: genetic and mechanistic dissection of a complex trait  

Microsoft Academic Search

The retina provides exquisitely sensitive vision that relies on the integrity of a uniquely vulnerable cell, the photoreceptor (PR). The genetic and mechanistic causes of retinal degeneration due to PR cell death — which occurs in conditions such as retinitis pigmentosa and age-related macular degeneration — are being successfully dissected. Over one hundred loci, some containing common variants but most

Christina F. Chakarova; Mai M. Abd El-Aziz; Alan F. Wright; Shomi S. Bhattacharya

2010-01-01

311

Using Small Molecules To Dissect Mechanisms of Microbial Pathogenesis  

E-print Network

Using Small Molecules To Dissect Mechanisms of Microbial Pathogenesis Aaron W. Puri and Matthew of the infection cycle, small molecules that modulate or monitor enzyme activity levels are ideal tools for study- proaches to study pathogenesis. In addition to being used to perturb protein function, small molecule

Bogyo, Matthew

312

The Influence of Emotion on Students' Performance in Dissection Exercises  

ERIC Educational Resources Information Center

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

Holstermann, Nina; Grube, Dietmar; Bogeholz, Susanne

2009-01-01

313

Mutations in myosin light chain kinase cause familial aortic dissections.  

PubMed

Mutations in smooth muscle cell (SMC)-specific isoforms of ?-actin and ?-myosin heavy chain, two major components of the SMC contractile unit, cause familial thoracic aortic aneurysms leading to acute aortic dissections (FTAAD). To investigate whether mutations in the kinase that controls SMC contractile function (myosin light chain kinase [MYLK]) cause FTAAD, we sequenced MYLK by using DNA from 193 affected probands from unrelated FTAAD families. One nonsense and four missense variants were identified in MYLK and were not present in matched controls. Two variants, p.R1480X (c.4438C>T) and p.S1759P (c.5275T>C), segregated with aortic dissections in two families with a maximum LOD score of 2.1, providing evidence of linkage of these rare variants to the disease (p = 0.0009). Both families demonstrated a similar phenotype characterized by presentation with an acute aortic dissection with little to no enlargement of the aorta. The p.R1480X mutation leads to a truncated protein lacking the kinase and calmodulin binding domains, and p.S1759P alters amino acids in the ?-helix of the calmodulin binding sequence, which disrupts kinase binding to calmodulin and reduces kinase activity in vitro. Furthermore, mice with SMC-specific knockdown of Mylk demonstrate altered gene expression and pathology consistent with medial degeneration of the aorta. Thus, genetic and functional studies support the conclusion that heterozygous loss-of-function mutations in MYLK are associated with aortic dissections. PMID:21055718

Wang, Li; Guo, Dong-chuan; Cao, Jiumei; Gong, Limin; Kamm, Kristine E; Regalado, Ellen; Li, Li; Shete, Sanjay; He, Wei-Qi; Zhu, Min-Sheng; Offermanns, Stephan; Gilchrist, Dawna; Elefteriades, John; Stull, James T; Milewicz, Dianna M

2010-11-12

314

Mutations in Myosin Light Chain Kinase Cause Familial Aortic Dissections  

PubMed Central

Mutations in smooth muscle cell (SMC)-specific isoforms of ?-actin and ?-myosin heavy chain, two major components of the SMC contractile unit, cause familial thoracic aortic aneurysms leading to acute aortic dissections (FTAAD). To investigate whether mutations in the kinase that controls SMC contractile function (myosin light chain kinase [MYLK]) cause FTAAD, we sequenced MYLK by using DNA from 193 affected probands from unrelated FTAAD families. One nonsense and four missense variants were identified in MYLK and were not present in matched controls. Two variants, p.R1480X (c.4438C>T) and p.S1759P (c.5275T>C), segregated with aortic dissections in two families with a maximum LOD score of 2.1, providing evidence of linkage of these rare variants to the disease (p = 0.0009). Both families demonstrated a similar phenotype characterized by presentation with an acute aortic dissection with little to no enlargement of the aorta. The p.R1480X mutation leads to a truncated protein lacking the kinase and calmodulin binding domains, and p.S1759P alters amino acids in the ?-helix of the calmodulin binding sequence, which disrupts kinase binding to calmodulin and reduces kinase activity in vitro. Furthermore, mice with SMC-specific knockdown of Mylk demonstrate altered gene expression and pathology consistent with medial degeneration of the aorta. Thus, genetic and functional studies support the conclusion that heterozygous loss-of-function mutations in MYLK are associated with aortic dissections. PMID:21055718

Wang, Li; Guo, Dong-chuan; Cao, Jiumei; Gong, Limin; Kamm, Kristine E.; Regalado, Ellen; Li, Li; Shete, Sanjay; He, Wei-Qi; Zhu, Min-Sheng; Offermanns, Stephan; Gilchrist, Dawna; Elefteriades, John; Stull, James T.; Milewicz, Dianna M.

2010-01-01

315

Alternative paratracheal lymph node dissection in left-sided hilar lung cancer patients: comparing the number of lymph nodes dissected to the number of lymph nodes dissected in right-sided mediastinal dissections  

Microsoft Academic Search

Objective: Removing or sampling lymph nodes from the bilateral paratracheal area through a left thoracotomy is not a standard procedure in patients with lung cancer. The aim of this study was to evaluate the feasibility of a technique without ductus arteriosus division and mobilization of the aortic arch and to compare the number of lymph nodes resected in left-sided dissections

Alper Toker; Serhan Tanju; Sedat Ziyade; Serkan Kaya; Suat Erus; Berker Ozkan; Dilek Yilmazbayhan

2011-01-01

316

Digital dissection system for medical school anatomy training  

Microsoft Academic Search

As technology advances, new and innovative ways of viewing and visualizing the human body are developed. Medicine has benefited greatly from imaging modalities that provide ways for us to visualize anatomy that cannot be seen without invasive procedures. As long as medical procedures include invasive operations, students of anatomy will benefit from the cadaveric dissection experience. Teaching proper technique for

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

2003-01-01

317

Kendall Hunt Dissection of a Squid: Part 2  

NSDL National Science Digital Library

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

2012-01-01

318

Cancer Cell Dissecting the Unique Role of the Retinoblastoma  

E-print Network

Cancer Cell Article Dissecting the Unique Role of the Retinoblastoma Tumor Suppressor during-cycle control. However, cancer-associated mutations are almost exclusively found in RB, implying that RB has for cancer development; hence, the roles and regulation of RB have been intensively studied (reviewed

319

Neurovascular Bundle Decompression without Excessive Dissection for Tarsal Tunnel Syndrome.  

PubMed

Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the posterior tibial nerve and its branches in the tarsal tunnel. We present our less invasive surgical treatment of TTS in 69 patients (116 feet) and their clinical outcomes. The mean follow-up period was 64.6 months. With the patient under local anesthesia we use a microscope to perform sharp dissection of the flexor retinaculum and remove the connective tissues surrounding the posterior tibial nerve and vessels. To prevent postoperative adhesion and delayed neuropathy, decompression is performed to achieve symptom improvement without excessive dissection. Decompression is considered complete when the patient reports intraoperative symptom abatement and arterial pulsation is sufficient. The sensation of numbness and/or pain and of foreign substance adhesion was reduced in 92% and 95% of our patients, respectively. In self-assessments, 47 patients (68%) reported the treatment outcome as satisfactory, 15 (22%) as acceptable, and 7 (10%) were dissatisfied. Of 116 feet, 4 (3%) required re-operation, initial decompression was insufficient in 2 feet and further decompression was performed; in the other 2 feet improvement was achieved by decompression of the distal tarsal tunnel. Our surgical method involves neurovascular bundle decompression to obtain sufficient arterial pulsation. As we use local anesthesia, we can confirm symptom improvement intraoperatively, thereby avoiding unnecessary excessive dissection. Our method is simple, safe, and without detailed nerve dissection and it prevents postoperative adhesion. PMID:25367582

Kim, Kyongsong; Isu, Toyohiko; Morimoto, Daijiro; Sasamori, Toru; Sugawara, Atsushi; Chiba, Yasuhiro; Isobe, Masahiro; Kobayashi, Shiro; Morita, Akio

2014-11-15

320

Marquette University Gross Dissection Workshop - Upper & Lower Extremity  

NSDL National Science Digital Library

This website provides information regarding Marquette University's Gross Dissection of the Extremities workshop. The focus of the course is an intensive anatomy and kinesiology review. Even years this course focus on the lower extremity and the odd years the focus is on the upper extremity.

Marquette University (Marquette University)

2012-07-24

321

Dissection of Conformational Conversion Events during Prion Amyloid Fibril  

E-print Network

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

322

Dissection of the Hyperadhesive Phenotype of Airway Eosinophils in Asthma  

E-print Network

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

Mosher, Deane F.

323

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

ERIC Educational Resources Information Center

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

Lee, Yeung Chung

2004-01-01

324

A Novel Approach to the Dissection of the Human Knee  

ERIC Educational Resources Information Center

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

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

2009-01-01

325

Field safety notices released by manufacturers in cases of failure of products for infection testing: analysis of cases reported to the BfArM between 2005 and 2007.  

PubMed

The European Directive 98/79/EC for in vitro diagnostic medical devices (IVD) regulates marketing and post marketing surveillance of IVD in the European Economic Area. Manufacturers have to inform the responsible Competent Authorities (CA) about incidents and field safety corrective actions (FSCA) related to IVD. In Germany, the Federal Institute for Drugs and Medical Devices (BfArM) is the responsible CA for most IVD, only few IVD as specified in Annex II of the Directive are under the responsibility of the Paul Ehrlich Institute (PEI). In case of a FSCA manufacturers have to inform customers by means of a Field Safety Notice (FSN) which should be sent to BfArM prior to release and is published on the BfArM homepage. Between beginning of 2005 and end of 2007 the BfArM received a total of 1025 reports regarding IVD. From these, 38 related to tests, reagents, calibrators, and control materials for infection testing, 13 related to analysers and general consumables (n = 8 and n = 5, respectively) based on culture techniques, and 7 related to analysers and general consumables (n = 5 and n = 2, respectively) based on molecular biological methods. FSCA were performed in Germany in 32 (84.2%) of all notifications related to tests reagents, calibrators, and control materials as well as in 13 (100%) and 7 (100%) of notifications related to analysers and consumables based on culture techniques and molecular biological methods, respectively. A number of relevant deficiencies regarding the quality of the FSN were separately demonstrated for FSN in German and English language. In brief, manufacturers often sent their FSN to the BfArM with delay. Additionally, a subset of FSN provided insufficient information on the product related risks or the measures to be performed by the customer to mitigate product related risks. Furthermore, customer confirmation forms often were missing in the FSN sent to the BfArM. Our data suggest that for IVD for infection testing FSCA and FSN are frequently performed. For better vigilance performance, manufacturers could shorten the time until release and improve the contents of FSN to ensure the safety of IVD in cases of product related corrective actions. PMID:21147647

Siekmeier, R; Lisson, K; Wetzel, D

2010-11-01

326

[Leg Swelling following Inguinal and Ilioinguinal Dissection of Melanoma Metastases.  

PubMed

Background: With respect to survival and local disease control, the adequate extent of lymph node dissection for melanoma metastasis to the groin is controversial. Since the methods for accurate quantification of leg oedemas are not well standardised, it remains also unclear whether the iliac part of a radical ilioinguinal lymph node dissection contributes to postoperative lymphoedema. Patients and Methods: Using a questionnaire and clinical examinations, we prospectively studied 65?persons for the presence of leg swellings (11?with inguinal lymph node dissection (sCLND), 23?with ilioinguinal dissection (rCLND), and 31 without nodal surgery and without signs of venous insufficiency). Exact volumetry of the legs was performed using the Image 3 D method. Results: The mean interval between the lymphadenectomy and the examination for swellings was 24?±?30?months. Compared with sCLND, the amount of postoperative drainage fluid was significantly higher after rCLND (1960?±?1390 mL versus (vs.) 898?±?578 mL). Patients with rCLND perceived more frequently leg swellings (83 % vs. 55 %, p?= 0.09), however, also 23 % of the control persons perceived leg swellings. Clinical signs of swelling were found slightly more frequently in the rCLND group (52 % vs. 45 %). After rCLND, the gain in volume of the ipsilateral thigh was significantly higher than after sCLND (7.01?±?4.83 % vs. 1.29?±?6.12 %, p?= 0.01). Patients with rCLND more frequently needed manual lymph drainage (70 % vs. 45 %). In the control persons, the volumes of the right (mostly dominant) and the left legs did not differ significantly. Conclusions: Our results suggest that the iliac part of an ilioinguinal lymph node dissection significantly contributes to lymphoedema. Because of the multitude of reasons for swellings of the lower leg, volumetry of the thigh seems to be most adequate for quantifying the amount of postoperative lymphoedema. PMID:22511022

Pratsch, A L; Kretschmer, L

2012-04-17

327

Inadvertent left aorto-coronary dissection following percutaneous coronary intervention treated successfully by bail-out left main coronary artery stenting  

PubMed Central

Left main coronary artery (LMCA) dissection occurs very rarely following percutaneous coronary intervention (PCI). It caused major consequences with no flow in coronary artery and requires immediate surgical or percutaneous intervention. We are reporting a case of 42-year-male patient who presented with effort angina. Coronary angiogram revealed significant stenosis in left anterior descending (LAD) and left circumflex (LCX) coronary artery. During removal of angioplasty balloon and guide wire after successfully stenting in LAD and balloon angioplasty in LCX, guiding catheter induced dissection of LMCA was happened. Subsequently, LMCA was stented; kissing balloon dilatation was done at carina & TIMI III flow re-established. PMID:24027361

Badnur, Srinivas C.; Nagesh, Chamrajnagar Mahadevappa; Patra, Soumya; Reddy, Babu; Manjunath, Cholenahally Nanjappa

2013-01-01

328

Genetic Variants in FBN-1 and Risk for Thoracic Aortic Aneurysm and Dissection  

PubMed Central

Objectives A recent genome wide association study (GWAS) by LeMaire et al. found that two single nucleotide polymorphisms (SNPs), rs2118181 and rs10519177 in the FBN-1 gene (encoding Fibrillin-1), were associated with thoracic aortic dissection (TAD), non-dissecting thoracic aortic aneurysm (TAA), and thoracic aortic aneurysm or dissection (TAAD); the largest effect was observed for the association of rs2118181 with TAD. We investigated whether rs2118181 and rs10519177 were associated with TAD, TAA, and TAAD in the Yale study. Methods The genotypes of rs2118181 and rs10519177 were determined for participants in the Yale study: 637 TAAD cases (140 TAD, 497 TAA) and 275 controls from the United States, Hungary, and Greece. The association of the genotypes with TAD, TAA and TAAD were assessed using logistic regression models adjusted for sex, age, study center and hypertension. Results and Conclusions In the Yale study, rs2118181 was associated with TAD: compared with non-carriers, carriers of the risk allele had an unadjusted odds ratio for TAD of 1.80 (95% CI 1.15–2.80) and they had odds ratio for TAD of 1.87 (95% CI 1.09–3.20) after adjusting for sex, age, study center and hypertension. We did not find significant differences in aortic size, a potential confounder for TAD, between rs2118181 risk variant carriers and non-carriers: mean aortic size was 5.56 (95% CI: 5.37–5.73) for risk variant carriers (CC+CT) and was 5.48 (95% CI: 5.36–5.61) for noncarriers (TT) (p?=?0.56). rs2118181 was not associated with TAA or TAAD. rs10519177 was not associated with TAD, TAA, or TAAD in the Yale study. Thus, the Yale study provided further support for the association of the FBN-1 rs2118181SNP with TAD. PMID:24743685

Iakoubova, Olga A.; Tong, Carmen H.; Rowland, Charles M.; Luke, May M.; Garcia, Veronica E.; Catanese, Joseph J.; Moomiaie, Remo M.; Sotonyi, Peter; Ascady, Gyorgy; Nikas, Demitrios; Dedelias, Panagiotis; Tranquilli, Maryann; Elefteriades, John A.

2014-01-01

329

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

ERIC Educational Resources Information Center

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

De Villiers, Rian; Monk, Martin

2005-01-01

330

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

ERIC Educational Resources Information Center

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

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

2010-01-01

331

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

ERIC Educational Resources Information Center

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

Milano, Regina Nicole

2010-01-01

332

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

ERIC Educational Resources Information Center

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

Carlin, Joel L.

2010-01-01

333

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

ERIC Educational Resources Information Center

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

Fancovicova, Jana; Prokop, Pavol; Leskova, Andrea

2013-01-01

334

Increased Carotid Artery Stiffness Without Atherosclerotic Change in Patients With Aortic Dissection  

Microsoft Academic Search

The arterial properties and pathogenesis of aortic dissection remain obscure. To examine the arterial properties of patients with aortic dissection, the authors studied the ultrasonographic characteristics of the carotid artery in patients with an aortic dissection (AD, n=86), and compared these findings with data of patients suffering from arteriosclerosis obliterans (ASO, n=151), coronary artery disease (CAD, n=163), and with healthy

Shinji Makita; Atsushi Ohira; Yujiro Naganuma; Yoshiteru Moriai; Hiroyuki Niinuma; Akihiko Abiko; Katsuhiko Hiramori

2006-01-01

335

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

PubMed Central

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

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

2014-01-01

336

[Surgical correction of visceral-organ and lower-limb malperfusion syndrome in patients with aortic dissection].  

PubMed

The article deals with the experience gained in treatment of 28 patients presenting with type I and III aortic dissection (according to DeBakey) complicated by visceral-organ and lower-limb malperfusion syndrome. Those presenting with type I aortic dissection were subjected to reconstructive operations on the aortic arch as the first stage. The events of renal insufficiency and abdominal ischaemia were coped with and relieved using by-passing operations on the visceral branches - iliac-renal, ilac-renal-mesenteric by-pass grafting. In two cases in acute ischaemia of the lower limbs we performed aorto-bi-iliac prosthetic repair. In one case we revealed thrombosis of the iliac-renal by-pass, also performing iliac-renal re-do shunting. No other complications during surgical interventions were observed, neither were any lethal outcomes encountered. Bypassing operations on the visceral and renal arteries in patients with aortic dissection make it possible to eliminate both abdominal and renal ischaemia as well as malperfusion of lower extremities. PMID:23324633

Karpenko, A A; Cherniavski?, A M; Starodubtsev, V B; Cherniavski?, M A; Valentik, A V

2012-01-01

337

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

SciTech Connect

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

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

2007-06-15

338

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

PubMed

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

Hopper, Lm; Holmes, An; Williams, LE; Brosnan, Sf

2013-01-01

339

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

PubMed Central

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

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

2013-01-01

340

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

PubMed Central

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

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

2013-01-01

341

Aortic Dissection and Thrombosis Diagnosed by Emergency Ultrasound in a Patient with Leg Pain and Paralysis  

PubMed Central

The authors present a case of aortic dissection and abdominal aortic aneurysm thrombosis in a 78-year-old male who presented to the emergency department (ED) complaining of lower extremity and paralysis for the past 1.5 hours. The initial vital signs in the ED were as follows: blood pressure (BP) 132/88?mmHg, heart rate (HR) 96, respiratory rate (RR) 14, and an oxygen saturation of 94% at room air. Physical exam was notable for pale and cold left leg. The ED physician was unable to palpate or detect a Doppler signal in the left femoral artery. Bedside ultrasound was performed which showed non-pulsatile left femoral artery and limited flow on color Doppler. Abdominal aortic aneurysm screening ultrasound was performed showing a 4.99?cm infrarenal abdominal aortic aneurysm and an intra-aortic thrombus with an intimal flap. Vascular surgery was promptly contacted and the patient underwent emergent aorto-bi-femoral bypass, bilateral four compartment fasciotomy, right common femoral artery endarterectomy with profundoplasty, and subsequent left leg amputation. Emergency physicians should utilize bedside ultrasound in patients who present with risk factors or threatening signs and symptoms that may suggest aortic dissection or aneurysm. Bedside ultrasound decreases time to definitive treatment and the mortality of the patients. PMID:23431495

Tsung, Ann H.; Nickels, Leslie C.; De Portu, Giuliano; Flach, Eike F.; Stead, Latha Ganti

2013-01-01

342

High-energy drinks may provoke aortic dissection.  

PubMed

High-energy drinks have become extremely popular after Red Bull's promotion at 1987 in Austria and 1997 in the United States. Since then, we witnessed spectacular increase in different brands, caffeine content and market consumption all over the world. However, there are no reports published in the scientific literature related with detrimental side effects after heavy consumption of high-energy drinks. We report a series of three high-risk cardiovascular patients who had aortic dissection (De Bakey type I and II) following significant consumption of high-energy drinks. All of them required emergency surgical procedure and were remaining stable after surgery. We propose that uncontrolled consumption of high-energy drinks, especially in patients with underlying heart disease, could provoke potentially lethal cardiovascular events as well as acute aortic dissection. PMID:23914511

Jonjev, Zivojin S; Bala, Gustav

2013-05-01

343

Description, dissection, and subsampling of Apollo 14 core sample 14230  

NASA Technical Reports Server (NTRS)

Core sample 14230, collected at Triplet Crater near the Fra Mauro landing site of the Apollo 14 mission, was dissected in greater detail than any previous core. Sediment from the actual lunar surface was missing, and 6.7 grams of sediment were removed from the base of the core for a portion of the biotest prime sample. Upper and lower portions of the original 70.7-gram core (12.5 centimeters long) were fractured excessively but not mixed stratigraphically. Three major morphologic units and 11 subdivisions were recognized. Dissection provided 55 subsamples in addition to three others made by removing longitudinal sections of the core impregnated with n-butyl methacrylate for use as a permanent documentary record and for studies requiring particles of known orientation.

Fryxell, R.; Heiken, G.

1971-01-01

344

Management of Acute Aortic Syndrome and Chronic Aortic Dissection  

SciTech Connect

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

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

2011-10-15

345

A quantum informational approach for dissecting chemical reactions  

E-print Network

We present a conceptionally different approach to dissect bond-formation processes in metal-driven catalysis using concepts from quantum information theory. Our method uses the entanglement and correlation among molecular orbitals to analyze changes in electronic structure that accompany chemical processes. As a proof-of-principle example, the evolution of nickel-ethene bond-formation is dissected which allows us to monitor the interplay of back-bonding and $\\pi$-donation along the reaction coordinate. Furthermore, the reaction pathway of nickel-ethene complexation is analyzed using quantum chemistry methods revealing the presence of a transition state. Our study supports the crucial role of metal-to-ligand back-donation in the bond-forming process of nickel-ethene.

Duperrouzel, Corinne; Boguslawski, Katharina; Barcza, Gergerly; Legeza, Örs; Ayers, Paul W

2014-01-01

346

Age-dependent differences in cervical artery dissection.  

PubMed

The goal of this work was to explore age-dependent differences in cervical artery dissection (CeAD). This study is based on the Cervical Artery Dissection and Ischemic Stroke Patients population comprising 983 consecutive CeAD patients and 658 control patients with a non-CeAD ischemic stroke (IS), frequency-matched for age and gender. Patients were divided into three age categories: ?33 (for CeAD, n = 150), 34-54 (n = 688), and ?55 (n = 145) years, and the youngest and oldest groups were compared. The youngest patients were mostly women and the oldest men. The frequency of internal carotid artery dissection (ICAD) versus vertebral artery dissection (VAD) increased with age from 44 to 75 %. This age-related shift remained significant after adjustment for sex. The frequency of a transient ischemic event as the CeAD symptom declined from 33 % in the youngest age group, to 19 % in the oldest. Vascular risk factors increased in frequency with advancing age in both groups, but for hypertension the increase was steeper for non-CeAD IS patients. For CeAD patients, but not for patients with non-CeAD IS, preceding infection was more common in the oldest group. The youngest non-CeAD IS patients had better functional outcome (modified Rankin Scale 0-1) than the oldest, while the similar trend was not statistically significant among CeAD patients. Younger age seems to be associated with VAD and female gender, and older age with ICAD and male gender. Age-related changes in the frequencies of hypertension and recent infection were different between the CeAD and non-CeAD IS groups. Age does not seem to be an important outcome predictor in CeAD strokes. PMID:22527225

Metso, Tiina M; Debette, Stéphanie; Grond-Ginsbach, Caspar; Engelter, Stefan T; Leys, Didier; Brandt, Tobias; Pezzini, Alessandro; Bersano, Anna; Kloss, Manja; Thijs, Vincent; Lyrer, Philippe A; Tatlisumak, Turgut; Metso, Antti J

2012-10-01

347

Science Sampler: Frog dissection--An alternative model  

NSDL National Science Digital Library

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

Sanders, June

2007-02-01

348

Modeling Plaque Fissuring and Dissection during Balloon Angioplasty Intervention  

Microsoft Academic Search

Balloon angioplasty intervention is traumatic to arterial tissue. Fracture mechanisms such as plaque fissuring and\\/or dissection\\u000a occur and constitute major contributions to the lumen enlargement. However, these types of mechanically-based traumatization\\u000a of arterial tissue are also contributing factors to both acute procedural complications and chronic restenosis of the treatment\\u000a site. We propose physical and finite element models, which are generally

T. Christian Gasser; Gerhard A. Holzapfel

2007-01-01

349

Laparoscopic gastrectomy with lymph node dissection for gastric cancer  

Microsoft Academic Search

Since 1991, laparoscopic surgery has been adopted for the treatment of gastric cancer, and it has been performed worldwide,\\u000a especially in Japan and Korea. We reviewed the English-language literature to clarify the current status of and problems associated\\u000a with laparoscopic gastrectomy with lymph node dissection as treatment for gastric cancer. In Japan, early-stage gastric cancer\\u000a (T1\\/T2, N0) is considered the

Norio Shiraishi; Kazuhiro Yasuda; Seigo Kitano

2006-01-01

350

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

PubMed

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

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

2014-03-01

351

Dissecting disks around B-type protostars  

NASA Astrophysics Data System (ADS)

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

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

2013-07-01

352

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

PubMed Central

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

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

2014-01-01

353

Magnetic resonance imaging of suspected cervicocranial arterial dissections.  

PubMed

The authors propose that the optimal screening protocol for evaluation of suspected cervicocranial arterial dissections is magnetic resonance imaging (MRI) that includes three components: 1) contrast-enhanced three-dimensional time-of-flight magnetic resonance angiography (MRA) through the superior mediastinum, neck, and skull base; 2) three-dimensional multiple overlapping thin-section acquisition MRA of the skull base and Circle of Willis region; and 3) axial non-contrast, non-fat-suppressed T1-weighted, fat-suppressed T1-weighted, and T2-weighted spin-echo MRI from the level of the aortic arch through the level of the circle of Willis. MRA permits visualization of vascular luminal narrowing or obliteration, which can suggest vascular dissection but can also be caused by congenital variation, dysplasia, intraluminal thrombus, vasospasm, or extramural compression by tumor. By directly visualizing the blood vessel wall, axial T1-weighted and T2-weighted spin-echo MRI can identify the intramural hemorrhage of vascular dissection. This protocol is designed to maximize the sensitivity of a noninvasive technique and may eliminate the need for conventional endovascular angiography. PMID:15662248

Shah, Gaurang V; Quint, Douglas J; Trobe, Jonathan D

2004-12-01

354

Saphenous Vein Sparing Superficial Inguinal Dissection in Lower Extremity Melanoma  

PubMed Central

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

Ozturk, Muhammed Besir; Akan, Arzu; Ozkaya, Ozay; Egemen, Onur; Oreroglu, Ali R?za; Akan, Mithat

2014-01-01

355

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

ERIC Educational Resources Information Center

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

Kotze, Sanet Henriet; Mole, Calvin Gerald

2013-01-01

356

COBRA CONTINUATION REQUIREMENT NOTICE  

E-print Network

COBRA CONTINUATION REQUIREMENT NOTICE HUMAN RESOURCES Employee Support Services | One Washington IMPORTANT NOTICE OF COBRA CONTINUATION RIGHTS FOR CALIFORNIA STATE UNIVERSITY EMPLOYEES AND/OR COVERED contains important information about your right to COBRA continuation coverage, which is a temporary

Su, Xiao

357

Milky Way Tomography IV: Dissecting Dust  

SciTech Connect

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

Berry, Michael; /Washington U., Seattle, Astron. Dept. /Rutgers U., Piscataway; Ivezic, Zeljko; /Washington U., Seattle, Astron. Dept.; Sesar, Branimir; /Caltech; Juric, Mario; /Harvard U., Phys. Dept.; Schlafly, Edward F.; /Harvard-Smithsonian Ctr. Astrophys.; Bellovary, Jillian; /Michigan U.; Finkbeiner, Douglas; /Harvard-Smithsonian Ctr. Astrophys.; Vrbanec, Dijana; /Zagreb U.; Beers, Timothy C.; /Natl. Solar Observ., Tucson; Brooks, Keira J.; /Washington U., Seattle, Astron. Dept.; Schneider, Donald P.; /Penn State U. /Washington U., Seattle, Astron. Dept.

2011-11-01

358

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

ERIC Educational Resources Information Center

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

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

2014-01-01

359

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

PubMed

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

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

2014-01-01

360

Bilateral Leg Ischemia due to Descending Aortic Dissection: Combined Treatment with Femoro-femoral Cross-over Bypass and Unilateral Aorto-iliac stenting  

SciTech Connect

We report a case of aorto-iliac occlusion due to descending aortic dissection treated initially with femoro-femoral cross-over bypass and secondarily with unilateral aorto-iliac stenting because of progression of the dissection. A 75-year-old man presented with acute ischemia of the right leg. CT revealed occlusion of the right iliac artery due to descending aortic dissection with a clotted false lumen. Three days after femoro-femoral cross-over bypass,ischemia of both legs developed and angiography demonstrated occlusion of the infrarenal aorta and left common iliac artery. Two overlapping stents were deployed in these vessel segments. Completion angiography confirmed successful recanalization with adequate distal flow and good patency of the cross-over bypass. Peripheral pulses were restored and the patient's symptoms were alleviated. Combined treatment with cross-over bypass and endovascular recanalization may be considered as a viable alternative to open aortic surgery in selected cases of complicated aorto-iliac dissection with bilateral leg ischemia.

Frahm, Christian [Department of Diagnostic Radiology, University Hospital Kiel, Arnold-Heller-Strasse 9, D-24105 Kiel (Germany); Widmer, Matthias K. [Division of Cardiovascular Surgery, University Hospital/Inselspital Bern, Freiburgstrasse, CH-3010 Bern (Switzerland); Brossmann, Joachim [Department of Diagnostic Radiology, University Hospital Kiel, Arnold-Heller-Strasse 9, D-24105 Kiel (Germany); Do, Dai-Do [Division of Angiology, University Hospital/Inselspital Bern, Freiburgstrasse, CH-3010 Bern (Switzerland)

2002-10-15

361

Contemporary management of pregnancy-related coronary artery dissection: A single-centre experience and literature review  

PubMed Central

Spontaneous coronary artery dissection (SCAD) is an infrequent event that is most commonly associated with pregnant women or those in the postpartum period. Because of its rarity, the literature describing this condition is confined to sporadic case reports, with few reporting long-term follow-up, and no clear consensus exists on the optimal treatment strategy for these patients. The present article reports a single-centre experience with SCAD, highlighting the issues surrounding its management with a brief description of five cases of pregnancy-associated coronary dissection. The treatment used in these cases ranged from a conservative medical approach to surgical and percutaneous intervention, with one patient proceeding to transplantation. Four of the cases have long-term angiographic follow-up. In addition, a comprehensive review of all previously published cases is presented, and temporal trends in the management strategy are highlighted. Possible pathophysiological mechanisms pertaining to this condition, and the complex diagnostic and therapeutic issues involved, which may affect both patient and fetus, are discussed. Finally, an optimal approach to patients with SCAD, informed by our experience and literature review, is described. PMID:19492033

Appleby, Clare E; Barolet, Alan; Ing, Doug; Ross, John; Schwartz, Leonard; Seidelin, Peter; Silversides, Candice; Horlick, Eric

2009-01-01

362

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

NASA Astrophysics Data System (ADS)

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

Youngblut, Christine

363

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

PubMed Central

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

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

2013-01-01

364

Outcome after endoscopic submucosal dissection for early gastric cancer in Korea  

PubMed Central

Endoscopic treatment, such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), has been established as one of the treatment options for selected cases with early gastric cancer (EGC). Most studies on this topic have been carried out by researchers in Japan. Recently, the experience in EMR/ESD for EGC outside Japan is increasingly reported. In Korea, gastric cancer is the most common malignant disease, and the second leading cause of cancer death. Currently, EMR for EGC is widely performed in many centers in Korea. Early results with a short-term follow-up period are very promising in Korea. The complete resection rate of EMR was 37.8%-94.3%, and that of ESD was 77.4%-93.1%. In this review, we will provide an overview of the outcomes of endoscopic treatments in Korea. PMID:21987605

Lee, Jun Haeng; Hong, Su Jin; Jang, Jae Young; Kim, Seong Eun; Seol, Sang Young

2011-01-01

365

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

SciTech Connect

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

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

2008-12-01

366

[Does the use of TachoSil allow to reduce the morbidity of axillary dissection?].  

PubMed

The lymphocele is the most frequently encountered complication after axillary dissection performed for breast cancer (15-81%). This study compares the efficacy of a lympho-hemostatic combipatch TachoSil(®) versus conventional implementation of a suction drain on the incidence and severity of lymphoceles. This is a case (group TachoSil(®)n=20) control (drainage group) n=40 study. In our study, we demonstrated an increased rate of postoperative complications (<3weeks) in the group TachoSil(®) (P=0.0265) explained by a lymphocele rate significantly higher (P=0.0194). However, no significant difference was demonstrated on the severity of these lymphoceles. Beyond 3weeks postoperatively, the two groups were comparable in terms of postoperative complications. The TachoSil(®) does not prevent the formation of seroma but their severity is not increased. In addition, it reduces of more than 48hours the duration of hospitalization stay (P=0.002). PMID:23375637

Lacoste, C; Ouldamer, L; Body, G; Marret, H

2013-02-01

367

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

PubMed Central

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

2014-01-01

368

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

PubMed Central

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

2014-01-01

369

Multidetector computed tomography angiography: Application in vertebral artery dissection  

PubMed Central

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

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

2011-01-01

370

Follicle trauma and the role of the dissecting microscope in hair transplantation. A multicenter study.  

PubMed

Use of the dissecting stereomicroscope during hair transplant graft dissection has been advocated as a means of reducing hair follicle transection and improving graft growth. The study evaluated the prevalence of hair follicle transection in grafts prepared with and without the dissecting stereomicroscope. Approximately half as much transection (10% vs 20%, p < 0.05) was noted in grafts prepared with microscopes, suggesting their use may be associated with less hair follicle trauma and improved hair growth. PMID:10327300

Cooley, J E; Vogel, J E

1999-04-01

371

In utero release of constriction amniotic bands via blunt dissection.  

PubMed

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

Assaf, Raymen; Llanes, Arlyn; Chmait, Ramen

2012-02-01

372

Coronary angiogram classification of spontaneous coronary artery dissection.  

PubMed

Spontaneous coronary artery dissection (SCAD) is under-diagnosed and the true prevalence is underestimated. Unfortunately, SCAD is frequently missed on coronary angiogram since the arterial wall is not imaged with this test. Optical coherence tomography or intravascular ultrasound should be the true gold-standard to diagnose SCAD. Given the elusive angiographic diagnosis of SCAD and the lack of familiarity with angiographic variants of SCAD, a diagnostic algorithm and angiographic classification for SCAD is proposed in this article. © 2013 Wiley Periodicals, Inc. PMID:24227590

Saw, Jacqueline

2014-12-01

373

Aortic intramural hematoma progressing rapidly to aortic dissection.  

PubMed

A 73-year-old man presented with intermittent chest pain radiating to the back, which had started 12 hours earlier. On the day after emergency consultation, a thoracic scan showed an acute aortic intramural hematoma starting at the sinotubular junction with an ascending aorta diameter of 5.7 cm. One hour after the initial scan, the patient had acute chest pain followed by a loss of consciousness. A second scan was obtained 2 hours after the initial scan and showed a type A aortic dissection that extended from the sinotubular junction to the descending aorta. PMID:25154802

Dionne, Pierre Olivier; Perrault, Louis P

2014-10-01

374

Models and approaches to dissect host-symbiont specificity.  

PubMed

Animals are symbiotic superorganisms, composed of eukaryotic cells and specific microbial residents that perform essential functions for their host. As humans, we are beginning to appreciate the diversity and function of our own microbiota, but model systems are leading the field in illustrating the molecular mechanisms that allow specific relationships to be recapitulated during each host generation. This review focuses on models in which genetic screens, coupled with genomics, imaging, phylogenetics and population biology, have begun to allow a remarkably detailed investigation into the molecular dissection of the evolution of host specificity in animal symbionts. PMID:20729086

Mandel, Mark J

2010-11-01

375

Dissecting inhibitory brain circuits with genetically-targeted technologies  

PubMed Central

The evolution of genetically targeted tools has begun to allow us to dissect anatomically and functionally heterogeneous interneurons, and to probe circuit function from synapses to behavior. Over the last decade, these tools have been used widely to visualize neurons in a cell type-specific manner, and engage them to activate and inactivate with exquisite precision. In this process, we have expanded our understanding of interneuron diversity, their functional connectivity, and how selective inhibitory circuits contribute to behavior. Here we discuss the relative assets of genetically encoded fluorescent proteins (FPs), viral tracing methods, optogenetics, chemical genetics, and biosensors in the study of inhibitory interneurons and their respective circuits. PMID:25368555

Murphey, Dona K.; Herman, Alexander M.; Arenkiel, Benjamin R.

2014-01-01

376

29 CFR 1601.74 - Designated and notice agencies.  

Code of Federal Regulations, 2012 CFR

...in which case it shall be deemed a “Notice Agency.” Huntington (WV) Human Relations Commission Idaho Human Rights Commission...Safety New Mexico Human Rights Commission New York City (NY) Commission on Human Rights New York State Division on...

2012-07-01

377

29 CFR 1601.74 - Designated and notice agencies.  

Code of Federal Regulations, 2013 CFR

...in which case it shall be deemed a “Notice Agency.” Huntington (WV) Human Relations Commission Idaho Human Rights Commission...Safety New Mexico Human Rights Commission New York City (NY) Commission on Human Rights New York State Division on...

2013-07-01

378

29 CFR 1601.74 - Designated and notice agencies.  

...in which case it shall be deemed a “Notice Agency.” Huntington (WV) Human Relations Commission Idaho Human Rights Commission...Safety New Mexico Human Rights Commission New York City (NY) Commission on Human Rights New York State Division on...

2014-07-01

379

29 CFR 1601.74 - Designated and notice agencies.  

Code of Federal Regulations, 2011 CFR

...in which case it shall be deemed a “Notice Agency.” Huntington (WV) Human Relations Commission Idaho Human Rights Commission...Safety New Mexico Human Rights Commission New York City (NY) Commission on Human Rights New York State Division on...

2011-07-01

380

COPYRIGHT NOTICE: Elias Kiritsis: String Theory in a Nutshell  

E-print Network

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

Landweber, Laura

381

Application of blunt dissection in ESD of a gastric submucosal tumor  

PubMed Central

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

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

2014-01-01

382

Nanometer-Scale Dissection of Chromosomes by Atomic Force Microscopy Combined with Heat-Denaturing Treatment  

NASA Astrophysics Data System (ADS)

We have developed a method for dissecting chromosome fragments with a size of a few hundred nanometers by atomic force microscopy (AFM). By using this method, we demonstrated reproducible dissections of silkworm chromosomes in the pachytene phase. The dissected fragments were successfully recovered on the cantilever tips, as confirmed by fluorescent microscopy using fluorescent stained chromosomes. To recover dissected chromosome fragments from a larger chromosome, such as the human metaphase chromosome of a somatic cell, heat denaturation was found to be effective. Further improvements in this method may lead to a novel tool for isolating valuable genes and/or investigating local genome structures in the near future.

Tsukamoto, Kazumi; Kuwazaki, Seigo; Yamamoto, Kimiko; Shichiri, Motoharu; Yoshino, Tomoyuki; Ohtani, Toshio; Sugiyama, Shigeru

2006-03-01

383

Cell-type Specific Optogenetic Mice for Dissecting Neural Circuitry Function  

E-print Network

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

Zhao, Shengli

384

Vertebral Dissecting Aneurysm Treated with Wingspan Stent Deployment and Detachable Coils  

PubMed Central

Summary We describe the first documented endovascular treatment of vertebral dissecting aneurysm using a Wingspan stent and detachable coils. A 54-year-old man presented with a nonruptured vertebral dissecting aneurysm. Because of the dissecting nature of the vertebral aneurysms, a 3x15-mm Wingspan stent was placed in the left vertebral artery. One month later, several detachable coils were introduced into the aneurysm. Six-month follow-up angiogram confirmed the obliteration. Vertebral dissecting aneurysm can be treated with Wingspan stent placement and detachable coils. PMID:20465940

Lv, M.; Lv, X.; Li, Y.; Yang, X.; Wu, Z.

2009-01-01

385

Subretinal Perfluorocarbon Liquid for Dissection of Proliferative Vitreoretinopathy  

PubMed Central

Proliferative vitreoretinopathy (PVR) is a frequent condition following complex retinal detachments or trauma, and subretinal PVR is a common cause of retinal redetachment. Subretinal PVR removal is challenging and may require creating multiple or large retinotomies, making manipulation of the retina difficult and sometimes hazardous. We propose a novel surgical technique that may facilitate subretinal removal of PVR. After peripheral retinotomy of 180 degrees or greater, perfluorocarbon liquid (PFCL) is carefully introduced into the subretinal space as a single bubble which provides space to perform the maneuvers. The PFCL serves as a second hand which folds the retina over, thereby allowing better visualization for safer and easier subretinal PVR removal. PFCL in then removed by direct aspiration as a single bubble while still under balanced salt solution, taking advantage of its high surface tension which prevents leaving bubbles behind. The described technique allows adequate exposure of the subretinal space for proper dissection of difficult-to-reach subretinal PVR. We applied this technique in five patients with chronic retinal detachment, extensive subretinal PVR and poor visual potential. The utilization of subretinal PFCL can assist dissection of subretinal PVR and may be useful in eyes with complicated retinal detachment and poor visual prognosis. PMID:23502847

Dalma-Weiszhausz, Jose; Franco-Cardenas, Valentina; Dalma, Alejandro

2012-01-01

386

Predicting aortic enlargement in type B aortic dissection  

PubMed Central

Patients with uncomplicated acute type B aortic dissection (ABAD) can generally be treated with conservative medical management. However, these patients may develop aortic enlargement during follow-up, with the risk of rupture. Several predictors have been studied in recent years to identify ABAD patients at high risk of aortic enlargement, who may benefit from early surgical or endovascular intervention. This study reviewed and summarized the current available literature on prognostic variables related to aortic enlargement during follow-up in uncomplicated ABAD patients. It revealed multiple factors affecting aortic expansion including demographic, clinical, pharmacologic and radiologic variables. Such predictors may be used to identify those ABAD patients at higher risk for aortic enlargement who may benefit from closer radiologic surveillance or early endovascular intervention. This approach deserves even more consideration because a significant number of patients develop aneurysmal degeneration along the dissected segments during follow-up, and may lose the opportunity for endovascular treatment if not identified at an early stage. PMID:24967168

Jonker, Frederik H. W.; van Bogerijen, Guido H. W.; Tolenaar, Jip L.; Moll, Frans L.; Czerny, Martin; Patel, Himanshu J.

2014-01-01

387

Virtual Temporal Bone Dissection System: Development and Testing  

PubMed Central

Objectives/Hypothesis The objective of this project was to develop a virtual temporal bone dissection system that would provide an enhanced educational experience for the training of otologic surgeons. Study Design A randomized, controlled, multi-institutional single blinded validation study. Methods The project encompassed 4 areas of emphasis: structural data acquisition, integration of the system, dissemination of the system, and validation. Results Structural acquisition was performed on multiple imaging platforms. Integration achieved a cost effective system. Dissemination was achieved on different levels including casual interest, downloading of software, and full involvement in development and validation studies. A validation study was performed at 8 different training institutions across the country using a two arm, randomized trial where study subjects were randomized to a two-week practice session using either the virtual temporal bone or standard cadaveric temporal bones. Eighty subjects were enrolled and randomized to one of the two treatment arms, 65 completed the study. There was no difference between the two groups using a blinded rating tool to assess performance after training. Conclusions 1. A virtual temporal bone dissection system has been developed and compared to cadaveric temporal bones for practice using a multi-center trial. 2. There is no statistical difference seen between practice on the current simulator when compared to practice on human cadaveric temporal bones. 3. Further refinements in structural acquisition and interface design have been identified which can be implemented prior to full incorporation into training programs and use for objective skills assessment. PMID:22294268

Wiet, Gregory J.; Stredney, Don; Kerwin, Thomas; Hittle, Bradley; Fernandez, Soledad A.; Welling, D. Bradley

2012-01-01

388

Genetic basis of thoracic aortic aneurysms and aortic dissections.  

PubMed

Ascending thoracic aortic aneurysms leading to type A dissections (TAAD) can occur in association with a genetic syndrome, such as Marfan syndrome (MFS), or as an autosomal dominant disorder in the absence of syndromic features, termed familial TAAD. Familial TAAD demonstrates genetic heterogeneity, and linkage studies have identified three TAAD loci at 5q13-14 (TAAD1), 11q23 (FAA1), and 3p24-25 (TAAD2). The underlying genetic heterogeneity of TAAD is reflected in the phenotypic variation associated with familial TAAD with respect to age of onset, progression, penetrance, and association with additional cardiac and vascular features. Recently, mutations in the TGFBR2 gene have been identified as the cause of disease linked to the TAAD2 locus, supporting the hypothesis that dysregulation of TGFbeta signaling is a mechanism leading to aneurysms and dissections. The recent identification of the TGFbeta pathway as a key target in the molecular pathogenesis of TAAD has opened new avenues for future genetic and therapeutic research. PMID:16273536

Pannu, Hariyadarshi; Tran-Fadulu, Van; Milewicz, Dianna M

2005-11-15

389

Popliteal lymph node dissection for metastases of cutaneous malignant melanoma  

PubMed Central

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

2014-01-01

390

Maternal uniparental disomy 14 dissection of the phenotype with respect to rare autosomal recessively inherited traits, trisomy mosaicism, and genomic imprinting  

Microsoft Academic Search

The phenotype of maternal uniparental disomy of chromosome 14 (upd(14)mat) is characterized by pre and postnatal growth retardation, early onset of puberty, joint laxity, motor delay, and minor dysmorphic features of the face, hands, and feet. Based on a clinical analysis of 24 cases extracted from the literature the phenotype of upd(14)mat was dissected with respect to each symptom’s most likely

Dieter Kotzot

2004-01-01

391

Hemizygous deletion of COL3A1, COL5A2, and MSTN causes a complex phenotype with aortic dissection: a lesson for and from true haploinsufficiency  

Microsoft Academic Search

Aortic dilatation\\/dissection (AD) can occur spontaneously or in association with genetic syndromes, such as Marfan syndrome (MFS; caused by FBN1 mutations), MFS type 2 and Loeys–Dietz syndrome (associated with TGFBR1\\/TGFBR2 mutations), and Ehlers–Danlos syndrome (EDS) vascular type (caused by COL3A1 mutations). Although mutations in FBN1 and TGFBR1\\/TGFBR2 account for the majority of AD cases referred to us for molecular genetic

Janine Meienberg; Marianne Rohrbach; Stefan Neuenschwander; Katharina Spanaus; Cecilia Giunta; Sira Alonso; Eliane Arnold; Caroline Henggeler; Stephan Regenass; Andrea Patrignani; Silvia Azzarello-Burri; Bernhard Steiner; Anders OH Nygren; Thierry Carrel; Beat Steinmann; Gábor Mátyás

2010-01-01

392

Structural Dissection of a Highly Knotted Peptide Reveals Minimal Motif with Antimicrobial Activity*S  

E-print Network

that understanding the structural features responsible for the activity of these natural products (11­14) may provideStructural Dissection of a Highly Knotted Peptide Reveals Minimal Motif with Antimicrobial Activity in nature. We have undertaken the structural dissection of a highly knotted, cysteine-rich plant thionin

Pompeu Fabra, Universitat

393

Adaptive techniques for real-time haptic and visual simulation of bone dissection  

Microsoft Academic Search

Bone dissection is an important component of many sur- gical procedures. In this paper, we discuss adaptive tech- niques for providing real-time haptic and visual feedback during a virtual bone dissection simulation. The simulator is being developed as a component of a training system for temporal bone surgery. We harness the difference in com- plexity and frequency requirements of the

Marco Agus; Andrea Giachetti; Enrico Gobbetti; Gianluigi Zanetti; Antonio Zorcolo

2003-01-01

394

The Specific Relationship between Disgust and Interest: Relevance during Biology Class Dissections and Gender Differences  

ERIC Educational Resources Information Center

This investigation examined trajectories of interest and disgust related to a biology dissection class. Three hundred and two secondary students completed ratings of disgust sensitivity and individual interest in the topic of the heart approximately one week before a dissection class. States of disgust and interest were recorded before, during,…

Holstermann, Nina; Ainley, Mary; Grube, Dietmar; Roick, Thorsten; Bogeholz, Susanne

2012-01-01

395

Traumatic dissection of the internal carotid artery: simultaneous infarct of optic nerve and brain  

PubMed Central

Key Clinical Message Traumatic intracranial internal carotid artery dissection is a rare but significant cause of stroke in patients in their forties, leading to high morbidity and mortality. Simultaneous ischemic stroke and optic nerve infarction can occur. Clinical suspicion of dissection is determining in the acute management. PMID:25356244

Correa, Edgar; Martinez, Braulio

2014-01-01

396

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

Microsoft Academic Search

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

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

2004-01-01

397

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

ERIC Educational Resources Information Center

Questionnaires from students passing the General Certificate of Secondary Education (GCSE) that explored attitudes to dissection and using animals in product testing administered to (n=469) students ages 14-15 showed a high level of support for peers who object to dissection, although objectors are likely to be met with derogatory comments,…

Lock, Roger

1995-01-01

398

Medical Students' Reactions to Anatomic Dissection and the Phenomenon of Cadaver Naming  

ERIC Educational Resources Information Center

The teaching of gross anatomy has, for centuries, relied on the dissection of human cadavers, and this formative experience is known to evoke strong emotional responses. The authors hypothesized that the phenomenon of cadaver naming is a coping mechanism used by medical students and that it correlates with other attitudes about dissection and body…

Williams, Austin D.; Greenwald, Emily E.; Soricelli, Rhonda L.; DePace, Dennis M.

2014-01-01

399

Perceptions of dissection by students in one medical school: beyond learning about anatomy. A qualitative study  

Microsoft Academic Search

INTRODUCTION The practice of dissection, as part of undergraduate medical education, has recently resurfaced in the public eye. This paper focuses on a number of important learning outcomes that were reported by Year 1-5 medical students in a British medical school, during the dissection sessions in the first 2 years of their training, as part of a wider qualitative research

Heidi K Lempp

2005-01-01

400

Numerical simulation of arterial dissection during balloon angioplasty of atherosclerotic coronary arteries  

E-print Network

1 Numerical simulation of arterial dissection during balloon angioplasty of atherosclerotic, published in "Journal of Biomechanics 47, 4 (2014) pages 878-889" #12;2 Abstract Balloon angioplasty-onset complications such as restenosis. Keywords balloon angioplasty, coronary artery, arterial dissection, cohesive

Boyer, Edmond

401

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

PubMed Central

In the first half of the third century B.C, two Greeks, Herophilus of Chalcedon and his younger contemporary Erasistratus of Ceos, became the first and last ancient scientists to perform systematic dissections of human cadavers. In all probability, they also conducted vivisections of condemned criminals. Their anatomical and physiological discoveries were extraordinary. The uniqueness of these events presents an intriguing historical puzzle. Animals had been dissected by Aristotle in the preceding century (and partly dissected by other Greeks in earlier centuries), and, later, Galen (second century A.D.) and others again systematically dissected numerous animals. But no ancient scientists ever seem to have resumed systematic human dissection. This paper explores, first, the cultural factors--including traditional Greek attitudes to the corpse and to the skin, also as manifested in Greek sacred laws--that may have prevented systematic human dissection during almost all of Greek antiquity, from the Pre-Socratic philosopher-scientists of the sixth and fifth centuries B.C. to distinguished Greek physicians of the later Roman Empire. Second, the exceptional constellation of cultural, political, and social circumstances in early Alexandria that might have emboldened Herophilus to overcome the pressures of cultural traditions and to initiate systematic human dissection, is analyzed. Finally, the paper explores possible reasons for the mysteriously abrupt disappearance of systematic human dissection from Greek science after the death of Erasistratus and Herophilus. PMID:1285450

von Staden, H.

1992-01-01

402

Positive and negative motivational gradients during first use of the dissecting room  

Microsoft Academic Search

Immediately after their first use of the dissecting room, 45 preclinical medical students rated their enthusiasm and reluctance at seven points along a time sequence encompassing their experience from the night before to the completion of their first dissection. A second group of 42 preclinical medical students carried out the same ratings in real time. A naive group of 24

John Gaskell

1985-01-01

403

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

NASA Astrophysics Data System (ADS)

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

Waters, John R.

404

Dissecting and recording from the C. Elegans neuromuscular junction.  

PubMed

Neurotransmission is the process by which neurons transfer information via chemical signals to their post-synaptic targets, on a rapid time scale. This complex process requires the coordinated activity of many pre- and post-synaptic proteins to ensure appropriate synaptic connectivity, conduction of electrical signals, targeting and priming of secretory vesicles, calcium sensing, vesicle fusion, localization and function of postsynaptic receptors and finally, recycling mechanisms. As neuroscientists it is our goal to elucidate which proteins function in each of these steps and understand their mechanisms of action. Electrophysiological recordings from synapses provide a quantifiable read out of the underlying electrical events that occur during synaptic transmission. By combining this technique with the powerful array of molecular and genetic tools available to manipulate synaptic proteins in C. elegans, we can analyze the resulting functional changes in synaptic transmission. The C. elegans NMJs formed between motor neurons and body wall muscles control locomotion, therefore, mutants with uncoordinated locomotory phenotypes (known as unc s) often perturb synaptic transmission at these synapses (1). Since unc mutants are maintained on a rich supply of a bacterial food source, they remain viable as long as they retain some pharyngeal pumping ability to ingest food. This, together with the fact that C. elegans exist as hermaphrodites, allows them to pass on mutant progeny without the need for elaborate mating behaviors. These attributes, coupled with our recent ability to record from the worms NMJs (2 3) make this an excellent model organism in which to address precisely how unc mutants impact neurotransmission. The dissection method involves immobilizing adult worms using a cyanoacrylic glue in order to make an incision in the worm cuticle exposing the NMJs. Since C. elegans adults are only 1 mm in length the dissection is performed with the use of a dissecting microscope and requires excellent hand-eye coordination. NMJ recordings are made by whole-cell voltage clamping individual body wall muscle cells and neurotransmitter release can be evoked using a variety of stimulation protocols including electrical stimulation, light-activated channel-rhodopsin-mediated depolarization (4) and hyperosmotic saline, all of which will be briefly described. PMID:19488020

Richmond, Janet

2009-01-01

405

Quantitative trait locus analysis of leaf dissection in tomato using Lycopersicon pennellii segmental introgression lines.  

PubMed Central

Leaves are one of the most conspicuous and important organs of all seed plants. A fundamental source of morphological diversity in leaves is the degree to which the leaf is dissected by lobes and leaflets. We used publicly available segmental introgression lines to describe the quantitative trait loci (QTL) controlling the difference in leaf dissection seen between two tomato species, Lycopersicon esculentum and L. pennellii. We define eight morphological characteristics that comprise the mature tomato leaf and describe loci that affect each of these characters. We found 30 QTL that contribute one or more of these characters. Of these 30 QTL, 22 primarily affect leaf dissection and 8 primarily affect leaf size. On the basis of which characters are affected, four classes of loci emerge that affect leaf dissection. The majority of the QTL produce phenotypes intermediate to the two parent lines, while 5 QTL result in transgression with drastically increased dissection relative to both parent lines. PMID:14668401

Holtan, Hans E E; Hake, Sarah

2003-01-01

406

Tenascin C protects aorta from acute dissection in mice  

NASA Astrophysics Data System (ADS)

Acute aortic dissection (AAD) is caused by the disruption of intimomedial layer of the aortic walls, which is immediately life-threatening. Although recent studies indicate the importance of proinflammatory response in pathogenesis of AAD, the mechanism to keep the destructive inflammatory response in check is unknown. Here, we report that induction of tenascin-C (TNC) is a stress-evoked protective mechanism against the acute hemodynamic and humoral stress in aorta. Periaortic application of CaCl2 caused stiffening of abdominal aorta, which augmented the hemodynamic stress and TNC induction in suprarenal aorta by angiotensin II infusion. Deletion of Tnc gene rendered mice susceptible to AAD development upon the aortic stress, which was accompanied by impaired TGF? signaling, insufficient induction of extracellular matrix proteins and exaggerated proinflammatory response. Thus, TNC works as a stress-evoked molecular damper to maintain the aortic integrity under the acute stress.

Kimura, Taizo; Shiraishi, Kozoh; Furusho, Aya; Ito, Sohei; Hirakata, Saki; Nishida, Norifumi; Yoshimura, Koichi; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Ikeda, Yasuhiro; Miyamoto, Takanobu; Ueno, Takafumi; Hamano, Kimikazu; Hiroe, Michiaki; Aonuma, Kazutaka; Matsuzaki, Masunori; Imaizumi, Tsutomu; Aoki, Hiroki

2014-02-01

407

Desirable training of endoscopic submucosal dissection: further spread worldwide  

PubMed Central

Endoscopic submucosal dissection (ESD) is an excellent treatment because of its high curative resection rate and low local recurrence rate. However, its technical difficulty prevents from its permeation worldwide. For further permeation of ESD, the establishment of an appropriate training system is essential. In Japan, trainee endoscopists who have had prerequisites for ESD, that is to say, basic knowledge and skills, start ESD in accordance with a stepwise training system under close supervision by experts. The trainers select an appropriate lesion in human for each step of developments in ESD techniques. In Western countries there are few ESD experts at present, so an ex vivo animal model training must play a major role in the training system. It is desirable that these training systems should be constructed by some authorized organizations such as Japan Gastroenterological Endoscopy Society (JGES).

Fujishiro, Mitsuhiro; Kodashima, Shinya; Niimi, Keiko; Ono, Satoshi; Yamamichi, Nobutake; Koike, Kazuhiko

2014-01-01

408

Dissecting the role of milk components on gut microbiota composition.  

PubMed

The composition of human milk is tailored to contribute to the development of the gastrointestinal (GI) tract of newborns and infants. Importantly, human milk contains the antimicrobial compounds lysozyme and lactoferrin that are thought to contribute to the formation of a health-promoting microbiota. As these protective factors are lacking in the milk of dairy animals, we genetically engineered goats expressing human lysozyme in their milk and have recently reported a new animal model to dissect out the role of milk components on gut microbiota formation. Using the pig as a more human-relevant animal model, we demonstrated that consumption of lysozyme-rich milk enriched the abundance of bacteria associated with GI health and decreased those associated with disease, much like human milk. This work demonstrated that the pig is a valid animal model for gut microbiome studies on the effects of dietary components on microbiota composition, host-microbe interactions and state of the intestine. PMID:23235404

Maga, Elizabeth A; Weimer, Bart C; Murray, James D

2013-01-01

409

Complications Related to Gastric Endoscopic Submucosal Dissection and Their Managements  

PubMed Central

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

Saito, Itaru; Tsuji, Yosuke; Sakaguchi, Yoshiki; Niimi, Keiko; Ono, Satoshi; Kodashima, Shinya; Yamamichi, Nobutake; Koike, Kazuhiko

2014-01-01

410

Dissecting teleost B cell differentiation using transcription factors.  

PubMed

B cell developmental pathways in teleost fishes are poorly understood. In the absence of serological reagents, an alternative approach to dissecting teleost B cell development is to use transcription factors that are differentially expressed during B cell development. This review discusses the structure and function of six transcription factors that play essential roles during teleost B cell development: Ikaros, E2A, EBF, Pax5, Blimp1, and XbpI. Research on alternative splicing of both the Ikaros and Pax5 genes in rainbow trout is presented, including their functional significance. An application is discussed that should aid in elucidating teleost B cell development and activation, by using transcription factors as developmental markers in flow cytometric analysis. Possible future studies in teleost B cell development are suggested in the context of gene regulation. Lastly, broader impacts and practical applications are discussed. PMID:21251922

Zwollo, Patty

2011-09-01

411

Tenascin C protects aorta from acute dissection in mice  

PubMed Central

Acute aortic dissection (AAD) is caused by the disruption of intimomedial layer of the aortic walls, which is immediately life-threatening. Although recent studies indicate the importance of proinflammatory response in pathogenesis of AAD, the mechanism to keep the destructive inflammatory response in check is unknown. Here, we report that induction of tenascin-C (TNC) is a stress-evoked protective mechanism against the acute hemodynamic and humoral stress in aorta. Periaortic application of CaCl2 caused stiffening of abdominal aorta, which augmented the hemodynamic stress and TNC induction in suprarenal aorta by angiotensin II infusion. Deletion of Tnc gene rendered mice susceptible to AAD development upon the aortic stress, which was accompanied by impaired TGF? signaling, insufficient induction of extracellular matrix proteins and exaggerated proinflammatory response. Thus, TNC works as a stress-evoked molecular damper to maintain the aortic integrity under the acute stress. PMID:24514259

Kimura, Taizo; Shiraishi, Kozoh; Furusho, Aya; Ito, Sohei; Hirakata, Saki; Nishida, Norifumi; Yoshimura, Koichi; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Ikeda, Yasuhiro; Miyamoto, Takanobu; Ueno, Takafumi; Hamano, Kimikazu; Hiroe, Michiaki; Aonuma, Kazutaka; Matsuzaki, Masunori; Imaizumi, Tsutomu; Aoki, Hiroki

2014-01-01

412

Recommended sedation and intraprocedural monitoring for gastric endoscopic submucosal dissection.  

PubMed

Endoscopic submucosal dissection is associated with a longer treatment time and a higher risk of patient discomfort than conventional procedures. Adequate, safe sedation is therefore essential. Sedation can cause adverse effects such as hypoxemia and hypotension, requiring continuous intraoperative and postoperative monitoring of blood pressure, use of the electrocardiogram, and arterial blood oxygen saturation by pulse oximetry. A physician and a nurse solely responsible for sedating and monitoring the patient should be present during treatment.A combination of benzodiazepines and analgesics are generally used for sedation, but new sedatives such as propofol and dexmedetomidine hydrochloride are expected to be useful agents. Endoscopists should become more familiar with sedatives, analgesics, and emergency procedures in the future. PMID:23406354

Sasaki, Tohru; Tanabe, Satoshi; Ishido, Kenji; Azuma, Mizutomo; Katada, Chikatoshi; Higuchi, Katsuhiko; Koizumi, Wasaburo

2013-03-01

413

Acute Aortic Dissections with Pregnancy in Women with ACTA2 Mutations  

PubMed Central

Mutations in ACTA2 predispose to thoracic aortic aneurysms and dissections as well as coronary artery and cerebrovascular disease. Here we examined the risk of aortic dissections, stroke and myocardial infarct with pregnancy in women with ACTA2 mutations. Of the 53 women who had a total of 137 pregnancies, eight had aortic dissections in the third trimester or the postpartum period (6% of pregnancies). One woman also had a myocardial infarct that occurred during pregnancy that was independent of her aortic dissection. Compared to the population-based frequency of peripartum aortic dissections of 0.6%, the rate of peripartum aortic dissections in women with ACTA2 mutations is much higher (8 out of 39; 20%). Six of these dissections initiated in the ascending aorta (Stanford type A), three of which were fatal. Three women had ascending aortic dissections at diameters less that 5.0 cm (range 3.8 to 4.7 cm). Aortic pathology showed mild to moderate medial degeneration of the aorta in three women. Of note, five of the women had hypertension either during or before the pregnancy. In summary, the majority of women with ACTA2 mutations did not have aortic or other vascular complications with pregnancy. However, these findings show that pregnancy is associated with significant risk for aortic dissections in women in whom diagnosis of ACTA2 mutation has not been made. Women with ACTA2 mutations who are planning to get pregnant should be counseled about this risk of aortic dissections, and proper clinical management should be initiated to reduce this risk. PMID:24243736

Regalado, Ellen S.; Guo, Dong-chuan; Estrera, Anthony L.; Buja, L. Maximilian; Milewicz, Dianna M.

2014-01-01

414

Murine Model of Surgically Induced Acute Aortic Dissection Type A  

PubMed Central

Objectives This study aimed at developing a murine model of surgically induced acute aortic dissection type A (AAD) for investigation of the formation and progression of AAD, and to test whether this system could be used for biomarker discovery. Methods Adult fibrillin-1 deficient, Fbn1C1039G/+ mice and wild-type mice were anesthetized, ventilated and the ascending aorta exposed via hemisternotomy. We hypothesized that AAD could be induced either by injecting autologous blood into the aortic wall or by injury to the wall with aortic clamping. Echocardiography was done preoperatively, and serum samples collected before and 30 minutes after surgery, and analyzed by ELISA. Results Echocardiography revealed larger aortic root diameters in Fbn1C1039G/+ compared with wild-type mice (P=0.001). Histology showed that aortic clamp injury but not injection of blood leads to large intimal tears, disruption of aortic wall structures and localized dissection of the aortic media in Fbn1C1039G/+ mice. AAD developed in 4 out of 5 Fbn1C1039G/+ mice versus 0 out of 5 wild-type mice after aortic clamping (P<0.01). Elastin staining showed higher elastic fiber fragmentation and disarray in Fbn1C1039G/+ compared with wild-type mice. ELISA analysis revealed elevated circulating TGF?1 concentrations after inducing AAD in Fbn1C1039G/+ mice (P=0.02, 150±61 ng/ml vs. 456±97 ng/ml), but not in wild-type or sham-operated mice. Conclusions Aortic clamp injury can induce AAD in Fbn1C1039G/+, but not in wild-type mice. This murine model of surgically induced AAD is highly reproducible and non-lethal in the short-term. Using this system, we revealed that circulating TGF?1 is a promising biomarker for AAD. PMID:19910001

Matt, Peter; Huso, David L.; Habashi, Jennifer; Holm, Tammy; Doyle, Jeff; Schoenhoff, Florian; Liu, Guosheng; Black, James; Van Eyk, Jennifer E.; Dietz, Harry C.

2010-01-01

415

Students as teachers in an anatomy dissection course.  

PubMed

One way to improve students' learning outcomes and well-being is to change teaching practices to allow students to become more active participants. We used an anatomy dissection course to test a cooperative group work method in which first-year veterinary students took turns leading their peer group and were each responsible for teaching the anatomy of a particular topographic region. The important blood vessels, lymphatic system, and nerves of each region of the body were covered. Students felt that exploration of the entire topographic region helped them to acquire a comprehensive understanding of the respiratory apparatus and the cardiovascular and nervous systems. Assigning individual tasks to each group member resulted in sharing the workload equally. Open-ended comments revealed that support from other group members was important for the students' learning experience, but the results also offered insight into a lack of constructive criticism. While teaching was considered challenging, and even a stress factor that hindered learning for some students, group work was generally held to be supportive of learning. The results suggest that more thorough instruction of students in their group work and in their individual tasks is required. Some students experienced difficulty in expressing their concerns openly and in seeking guidance from teachers, demonstrating the need for further investigation regarding students' self-regulation skills. Comments from the open-ended responses suggest that use of a cooperative learning method in anatomy dissection courses not only deepens student understanding of a subject but also offers first-year students an opportunity to practice the generic skills that will be needed in their future profession. PMID:24219999

Salomäki, Tiina; Laakkonen, Juha; Ruohoniemi, Mirja

2014-01-01

416

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

Code of Federal Regulations, 2010 CFR

... false Notice of network changes: Content of notice. 51.327 Section 51... Additional Obligations of Incumbent Local Exchange Carriers § 51.327 Notice of network changes: Content of notice. (a) Public notice...

2010-10-01

417

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

Code of Federal Regulations, 2013 CFR

... 2013-10-01 false Notice of network changes: Content of notice. 51...Exchange Carriers § 51.327 Notice of network changes: Content of notice. (a) Public notice of planned network changes must, at a minimum,...

2013-10-01

418

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

Code of Federal Regulations, 2012 CFR

... 2012-10-01 false Notice of network changes: Content of notice. 51...Exchange Carriers § 51.327 Notice of network changes: Content of notice. (a) Public notice of planned network changes must, at a minimum,...

2012-10-01

419

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

Code of Federal Regulations, 2011 CFR

... 2011-10-01 false Notice of network changes: Content of notice. 51...Exchange Carriers § 51.327 Notice of network changes: Content of notice. (a) Public notice of planned network changes must, at a minimum,...

2011-10-01

420

Virtual, on-line, frog dissection vs. conventional laboratory dissection: A comparison of student achievement and teacher perceptions among honors, general ability, and foundations-level high school biology classes  

NASA Astrophysics Data System (ADS)

Dissecting animal specimens has long been a tradition in biology classes. Objections by students, based on religious or ethical grounds, have been raised regarding the dissections of animals in classroom laboratories. A number of states now have legal proceedings or statewide policies requiring that alternatives to the actual dissection of laboratory animal specimens be permitted in their school districts. Alternatives to actual dissections have been developed in recent years. For a variety of reasons, performing an actual or conventional animal dissection may not be a desirable option. The purpose of this study was to investigate how a virtual On-line frog dissection compares with an actual laboratory dissection. What were the perceptions of the teacher's using it? How does student achievement compare among three the different ability levels on a pre and posttest regarding basic frog anatomy? Is a virtual On-line dissection a suitable alternative for students who, for whatever reason, do not participate in the actual laboratory experience? The subjects consisted of 218 biology students among three different ability levels, in a Northeastern suburban high school. Approximately half of the student groups participated in a virtual On-line dissection, the other half in an actual laboratory dissection. A pretest of basic frog anatomy was administered to the students two days before and the posttest one day after their dissection experience. Data were analyzed using matched pairs t-Tests, Analysis of Variance, Tukey HSD, and Squared Curvilinear Coefficients. Survey questionnaires were administered to the teachers after the dissection experiences were completed. There were no significant differences found in achievement between the virtual and conventional dissection groups. There were significant differences found in achievement score means among the three ability levels. There was no significant interaction between gender and achievement. Perceptions of the teacher's facilitating the two instructional methods varied. The main area of agreement among them was that a virtual On-line frog dissection was a viable alternative for students who objected to doing a conventional dissection.

Kopec, Ronald H.

2002-09-01

421

Multislice CT virtual intravascular endoscopy of aortic dissection: A pictorial essay  

PubMed Central

AIM: To present our experience of using 3D virtual intravascular endoscopy (VIE) to characterize and evaluate the intraluminal appearances of aortic dissection. METHODS: Ten patients with known aortic dissection underwent dual-source computed tomography angiography and were included in the study. In addition to 2D axial and multiplanar reformatted images as well as 3D reconstructions, VIE images were created in each patient to demonstrate intraluminal views of the aorta and its branches, origin of artery branches and artery branch involvement by aortic dissection. RESULTS: Stanford A dissection was found in 8 patients and B dissection in the remaining 2 patients. VIE images were successfully generated in all of the patients with excellent visualization of the normal anatomical structures, intimal flap and intimal entrance tear, communication between true and false lumens, as well as assessment of the extent of aortic dissection. CONCLUSION: Our preliminary experience suggests that VIE could be used as a complementary tool to assist radiologists accurately evaluate aortic dissection so that better patient management can be achieved. PMID:21179312

Sun, Zhonghua; Cao, Yan

2010-01-01

422

Triple Plane Dissection in Open Primary Rhinoplasty in Middle Eastern Noses  

PubMed Central

Objective: Rhinoplasty started as a closed technique and then the open technique gained popularity. Open technique gave surgeons the opportunity to visualize and manipulate the cartilaginous skeleton at the tip of the nose precisely. The dissection planes in open rhinoplasty technique may be subcutaneous, submuscular (under the superficial musculoaponeurotic system), or subpericondrial subperiosteal. Each plane has advantages and disadvantages. The aim of this study was to combine planes to get the maximal benefit of each plane. Method: The study was performed on 38 Middle Eastern patients, among whom 23 were females and 15 were males. All patients presented for primary rhinoplasty. They were divided into 5 groups on the basis of their skin thickness. Dissection started subcutaneous at the area of the lower lateral cartilages and then shifted subsuperficial musculoaponeurotic system over the upper lateral cartilages and ended subperiosteal over the bony skeleton. Results: This triple plane of dissection gave acceptable results without any complication. Subcutaneous dissection allowed thinning of the thick sebaceous skin at the tip and alar region, subsuperficial musculoaponeurotic system dissection allowed direct exposure of the upper lateral cartilage without thinning skin at an area where it is thin, and subperiosteal dissection helped masking any bony irregularities resulted from osteotomies. Conclusion: The triple plane dissection in open primary rhinoplasty in Middle Eastern patients maximized the advantages of each plane and minimized the disadvantages and resulted in safe cosmetic results. PMID:23967367

Elshahat, Ahmed

2013-01-01

423

Fibrin Sealant Injection: An Aid to Reduce Venous Bleeding during Jugular Bulb and Sigmoid Sinus Dissection in Glomus Jugulare (Jugulotympanic Paraganglioma) Surgery  

PubMed Central

Glomus jugulare (jugulotympanic paraganglioma) surgery requires tumor dissection in the region of the jugular bulb, upper internal jugular vein, and sigmoid sinus. Despite ligation or external compression of the sigmoid sinus proximally and ligation of the internal jugular vein distally, troublesome venous bleeding can arise from the inferior petrosal sinus or condylar veins at the medial wall of the jugular bulb. Excessive packing in this area can place the integrity of the lower cranial nerves at risk. We report a technique in which Tisseel® fibrin sealant is injected into the ligated sigmoid sinus and internal jugular vein. This forms an internal cast around the tumor in the sigmoid-jugular complex and helps seal the inferior petrosal sinus and condylar veins. This allows for safer dissection with reduced venous bleeding. Our experience in five cases has shown this technique to be effective. PMID:22451831

List, Richard James; Thomas, Sebastien Philippe Henry; Shenouda, Emad; Lang, Dorothy; Davis, Anne; Mathad, Nijaguna

2011-01-01

424

Familial Thoracic Aortic Aneurysms and Dissections: Identification of a Novel Locus for Stable Aneurysms with a Low Risk for Progression to Aortic Dissection  

PubMed Central

Background Thoracic aortic aneurysms leading to acute aortic dissections (TAAD) are the major diseases that affect the thoracic aorta. Approximately 20% of patients with TAAD have a family history of TAAD, and these patients present younger with more rapidly enlarging aneurysms than patients without a family history of aortic disease. Methods and Results A large family with multiple members with TAAD inherited in an autosomal dominant manner was identified. The ascending aortic aneurysms were associated with slow enlargement, a low risk of dissection, and decreased penetrance in women. Genome-wide linkage analysis was performed and a novel locus on chromosome 12 was identified for the mutant gene causing disease in this family. Of the 12 male members who carry the disease-linked microsatellite haplotype, nine had ascending aortic aneurysms with an average diameter of 4.7 cm and average age of 55 years (age range, 32-76) at the time of diagnosis; only one individual had progressed to acute aortic dissection and no other members with aortic dissections were identified. Women harboring the disease-linked haplotype did not have thoracic aortic disease, including an 84 year old woman. Sequencing of 9 genes within the critical interval at the chromosome 12 locus did not identify the mutant gene. Conclusion Mapping a locus for ascending thoracic aortic aneurysms associated with a low risk of aortic dissection supports our hypothesis that genes leading to familial disease can be associated with less aggressive thoracic aortic disease. PMID:21163914

Guo, Dong-Chuan; Regalado, Ellen S.; Minn, Charles; Tran-Fadulu, Van; Coney, Joshua; Cao, Jiumei; Wang, Min; Yu, Robert K.; Estrera, Anthony L.; Safi, Hazim J.; Shete, Sanjay S.; Milewicz, Dianna M.

2013-01-01

425

Iatrogenic aortic dissection during left subclavian artery stenting: immediate detection by calcium sign under fluoroscope.  

PubMed

Calcified aorta with acute iatrogenic aortic dissection is a potential but rarely reported complication of subclavian or innominate artery intervention. We report a patient who developed aortic dissection during stenting for left subclavian artery. A newly developed "calcium sign," signifying displacement of the intimal calcification from the outer soft-tissue margin and which is traditionally recognized on chest radiograph, was detected by real-time fluoroscopy and served as the diagnostic clue. Type B aortic dissection was further confirmed by chest computed tomography. PMID:20532777

Wang, Yi-Chih; Hwang, Juey-Jen; Lai, Ling-Ping; Tseng, Chuen-Den

2011-02-01

426

Pipeline endovascular reconstruction of traumatic dissecting aneurysms of the intracranial internal carotid artery.  

PubMed

A 22-year-old woman was involved in a motor vehicle collision resulting in multiple facial fractures and extensive internal carotid artery (ICA) injury including a right carotid-cavernous fistula, complex dissection flap and dissecting aneurysms. Endovascular coil embolization was initially performed to treat the cavernous carotid fistula and then again on two separate occasions to treat expanding dissecting aneurysms. Parent vessel reconstruction of the right ICA was subsequently performed with the Pipeline embolization device, resulting in complete anatomical restoration of this vessel. PMID:24353328

Prasad, Vikram; Gandhi, Dheeraj; Jindal, Gaurav

2014-12-01

427

Determinants of Early and Late Outcome after Surgery for TypeA Aortic Dissection  

Microsoft Academic Search

  The aim of this study was to identify the\\u000a most important variables associated with early and late mortality in\\u000a patients operated on for type A aortic dissection over a 15-year\\u000a period. From January 1984 to March 1999, 110 patients underwent surgery\\u000a for type A aortic dissection. The 88.1% of patients had an acute type\\u000a A dissection (AD) and 11.8% had

2001-01-01

428

Outcome analysis of laporoscopic D1 and D2 dissection in patients 70 years and older with gastric cancer  

PubMed Central

Objective: Gastric cancer is a worldwide aggressive tumor with a bad prognosis. The purpose of this study was to retrospectively investigate operative findings of 53 patients aged over 70 with gastric cancer who underwent laporoscopic operations in our clinic. Material and methods: A retrospective review of all patients who underwent laporoscopic surgery for pathologically confirmed gastric cancer at our clinic between March 2008 and October 2010 was conducted. D1 resection (Level1 lymphadenectomy) was compared with D2 resection (Levels 1 and 2 lymphadenectomy). The two groups in which D1 and D2 Lymph node Dissection (LND) were applied were compared with respect to number of patients, sex, age, stage of disease, and score of American Society of Anesthesiologists (ASA). We analyzed surgical methods, the use of staplers, operative time, additional organ resections, hospital stay, postoperative complications and the need for re-operation, operative mortality, and the effects of prognostic factors on survival. Results: The patient group consisted of 31 (58%) males and 22 (42%) females. Of the patients, 28 (52%) underwent D1 and 25 (48%) D2 LND. There was a significant difference between the two groups with regard to length of surgery (p < 0.01). The length of operation, blood loss, and transfusion requirement in the D2 group were significantly more than those in the D1 group. There was no mortality in cases that underwent additional organ resection. The survival times of cases with a ? 0.25 ratio of dissected number of lymph nodes to metastatic lymph nodes were significantly longer than those of other cases. The survival time of cases with perineural and vascular invasion was significantly shorter. The survival rates of Stage I patients was significantly higher than those of Stage III (p:0.002) and Stage IV (p:0.003) patients. Conclusions: Although extensive dissection had an increased morbidity, there was no significant statistical difference between the two procedures. Early complications should not be attributed only to the extent of LND. The important prognostic factors related to long-time survival are the stage of the tumor, perineural and perivascular invasion, and metastatic lymph nodes.

Emir, Seyfi; Sözen, Selim; Bali, ?lhan; Gürdal, Sibel Özkan; Turan, Bünyamin Cüneyt; Y?ld?r?m, Oguzhan; Yeti?yi?it, Tarkan

2014-01-01

429

A new order of D2 lymphadenectomy in laparoscopic gastrectomy for cancer: live anatomy-based dissection.  

PubMed

It was the aim of this study to develop a methodology for dissection in laparoscopic distal gastrectomy with D2 lymphadenectomy (D2 LDG) for gastric cancer. One-hundred and thirty-two patients with distal gastric cancer underwent D2 LDG with a novel sequence of lymph node dissection between August 2004 and June 2008. Live anatomy in each step was observed simultaneously to ensure and confirm the newly developed methodology. Dissections in LDG were standardized as sequential steps: Dividing the gastrocolic ligament and getting access to the prepancreatic space--lymph node dissection in the lower left area--lymph node dissection in the lower right area--lymph node dissection in the upper right area--lymph nodes dissection centrally--lymph node dissection between liver and stomach. All dissections were successfully performed in peripancreatic spaces and their extensions. Gastric vessels were located by special landmarks, traced along vascular trunks and bifurcations, and identified by fine dissection technique in vaginavasorum. Sequential dissection around the pancreas was an effective method for D2 LDG. It was ensured by anatomical knowledge in each step: Vessels and fascial spaces around a central landmark, the pancreas. PMID:21091070

Li, Guo-Xin; Zhang, Ce; Yu, Jiang; Wang, Ya-Nan; Hu, Yan-Feng

2010-12-01

430

Dissecting impulsivity and its relationships to drug addictions.  

PubMed

Addictions are often characterized as forms of impulsive behavior. That said, it is often noted that impulsivity is a multidimensional construct, spanning several psychological domains. This review describes the relationship between varieties of impulsivity and addiction-related behaviors, the nature of the causal relationship between the two, and the underlying neurobiological mechanisms that promote impulsive behaviors. We conclude that the available data strongly support the notion that impulsivity is both a risk factor for, and a consequence of, drug and alcohol consumption. While the evidence indicating that subtypes of impulsive behavior are uniquely informative-either biologically or with respect to their relationships to addictions-is convincing, multiple lines of study link distinct subtypes of impulsivity to low dopamine D2 receptor function and perturbed serotonergic transmission, revealing shared mechanisms between the subtypes. Therefore, a common biological framework involving monoaminergic transmitters in key frontostriatal circuits may link multiple forms of impulsivity to drug self-administration and addiction-related behaviors. Further dissection of these relationships is needed before the next phase of genetic and genomic discovery will be able to reveal the biological sources of the vulnerability for addiction indexed by impulsivity. PMID:24654857

Jentsch, J David; Ashenhurst, James R; Cervantes, M Catalina; Groman, Stephanie M; James, Alexander S; Pennington, Zachary T

2014-10-01

431

Zebrafish as a novel vertebrate model to dissect enterococcal pathogenesis.  

PubMed

Enterococcus faecalis is an opportunistic pathogen responsible for a wide range of life-threatening nosocomial infections, such as septicemia, peritonitis, and endocarditis. E. faecalis infections are associated with a high mortality and substantial health care costs and cause therapeutic problems due to the intrinsic resistance of this bacterium to antibiotics. Several factors contributing to E. faecalis virulence have been identified. Due to the variety of infections caused by this organism, numerous animal models have been used to mimic E. faecalis infections, but none of them is considered ideal for monitoring pathogenesis. Here, we studied for the first time E. faecalis pathogenesis in zebrafish larvae. Using model strains, chosen isogenic mutants, and fluorescent derivatives expressing green fluorescent protein (GFP), we analyzed both lethality and bacterial dissemination in infected larvae. Genetically engineered immunocompromised zebrafish allowed the identification of two critical steps for successful establishment of disease: (i) host phagocytosis evasion mediated by the Epa rhamnopolysaccharide and (ii) tissue damage mediated by the quorum-sensing Fsr regulon. Our results reveal that the zebrafish is a novel, powerful model for studying E. faecalis pathogenesis, enabling us to dissect the mechanism of enterococcal virulence. PMID:24002065

Prajsnar, Tomasz K; Renshaw, Stephen A; Ogryzko, Nikolay V; Foster, Simon J; Serror, Pascale; Mesnage, Stéphane

2013-11-01

432

Dissecting the Role of COPI Complexes in Influenza Virus Infection  

PubMed Central

As an obligate pathogen, influenza virus requires host cell factors and compartments to mediate productive infection and to produce infectious progeny virus. Recently, several small interfering RNA (siRNA) knockdown screens revealed influenza virus host dependency proteins, all of which identified at least two subunits of the coat protein I (COPI) complex. COPI proteins oligomerize to form coated vesicles that transport contents between the Golgi apparatus and the endoplasmic reticulum, and they have also been reported to mediate endosomal trafficking. However, it remains unclear which steps in the influenza virus infection cycle rely on the COPI complex. Upon systematic dissection of the influenza virus infection cycle, from entry to progeny virion production, we found that prolonged exposure to COPI complex disruption through siRNA depletion resulted in significant defects in virus internalization and trafficking to late endosomes. Acute inhibition of COPI complex recruitment to the Golgi apparatus with pharmacological compounds failed to recapitulate the same entry defects as observed with the COPI-depleted cells but did result in specific decreases in viral membrane protein expression and assembly, leading to defects in progeny virion production. Taken together, our findings suggest that COPI complexes likely function indirectly in influenza virus entry but play direct roles in viral membrane protein expression and assembly. PMID:23255804

Sun, Eileen; He, Jiang

2013-01-01

433

Preventing and Controlling Bleeding in Gastric Endoscopic Submucosal Dissection  

PubMed Central

Although techniques and instruments for endoscopic submucosal dissection (ESD) have improved, bleeding is still the most common complication. Minimizing the occurrence of bleeding is important because blood can interfere with subsequent procedures. Generally, ESD-related bleeding can be divided into intraprocedural and postprocedural bleedings. Postprocedural bleeding can be further classified into early post-ESD bleeding which occurs within 48 hours after ESD and late post-ESD bleeding which occurs later than 48 hours after ESD. A basic principle for avoiding intraprocedural bleeding is to watch for vessels and coagulate them before cutting. Several countertraction devices have been designed to minimize intraprocedural bleeding. Methods for reducing postprocedural bleeding include administration of proton-pump inhibitors or prophylactic coagulation after ESD. Medical adhesive spray such as n-butyl-2-cyanoacrylate is also an option for preventing postprocedural bleeding. Various endoscopic treatment modalities are used for both intraprocedural and postprocedural bleeding. However, hemoclipping is infrequently used during ESD because the clips interfere with subsequent resection. Bleeding that occurs as a result of ESD can usually be managed easily. Nonetheless, more effective ways to prevent bleeding, including reliable ESD techniques, must be developed. PMID:24143302

Park, Chan Hyuk

2013-01-01

434

Pulse energy dependence of subcellular dissection by femtosecond laser pulses  

NASA Technical Reports Server (NTRS)

Precise dissection of cells with ultrashort laser pulses requires a clear understanding of how the onset and extent of ablation (i.e., the removal of material) depends on pulse energy. We carried out a systematic study of the energy dependence of the plasma-mediated ablation of fluorescently-labeled subcellular structures in the cytoskeleton and nuclei of fixed endothelial cells using femtosecond, near-infrared laser pulses focused through a high-numerical aperture objective lens (1.4 NA). We find that the energy threshold for photobleaching lies between 0.9 and 1.7 nJ. By comparing the changes in fluorescence with the actual material loss determined by electron microscopy, we find that the threshold for true material ablation is about 20% higher than the photobleaching threshold. This information makes it possible to use the fluorescence to determine the onset of true material ablation without resorting to electron microscopy. We confirm the precision of this technique by severing a single microtubule without disrupting the neighboring microtubules, less than 1 micrometer away. c2005 Optical Society of America.

Heisterkamp, A.; Maxwell, I. Z.; Mazur, E.; Underwood, J. M.; Nickerson, J. A.; Kumar, S.; Ingber, D. E.

2005-01-01

435

Dissecting Social Cell Biology and Tumors Using Drosophila Genetics  

PubMed Central

Cancer was seen for a long time as a strictly cell-autonomous process in which oncogenes and tumor-suppressor mutations drive clonal cell expansions. Research in the past decade, however, paints a more integrative picture of communication and interplay between neighboring cells in tissues. It is increasingly clear as well that tumors, far from being homogenous lumps of cells, consist of different cell types that function together as complex tissue-level communities. The repertoire of interactive cell behaviors and the quantity of cellular players involved call for a social cell biology that investigates these interactions. Research into this social cell biology is critical for understanding development of normal and tumoral tissues. Such complex social cell biology interactions can be parsed in Drosophila. Techniques in Drosophila for analysis of gene function and clonal behavior allow us to generate tumors and dissect their complex interactive biology with cellular resolution. Here, we review recent Drosophila research aimed at understanding tissue-level biology and social cell interactions in tumors, highlighting the principles these studies reveal. PMID:23988119

Pastor-Pareja, Jose Carlos; Xu, Tian

2014-01-01

436

Acute Type A Aortic Dissection: for Further Improvement of Outcomes  

PubMed Central

Despite improved outcomes of acute type A aortic dissection (AAAD), many patients die at the moment of onset, and hospital mortality is still high. This article reviews the latest literature to seek the best possible way to optimize outcomes. Delayed diagnosis is caused by variation in or absence of typical symptoms, especially in patients with neurological symptoms. Misdiagnosis as acute myocardial infarction is another problem. Improved awareness by physicians is needed. On arrival, quick admission to the OR is desirable, followed by assessment with transesophageal echocardiography, and malperfusion already exists or newly develops in the OR; thus, timely diagnosis without delay with multimodality assessment is important. Although endovascular therapy is promising, careful introduction is mandatory so as not to cause complications. While various routes are used for the systemic perfusion, not a single route is perfect, and careful monitoring is essential. Surgical treatment on octogenarians is increasingly performed and produces better outcomes than conservative therapy. Complications are not rare, and consent from the family is essential. Prevention of AAAD is another important issue because more patients die at its onset than in the following treatment. In addition to hereditary diseases, including bicuspid aortic valve disease, the management of blood pressure is important. PMID:23555530

2012-01-01

437

Management of ruptured and unruptured intracranial vertebral artery dissecting aneurysms.  

PubMed

Vertebral artery dissecting aneurysms (VADA) are challenging disorders for neurosurgeons. Between December 2005 and May 2010, we treated 12 patients for DA of the intracranial VA. Three were treated by open surgery, seven underwent endovascular manipulation, and two were conservatively managed. Nine patients presented with subarachnoid hemorrhage from the ruptured aneurysm, and of these, two experienced abrupt re-hemorrhage and three presented with symptoms of brainstem ischemia. One of the two patients with a re-hemorrhage underwent conservative management and died in hospital of re-bleeding at 30 days after initial presentation. No postoperative neurological deficits occurred in patients treated by open surgery or via an endovascular approach. No re-hemorrhage or ischemic symptoms were observed in the 11 remaining patients during the mean 29-month (range: 14-54-month) follow-up. The chosen management strategy should be developed according to the patient's clinical condition and imaging results. Endovascular treatment, which includes several techniques, is the first choice for most patients. PMID:22018807

Su, Wandong; Gou, Shouzhong; Ni, Shilei; Li, Gang; Liu, Yuguang; Zhu, Shugan; Li, Xingang

2011-12-01

438

Dissecting a complex chemical stress: chemogenomic profiling of plant hydrolysates  

PubMed Central

The efficient production of biofuels from cellulosic feedstocks will require the efficient fermentation of the sugars in hydrolyzed plant material. Unfortunately, plant hydrolysates also contain many compounds that inhibit microbial growth and fermentation. We used DNA-barcoded mutant libraries to identify genes that are important for hydrolysate tolerance in both Zymomonas mobilis (44 genes) and Saccharomyces cerevisiae (99 genes). Overexpression of a Z. mobilis tolerance gene of unknown function (ZMO1875) improved its specific ethanol productivity 2.4-fold in the presence of miscanthus hydrolysate. However, a mixture of 37 hydrolysate-derived inhibitors was not sufficient to explain the fitness profile of plant hydrolysate. To deconstruct the fitness profile of hydrolysate, we profiled the 37 inhibitors against a library of Z. mobilis mutants and we modeled fitness in hydrolysate as a mixture of fitness in its components. By examining outliers in this model, we identified methylglyoxal as a previously unknown component of hydrolysate. Our work provides a general strategy to dissect how microbes respond to a complex chemical stress and should enable further engineering of hydrolysate tolerance. PMID:23774757

Skerker, Jeffrey M; Leon, Dacia; Price, Morgan N; Mar, Jordan S; Tarjan, Daniel R; Wetmore, Kelly M; Deutschbauer, Adam M; Baumohl, Jason K; Bauer, Stefan; Ibanez, Ana B; Mitchell, Valerie D; Wu, Cindy H; Hu, Ping; Hazen, Terry; Arkin, Adam P

2013-01-01

439

Virtual fetal pig dissection as an agent of knowledge acquisition and attitudinal change in female high school biology students  

NASA Astrophysics Data System (ADS)

One way to determine if all students can learn through the use of computers is to introduce a lesson taught completely via computers and compare the results with those gained when the same lesson is taught in a traditional manner. This study attempted to determine if a virtual fetal pig dissection can be used as a viable alternative for an actual dissection for females enrolled in high school biology classes by comparing the knowledge acquisition and attitudinal change between the experimental (virtual dissection) and control (actual dissection) groups. Two hundred and twenty-four students enrolled in biology classes in a suburban all-girl parochial high school participated in this study. Female students in an all-girl high school were chosen because research shows differences in science competency and computer usage between the genders that may mask the performance of females on computer-based tasks in a scien