Sample records for dissection case noticed

  1. Dissecting the unspeakable: a fatal case of aortic dissection.

    PubMed

    Dherange, Parinita A; Patel, Sarah; Singh, Nirmal; Suryanarayana, Prakash

    2015-01-01

    A 47-year-old man with diabetes and hypertension presented with sudden onset of chest pain and subsequently developed expressive aphasia. Brain imaging revealed multiple areas of ischaemic infarcts. Transoesophageal echocardiogram revealed aortic dissection with a free-floating thrombus on the dissection flap, which was the source of emboli. Given the poor prognosis, surgical intervention was not pursued and artificial support was withdrawn. Aortic dissection is a highly fatal condition with varied presentation including heart failure, myocardial infarction, neurological deficits, abdominal pain or acute renal failure. Aortic dissection is a relatively uncommon but catastrophic condition. A high degree of clinical suspicion is required for early and accurate diagnosis since mortality is high and increases by the hour. The mechanism for stroke in our case was due to an artery-to-artery embolism from a thrombus, which developed on the intimal surface of the dissected artery. This is an infrequent complication with a very unique mechanism. PMID:26077807

  2. Virtual temporal bone dissection: a case study

    Microsoft Academic Search

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

    2001-01-01

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

  3. Six Cases of Chylous Leakage after Axillary Lymph Node Dissection

    Microsoft Academic Search

    Ming-hua Cong; Qi Liu; Wen-hong Zhou; Jian Zhu; Chen-xin Song; Xing-song Tian

    2008-01-01

    Summary Background: Chylous leakage has been described after several surgical procedures, especially in the region of the neck and thorax. However, it has rarely been reported after axillary lymph node dissection. Patients and Methods: We encountered 6 cases of chylous leakage after axillary lymph node dissection out of a total of 882 breast cancer patients between July 2005 and June

  4. Peripartum acute aortic dissection: A case report & review of literature.

    PubMed

    Aziz, Fahad; Penupolu, Sudheer; Alok, Anshu; Doddi, Sujatha; Abed, Mary

    2011-03-01

    Acute aortic dissection is a rare clinical entity that mainly affects patients older than 50 years. It is unusual in younger patients and its presence has been traditionally associated with trauma, Marfan syndrome, bicuspid aortic valve and pregnancy. We present here, a case of a 30 year old pregnant female with acute aortic dissection type A (De Bakey II), without family history of connective tissue diseases and signs of Marfan syndrome. PMID:22263062

  5. Dissection Dissected.

    ERIC Educational Resources Information Center

    Berman, William

    1984-01-01

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

  6. Open Retrograde Endovascular Stenting for Left Common Carotid Artery Dissection Secondary to Surgical Repair of Acute Aortic Dissection: A Case Report and Review of the Literature.

    PubMed

    Gao, Peng; Wang, Yabing; Chen, Yanfei; Jiao, Liqun

    2015-07-01

    A 30-year-old male presented with an acute aortic artery dissection (Stanford type A) and underwent total arch replacement using a stented elephant trunk technique. One month later, the patient developed dissections in the innominate and left common carotid artery (CCA). The innominate artery dissection caused occlusion in the right internal carotid artery (ICA) and a major stroke. Dissection of the left CCA progressed and extended to the bifurcation site. Antegrade access for a left carotid intervention was deemed as difficult because of the previously implanted stent and the additional risks of embolic events and dissection enlargement. Hybrid procedures combining left carotid bifurcation exposure and retrograde endovascular stenting were successfully completed. This report is a rare case of retrograde endovascular reconstruction for the left CCA dissection following surgical repair of an aortic artery dissection. Here, we also review previous cases of iatrogenic carotid dissections following surgical intervention. PMID:25765635

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

    PubMed Central

    Menon, Rajeev; Kapadia, Anuj

    2014-01-01

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

  8. Unusual cause of acute back pain mimicking aortic dissection: a case report.

    PubMed

    Czesla, Markus; Karnari, Olga; Götte, Julia; Schulte, Bernhard; Pfeilsticker, Ulrich; Narr, Anita; Doll, Nicolas

    2012-12-01

    We report the case of a 62-year-old woman who initially presented with symptoms suggesting acute type A aortic dissection. Imaging studies revealed hemorrhagic pericardial fluid without the evidence of dissection. Foreign body material was noted floating in the inferior vena cava (IVC) and also piercing the right ventricular wall. Upon surgical exploration, the extracted material could be identified to be acrylic bone cement (palacos). The patient had reported a history of kyphoplasty in 2008. PMID:22207371

  9. A case of Marfan’s syndrome with multi-level aortic dissections

    PubMed Central

    Khosravi, Alireza; Behjati, Mohaddeseh; Nilforoush, Peyman; Saieedi, Mahmoud; Balouchi, Abbas

    2014-01-01

    BACKGROUND Although Marfan’s syndrome is a disease with various phenotypes, but the major mechanism of death is cardiovascular complication. Aortic dissection is a major cause of death in Marfan syndrome. CASE REPORT A 30-year-old man with severe refractory chest and left flank pain and history of previously surgically repaired Type A aortic dissection was referred to the hospital. His typical manifestations of Marfan’s syndrome were identified. Cardiovascular imaging showed an acute spiral dissection in the descending aorta extending to the left renal and femoral arteries with no evidence of thrombosis in its huge false lumen (8 cm). By the diagnosis of acute, expanded, spiral, Type B aortic dissection, he underwent the stent grafting of dissected aorta. He discharged without any complication. On follow-up cardiovascular imaging, thrombosed false lumen in stented aorta from descending aorta to the proximal abdominal aorta was seen. CONCLUSION Endovascular treatment of Type B dissection is an effective treatment in Type B dissection, even in patients with Marfan syndrome. PMID:25815023

  10. An unusual case of chronic coronary artery dissection: Did cisplatin play a role?

    PubMed Central

    Ghosh, Nina; Chow, Chi-Ming; Korley, Victoria; Chisholm, Robert

    2008-01-01

    Spontaneous coronary artery dissection is an unusual cause of acute myocardial ischemia. The natural history of spontaneous coronary artery dissection that persists on angiography after the acute event has not been well characterized. A case of a 36-year-old man who presented with monomorphic ventricular tachycardia 12 years following a myocardial infarction that occurred during his last course of bleomycin-etoposidecisplatin therapy for testicular cancer is reported. On further investigation, coronary angiography revealed a long chronic dissection of the right coronary artery. The patient was successfully treated with medical management and insertion of an implantable cardioverter defibrillator. The case also highlights the increased cardiovascular morbidity in testicular cancer survivors and evokes the possibility of mechanisms of myocardial ischemia other than atherosclerotic disease in these young patients. PMID:18841261

  11. Endovascular Treatment of Cervical Artery Dissection: Ten Case Reports and Review of the Literature

    PubMed Central

    Ahlhelm, Frank; Benz, Robyn Melanie; Ulmer, Stephan; Lyrer, Philippe; Stippich, Christoph; Engelter, Stefan

    2013-01-01

    Purpose The role of endovascular treatment in cases of cervical artery dissection (CeAD) is debatable. With an increasing number of endovascular therapies such as endovascular recanalization and embolization the number of complications such as iatrogenic dissection is also rising. We report our experience with endovascular stenting in the treatment of patients presenting with CeAD. Methods We included all consecutive patients with CeAD (n = 168) treated in our hospital between 2001 and 2010 for our retrospective study. Patients with CeAD were considered eligible for stenting: (1) in iatrogenic dissections and (2) in noniatrogenic dissections if they suffered from recurrent ischemic events despite antithrombotic treatment. Results During our observation period 10 out of 168 patients presenting with CeAD were selected for stenting. Several types of stents were used. Stenting was technically successful in 8 but unsuccessful in 2 patients with complete arterial occlusion. Stent-related clinically apparent complications occurred in 3 of the 10 patients. All were transient. During a mean follow-up of 47 (±24.8) months none of the patients had new cerebrovascular ischemic events. Conclusion In our patient sample stenting due to dissection is a rare procedure performed in less than 10% of CAD patients. It should be considered as a feasible rescue treatment in cases of impending stroke despite optimal antithrombotic therapy. PMID:25187774

  12. Common carotid artery dissection: a case report and review of the literature.

    PubMed

    Zach, Victor; Zhovtis, Svetlana; Kirchoff-Torres, Kathryn F; Weinberger, Jesse M

    2012-01-01

    Common carotid artery dissection (CCAD) is a rare and poorly characterized cause of ischemic stroke. We describe a case of multiple cerebral infarcts in a patient with CCAD initially detected by carotid duplex ultrasonography, and review the literature on CCAD. A Medline search from 1960 to the present for cases of CCAD yielded 46 cases. We extracted demographic data, anatomical location, symptoms, neurosonography, neuroradiology, pathological findings, treatment, and outcomes. The mean age of the patients was 48.8 ± 15.8 years (range, 19-89 years). With our patient, our search found 20 cases of spontaneous CCAD, 11 cases of traumatic CCAD, 4 cases of iatrogenic CCAD, and 12 cases of CCAD associated with aortic arch dissection. The most common presenting neurologic symptoms of CCAD were hemiparesis, decreased consciousness, headache/neck pain, aphasia, and monocular field deficit. The most frequently reported neurosonographic findings included a double lumen, mural thrombus, intraluminal hyperechoic/isoechoic lesion, and intimal flap. Most cases of CCAD were subsequently confirmed with conventional angiography, computed tomography angiography, or magnetic resonance angiography. Treatment differed based on etiology; anticoagulation was used most commonly for spontaneous CCAD, and surgical repair was most often done for traumatic and aortic dissection-associated CCAD. Prognosis was generally good; the majority of patients achieved complete clinical recovery, but 3 died. Our findings indicate that carotid Doppler is a widely accessible, rapid, and noninvasive technique for diagnosing CCAD. Our case and literature review further characterizes the diverse etiologies, clinical course, and radiographic features of CCAD. PMID:20851634

  13. Safety and Efficacy of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Neoplasms: A Case Series

    PubMed Central

    Akiyama, Hitoshi; Suzuki, Koyu; Fujita, Yoshiyuki

    2015-01-01

    Sixteen non-ampullary duodenal neoplasms in 16 patients were treated with endoscopic submucosal dissection (ESD) performed by an endoscopist and an instrument assistant between February 2011 and November 2014. En bloc resection was performed in 15 cases (94%); lateral and vertical margins were pathologically free in 13 cases. Perforation occurred during submucosal dissection using a flex knife, but no perforations occurred in 15 cases using the hook knife only. No postoperative bleeding nor recurrence has been reported in any patient during the median 17-month follow-up period. Use of the hook knife as the main instrument and targeted training of the endoscopist and instrument assistant contributed to safe and effective duodenal ESD for non-ampullary duodenal neoplasms.

  14. Risk Factors and Clinical Presentation of Cervical Arterial Dissection: Preliminary Results of a Prospective Case-Control Study.

    PubMed

    Thomas, Lucy C; Rivett, Darren A; Attia, John R; Levi, Christopher

    2015-07-01

    Study Design Cross-sectional case-control study. Objectives To identify risk factors and clinical presentation of individuals with cervical arterial dissection. Background Cervical arterial dissection is a common cause of stroke in young people and has in rare cases been associated with cervical manipulative therapy. The mechanism is considered to involve pre-existing arterial susceptibility and a precipitating event, such as minor trauma. Identification of individuals at risk or early recognition of a dissection in progress could help expedite medical intervention and avoid inappropriate treatment. Methods Participants were individuals 55 years of age or younger from the Hunter region of New South Wales, Australia with radiologically confirmed vertebral or internal carotid artery dissection and an age- and sex-matched comparison group. Participants were interviewed about risk factors, preceding events, and clinical features of their stroke. Physical examination of joint mobility and soft tissue compliance was undertaken. Results Twenty-four participants with cervical arterial dissection and 21 matched comparisons with ischemic stroke but not dissection were included in the study. Seventeen (71%) of the 24 participants with dissection reported a recent history of minor mechanical neck trauma or strain, with 4 of these 17 reporting recent neck manipulative therapy treatment. Cardiovascular risk factors were uncommon, with the exception of diagnosed migraine. Among the participants with dissection, 67% reported transient ischemic features in the month prior to their admission for dissection. Conclusion Recent minor mechanical trauma or strain to the head or neck appears to be associated with cervical arterial dissection. General cardiovascular risk factors, with the exception of migraine, were not important risk factors for dissection in this cohort. Preceding transient neurological symptoms appear to occur commonly and may assist in the identification of this serious pathology. Level of Evidence Prognosis, level 4. J Orthop Sports Phys Ther 2015;45(7):503-511. Epub 21 May 2015. doi:10.2519/jospt.2015.5877. PMID:25996363

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

    PubMed Central

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

    2014-01-01

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

  16. Mesothelial/monocytic incidental cardiac excrescences (cardiac MICE) associated with acute aortic dissection: a study of two cases

    PubMed Central

    Strecker, Thomas; Bertz, Simone; Wachter, David Lukas; Weyand, Michael; Agaimy, Abbas

    2015-01-01

    Acute aortic dissection is a life-threatening condition mainly caused by hypertension, atherosclerotic disease and other degenerative diseases of the connective tissue of the aortic wall. Mesothelial/monocytic incidental cardiac excrescences (cardiac MICE) is a rare benign reactive tumor-like lesion composed of admixture of histiocytes, mesothelial cells, and inflammatory cells set within a fibrinous meshwork without a vascular network or supporting stroma. Cardiac MICE occurring in association with aortic dissection is exceptionally rare (only one such case reported to date). We herein report on the surgical repair of two Stanford type A aortic dissections caused by idiopathic giant cell aortitis in a 66-year-old-woman and by atherosclerotic disease in a 58-year-old-man, respectively. In both cases, the dissections could be visualized via computed tomography. Histopathology showed cardiac incidental MICE within the external aortic wall near the pericardial surface which was confirmed by immunohistochemistry.

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

    Microsoft Academic Search

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

    2005-01-01

    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

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

    PubMed

    Kumar, Bharat; Kanna, Balavenkatesh; Kumar, Suresh

    2011-01-01

    Premature closure is a type of cognitive error in which the physician fails to consider reasonable alternatives after an initial diagnosis is made. It is a common cause of delayed diagnosis and misdiagnosis borne out of a faulty clinical decision-making process. The authors present a case of aortic dissection in which premature closure was avoided by the aggressive pursuit of the appropriate differential diagnosis, and discuss the importance of disciplined clinical decision-making in the setting of chest pain. PMID:22679162

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

    PubMed Central

    Kumar, Bharat; Kanna, Balavenkatesh; Kumar, Suresh

    2011-01-01

    Premature closure is a type of cognitive error in which the physician fails to consider reasonable alternatives after an initial diagnosis is made. It is a common cause of delayed diagnosis and misdiagnosis borne out of a faulty clinical decision-making process. The authors present a case of aortic dissection in which premature closure was avoided by the aggressive pursuit of the appropriate differential diagnosis, and discuss the importance of disciplined clinical decision-making in the setting of chest pain. PMID:22679162

  20. Dissection of left iliac artery during anterior lumbar interspace fusion: Report of a case.

    PubMed

    Fischer, Uwe M; Davies, Mark G; Sayed, Hosam El

    2015-04-01

    Vascular injury is an uncommon complication of spine surgery. Among the different approaches, anterior lumbar interbody fusion has increased potential for vascular injuries, since the great vessels and their branches overly the disc spaces to be operated on, and retraction of these vessels is necessary to gain adequate surgical exposure. The reported incidence for anterior lumbar interbody fusion-associated vascular injuries ranges from 0% to 18.1%, with venous laceration as the most common type. We report a case of anterior lumbar interbody fusion-associated left common iliac artery dissection leading to delayed acute limb ischemia developing in early post-operative period. PMID:24848500

  1. Spontaneous coronary artery dissection: a report of three cases and review of the literature.

    PubMed Central

    Kearney, P.; Singh, H.; Hutter, J.; Khan, S.; Lee, G.; Lucey, J.

    1993-01-01

    We describe the clinical course of three patients who developed spontaneous coronary artery dissection. All patients were young women, one 9 weeks pregnant. All presented with chest pain; one died suddenly proving refractory to resuscitation, another developed unstable angina culminating in myocardial infarction, cardiogenic shock and death, and the third patient underwent coronary artery bypass grafting following diagnosis of a spontaneous coronary dissection of the left anterior descending artery at angiography. Pathological findings in the two fatal cases are reported. This condition, although rare, is a prominent cause of ischaemic coronary events in young women, when it is frequently associated with pregnancy or the puerperium. Most patients die suddenly, but a clinical spectrum is seen including stable and unstable angina, myocardial infarction and cardiogenic shock. The left anterior descending artery is most frequently affected. The classical histological finding is that of a large haematoma occupying the outer third of the media resulting in complete compression of the true lumen. The cause of spontaneous dissection remains unclear but theories of aetiology include a medial eosinophilic angiitis, pregnancy-induced degeneration of collagen in conjunction with the stresses of parturition, and rupture of the vasal vasorum. The diagnosis must be considered when a patient presents with a suggestive clinical profile. Urgent angiography should be undertaken to establish the diagnosis and consideration given to the need for coronary artery bypass grafting, which has been successfully employed in a number of patients. The uneventful long-term survival of cases treated conservatively has been reported. Images Figure 1 Figure 2 PMID:8121872

  2. Multivessel spontaneous dissection of the left coronary tree in the postpartum period: case report and review of the literature.

    PubMed

    Petrou, E; Bousoula, E; Boutsikou, M; Iakovou, I; Kolovou, G; Pavlides, G

    2014-01-01

    Spontaneous coronary artery dissection is a rare cause of myocardial infarction predominantly associated with young women during the third trimester of pregnancy or during the postpartum period. Multivessel spontaneous coronary artery dissection is an even less frequent condition with limited reports in medical literature. Hormonal changes as well as hemodymanic stress are some of the factors that have been implicated in the etiology of this condition. However, the exact pathophysiological process leading to spontaneous coronary artery dissection has not yet been elucidated. The spectrum of clinical presentation ranges from mild symptoms to cardiac arrest. Herein, we report the case of a 39-year-old woman with spontaneous two coronary vessel dissection during her postpartum period presented with ST elevation myocardial infarction on electrocardiogram complicated with pulmonary edema and cardiorespiratory arrest. PMID:25555861

  3. Diabetes and Reduced Risk for Thoracic Aortic Aneurysms and Dissections: A Nationwide Case-Control Study

    PubMed Central

    Prakash, Siddharth K.; Pedroza, Claudia; Khalil, Yameen A.; Milewicz, Dianna M.

    2012-01-01

    Background Vascular diseases are the principal causes of death and disability in people with diabetes. At the same time, studies suggest a protective role of diabetes in the development of abdominal aortic aneurysms. We sought to determine whether diabetes is associated with decreased hospitalization due to thoracic aortic aneurysms and dissections (TAAD). Methods and Results We used the 2006 and 2007 Nationwide Inpatient Sample (NIS) to determine TAAD discharge rates. Control subjects were randomly selected to achieve three controls per case. Predictor variables in multilevel logistic regression included age, race, median income, diabetes, and hypertension. We estimated that the average rate of hospital discharge for TAAD among individuals diagnosed with diabetes was 9.7 per 10 000, compared to 15.6 per 10 000 among all discharges. The prevalence of diabetes was substantially lower in TAAD (13%) than in control (22%) records. After adjustment for demographic characteristics, the negative association between diabetes and TAAD remained highly significant in both NIS datasets. Compared to discharges without diabetes, those with chronic complications of diabetes were least likely to be diagnosed with TAAD (OR [odds ratio] 0.17, 95% CI, 0.12–0.23). A significant association remained between uncomplicated diabetes and TAAD. We replicated these findings in an independent group of patients who were hospitalized with acute thoracic aortic dissections. Conclusions The principal implication of our findings is that diabetes is independently associated with a decreased rate of hospitalization due to TAAD in proportion to the severity of diabetic complications. Future studies should consider diabetes in predictive models of aneurysm expansion or dissection. (J Am Heart Assoc. 2012;1:jah3-e000323 doi: 10.1161/JAHA.111.000323.) PMID:23130125

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

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

    1996-01-01

    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

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

    PubMed Central

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

    2015-01-01

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

  7. Three Case Report of Spontaneous Isolated Dissection of the Superior Mesenteric Artery—With an Algorithm Proposed for the Management

    PubMed Central

    Nakayama, Yoshihiro; Shiroma, Shinyu; Ido, Koki

    2015-01-01

    Spontaneous isolated dissection of the superior mesenteric artery (SID-SMA) is a rare condition, and there is still no consensus on optimal management. Here, we present three cases of SID-SMA, that were treated by surgical revascularization with urgent iliomesenteric bypass surgery without intestine resection, endovascular therapy with stent placement, and conservative management. The purpose of this study is to review these three cases and propose an algorithm for optimal management of SID-SMA.

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

    PubMed

    Bauer, Martin; Tatschner, Thomas; Patzelt, Dieter

    2007-05-01

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

  9. Reoperative sentinel lymph node biopsy for ipsilateral breast tumor recurrence after previous axillary lymph node dissection: Report of a case

    Microsoft Academic Search

    Masaya Hattori; Seiichiro Nishimura; Keiichiro Tada; Masamichi Koyama; Futoshi Akiyama; Yoshinori Ito; Takuji Iwase

    2011-01-01

    Sentinel lymph node biopsy has become a standard component of the evaluation of early-stage breast cancer, with a gradually\\u000a increasing number of indications in this patient population. This report presents the case of a patient who underwent reoperative\\u000a sentinel lymph node biopsy as part of an evaluation of ipsilateral breast tumor recurrence; she had previously undergone axillary\\u000a lymph node dissection.

  10. Popliteal lymph node dissection for metastatic squamous cell carcinoma: a case report of an uncommon procedure for an uncommon presentation

    PubMed Central

    2011-01-01

    Lymph node metastasis from cutaneous squamous cell carcinoma is uncommon. The popliteal fossa is rarely involved with metastasis. Popliteal lymph node dissection is uncommonly performed and not frequently discussed in the literature. We present a case of squamous cell carcinoma of the heel with popliteal and inguinal metastasis. This is followed by a description of the relevant anatomy of the popliteal fossa and the technique of popliteal lymphadenectomy. PMID:21999203

  11. Surgical treatment for chronic dissecting aneurysm (DeBakey Type I) —A case using “elephant trunk” and “aortic tailoring”—

    Microsoft Academic Search

    Taira Yamamoto; Haruo Makuuchi; Yoshihiro Naruse; Toshiya Kobayashi; Masahiro Goto; Kenji Nonaka

    1998-01-01

    We present a surgical case of a 54-year-old man with chronic dissecting aortic aneurysm (Type I). At the first operation,\\u000a ascending aorta and aortic arch were replaced with a tube graft under cardiopulmonary bypass and selective cerebral perfusion.\\u000a Elephant trunk method was employed for the second operation. At the second operation, graft replacement of the proximal two-thirds\\u000a of the descending

  12. Clam Dissection

    NSDL National Science Digital Library

    Kelly Riedell

    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.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    Faramarzi, Abolahassan; Heydari, Seyed Taghi

    2010-01-01

    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

  16. Spontaneous Isolated Superior Mesenteric Artery Dissection: Genetic Heterogeneity of Chromosome Locus 5q13-14 in 2 Male Familial Cases.

    PubMed

    Jia, Zhongzhi; Zhang, Xiaoping; Wang, Weiping; Tian, Feng; Jiang, Guomin; Li, Maoquan

    2015-07-01

    Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare disease that occurs sporadically. In this report, we describe 2 cases of SISMAD involving an uncle and his nephew. Genetic studies revealed the presence of heterogeneity of a chromosome locus at 5q13-14 in 3 family members (the 2 patients and the nephew's mother), an area previously found to be linked to familial ascending aortic aneurysms and dissections. PMID:25770389

  17. [Acute type a aortic dissection operated in childhood; report of a case].

    PubMed

    Okawa, Hideyuki; Yuhara, Satoshi; Kozakai, Motoshi; Yokote, Jun; Yokoyama, Yukifusa; Tamaki, Shuji; Go, Kiyotaka; Ohta, Takaya; Nishihara, Eiki; Kuraishi, Kenji; Tauchi, Nobuo

    2013-04-01

    A 12-year-old boy without any previous history and risk factors of cardiovascular disease presented to the emergency room with persisting general fatigue, bilateral shoulder pain and facial pallor. He was diagnosed as acute type A aortic dissection with cardiac tamponade by ultrasonic cardiogram (UCG) and computed tomography (CT) imaging, and the emergency surgery was indicated. He underwent hemiarch replacement because his aorta diameter was quite small but grafting as a large vascular prosthesis as possible was necessary in consideration of the growth. His postoperative course was uneventful and good, and he was discharged from our hospital in day 21 postoperatively. Acute aortic dissection in childhood is very rare but life-threatening. We should consider the particularity of children and make early diagnosis and treatment appropriately. PMID:23575188

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

    PubMed Central

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

    2014-01-01

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

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

    Microsoft Academic Search

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

    2003-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  1. Case report of an endovascular repair of a residual type A dissection using a not CE not FDA-approved Najuta thoracic stent graft system.

    PubMed

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

    2015-01-01

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

  2. Quahog Dissection

    NSDL National Science Digital Library

    Rhode Island Sea Grant

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

  3. Endovascular angioplasty-stenting as a definitive treatment for isolated spontaneous common carotid artery dissection. A case report.

    PubMed

    Kervancioglu, S; Sirikci, A; Yigiter, R; Cakir, Y; Metin Bayram, M

    2006-06-30

    Isolated spontaneous common carotid artery (CCA) dissection is rare. So far, surgical or medical treatment have only been reported in a few cases in the literature. We report a 39-year-old man, diagnosed as isolated spontaneous CCA dissection one year ago, who experienced a new minor stroke despite medical treatment. Because of the presence of new ischemic lesions on new magnetic resonance imaging despite medical treatment, and critical narrowing of internal carotid artery (ICA) orifice with jet and turbulence flow pattern at the bulbar portion of the ICA, endovascular management was performed with carotid stent deployment. To the best of our knowledge, this is the first case of spontaneous isolated CCA dissection treated with stenting of the carotid artery reported in literature. - ÖZET - ?zole spontan common carotid arter (CCA) diseksiyonu nadirdir. Literatürde sadece birkaç adet, medikal veya cerrahi tedavi uygulanan, CCA diseksiyonu olgusu bildirilmi?tir. Bildirimizde, bir y?l önce izole spontan CCA diseksiyonu tan?s? alm?? ve medikal tedavi alt?nda iken yeni minor strok geçiren 39 ya??nda erkek olguyu sunuyoruz. Olgunun yeni magnetik rezonans görüntülemesinde (MRG), sol posterior frontal ve pariyetal loblarda yeni iskemik lezyonlar?n ortaya ç?kt??? görüldü. Renkli Doppler ultrasonografi (RDUS) incelemesinde eski incelemesine gore darl???n artt??? izlendi. Karotis anjiografide de internal karotis arter ba?lang?c?nda jet ve türbülans ak?ma neden olan kritik darl?k saptanmas? üzerine endovasküler tedavi planland?. Femoral giri?imle koruyucu filtre kullan?larak self ekspand?bl stent yerle?tirildi ve postdilatasyon balon uyguland?. I?lemden 24 saat sonra al?nan difüzyon MRG incelemesinde yeni iskemik alan görülmedi. Birinci ve 3. ay kontrollerinde, nörolojik muayenesinde yeni bulgu saptanmad?. RDUS incelemelerinde stentin aç?k oldu?u görüldü. Karotis artere stent yerle?tirimesi cerrahiye alternatif bir tedavi olup daha az invazivdir. Stent uygulamas?, spontan ve travmatik internal karotis arter darl?klar?nda kullan?lm??, ancak izole spontan CCA diseksiyonunda kullan?lmam??t?r. Olgumuz nadir görülen izole spontan CCA diseksiyonu olgular?ndan biri olup stent yerle?tirilerek tedavi edilmi?tir. Sonuç olarak, medikal tedaviye ra?men tekrarlayan semptomlar? olan izole spontan CCA diseksiyonu olgularda tromboemboli kayna??n?n kontrol alt?na al?nmas? ve yeterli karotis ak?m?n?n sa?lanmas? için stent yerle?tirilmesi gerekebilir. PMID:24351221

  4. Malignant hypertension and acute aortic dissection associated with caffeine-based ephedra-free dietary supplements: a case report.

    PubMed

    Ahmed, Imdad

    2009-01-01

    The use of weight loss dietary supplements is prevalent in the United States, and over the past decade, there has been tremendous growth of the use of these products. It is well documented that ephedra-based products are associated with various cardiovascular adverse effects. With new restrictions placed on such products, companies are now manufacturing caffeine-based ephedra-free herbal supplements. We present the case of 36-year old, previously healthy female who developed malignant hypertension and aortic dissection while taking various caffeine-based dietary supplements. Given the lack of research studies in regards to their safety and efficacy, judicious care should be taken with the use of dietary supplements, including those designated as ephedra-free. PMID:20181166

  5. Aortic Dissection Mimicking Subarachnoidal Hemorrhage

    Microsoft Academic Search

    Ulrike Ernemann; Gunnar Tepe; Rainer Ritz; Dorothee Bail

    2005-01-01

    Inthisreportwedescribeacomatosepatientwithprox- imal aortic dissection who presented with the signs of subarachnoidalhemorrhage.Shortlybeforelosingcon- sciousness, the patient complained of an excruciating headache. Upon initial examination, neck stiffness and opisthotonos were present. The cardiovascular exami- nation, chest radiograph, and cerebral computed to- mography were normal. Eight hours later, the aortic dissection was verified by a thoracic computed tomog- raphy. This case shows that aortic

  6. Future directions of duodenal endoscopic submucosal dissection

    PubMed Central

    Matsumoto, Satohiro; Miyatani, Hiroyuki; Yoshida, Yukio

    2015-01-01

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

  7. Future directions of duodenal endoscopic submucosal dissection.

    PubMed

    Matsumoto, Satohiro; Miyatani, Hiroyuki; Yoshida, Yukio

    2015-04-16

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

  8. Spontaneous Dissection of the Superior Mesenteric Artery

    SciTech Connect

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

    2001-09-15

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

  9. Paper dissection

    NSDL National Science Digital Library

    David Varricchio

    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?

  10. Dissect It!

    NSDL National Science Digital Library

    Olga Wood

    2012-06-27

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

  11. Polyomino Dissections

    ERIC Educational Resources Information Center

    Hohn, Tiina; Liu, Andy

    2012-01-01

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

  12. Doppler sonograpy with dynamic testing in a case of aortic dissection extending to the innominate and right common carotid arteries.

    PubMed

    Bonnin, P; Giannesini, C; Amah, G; Kevorkian, J P; Woimant, F; Levy, B I

    2003-07-01

    A 50-year-old woman with Marfan's syndrome was admitted for an aortic dissection with an intimal flap extending from the sinus of Valsalva to the descending aorta and aortic valve incompetence. Ultrasonography revealed a double lumen in the innominate and right common carotid (RCCA) arteries. The false lumen extended from the aortic arch to the distal RCCA and compressed and nearly occluded the true lumen in the innominate artery. At the end of the RCCA was a large tear allowing communication between the false and true lumens. Colour-coded Doppler sonography showed blood passing from the false lumen into the true lumen and antegrade flow in the false lumen but reverse flow in the true channel. A dynamic test, as used in accessing for subclavian steal syndrome, producing reactive hyperaemia, showed the retrograde flow in the true channel to be markedly increased, supplying the subclavian artery. We emphasie the importance of functional description of an abnormal haemodynamic situation, which in this case helped to avoid unnecessary surgery to the supra-aortic arteries. PMID:12774182

  13. [Surgical treatment for chronic dissecting aneurysm (DeBakey type I)--a case using "elephant trunk" and "aortic tailoring"].

    PubMed

    Yamamoto, T; Makuuchi, H; Naruse, Y; Kobayashi, T; Goto, M; Nonaka, K

    1998-09-01

    We present a surgical case of a 54-year-old man with chronic dissecting aortic aneurysm (Type I). At the first operation, ascending aorta and aortic arch were replaced with a tube graft under cardiopulmonary bypass and selective cerebral perfusion. Elephant trunk method was employed for the second operation. At the second operation, graft replacement of the proximal two-thirds of the descending aorta was performed, and the lower third of the descending aorta was tailored. Aortic tailoring consisted of the longitudinal aortomy and the removal of the initimal flap from the distal part of the descending aorta from the level of the 9th intercostal artery down to the diaphragm. The aorta was closed creating single channel 21 mm in diameter and containing the origins of the important intercostal arteries. He discharged the hospital without any complication including paraplegia or visceral ischemia, and his follow-up CT scan (1 year-later) did not show any dilatation of the tailored segment of the descending aorta and abdominal aorta. PMID:9796292

  14. Clam Dissection

    NSDL National Science Digital Library

    Roy Plotnick

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

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

    PubMed Central

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

    2014-01-01

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

  16. Aortic dissection mimicking subarachnoidal hemorrhage.

    PubMed

    Nohé, Boris; Ernemann, Ulrike; Tepe, Gunnar; Ritz, Rainer; Bail, Dorothee

    2005-07-01

    In this report we describe a comatose patient with proximal aortic dissection who presented with the signs of subarachnoidal hemorrhage. Shortly before losing consciousness, the patient complained of an excruciating headache. Upon initial examination, neck stiffness and opisthotonos were present. The cardiovascular examination, chest radiograph, and cerebral computed tomography were normal. Eight hours later, the aortic dissection was verified by a thoracic computed tomography. This case shows that aortic dissection, which causes severe pain and possibly transient malperfusion of the carotid arteries, may present with the misleading signs of subarachnoidal hemorrhage but without classical symptoms of aortic syndromes. PMID:15976237

  17. Dissected Plateau

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03193 Dissected Plateau

    This plateau borders Echus Chasma. The surface of the plateau has been dissected by shallow channels of unknown origin.

    Image information: VIS instrument. Latitude 0.2N, Longitude 279.1E. 17 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  18. Dissected Surface

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03286 Dissected Surface

    Small channels dissect this region near Nectaris Fossae.

    Image information: VIS instrument. Latitude -22.9N, Longitude 17.4E. 17 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  19. Surface Dissection

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Context image for PIA03290 Surface Dissection

    At the southern end of Echus Cansma this dissected surface and mega-gullies occur.

    Image information: VIS instrument. Latitude -1.1N, Longitude 278.8E. 17 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  20. [Paraplegia and dissection of the abdominal aorta after closed trauma. Apropos of a case. Current review of the literature (1982-1993)].

    PubMed

    Solovei, G; Alame, A; Bardoux, J; Cart, P; Vix, J; Petit, J; Dion, J J; Ribere, R

    1994-05-01

    A case of dissection with thrombosis of the subrenal abdominal aorta after blunt trauma led to paraplegia and bilateral ischaemia of the lower limbs in addition to acute abdominal signs. A review of the recent literature (1982-1993) revealed 32 reported cases. The patients were predominantly male and most often victims of an automobile accident (18 cases) or crushing trauma (6 cases). The clinical picture associated diverse degrees of abdominal signs, ischaemia and sensorial-motor impairment of the lower limbs. The diagnosis was established immediately on D0 in only 18 cases, early on days 1 to 7 in 4 cases and was late (day 8 to day 30) in 5 cases or very late (beyond day 30) in 6 cases. The difficulty in immediate diagnosis was related to the absent or incomplete vascular symptomatology or the late onset of the first signs. When a lesion of the aorta was suspected, an arteriography, angioscanner or peroperative exploration led to diagnosis. Neurological signs were frequent (10 cases including 8 with paraplegia) and generally related to ischaemia of the peripheral nerves. They may lead to denate from the diagnosis of vascular lesions. Fractures of the intima (17 cases) was the most frequent aortic lesion which also involved fracture of the media in a number of cases. Dissection was associated in 7 cases and complete or partial thrombosis of the aorta in 7. False aneurysms observed in 6 cases are the usual pathological form in cases of late diagnosis. Nearly all of the lesions were subrenal. Damage to abdominal organs was frequently observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7989410

  1. Pancreatitis Secondary to Celiac Trunk Dissection

    PubMed Central

    Obando, Jorge V.; Burbridge, Rebecca A.

    2014-01-01

    Dissection of the visceral arteries happens infrequently, with the superior mesenteric artery being the most commonly affected. Isolated dissection of the celiac trunk is rare, and only a few cases have been reported in the medical literature. We report the case of a 51-year-old male who presented with abdominal pain and was subsequently diagnosed with a celiac trunk dissection with secondary pancreatitis and pancreatic infarction. The patient's symptoms improved with conservative medical management. We review the current literature involving celiac trunk dissection and its management, and provide discussion regarding this unrecognized complication of pancreatitis.

  2. Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up

    Microsoft Academic Search

    Patty H Spruit; Sabine Siesling; Marloes AG Elferink; Ernest JA Vonk; Carel JM Hoekstra

    2007-01-01

    BACKGROUND: The standard treatment of the axilla in breast cancer used to be an axillary lymph node dissection. An axillary lymph node dissection is known to give substantial risks of morbidity. In recent years the sentinel node biopsy has become common practice. Future randomized study results will determine whether the expected decrease in morbidity can be proven. METHODS: Before the

  3. [DeBakey type 2 Aortic Dissection Failed to Diagnose by Enhanced Computed Tomography;Report of a Case].

    PubMed

    Numata, Ruriko; Shima, Shotaro; Okamura, Kenichi; Morizumi, Sei; Kawata, Mitsuhiro; Suematsu, Yoshihiro

    2015-05-01

    An 81-year-old woman presented with dyspnea and chest pain. A plain chest X-ray revealed widening of the mediastinum and a contrast-enhanced chest computed tomography showed dilatation of the ascending aorta without any specific findings of aortic dissection. Transesophageal echocardiography revealed severe aortic regurgitation (AR). We planned an aortic valve replacement on the 34th day after admission because of the severe AR. During the operation, we found an entry in the intima of the ascending aorta 5 mm above the aortic valve and she was diagnosed with DeBakey type II aortic dissection. Therefore, we decided to perform Bentall's operation and the operation was successful. PMID:25963787

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

    PubMed

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

    2015-03-01

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

  5. [Four cases of hypopharyngeal cancer treated with docetaxel, cisplatin, and 5-FU followed by radiotherapy and/or neck dissection].

    PubMed

    Miyahara, Hiroshi; Nario, Kazuhiko; Matsushiro, Naoki; Sasai, Hisanori; Kajikawa, Hiroshi

    2004-05-01

    We treated 4 patients with hypopharyngeal cancer, each of whom had a complete response after 2 cycles of chemotherapy with docetaxel, cisplatin, and 5-FU followed by radiation and/or neck dissection. Twenty-one months to 2 years after this therapy, 3 patients had no recurrence and no metastasis with their laryngeal framework and function preserved. Chemotherapy including docetaxel, cisplatin, and 5-FU is a useful treatment for early head and neck cancer. PMID:15170983

  6. Marquette University Neuroanatomical Dissection

    NSDL National Science Digital Library

    Marquette University (Marquette University)

    2012-07-24

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

  7. Neck Dissection Through a Facelift Incision

    PubMed Central

    Melvin, Thuy-Anh N.; Eliades, Steven J.; Ha, Patrick K.; Fakhry, Carole; Saunders, John M.; Califano, Joseph A.; Blanco, Ray G. F.

    2013-01-01

    Obectives/Hypothesis To determine the feasibility and safety of neck dissection through a facelift incision. Study Design Prospective case series. Methods Cadavers and live subjects underwent neck dissection using a facelift incision with and without endoscopic assistance. In the live facelift neck dissection (FLND), the preoperative surgical indications, staging, adjuvant therapy, intraoperative technical procedure, pathology reports on lymph nodes, and short-term outcomes were reviewed. Results FLND was successfully performed in four cadavers and four live subjects, including selective (less than five neck levels removed) and comprehensive (levels I–V removed) neck dissections. All levels were accessible through this approach, with additional retraction required for levels I and IV. Endoscopic assistance was required in one neck dissection for adequate visualization. Short-term complications and number of excised lymph nodes were comparable to those from traditional neck dissection approaches. Conclusions Open neck dissection through a facelift incision is feasible and offers an alternate approach to traditional incisions. This can be performed without requiring robotic assistance and with endoscopic assistance only in certain cases. Endoscopic assistance can offer enhanced visualization of the surgical field and complement open direct approaches in neck dissection. Although FLND offers improved cosmetic outcomes when compared to those of traditional neck incisions, further study is required to determine its efficacy and indications. PMID:23023877

  8. Radiological changes in infantile dissecting anterior communicating artery aneurysm treated endovascularly. A case report and five-year follow-up.

    PubMed

    Yatomi, Kenji; Oishi, Hidenori; Yamamoto, Munetaka; Suga, Yasuo; Nonaka, Senshu; Yoshida, Kensaku; Arai, Hajime

    2014-12-01

    Intracranial aneurysms are extremely rare in infants, and to our knowledge only seven infants treated for ruptured spontaneous dissecting aneurysms have been reported. Good outcomes have been achieved with endovascular treatment of infantile aneurysm. We the endovascular treatment of a one-month-old girl for ruptured dissecting aneurysm located in the anterior communicating artery, and the unique radiological changes that were observed during the perioperative and follow-up periods. These changes suggest that blood coagulation and fibrinolytic response play a part in the repair and healing processes of dissecting aneurysms. Careful neuroradiological surveys are needed for pediatric dissecting aneurysms treated endovascularly. PMID:25496693

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

    PubMed Central

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

    2015-01-01

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

  10. Peripartum presentation of an acute aortic dissection.

    PubMed

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

    2005-04-01

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

  11. "Hands-Off" Dissection?

    ERIC Educational Resources Information Center

    Allchin, Douglas

    2005-01-01

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

  12. Cervicocerebral arterial dissection.

    PubMed

    Jensen, Matt B; Chacon, Marcus R; Aleu, Aitziber

    2008-01-01

    Dissection of the cervicocerebral arteries is an infrequent occurrence but is a leading cause of stroke in young and otherwise healthy patients. A brief review of the history, pathogenesis, and management is presented. The proper management for stroke prevention in dissection is unclear as there have been no randomized, controlled trials performed; small trials are under way. PMID:18195650

  13. 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.

  14. 76 FR 40907 - Ohio Valley Hub, LLC; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-12

    ...Regulatory Commission [Docket No. PR09-2-001] Ohio Valley Hub, LLC; Notice of Motion for Extension of Rate Case Filing Deadline Take notice that on June 30, 2011, Ohio Valley Hub, LLC (OVH) filed a request for an extension consistent...

  15. Emergency rescue endovascular stent grafting of ascending aorta to relieve life-threatening coronary obstruction in a case of acute aortic dissection.

    PubMed

    Tauchi, Yuuya; Tanioka, Hideki; Kondoh, Haruhiko; Satoh, Hisashi; Matsuda, Hikaru

    2014-12-01

    Myocardial ischemia associated with acute aortic dissection is frequently a fatal complication, and the emergent management still remains a challenge. We report a patient with life-threatening myocardial ischemia due to acute aortic dissection managed by rescue stent grafting of the ascending aorta. Coronary blood flow improved immediately with this endovascular procedure, hemodynamic status was ameliorated dramatically, followed by uneventful open repair. PMID:25468124

  16. Case report - Vascular thoracic Aorta non-touch coronary artery bypass grafting after total arch replacement for acute type A aortic dissection

    Microsoft Academic Search

    Yosuke Takahashi; Yasushi Tsutsumi; Osamu Monta; Hirokazu Ohashi

    We report successful surgical treatment of coronary artery disease (CAD) in a 53-year-old man. The man was admitted to our hospital due to severe anterior chest pain. He had a surgical history of total arch replacement for acute type A dissection 10 years previously. Angiography showed triple-vessel disease and partial dissection of the descending aorta. To avoid excessive excision and

  17. Spontaneous Mirror Dissections of Cervicocephalic Arteries

    PubMed Central

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

    2006-01-01

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

  18. Introduction to Dissection

    NSDL National Science Digital Library

    Wineski, Lawrence

    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.

  19. Neck dissections: radical to conservative

    Microsoft Academic Search

    K Harish; M. S. Ramaiah

    2005-01-01

    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

  20. Backward Genotype-Trait Association (BGTA)-Based Dissection of Complex Traits in Case-Control Designs

    PubMed Central

    Zheng, Tian; Wang, Hui; Lo, Shaw-Hwa

    2009-01-01

    Background The studies of complex traits project new challenges to current methods that evaluate association between genotypes and a specific trait. Consideration of possible interactions among loci leads to overwhelming dimensions that cannot be handled using current statistical methods. Methods In this article, we evaluate a multi-marker screening algorithm – the backward genotype-trait association (BGTA) algorithm for case-control designs, which uses unphased multi-locus genotypes. BGTA carries out a global investigation on a candidate marker set and automatically screens out markers carrying diminutive amounts of information regarding the trait in question. To address the ‘too many possible genotypes, too few informative chromosomes’ dilemma of a genomic-scale study that consists of hundreds to thousands of markers, we further investigate a BGTA-based marker selection procedure, in which the screening algorithm is repeated on a large number of random marker subsets. Results of these screenings are then aggregated into counts that the markers are retained by the BGTA algorithm. Markers with exceptional high counts of returns are selected for further analysis. Results and Conclusion Evaluated using simulations under several disease models, the proposed methods prove to be more powerful in dealing with epistatic traits. We also demonstrate the proposed methods through an application to a study on the inflammatory bowel disease. PMID:17114886

  1. Treatment of spontaneous intradural vertebral artery dissections.

    PubMed

    Nakazawa, T; Takeichi, Y; Yokoi, T; Fukami, T; Jito, J; Nitta, N; Takagi, K; Nozaki, K

    2011-10-31

    Spontaneous intradural vertebral artery dissections may cause subarachnoid hemorrhage and often result in devastating damage. Increased use of noninvasive imaging studies has allowed larger numbers of patients to be diagnosed. In addition, intracranial vertebral artery dissection tends to induce multiple lesions affecting both intracranial vertebral arteries recurrently. Although unruptured dissections in this area usually have a benign nature, some authors have reported on the incidence of rupture from this lesion. Once hemorrhage from a dissecting vessel wall has occurred, it needs to be treated in the acute phase because of the high risk of rebleeding resulting in high morbidity and mortality. From December 2004 to July 2010, we managed 47 patients with spontaneous vertebral artery dissection, 31 patients were ruptured and 16 were unruptured. All patients who suffered from subarachnoid hemorrhage were treated with endovascular procedures. Most of the patients with unruptured dissection received medical therapy, but if the aneurysmal dilatation persisted or grew, surgical interventions were performed. Stenting with or without coils was deployed for 13 patients with posterior inferior cerebellar artery involvement at the site of dissection and/or were affected on the dominant side. In some patients, stenting was performed even if they were in the acute phase. For other ruptured patients, internal coil trappings were performed. Six patients died due to severe initial subarachnoid hemorrhage and one patient, who underwent stent deployment with coils for the dominant vertebral artery, with bilateral dissection continuing to the basilar artery died due to rerupture while the next additional coiling was planning. There were two cases of complications related to the intervention. During the follow-up period no bleeding occurred in any of the patients except for the previously mentioned patient. In conclusion, internal coil trapping or stent placement with or without coils was effective in preventing rebleeding of ruptured vertebral artery dissection. If the dissection is unruptured, it is necessary to detect the risk of bleeding with careful watching and when progress appears to be made, patients should be treated promptly. Stent-assisted therapy for preserving the patency of the parent artery and major branches is a promising treatment for vertebral artery dissection, even in the acute stage of subarachnoid hemorrhage. However, the risk of acute rerupture and recurrence remains even with the porous stent placement with or without coils. PMID:24059764

  2. Aortic dissection after ingestion of "ecstasy" (MDMA).

    PubMed

    Duflou, J; Mark, A

    2000-09-01

    The authors report a case of aortic dissection and cardiac tamponade in a 29-year-old man after ingestion of ecstasy (methylenedioxymethamphetamine, MDMA) at a "rave" party. There was no history of hypertension, myxoid heart disease, or other risk factors for aortic dissection in the deceased, although a minor degree of cystic medial necrosis was noted on histologic examination of the aorta. Autopsy toxicology revealed low residual levels of MDMA in the blood about 48 hours after ingestion of the drug. This case report describes a probable association between MDMA ingestion and aortic dissection in a previously well young adult. The likely mechanisms are discussed, and the difficulties in diagnosing this complication are highlighted. PMID:10990289

  3. Isolated Spontaneous Renal Artery Dissection Presented with Flank Pain

    PubMed Central

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

    2015-01-01

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

  4. Active inflammatory bowel disease and coronary artery dissection

    PubMed Central

    Srinivas, M; Basumani, P; Muthusamy, R; Wheeldon, N

    2005-01-01

    The case of a young woman with flare-up of Crohn's disease, who had an acute myocardial infarction due to the spontaneous dissection of the left anterior descending coronary artery, is reported. The literature on this rare condition is reviewed and a mechanism postulated for spontaneous coronary artery dissection in inflammatory bowel disease. PMID:15640436

  5. Virtual Pig Dissection

    NSDL National Science Digital Library

    Fleck, Earl W.

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

  6. Parametric binary dissection

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

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

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

    Microsoft Academic Search

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

    1999-01-01

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

  8. Circumferential intramural esophageal dissection successfully treated by endoscopic procedure and metal stent insertion

    Microsoft Academic Search

    Seong Hun Kim; Seung-Ok Lee

    2005-01-01

    Spontaneous intramural esophageal dissection is a rare disorder characterized by a lengthy laceration between the mucosal\\u000a and submucosal layers of the esophageal wall, without perforation. The majority of previously reported cases of spontaneous\\u000a intramural esophageal dissection were partial, and the circumferential type of intramural esophageal dissection has not been\\u000a reported previously. Most spontaneous intramural esophageal dissection responds to conservative management,

  9. Dissection of the aorta in Turner's syndrome.

    PubMed Central

    Price, W H; Wilson, J

    1983-01-01

    Three deaths from dissection of the aorta in a series of 157 adult women with Turner's syndrome are reported. These are greatly in excess of the numbers expected. None of the three patients had a coarctation of the aorta. One had aortic regurgitation but there was no reason to believe that the aorta in the other two patients had been subjected to unusual haemodynamic stresses. Cystic medial necrosis of the aorta was described in two patients on whom necropsies were carried out. It is concluded that there is probably a greatly increased risk of dissection of the aorta in Turner's syndrome even in the absence of any other abnormality of the aorta and aortic valve. Previously reported cases of aortic dissection in Turner's syndrome are discussed. PMID:6842536

  10. Endoluminal treatment of aortic dissection

    Microsoft Academic Search

    Ajay Chavan; Joachim Lotz; Frank Oelert; Michael Galanski; Axel Haverich; Matthias Karck

    2003-01-01

    Aortic dissection is most often a catastrophic medical emergency which, if untreated, can be potentially fatal. The intention of therapy in patients with aortic dissection is to prevent aortic rupture or aneurysm formation as well as to relieve branch vessel ischaemia. Patients with aortic dissection are often poor candidates for anaesthesia and surgery and the surgical procedure itself is challenging

  11. 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.

  12. Pediatric traumatic carotid, vertebral and cerebral artery dissections: a review.

    PubMed

    Mortazavi, Martin M; Verma, Ketan; Tubbs, R Shane; Harrigan, Mark

    2011-12-01

    Traumatic cerebral dissections are rare but potentially dangerous conditions that through improved diagnostics have recently gained increased interest. However, there is still a significant lack of knowledge on the natural history, as well as on the best treatment options. Most of the literature on this topic consists of case reports and retrospective studies with no prospective randomized controlled studies. In our review, we highlight the fact that there is no level 1 evidence for the natural history of cerebral dissections or for the best treatment. We present 26 case studies derived from 70 pediatric patients affected by dissections, occlusions, and pseudoaneurysms. PMID:21318614

  13. Neck dissections: radical to conservative

    PubMed Central

    Harish, K

    2005-01-01

    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

  14. Choosing the correct treatment for acute aortic type B dissection.

    PubMed

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

    2015-04-01

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

  15. Sheep Brain Dissection

    NSDL National Science Digital Library

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

    2004-04-30

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

  16. 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.

  17. Triangular dissections, aperiodic tilings and Jones algebras

    E-print Network

    R. Coquereaux

    1995-03-27

    The Brattelli diagram associated with a given bicolored Dynkin-Coxeter graph of type $A_n$ determines planar fractal sets obtained by infinite dissections of a given triangle. All triangles appearing in the dissection process have angles that are multiples of $\\pi/ (n+1).$ There are usually several possible infinite dissections compatible with a given $n$ but a given one makes use of $n/2$ triangle types if $n$ is even. Jones algebra with index $[ 4 \\ \\cos^2{\\pi \\over n+1}]^{-1}$ (values of the discrete range) act naturally on vector spaces associated with those fractal sets. Triangles of a given type are always congruent at each step of the dissection process. In the particular case $n=4$, there are isometric and the whole structure lead, after proper inflation, to aperiodic Penrose tilings. The ``tilings'' associated with other values of the index are discussed and shown to be encoded by equivalence classes of infinite sequences (with appropriate constraints) using $n/2$ digits (if $n$ is even) and generalizing the Fibonacci numbers.

  18. Vertebral artery stenting in an aneurysm after dissection

    Microsoft Academic Search

    B. Griewing; F. Brassel; V. Schminke

    2000-01-01

    Purpose: Traumatic and spontaneous dissections of brain-supplying arteries are the cause of approximately 5% of cerebral infarctions in young adults. They are localized more often in the carotid, and less frequently in vertebral arteries. Aneurysms following dissections, which can develop as a possible embolic source, are generally treated with endovascular surgery.Methods: We describe the case of a 42-year-old man who

  19. “Curettage and aspiration dissection technique” using PMOD for liver resection

    PubMed Central

    Peng, S. Y.

    2008-01-01

    Background and aims. To introduce a special dissection technique named “Curettage and Aspiration Dissection Technique” (CADT) using a versatile instrument called Peng's Multifunction Operative Dissector (PMOD) for liver resection. PMOD is an electrosurgical pencil with an inline suction, bearing four functions: electric cutting, coagulation, aspiration and dissection, The above-mentioned functions can be achieved simultaneously or sequentially during liver resection. The purpose of this study was to evaluate this technique and the special electrosurgical device in hepatic surgery. Patients and methods. From June 2005 to December 2006, 70 consecutive patients with segmentectomy or major hepatectomy were performed with this dissection technique by the same surgeon. Peri-operative data and the technical aspect of this device and dissection technique for various types of liver resection were summarised. Results. Forty-nine of 70 cases with various degrees of cirrhosis. Median blood loss were 470 ml (100–2400 ml), the bleeding and mortality within one month postoperatively was zero. There were postoperative complications in 20 patients: bile leak occurred in five cases, nine cases with right pleural effusion and six with ascites. No relative complications with this method were found. Conclusion. The CADT and PMOD can achieve better dissection and hemostasis. It possible is a much more valuable alternative to other devices currently used for liver surgery. PMID:18773106

  20. Duplication of the left vertebral artery in a patient with dissection of the right internal carotid artery and Ehlers-Danlos syndrome: case report and review of the literature.

    PubMed

    Polguj, Micha?; J?drzejewski, Kazimierz; Topol, Miros?aw; Wieczorek-Pastusiak, Julia; Majos, Agata

    2013-03-01

    Duplication of the left vertebral artery was observed in a 43-year-old Caucasian male with dissection of the right internal carotid artery during multidetector 64-row computer tomography and Doppler ultrasonography B-flow mode. Both duplicated segments arose from the left subclavian artery and united at levels C5-C6 to form a single vessel. The presented case describes precisely the origin and diameter of both vertebral arteries. Additionally, after all procedures associated with diagnosis and treatment of the patient, Ehlers-Danlos syndrome type IV was diagnosed. The lumen of the duplicated vertebral artery was smaller than normal; it can be concluded that this variant has clinical implications and should be taken into consideration when vertebral arteries need catheterization. PMID:22956231

  1. Thoracic aortic aneurysm and dissection.

    PubMed

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

    2014-10-21

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

  2. Automatic Dissection Of Plantlets

    NASA Astrophysics Data System (ADS)

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

    1989-03-01

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

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

    SciTech Connect

    Ishida, Masaki, E-mail: mishida@clin.medic.mie-u.ac.jp; Kato, Noriyuki [MieUniversity Hospital, 2-174 Edobashi Tsu, Mie 514-8507, Department of Radiology (Japan); Hirano, Tadanori [Mie University Hospital, Mie, Department ofThoracic and Cardiovascular Surgery (Japan); Suzuki, Tomoaki; Shomura, Yu; Yada, Isao [Matsusaka General Hospital, Matsusaka, Department ofRadiology (Japan); Takeda, Kan [MieUniversity Hospital, 2-174 Edobashi Tsu, Mie 514-8507, Department of Radiology (Japan)

    2003-08-15

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

  4. Vertebral Artery Dissect Injury with Brown-Séquard Syndrome by a Neural Foramen Penetrated Electric Screw Driver Bit : A Case Report

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

    Background. Previously, we reported that the Flushknife (electrosurgical endoknife with a water-jet function) could reduce the operation time of colorectal endoscopic submucosal dissection (ESD) however, suitable situation for the Flushknife was obscure. This subgroup analysis of a prospective randomized controlled trial was aimed to investigate the suitable situation for the Flushknife. Methods. A total of 48 superficial colorectal neoplasms that underwent ESD using either the Flexknife or the Flushknife in a referral center were enrolled. The differences of operation time between the Flexknife and the Flushknife groups in each subgroup (tumor size, location, and macroscopic type) were analyzed. Results. Median (95% CI) operation time calculated using survival curves was significantly shorter in the Flushknife group than in the Flexknife group (55.5?min [41, 78] versus 74.0 [57, 90]?min; P = 0.039, Hazard Ratio HR: 0.53; 95% CI (0.29–0.97)). In particular, the HR in patients with laterally spreading tumors-nongranular type (LST-NG) in the Flushknife group was significantly smaller than in the Flexknife group (HR: 0.165?0.17; 95% CI (0.04–0.66)). There was a trend of decreasing HRs according to larger lesion size. Conclusions. The Flushknife proved its merits in colorectal ESD especially for the lesions which should be removed en bloc (LST-NG and large lesion). PMID:24174933

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

    PubMed Central

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

    2014-01-01

    Background: It has been found that 50% of all aortic dissections can be attributable to pregnancy in women younger than 45 years of age. An estimated 30% of cases are type B, with half occurring in the antepartum period. To date type B aortic dissection has rarely been reported in gemellary pregnancies. Case: A 24-year-old primigravida at 36 weeks of gemellary gestation presented symptoms of severe and persistent chest pain for 1 day, before suffering the acute type B aortic dissection. The primigravida was treated with immediate cesarean section and endovacular stent graft placement. Conclusion: Aortic dissection is a rare complication of pregnancy, especially in gemellary pregnancies. Pregnancy is considered an independent risk factor for aortic dissection and endovascular repair may be an ideal option for the treatment of complicated type B aortic dissection during pregnancy, with reduced maternal and fetal mortality. PMID:25550939

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

    SciTech Connect

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

    2004-09-15

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

  8. Experience with parametric binary dissection

    NASA Technical Reports Server (NTRS)

    Bokhari, Shahid H.

    1993-01-01

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

  9. Concomitant Reconstruction of Arch Vessels during Repair of Aortic Dissection

    PubMed Central

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

    2014-01-01

    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

  10. Concomitant reconstruction of arch vessels during repair of aortic dissection.

    PubMed

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

    2014-08-01

    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

  11. Spontaneous coronary artery dissection in polycystic kidney disease

    PubMed Central

    Limburg, Sander; Boereboom, Frans

    2012-01-01

    Little is known about the association between autosomal-dominant polycystic kidney disease (ADPKD) and coronary artery dissection (CAD). We suggest that the genetic disorder in ADPKD is the main cause of instable artery vasculature. Our case also shows that CAD can be missed in the acute phase. Therefore, we recommend additional investigation in patients with ADPKD presenting with acute chest pain. We report a case of a patient who developed a myocardial infarction due to a spontaneous dissection of the left anterior descending coronary artery. ADPKD was diagnosed during the additional investigation. The patient received medical management.

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

    PubMed

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

    2013-12-01

    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

  13. A standardized surgical technique for mastoscopic axillary lymph node dissection.

    PubMed

    Chengyu, Luo; Yongqiao, Zhou; Hua, Lin; Xiaoxin, Ji; Chen, Guan; Jing, Li; Jian, Zhang

    2005-06-01

    To standardize the surgical technique for mastoscopic axillary lymph node dissection (MALND). Mastoscopic lymph node dissection was performed consistently by a group of surgeons in 316 cases of breast cancer. The mean operation time was 46.7 minutes with minimal bleeding, and the median number of lymph nodes dissected at each operation was 17.0. There were no operative complications in any case, nor did trocar implantation or tumor diffusion occurring during the mean follow-up time of 15.1 months. MALND is distinctive and practicable in operative anatomy as well as safe and convenient. The location of critical anatomy such as the intercostobrachial nerve, lateral thoracic artery, medial thoracic nerve, and thoracoepigastric vein should be clearly identified to avoid damage to them, so that is the great advantage of MALND. PMID:15956900

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

    SciTech Connect

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

    2005-05-15

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

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

    Microsoft Academic Search

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

    1996-01-01

    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.

  16. Postpartum multivessel spontaneous coronary artery dissection confirmed by coronary CT angiography

    PubMed Central

    Schroder, Catherine; Stoler, Robert C.; Branning, George B.

    2006-01-01

    Spontaneous coronary artery dissection is a rare but potentially life-threatening event associated with the peripartum period. We present a case of postpartum multivessel spontaneous coronary artery dissection diagnosed by conventional angiography and monitored with computed tomographic coronary angiography. The patient was initially managed medically and later received a coronary stent. PMID:17106495

  17. Aortic tear and dissection related to connective tissues abnormalities resembling Marfan syndrome in a Great Dane.

    PubMed

    Lenz, Jennifer A; Bach, Jonathan F; Bell, Cynthia M; Stepien, Rebecca L

    2015-06-01

    Aortic tears and acute aortic dissection are rarely reported in dogs. This report describes a case of aortic dissection and probable sinus of Valsalva rupture in a young Great Dane with associated histopathologic findings suggestive of a connective tissue abnormality. PMID:25890485

  18. Aortic Dissection in Young Adults Who Abuse Amphetamines

    PubMed Central

    Westover, Arthur N.; Nakonezny, Paul A.

    2010-01-01

    Background Case reports suggest a relationship between amphetamine abuse/dependence and aortic dissection, but no population-based epidemiologic studies have examined this link. Our objective was to test the hypothesis that young adults with a diagnosis of amphetamine abuse or dependence would be at higher risk for aortic dissection, after accounting for known risk factors. Methods In this population-based case control study of 30,922,098 discharges from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) from 1995 to 2007, among persons aged 18 to 49 years, we identified 3,116 thoracic and thoracoabdominal aortic dissections using ICD-9-CM codes 441.01 and 441.03. The SURVEYLOGISTIC procedure in SAS 9.2 was used to account for the NIS sampling methodology. Results In a multiple logistic regression analysis, while controlling for known risk factors, amphetamine abuse/dependence was significantly associated with aortic dissection (adjusted odds ratio = 3.33; 95% CI=2.37—4.69, p < 0.0001). Conclusions This statistically significant association suggests that amphetamine abuse/dependence may play a role in aortic dissection in young adults in the United States. PMID:20691838

  19. A Matched Case-Control Study of a Novel Acid-Pump Antagonist and Proton-Pump Inhibitor for the Treatment of Iatrogenic Ulcers Caused by Endoscopic Submucosal Dissection

    PubMed Central

    Kim, Yong Gil; Kim, Tae Nyeun

    2010-01-01

    Background/Aims Revaprazan, a novel acid-pump antagonist, and proton-pump inhibitors (PPIs) have pH-independent effects on ulcer healing. The addition of a PPI promotes the cell restitution rate as well as vessel regeneration and maturation for ulcer repair. Revaprazan is known to protect the mucosa by increasing the prostaglandin concentration. Methods We reviewed the medical records of patients who underwent endoscopic submucosal dissection (ESD) for gastric neoplasia at Yeungnam University Hospital between January 2008 and May 2009. We conducted a matched case-control study to compare the healing rates effected by revaprazan and rabeprazole. Results Each group consisted of 30 patients. The baseline characteristics did not differ significantly between the two groups. Stage S1 disease was observed in 97% and 100% of patients after 8 weeks of treatment in the revaprazan and rabeprazole groups, respectively. In the revaprazan group, only one patient had stage H2 disease: a 54-year-old man with a 5.5-cm lesion after ESD of the ulcer, type IIa early gastric cancer, and adenocarcinoma. No serious adverse effects occurred during the treatment period in either group. Conclusions The safety and efficacy profiles of revaprazan and rabeprazole are similar for the treatment of ESD-induced ulcers. PMID:20479909

  20. Running, ischaemic stroke and carotid artery dissection

    E-print Network

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

    2015-05-13

    demonstrated bilateral dissection of the internal carotid arteries (figure 1). The patient was started on longterm aspirin (75mg daily) and atorvastatin (80mg daily) with advice against participating in activities associated with carotid dissection...

  1. Delayed left atrial wall dissection after mitral valve replacement.

    PubMed

    Idir, M; Deville, C; Roudaut, R

    2000-04-01

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

  2. Emergent endovascular treatment of ruptured vertebral artery dissecting aneurysms

    Microsoft Academic Search

    K. Sugiu; K. Tokunaga; K. Watanabe; W. Sasahara; S. Ono; T. Tamiya; I. Date

    2005-01-01

    The goal of this study was to evaluate the results of endovascular and surgical treatments for ruptured vertebral artery dissecting aneurysms (VADAs) to determine which treatment is preferable. We evaluated the cases of 25 consecutive patients with ruptured VADAs treated in our institution. From 1992 to 1997, five patients were treated surgically. Since 1998, 20 patients with VADAs have been

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  4. Advanced, recurrent mesothelioma growth mimicking an aortic dissection

    PubMed Central

    Pankhania, Miran; Hardiment, Kate; Marathe, Mandar

    2011-01-01

    In the emergency setting, a cold, clammy, dyspnoeic patient presenting with interscapular chest pain and unequal blood pressures suggests an acute aortic dissection until proven otherwise. By means of a case report, the authors detail one such patient who presented identically to one having an acute aortic dissection. Initial assessment showed unequal blood pressures in left and right arms, a resting tachycardia and indistinct heart sounds. Fluid resuscitation failed to improve the patient's physiological parameters and they rapidly deteriorated. The medical history included mesothelioma and atrial fibrillation. Existing investigations were reviewed and after thorough consideration of the patient's premorbid state and likely prognosis, the decision was made to palliate. The patient died shortly after being transferred to the oncology ward. Imaging is therefore integral to the assessment and management of a patient in whom an aortic dissection is feared. PMID:22714611

  5. Animal Rights Activism Threatens Dissection.

    ERIC Educational Resources Information Center

    Holden, Constance

    1990-01-01

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

  6. Expressive Aphasia and Carotid Dissection

    E-print Network

    Simmons, Joshua R; Laselle, Brooks T; Della-Giustina, David A.

    2010-01-01

    Figure 2. Color Doppler ultrasound (CDUS) showing aliasing,Doppler techniques may require specialized training, they are not beyond the scope of emergency ultrasound.ultrasound can identify up to 72% of dissections and an additional 10% can be identified with use of color Doppler,

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

    PubMed

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

    2014-08-01

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

  8. Spontaneous coronary artery dissection in a young woman precipitated by retching.

    PubMed

    Velusamy, Muthu; Fisherkeller, Mark; Keenan, Michael E; Kiernan, Francis J; Fram, Daniel B

    2002-04-01

    Spontaneous coronary artery dissection as a cause of acute myocardial ischemia is a rare entity that has been associated with several different clinical profiles and precipitating events. The recognition of this entity as the cause of acute ischemia is important because the therapeutic considerations may be different than that for ischemia due to a ruptured atherosclerotic plaque. We report a case of spontaneous coronary artery dissection in a 31-year-old female that was induced by prolonged, forceful retching. To our knowledge, this is the first reported case of such an association. Prolonged retching should be added to the list of causes of spontaneous coronary artery dissection. PMID:11923575

  9. Recurrent spontaneous coronary artery dissection in a woman with fibromuscular dysplasia.

    PubMed

    Khosla, Amit; Saw, Jacqueline

    2015-06-01

    We report a case of five recurrent myocardial infarctions due to repeat spontaneous coronary artery dissection (SCAD) in a woman with underlying fibromuscular dysplasia. Her angiographic SCADs were missed on two occasions. Patients with a history of SCAD are at risk for recurrent dissections. This case also highlights the angiographic variants of SCAD, and the utility of intracoronary imaging in diagnosing suspected SCAD. PMID:26028659

  10. Spontaneous renal artery dissection with renal infarction

    PubMed Central

    Leray-Moraguès, Hélène; Chenine, Leila; Vernhet-Kovacsik, Hélène

    2012-01-01

    Spontaneous renal artery dissection (SRAD) is a rare entity, which often presents diagnostic difficulties because of its non-specific clinical presentation. We report six cases complicated with renal infarction, occurring in middle-aged male patients without risk factors, illustrating the difficulty and delay for diagnosing SRAD. Ultrasound and Doppler imaging were not sensitive enough to confirm the diagnosis, and contrast-enhanced abdominal computed tomography was used to correct the diagnosis and allow the clinicians to propose appropriate treatment. We conclude that considering the urgency in diagnosing and treating SRAD, contrast enhanced abdominal tomography and/or abdominal magnetic resonance imaging should be proposed as soon as a suspicion of SRAD is evoked by the clinical presentation.

  11. Acute infra-renal aortic dissection presenting as back pain and transient paralysis of the lower limbs.

    PubMed

    Ahmed, M

    2012-01-01

    Spinal cord injury is a rare complication in patients with aortic dissection. Spinal ischaemia has been reported as a complication of aortic dissection due to impairment of its extrinsic supply in the great radicular artery (GRA) of Adamkiewicz. The extrinsic arterial blood supply to the spinal cord, diminishes caudally and is believed to become critically dependent upon the GRA.(1) infra-renal aortic dissections (IAAD) inducing spinal ischaemia are exceptionally rare in the literature. We present a case of an infra-renal aortic dissection (IAAD) presenting with transient spinal ischaemia. PMID:22288040

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

    PubMed

    Kim, Myeong-Soo

    2013-06-01

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

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

    PubMed

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

    2009-01-01

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

  14. Temporoparietal Headache as the Initial Presenting Symptom of a Massive Aortic Dissection

    PubMed Central

    Parikh, Manan; Thyagarajan, Braghadheeswar; Alagusundaramoorthy, Sayee Sundar; Martin, James

    2015-01-01

    Aortic dissection is a life-threatening medical emergency often presenting with severe chest pain and acute hemodynamic compromise. The presentation of aortic dissection can sometimes be different thus leading to a challenge in prompt diagnosis and treatment as demonstrated by the following presentation and discussion. We present a case of a 71-year-old male who presented to the emergency department with complaints of left sided temporoparietal headache and was eventually diagnosed with a thoracic aortic dissection involving the ascending aorta and descending aorta, with an intramural hematoma in the descending aorta. This case illustrates the importance of keeping in mind aortic dissection as a differential diagnosis in patients with acute onset headaches in which any intracranial source of headache is not found.

  15. Monotherapy with stenting in subarachnoid hemorrhage (SAH) after middle cerebral artery dissection.

    PubMed

    Puri, Ajit S; Gounis, Matthew J; Massari, Francesco; Howk, Mary; Weaver, John; Wakhloo, Ajay K

    2015-01-01

    Isolated middle cerebral artery dissection is a rare clinical entity, with descriptions limited to a few case reports and case series. Symptomatic dissection in the anterior circulation can present as an ischemic stroke in a young population; however, it is rarely associated with subarachnoid hemorrhage. We describe a young patient who presented with acute headache from a subarachnoid hemorrhage that was ultimately determined to be due to a vascular dissection in the middle cerebral artery. The initial angiogram showed vascular irregularities in this area with stenosis. Repeat imaging 4?days after presentation identified a pseudoaneurysm proximal to the stenosis. The patient was successfully treated with a self-expanding nitinol stent and followed up with serial angiography during postoperative recovery in the hospital; additional angiograms were performed approximately 1 and 6?months after treatment. Serial angiograms demonstrated incremental healing of the dissection. The patient was discharged and remains neurologically intact at the 6-month follow-up. PMID:25833904

  16. Spontaneous hemomediastinum and hemothorax after dissecting bronchial artery aneurysm.

    PubMed

    Quero-Valenzuela, Florencio; Piedra-Fernández, Inmaculada; Sevilla-López, Sebastián; Cueto-Ladrón de Guevara, Antonio

    2011-04-01

    Spontaneous hemomediastinum is a rare pathological event due to bleeding disorders, mediastinal organ hemorrhage or idiopathic causes. It usually presents with chest pain and dyspnea, which can lead to confusion with other clinical conditions. The election diagnostic method is computed tomography and treatment depends on underlying etiology, aimed on controlling hemorrhages, if present. In this paper, we present a case of spontaneous hemomediastinum and hemothorax after bronchial artery aneurysm dissection treated with endovascular embolization and chest drainage. PMID:21228046

  17. Pediatric traumatic carotid, vertebral and cerebral artery dissections: a review

    Microsoft Academic Search

    Martin M. Mortazavi; Ketan Verma; R. Shane Tubbs; Mark Harrigan

    Traumatic cerebral dissections are rare but potentially dangerous conditions that through improved diagnostics have recently\\u000a gained increased interest. However, there is still a significant lack of knowledge on the natural history, as well as on the\\u000a best treatment options. Most of the literature on this topic consists of case reports and retrospective studies with no prospective\\u000a randomized controlled studies. In

  18. Superior mesenteric artery plasty for type A acute aortic dissection with visceral ischemia.

    PubMed

    Kato, Wataru; Fujita, Takashi; Uchida, Kenichiro; Munakata, Hisaaki; Hibino, Makoto; Fujii, Kei; Tanaka, Keisuke; Sakai, Yoshimasa; Tajima, Kazuyoshi

    2014-11-18

    Treatment of visceral ischemia complicated with acute type A aortic dissection is controversial. We had two cases of acute type A aortic dissection complicated by superior mesenteric artery (SMA) ischemia and successfully treated them with direct SMA perfusion during central aortic repair followed by SMA plasty. The presented procedures can be an option to treat visceral ischemia with a standard operative theater and equipment. PMID:25403999

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

    SciTech Connect

    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

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

  20. Left anterior descending coronary artery dissection after blunt chest trauma.

    PubMed

    Sadr-Ameli, Mohammad Ali; Amiri, Elaheh; Pouraliakbar, Hamidreza; Heidarali, Mona

    2014-01-01

    Coronary artery dissection is a well-known albeit unusual complication of blunt chest trauma. It is also an uncommon cause of myocardial infarction. Only a few such cases have been reported, probably due to the high rate of sudden death. We report a case of left anterior descending (LAD) coronary artery dissection in a healthy 38-year-old female caused by blunt chest trauma. The patient was referred to our hospital with a complaint of chest pain. Electrocardiography showed T-wave inversion, echocardiography a revealed circumferential pericardial effusion, and the coronary angiogram demonstrated a thrombotic dissection of the LAD.  Troponin I was the only biomarker with elevated level. CT coronary angiography was performed using the subtotal occlusion of the LAD and illustrated a relatively good LAD run-off, and thallium scintigraphy displayed viable myocardium in this territory. Despite the total occlusion of the LAD in our case, myocardial injury was not significant due to the relatively good LAD run-off. She underwent coronary artery bypass graft surgery with an excellent result. PMID:24444069

  1. Modeling the propagation of arterial dissection

    Microsoft Academic Search

    T. Christian Gasser; Gerhard A. Holzapfel

    2006-01-01

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

  2. Keeping Dissection Alive for Medical Students

    ERIC Educational Resources Information Center

    Chambers, James; Emlyn-Jones, Daniel

    2009-01-01

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

  3. Objecting To Dissection: A College Student's Handbook.

    ERIC Educational Resources Information Center

    National Anti-Vivisection Society, Chicago, IL.

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

  4. Dissection of the Abdominal Aorta in Blunt Trauma: Management by Percutaneous Stent Placement

    Microsoft Academic Search

    Helene Vernhet; Charles-Henri Marty-Ane; Alvian Lesnik; Regis Chircop; Olivier Serres-Cousine; Eric Picard; Henry Mary; Jean Paul Senac

    1997-01-01

    We implanted stents in three patients who had traumatic abdominal aortic dissections, complicated by right limb ischemia in one case. The circulating false channel extended to the left iliac artery in one case and to both iliac arteries in the last case. Diagnosis and radiological follow-up included ultrasound, computed tomography, and arteriography. Two patients were treated with Wallstents, one with

  5. [Stagewise surgical treatment in type III B chronic aortic dissection].

    PubMed

    Ignat'ev, I M; Generalov, M I; A?riian, N E; Volodiukhin, M Iu; Zanochkin, A V

    2012-01-01

    Presented herein is a clinical case report of successful surgical treatment (open and endovascular operation) of a patient with DeBakey type III B chronic aortic dissection. The diagnosis was verified by contrast-enhanced multispiral computed tomography (MSCT). The first stage consisted in operation of carotid-subclavian bypass grafting and aortomy with dissection of the internal membrane of the abdominal aorta, dividing the false and true channels. The second stage included endovascular prosthetic repair of the thoracic aorta with the Relay stent graft. The course of the postoperative period was uneventful. According to the MSCT findings 2 months after the intervention, the endograft was patent, with neither shift nor endoleack. The false channel along the descending thoracic aorta is thrombosed. The maximal diameter of the abdominal aorta does not exceed 4 cm. According to the findings of duplex scanning, the carotid-subclavian bypass is functioning. The patient's condition is satisfactory. PMID:23059612

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

    PubMed Central

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

    2014-01-01

    Aortic size index (ASI) has been proposed as a reliable criterion to predict risk for aortic dissection in Turner syndrome with significant thresholds of 20-25 mm/m2. We report a case of aortic arch dissection in a patient with Turner syndrome who, from the ASI thresholds proposed, was deemed to be at low risk of aortic dissection or rupture and was not eligible for prophylactic surgery. This case report strongly supports careful monitoring and surgical evaluation even when the ASI is < 20 mm/m2 if other significant risk factors are present. PMID:24944765

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

    PubMed Central

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

    2015-01-01

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

  8. 75 FR 56093 - Eagle Rock Desoto Pipeline, LP; Notice of Motion for Extension of Rate Case Filing Deadline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-15

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

  9. A New Idea for Dissecting Tray

    ERIC Educational Resources Information Center

    Branham, Arthur

    1976-01-01

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

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

    NASA Video Gallery

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

  11. [Cervical, inguinal and abdominal lymphnode dissection].

    PubMed

    Kraus, T W; Suna, K; Berkhoff, S; Jäger, E; Kraus-Tiefenbacher, U

    2013-07-01

    Diagnostic lymph node dissections can be defined as a form of oncological service surgery. These procedures aim at clarification of differential diagnoses of local or systemic lymph node pathologies or contribute to tumor staging. Procedure implementation can either involve incisional biopsy, selective lymph node extirpation or regional systematic lymph node dissection. Sentinel lymph node lymphadenectomy is a focused form of selective lymphadenectomy. Both surgeon and oncologist must have a preoperative consensus and mutual understanding about the detailed purpose of the procedure in the individual patient setting. Terminology conventions must be considered in communication. Potential reasons to extend surgery should be strategically reflected prior to surgery. Interventional techniques and minimally invasive forms of surgical lymph node dissection must be technically taken into account in order to reduce procedural morbidity. Clinically indicative scenarios, pathophysiological concepts and technical options of surgical lymph node dissection are described and discussed for various anatomical regions. PMID:23719728

  12. Neck dissection: current concepts and future directions.

    PubMed

    Rigual, Nestor R; Wiseman, Sam M

    2004-01-01

    For individuals diagnosed with head and neck cancer, neck dissection may be performed for therapy or disease staging. The classification of neck dissection and the definition of precise anatomic landmarks have allowed for this operation, and its many variations, to become standardized world-wide. SLNBX shows promise in its ability to accurately stage NO head and neck cancer and may allow patients with no micro metastatic disease to avoid neck dissection. Before this technique becomes adopted into routine clinical practice, however, it must first be prospectively scrutinized in large patient populations. Regardless of the future role of SLNBX in the management of head and neck cancer, currently it is only through a complete understanding of the clinical, theoretic, and technical aspects of neck dis-section that surgeons may benefit individual patients and the head and neck cancer patient population as a whole. PMID:15062367

  13. 63 FR 32015 - Medicare Program; Notice for the Solicitation for Proposals for a Case Management Demonstration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    1998-06-11

    ...Demonstration Project Focused on Congestive Heart Failure or Diabetes Mellitus AGENCY: Health...life for beneficiaries with congestive heart failure or diabetes mellitus who are in...focusing on case management of congestive heart failure, diabetes mellitus, or...

  14. Recurrent transient ischemic attacks as the initial presenting manifestation of type A aortic dissection.

    PubMed

    Zaidat, Osama O; Ubogu, Eroboghene E; Lerner, Alan J

    2002-09-01

    A case is reported of an 84-year-old woman with recurrent episodes of aphasia and right-sided weakness with spontaneous complete resolution associated with hypotension. She subsequently developed lower gastrointestinal bleeding, ischemic toes, and anuria without associated chest pain. An emergent transesophageal echocardiography showed a type A aortic dissection with aortic valve insufficiency and tamponade. Emergent thoracotomy was performed, which confirmed a severe acute type A aortic dissection. This is a reported case of acute painless aortic dissection presenting initially as recurrent transient ischemic attacks. The etiology of focal neurologic deficits should be crucially determined by an experienced clinician prior to thrombolytic administration. This case illustrates the importance of aortic disease in the etiology of acute stroke syndromes. PMID:12183771

  15. Cancer borealis stomatogastric nervous system dissection.

    PubMed

    Gutierrez, Gabrielle J; Grashow, Rachel G

    2009-01-01

    The stomatogastric ganglion (STG) is an excellent model for studying cellular and network interactions because it contains a relatively small number of cells (approximately 25 in C. borealis) which are well characterized. The cells in the STG exhibit a broad range of outputs and are responsible for the motor actions of the stomach. The stomach contains the gastric mill which breaks down food with three internal teeth, and the pylorus which filters the food before it reaches the midgut. The STG produces two rhythmic outputs to control the gastric mill and pylorus known as central pattern generators (CPGs). Each cell in the STG can participate in one or both of these rhythms. These CPGs allow for the study of neuromodulation, homeostasis, cellular and network variability, network development, and network recovery. The dissection of the stomatogastric nervous system (STNS) from the Jonah crab (Cancer borealis) is done in two parts; the gross and fine dissection. In the gross dissection the entire stomach is dissected from the crab. During the fine dissection the STNS is extracted from the stomach using a dissection microscope and micro-dissection tools (see figure 1). The STNS includes the STG, the oesophageal ganglion (OG), and the commissural ganglia (CoG) as well as the nerves that innervate the stomach muscles. Here, we show how to perform a complete dissection of the STNS in preparation for an electrophysiology experiment where the cells in the STG would be recorded from intracellularly and the peripheral nerves would be used for extracellular recordings. The proper technique for finding the desired nerves is shown as well as our technique of desheathing the ganglion to reveal the somata and neuropil. PMID:19308017

  16. Bilateral spontaneous dissection of extracranial vertebral arteries

    Microsoft Academic Search

    D. Leys; F. Lesoin; J. P. Pruvo; G. Gozet; M. Jomin; H. Petit

    1987-01-01

    A previously healthy 35-year-old man suddenly developed vertebrobasilar ischaemia while playing tennis. Cerebral arteriography revealed a dissecting aneurysm of the cervical portion of both vertebral arteries. The neurological deficit and the angiographic features resolved with anticoagulant treatment alone. Only 15 patients with non-traumatic extracranial vertebral artery dissection have been previously reported. It is necessary to recognize the condition very quickly,

  17. 37 CFR 202.2 - Copyright notice.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...the abbreviation “Copr.”, or the symbol © , or, in the case of a sound recording, the symbol © ; the name of the copyright proprietor...law; (4) The notice is in a foreign language; (5) The name in the notice is...

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

    PubMed

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

    2015-05-01

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

  19. Molecular Dissection of Phage Endolysin

    PubMed Central

    Pohane, Amol Arunrao; Joshi, Himanshu; Jain, Vikas

    2014-01-01

    Mycobacterium tuberculosis has always been recognized as one of the most successful pathogens. Bacteriophages that attack and kill mycobacteria offer an alternate mechanism for the curtailment of this bacterium. Upon infection, mycobacteriophages produce lysins that catalyze cell wall peptidoglycan hydrolysis and mycolic acid layer breakdown of the host resulting in bacterial cell rupture and virus release. The ability to lyse bacterial cells make lysins extremely significant. We report here a detailed molecular dissection of the function and regulation of mycobacteriophage D29 Lysin A. Several truncated versions of Lysin A were constructed, and their activities were analyzed by zymography and by expressing them in both Escherichia coli and Mycobacterium smegmatis. Our experiments establish that Lysin A harbors two catalytically active domains, both of which show E. coli cell lysis upon their expression exclusively in the periplasmic space. However, the expression of only one of these domains and the full-length Lysin A caused M. smegmatis cell lysis. Interestingly, full-length protein remained inactive in E. coli periplasm. Our data suggest that the inactivity is ensued by a C-terminal domain that interacts with the N-terminal domain. This interaction was affirmed by surface plasmon resonance. Our experiments also demonstrate that the C-terminal domain of Lysin A selectively binds to M. tuberculosis and M. smegmatis peptidoglycans. Our methodology of studying E. coli cell lysis by Lysin A and its truncations after expressing these proteins in the bacterial periplasm with the help of signal peptide paves the way for a large scale identification and analysis of such proteins obtained from other bacteriophages. PMID:24627486

  20. Aortic fenestration for type B chronic aortic dissection complicated with lower limb malperfusion induced by walking exercise.

    PubMed

    Arata, Kenichi; Imagama, Itsumi; Shigehisa, Yoshiya; Mukaihara, Kousuke; Toyokawa, Kenji; Matsuba, Tomoyuki; Imoto, Yutaka

    2015-01-01

    We report a case of a 55-year-old male with type B-chronic aortic dissection. Patient presented with intermittent claudication due to limb malperfusion resulting from expansion of a patent false lumen during walking regardless of normal range ankle-brachial index (ABI) at rest. Preoperative stress vascular ultrasonography was an effective modality for proper diagnosis. We should be concerned of reversible ischemia due to the dissection flap in patients with type B aortic dissection. Fenestration of the aorta can be a choice of treatment in such patients. The patient has been doing well with no ischemia for 3.5 years after the operation. PMID:25848428

  1. Aortic Fenestration for Type B Chronic Aortic Dissection Complicated with Lower Limb Malperfusion Induced by Walking Exercise

    PubMed Central

    Imagama, Itsumi; Shigehisa, Yoshiya; Mukaihara, Kousuke; Toyokawa, Kenji; Matsuba, Tomoyuki; Imoto, Yutaka

    2015-01-01

    We report a case of a 55-year-old male with type B-chronic aortic dissection. Patient presented with intermittent claudication due to limb malperfusion resulting from expansion of a patent false lumen during walking regardless of normal range ankle-brachial index (ABI) at rest. Preoperative stress vascular ultrasonography was an effective modality for proper diagnosis. We should be concerned of reversible ischemia due to the dissection flap in patients with type B aortic dissection. Fenestration of the aorta can be a choice of treatment in such patients. The patient has been doing well with no ischemia for 3.5 years after the operation. PMID:25848428

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

    PubMed

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

    2015-01-01

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

  3. Morbidity comparison of sentinel lymph node biopsy versus conventional axillary lymph node dissection for breast cancer patients: Results of the sentinella–GIVOM Italian randomised clinical trial

    Microsoft Academic Search

    P. Del Bianco; G. Zavagno; P. Burelli; G. Scalco; L. Barutta; P. Carraro; P. Pietrarota; G. Meneghini; T. Morbin; G. Tacchetti; P. Pecoraro; V. Belardinelli; G. L. De Salvo

    2008-01-01

    AimsTo compare physical morbidity and health-related quality of life (HRQOL) in breast cancer patients who received standard axillary dissection (ALND) or sentinel lymph node biopsy (SLNB), followed by axillary dissection only in the case of sentinel-node positivity, within a randomised clinical trial.

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

    NSDL National Science Digital Library

    Ken Roy

    2007-02-01

    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.

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

    SciTech Connect

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

    2007-07-01

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

  6. The nature of dissection: Exploring student conceptions

    NASA Astrophysics Data System (ADS)

    York, Katharine

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

  7. An approach to dissecting the congenitally malformed heart in the forensic autopsy: the value of sequential segmental analysis.

    PubMed

    Horn, K D; Devine, W A

    2001-12-01

    The demonstration of congenital heart disease at autopsy necessitates the careful preservation and examination of the heart, the vessels, and their connections. Techniques preserving these connections and using a reproducible and systematic approach are preferred. The Rokitansky method of organ block dissection, in combination with a system of heart examination termed sequential segmental analysis, provides such an approach. This study is based on the examination of heart specimens accessioned into the Frank E. Sherman, M.D., and Cora C. Lenox, M.D., Heart Museum (containing approximately 2400 specimens) of the Pathology Department, Children's Hospital of Pittsburgh. Specimens received in consultation during a 25-year period from hospitals and coroners'/medical examiners' offices were examined, and the corresponding reports were reviewed. Of 46 total heart specimens examined (1975-1999), 29 (63%) were dissected properly or left intact for dissection at Children's Hospital of Pittsburgh, and 17 (37%) were incorrectly dissected for the demonstration of congenital heart disease. Of these 17 cases, 11 (24%) displayed dissection errors, which did not hinder a complete diagnosis, 3 cases (6.5%) had errors that enabled only an incomplete diagnosis, and in 3 cases (6.5%), no diagnosis of congenital heart disease could be made. Dissection mistakes and means of avoiding them are discussed. Review of medical and family history, external and internal examination, and a reproducible and sequential method of examining the heart and its connections enables documentation of even the most complex cardiovascular anomalies. PMID:11764911

  8. Dissection of the Abdominal Aorta in Blunt Trauma: Management by Percutaneous Stent Placement

    Microsoft Academic Search

    Hélène Vernhet; Charles-Henri Marty-Ané; Alvian Lesnik; Régis Chircop; Olivier Serres-Cousiné; Eric Picard; Henry Mary; Jean Paul Senac

    1997-01-01

    We implanted stents in three patients who had traumatic abdominal aortic dissections, complicated by right limb ischemia\\u000a in one case. The circulating false channel extended to the left iliac artery in one case and to both iliac arteries in the\\u000a last case. Diagnosis and radiological follow-up included ultrasound, computed tomography, and arteriography. Two patients\\u000a were treated with Wallstents, one with

  9. Determinants of axillary recurrence after axillary lymph node dissection for invasive breast cancer

    Microsoft Academic Search

    A. C. Voogd; R. de Boer; M. J. C. van der Sangen; R. M. H. Roumen; H. J. T. Rutten; J. W. W. Coebergh

    2001-01-01

    Aim This study was undertaken to gain insight into the risk factors for axillary recurrence among patients with invasive breast cancer who underwent breast-conserving treatment or mastectomy and axillary lymph node dissection. Methods In a matched case–control design, 59 patients with axillary recurrence and 295 randomly selected control patients without axillary recurrence were compared. Matching factors included age, year of

  10. Successful emergency surgery on triple-vessel spontaneous coronary artery dissection

    Microsoft Academic Search

    Adrian Ooi; Michael Lavrsen; James Monro; Stephen M Langley

    2004-01-01

    Although there is increasing number of reported spontaneous coronary artery dissection (SCAD) recently, this is the first successful operative case of myocardial revascularization on triple-vessel SCAD. Emergency coronary artery bypass grafting was performed on a 42-year-old female presented with acute myocardial infarction, who had failed thrombolysis with on-going angina and acute heart failure.

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

    PubMed Central

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

    2015-01-01

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

  12. Retroperitoneal lymph node dissection for metastatic germ cell tumours

    PubMed Central

    Haldipur, N; Devaraj, S; Shehata, A; Lewis, AK; Smith, MO; Hatton, M; Nassef, A; Beard, JD

    2011-01-01

    INTRODUCTION In the North Trent Cancer Network (NTCN) patients requiring retroperitoneal lymphadenectomy for metastatic testicular cancer have been treated by vascular service since 1990. This paper reviews our experience and considers the case for involvement of vascular surgeons in the management of these tumours. PATIENTS AND METHODS Patients referred by the NTCN to the vascular service for retroperitoneal lymphadenectomy between 1990 and 2009 were identified through a germ cell database. Data were supplemented by a review of case notes to record histology, intraoperative and postoperative details. RESULTS A total of 64 patients were referred to the vascular service for retroperitoneal lymph node dissection, with a median age of 29 years (16–63 years) and a median follow-up of 4.9 years. Ten patients died: eight from tumour recurrence, one from septicaemia during chemotherapy and one by suicide. Of the 54 who survived, 7 were alive with residual masses and 47 patients were disease-free at the last follow-up. Sixteen patients required vascular procedures: four had aortic repair (fascia), three had aortic replacement (spiral graft), four had inferior vena cava resection, two had iliac artery replacement and two had iliac vein resection. CONCLUSIONS Retroperitoneal lymph node dissection often involves mobilisation and/or the resection/replacement of major vessels. We recommend that a vascular surgeon should be a part of testicular germ cell multidisciplinary team. PMID:21944797

  13. Combined subgaleal/myocutaneous technique for temporalis muscle dissection.

    PubMed

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

    2012-12-01

    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

  14. Combined Subgaleal/Myocutaneous Technique for Temporalis Muscle Dissection

    PubMed Central

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

    2012-01-01

    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

  15. Anterior subcarinal node dissection on the left side using video thoracoscopy: an easier technique.

    PubMed

    Baste, Jean-Marc; Haddad, Laura; Melki, Jean; Peillon, Christophe

    2015-04-01

    Lobectomy for lung carcinoma is usually associated with complete node dissection, but it is often difficult to perform using video thoracoscopy, especially on the left side. In this case, our team uses an anterior technique for subcarinal lymphadenectomy. After left lobectomy, we lift the bronchial stump by its anterior face to open and dissect the subcarinal space. Exposure is difficult using the more usual technique of posterior subcarinal lymphadenectomy, and the different techniques (often requiring retractors) remain complex because some vessels might be injured. We recommend using anterior lymphadenectomy, which should facilitate video thoracoscopy for lymphadenectomy on the left side. PMID:25841862

  16. Blunt traumatic carotid artery dissection still a pitfall? The rationale for aggressive screening

    Microsoft Academic Search

    K. J. P. van Wessem; J. M. R. Meijer; L. P. H. Leenen; H. B. van der Worp; F. L. Moll; G. J. de Borst

    2011-01-01

    Introduction  The optimal diagnostic strategy for carotid dissection following blunt trauma is yet unclear. The rationale for aggressive\\u000a screening will be discussed based on a consecutive case series of blunt traumatic carotid artery dissection (CAD).\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  Five patients admitted to our level I trauma center developed severe complications as a consequence of blunt traumatic CAD.\\u000a The diagnosis of CAD was

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

    SciTech Connect

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

    2005-01-15

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

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

    SciTech Connect

    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

    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.

  19. Endovascular Treatment in Ruptured Middle Cerebral Artery Dissection Preservation of Arterial Continuity

    PubMed Central

    Nam, Dong Hyuk

    2015-01-01

    Rupture of spontaneous dissecting aneurysms of the middle cerebral artery (MCA) is rare and its etiology remains obscure, although the risk of rebleeding is greater than with saccular aneurysms. Most reports concerning the treatment of a ruptured dissecting aneurysm of the anterior circulation involve surgical trapping or wrapping. Here, we report on a case of an MCA dissecting rupture treated with endovascular procedures. A 22-year-old female presented with sudden stuporous mental change following severe headache and left side hemiparesis. A computed tomography scan showed a diffuse subarachnoid hemorrhage and diffusion MR showed diffusion restriction at the right putamen and internal capsule. A 3-hour follow-up digital subtraction angiography (DSA) showed a dissecting aneurysm, which was not seen on an initial DSA. A stent assisted coil embolization was performed and double stents were applied to achieve flow diversion effects. A small remnant area of the dissecting aneurysm had disappeared at 60-day and was not observed on 12-month follow-up DSA.

  20. Acute cervical artery dissection after a dental procedure due to a second inferior molar infection.

    PubMed

    Delgado, Montserrat G; Riesco, Nuria; Murias, Eduardo; Calleja, Sergio

    2015-01-01

    Periodontal infections might represent one of the causative factors for cervical artery dissection. We present a case of a 49-year-old woman admitted due to headache. The patient had been suffering from a right second inferior molar infection with a cervical phlegmon for 1?week prior to admission. On 2 October 2014, the patient went to the dentist and a molar extraction was performed in the morning. In the afternoon, the patient began to experience right hemifacial pain that progressed towards an intense and bilateral headache. Neurological status at the time of admission revealed right miosis, ptosis and conjuntival hyperaemia. A CT angiography showed a right internal carotid artery dissection provoking a high-degree stenosis. The relationship between periodontal infection and vascular disease has been previously presented. Microbial agents may directly, and inflammatory and immunological host response indirectly, influence inflammatory changes in cervical arteries favouring dissections with minor traumas. PMID:26038385

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

    NSDL National Science Digital Library

    Michael Schumaker (Youngstown Orthopedics)

    2009-02-01

    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.

  2. Incidental Discovery of Carotid Artery Dissection as a Cause of Horner's Syndrome and Headache in a Patient Presenting for Follow-Up of Lumbar Epidural Steroid Injection: A Case Report with A Three Year Follow-Up

    Microsoft Academic Search

    Sukdeb Datta; Kenneth D. Candido

    Objective : To describe management challenges and follow-up data for three years in a case with spontaneous carotid artery dis- section (SCAD). Case Report : We present a case of SCAD that presented with Horner's syn- drome and headache. The patient developed the SCAD, Horner's syndrome and headache one month after a lumbar epidural steroid in- jection for radicular pain.

  3. Gastric mucosa under the dissecting microscope

    Microsoft Academic Search

    S. N. Salem

    1965-01-01

    D ISSECTING-MICROSCOPY~ EXAMINATION of the small-intestinal mucosa has become an important part of biopsy study in diseases affecting the small intestine, particularly tile condition known as idiopathic steatorrhea (nontropical sprue). Examination of the biopsy specimen with the dissecting microscope provides immediate diagnosis in that condition. Rubin et at. 1 showed that in nontropical sprue, the appearance of the jejunal biopsy

  4. Pythagoras and the Dissection of Polygons.

    ERIC Educational Resources Information Center

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

    1984-01-01

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

  5. Course review: the 4th Bob Huffstadt upper and lower limb flap dissection course.

    PubMed

    Dunne, Jonathan A

    2014-12-01

    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

  6. Aortic dissection associated with blunt chest trauma diagnosed by elevated D-dimer

    PubMed Central

    Penn, Joshua L.; Martindale, Jennfier L.; Milne, Leslie W.; Marill, Keith A.

    2015-01-01

    Introduction Similar to spontaneous aortic dissection, traumatic aortic dissection is diagnosed with a careful history and physical exam, chest radiograph, and ultimately, dedicated aortic imaging. The diagnosis of spontaneous aortic dissection may be aided by using the serum D-dimer test. The use of D-dimer for diagnosing aortic injury in the setting of blunt trauma has not previously been reported. Presentation of case We present a case of aortic dissection in a 61-year-old male diagnosed when the patient presented with chest pain after blunt chest trauma. Discussion The patient had no known history or risk factors for aortic disease. None of the classic findings were present by history, physical examination or chest radiograph and the diagnosis was made as the result of an elevated D-dimer. We discuss how the D-dimer test fortuitously led to the diagnosis in this case, and the implications. Conclusion D-dimer could be helpful in diagnosing aortic injuries in low-risk chest trauma patients. PMID:25805614

  7. Lymph node dissection for lung cancer: past, present, and future.

    PubMed

    Watanabe, Shun-ichi

    2014-07-01

    In 1978, Naruke et al. proposed an anatomical map that included numbered lymph node stations, which then became widely used for nodal dissection. In 1997, Mountain and Dresler published a new map, which is now favored by the American Thoracic Society and the European Respiratory Society. Using these maps, regional nodal dissection has been universally performed in lung cancer surgery. Clear evidence regarding the survival benefit of lymph node dissection for lung cancer is lacking. However, lobectomy with lymph node dissection continues to be a standard surgical procedure for lung cancer because lymph node dissection is an important investigative process in staging patients. Over the last decade, the extent of nodal dissection for lung cancer has changed due to the increasing number of early detected lung cancers made possible by the recent development of the CT scanner. This manuscript describes the history, present strategy, and future perspectives of lymph node dissection for lung cancer. PMID:24823489

  8. Spontaneous Bilateral Internal Carotid Artery Dissection with Acute Stroke in Young Patients

    Microsoft Academic Search

    Hsiu-Chuan Wu; Yi-Chun Chen; Chi-Jen Chen; Sien-Tsong Chen; Tsong-Hai Lee

    2006-01-01

    We studied the clinical and neuroradiological features of 41 cases with spontaneous bilateral internal carotid artery dissection (ICAD), including 3 cases in our hospital and 38 retrieved from the English literature. Bilateral ICAD accounts for 15.8% of young stroke patients with ICAD in our hospital. The most common presentations are head and\\/or neck pain, cerebral ischemia, carotid bruit and Horner’s

  9. Radical resection with autonomic nerve preservation and lymph node dissection techniques in lower rectal cancer surgery and its results: the impact of lateral lymph node dissection

    Microsoft Academic Search

    T. Mori; K. Takahashi; M. Yasuno

    1998-01-01

    Lateral lymph node metastases occur in 9% of rectal cancer patients. For cancers localized in the lower rectum below peritoneal\\u000a reflection, the frequency increases to 13% of all cases and to 25.5% in those of Dukes' stage C. The most important technique\\u000a in colorectal surgery for decreasing local failure in the pelvis is lateral lymph node dissection. Today, however, it

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

    PubMed

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

    2015-02-01

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

  11. Renal artery dissection associated with Gz acceleration.

    PubMed

    Beyer, Reinaldo W; Daily, Pat O

    2004-03-01

    A 55-yr-old male presented with flank pain and nausea minutes after intensive aerobatic flight maneuvers. An initial diagnosis of acute appendicitis was made. Computed axial tomography and renal arteriography showed a right kidney with two renal arteries, a right upper pole infarction, and a dissection in the upper renal artery which had a more vertical trajectory than the usual main renal artery. No signs of diseases known to be associated with renal artery dissection were present. The patient recovered without residual hypertension. Heavy positive G loads may have potential to cause renal arterial injury, particularly when renal vascular anatomical variations exist. The postulated mechanism is similar to fall injuries in which the subjects landed on their feet, with inertia causing caudal renal dislodgement and stretch of the renal vessels. PMID:15018300

  12. Managing aortic aneurysms and dissections during pregnancy.

    PubMed

    Muiño Mosquera, Laura; De Backer, Julie

    2015-06-01

    Cardiovascular diseases during pregnancy account for significant morbidity and mortality, with aortic aneurysms, complicated by aortic dissection or rupture, being high on the list of underlying causes in this category. Correct knowledge of the diagnosis, risks and treatment is mandatory to improve the outcome and save lives. In this article, the authors aim to provide an overview of the underlying causes and risk factors for aortic aneurysms and dissections during pregnancy, while presenting the ways of preventing and treating these conditions. Although an important focus lies on the proximal part of the aorta due to it bearing the greatest risk for complications and being more frequently implicated in aortic disease in younger subjects, many aspects on the etiology and underlying diseases also apply to the other parts of the vessel. PMID:26000563

  13. Dissecting mammalian immunity through mutation

    PubMed Central

    Siggs, Owen M

    2014-01-01

    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

  14. Recanalization of Spontaneous Carotid Artery Dissection

    Microsoft Academic Search

    Krassen Nedeltchev; Stefan Bickel; Marcel Arnold; Hakan Sarikaya; Dimitrios Georgiadis; Matthias Sturzenegger; Heinrich P. Mattle; Ralf W. Baumgartner

    Background and Purpose—We set out to investigate the predictors and time course for recanalization of spontaneous dissection of the cervical internal carotid artery (SICAD). Methods—We prospectively included 249 consecutive patients (mean age, 4511 years) with 268 SICAD. Ultrasound examinations were performed at presentation, during the first month, and then at 3, 6, and 12 months, and clinical follow-ups after 3,

  15. Geometric dissections now swing and twist

    Microsoft Academic Search

    Greg N. Frederickson

    2001-01-01

    Conclusion  With their visual and kinetic appeal, hinged dissections and their design techniques will continue to play a role in mathematical\\u000a recreation and education. They also invite substantive research in mathematics and computer science. Hinges are the simplest\\u000a of linkages, permitting only relative rotation between connected pieces; with hingeability we address issues of transformation\\u000a of objects which have wider relevance. In

  16. Whole Vitreous Humor Dissection for Vitreodynamic Analysis.

    PubMed

    Murali, Karthik; Kashani, Amir H; Humayun, Mark S

    2015-01-01

    The authors propose an effective technique to isolate whole, intact vitreous core and cortex from post mortem enucleated porcine eyes. While previous studies have shown the results of such dissections, the detailed steps have not been described, precluding researchers outside the field from replicating their methods. Other studies harvest vitreous either through aspiration, which does not maintain the vitreous structure anatomy, or through partial dissection, which only isolates the vitreous core. The proposed method isolates the whole vitreous body, with the vitreous core and cortex intact, while maintaining vitreous anatomy and structural integrity. In this method, a full thickness scleral flap in an enucleated porcine eye is first created and through this, the choroid tissue can be separated from the sclera. The scleral flap is then expanded and the choroid is completely separated from the sclera. Finally the choroid-retina tissue is peeled off the vitreous to leave an isolated intact vitreous body. The proposed vitreous dissection technique can be used to study physical properties of the vitreous humor. In particular, this method has significance for experimental studies involving drug delivery, vitreo-retinal oxygen transport, and intraocular convection. PMID:26065393

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

    PubMed Central

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

    2014-01-01

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

  18. Open fenestration for complicated acute aortic B dissection

    PubMed Central

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

    2014-01-01

    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

  19. Multivessel spontaneous coronary artery dissection in an unlikely patient.

    PubMed

    Jehangir, Waqas; Aly, Tarek; Bedran, Kebir H; Yousif, Abdalla; Niemiera, Mark L

    2015-01-01

    When approaching the symptom of acute onset chest pain in a previously healthy 26-year-old male, anchoring heuristic presents a challenge to healthcare workers. This diagnostic error is the healthcare professional's tendency to rely on a previous diagnosis, and, in situations where a set of symptoms might mask a rare and deadly condition, this error can prove fatal for the patient. One such condition, Spontaneous Coronary Artery Dissection (SCAD), is an uncommon and malefic presentation of coronary artery disease that can lead to myocardial infarction and sudden death. We present a case of SCAD in an otherwise healthy 26 year-old male who had been experiencing chest pain during and after sports activity. In the young, athletic male with SCAD, the danger of diagnostic error was a reality due to the broad symptomatology and the betraying demographics. PMID:25945264

  20. How many cases are enough for accreditation in sentinel lymph node biopsy in breast cancer?

    Microsoft Academic Search

    Elias E Sanidas; Eelco de Bree; Dimitris D Tsiftsis

    2003-01-01

    BackgroundThere is considerable argument concerning the number of sentinel node biopsy cases with axillary dissection that surgeons should perform before they are eligible on abandoning axillary dissection in negative sentinel node patients.

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

    PubMed

    Anyanwu, Emeka G

    2015-06-01

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

  2. 37 CFR 2.155 - Notice of publication.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  3. Endovascular repair of a double-lumen dissecting aneurysm

    PubMed Central

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

    2013-01-01

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

  4. Biomechanical Properties of Human Ascending Thoracic Aortic Dissections.

    PubMed

    Babu, Anju R; Byju, Achu G; Gundiah, Namrata

    2015-08-01

    Thoracic aortic dissections are associated with a significant risk of morbidity and mortality, and currently challenge our understanding of the biomechanical factors leading to their initiation and propagation. We quantified the biaxial mechanical properties of human type A dissections (n?=?16) and modeled the stress-strain data using a microstructurally motivated form of strain energy function. Our results show significantly higher stiffness for dissected tissues as compared to control aorta without arterial disease. Higher stiffness of dissected tissues did not, however, correlate with greater aortic diameter measured prior to surgery nor were there any age dependent differences in the tissue properties. PMID:26043270

  5. A Comparative Approach To Animal Dissections (A Phylogenic Study)

    NSDL National Science Digital Library

    In this biology inquiry lab, students study evolutionary relationships by making observations of preserved animal specimens, developing a question, then investigating by dissecting the specimens provided.

  6. Retraction: notice.

    PubMed

    2014-10-01

    Ping Gao, Shun-Chang Jiao, Li Bai, et al. 'Detection of circulating tumour cells in gastric and hepatocellular carcinoma: A systematic review' Journal of International Medical Research August 2013 vol. 41 no. 4 923-933. DOI: 10.1177/0300060513489789 has been retracted. This is because it contains unattributed overlap with material from the following article: FC Bidard, FR Ferrand, F Huguet, et al. 'Disseminated and circulating tumor cells in gastrointestinal oncology' Critical Reviews in Oncology / Hematology, Volume 82, Issue 2, Pages 103-115, May 2012. DOI: 10.1016/j.critrevonc.2011.05.008 NOTICE: Yongsheng Zhao, Yuxin Liu and Yanping Zheng, 'Osteoporosis and related factors in older females with skeletal pain or numbness: A retrospective study in East China', Journal of International Medical Research June 2013 vol. 41 no. 3 859-866. DOI: 10.1177/0300060513483414 has been retracted. This is because it contains unattributed overlap with material from the following article: Shasha Li, Hongchen He, Mingfu Ding et al. 'The correlation of osteoporosis to clinical features: a study of 4382 Female Cases of a Hospital Cohort with musculoskeletal symptoms in Southwest China' BMC Musculoskeletal Disorders 2010, 11:183. DOI: 10.1186/1471-2474-11-183 NOTICE: Ao Qiang Guo, Lei Sheng, Xu Lei et al. 'Pharmacological and physical prevention and treatment of no-reflow after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction' Journal of International Medical Research June 2013 vol. 41 no. 3 537-547. DOI: 10.1177/0300060513479859 has been retracted. This is because it contains unattributed overlap with material from the following article: Giampaolo Niccoli, Rajesh K Kharbanda, Filippo Crea, et al. 'No-reflow: again prevention is better than treatment' European Heart Journal (2010) 31(20): 2449-2455. DOI: 10.1093/eurheartj/ehq299. PMID:25239877

  7. Diagnosis and treatment of cervical artery dissection.

    PubMed

    Engelter, Stefan T; Traenka, Christopher; Von Hessling, Alexander; Lyrer, Philippe A

    2015-05-01

    Cervical artery dissection (CAD) is a major cause of stroke in the young. A mural hematoma is detected in most CAD patients. The intramural blood accumulation should not be considered a reason to withhold intravenous thrombolysis in patients with CAD-related stroke. Because intravenous-thrombolyzed CAD patients might not recover as well as other stroke patients, acute endovascular treatment is an alternative. Regarding the choice of antithrombotic agents, this article discusses the findings of 4 meta-analyses across observational data, the current status of 3 randomized controlled trials, and arguments and counterarguments favoring anticoagulants over antiplatelets. Furthermore, the role of stenting and surgery is addressed. PMID:25907914

  8. Prognostic biological features in neck dissection specimens.

    PubMed

    Woolgar, Julia A; Triantafyllou, Asterios; Lewis, James S; Hunt, Jennifer; Williams, Michelle D; Takes, Robert P; Thompson, Lester D R; Slootweg, Pieter J; Devaney, Kenneth O; Ferlito, Alfio

    2013-05-01

    The superior prognostic value offered by routine histopathological staging of neck dissections, as compared to clinical staging using palpation and modern imaging techniques, is well established in the literature concerning the management of squamous cell carcinoma of the head and neck. In this review, we discuss the definitions and criteria used in standardised routine histopathological reporting and explore additional potential nodal prognostic features. In addition, we critically appraise the value of immunohistochemistry, histochemistry, molecular and other non-morphological techniques and suggest tumour and host features that merit further investigations. PMID:22983222

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  10. Acute myocardial infarction due to left main compression aortic dissection treated by direct stenting.

    PubMed

    Cardozo, Carlos; Riadh, Rihani; Mazen, Moukahal

    2004-02-01

    We describe a case of acute myocardial infarction (AMI) due to compression of the left main coronary artery (LMCA) by a false channel created by an acute aortic dissection (AAD). The dynamic pattern of artery obstruction is detailed as a key element to the diagnosis of extrinsic coronary compression throughout the angiography. Treatment by direct stenting restored complete anterograde coronary flow and improved myocardial perfusion. PMID:14760201

  11. Fatal fungal infection complicating aortic dissection following coronary artery bypass grafting

    Microsoft Academic Search

    D. M Rassl; S. K Suvarna; G. J Cooper

    2000-01-01

    The case of a 52-year-old man with severe coronary atheroma\\/ischaemic heart disease, who underwent successful triple vessel coronary artery bypass grafting is described. One month later this was complicated by aortic dissection arising at the aortic cannulation site. An emergency resection and Dacron graft placement were performed. Five weeks later he represented with haemoptysis. Despite inconclusive investigations the patient went

  12. Successful emergency surgery on triple-vessel spontaneous coronary artery dissection

    Microsoft Academic Search

    Adrian Ooi; Michael Lavrsen; James Monro; Stephen M. Langley

    2010-01-01

    Although there is increasing number of reported spontaneous coronary artery dissection (SCAD) recently, this is the first successful operative case of myocardial revascularization on triple-vessel SCAD. Emergency coronary artery bypass grafting was performed on a 42-year-old female presented with acute myocardial infarction, who had failed thrombolysis with on-going angina and acute heart failure. q 2004 Elsevier B.V. All rights reserved.

  13. Early recognition of acute thoracic aortic dissection and aneurysm

    PubMed Central

    2013-01-01

    Background Thoracic aortic dissection (TAD) and aneurysm (TAA) are rare but catastrophic. Prompt recognition of TAD/TAA and differentiation from acute coronary syndrome (ACS) is difficult yet crucial. Earlier identification of TAA/TAD based upon routine emergency department screening is necessary. Methods A retrospective analysis of patients that presented with acute thoracic complaints to the ED from January 2007 through June 2012 was performed. Cases of TAA/TAD were compared to an equal number of controls which consisted of patients with the diagnosis of ACS. Demographics, physical findings, EKG, and the results of laboratory and radiological imaging were compared. P-value of?>?0.05 was considered statistically significant. Results In total, 136 patients were identified with TAA/TAD, 0.36% of patients that presented with chest complaints. Compared to ACS patients, TAA/TAD group was older (68.9 vs. 63.2 years), less likely to be diabetic (13% vs 32%), less likely to complain of chest pain (47% vs 85%) and head and neck pain (4% vs 17%). The pain for the TAA/TAD group was less likely characterized as tight/heavy in nature (5% vs 37%). TAA/TAD patients were also less likely to experience shortness of breath (42% vs. 51%), palpitations (2% vs 9%) and dizziness (2% vs 13%) and had a greater incidence of focal lower extremity neurological deficits (6% vs 1%), bradycardia (15% vs. 5%) and tachypnea (53% vs. 22%). On multivariate analysis, increasing heart rate, chest pain, diabetes, head & neck pain, dizziness, and history of myocardial infarction were independent predictors of ACS. Conclusions Increasing heart rate, chest pain, diabetes, head & neck pain, dizziness, and history of myocardial infarction can be used to differentiate acute coronary syndromes from thoracic aortic dissections/aneurysms. PMID:24499618

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

    SciTech Connect

    Walkden, R. Miles, E-mail: rwalkden@nhs.net; Morgan, Rob A.; Loftus, Ian; Thompson, Matt [St Georges Hospital, St Georges Vascular Institute (United Kingdom)

    2008-07-15

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

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

    ERIC Educational Resources Information Center

    Franklin, Sue; Peat, Mary; Lewis, Alison

    2002-01-01

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

  16. 78 FR 6838 - Certain Balloon Dissection Devices and Products Containing Same; Institution of Investigation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

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

  17. Molecular Mechanisms of Thoracic Aortic Dissection

    PubMed Central

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

    2013-01-01

    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

  18. Sudden cardiac death due to coronary artery dissection as a complication of cardiac sarcoidosis.

    PubMed

    Kanaroglou, Savas; Nair, Vidhya; Fernandes, John R

    2015-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS), cardiac tamponade and sudden cardiac death that typically affects young women in the postpartum period. Rarely, it can be caused by systemic inflammatory conditions such as sarcoidosis. Sarcoidosis is an inflammatory disease most often affecting the lung and lymph nodes that can sometimes affect the heart. The authors report a case of sudden cardiac death caused by SCAD in the context of undiagnosed and subclinical cardiac sarcoidosis. The decedent was a 47-year-old male with a relatively innocuous past medical history. He was found dead in bed. At autopsy, there was a lethal hemopericardium resulting in cardiac tamponade. Gross examination of the heart revealed dissection of the posterior descending coronary branch of the right coronary artery. Histologically, the coronary artery showed acute and organizing dissection with evidence of vasculitis. A chronic inflammatory infiltrate consisting of lymphocytes, histiocytes, eosinophils and giant cells was seen. Sections of the myocardium showed myocarditis with a nonnecrotizing granuloma. The death was attributed to cardiac tamponade secondary to SCAD in the context of systemic sarcoidosis. The presented case demonstrates two concurrent rare pathologies and highlights the importance of considering SCAD in cases of sudden cardiac death at autopsy. PMID:25638512

  19. A Modified Dissection Method to Preserve Neck Structures

    ERIC Educational Resources Information Center

    Hankin, Mark H.; Stoller, Jeremy L.

    2009-01-01

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

  20. Value of systematic mediastinal lymph node dissection during pulmonary metastasectomy

    Microsoft Academic Search

    Florian Loehe; Sonja Kobinger; Rudolf A Hatz; Thomas Helmberger; Udo Loehrs; Heinrich Fuerst

    2001-01-01

    Background. Systematic mediastinal lymph node dissection is the accepted standard when curative resection of bronchial carcinoma is performed. However, mediastinal lymph node dissection is not routinely performed with pulmonary metastasectomy, in which only enlarged or suspicious lymph nodes are removed. The incidence of malignant infiltration of mediastinal lymph nodes in patients with pulmonary metastases is not known.Methods. Sixty-three patients who

  1. Geographic Dissection of the Twitter Network Juhi Kulshrestha Farshad Kooti

    E-print Network

    Gummadi, Krishna P.

    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

  2. Aortic Valve Conservation in Acute Type A Dissection

    Microsoft Academic Search

    Stephen Westaby; Takahiro Katsumata; Edward Freitas

    1997-01-01

    Background. We consider operative survival as the primary objective in acute type A dissection and believe that virtually all native aortic valves can be conserved. We sought to answer the question: “Does glue repair improve the long-term stability of proximal aortic repair?”Methods. We retrospectively studied 64 patients with an acute type A dissection, an ascending aortic tear, and aortic regurgitation

  3. Late Sequelae of Whiplash Injury with Dissection of Cervical Arteries

    Microsoft Academic Search

    Vital Hauser; Peter Zangger; Yaroslav Winter; Wolfgang Oertel; Jürg Kesselring

    2010-01-01

    Background\\/Aims: The objective of our study was to estimate the incidence of posttraumatic dissections of cervical arteries in patients with whiplash injury acquired in a car accident. Methods and Patients: We performed a retrospective analysis of medical records of 500 patients with whiplash injury acquired in car accidents between 1996 and 2005 and searched for dissections of cervical arteries occurring

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

    NSDL National Science Digital Library

    Thelma Quince (University of Cambridge Department of Public Health and Primary Care)

    2011-06-08

    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.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  6. Endovascular Treatment of a Carotid Dissecting Pseudoaneurysm in a Patient with Ehlers-Danlos Syndrome Type IV with Fatal Outcome

    SciTech Connect

    Lim, Siok Ping, E-mail: siokpinglim@yahoo.co.uk; Duddy, Martin J. [Selly Oak Hospital, University Hospital, Birmingham NHS Foundation Trust, Department of Radiology (United Kingdom)

    2008-01-15

    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.

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

    PubMed Central

    Terada, Takuro; Tamaki, Masato

    2015-01-01

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

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

    PubMed

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

    2012-03-01

    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

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

    PubMed Central

    Kent, William D.T.; Manjunath, Adarsh

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

    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

  11. Concomitant femoro-femoral bypass graft during surgery for acute type A dissection to treat lower limb malperfusion.

    PubMed

    Gottardi, Roman; Resetar, Michaela; Bacher, Bernhard; Freilibs, Edgars; Taheri, Niuscha; Steindl, Johannes; Schreiber, Catharina; Seitelberger, Rainald

    2015-01-01

    We report the case of a 69-year-old male patient who was admitted to our department with an acute type A dissection complicated by ischemia of the left lower limb. During surgery for acute type A dissection, the patient underwent concomitant femoro-femoral crossover bypass graft placement to ensure blood supply of the left lower limb during surgery and minimize ischemia-reperfusion injury. The patient underwent supracoronary replacement of the ascending aorta while in deep circulatory arrest with a deepest core temperature of 25°C. Postoperative computed tomography showed antegrade perfusion and patency of the crossover bypass. Postoperative course was eventless without sequelae, especially of the left lower limb. We conclude that concomitant crossover bypass graft reduces the risk of ischemia-reperfusion injury in lower limb ischemia in patients undergoing surgery for acute type A dissection. PMID:25555950

  12. 12 CFR 1511.8 - Notice of attachment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 2013-01-01 false Notice of attachment. 1511.8 Section 1511.8 Banks...BOOK-ENTRY PROCEDURE § 1511.8 Notice of attachment. The interest of a debtor...to honor an order or other notice of attachment in any particular case or class of...

  13. 12 CFR 1511.8 - Notice of attachment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2014-01-01 false Notice of attachment. 1511.8 Section 1511.8 Banks...BOOK-ENTRY PROCEDURE § 1511.8 Notice of attachment. The interest of a debtor...to honor an order or other notice of attachment in any particular case or class of...

  14. 12 CFR 1511.8 - Notice of attachment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 2012-01-01 false Notice of attachment. 1511.8 Section 1511.8 Banks...BOOK-ENTRY PROCEDURE § 1511.8 Notice of attachment. The interest of a debtor...to honor an order or other notice of attachment in any particular case or class of...

  15. 12 CFR 1511.8 - Notice of attachment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 2010-01-01 false Notice of attachment. 1511.8 Section 1511.8 Banks...BOOK-ENTRY PROCEDURE § 1511.8 Notice of attachment. The interest of a debtor...to honor an order or other notice of attachment in any particular case or class of...

  16. 12 CFR 1511.8 - Notice of attachment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 2011-01-01 false Notice of attachment. 1511.8 Section 1511.8 Banks...BOOK-ENTRY PROCEDURE § 1511.8 Notice of attachment. The interest of a debtor...to honor an order or other notice of attachment in any particular case or class of...

  17. Nanoscale scraping and dissection of collagen fibrils.

    PubMed

    Wenger, M P E; Horton, M A; Mesquida, P

    2008-09-24

    The main function of collagen is mechanical, hence there is a fundamental scientific interest in experimentally investigating the mechanical and structural properties of collagen fibrils on the nanometre scale. Here, we present a novel atomic force microscopy (AFM) based scraping technique that can dissect the outer layer of a biological specimen. Applied to individual collagen fibrils, the technique was successfully used to expose the fibril core and reveal the presence of a D-banding-like structure. AFM nanoindentation measurements of fibril shell and core indicated no significant differences in mechanical properties such as stiffness (reduced modulus), hardness, adhesion and adhesion work. This suggests that collagen fibrils are mechanically homogeneous structures. The scraping technique can be applied to other biological specimens, as demonstrated on the example of bacteria. PMID:21832566

  18. Spontaneous internal carotid artery dissection: an uncommon cause of recurrent postpartum headache.

    PubMed

    Stamboulis, Elefterios; Raptis, Georgios; Andrikopoulou, Athina; Arvaniti, Chrisa; Brountzos, Elias; Oikonomopoulos, Nikos; Stefanis, Leonidas; Voumvourakis, Konstantinos

    2011-01-01

    Postpartum spontaneous cervicocephalic artery dissection is an uncommon, poorly understood condition following pregnancy. We report a case of a 32-year-old woman with no history of trauma, chiropractic manipulation, connective tissue disorder, or previous headache who developed a mild, unilateral headache 7 days after the uneventful delivery of her third child (no general or neuraxial anesthesia was delivered). Seven days latter she presented to our emergency department complaining of recurrent episodes of right-sided headache coupled with a transient episode of sensory deficits in her left lower limb. Brain magnetic resonance imaging disclosed small infarctions in the internal watershed distribution of right internal carotid artery (ICA). Carotid artery dissection was diagnosed using DSA and T1 FAT-SAT sequences for the depiction of intramural hematoma. The patient was placed under oral anticoagulation and remained asymptomatic during a follow-up period of 6 months. The present case report highlights that cervicocephalic artery dissection is a condition that should be looked for in women with persisting or remitting unilateral headache following childbirth. PMID:19453826

  19. Functional neck dissection for the clinically negative neck: effectiveness and controversies.

    PubMed

    Lassaletta, Luis; García-Pallarés, Marta; Morera, Eduardo; Salinas, Silvia; Bernáldez, Ricardo; Patrón, Mercedes; Gavilán, Javier

    2002-02-01

    This study was performed to evaluate the effectiveness of functional neck dissection in controlling metastasis to the clinically negative (cN0) neck, focusing on recurrences in the pathologically negative (pN0) neck and the role of extracapsular spread in the cN0 neck. A series of 172 patients (253 dissected fields) treated for cN0 laryngeal or hypopharyngeal cancer with a 5-year minimum follow-up is presented. Occult metastasis was observed in 30% of the patients. Extracapsular spread was present in 39% of the positive nodes. The neck recurrence rate was 5.2%. Surgical specimens from cases of neck recurrence in pN0 necks were reevaluated for micrometastasis by immunostaining with antibody for cytokeratins. The immunohistochemical findings were positive in 1 of 4 cases. Functional neck dissection provides good neck control and survival rates for the cN0 neck. The accurate prognostic significance of extracapsular spread in cN0 necks is still unknown. Micrometastasis alone may be insufficient to explain recurrences in pN0 necks. PMID:11860071

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

    PubMed Central

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

    2014-01-01

    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. PMID:25317268

  1. Secretory breast carcinoma in a 6-year-old girl: mastectomy with sentinel lymph node dissection.

    PubMed

    Soyer, Tutku; Yaman Bajin, ?nci; Orhan, Diclehan; Yalçin, Bilgehan; Özgen Kiratli, Pinar; O?uz, Berna; Karnak, ?brahim

    2015-07-01

    Secretory breast carcinoma (SBC) is a rare type of breast neoplasia that was originally described in children. SBC is an indolent breast tumor with good clinical outcome and rare systemic involvement. Since, majority of studies concerning pediatric SBC have been case reports, it has been difficult to clearly elucidate the characteristics and optimal treatment strategies for SBC in children. Although treatment recommendations vary, surgical excision is the primary mode of treatment. Also, necessity of axillary and/or sentinel lymph node dissection is another matter of discussion in children. We report a 6-year-old girl who was diagnosed as SBC was reported to discuss the use of mastectomy with sentinel lymph node dissection in the treatment of this rare tumor in children. PMID:25994562

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

    Sveinsson, Olafur; Kostulas, Nikolaos; Herrman, Lars

    2013-01-01

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

  4. Immunostaining of dissected zebrafish embryonic heart.

    PubMed

    Yang, Jingchun; Xu, Xiaolei

    2012-01-01

    Zebrafish embryo becomes a popular in vivo vertebrate model for studying cardiac development and human heart diseases due to its advantageous embryology and genetics. About 100-200 embryos are readily available every week from a single pair of adult fish. The transparent embryos that develop ex utero make them ideal for assessing cardiac defects. The expression of any gene can be manipulated via morpholino technology or RNA injection. Moreover, forward genetic screens have already generated a list of mutants that affect different perspectives of cardiogenesis. Whole mount immunostaining is an important technique in this animal model to reveal the expression pattern of the targeted protein to a particular tissue. However, high resolution images that can reveal cellular or subcellular structures have been difficult, mainly due to the physical location of the heart and the poor penetration of the antibodies. Here, we present a method to address these bottlenecks by dissecting heart first and then conducting the staining process on the surface of a microscope slide. To prevent the loss of small heart samples and to facilitate solution handling, we restricted the heart samples within a circle on the surface of the microscope slides drawn by an immEdge pen. After the staining, the fluorescence signals can be directly observed by a compound microscope. Our new method significantly improves the penetration for antibodies, since a heart from an embryonic fish only consists of few cell layers. High quality images from intact hearts can be obtained within a much reduced procession time for zebrafish embryos aged from day 2 to day 6. Our method can be potentially extended to stain other organs dissected from either zebrafish or other small animals. PMID:22258109

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

    SciTech Connect

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

    2011-12-15

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

  6. Familial thoracic aortic aneurysm\\/dissection with patent ductus arteriosus: genetic arguments for a particular pathophysiological entity

    Microsoft Academic Search

    Philippe Khau Van Kien; Jean-Eric Wolf; Flavie Mathieu; Limin Zhu; Nicolas Salve; Alain Lalande; Caroline Bonnet; Gaëtan Lesca; Henri Plauchu; Arnaud Dellinger; Annie Nivelon-Chevallier; François Brunotte; Xavier Jeunemaitre

    2004-01-01

    Thoracic aortic aneurysm and aortic dissection (TAA and AD) are an important cause of sudden death. Familial cases could account for 20% of all cases. A genetic heterogeneity with two identified genes (FBN1 and COL3A1) and three loci (3p24–25 or MFS2\\/TAAD2, 5q13–q14 and 11q23.2–24) has been shown previously. Study of a single family composed of 179 members with an abnormally

  7. The Harmonic Scalpel versus Conventional Hemostasis for Neck Dissection: A Meta-Analysis of the Randomized Controlled Trials

    PubMed Central

    Ren, Zhen-Hu; Xu, Jian-Lin; Fan, Teng-Fei; Ji, Tong; Wu, Han-Jiang; Zhang, Chen-Ping

    2015-01-01

    Objective Neck dissection is the most definitive and effective treatment for head and neck cancer. This systematic review aims to compare the efficacy and surgical outcomes of neck dissection between the harmonic scalpel and conventional surgical techniques and conduct a quantitative meta-analysis of the randomized trials. Methods Randomized controlled trials (RCTs) were identified from the major electronic databases (MEDLINE, EMBASE and Cochrane Library) using the keywords ‘‘harmonic scalpel’’ and ‘‘neck dissection,’’ and a quantitative meta-analysis was conducted. The operative time and intraoperative bleeding were the primary outcome measures, and other parameters assessed included the drainage fluid volume and length of hospital stay. Results Seven trials that met the inclusion criteria included 406 neck dissection cases (201 in the harmonic scalpel group). Compared with conventional surgical techniques, the HS group had an operative time that was significantly reduced by 29.3 minutes [mean difference: -29.29; 95% CI = (-44.26, -14.32); P=0.0001], a reduction in intraoperative bleeding by 141.1 milliliters [mean difference: -141.13; 95% CI = (-314.99, 32.73); P=0.11], and a reduction in drainage fluid volume by 64.9 milliliters [mean difference: -64.86; 95% CI = (-110.40, -19.32); P=0.005] , but it is not significant after removal of studies driving heterogeneity. There was no significant difference in the length of the hospital stay [mean difference: -0.21; 95% CI = (-0.48, 0.07); P=0.14]. Conclusion This systematic review showed that using the harmonic scalpel for neck dissection significantly reduces the operative time and drainage fluid volume and that it is not associated with an increased length of hospital stay or perioperative complications. Therefore, the harmonic scalpel method is safe and effective for neck dissection. However, the statistical heterogeneity was high. Further studies are required to substantiate our findings. PMID:26161897

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

    SciTech Connect

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

    2009-05-15

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

  9. Dissection of the Hyperadhesive Phenotype of Airway Eosinophils in Asthma

    E-print Network

    Mosher, Deane F.

    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

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

    MedlinePLUS

    Spontaneous Coronary Artery Dissection: Not Just a Heart Attack Updated:May 15,2015 Sometimes a heart attack is not just a ... the result of spontaneous tearing in the coronary artery wall. The artery wall has three layers and ...

  11. Cadaver Dissection and the Ritual Transformation of Medical Students

    E-print Network

    Laudermilk, Ryan

    2011-12-31

    Human cadaver dissection is a common component of Western medical education. While most students react emotionally to the presence of such a deeply-held symbol of death, the expression of emotion is often seen as unprofessional, ...

  12. Isolated regional lymph node dissection: morbidity, mortality and economic considerations.

    PubMed Central

    Bland, K I; Klamer, T W; Polk, H C; Knutson, C O

    1981-01-01

    Between 1971-1979, 330 consecutive isolated regional lymph node dissections (RLNDs) were performed as therapeutic procedures for metastatic disease, at the University of Louisville Affiliated Hospitals and the Ellis-Fischel State Cancer Hospital in Columbia, Missouri. This retrospective analysis includes 133 radical neck RLNDs, 87 axillary RLNDs, and 110 superficial groin RLNDs. All accessioned cases were elective and were performed as isolated procedures, discrete from resection of contiguous or remote organs. No patients received preoperative irradiation, chemotherapy or immunotherapy. Forty-eight per cent of the 330 RLND procedures resulted in some form of postoperative complication. However, 91% of the incurred morbidity was localized to the operative site and was related to serum collection and/or flap necrosis. The occurrence of postoperative complications for each RLND site resulted in a prolongation of the patients' hospital stays by a mean of 9 days, and was most extended for the superficial groin RLND by a mean of 11 days. Nine patients (3%) died. These data for morbidity and mortality rates, as well as the implicit economic impact, represent substantial factors in the utilization of elective RLND. PMID:7212799

  13. 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

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

    1995-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  15. Emergency stent grafting of type B aortic dissection: technical considerations

    Microsoft Academic Search

    Tommaso Lupattelli; Francesco Giuseppe Garaci; Antonio Basile; Andrea Casini; Ilias Dalainas; Daniela Paola Minnella; Roberto Iezzi

    2008-01-01

    Type B aortic dissection is an uncommon yet potentially catastrophic clinical event that mandates prompt recognition and expeditious\\u000a treatment. Patient survival depends on early and accurate diagnosis and prompt medical or surgical treatment. Unfortunately,\\u000a when type B aortic dissection is associated with end-organ ischemia, medical treatment may not prove beneficial, with patients\\u000a addressed to surgery; recently, either percutaneous fenestration or

  16. Stroke prevention and treatment in patients with spontaneous carotid dissection

    Microsoft Academic Search

    Ralf W. Baumgartner

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

  17. Primary headaches and painful spontaneous cervical artery dissection

    Microsoft Academic Search

    Cynthia R. Campos; Marcelo Calderaro; Milberto Scaff; Adriana B. Conforto

    2007-01-01

    The relation between primary headaches (PH) and pain related to spontaneous cervical artery dissection (SCAD) is still unclear,\\u000a as well as the progress of PH after dissection. To investigate this relation, the characteristics of pain related to SCAD\\u000a and changes in PH patterns after SCAD, we evaluated 54 consecutive patients. Thirty-five (65%) had previous PH. Painful SCAD\\u000a occurred in 39

  18. A Modified Dissection Method to Preserve Neck Structures

    NSDL National Science Digital Library

    Mark Hankin (Toledo Neurosciences)

    2009-07-27

    This article provides 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 the accessory nerve, and (2) provide wide exposure of the root of the neck. These modified procedures can be readily performed by first-year medical students and integrate well with methods described in widely used anatomy dissection manuals.

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

    PubMed Central

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

    2013-01-01

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

  20. [Application of multiple-branch prostheses in reconstruction of the aortic arch in DeBakey Type I aortic dissection].

    PubMed

    Cherniavski?, A M; Alsov, S A; Marchenko, A V; Smolianinov, K A; Sizov, G G; Zotov, A S

    2006-01-01

    Over the period from January 2002 to March 2005, a total of 78 patients were operated on for DeBakey type I aortic dissection. Of these, five patients underwent prosthetic reconstruction of the aortic arch and brachiocephalic arteries (BCA), performed with the help of the Dacron prosthesis Gelweave four-branch plexus Vascutek. The major indication for using this prosthesis was the extending of the dissection into the BC As, with various degree of obstruction thereof. The overwhelming majority of the patients were men (80 %). The patients' average age amounted to 44.3+/-5.6 years (ranging from 36 to 57 years). In three cases, the aortic dissection was of chronic course, with acute and subacute dissection being diagnosed in the remaining two cases. The median-sternotomy access, and additional approaches to the left and right common carotid arteries were used in order to carry out prosthetic reconstruction of the ascending branch, aortic arch, right subclavian artery, right common carotid artery (CCA) and left CCA with the help of the multiple-branch prosthesis. Protection of the brain consisted of craniocerebral hypothermia, hypothermal circulatory arrest in a combination with retrograde cerebral perfusions through the vena cava superior. The duration of the circulatory arrest averagely amounted to 59.2+/-4 min, with the mean time of artificial circulation equalling 230.6+/-19.7 min, and the time of aortic occlusion was 193.1+/-11 minutes. None of the patients developed either neurological or haemorrhagic complications postoperatively. Hence, the surgical technique using multiple-branch prostheses for prosthetic reconstruction of the aortic arch in type I aortic dissection with BCA obstruction proved to be effective and safe. PMID:17641624

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

    SciTech Connect

    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

    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.

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2014-09-01

    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. PMID:25242850

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

    PubMed Central

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

    2014-01-01

    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. PMID:25242850

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

    PubMed

    Afzal, Aasim M; Sarmast, Syed A; Weber, Nicholas A; Schussler, Jeffrey M

    2015-07-01

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

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

    PubMed Central

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

    2015-01-01

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

  7. Proximity injury by the ultrasonically activated scalpel during dissection.

    PubMed

    Kadesky, K M; Schopf, B; Magee, J F; Blair, G K

    1997-06-01

    The ultrasonically activated scalpel is a high-frequency oscillating instrument that is reported to have a decreased dispersion of energy to surrounding tissues during use. To determine if this effect is beneficial and safe to surrounding tissue, it was used on anesthetized adolescent swine to dissect the portal vein from the pancreas, the renal artery and vein from the renal hilum, the ureter from the retroperitoneum, the aorta from the inferior vena cava and the common bile duct from surrounding tissue. Three-second contact to intestine and nerve roots was also performed. Wedge biopsy specimens of liver and spleen were performed. Dissection technique used was as described by the company. Structures were dissected with electrocautery using similar techniques for comparison. Tissues were harvested and placed in formalin for histological analysis. Dissection with the ultrasonically activated scalpel was simple, achieved excellent hemostasis, and did not appear to damage adjacent tissue. Microscopic analysis showed adventicial and media injury to vascular structures. The ureter and common bile duct demonstrated marked injury with regions of transmural coagulation. Nerve and small bowel did not appear to have much injury from the 3-second contact with the instrument. This study indicated that although the ultrasonically activated scalpel can ease dissection with good hemostasis, care must be taken to avoid injury to adjacent structures. Although its lateral energy dispersion may be less than that of cautery, it can still cause transmural necrosis to major structures. PMID:9200091

  8. A Simple Emergency Prediction Tool for Acute Aortic Dissection

    PubMed Central

    Peng, Wen; Zhu, Qing-yi; Zhou, Xiang-hong; Chai, Xiang-ping

    2013-01-01

    Abstract Background A simple emergency risk prediction tool should be developed for clinicians to quickly identify the prognosis of patients with acute aortic dissection. Methods We enrolled 280 patients with acute aortic dissection admitted to emergency department between May 2010 and February 2013. Multivariate logistic regression analysis was performed to identify independent predictors of in-hospital death. Results The in-hospital mortality of our patients with acute aortic dissection was 32.5%, in-hospital deaths with surgery less than the survived (34.1% VS 54.5%). Multivariate analysis identified that age (?65 years old), Type A, blood pressure (mean systolic blood pressure ? 90 mmHg), neutrophil percentage (? 80%) and serum D-dimer (? 5.0 mg/L) were significant predictors of death. With the simple emergency risk prediction tool, scores of all in-hospital deaths were ? 3, whereas almost all of the survivors (97.9%) had scores < 15. A score of 10 offered the best threshold value, with the highest sensitivity (81.3%) and specificity (86.8%). Conclusions The in-hospital mortality rate of patients with acute aortic dissection is high and can be predicted. Early surgery would be beneficial for in-hospital survive. This tool should be available for clinicians in the emergency department to quickly identify the prognosis of patients with acute aortic dissection.

  9. Progressive Intracranial Vertebral Artery Dissection Presenting with Isolated Trigeminal Neuralgia-Like Facial Pain

    PubMed Central

    Nakamizo, Tomoki; Koide, Takashi; Miyazaki, Hiromichi

    2015-01-01

    Intracranial vertebral artery dissection (IVAD) is a potentially life-threatening disease, which usually presents with ischemic stroke or subarachnoid hemorrhage. IVAD presenting with isolated facial pain is rare, and no case with isolated trigeminal neuralgia- (TN-) like facial pain has been reported. Here, we report the case of a 57-year-old male with IVAD who presented with acute isolated TN-like facial pain that extended from his left cheek to his left forehead and auricle. He felt a brief stabbing pain when his face was touched in the territory of the first and second divisions of the left trigeminal nerve. There were no other neurological signs. Magnetic resonance imaging (MRI) of the brain 7 days after onset revealed dissection of the left intracranial vertebral artery without brain infarction. The pain gradually disappeared in approximately 6 weeks, and the patient remained asymptomatic thereafter, except for a brief episode of vertigo. Follow-up MRI revealed progressive narrowing of the artery without brain infarction. This case indicates that IVAD can present with isolated facial pain that mimics TN. IVAD should be considered in the differential diagnosis of acute facial pain or TN. PMID:26146576

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

    PubMed

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

    2015-07-01

    Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and diminished negative professional stereotypes. An intensive interprofessional gross anatomy dissection course was created in 2009 to facilitate IPE at McMaster University. Data were collected from five cohorts over five years to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions. Each year, 28 students from the medicine, midwifery, nursing, physician's assistant, physiotherapy, and occupational therapy programs were randomly assigned into interprofessional teams for 10 weeks. Sessions involved an anatomy and scope-of-practice presentation, a small-group case-based session, and a dissection. A before/after design measured changes in attitudes and perceptions, while focus group data elaborated on the student experience with the course. Pre- and postmatched data revealed significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative analysis of intraprofessional focus group interviews revealed meaningful improvements in a number of areas including learning anatomy, role clarity, and attitudes towards other health professions. Anat Sci Educ 8: 305-316. © 2015 American Association of Anatomists. PMID:25641912

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

    PubMed

    Chung, Beom Sun; Chung, Min Suk

    2015-06-01

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

  12. Biostatistical basis of elective node dissection for malignant melanoma.

    PubMed Central

    Fortner, J G; Woodruff, J; Schottenfeld, D; Maclean, B

    1977-01-01

    During the years 1954 through 1964, 259 individuals with primary malignant melanoma had an elective node dissection. Microscopic metastases were found in 15% of these patients. The presence of only a microscopic focus of involvement gave a 10-year cure rate of 67%; metastasis larger than a microscopic focus in a single node, 50%; and more than one node, 15%. One hundred forty-five individuals were treated by wide excision alone with 18% subsequently requiring a therapeutic lymphadenectomy with a ten-year cure of only 6%. A prospective study was then initiated which was concerned with efficacy of selection of patients for elective node dissection. Clark's level of invasion was determined for 258 patients treated since January 1972. The depth of invasion of the primary lesion was found to correlate directly with the absence of lymph node metastases, extent of nodal involvement, and rate of recurrence. It is concluded that the concept of elective node dissection is valid. PMID:879870

  13. Digital dissection system for medical school anatomy training

    NASA Astrophysics Data System (ADS)

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

    2003-05-01

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

  14. Blunt dissection for the treatment of plantar verrucae.

    PubMed

    Baruch, K

    1990-08-01

    The treatment of plantar verrucae has always been a challenging and perplexing problem to physicians. Due to the inherent nature of verrucae, response to various forms of treatment has been extremely unpredictable. It is believed that hyperhidrosis and abnormal pressure to the plantar aspects of the feet are contributing factors predisposing one to developing verrucae. This article describes a painless and effective approach to the treatment of plantar verruca through the use of blunt dissection. Following anesthesia obtained with a posterior tibial nerve block, the plantar verruca can be successfully dissected with an 80 percent cure rate. PMID:2209078

  15. Delayed Perforation Occurring after Endoscopic Submucosal Dissection for Early Gastric Cancer

    PubMed Central

    Kang, Soo Hoon; Lee, Kyungho; Lee, Hyun Woo; Park, Ga Eun; Hong, Yun Soo

    2015-01-01

    Delayed perforation is a very rare complication of endoscopic submucosal dissection (ESD), with a reported incidence of 0.1% to 0.45%. Few reports exist on the clinical features and outcomes of delayed perforation after ESD, and it is unclear whether the optimal management strategy is emergency surgery or endoscopic closure with conservative treatment. Here, we report two cases of delayed perforation occurring after ESD for early gastric cancer. In both cases, lesions were located in the antrum, and tumor depths were confined to the mucosal layer. Total procedure times for ESD were 25 and 45 minutes, respectively. Because delayed perforation may be associated with excessive thermal damage and necrosis of the muscle layer, treatment with emergency surgery should be used instead of conservative management in cases of delayed perforation after ESD.

  16. Dissecting Single-Molecule Signal Transduction in Carbon Nanotube Circuits with Protein Engineering

    E-print Network

    Weiss, Gregory A.

    Dissecting Single-Molecule Signal Transduction in Carbon Nanotube Circuits with Protein Engineering dissected using eight di erent lysozyme variants synthesized by protein engineering. The data prove that e

  17. 78 FR 17429 - Certain Balloon Dissection Devices and Products Containing Same; Commission Determination Not To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-21

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

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

    PubMed

    Li, Jinzhong; Han, Zhengxue

    2015-01-01

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

  19. The results and limitations of endoscopic submucosal dissection for colorectal tumors.

    PubMed

    Toyanaga, T; Man-I, M; Ivanov, D; Sanuki, T; Morita, Y; Kutsumi, H; Inokuchi, H; Azuma, T

    2008-01-01

    In the colorectal tumor, the lesions suitable for the endoscopic treatment are those with no lymph node metastasis such as adenomas, intramucosal cancers, and minimally invasive submucosal cancer (invasion depth 1000 m, well and moderately differentiated type, no lymphovascular invasion). The new endOscopic technique, endoscopic submucosal dissection (ESD) enables en-bloc resection of the lesions regardless of their size and location. In order to perform ESD more easily, safely, and efficiently, we invented water jet short needle knives (Flush knife). Emitting a jet of water from the tip of a sheath enables submucosal local injection with a knife itself without replacement of operative instruments, which leads to efficient treatment. Especially, Flush knife is very effective for the lesions located at lower rectum and anal canal where there are many vessels. We treated a total of 361 colorectal lesions by ESD between June 2002 and July 2007, and en-block complete resection rate was 98.3 %. In 12 cases, "muscle retracting sign" was recognized. This sign is an index of the discontinuation of ESD, but it is impossible to diagnose preoperatively. The postoperative bleeding occurred in 0.8 % (3 cases: no blood transfusion is needed). The intraoperative perforation occurred in 1.9 % (6 cases: 5 cases were treated conservatively, 1 case was treated surgically) and the postoperative perforation occurred in 1 case (0.3%) treated surgically. ESD is the extremely effective treatment for the colorectal tumors and also is possible to be performed safely with the appropriate choice of the devices and strategy for dissection. PMID:19069688

  20. Management strategy of early-stage breast cancer patients with a positive sentinel lymph node: With or without axillary lymph node dissection

    Microsoft Academic Search

    Jia-Jian Chen; Jiong Wu

    2011-01-01

    Sentinel lymph node biopsy (SLNB) has been generally adopted as an alternative procedure to axillary lymph node dissection (ALND) for node staging. ALND remains the standard management of the axilla when a tumor-positive sentinel lymph node (SLN) is identified. However, further analysis has demonstrated that in 40–70% of cases with metastasis to the axillary lymph nodes, the SLN is the

  1. Therapeutic Decision Making in Acute Stroke due to Carotid Artery Dissection: A Potential Role for Percutaneous Vascular Intervention following Intravenous Thrombolysis

    PubMed Central

    Lewis, J. B.; Merwick, Á.; Laoide, R. Ó.; O'Hare, A.; McGuigan, C.

    2013-01-01

    Internal carotid artery dissection (ICAD) is an important cause of acute ischemic stroke in younger patients. Potential acute treatments include anticoagulation, intravenous thrombolysis (IVT), and endovascular thrombectomy (ET). We report a case where the use of IVT followed by ET resulted in a good clinical outcome in a patient with tandem internal carotid and middle cerebral artery occlusion following ICAD. PMID:23509662

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

    SciTech Connect

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

    2007-06-15

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

  3. Residual dissection of the brachiocephalic arteries: Significance, management, and long-term outcome

    Microsoft Academic Search

    Eugenio Neri; Guido Sani; Massimo Massetti; Giacomo Frati; Dimitrios Buklas; Rossana Tassi; Michele Giubbolini; Antonio Benvenuti; Carlo Sassi

    2004-01-01

    ObjectivesResidual dissection of the brachiocephalic arteries after operations for acute type A dissection is considered a benign condition that does not expose patients to late neurologic events. This retrospective study, conducted on an outpatient clinic basis between June 1995 and May 2003, had the objectives of evaluating the consequences of residual dissection of the brachiocephalic arteries, investigating the long-term outcomes

  4. Changes in Inflammatory Response after Endovascular Treatment for Type B Aortic Dissection

    Microsoft Academic Search

    Bernice L. Y. Cheuk; Y. C. Chan; Stephen W. K. Cheng

    2012-01-01

    This present study aims to investigate the changes in the inflammatory markers after elective endovascular treatment of Type B aortic dissection with aneurysm, as related to different anatomical features of the dissection flap in the paravisceral perfusion. Consecutive patients with type B aortic dissections with elective endovascular stent graft repair were recruited and categorized into different groups. Serial plasma levels

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

    ERIC Educational Resources Information Center

    Fancovicova, Jana; Prokop, Pavol; Leskova, Andrea

    2013-01-01

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

  6. Acute complicated and uncomplicated Type III Aortic Dissection: An endovascular perspective

    PubMed Central

    Bhamidipati, Castigliano; Ailawadi, Gorav

    2010-01-01

    Type III aortic dissection is associated with high morbidity and mortality. There is a shifting paradigm in the treatment of complicated and uncomplicated acute Type III aortic dissection towards earlier endovascular repair. In this review, the authors present the current perspective on the endovascular management of acute complicated and uncomplicated Type III aortic dissection. PMID:20226352

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

    Microsoft Academic Search

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

    2006-01-01

    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

  8. Appropriate lymph node dissection for early gastric cancer based on lymph node metastases

    Microsoft Academic Search

    Chikara Kunisaki; Hiroshi Shimada; Masato Nomura; Hirotoshi Akiyama

    2001-01-01

    Background. Lymph node dissection in patients with early gastric cancer is controversial because lymph node metastases are much less common than in advanced cancer. Therefore, routine extensive lymph node dissection with wide resection of the stomach may be excessive, and an appropriate lymph node dissection procedure in patients with early gastric cancer should be established. Methods. Retrospectively, 588 consecutive patients

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

    PubMed Central

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

    2014-01-01

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

  10. Dissection of epistasis in oligogenic Bardet-Biedl syndrome

    Microsoft Academic Search

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

    2006-01-01

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

  11. Dissecting the Molecular Basis of the Mechanics of Living Cells

    E-print Network

    Kumar, Sanjay

    , and differentiation. For example, the differentiation trajectory of mesenchymal stem cells (MSCs) may be controlled-induced osteogenic differentiation of MSCs may be blocked by inhibiting Rho GTPase-dependent cell contractility [1Dissecting the Molecular Basis of the Mechanics of Living Cells S. Kumar & P.R. LeDuc Received: 29

  12. Parent Vessel Occlusion for Vertebrobasilar Fusiform and Dissecting Aneurysms

    Microsoft Academic Search

    R. Leibowitz; M. L. Marcellus; S. D. Chang; G. K. Steinberg; M. P. Marks

    BACKGROUND AND PURPOSE: Previous reports of outcome with permanent vessel occlu- sion (PVO) for large, giant, or fusiform aneurysms in the posterior circulation have been limited. We undertook this study to evaluate the perioperative (within 30 days) and follow-up outcomes for patients treated with permanent occlusion of the vertebral artery for vertebro- basilar fusiform and dissecting aneurysms. METHODS: Thirteen consecutive

  13. Constant Weight Codes: A Geometric Approach Based on Dissections

    E-print Network

    Fisher, Kathleen

    -rectangle and a polytope in this Euclidean space. An inductive dissection algorithm is developed for constructing. Our technique is based on embedding the codebook in a Euclidean space of dimension equal to the weight such a bijection. We prove that the algorithm is correct and then analyze its complexity. The complexity depends

  14. Gastric Wall Dissection as a Complication of Percutaneous Gastrostomy

    SciTech Connect

    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

    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.

  15. Exploring Dissections of Rectangles into Right-Angled Triangles

    ERIC Educational Resources Information Center

    Griffiths, Martin

    2013-01-01

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

  16. Standard methods for Apis mellifera anatomy and dissection

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  17. Mutations in Myosin Light Chain Kinase Cause Familial Aortic Dissections

    PubMed Central

    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

    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

  18. Effect of Skeletonizing Dissection on the Internal Thoracic Artery

    Microsoft Academic Search

    Tadahiro Sasajima; Moses Hong-De Wu; Qun Shi; Naoki Hayashida; Lester R. Sauvage

    1998-01-01

    Background. Skeletonization of the internal thoracic artery (ITA) produces greater length for coronary bypass grafting. We studied the effect of skeletonization on the morphology, histology, and tissue viability of the ITA wall.Methods. Six mongrel dogs underwent unilateral ITA dissection; the contralateral ITA was the control. Study periods were 3 weeks (n = 3) and 12 weeks (n = 3). At

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

    ERIC Educational Resources Information Center

    Cahill, Kevin C.; Ettarh, Raj R.

    2008-01-01

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

  20. Molecular and Functional Dissection of the Maize B Chromosome Centromere

    E-print Network

    Molecular and Functional Dissection of the Maize B Chromosome Centromere Weiwei Jin,a Jonathan C, Georgia 30602 The centromere of the maize (Zea mays) B chromosome contains several megabases of a B-specific repeat (ZmBs), a 156-bp satellite repeat (CentC), and centromere-specific retrotransposons (CRM elements

  1. Student Attitudes to Whole Body Donation are Influenced by Dissection

    NSDL National Science Digital Library

    2008-09-01

    This article describes a pre-post survey given to medical students in a gross anatomy course addressing the attitudes toward becoming cadaver donators. Outcomes discuss the influence of actively dissecting a cadaver and how that shifts students away from donating one's body.

  2. Lymph node dissection – understanding the immunological function of lymph nodes

    PubMed Central

    Buettner, M; Bode, U

    2012-01-01

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

  3. 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

  4. Blood Vessels of the Fetal Pig Dissection Posterior Vessels Protocol

    E-print Network

    Loughry, Jim

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

  5. Dissecting BitTorrent: Five Months in a Torrent's Lifetime

    E-print Network

    Rivière, Etienne

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

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

    ERIC Educational Resources Information Center

    Lee, Yeung Chung

    2004-01-01

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

  7. INVESTIGATION Genetic Dissection of a Key Reproductive Barrier

    E-print Network

    Nachman, Michael

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

  8. Dissection of midgut and salivary glands from Ae. aegypti mosquitoes.

    PubMed

    Coleman, Judy; Juhn, Jennifer; James, Anthony A A

    2007-01-01

    The mosquito midgut and salivary glands are key entry and exit points for pathogens such as Plasmodium parasites and Dengue viruses. This video protocol demonstrates dissection techniques for removal of the midgut and salivary glands from Aedes aegypti mosquitoes. PMID:18979026

  9. Summary of selected FINRA regulatory notices, September-November 2008

    Microsoft Academic Search

    Henry A. Davis

    2009-01-01

    Purpose – The purpose of this summary is to provide excerpts of selected Financial Industry Regulatory Authority (FINRA) regulatory notices issued from September to November 2008. Design\\/methodology\\/approach – The paper provides excerpts from FINRA Regulatory Notice 08-54, Guidance on Special Purpose Acquisition Companies; Regulatory Notice 08-62, Limit on Close Case Submissions; 08-66, Retail Foreign Exchange; and 08-70, FINRA Investigations. Findings

  10. Accidental injury of the latissimus dorsi flap pedicle during axillae dissection: types and reconstruction algorithm.

    PubMed

    Laporta, Rosaria; Longo, Benedetto; Pagnoni, Marco; Catta, Federico; Garbarino, Giovanni Maria; Santanelli, Fabio

    2014-01-01

    The intra-operative latissimus dorsi (LD) pedicle damage during axillary lymph-node dissection by the general surgeon is a rare complication leading to flap failure and poor outcomes. The authors present their experience on this topic and develop a classification of the thoracodorsal (TD) pedicle injuries and reconstruction algorithm. Pedicle damage of LD occurred in five cases, three of which were experienced during immediate breast reconstruction and two observed in patients who underwent prior surgery. In two cases the thoracodorsal vein (TDV) was damaged in its proximal segment, thus end-to-end anastomosis was performed between distal stump of TDV and circumflex scapular vein (CSV). In one case the TDV required simple microsurgical repair while in other two cases the severe damage of vein and artery required more complex surgical strategies in attempt to salvage the flap. Four cases completely survived with one case of rippling phenomenon. One case had partial flap necrosis that required subtotal muscle resection. Based on these cases, the authors have developed a reconstruction algorithm in attempt to repair LD pedicle damage while preserving breast reconstruction. Taking into account its anatomical conformation, TD pedicle injuries are classified in four different types and available options are suggested for all of them according to the anatomical site and to the mechanism and timing of injury. PMID:23836695

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

    PubMed Central

    Pereira, Filipa; Cardoso, Teresa; Sá, Paula

    2015-01-01

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

  12. Howison, the Cramond Murderer, and last person to be hanged and dissected.

    PubMed

    Kaufman, M H

    2000-02-01

    An articulated skeleton in Edinburgh University's Anatomy Museum of "Howison, The Cramond Murderer", shares a show-case with the articulated skeleton of "William Burke, The Murderer". While the murderous activities of William Burke are well known, because of his association and activities with William Hare, and because they sold the bodies of their victims to Dr Robert Knox, the anatomist, little these days is recalled of Howison. He was executed for the murder of a woman in Cramond in December 1831, and was hanged on 21st January 1832. The case is important because he was the last individual executed before the implementation of the Anatomy Act of 1832. Accordingly, under the conditions of the previous Act, of 1752, entitled "An Act for better preventing the horrid Crime of Murder", his body had to be handed across to the surgeons to be "dissected and anatomized", before it could be buried. PMID:10765533

  13. Spontaneous coronary artery dissection: a rare cause of acute coronary syndrome

    PubMed Central

    Laghari, Abid Hussain; Khan, Aamir Hameed; Kazmi, Khawar Abbas

    2013-01-01

    We present a case of a 71-year-old man, with a history of hypertension and dyslipidaemia, who presented with typical cardiac chest pain and palpitations of 2?h duration. The examination revealed irregular pulse of 138?bpm, blood pressure 115/75?mm?Hg, variable first and normal second heart sounds. The lungs were clear to auscultation. The ECG showed atrial fibrillation with a rapid ventricular rate. His heart rate was controlled with ? blockers and the acute coronary syndrome treatment protocol was initiated. His baseline blood reports were within normal limits and two serial troponin I tests were negative. Coronary angiogram showed dissection in the left coronary system extending into the branch vessels and 30–40% stenosis in the right coronary artery. The patient underwent coronary artery bypass graft as an emergent case. He suffered a mild stroke postsurgery with complete functional recovery. He is being followed up in the clinic and has performed well. PMID:23709531

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

    PubMed

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

    2011-12-01

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

  15. Acquisition and interactive 3D exploration of the internal structure of a dissected specimen.

    PubMed

    Serres, B; Zemmoura, I; Destrieux, C; Andersson, F; Tauber, C; Venturini, G

    2011-01-01

    We present a system to keep track of a destructive process such as a medical specimen dissection, from data acquisition to interactive and immersive visualization, in order to build ground truth models. Acquisition is a two-step process, first involving a 3D laser scanner to get a 3D surface, and then a high resolution camera for capturing the texture. This acquisition process is repeated at each step of the dissection, depending on the expected accuracy and the specific objects to be studied. Thanks to fiducial markers, surfaces are registered on each others. Experts can then explore data using interaction hardware in an immersive 3D visualization. An interactive labeling tool is provided to the anatomist, in order to identify regions of interest on each acquired surface. 3D objects can then be reconstructed according to the selected surfaces. We aim to produce ground truths which for instance can be used to validate data acquired with MRI. The system is applied to the specific case of white fibers reconstruction in the human brain. PMID:22255329

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

    PubMed Central

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

    2001-01-01

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

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

    PubMed

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

    2015-01-01

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

  18. [Curative dissection of paraaortic lymph node metastases after operation for ascending colon cancer].

    PubMed

    Yoshino, Jun; Fukunari, Hiroyuki; Kato, Tomotaka; Nakajima, Yutaka; Okajima, Chisato; Shitara, Kenji; Hayashi, Tetsuji

    2014-11-01

    In October 2007, a 69-year-old woman underwent right hemicolectomy and D3 lymph node dissection for the treatment of adenocarcinoma (type 2, por2]tub2, pSS, pN3, fStage IIIb). Serum carcinoembryonic antigen (CEA) concentration was 152.8 ng/mL preoperation, but returned to normal after the operation. Adjuvant chemotherapy using 450 mg/day UFT-E was added. Computed tomography (CT) examination revealed a swollen paraaortic lymph node 3 months after the operation, while serum CEA concentration had increased to 92.7 ng/mL. After the chemotherapy was changed to FOLFOX, the paraaortic lymph node shrank and serum CEA concentration decreased. However, after 6 courses, serum CEA concentration increased again and bevacizumab-FOLFIRI therapy was initiated. After 3 courses of bevacizumab-FOLFIRI were not effective, paraaortic lymph node dissection was performed in February 2009. Pathological examination of the resected specimen showed metastatic adenocarcinoma. At present, the patient is alive without any signs of recurrence. Although the effectiveness of chemotherapy for paraaortic lymph node metastasis of colorectal cancer has been described, complete cure has not been reported. Thus, surgical resection has the potential to cure solitary recurrence of paraaortic lymph node metastasis, and therefore, should be considered in the treatment of such cases. PMID:25731270

  19. Medical Student Dissection of Cadavers Improves Performance on Practical Exams but not on the NBME Anatomy Subject Exam

    Microsoft Academic Search

    Jones LS; Paulman LE; Leslie Sargent Jones; Lance E. Paulman; Raj Thadani; Louis Terracio

    We have examined whether cadaver dissection by first year medical students ( MIs) affected their performance in two test measures: the NBME Gross Anatomy and Embryology Subject Exam (dissection-relevant questions only), and practical exams given at the end of each major section within the course. The dissections for the entire course were divided into 18 regional dissection units and each

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

    ERIC Educational Resources Information Center

    Kotze, Sanet Henriet; Mole, Calvin Gerald

    2013-01-01

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

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

    PubMed

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

    2014-03-01

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

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

    SciTech Connect

    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

    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.

  3. Echocardiographic detection of intimo-intimal intussusception in a patient with acute Stanford type A aortic dissection.

    PubMed

    Thunberg, Christopher A; Ramakrishna, Harish

    2015-01-01

    Intimo-intimal intussusception is a very rare and unusual complication of type A dissections, typically noted on TEE exam. It has been reported in a few cases in the cardiothoracic surgical and radiology literature, and even more rarely in the cardiac anesthesia/TEE literature. This uncommon variation occurs in severe, acute, type A dissections when the ascending aortic intima circumferentially strips and detaches from the media and forms a tube-like structure which may either prolapse antegrade into the ascending aortic lumen or retrograde into the left ventricular (LV) outflow tract and LV cavity. Antegrade intussusceptions may be severe enough to partially or completely occlude the ostia of the innominate, left common carotid, and left subclavian arteries producing acute neurologic symptoms. Retrograde intussusceptions may severely impair LV filling in diastole, can worsen aortic insufficiency, mitral regurgitation, as well as produce occlusion of the coronary ostia and acute coronary ischemia. Here, we describe the incidental finding of a retrograde intussusception that was not visualized on computed tomography scan but by intraoperative TEE examination, in a patient with a severe, extensive type A dissection. PMID:25849697

  4. The role of imaging in aortic dissection and related syndromes.

    PubMed

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

    2014-04-01

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

  5. A quantum informational approach for dissecting chemical reactions

    NASA Astrophysics Data System (ADS)

    Duperrouzel, Corinne; Tecmer, Pawe?; Boguslawski, Katharina; Barcza, Gergely; Legeza, Örs; Ayers, Paul W.

    2015-02-01

    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 ?-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.

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

    PubMed Central

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

    2015-01-01

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

  7. Pathomorphological differentiation between traumatic rupture and nontraumatic arterial dissection of the intracranial vertebral artery.

    PubMed

    Ro, Ayako; Kageyama, Norimasa

    2014-05-01

    We aimed to establish an objective indicator for differential diagnosis between traumatic rupture of the intracranial vertebral artery (TRIVA) and nontraumatic rupture from intracranial vertebral artery dissection (NIVAD). We investigated 19 intracranial vertebral artery (IVA) samples, including three from TRIVA, seven from NIVAD and nine non-IVA rupture cases using 0.2-mm serial histological sections through the IVA. The internal elastic lamina (IEL)-adventitia ratio for each slide was calculated as the ratio of the traced length of the adventitia to the length of the IEL as measured by digital photomicrography. NIVAD cases showed a significant peak in the IEL-adventitia ratio around the area of rupture, whereas TRIVA and non-rupture cases showed no specific increase or decrease in IEL-adventitia ratios throughout the IVAs. All NIVAD cases had a significantly higher average IEL-adventitia ratio across 10 slides at the site of the rupture lesion than at the site furthest from the rupture. In contrast, two out of three TRIVA cases showed no significant difference between the two points. The other TRIVA case showed a significantly lower IEL-adventitia ratio at the point nearest the rupture compared with that at the point farthest from the rupture. Other histological characteristics considered specific to either TRIVA or NIVAD were observed. Our results indicate that measuring and comparing IEL-adventitia ratios at ruptured and non-ruptured sites of the IVA could be a useful practical indicator for differential diagnosis between TRIVAs and NIVADs. PMID:24524943

  8. SLE 1, 2, 3…Genetic Dissection of Lupus

    Microsoft Academic Search

    Jiankun Zhu; Chandra Mohan

    \\u000a Systemic lupus erythematosus (SLE) is a chronic and complex autoimmune disease of unknown etiology, characterized by the presence\\u000a of widespread immunological abnormalities and multiorgan injury. An important advance over the past decade has been our understanding\\u000a of how different genetic loci (or genes) may dictate specific immune abnormalities in lupus. “Genetic dissection” has unveiled\\u000a some of the mystery enshrouding lupus

  9. Robotic thyroidectomy and neck dissection: past, present, and future.

    PubMed

    Lee, Jandee; Chung, Woong Youn

    2013-01-01

    The advantages of endoscopic thyroidectomy and neck dissection include reduced hyperesthesia or paresthesia in the neck and favorable cosmetic outcomes. However, endoscopic thyroidectomy with neck dissection has a long learning curve, as well as technical limitations associated with a 2-dimensional view and a reduced dexterity of movement, particularly when operating in deep and narrow spaces such as the neck area. A robotic approach has been developed to overcome these limitations, facilitating manipulation and shortening the learning curve. This system enables the surgeon to control the 3-dimensional high-definition camera, reducing physiological tremors and enabling free dexterity of movement using articulated instruments. Therefore, robotic surgery has been found to eliminate many problems encountered with conventional endoscopic techniques.Recently, robotic thyroidectomy with neck dissection via a gasless transaxillary approach was shown to yield similar oncologic outcomes as conventional open procedures, as determined by postoperative radioactive iodine scans, serum thyroglobulin concentrations, and number of retrieved cervical lymph nodes. We also found that the robotic technique was safe and feasible in thyroid cancer patients, yielding excellent cosmetic results, reduced pain, improved sensory changes and decreased postoperative voice changes and swallowing discomfort. For surgeons, the use of a robot offers a shorter operation time and the need for a shorter learning curve than conventional endoscopic thyroidectomy. Robotic thyroidectomy also causes less musculoskeletal discomfort to surgeons than open or endoscopic thyroidectomy. The advantages of robotic surgery over open or endoscopic surgery suggest that robotic thyroidectomy with neck dissection may become the preferred surgical option for patients with thyroid cancer. Further analyses of surgeons' experience, assessments of long-term outcomes, and randomized controlled trials remain important. PMID:23528724

  10. A study of sternocleidomastoid muscular atrophy after modified neck dissection

    Microsoft Academic Search

    Takahiro Ohtawa; Makoto Katagiri; Tanekazu Harada

    1998-01-01

    To elucidate the conditions of atrophy in the sternocleidomastoid muscle (SCM) after modified neck dissection (MND), we tried\\u000a to scrutizine the atrophic regions in the SCM and determine the cause of atrophy, by electromyography in 40 patients with\\u000a SCM atrophy following MND. We also examined the detailed anatomy of the SCM in 40 cadavers. Atrophy was observed in the caudal

  11. Compartment-mediated dissection for papillary thyroid cancer

    Microsoft Academic Search

    Jeffrey F. Moley; Samuel A. Wells

    1999-01-01

    There is considerable controversy surrounding the appropriate treatment of papillary thyroid carcinoma (PTC), most of which\\u000a centers around the extent of thyroidectomy. Despite the advocation of less than total thyroidectomy by many surgeons, there\\u000a is a renewed interest by others, mainly in Europe and Japan, in the performance of routine total thyroidectomy and extensive\\u000a lymph-node dissection for PTC. This has

  12. Resection of the sternocleidomastoid muscle during radical neck dissection

    Microsoft Academic Search

    M. Jaehne; Jürgen Ußmüller; Wolfgang Kehrl

    2001-01-01

    Background: Surgical therapy of lymph node metastasis is based on accessibility for en bloc resection. First described as “radical neck\\u000a dissection”, this original approach has since undergone various modifications. This has produced controversy about the particular\\u000a indications for the individual techniques. The aim of this study was to evaluate whether intraoperative macroscopic inspection\\u000a of the sternocleidomastoid muscle (SCM) in regard

  13. Debranching Solutions in Endografting for Complex Thoracic Aortic Dissections

    PubMed Central

    Goksel, Onur Selcuk; Guven, Koray; Karatepe, Celalettin; Gok, Emre; Acunas, Bulent; Cinar, Bayer; Alpagut, Ufuk

    2014-01-01

    Background Conventional surgical repair of thoracic aortic dissections is a challenge due to mortality and morbidity risks. Objectives We analyzed our experience in hybrid aortic arch repair for complex dissections of the aortic arch. Methods Between 2009 and 2013, 18 patients (the mean age of 67 ± 8 years-old) underwent hybrid aortic arch repair. The procedural strategy was determined on the individual patient. Results Thirteen patients had type I repair using trifurcation and another patient with bifurcation graft. Two patients had type II repair with replacement of the ascending aorta. Two patients received extra-anatomic bypass grafting to left carotid artery allowing covering of zone 1. Stent graft deployment rate was 100%. No patients experienced stroke. One patient with total debranching of the aortic arch following an acute dissection of the proximal arch expired 3 months after TEVAR due to heart failure. There were no early to midterm endoleaks. The median follow-up was 20 ± 8 months with patency rate of 100%. Conclusion Various debranching solutions for different complex scenarios of the aortic arch serve as less invasive procedures than conventional open surgery enabling safe and effective treatment of this highly selected subgroup of patients with complex aortic pathologies. PMID:25211314

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

    PubMed Central

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

    2014-01-01

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

  15. The zygorbicular dissection in composite rhytidectomy: an ideal midface plane.

    PubMed

    Hamra, S T

    1998-10-01

    Composite rhytidectomy added the repositioning of the orbicularis oculi muscle to the deep plane face lift to achieve a more harmonious appearance of the face by adding periorbital rejuvenation. By not separating the orbicularis oculi from the zygomaticus minor and by extending the dissection under medial portions of the zygomaticus major and minor muscles, a more significant improvement in composite rhytidectomy can now be achieved. A thin nonrestrictive mesentery between the deep plane face lift dissection and the zygorbicular dissection still allows vertical movement of the composite face lift flap without interrupting the intimate relationship between the platysma, cheek fat, and orbicularis oculi muscle. This modification eliminates the occasional prolonged edema and occasional temporary dystonia previously observed. It allows the continuation of the use of the arcus marginalis release, which has also been modified by resetting the septum orbitale over the orbital rim. These two modifications allow a more predictable and impressive result. They reinforce the concept of periorbital rejuvenation as an integral part of facial rejuvenation, which not only produces a more harmonious immediate result but prevents the possible unfavorable sequelae of conventional rhytidectomy and lower blepharoplasty. PMID:9774027

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  17. Dissecting the many genetic faces of schizophrenia.

    PubMed

    Rujescu, Dan; Collier, David A

    2009-01-01

    Abstract. Recent genome-wide association studies in schizophrenia have provided strongest evidence for association and this strengthened when the affected phenotype included bipolar disorder suggesting that genes may not always associate with operationalised diagnostic entities. Several further large Genome Wide Association (GWA) studies on schizophrenia are under way and identified and replicated further loci in well-powered cohorts. The last 2 years have also witnessed an explosion of interest in human Copy Number Variants (CNVs). Deletions recently identified in schizophrenia (1q21.1; 2p16.3; 15q11.2; 15q13.3) have also been most recently found in further neurodevelopmental diseases. Thus, a significant fraction of individuals with neurodevelopmental diseases including schizophrenia carry CNVs and many will be defined as "genomic disorders" in the coming years. These findings could represent a decisive step towards understanding the causes of this severe mental disorder as well as developing new potential treatments. There is new hope that these new avenues will help understanding the neurobiology of schizophrenia in more depth leading to the development of new innovative diagnostic tools and therapies as was the case after the discovery of rare APP and presenilin 1 and 2 mutations in Alzheimer's disease. PMID:19526738

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

    PubMed Central

    2014-01-01

    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

  19. Endoscopic submucosal dissection for removal of superficial gastrointestinal neoplasms: A technical review.

    PubMed

    Matsui, Noriaki; Akahoshi, Kazuya; Nakamura, Kazuhiko; Ihara, Eikichi; Kita, Hiroto

    2012-04-16

    Endoscopic submucosal dissection (ESD) is now the most common endoscopic treatment in Japan for intramucosal gastrointestinal neoplasms (non-metastatic). ESD is an invasive endoscopic surgical procedure, requiring extensive knowledge, skill, and specialized equipment. ESD starts with evaluation of the lesion, as accurate assessment of the depth and margin of the lesion is essential. The devices and strategies used in ESD vary, depending on the nature of the lesion. Prior to the procedure, the operator must be knowledgeable about the treatment strategy(ies), the device(s) to use, the electrocautery machine settings, the substances to inject, and other aspects. In addition, the operator must be able to manage complications, should they arise, including immediate recognition of the complication(s) and its treatment. Finally, in case the ESD treatment is not successful, the operator should be prepared to apply alternative treatments. Thus, adequate knowledge and training are essential to successfully perform ESD. PMID:22523613

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

    PubMed Central

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

    2015-01-01

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

  1. The role of Intravascular Ultrasound in the management of spontaneous coronary artery dissection

    PubMed Central

    Arnold, Jayanth R; West, Nick EJ; van Gaal, William J; Karamitsos, Theodoros D; Banning, Adrian P

    2008-01-01

    Primary or spontaneous coronary artery dissection (SCAD) is an unusual but increasingly recognized cause of acute myocardial ischemia and sudden cardiac death. Typically, SCAD presents in younger patients without conventional risk factors for coronary artery disease. It occurs more commonly in women than in men, and frequently during pregnancy or the postpartum period. Its pathophysiology is poorly understood, and there is considerable controversy regarding the optimal management of patients with SCAD-related myocardial ischemia. Therapeutic approaches include conservative medical therapy, coronary artery bypass graft surgery and percutaneous coronary intervention (PCI). We present four cases of SCAD to illustrate specific aspects of the presentation and management of this condition, with particular reference to the importance of intravascular ultrasound (IVUS) to aid diagnosis and guide subsequent PCI. PMID:18513437

  2. Bilateral dissection of the internal carotid artery at the base of the skull due to blunt trauma: incidence and severity.

    PubMed

    Alimi, Y; Di Mauro, P; Tomachot, L; Albanese, J; Martin, C; Alliez, B; Juhan, C

    1998-11-01

    Between January 1, 1992 and December 31, 1996, a total of 1095 head trauma vicims were admitted in our intensive care unit. If CT scans demonstrated ischemic brain lesions, arteriography to visualize supraaortic vessels was performed. Carotid artery dissection was observed in ten patients (0.91%) and was bilateral in eight patients (0.73%). In the bilateral carotid artery dissection (BCAD) group, there were five women and three men, with a mean age of 35.2 years (range: 17 to 54 years). Injuries resulted from traffic accidents in seven patients and a fall in one patient. Upon admission, six patients presented with alteration of consciousness and three with hemiplegia or hemiparesia, associated with aphasia in two cases. In two other cases, hemiplegia occurred 24 hr and 13 days after the accident. All patients had brain infarction, which was unilateral in five cases and bilateral in three cases. The severity of lesions was graded on the basis of arteriographic findings as follows: Type I, wall involvement without significant stenosis or dilation; Type II, arterial dissection with stenosis >70% (Type IIA) or dilatation >50% (Type IIB) and the normal diameter of the proximal or distal internal carotid artery; and Type III, thrombosis of the internal carotid artery. Lesions were asymmetrical in six patients, including two with Type II and III lesions and four with Type I and II lesions, and symmetrical in two patients, including one with bilateral Type III lesions and one with bilateral Type II lesions. Surgery was performed in two patients with Type II lesions, including one case associated with contralateral carotid thrombosis. The intrapetrous carotid artery was exposed by an ear-nose-throat (ENT) surgeon and repaired by interposition grafting. Follow-up in these two surgical cases was 28 and 31 months. In the remaining six cases, medical treatment was performed. Outcome in nonsurgical cases was variable: death in two cases at 31 and 43 days after the accident, severe permanent hemiplegia in two cases, and minimal or no sequels in two cases. Following blunt trauma, arteriography of supraaortic vessels should be performed to detect BCAD in any patient with immediate or delayed neurologic symptoms that cannot be explained by CT-scan findings. To better understand the natural course of these lesions and define the indications for surgery, we propose a three-grade classification according to arteriographic findings. If surgery is undertaken, vein grafting should be performed following resection of the carotid artery lesions. PMID:9841686

  3. 30 CFR 18.10 - Notice of approval or disapproval.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS ELECTRIC MOTOR-DRIVEN...written notice of disapproval, as the case may require. No informal notification of approval will be issued. If a...

  4. 30 CFR 18.10 - Notice of approval or disapproval.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS ELECTRIC MOTOR-DRIVEN...written notice of disapproval, as the case may require. No informal notification of approval will be issued. If a...

  5. COPYRIGHT NOTICE: Elias Kiritsis: String Theory in a Nutshell

    E-print Network

    Landweber, Laura

    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

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

    PubMed Central

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

    2008-01-01

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

  7. Long-Term Treatment Outcome after Only Popliteal Lymph Node Dissection for Nodal Metastasis in Malignant Melanoma of the Heel: The Only “Interval Node” Dissection Can Be an Adequate Surgical Treatment

    PubMed Central

    Tanaka, Kentaro; Mori, Hiroki; Okazaki, Mutsumi; Nishizawa, Aya; Yokozeki, Hiroo

    2013-01-01

    We present a patient with malignant melanoma on his heel. Wide local excision was performed, along with sentinel lymph node biopsy of the inguinal and popliteal lesions. The primary site was clear of tumor at all margins; the inguinal nodes were negative, but the popliteal node was positive for metastatic melanoma. Only radical popliteal lymph node dissection was performed. The patient went on to receive adjuvant chemoimmunotherapy. There was no recurrence or complication until the long-term followup. Popliteal drainage from below the knee is uncommon, and the rate of popliteal-positive and inguinal-negative cases is estimated to be less than 1% of all melanomas. There is no established evidence about how to treat lymph nodes in these cases. Because we considered popliteal nodes as a regional, not interval, lymph node basin, only popliteal lymph node dissection was performed, and good postoperative course was achieved. The first site of drainage is the sentinel node, and the popliteal node can be a sentinel node. The inguinal node is not a sentinel node in all lower extremity melanomas. This case illustrates the importance of individual detailed investigation of lymphatic drainage patterns from foot to inguinal and popliteal nodes. PMID:23762687

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

    NASA Astrophysics Data System (ADS)

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

    2006-03-01

    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.

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

    E-print Network

    Zhao, Shengli

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

  10. Decreased expression of fibulin-4 in aortic wall of aortic dissection.

    PubMed

    Huawei, P; Qian, C; Chuan, T; Lei, L; Laing, W; Wenlong, X; Wenzhi, L

    2014-02-01

    In this research, we will examine the expression of Fibulin-4 in aortic wall to find out its role in aortic dissection development. The samples of aortic wall were obtained from 10 patients operated for acute ascending aortic dissection and five patients for chronic ascending aortic dissection. Another 15 pieces of samples from patients who had coronary artery bypass were as controls. The aortic samples were stained with aldehyde magenta dyeing to evaluate the arrangement of elastic fibers. The Fibulin-4 protein and mRNA expression were both determined by Western blot and realtime quantitative polymerase chain reaction. Compared with the control group, both in acute and chronic ascending aortic dissection, elastic fiber fragments increased and the expression of fibulin-4 protein significantly decreased (P= 0.045 < 0.05). The level of fibulin-4 mRNA decreased in acute ascending aortic dissection (P= 0.034 < 0.05), while it increased in chronic ascending aortic dissection (P=0.004 < 0.05). The increased amounts of elastic fiber fragments were negatively correlated with the expression of fibulin-4 mRNA in acute ascending aortic dissection. In conclusion, in aortic wall of ascending aortic dissection, the expression of fibulin-4 protein decreased and the expression of fibulin-4 mRNA was abnormal. Fibulin-4 may play an important role in the pathogenesis of aortic dissection. PMID:23518852

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

    PubMed Central

    Kacila, Mirsad; Vranic, Haris; Straus, Slavenka

    2014-01-01

    Objective: In our study we wanted to showed the safety, feasibility, efficacy and way how to solve the problems of endovascular repair for aortic dissection with insufficient proximal Landing Zone. Methods: The clinical data of all the patients with insufficient proximal Landing Zone (PLZ) for endovascular repair for aortic aneurism and dissection Stanford type B for the period from October 2013 to June 2014 was prospectively reviewed. According to the classification proposed by Mitchell et al, aortic Zone 0 was involved in 3 cases, Zone 1 in 1 case, Zone 2 in 9 cases and Zone 3 in 6 cases (19 patients in total). A hybrid surgical procedure of supraortic debranching and revascularization, with direct anastomosed truncus brachiocephalicus and left common carotid artery, were performed to obtain an adequate aortic PLZ. Revascularization of the left subclavian artery was carried out on the patient with dissection Stanford type B and short PLZ 2. Results: There was no significant difference of risk factors between Zone 0, Zone 1, and Zone 2 (Table 1.), but the length of the PLZ significantly differed between groups (p<0.01) and there is no significant difference in technical and clinical success rate among the groups. Conclusion: The procedure of extending insufficient PLZ for endovascular repair for aortic arch pathology is feasible and relatively safe. The TEVAR applicability in such aortic disorders could be extended. PMID:25684839

  12. Early Squamous Cell Carcinoma of the Anal Canal Resected by Endoscopic Submucosal Dissection

    PubMed Central

    Tamaru, Yuzuru; Oka, Shiro; Tanaka, Shinji; Ninomiya, Yuki; Asayama, Naoki; Shigita, Kenjiro; Nishiyama, Soki; Hayashi, Nana; Arihiro, Koji; Chayama, Kazuaki

    2015-01-01

    The standard treatment approach for squamous cell carcinoma (SCC) of the anal canal includes abdominoperineal resection and chemoradiotherapy. However, there are currently very few reports of early SCC of the anal canal resected by endoscopic submucosal dissection (ESD). We report 2 rare cases of SCC of the anal canal resected by ESD. In case 1, a 66-year-old woman underwent a colonoscopy due to blood in her stool, and an elevated lesion, 15 mm in size, was identified from the rectum to the dentate line of the anal canal on internal hemorrhoids. The lesion was diagnosed as an early SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. In case 2, a 71-year-old woman underwent a colonoscopy due to constipation, and an elevated lesion, 25 mm in size, was identified from the dentate line to the anal canal. The lesion was diagnosed as early-stage SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. No complications or recurrence after ESD occurred in either case.

  13. Early squamous cell carcinoma of the anal canal resected by endoscopic submucosal dissection.

    PubMed

    Tamaru, Yuzuru; Oka, Shiro; Tanaka, Shinji; Ninomiya, Yuki; Asayama, Naoki; Shigita, Kenjiro; Nishiyama, Soki; Hayashi, Nana; Arihiro, Koji; Chayama, Kazuaki

    2015-01-01

    The standard treatment approach for squamous cell carcinoma (SCC) of the anal canal includes abdominoperineal resection and chemoradiotherapy. However, there are currently very few reports of early SCC of the anal canal resected by endoscopic submucosal dissection (ESD). We report 2 rare cases of SCC of the anal canal resected by ESD. In case 1, a 66-year-old woman underwent a colonoscopy due to blood in her stool, and an elevated lesion, 15 mm in size, was identified from the rectum to the dentate line of the anal canal on internal hemorrhoids. The lesion was diagnosed as an early SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. In case 2, a 71-year-old woman underwent a colonoscopy due to constipation, and an elevated lesion, 25 mm in size, was identified from the dentate line to the anal canal. The lesion was diagnosed as early-stage SCC of the anal canal, and ESD was successfully performed. The histopathological diagnosis was SCC in situ. No complications or recurrence after ESD occurred in either case. PMID:26034474

  14. Dissecting inhibitory brain circuits with genetically-targeted technologies

    PubMed Central

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

    2014-01-01

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

  15. Characterization of residual stresses by WEDM-assisted dissectioning

    NASA Astrophysics Data System (ADS)

    Regener, B.; Krempaszky, C.; Werner, E.; Berhuber, E.; Stockinger, M.

    2010-06-01

    Within the scope of this contribution a wire electric discharge machining assisted dissectioning method is presented, which combines high precision cutting, minimum generation of additional residual stresses during the cutting process and high precision measurement of the resulting distortion. As an example a forged component made of the titanium alloy Ti6Al4V is investigated in a multiple cut procedure. A finite element based mechanical model for the estimation of the residual stress distribution in the component from the distortion data is introduced and discussed.

  16. Genetic Dissection of Learning and Memory in Mice

    PubMed Central

    Mineur, Yann S.; Crusio, Wim E.; Sluyter, Frans

    2004-01-01

    In this minireview, we discuss different strategies to dissect genetically the keystones of learning and memory. First, we broadly sketch the neurogenetic analysis of complex traits in mice. We then discuss two general strategies to find genes affecting learning and memory: candidate gene studies and whole genome searches. Next, we briefly review more recently developed techniques, such as microarrays and RNA interference. In addition, we focus on gene-environment interactions and endophenotypes. All sections are illustrated with examples from the learning and memory field, including a table summarizing the latest information about genes that have been shown to have effects on learning and memory. PMID:15656270

  17. Complicated type B aortic dissection causing ischemia in the celiac and inferior mesenteric artery distribution despite patent superior mesenteric artery bypass.

    PubMed

    Afifi, Rana O; Zhu, Youwei; Leake, Samuel S; Kott, Amy; Azizzadeh, Ali; Estrera, Anthony L; Safi, Hazim J; Charlton-Ouw, Kristofer M

    2015-08-01

    Mortality rates associated with acute type B aortic dissection (ABAD) complicated by malperfusion remains significant. Optimal management of patients with ABAD is still debatable. We present a case report of a 50-year-old man who was admitted due to ABAD. He was treated medically with his pain resolved and he was discharged on oral antihypertensive medications. One month after initial diagnosis, he was readmitted with abdominal pain, nausea, vomiting, and diarrhea. On imaging, an extension of the aortic dissection into the visceral arteries with occlusion of the celiac and superior mesenteric arteries (SMA) was noted. He underwent thoracic endovascular aortic repair (TEVAR) and bypass grafting to the SMA. Despite the intervention, the patient developed large bowel, liver, and gastric ischemia and underwent bowel resection. He died from multi-organ failure. In selected cases of uncomplicated ABAD, TEVAR should be considered and when TEVAR fails and visceral malperfusion develops, an aggressive revascularization of multiple visceral arteries should be attempted. PMID:25298133

  18. Discordance of Intraoperative Frozen Section Analysis with Definitive Histology of Sentinel Lymph Nodes in Breast Cancer Surgery: Complementary Axillary Lymph Node Dissection is Irrelevant for Subsequent Systemic Therapy

    Microsoft Academic Search

    D. Geertsema; P. D. Gobardhan; E. V. E. Madsen; M. Albregts; J. van Gorp; P. de Hooge; Th. van Dalen

    2010-01-01

    Background  In breast cancer surgery, intraoperative frozen section (FS) analysis of sentinel lymph nodes (SLNs) enables axillary lymph\\u000a node dissection (ALND) during the same operative procedure. In case of discordance between a “negative” FS analysis and definitive\\u000a histology, an ALND as a second operation is advocated since additional lymph node metastases may be present. The clinical\\u000a implications of the subsequent ALND

  19. Plasma Homocysteine Concentration, C677T MTHFR Genotype, and 844ins68bp CBS Genotype in Young Adults With Spontaneous Cervical Artery Dissection and Atherothrombotic Stroke

    Microsoft Academic Search

    Alessandro Pezzini; Elisabetta Del Zotto; Silvana Archetti; Riccardo Negrini; Paolo Bani; Alberto Albertini; Mario Grassi; Deodato Assanelli; Roberto Gasparotti; Luigi Amedeo Vignolo; Mauro Magoni; Alessandro Padovani

    2010-01-01

    Background and Purpose—The role of mild hyperhomocysteinemia as a risk factor for cerebral ischemia may depend on stroke subtype. To test this hypothesis, we undertook a prospective case-control study of a group of patients with spontaneous cervical artery dissection (sCAD), a group of patients with atherothrombotic stroke (non-CAD), and a group of control subjects. Methods—Fasting total plasma homocysteine (tHcy) concentration,

  20. Venous organization in the transverse foramen: dissection, histology, and magnetic resonance imaging.

    PubMed

    Magro, Elsa; Gentric, Jean-Christophe; Talagas, Matthieu; Alavi, Zarrin; Nonent, Michel; Dam-Hieu, Phong; Seizeur, Romuald

    2015-07-01

    OBJECT The anatomical arrangement of the venous system within the transverse foramen is controversial; there is disagreement whether the anatomy consists of a single vertebral vein or a confluence of venous plexus. Precise knowledge of this arrangement is necessary in imaging when vertebral artery dissection is suspected, as well as in surgical approaches for the cervical spine. This study aimed to better explain anatomical organization of the venous system within the transverse foramen according to the Trolard hypothesis of a transverse vertebral sinus. METHODS This was an anatomical and radiological study. For the anatomical study, 10 specimens were analyzed after vascular injection. After dissection, histological cuts were prepared. For the radiological study, a high-resolution MRI study with 2D time-of-flight segment MR venography sequences was performed on 10 healthy volunteers. RESULTS Vertebral veins are arranged in a plexiform manner within the transverse canal. This arrangement begins at the upper part of the transverse canal before the vertebral vein turns into a single vein along with the vertebral artery running from the transverse foramen of the C-6. This venous system runs somewhat ventrolaterally to the vertebral artery. In most cases, this arrangement is symmetrical and facilitates radiological readings. The anastomoses between vertebral veins and ventral longitudinal veins are uniform and arranged segmentally at each vertebra. CONCLUSIONS These findings confirm recent or previous anatomical descriptions and invalidate others. It is hard to come up with a common description of the arrangement of vertebral veins. The authors suggest providing clinicians as well as anatomists with a well-detailed description of components essential to the understanding of this organization. PMID:25526272

  1. Clinical significance of the muscle-retracting sign during colorectal endoscopic submucosal dissection

    PubMed Central

    Toyonaga, Takashi; Tanaka, Shinwa; Man-I, Mariko; East, James; Ono, Wataru; Nishino, Eisei; Ishida, Tsukasa; Hoshi, Namiko; Morita, Yoshinori; Azuma, Takeshi

    2015-01-01

    Background and study aims: During colorectal endoscopic submucosal dissection (ESD), the feature of a muscle layer being pulled toward a neoplastic tumor is sometimes detected. We call this feature the muscle-retracting sign (MR sign). The aim of this study was to evaluate whether the MR sign is associated with particular types of neoplastic lesions and whether it has any clinical significance for ESD sessions. Patients and methods: A total of 329 patients underwent ESD for 357 colorectal neoplasms. The frequency of positivity for the MR sign was evaluated in different morphologic and histopathologic types of neoplasm. The success rate of complete resection and the incidence of complications were also evaluated according to whether lesions were positive or negative for the MR sign. Results: The rates of positivity for the MR sign in the various lesion types were as follows: laterally spreading tumor?–?granular nodular mixed type (LST-G-M), 9.6?%; laterally spreading tumor?–?granular homogeneous type (LST-G-H) and laterally spreading tumor?–?nongranular type (LST-NG), 0?%; sessile type, 41.2?%. The resection rate was 100?% (329?/329) in lesions negative for the MR sign; however, it was 64.3?% (18?/28) in lesions positive for the MR sign, which was significantly lower (P?dissected with great caution; alternatively, based on the features of the individual case, a switch to surgery should be considered for the benefit of the patient. PMID:26171438

  2. Dissection of epistasis in oligogenic Bardet-Biedl syndrome.

    PubMed

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

    2006-01-19

    Epistatic interactions have an important role in phenotypic variability, yet the genetic dissection of such phenomena remains challenging. Here we report the identification of a novel locus, MGC1203, that contributes epistatic alleles to Bardet-Biedl syndrome (BBS), a pleiotropic, oligogenic disorder. MGC1203 encodes a pericentriolar protein that interacts and colocalizes with the BBS proteins. Sequencing of two independent BBS cohorts revealed a significant enrichment of a heterozygous C430T mutation in patients, and a transmission disequilibrium test (TDT) showed strong over-transmission of this variant. Further analyses showed that the 430T allele enhances the use of a cryptic splice acceptor site, causing the introduction of a premature termination codon (PTC) and the reduction of steady-state MGC1203 messenger RNA levels. Finally, recapitulation of the human genotypes in zebrafish shows that modest suppression of mgc1203 exerts an epistatic effect on the developmental phenotype of BBS morphants. Our data demonstrate how the combined use of biochemical, genetic and in vivo tools can facilitate the dissection of epistatic phenomena, and enhance our appreciation of the genetic basis of phenotypic variability. PMID:16327777

  3. [Aortic dissection induced by symmetry aortic connector system].

    PubMed

    Ito, Yutaka; Okamoto, H; Niimi, T; Tamenishi, A

    2005-05-01

    A 74-year-old male with severe triple vessel disease underwent off-pump coronary artery bypass grafting (OPCAB). Preoperative computed tomography (CT) showed severely calcified ascending aorta. We revasculize the left coronary arteries with in situ internal thoracic artery (ITA) graft and the right coronary artery with a saphenous vein graft, which was attached to the disease-free portion of the aortic root, using Symmetry aortic connector system (ACS). Although the operation was uncomplicated, and postoperative course was uneventful until the 5th postoperative day when acute type A aortic dissection occurred. The patient died of aortic rupture on the 7th postoperative day. Necropsy disclosed that the entry located just on the proximal anastomotic site of the vein graft. It is possible placement of ACS device would trigger the dissecting process. With regard to the use of these one-shot devices for diseased aorta, its safety needs further investigation, even though it might be placed on an apparently intact portion. PMID:15881233

  4. Virtual Temporal Bone Dissection System: Development and Testing

    PubMed Central

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

    2012-01-01

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

  5. Popliteal lymph node dissection for metastases of cutaneous malignant melanoma

    PubMed Central

    2014-01-01

    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

  6. Endoscopic axillary lymph node dissection: an experimental study in human cadavers

    Microsoft Academic Search

    L. Michael Brunt; Daniel B. Jones; Justin S. Wu; Elizabeth M. Brunt; Diane M. Radford

    1998-01-01

    Background: The role of axillary lymph node dissection in the staging of patients with breast carcinoma is currently under evaluation. As a result of recent advances in minimally invasive techniques, an endoscopic approach to axillary lymph node dissection may be an attractive alternative to lymphadenectomy performed via a standard “open” axillary incision. The purpose of the present study was to

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

    PubMed Central

    Correa, Edgar; Martinez, Braulio

    2014-01-01

    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

  8. Extracranial internal carotid and vertebral artery dissections: angiographic spectrum, course and prognosis

    Microsoft Academic Search

    O. Pelkonen; T. Tikkakoski; S. Leinonen; J. Pyhtinen; M. Lepojärvi; K. Sotaniemi

    2003-01-01

    We reviewed the clinical and radiological findings of 93 consecutive patients with 111 extracranial internal carotid (ICAD) and vertebral artery (VAD) dissections and one concomitant intracranial VAD; 83% of the patients had unilateral and 17% multiple vessel dissections. The diagnosis was made by intra-arterial digital subtraction angiography in 92 patients and MR angiography in one. Follow-up angiography was performed in

  9. Dissection Reconsidered: A Reaction to de Villiers and Monk's "The First Cut Is the Deepest"

    ERIC Educational Resources Information Center

    Hug, Barbara

    2005-01-01

    Educators need to think about pedagogical as well as ethical issues when asking if dissection has a role in contemporary K-12 science education. I consider some arguments for and against dissection as a way to teach students the biological concepts of form and function.

  10. Science Laboratory Depth of Learning: Interactive Multimedia Simulation and Virtual Dissection Software

    ERIC Educational Resources Information Center

    Yuza, Steve C.

    2010-01-01

    The purpose of this study was to determine the effects of interactive multimedia simulations and virtual dissection software on depth of learning among students participating in biology and chemistry laboratory courses. By understanding more about how simulation and virtual dissection software changes depth of learning, educators will have the…

  11. Dissecting the Dissectors: Knowledge, Attitude, and Practice of Body Bequests by Nigerian Anatomists

    ERIC Educational Resources Information Center

    Anyanwu, Emeka G.; Obikili, Emmanuel N.

    2012-01-01

    Anatomy education in most African countries is limited by an insufficient number of cadavers for students to undertake dissection. This already significant shortage is exacerbated by an increasing number of medical schools and students. Virtual dissections are impractical in alleviating such a shortfall in African anatomy education, and further…

  12. Acute Basilar Artery Dissection Treated by Emergency Stenting in a 13YearOld Boy

    Microsoft Academic Search

    Masaki Komiyama; Masaki Yoshimura; Yuji Honnda; Yasuhiro Matsusaka; Toshihiro Yasui

    2005-01-01

    We report a 13-year-old boy who presented with acute basilar artery occlusion due to traumatic arterial dissection. Because a grave prognosis was expected if left untreated, and the chance of neurological recovery was believed to be unlikely but not zero, given that emergency stenting for the dissection was performed within 6 h of ictus. Recanalization of the basilar artery with

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  14. Stent Placement for Acute Superior Mesenteric Artery Occlusion Associated with Type B Aortic Dissection

    PubMed Central

    Suzuki, Kazushi; Shimohira, Masashi

    2015-01-01

    A 50-year-old man had a mesenteric ischemia related to superior mesenteric artery (SMA) occlusion associated with a type B aortic dissection. We decided to perform stent placement for the SMA and could avoid mesenteric ischemia. We think the stent placement in the SMA might be an option for the treatment of mesenteric ischemia caused by aortic dissection.

  15. Association of Left Ventricular Hypertrophy and Aortic Dilation in Patients with Acute Thoracic Aortic Dissection

    Microsoft Academic Search

    Diana Iarussi; Aurelio Caruso; Maurizio Galderisi; Franco Enrico Covino; Giovanni Dialetto; Eduardo Bossone; Oreste de Divitiis; Maurizio Cotrufo

    2001-01-01

    This study was designed to evaluate the impact of left ventricular mass on aortic diameters in patients who presented with acute thoracic aortic dissection where aortic dilation is common. Retrospective review of transthoracic and transesophageal echocardiograms was conducted for 63 patients treated for acute thoracic aortic dissection and for 16 normal subjects who were comparable for gender prevalence, age, heart

  16. Minimally invasive video-assisted functional lateral neck dissection for metastatic papillary thyroid carcinoma

    Microsoft Academic Search

    Celestino Pio Lombardi; Marco Raffaelli; Pietro Princi; Carmela De Crea; Rocco Bellantone

    2007-01-01

    Functional lateral neck dissection requires a large incision providing adequate exposure of the surgical field. We evaluated the feasibility of minimally invasive video-assisted functional lateral neck dissection (VALNED) in patients with papillary thyroid carcinoma (PTC). Low-risk PTC patients with lateral neck metastases

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    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,…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    The reactions of students to forensic dissection encompass psychologico-emotional and physical components. This exploratory study aimed to determine risk factors for students' adverse physical and psychological reactions to forensic dissection. All sixth-year medical students (n = 304) attending the compulsory practical course in forensic medicine…

  19. Dissecting Allele Architecture of Early Onset IBD Using High-Density Genotyping

    PubMed Central

    Prahalad, Sampath; Walters, Thomas; Guthery, Stephen L.; Dubinsky, Marla; Baldassano, Robert; Crandall, Wallace V.; Rosh, Joel; Markowitz, James; Stephens, Michael; Kellermayer, Richard; Pfefferkorn, Marian; Heyman, Melvin B.; LeLeiko, Neal; Mack, David; Moulton, Dedrick; Kappelman, Michael D.; Kumar, Archana; Prince, Jarod; Bose, Promita; Mondal, Kajari; Ramachandran, Dhanya; Bohnsack, John F.; Griffiths, Anne M.; Haberman, Yael; Essers, Jonah; Thompson, Susan D.; Aronow, Bruce; Keljo, David J.; Hyams, Jeffrey S.; Denson, Lee A.; Kugathasan, Subra

    2015-01-01

    Background The inflammatory bowel diseases (IBD) are common, complex disorders in which genetic and environmental factors are believed to interact leading to chronic inflammatory responses against the gut microbiota. Earlier genetic studies performed in mostly adult population of European descent identified 163 loci affecting IBD risk, but most have relatively modest effect sizes, and altogether explain only ~20% of the genetic susceptibility. Pediatric onset represents about 25% of overall incident cases in IBD, characterized by distinct disease physiology, course and risks. The goal of this study is to compare the allelic architecture of early onset IBD with adult onset in population of European descent. Methods We performed a fine mapping association study of early onset IBD using high-density Immunochip genotyping on 1008 pediatric-onset IBD cases (801 Crohn’s disease; 121 ulcerative colitis and 86 IBD undetermined) and 1633 healthy controls. Of the 158 SNP genotypes obtained (out of the 163 identified in adult onset), this study replicated 4% (5 SNPs out of 136) of the SNPs identified in the Crohn’s disease (CD) cases and 0.8% (1 SNP out of 128) in the ulcerative colitis (UC) cases. Replicated SNPs implicated the well known NOD2 and IL23R. The point estimate for the odds ratio (ORs) for NOD2 was above and outside the confidence intervals reported in adult onset. A polygenic liability score weakly predicted the age of onset for a larger collection of CD cases (p< 0.03, R2= 0.007), but not for the smaller number of UC cases. Conclusions The allelic architecture of common susceptibility variants for early onset IBD is similar to that of adult onset. This immunochip genotyping study failed to identify additional common variants that may explain the distinct phenotype that characterize early onset IBD. A comprehensive dissection of genetic loci is necessary to further characterize the genetic architecture of early onset IBD. PMID:26098103

  20. Cost-analysis of staging methods for lymph nodes in patients with prostate cancer: MRI with a lymph node-specific contrast agent compared to pelvic lymph node dissection or CT

    Microsoft Academic Search

    Anke M. Hövels; Roel A. M. Heesakkers; Eddy M. Adang; Gerrit J. Jager; Jelle O. Barentsz

    2004-01-01

    The aim of this study was to compare the costs of three strategies in patients with prostate cancer in a specific setting: firstly, a strategy including MR lymphography (MRL) in which pelvic lymph node dissection (PLND) is foregone in case of a negative result. The second strategy involves computed tomography (CT) followed by a biopsy or PLND. The third strategy

  1. Global Century IMPORTANT NOTICE

    E-print Network

    Chu, Xi

    Building a University for the Global Century 2012-2013 catalog 1 #12;IMPORTANT NOTICE This document . . . . . . . . . . . . . . . . . . . . . . . . 199 Global Public Health . . . . . . . . . . . . . . . . . . . . 209 History

  2. Acute Aortic Dissections with Pregnancy in Women with ACTA2 Mutations

    PubMed Central

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

    2014-01-01

    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

  3. 17 CFR 248.123 - Contents of opt out notice; consolidated and equivalent notices.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...2014-04-01 false Contents of opt out notice; consolidated and equivalent notices...Marketing § 248.123 Contents of opt out notice; consolidated and equivalent notices. (a) Contents of opt out notice —(1) In general. A...

  4. 12 CFR 41.23 - Contents of opt-out notice; consolidated and equivalent notices.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...2014-01-01 false Contents of opt-out notice; consolidated and equivalent notices...Marketing § 41.23 Contents of opt-out notice; consolidated and equivalent notices. (a) Contents of opt-out notice. —(1) In general....

  5. 17 CFR 248.123 - Contents of opt out notice; consolidated and equivalent notices.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...2012-04-01 false Contents of opt out notice; consolidated and equivalent notices...Marketing § 248.123 Contents of opt out notice; consolidated and equivalent notices. (a) Contents of opt out notice —(1) In general. A...

  6. 17 CFR 248.123 - Contents of opt out notice; consolidated and equivalent notices.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...2013-04-01 false Contents of opt out notice; consolidated and equivalent notices...Marketing § 248.123 Contents of opt out notice; consolidated and equivalent notices. (a) Contents of opt out notice —(1) In general. A...

  7. A Functional Dissection of PTEN N-Terminus: Implications in PTEN Subcellular Targeting and Tumor Suppressor Activity

    PubMed Central

    Gil, Anabel; Rodríguez-Escudero, Isabel; Stumpf, Miriam; Molina, María; Cid, Víctor J.; Pulido, Rafael

    2015-01-01

    Spatial regulation of the tumor suppressor PTEN is exerted through alternative plasma membrane, cytoplasmic, and nuclear subcellular locations. The N-terminal region of PTEN is important for the control of PTEN subcellular localization and function. It contains both an active nuclear localization signal (NLS) and an overlapping PIP2-binding motif (PBM) involved in plasma membrane targeting. We report a comprehensive mutational and functional analysis of the PTEN N-terminus, including a panel of tumor-related mutations at this region. Nuclear/cytoplasmic partitioning in mammalian cells and PIP3 phosphatase assays in reconstituted S. cerevisiae defined categories of PTEN N-terminal mutations with distinct PIP3 phosphatase and nuclear accumulation properties. Noticeably, most tumor-related mutations that lost PIP3 phosphatase activity also displayed impaired nuclear localization. Cell proliferation and soft-agar colony formation analysis in mammalian cells of mutations with distinctive nuclear accumulation and catalytic activity patterns suggested a contribution of both properties to PTEN tumor suppressor activity. Our functional dissection of the PTEN N-terminus provides the basis for a systematic analysis of tumor-related and experimentally engineered PTEN mutations. PMID:25875300

  8. Genetic Dissection of Rhythmic Motor Networks in Mice

    PubMed Central

    Grossmann, Katja S.; Giraudin, Aurore; Britz, Olivier; Zhang, Jingming; Goulding, Martyn

    2011-01-01

    Simple motor behaviors such as locomotion and respiration involve rhythmic and coordinated muscle movements that are generated by central pattern generator (CPG) networks in the spinal cord and hindbrain. These CPG networks produce measurable behavioral outputs, and thus represent ideal model systems for studying the operational principles that the nervous system uses to produce specific behaviors. Recent advances in our understanding of the transcriptional code that controls neuronal development have provided an entry point into identifying and targeting distinct neuronal populations that make up locomotor CPG networks in the spinal cord. This has spurred the development of new genetic approaches to dissect and manipulate neuronal networks both in the spinal cord and hindbrain. Here we discuss how the advent of molecular genetics together with anatomical and physiological methods has begun to revolutionize studies of the neuronal networks controlling rhythmic motor behaviors in mice. PMID:21111198

  9. Genetic dissection of rhythmic motor networks in mice.

    PubMed

    Grossmann, Katja S; Giraudin, Aurore; Britz, Olivier; Zhang, Jingming; Goulding, Martyn

    2010-01-01

    Simple motor behaviors such as locomotion and respiration involve rhythmic and coordinated muscle movements that are generated by central pattern generator (CPG) networks in the spinal cord and hindbrain. These CPG networks produce measurable behavioral outputs and thus represent ideal model systems for studying the operational principles that the nervous system uses to produce specific behaviors. Recent advances in our understanding of the transcriptional code that controls neuronal development have provided an entry point into identifying and targeting distinct neuronal populations that make up locomotor CPG networks in the spinal cord. This has spurred the development of new genetic approaches to dissect and manipulate neuronal networks both in the spinal cord and hindbrain. Here we discuss how the advent of molecular genetics together with anatomical and physiological methods has begun to revolutionize studies of the neuronal networks controlling rhythmic motor behaviors in mice. PMID:21111198

  10. Dissecting Arabidopsis G? signal transduction on the protein surface.

    PubMed

    Jiang, Kun; Frick-Cheng, Arwen; Trusov, Yuri; Delgado-Cerezo, Magdalena; Rosenthal, David M; Lorek, Justine; Panstruga, Ralph; Booker, Fitzgerald L; Botella, José Ramón; Molina, Antonio; Ort, Donald R; Jones, Alan M

    2012-07-01

    The heterotrimeric G-protein complex provides signal amplification and target specificity. The Arabidopsis (Arabidopsis thaliana) G?-subunit of this complex (AGB1) interacts with and modulates the activity of target cytoplasmic proteins. This specificity resides in the structure of the interface between AGB1 and its targets. Important surface residues of AGB1, which were deduced from a comparative evolutionary approach, were mutated to dissect AGB1-dependent physiological functions. Analysis of the capacity of these mutants to complement well-established phenotypes of G?-null mutants revealed AGB1 residues critical for specific AGB1-mediated biological processes, including growth architecture, pathogen resistance, stomata-mediated leaf-air gas exchange, and possibly photosynthesis. These findings provide promising new avenues to direct the finely tuned engineering of crop yield and traits. PMID:22570469

  11. From microscopes to microarrays: dissecting recurrent chromosomal rearrangements

    PubMed Central

    Emanuel, Beverly S.; Saitta, Sulagna C.

    2010-01-01

    Submicroscopic chromosomal rearrangements that lead to copy-number changes have been shown to underlie distinctive and recognizable clinical phenotypes. The sensitivity to detect copy-number variation has escalated with the advent of array comparative genomic hybridization (CGH), including BAC and oligonucleotide-based platforms. Coupled with improved assemblies and annotation of genome sequence data, these technologies are facilitating the identification of new syndromes that are associated with submicroscopic genomic changes. Their characterization reveals the role of genome architecture in the aetiology of many clinical disorders. We review a group of genomic disorders that are mediated by segmental duplications, emphasizing the impact that high-throughput detection methods and the availability of the human genome sequence have had on their dissection and diagnosis. PMID:17943194

  12. Mid-arm lymph nodes dissection for melanoma.

    PubMed

    Fujiwara, Masao; Suzuki, Ayano; Mizukami, Takahide; Nagata, Takeshi; Ito, Taisuke; Fukamizu, Hidekazu

    2010-09-01

    An interval node in the upper limb termed the mid-arm node was recently identified. However, its surgical anatomy remains unclear. We report a patient with metastatic melanoma of the mid-arm node and the epitrochlear node at 10 years after removal of the primary tumour from the forearm and therapeutic axillary lymph node dissection. The mid-arm node is located halfway up the upper arm on the medial intermuscular septum, at the site where the brachial vessels, the median nerve and the ulnar nerve run adjacent to each other. The mid-arm node lies adjacent to the basilic vein where lymphatic vessels ascend and converge. This is the first report regarding the surgical anatomy of the mid-arm node. PMID:20227935

  13. Brain virtual dissection and white matter 3D visualization.

    PubMed

    Serres, Barthélemy; Zemmoura, Ilyess; Andersson, Frédéric; Tauber, Clovis; Destrieux, Christophe; Venturini, Gilles

    2013-01-01

    This paper presents an immersive visualization tool that helps anatomists to establish a ground truth for brain white matter fiber bundles. Each step of a progressive anatomical dissection of human brain hemisphere is acquired using a high resolution 3D laser scanner and a photographic device. Each resulting surface is textured with a high resolution image and registered into a common 3D space using fiducial landmarks. Surfaces can be visualized using stereoscopic hardware and are interactively selectable. The tool allows the user to identify specific fiber bundle parts. Extracted fiber bundles are stacked together and rendered in stereoscopy with the corresponding MR volume. Surgeons have validated this tool for creating ground truth in medical imaging with the perspective of validating tractography algorithms. PMID:23400190

  14. Mesenteric malperfusion complicated with type A acute aortic dissection.

    PubMed

    Takagi, H; Watanabe, T; Umemoto, T

    2015-10-01

    Type A acute aortic dissection (AAAD), involving the ascending aorta, is one of life-threatening disorders. Emergent surgery, such as graft replacement of the aortic root, ascending aorta, aortic arch, or these combinations, is routinely performed to avoid sudden death due to free rupture, cardiac tamponade, or coronary obstruction. Even though appropriate surgery is immediately completed, however, operative mortality remains high, between 15% and 30%. Furthermore, mesenteric malperfusion, bringing about enteric ischemia, occurs unusually in AAAD with far and away higher mortality. In the present article, we reviewed contemporary evidence regarding incidence, mortality, and treatment of mesenteric malperfusion complicated with AAAD. The incidence and early mortality rate of mesenteric malperfusion complicated with AAAD was 4% and 68%, respectively. Patients with mesenteric malperfusion had a 9.7-fold risk of mortality relative to those without it. Evidence regarding optimal treatment of mesenteric malperfusion complicated with AAAD is very limited. PMID:25077517

  15. In vivo dissection of the chromosome condensation machinery

    PubMed Central

    Lavoie, Brigitte D.; Hogan, Eileen; Koshland, Douglas

    2002-01-01

    The machinery mediating chromosome condensation is poorly understood. To begin to dissect the in vivo function(s) of individual components, we monitored mitotic chromosome structure in mutants of condensin, cohesin, histone H3, and topoisomerase II (topo II). In budding yeast, both condensation establishment and maintenance require all of the condensin subunits, but not topo II activity or phospho-histone H3. Structural maintenance of chromosome (SMC) protein 2, as well as each of the three non-SMC proteins (Ycg1p, Ycs4p, and Brn1p), was required for chromatin binding of the condensin complex in vivo. Using reversible condensin alleles, we show that chromosome condensation does not involve an irreversible modification of condensin or chromosomes. Finally, we provide the first evidence of a mechanistic link between condensin and cohesin function. A model discussing the functional interplay between cohesin and condensin is presented. PMID:11864994

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

    PubMed Central

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

    2011-01-01

    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

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

    PubMed

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

    2011-09-01

    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

  18. Students' physical and psychological reactions to forensic dissection: Are there risk factors?

    PubMed

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

    2010-01-01

    The reactions of students to forensic dissection encompass psychologico-emotional and physical components. This exploratory study aimed to determine risk factors for students' adverse physical and psychological reactions to forensic dissection. All sixth-year medical students (n = 304) attending the compulsory practical course in forensic medicine in the 2005-2006 academic year were asked to complete a questionnaire at the conclusion of the five-day course. The questionnaire surveyed physical and psychological reactions (outcomes) and 47 student traits, beliefs, and behaviors (risk factors) that might predispose to adverse reactions. Multivariate ordinal logistic regression yielded five independent risk factors for negative psychological reactions: female gender, stereotypic beliefs about forensic pathologists, a less cognitive and more emotional frame of mind relative to forensic dissection, more passive coping strategies, and greater fear of death. The sole independent risk factor for physical symptoms was a less cognitive/more emotional approach to dissection. Students' reactions to forensic dissection integrate a host of inherent and dissection-related risk factors, and future interventions to improve this aspect of medical education will need to take into account the complexities underlying students' experiences with dissection. PMID:21046569

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

    PubMed Central

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

    2014-01-01

    Objective: Gastric cancer is a worldwide aggressive tumor with a bad prognosis. The purpose of this study was to retrospectively investigate operative findings of 53 patients aged over 70 with gastric cancer who underwent laporoscopic operations in our clinic. Material and methods: A retrospective review of all patients who underwent laporoscopic surgery for pathologically confirmed gastric cancer at our clinic between March 2008 and October 2010 was conducted. D1 resection (Level1 lymphadenectomy) was compared with D2 resection (Levels 1 and 2 lymphadenectomy). The two groups in which D1 and D2 Lymph node Dissection (LND) were applied were compared with respect to number of patients, sex, age, stage of disease, and score of American Society of Anesthesiologists (ASA). We analyzed surgical methods, the use of staplers, operative time, additional organ resections, hospital stay, postoperative complications and the need for re-operation, operative mortality, and the effects of prognostic factors on survival. Results: The patient group consisted of 31 (58%) males and 22 (42%) females. Of the patients, 28 (52%) underwent D1 and 25 (48%) D2 LND. There was a significant difference between the two groups with regard to length of surgery (p < 0.01). The length of operation, blood loss, and transfusion requirement in the D2 group were significantly more than those in the D1 group. There was no mortality in cases that underwent additional organ resection. The survival times of cases with a ? 0.25 ratio of dissected number of lymph nodes to metastatic lymph nodes were significantly longer than those of other cases. The survival time of cases with perineural and vascular invasion was significantly shorter. The survival rates of Stage I patients was significantly higher than those of Stage III (p:0.002) and Stage IV (p:0.003) patients. Conclusions: Although extensive dissection had an increased morbidity, there was no significant statistical difference between the two procedures. Early complications should not be attributed only to the extent of LND. The important prognostic factors related to long-time survival are the stage of the tumor, perineural and perivascular invasion, and metastatic lymph nodes. PMID:25419390

  20. Aortic dissection presenting as acute myocardial infarction: potential harm of antithrombin and antiplatelet therapy

    PubMed Central

    Gu, Y.L.; van den Heuvel, A.F.M.; Erasmus, M.E.; Zijlstra, F.

    2006-01-01

    In the treatment of acute myocardial infarction, antithrombin and antiplatelet therapy are indicated according to the current guidelines. When a patient presents with symptoms and signs of acute myocardial infarction, an extensive list of diagnoses should be considered. Because of the nonspecific symptoms of aortic dissection, the disease may be easily misdiagnosed. A high clinical suspicion of aortic dissection is therefore required. Once aortic dissection has been diagnosed, surgical intervention provides the only definitive treatment for these patients, regardless of antithrombin and antiplatelet therapy. ImagesFigure 1Figure 2 PMID:25696613

  1. Polyethylene glycol submucosal irrigation: a novel approach to improve visibility during endoscopic submucosal dissection

    PubMed Central

    Arantes, Vitor; Toyonaga, Takashi; Piñeros, Elias Alfonso Forero

    2014-01-01

    In order to expand the availability of endoscopic submucosal dissection (ESD), measures to facilitate the procedure are necessary. When bleeding occurs, the examiner’s field of vision is critically impaired, and ESD becomes less efficient and more hazardous because of the presence of submucosal hematoma and covered blood clot. We propose the use of polyethylene glycol (PEG) irrigation as a simple and effective measure to improve visibility during submucosal dissection, particularly when bleeding occurs. PEG irrigation facilitates further dissection by allowing a better recognition of the submucosal fibers and muscularis propria layer.

  2. Iatrogenic Aortic Dissection During Left Subclavian Artery Stenting: Immediate Detection by Calcium Sign Under Fluoroscope

    SciTech Connect

    Wang, Yi-Chih, E-mail: med011@seed.net.tw; Hwang, Juey-Jen; Lai, Ling-Ping; Tseng, Chuen-Den, E-mail: cdtseng@ha.mc.ntu.edu.tw [National Taiwan University Hospital, Department of Internal Medicine, Taiwan (China)

    2011-02-15

    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.

  3. Ischemic gall bladder perforation: a complication of type A aortic dissection.

    PubMed

    Jha, Neerod K; Kumar, Rajappan A; Ayman, Moataz; Khan, Javed A; Cristaldi, Massimo; Ahene, Charles; Augustin, Norbert

    2013-06-01

    Malperfusion of end organs occurs in 20% to 40% patients with acute type A aortic dissection. Because irreversible ischemia is a time-dependent event, expedient diagnosis and treatment are necessary. We herein report successful surgical management of a patient with acute type A aortic dissection causing transient gut ischemia and a rare gall bladder perforation. We implemented one-stage surgical and laparoscopic management approach for the diagnosis and treatment. Increased awareness of this complication and appropriate use of available diagnostic tools may improve the outcome in similar patients. Patients with aortic dissection complicated by visceral ischemia require a prompt sequential and rational multidisciplinary approach for successful management. PMID:23706468

  4. Total oesophagectomy for squamous cell carcinoma with or without standard two field node dissection - a prospective study.

    PubMed

    Shah, Shishir V; Chheda, Yogen Pavinchandra; Pillai, Sundaram Kaliappan; Shah, Shakuntala Viren

    2013-12-01

    Cancer of the esophagus and gastroesophageal junction (GEJ) is notorious for its advanced stage at the time of diagnosis with transmural invasion and early lymphatic spread in the majority of the patients. R0 resection is the aim of surgery with curative intent. Regarding the role of lymphadenectomy, as in any other solid organ cancer, there are opposing views. Some surgeons argue that the presence of lymph node involvement equals systemic disease and that survival remains unchanged despite removal of these lymph nodes. For others the presence of lymph node involvement, even at a distance from the primary tumor, justifies an aggressive approach with radical esophagectomy combined with lymphadenectomy. The purpose of this article is to compare standard two field lymph node dissection versus non formal lymph node dissection in carcinoma esophagus. The conclusions are based on the experience with 60 cases of carcinoma esophagus over 2 years. In our opinion total esophagectomy with 2-field lymphadenectomy is the standard surgery for resectable squamous cell carcinoma of esophagus. It improves the lymphnode yield thereby ensuring adequate staging of the disease. It can be performed with acceptable morbidity and mortality as the nonformal lymphadenectomy procedure. Locoregional recurrence following 2 field lymphadenectomy is significantly low as compared to nonformal lymphadenectomy procedure though the distant recurrence rate is same. 2 year disease free survival in this study shows advantage of 2 field lymphadenectomy compared to non formal lymphadenectomy procedure. PMID:24426753

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

    PubMed

    Li, Guo-Xin; Zhang, Ce; Yu, Jiang; Wang, Ya-Nan; Hu, Yan-Feng

    2010-12-01

    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

  6. Lower limb malperfusion in type B aortic dissection: a systematic review

    PubMed Central

    Massoni, Claudio Bianchini; Gallitto, Enrico; Freyrie, Antonio; Trimarchi, Santi; Faggioli, Gianluca; Stella, Andrea

    2014-01-01

    Background Lower limb malperfusion (LLM) syndrome occurs in up to 40% of complicated type B aortic dissections (TBAD) and in up to 71% of TBAD with malperfusion syndrome. This syndrome is associated with higher 30-day mortality. The aim of this systematic review was to provide clinical and procedural data of patients with LLM syndrome secondary to TBAD. Methods The PubMed database was systematically searched from January 2000 to June 2014 for English-language publications reporting on demographic data of patients with LLM secondary to TBAD. Results A total of 29 papers were included (10 original articles and 19 case reports), reporting on a total of 138 patients (mean age =58±12 years; male =87%). Lower limb complications developed in acute and chronic TBAD in 134 (97%) and 4 (3%) cases, respectively. LLM presented with acute limb ischemia in 120 (87%) patients. Bilateral clinical presentation occurred in 56% (40/72) of cases. LLM was the only clinically detected malperfusion in 52% of cases (44/84). In 40% (35/84) and 25% (21/84) of cases, LLM was clinically associated with renal and visceral malperfusion, respectively. Radiological imaging showed renal, celiac trunk and superior mesenteric artery involvement in 53% (47/88), 31% (27/88) and 34% (30/88) of cases, respectively. Medical, surgical and endovascular treatments were performed in 22 (16%), 51 (37%) and 65 (47%) patients, respectively. Thirty-day morbidity was 31% (13/42) and 46% (6/13) following surgical and endovascular treatment, respectively. Thirty-day mortality was 14% (5/36) and 8% (2/26) following surgical and endovascular treatment, respectively. Conclusions LLM syndrome secondary to TBAD usually developed during the acute phase and, in most cases, presented with acute limb ischemia. Bilateral clinical presentation occurred in more than half of cases. Renal and visceral malperfusion were frequently associated with lower limb flow reduction but LLM was the only clinically detected malperfusion in more than half of patients. Surgical fenestration was burdened with significant complication rates and 30-day mortality. Endovascular procedures showed lower mortality but complication rates remained high. PMID:25133098

  7. Dissecting biological ``dark matter'' with single-cell genetic analysis of rare and uncultivated TM7

    E-print Network

    Quake, Stephen R.

    Dissecting biological ``dark matter'' with single-cell genetic analysis of rare and uncultivated TM include cultivated representatives (1). This can be viewed as biology's ``dark matter'' problem: just

  8. Systematic dissection of regulatory motifs in 2000 predicted human enhancers using a massively parallel reporter assay

    E-print Network

    Kheradpour, Pouya

    Genome-wide chromatin annotations have permitted the mapping of putative regulatory elements across multiple human cell types. However, their experimental dissection by directed regulatory motif disruption has remained ...

  9. Cell type–specific channelrhodopsin-2 transgenic mice for optogenetic dissection of neural circuitry function

    E-print Network

    Zhao, Shengli

    Optogenetic methods have emerged as powerful tools for dissecting neural circuit connectivity, function and dysfunction. We used a bacterial artificial chromosome (BAC) transgenic strategy to express the H134R variant of ...

  10. J Physiol 580.3 (2007) pp 961975 961 Pharmacological dissection of the human gastro-

    E-print Network

    Brasseur, James G.

    2007-01-01

    J Physiol 580.3 (2007) pp 961­975 961 Pharmacological dissection of the human gastro- oesophageal and quantify in vivo the skeletal and smooth muscle sphincteric components pharmacologically and clarify

  11. Biomechanical roles of medial pooling of glycosaminoglycans in thoracic aortic dissection

    PubMed Central

    Roccabianca, Sara; Ateshian, Gerard A.; Humphrey, Jay D.

    2013-01-01

    Spontaneous dissection of the human thoracic aorta is responsible for significant morbidity and mortality, yet this devastating biomechanical failure process remains poorly understood. In this paper, we present finite element simulations that support a new hypothesis for the initiation of aortic dissections that is motivated by extensive histopathological observations. Specifically, our parametric simulations show that the pooling of glycosaminoglycans/proteoglycans that is singularly characteristic of the compromised thoracic aorta in aneurysms and dissections can lead to significant stress concentrations and intra-lamellar Donnan swelling pressures. We submit that these localized increases in intramural stress may be sufficient both to disrupt the normal cell-matrix interactions that are fundamental to aortic homeostasis and to delaminate the layered microstructure of the aortic wall and thereby initiate dissection. Hence, pathologic pooling of glycosaminoglycans/proteoglycans within the medial layer of the thoracic aortic should be considered as a possible target for clinical intervention. PMID:23494585

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

    E-print Network

    Wright, Dawn Jeannine

    in oceanic food webs. There is also a large commercial fishery for squid as they are highly prized by humans The Squid Dissection program at Hatfield Marine Science Center is designed to be a 50- minute lab

  13. Clinical Efficacy of Endoscopic Submucosal Dissection for Adenocarcinomas of the Esophagogastric Junction

    PubMed Central

    Nagami, Yasuaki; Machida, Hirohisa; Shiba, Masatsugu; Obayashi, Tomoko; Ominami, Masaki; Fukunaga, Shusei; Sugimori, Satoshi; Yamagami, Hirokazu; Tanigawa, Tetsuya; Watanabe, Kenji; Watanabe, Toshio; Tominaga, Kazunari; Fujiwara, Yasuhiro; Arakawa, Tetsuo

    2014-01-01

    Background and Study Aims There are a few reports about the efficacy of endoscopic submucosal dissection (ESD) for adenocarcinomas of the esophagogastric junction (EGJ). However, there is no detailed analysis that divides EGJ cancers into Barrett’s adenocarcinoma and gastric cardia adenocarcinoma. The aim of this study was to analyze the efficacy of ESD for EGJ cancers, comparing these two adenocarcinomas. Patients and Methods This study included 43 patients who underwent ESD for type II EGJ cancers between 2004 and 2011.?Pathological examination of resected specimens confirmed 14 cases of Barrett’s adenocarcinoma and 29 cases of gastric cardia adenocarcinoma. Cutting margins on the oral side were placed 1?cm from the squamocolumnar junction, or 1?cm away from the slight elevation that is an endoscopic sign of subsquamous carcinoma extension. Clinical outcomes, prevalence and length of subsquamous carcinoma extension, and long-term outcomes were compared between these two types of adenocarcinoma. Results No significant differences in clinical outcomes were found between these two types of adenocarcinoma (en bloc, 100?% versus 100?%; complete, 100?% versus 89.7?%; curative, 85.7?% versus 75.9?%). No serious adverse events were encountered. The prevalence of subsquamous carcinoma extension was significantly higher in Barrett’s adenocarcinoma compared with gastric cardia adenocarcinoma. Local and distant recurrence were not observed in any cases with curative resection during the follow-up period (1.6?–?87.6 months). Conclusion ESD for EGJ cancers, including both Barrett’s adenocarcinoma and gastric cardia adenocarcinoma, was efficient and useful. ESD with a 1?cm safety margin may be acceptable for EGJ cancers.

  14. Endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of sporadic nonampullary duodenal adenomatous polyps

    PubMed Central

    Marques, Joana; Baldaque-Silva, Francisco; Pereira, Pedro; Arnelo, Urban; Yahagi, Naohisa; Macedo, Guilherme

    2015-01-01

    Although uncommon, sporadic nonampullary duodenal adenomas have a growing detection due to the widespread of endoscopy. Endoscopic therapy is being increasingly used for these lesions, since surgery, considered the standard treatment, carries significant morbidity and mortality. However, the knowledge about its risks and benefits is limited, which contributes to the current absence of standardized recommendations. This review aims to discuss the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in the treatment of these lesions. A literature review was performed, using the Pubmed database with the query: “(duodenum or duodenal) (endoscopy or endoscopic) adenoma resection”, in the human species and in English. Of the 189 retrieved articles, and after reading their abstracts, 19 were selected due to their scientific interest. The analysis of their references, led to the inclusion of 23 more articles for their relevance in this subject. The increased use of EMR in the duodenum has shown good results with complete resection rates exceeding 80% and low complication risk (delayed bleeding in less than 12% of the procedures). Although rarely used in the duodenum, ESD achieves close to 100% complete resection rates, but is associated with perforation and bleeding risk in up to one third of the cases. Even though literature is insufficient to draw definitive conclusions, studies suggest that EMR and ESD are valid options for the treatment of nonampullary adenomas. Thus, strategies to improve these techniques, and consequently increase the effectiveness and safety of the resection of these lesions, should be developed.

  15. [Extended salvage pelvic and retroperitoneal lymph node dissection due to prostate cancer relapse].

    PubMed

    Osmonov, D K; Aksenov, A V; Jünemann, K-P

    2013-01-01

    Treatment of a biochemical prostate cancer relapse represents a difficult clinical dilemma, which has remained without a definitive solution so far. Based on clinical studies, we combine radical prostatectomy with extended pelvic lymph node dissection in intermediate and high risk patients as a routine procedure at our clinic. In this paper, we report on a case of extended salvage lymphadenectomy performed due to biochemical prostate cancer recurrence. The 56-year-old patient came to our clinic in April 2012 with a finding of lymph node metastasis according to PET-CT imaging. Laparoscopic radical retropubic prostatectomy with lymphadenectomy had been performed in 2008 [pT3a, N0 (0/4), M0, R0, GS 5+4=9, iPSA 26.67 ng/mL], and followed by radiotherapy as of September 2009. The extended salvage lymphadenectomy was performed in April 2012 due to a PSA-level rise up to 24 ng/mL and the aforementioned PET-CT findings. A total of 22 lymph nodes were removed, among them 3 lymph nodes with metastases. In the fossa obturatoria on the right we identified a walnut-size lymph node relapse with tumour necrosis, which fully corresponded to the PET-CT scan. The PSA level subsequently dropped to 0.4 ng/mL postoperatively, and further to the current value of 0.02 ng/mL (August 2012). PMID:23325670

  16. Association weight matrix for the genetic dissection of puberty in beef cattle.

    PubMed

    Fortes, Marina R S; Reverter, Antonio; Zhang, Yuandan; Collis, Eliza; Nagaraj, Shivashankar H; Jonsson, Nick N; Prayaga, Kishore C; Barris, Wes; Hawken, Rachel J

    2010-08-01

    We describe a systems biology approach for the genetic dissection of complex traits based on applying gene network theory to the results from genome-wide associations. The associations of single-nucleotide polymorphisms (SNP) that were individually associated with a primary phenotype of interest, age at puberty in our study, were explored across 22 related traits. Genomic regions were surveyed for genes harboring the selected SNP. As a result, an association weight matrix (AWM) was constructed with as many rows as genes and as many columns as traits. Each {i, j} cell value in the AWM corresponds to the z-score normalized additive effect of the ith gene (via its neighboring SNP) on the jth trait. Columnwise, the AWM recovered the genetic correlations estimated via pedigree-based restricted maximum-likelihood methods. Rowwise, a combination of hierarchical clustering, gene network, and pathway analyses identified genetic drivers that would have been missed by standard genome-wide association studies. Finally, the promoter regions of the AWM-predicted targets of three key transcription factors (TFs), estrogen-related receptor gamma (ESRRG), Pal3 motif, bound by a PPAR-gamma homodimer, IR3 sites (PPARG), and Prophet of Pit 1, PROP paired-like homeobox 1 (PROP1), were surveyed to identify binding sites corresponding to those TFs. Applied to our case, the AWM results recapitulate the known biology of puberty, captured experimentally validated binding sites, and identified candidate genes and gene-gene interactions for further investigation. PMID:20643938

  17. [Lymph node dissection: what for? From esophagus to rectum: surgical and lymph node related prognostic factors].

    PubMed

    Alline, Mathias; Bertrand, Martin Marie; Colombo, Pierre Emmanuel; Mourregot, Anne; Rouanet, Philippe

    2014-04-01

    Surgery has still a key role in curative treatment of digestive carcinomas, and for almost all localisations, lymph node status is a major prognostic factor. As far as oesophageal and gastric cancer are concerned, there is not yet any internationally standardized approach. Occidental guidelines recommend more limited lymph node dissections than Asiatic ones. Lymph node numbers requested during surgery of such cancers remain high, at least 23 lymph nodes for oesophageal cancer, and 25 for a D2 or D1.5 lymphadenectomy for gastric cancer. Generalisation of neo-adjuvant and adjuvant treatments has not yet modified these standards. On the other hand, rectal cancer surgery is well standardized since the global adoption of Total Mesorectal Excision (TME) for the late eighties. Development of mini-invasive techniques (laparoscopy and robot-assisted surgery) enabled an important decrease of surgery related morbidity as well as an enhanced post-operative recovery. However, rectal cancer surgery still has an important morbidity. Development of neo-adjuvant chemo-radiotherapy as well as in-depth knowledge of risk factor of lymph node invasion opened up the path for transanal full thickness resection without lymphadenectomy. The goal of such an approach is to avoid TME's morbidity without risking local recurrence rate increase. As a consequence, this technique might need to be completed with a TME case histological factors are not favorable. PMID:24793629

  18. Association weight matrix for the genetic dissection of puberty in beef cattle

    PubMed Central

    Fortes, Marina R. S.; Reverter, Antonio; Zhang, Yuandan; Collis, Eliza; Nagaraj, Shivashankar H.; Jonsson, Nick N.; Prayaga, Kishore C.; Barris, Wes; Hawken, Rachel J.

    2010-01-01

    We describe a systems biology approach for the genetic dissection of complex traits based on applying gene network theory to the results from genome-wide associations. The associations of single-nucleotide polymorphisms (SNP) that were individually associated with a primary phenotype of interest, age at puberty in our study, were explored across 22 related traits. Genomic regions were surveyed for genes harboring the selected SNP. As a result, an association weight matrix (AWM) was constructed with as many rows as genes and as many columns as traits. Each {i, j} cell value in the AWM corresponds to the z-score normalized additive effect of the ith gene (via its neighboring SNP) on the jth trait. Columnwise, the AWM recovered the genetic correlations estimated via pedigree-based restricted maximum-likelihood methods. Rowwise, a combination of hierarchical clustering, gene network, and pathway analyses identified genetic drivers that would have been missed by standard genome-wide association studies. Finally, the promoter regions of the AWM-predicted targets of three key transcription factors (TFs), estrogen-related receptor ? (ESRRG), Pal3 motif, bound by a PPAR-? homodimer, IR3 sites (PPARG), and Prophet of Pit 1, PROP paired-like homeobox 1 (PROP1), were surveyed to identify binding sites corresponding to those TFs. Applied to our case, the AWM results recapitulate the known biology of puberty, captured experimentally validated binding sites, and identified candidate genes and gene–gene interactions for further investigation. PMID:20643938

  19. Collaboration between the coroner and emergency physicians: efforts to improve outcomes from aortic dissection.

    PubMed

    Jelinek, George A; Bugeja, Lyndal C; Spanos, Paresa A; Neate, Sandra L; Bergman, Ruth L; Ranson, David L

    2014-11-17

    The Coroners Prevention Unit at the Coroners Court of Victoria (CCV) is a multidisciplinary team that investigates deaths referred by the state's coroners, with a view to identifying prevention opportunities. The death of a woman from acute aortic dissection (AAD) after an emergency department attendance prompted the coroner to request a roundtable meeting with emergency physicians (EPs) from Melbourne. The round table was attended by 17 EPs from Melbourne hospitals, along with representatives from the CCV. The meeting identified important clinical, system and cultural features of AAD presentation and management that might be useful in improving case detection and management, and hence outcomes. A key recommendation was that EPs teach junior staff that AAD is the "subarachnoid haemorrhage of chest pain", to change the way patients with chest pain are assessed, with an emphasis on red flags for AAD being considered at the beginning of any discussion. This innovative collaboration between the CCV and EPs may serve as a model for future interactions between the CCV and the medical profession. PMID:25390270

  20. The AFM as a tool for chromosomal dissection - the influence of physical parameters

    NASA Astrophysics Data System (ADS)

    Stark, R. W.; Thalhammer, S.; Wienberg, J.; Heckl, W. M.

    Human metaphase chromosomes were dissected using an atomic force microscope (AFM) in ambient conditions and in buffer. Cutting with z-modulation in air yielded precise cuts at loading forces F>17 ?N with a full width at maximum depth of 90 nm. After dissection, the chromosomal material adhered to the tip to be used for further biochemical processing. In liquids, we measured the effects of different types of buffer solution on swelling of the chromosomes and their elastic behaviour.

  1. Sentinel Lymph Node Biopsy in Patients with Previous Ipsilateral Complete Axillary Lymph Node Dissection

    Microsoft Academic Search

    Paramjeet Kaur; John V. Kiluk; Tammi Meade; Daniel Ramos; William Koeppel; Julia Jara; Jeff King; Charles E. Cox

    2011-01-01

    Background  Prior ipsilateral completion axillary lymph node dissection (CALND) may be considered a contraindication to performing a sentinel\\u000a lymph node (SLN) mapping in a patient with recurrent breast carcinoma. However, reoperative SLN biopsy following axillary\\u000a dissection would determine if alternative lymphatic drainage pathways exist. If nodes were found to contain metastatic disease,\\u000a staging and locoregional control of the disease could be

  2. Extent of Routine Central Lymph Node Dissection With Small Papillary Thyroid Carcinoma

    Microsoft Academic Search

    Yong Sang Lee; Seok Won Kim; Sun Wook Kim; Seok Ki Kim; Han-Sung Kang; Eun Sook Lee; Ki-Wook Chung

    2007-01-01

    The indications for and extent of routine lymph node dissection in patients with papillary thyroid carcinoma (PTC) are unclear.\\u000a The aim of this study was to investigate the association between the extent of central lymph node dissection (CLND) and the\\u000a therapeutic effects and potential risks in patients with a small PTC. A total of 103 patients with a PTC <2 cm

  3. Carotid and vertebral artery dissections: clinical aspects, imaging features and endovascular treatment

    Microsoft Academic Search

    Christine M. Flis; H. Rolf Jäger; Paul S. Sidhu

    2007-01-01

    Extracranial arterial dissections are a recognised cause of stroke, particularly in young adults. Clinical diagnosis may be\\u000a difficult, and the classical triad of symptoms is uncommon. Imaging plays a pivotal role in the diagnosis of extracranial\\u000a arterial dissections, and this review provides a detailed discussion of the relative merits and limitations of currently available\\u000a imaging modalities. Conventional arteriography has been

  4. Successful Treatment of Isolated Spontaneous Superior Mesenteric Artery Dissection with Stent Placement

    SciTech Connect

    Yoon, Young-Won; Choi, Donghoon; Cho, Seung-Yun [Yonsei Cardiovascular Hospital, Yonsei Cardiovascular Research Institute, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-Ku, 120-752 Seoul, Cardiology Division (Korea, Republic of); Lee, Do Yun [Yonsei Cardiovascular Hospital, Yonsei Cardiovascular Research Institute, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-Ku, 120-752 Seoul, Division of Diagnostic Radiology (Korea, Republic of)

    2003-09-15

    Isolated dissection of superior mesenteric artery is a rare condition and is usually treated surgically. We treated a patient with severe abdominal pain who was angiographically confirmed to have superior mesenteric artery thrombosis associated with isolated spontaneous dissection. He was treated initially by thrombolysis and oral anticoagulation, but recurrent symptoms developed with radiologic evidence of disease progression. We performed superior mesenteric artery stenting and recovery was uneventful.

  5. Three-Dimensional Computed Tomographic Angiography in Four Patients with Dissecting Aneurysms of the Vertebrobasilar System

    Microsoft Academic Search

    M. Nakatsuka; S. Mizuno

    2000-01-01

    Summary  ¶?Background. Recently, three-dimensional computed tomographic angiography (CTA) has been used for the diagnosis and treatment planning\\u000a of cerebral aneurysm presenting with or without subarachnoid haemorrhage, but the diagnostic value of CTA has not been established.\\u000a This study evaluated the usefulness of CTA in patients with dissecting aneurysms of the vertebrobasilar system.\\u000a \\u000a ?Method. Four patients with acute dissecting aneurysms were examined

  6. Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head and Neck Squamous Cell Carcinoma

    PubMed Central

    Thariat, Juliette; Ang, K. Kian; Allen, Pamela K.; Ahamad, Anesa; Williams, Michelle D.; Myers, Jeffrey N.; El-Naggar, Adel K.; Ginsberg, Lawrence E.; Rosenthal, David I.; Glisson, Bonnie S.; Morrison, William H.; Weber, Randal S.; Garden, Adam S.

    2014-01-01

    BACKGROUND This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation, and to determine the benefit of a neck dissection in those with less than CR by tumor site. METHODS Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log-rank test and prognostic factors by Cox analyses. RESULTS Nodal CR occurred in 377 (43%) patients of whom 365 patients did not undergo nodal dissection. The 5-year actuarial regional control rate of patients with CR was 92%. Two hundred sixty-eight of the remaining patients (53%) underwent neck dissections. The 5-year actuarial regional control rate for patients without a CR was 84%. Those who had a neck dissection fared better with 5-year actuarial regional control rates of 90% and 76% for those operated and those not operated (p <.001). Variables associated with poorer regional control rates included higher T and N stage, non-oropharynx cancers, non-CR, both clinical and pathological. CONCLUSIONS With 92% 5-year neck control rate without neck dissection after CR, there is little justification for systematic neck dissection. The addition of a neck dissection resulted in higher neck control after partial response though patients with viable tumor on pathology specimens had poorer outcomes. The identification of that subgroup that benefits from additional treatment remains a challenge. PMID:22284033

  7. Getting Ready for the Profession: Prospective Teachers' Noticing Related to Teacher Actions

    ERIC Educational Resources Information Center

    Osmanoglu, Aslihan; Isiksal, Mine; Koc, Yusuf

    2015-01-01

    The aim of this study was to investigate what the prospective elementary mathematics teachers noticed and how their noticing changed in an environment in which they discuss on video cases. To achieve this aim, we asked senior elementary mathematics prospective teachers to watch and discuss videos depicting real elementary mathematics classrooms.…

  8. DISSECTING OCD CIRCUITS: FROM ANIMAL MODELS TO TARGETED TREATMENTS.

    PubMed

    Ahmari, Susanne E; Dougherty, Darin D

    2015-08-01

    Obsessive-compulsive disorder (OCD) is a chronic, severe mental illness with up to 2-3% prevalence worldwide. In fact, OCD has been classified as one of the world's 10 leading causes of illness-related disability according to the World Health Organization, largely because of the chronic nature of disabling symptoms.([1]) Despite the severity and high prevalence of this chronic and disabling disorder, there is still relatively limited understanding of its pathophysiology. However, this is now rapidly changing due to development of powerful technologies that can be used to dissect the neural circuits underlying pathologic behaviors. In this article, we describe recent technical advances that have allowed neuroscientists to start identifying the circuits underlying complex repetitive behaviors using animal model systems. In addition, we review current surgical and stimulation-based treatments for OCD that target circuit dysfunction. Finally, we discuss how findings from animal models may be applied in the clinical arena to help inform and refine targeted brain stimulation-based treatment approaches. PMID:25952989

  9. Dissecting a complex chemical stress: chemogenomic profiling of plant hydrolysates

    PubMed Central

    Skerker, Jeffrey M; Leon, Dacia; Price, Morgan N; Mar, Jordan S; Tarjan, Daniel R; Wetmore, Kelly M; Deutschbauer, Adam M; Baumohl, Jason K; Bauer, Stefan; Ibáñez, Ana B; Mitchell, Valerie D; Wu, Cindy H; Hu, Ping; Hazen, Terry; Arkin, Adam P

    2013-01-01

    The efficient production of biofuels from cellulosic feedstocks will require the efficient fermentation of the sugars in hydrolyzed plant material. Unfortunately, plant hydrolysates also contain many compounds that inhibit microbial growth and fermentation. We used DNA-barcoded mutant libraries to identify genes that are important for hydrolysate tolerance in both Zymomonas mobilis (44 genes) and Saccharomyces cerevisiae (99 genes). Overexpression of a Z. mobilis tolerance gene of unknown function (ZMO1875) improved its specific ethanol productivity 2.4-fold in the presence of miscanthus hydrolysate. However, a mixture of 37 hydrolysate-derived inhibitors was not sufficient to explain the fitness profile of plant hydrolysate. To deconstruct the fitness profile of hydrolysate, we profiled the 37 inhibitors against a library of Z. mobilis mutants and we modeled fitness in hydrolysate as a mixture of fitness in its components. By examining outliers in this model, we identified methylglyoxal as a previously unknown component of hydrolysate. Our work provides a general strategy to dissect how microbes respond to a complex chemical stress and should enable further engineering of hydrolysate tolerance. PMID:23774757

  10. Cervical-artery dissections: predisposing factors, diagnosis, and outcome.

    PubMed

    Debette, Stéphanie; Leys, Didier

    2009-07-01

    Cervical-artery dissection (CAD) is a major cause of cerebral ischaemia in young adults and can lead to various clinical symptoms, some of which are benign (eg, headache, neck pain, Horner's syndrome, and cranial-nerve palsy), but most patients have a stroke or transient ischaemic attack. In addition to trauma to the neck, other risk factors have been suggested, such as infection, migraine, hyperhomocysteinaemia, and the 677TT genotype of the 5,10-methylenetetrahydrofolate reductase gene (MTHFR 677TT), although evidence is sparse. An underlying arteriopathy, which could in part be genetically determined, is believed to have a role in the development of CAD. Importantly, both research on and optimum management of CAD strongly rely on diagnostic accuracy. Although the functional outcome of CAD is good in most patients, socioprofessional effects can be important. Incidence of the disorder in the general population is underestimated. Mortality and short-term recurrence rates are low but possibly also underestimated. Further research is warranted to improve our understanding of the underlying pathophysiology, to assess the long-term outcome, and ultimately to provide treatment and prevention strategies. PMID:19539238

  11. Role of antisecretory agents for gastric endoscopic submucosal dissection.

    PubMed

    Fujishiro, Mitsuhiro; Chiu, Philip W Y; Wang, Hsui-Po

    2013-03-01

    Gastric endoscopic submucosal dissection (ESD) causes artificial gastric ulcers and there is no consensus regarding the optimal perioperative management in terms of prevention of intra- or postoperative bleeding and promotion of healing. Traditionally, 8-week administration of proton pump inhibitors (PPI) and mucosal protective agents were used in the same way as for peptic ulcer management. However, recent studies have revealed that prior use of PPI might reduce intraoperative bleeding or early-phase postoperative bleeding, and combination of histamine-2 receptor antagonist (H2RA), and second-look endoscopy might have a similar effect on postoperative bleeding to PPI. Additionally, the advantage of PPI over H2RA is not proven and the optimal duration of PPI may be shortened until 2 weeks when the deteriorating factors for ESD ulcer are excluded. Furthermore, mucosal protective agents may facilitate ulcer healing. Further studies are needed to determine the optimal treatment protocol before and after ESD for both prevention of bleeding complication and promotion of ulcer healing, by using available antisecretory agents and mucosal protective agents. PMID:23368844

  12. Molecular Dissection of the Checkpoint Kinase Hsl1p

    PubMed Central

    Crutchley, John; King, Kindra M.; Keaton, Mignon A.; Szkotnicki, Lee; Orlando, David A.; Zyla, Trevin R.; Bardes, Elaine S.G.

    2009-01-01

    Cell shape can influence cell behavior. In Saccharomyces cerevisiae, bud emergence can influence cell cycle progression via the morphogenesis checkpoint. This surveillance pathway ensures that mitosis always follows bud formation by linking degradation of the mitosis-inhibitory kinase Swe1p (Wee1) to successful bud emergence. A crucial component of this pathway is the checkpoint kinase Hsl1p, which is activated upon bud emergence and promotes Swe1p degradation. We have dissected the large nonkinase domain of Hsl1p by using evolutionary conservation as a guide, identifying regions important for Hsl1p localization, function, and regulation. An autoinhibitory motif restrains Hsl1p activity when it is not properly localized to the mother-bud neck. Hsl1p lacking this motif is active as a kinase regardless of the assembly state of cytoskeletal septin filaments. However, the active but delocalized Hsl1p cannot promote Swe1p down-regulation, indicating that localization is required for Hsl1p function as well as Hsl1p activation. We also show that the septin-mediated Hsl1p regulation via the novel motif operates in parallel to a previously identified Hsl1p activation pathway involving phosphorylation of the Hsl1p kinase domain. We suggest that Hsl1p responds to alterations in septin organization, which themselves occur in response to the local geometry of the cell cortex. PMID:19211841

  13. Zebrafish as a novel vertebrate model to dissect enterococcal pathogenesis.

    PubMed

    Prajsnar, Tomasz K; Renshaw, Stephen A; Ogryzko, Nikolay V; Foster, Simon J; Serror, Pascale; Mesnage, Stéphane

    2013-11-01

    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

  14. Pulse energy dependence of subcellular dissection by femtosecond laser pulses

    NASA Technical Reports Server (NTRS)

    Heisterkamp, A.; Maxwell, I. Z.; Mazur, E.; Underwood, J. M.; Nickerson, J. A.; Kumar, S.; Ingber, D. E.

    2005-01-01

    Precise dissection of cells with ultrashort laser pulses requires a clear understanding of how the onset and extent of ablation (i.e., the removal of material) depends on pulse energy. We carried out a systematic study of the energy dependence of the plasma-mediated ablation of fluorescently-labeled subcellular structures in the cytoskeleton and nuclei of fixed endothelial cells using femtosecond, near-infrared laser pulses focused through a high-numerical aperture objective lens (1.4 NA). We find that the energy threshold for photobleaching lies between 0.9 and 1.7 nJ. By comparing the changes in fluorescence with the actual material loss determined by electron microscopy, we find that the threshold for true material ablation is about 20% higher than the photobleaching threshold. This information makes it possible to use the fluorescence to determine the onset of true material ablation without resorting to electron microscopy. We confirm the precision of this technique by severing a single microtubule without disrupting the neighboring microtubules, less than 1 micrometer away. c2005 Optical Society of America.

  15. Dissection of complex protein dynamics in human thioredoxin

    PubMed Central

    Qiu, Weihong; Wang, Lijuan; Lu, Wenyun; Boechler, Amanda; Sanders, David A. R.; Zhong, Dongping

    2007-01-01

    We report our direct study of complex protein dynamics in human thioredoxin by dissecting into elementary processes and determining their relevant time scales. By combining site-directed mutagenesis with femtosecond spectroscopy, we have distinguished four partly time-overlapped dynamical processes at the active site of thioredoxin. Using intrinsic tryptophan as a molecular probe and from mutation studies, we ascertained the negligible contribution to solvation by protein sidechains and observed that the hydration dynamics at the active site occur in 0.47–0.67 and 10.8–13.2 ps. With reduced and oxidized states, we determined the electron-transfer quenching dynamics between excited tryptophan and a nearby disulfide bond in 10–17.5 ps for three mutants. A robust dynamical process in 95–114 ps, present in both redox states and all mutants regardless of neighboring charged, polar, and hydrophobic residues around the probe, is attributed to the charge transfer reaction with its adjacent peptide bond. Site-directed mutations also revealed the electronic quenching dynamics by an aspartate residue at a hydrogen bond distance in 275–615 ps. The local rotational dynamics determined by the measurement of anisotropy changes with time unraveled a relatively rigid local configuration but implies that the protein fluctuates on the time scale of longer than nanoseconds. These results elucidate the temporal evolution of hydrating water motions, electron-transfer reactions, and local protein fluctuations at the active site, and show continuously synergistic dynamics of biological function over wide time scales. PMID:17369362

  16. Dissecting the role of endothelial SURVIVIN ?Ex3 in angiogenesis

    PubMed Central

    Caldas, Hugo; Fangusaro, Jason R.; Boué, Daniel R.; Holloway, Michael P.; Altura, Rachel A.

    2007-01-01

    The identification of alternative splice variants of Survivin that possess distinct functions from those originally identified for the main Survivin isoform has greatly increased the complexity of our understanding of the role of Survivin in different cells. Previous functional studies of the Survivin splice variants have been performed almost exclusively in cancer cells. However, Survivin has increasingly been implicated in other normal physiologic and pathophysiologic processes, including angiogenesis. In this study, we dissect the involvement of Survivin ?Ex3 in angiogenesis. We show by confocal microscopy that a pool of endothelial Survivin ?Ex3 is localized to membrane ruffles. We also demonstrate that Survivin ?Ex3 is the Survivin splice variant responsible for modulating angiogenesis in vitro, in tube formation assays, and in vivo, in an in vivo angiogenesis assay. Our data indicate that Survivin ?Ex3 may regulate angiogenesis via several mechanisms including cell invasion, migration, and Rac1 activation. Our findings identify a novel pathway regulating angiogenesis through Survivin ?Ex3 and a novel mechanism for Rac1 activation during angiogenesis. In conclusion, our results provide new insights into the regulation of endothelial cell homeostasis and angiogenesis by the Survivin proteins. PMID:17038538

  17. Genetic dissection of the function of hindbrain axonal commissures.

    PubMed

    Renier, Nicolas; Schonewille, Martijn; Giraudet, Fabrice; Badura, Aleksandra; Tessier-Lavigne, Marc; Avan, Paul; De Zeeuw, Chris I; Chédotal, Alain

    2010-03-01

    In Bilateria, many axons cross the midline of the central nervous system, forming well-defined commissures. Whereas in mammals the functions of commissures in the forebrain and in the visual system are well established, functions at other axial levels are less clearly understood. Here, we have dissected the function of several hindbrain commissures using genetic methods. By taking advantage of multiple Cre transgenic lines, we have induced site-specific deletions of the Robo3 receptor. These lines developed with the disruption of specific commissures in the sensory, motor, and sensorimotor systems, resulting in severe and permanent functional deficits. We show that mice with severely reduced commissures in rhombomeres 5 and 3 have abnormal lateral eye movements and auditory brainstem responses, respectively, whereas mice with a primarily uncrossed climbing fiber/Purkinje cell projection are strongly ataxic. Surprisingly, although rerouted axons remain ipsilateral, they still project to their appropriate neuronal targets. Moreover, some Cre;Robo3 lines represent potential models that can be used to study human syndromes, including horizontal gaze palsy with progressive scoliosis (HGPPS). To our knowledge, this study is one of the first to link defects in commissural axon guidance with specific cellular and behavioral phenotypes. PMID:20231872

  18. Dissecting the role of infections in atopic dermatitis.

    PubMed

    Biedermann, Tilo

    2006-01-01

    In patients with atopic dermatitis the skin is highly susceptible to infection by bacteria, fungi and viruses. Increasing knowledge about the complex immune network that regulates anti-microbial responses has helped to dissect further the role of infections in atopic dermatitis. Conserved patterns of microbes are recognized by the innate immune system, which mediates microbicidal activity, either directly or through inflammatory responses. New evidence suggests that components of the innate immune system, such as anti-microbial peptides, humoural lectins, nucleotide-binding oligomerization domain-containing (NOD) proteins, and Toll-like receptors not only protect from microbial invasion, but contribute to skin inflammation in atopic dermatitis. In addition, atopic patients tend to develop Th2-dominated immune responses that weaken anti-microbial immunity. This impairment of an appropriate anti-microbial defence compounded by amplified microbe-driven innate and adaptive immune responses leads to the vicious circle of skin inflammation. New microbial management in atopic dermatitis will foster a well-balanced microbial flora, which establishes natural defence mechanisms to maintain immuno-surveillance of the skin. In addition to anti-microbial therapies, other innate immune stimuli may suppress pro-inflammatory signals and help to break the vicious circle of cutaneous inflammation. To elucidate further these different interactions of the skin immune system and microbes in atopic dermatitis, clinical studies and further efforts in basic research are needed. PMID:16648910

  19. Dissecting specific and global transcriptional regulation of bacterial gene expression

    PubMed Central

    Gerosa, Luca; Kochanowski, Karl; Heinemann, Matthias; Sauer, Uwe

    2013-01-01

    Gene expression is regulated by specific transcriptional circuits but also by the global expression machinery as a function of growth. Simultaneous specific and global regulation thus constitutes an additional—but often neglected—layer of complexity in gene expression. Here, we develop an experimental-computational approach to dissect specific and global regulation in the bacterium Escherichia coli. By using fluorescent promoter reporters, we show that global regulation is growth rate dependent not only during steady state but also during dynamic changes in growth rate and can be quantified through two promoter-specific parameters. By applying our approach to arginine biosynthesis, we obtain a quantitative understanding of both specific and global regulation that allows accurate prediction of the temporal response to simultaneous perturbations in arginine availability and growth rate. We thereby uncover two principles of joint regulation: (i) specific regulation by repression dominates the transcriptional response during metabolic steady states, largely repressing the biosynthesis genes even when biosynthesis is required and (ii) global regulation sets the maximum promoter activity that is exploited during the transition between steady states. PMID:23591774

  20. Dissecting Social Cell Biology and Tumors Using Drosophila Genetics

    PubMed Central

    Pastor-Pareja, José Carlos; Xu, Tian

    2014-01-01

    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

  1. Posterior subscapular dissection: An improved approach to the brachial plexus for human anatomy students.

    PubMed

    Hager, Shaun; Backus, Timothy Charles; Futterman, Bennett; Solounias, Nikos; Mihlbachler, Matthew C

    2014-05-01

    Students of human anatomy are required to understand the brachial plexus, from the proximal roots extending from spinal nerves C5 through T1, to the distal-most branches that innervate the shoulder and upper limb. However, in human cadaver dissection labs, students are often instructed to dissect the brachial plexus using an antero-axillary approach that incompletely exposes the brachial plexus. This approach readily exposes the distal segments of the brachial plexus but exposure of proximal and posterior segments require extensive dissection of neck and shoulder structures. Therefore, the proximal and posterior segments of the brachial plexus, including the roots, trunks, divisions, posterior cord and proximally branching peripheral nerves often remain unobserved during study of the cadaveric shoulder and brachial plexus. Here we introduce a subscapular approach that exposes the entire brachial plexus, with minimal amount of dissection or destruction of surrounding structures. Lateral retraction of the scapula reveals the entire length of the brachial plexus in the subscapular space, exposing the brachial plexus roots and other proximal segments. Combining the subscapular approach with the traditional antero-axillary approach allows students to observe the cadaveric brachial plexus in its entirety. Exposure of the brachial dissection in the subscapular space requires little time and is easily incorporated into a preexisting anatomy lab curriculum without scheduling additional time for dissection. PMID:24698357

  2. Treatment of Intra- and Extracranial Arterial Dissections Using Stents and Embolization

    SciTech Connect

    Joo, Jin Yang [Yonsei University College of Medicine, Department of Neurosurgery (Korea, Republic of); Ahn, Jung Yong, E-mail: jyahn@cha.ac.kr; Chung, Young Sun; Han, In Bo; Chung, Sang Sup [Pochon CHA Medical University, Department of Neurosurgery (Korea, Republic of); Yoon, Pyeong Ho; Kim, Sang Heum [Pochon CHA Medical University, Department of Radiology (Korea, Republic of); Choi, Eun Wan [National Police Hospital, Department of Radiology (Korea, Republic of)

    2005-06-15

    Purpose. To evaluate the safety and efficacy of stent placement for extracranial and intracranial arterial dissections. Methods. Eighteen patients underwent endovascular treatment of carotid and vertebral dissections using intraluminal stent placement. Five patients with arterial dissection were treated, 2 using one insertion of a single stent and 3 using placement of two stents. Patients with a dissecting aneurysm were treated as follows: 7 patients with insertion of one stent, 4 with placement of two stents, and 2 by stent-assisted Guglielmi detachable coil embolization. In the 18 patients in whom stenting was attempted, the overall success in reaching the target lesion was 94.4%. Of the 17 patients treated with stents, stent release and positioning were considered optimal in 16 (94%) and suboptimal in one (6%). In patients who underwent a successful procedure, all parent arteries were preserved. There were no instances of postprocedural ischemic attacks, new neurologic deficits, or new minor or major strokes prior to patient discharge. In follow up, all patients were assessed, using the modified Rankin scale, as functionally improved or of stable clinical status. The reduction in dissection-induced stenosis or pseudoaneurysm, the patency rate obtained at follow-up, and the lack of strokes (ischemic or hemorrhagic) suggest that stent placement offers a viable alternative to complex surgical bypass or reconstructive procedures. The long-term efficacy and durability of stent placement for arterial dissection remain to be determined in a larger series.

  3. Thoracic endovascular aortic repair versus open surgery for type-B chronic dissection.

    PubMed

    Roselli, Eric E

    2015-02-01

    An aging population, increased awareness, high-resolution imaging, and improving access to care all mean that more people are being diagnosed with acute aortic dissection. A better understanding of the role of initial medical therapy, improved surgical techniques, and the addition of endovascular approaches to the treatment algorithm, have resulted in more patients surviving the acute phase of disease. During the chronic phase, patients with residual dissection are challenged by the competing risks of reoperation or death. Open repair for chronic type-B dissection can be performed safely but is a relatively morbid operation. For this reason, surgery is often postponed until patients develop very late complications. Despite encouraging results for thoracic endovascular aortic repair of acute type-B dissection, chronic type-B dissection poses unique challenges that make application of endovascular technology more difficult. As our understanding of the disease and its natural history evolves, the ways in which these 2 methods of treatment complement each other need to be better understood. The benefits and limitations of each therapy, and how and when to apply each in the setting of chronic distal dissection, are discussed. PMID:25726076

  4. [Arterial vascularization and innervation of the lacrimal gland. Apropos of 100 dissections].

    PubMed

    Ducasse, A; Segal, A; el Ladki, S; Flament, J B

    1990-01-01

    The authors report the different types of arterial vascularization and lacrimal gland innervation, noticed in 100 human orbits with arterial latex injected. The lacrimal artery may be unique, arising either from the ophtalmic artery, the most frequent case (vascularization of type I) or from the external carotid system (vascularization of type II): it is possible that 2 lacrimal arteries are simultaneously present, originating from the 2 carotid system (vascularization of type III). The lacrimal gland is innerved by the lacrimal nerve and by one or several nervous branches, originated from the maxillary nerve. 3 possibilities can be found: a zigomatic branch from the maxillary nerve makes a preglandular anastomosis with the lacrimal nerve; a real lacrimal loop, which may form either an intraglandular anastomosis or be completely independant of the lacrimal nerve. Sometimes, several zigomatic rami do exist. These different variations and their frequency are analyzed and referred to the literature. PMID:2250931

  5. Unilateral cerebellar and brain stem hypoplasia in a child with a postnatal diagnosis of dissecting aneurysm in basilar artery.

    PubMed

    Akkas-Yazici, Sinem; Benbir, Gulcin; Kocer, Naci; Yalcinkaya, Cengiz

    2014-12-01

    Cerebellum is highly vulnerable in the prenatal period. Increasing experience with fetal imaging studies has demonstrated that unilateral cerebellar hypoplasia (UCH) is mainly prenatally acquired, representing disruption rather than a true malformation. Here, we report the case of a 17-month-old boy presented with a sudden onset of abnormal eye movements, who was diagnosed during routine fetal screening with UCH and brain stem hypoplasia and suffered from cerebral palsy; however, no posterior arterial system pathology was detected on cranial magnetic resonance images at that time. Following this acute event, diagnostic neuroradiological interventions revealed a dissecting aneurysm with a saccular component in midbasilar arterial segment and hypoplastic left posterior cerebral artery, which may support the ischemic disruptive mechanism in the development of prenatally detected UCH in this child. The pathogenetic mechanisms for cerebellar disruption are certainly multifactorial in origin, although ischemic arterial etiologies were often undervalued. PMID:25098833

  6. Delayed Visceral and Spinal Cord Malperfusion after Axillo-Bifemoral Bypass for Complicated Acute Type B Aortic Dissection

    PubMed Central

    Tomioka, Hideyuki; Katahira, Seiichiro; Hoshino, Takeshi; Hanzawa, Kazuhiko

    2014-01-01

    We describe a successfully treated case of acute type B aortic dissection complicated with lower extremity, visceral, and spinal cord malperfusion. To restore perfusion to both lower extremities, we performed an emergency right axillo-bifemoral bypass. Furthermore, we performed total arch replacement, including primary entry closure, because of delayed visceral organ ischemia. Unexpectedly, delayed paraplegia occurred after hospital discharge; however, the patient recovered without any neurologic sequelae after early introduction of hyperbaric oxygen therapy. Because another episode of organ malperfusion in the long term cannot be anticipated, and even though the previous organ malperfusion episode was treated successfully, close observation is mandatory for detecting clinical manifestations in combination with the availability of imaging modalities. PMID:25298840

  7. Dissecting the Machinery That Introduces Disulfide Bonds in Pseudomonas aeruginosa

    PubMed Central

    Arts, Isabelle S.; Ball, Geneviève; Leverrier, Pauline; Garvis, Steven; Nicolaes, Valérie; Vertommen, Didier; Ize, Bérengère; Tamu Dufe, Veronica; Messens, Joris; Voulhoux, Romé; Collet, Jean-François

    2013-01-01

    ABSTRACT Disulfide bond formation is required for the folding of many bacterial virulence factors. However, whereas the Escherichia coli disulfide bond-forming system is well characterized, not much is known on the pathways that oxidatively fold proteins in pathogenic bacteria. Here, we report the detailed unraveling of the pathway that introduces disulfide bonds in the periplasm of the human pathogen Pseudomonas aeruginosa. The genome of P. aeruginosa uniquely encodes two DsbA proteins (P. aeruginosa DsbA1 [PaDsbA1] and PaDsbA2) and two DsbB proteins (PaDsbB1 and PaDsbB2). We found that PaDsbA1, the primary donor of disulfide bonds to secreted proteins, is maintained oxidized in vivo by both PaDsbB1 and PaDsbB2. In vitro reconstitution of the pathway confirms that both PaDsbB1 and PaDsbB2 shuttle electrons from PaDsbA1 to membrane-bound quinones. Accordingly, deletion of both P. aeruginosa dsbB1 (PadsbB1) and PadsbB2 is required to prevent the folding of several P. aeruginosa virulence factors and to lead to a significant decrease in pathogenicity. Using a high-throughput proteomic approach, we also analyzed the impact of PadsbA1 deletion on the global periplasmic proteome of P. aeruginosa, which allowed us to identify more than 20 new potential substrates of this major oxidoreductase. Finally, we report the biochemical and structural characterization of PaDsbA2, a highly oxidizing oxidoreductase, which seems to be expressed under specific conditions. By fully dissecting the machinery that introduces disulfide bonds in P. aeruginosa, our work opens the way to the design of novel antibacterial molecules able to disarm this pathogen by preventing the proper assembly of its arsenal of virulence factors. PMID:24327342

  8. Building a virtual reality temporal bone dissection simulator.

    PubMed

    Kuppersmith, R B; Johnston, R; Moreau, D; Loftin, R B; Jenkins, H

    1997-01-01

    The temporal bone is one of seven bones that comprise the human skull, and has an intimate relationship with many vital structures. Anatomically, its three-dimensional relationships make it one of the most challenging areas for surgeons to understand and master. In addition, the temporal bone contains minute structures that are among the most sophisticated and delicate in the human body. These structures include the cochlea and vestibular organs, which are responsible for hearing and balance; the middle ear, including the ossicles, which conduct acoustic energy to the cochlea; and the facial nerve, which is responsible for controlling the muscles of facial expression, and contributes to the sensation of taste. Additionally, the temporal bone forms a major portion of the skull base, and has intimate relationships to vital structures including the carotid artery, jugular vein, cerebral cortex, brainstem, and cranial nerves. Surgical procedures performed on the temporal bone include: procedures to eradicate chronic and acute infections; procedures to remove malignant and benign tumors within the temporal bone, from the skull base, or from the posterior cranial fossa; procedures to restore the hearing mechanism; procedures to eliminate balance disorders; and procedures to correct congenital anomalies. For surgeons-in-training, and even surgeons-in-practice, mastery of the anatomy of the temporal bone and the many complex approaches necessary to treat patients takes years of focused endeavor. This is typically accomplished through the dissection of human cadaver temporal bones, which are scarce, and require a dedicated laboratory facility. Efforts are currently underway to develop a realistic simulator for temporal bone procedures. Users immersed in the simulator will interact with a three-dimensional temporal bone, derived from patient-specific data, using a haptic interface to simulate traditional surgical procedures. Feedback from experts in otologic surgery will be built into the system for additional instruction. This presentation will include an overview of the application being developed, a report of its current state of development, and plans for the future. PMID:10168915

  9. Dissecting structural and electronic effects in inducible nitric oxide synthase.

    PubMed

    Hannibal, Luciana; Page, Richard C; Haque, Mohammad Mahfuzul; Bolisetty, Karthik; Yu, Zhihao; Misra, Saurav; Stuehr, Dennis J

    2015-04-01

    Nitric oxide synthases (NOSs) are haem-thiolate enzymes that catalyse the conversion of L-arginine (L-Arg) into NO and citrulline. Inducible NOS (iNOS) is responsible for delivery of NO in response to stressors during inflammation. The catalytic performance of iNOS is proposed to rely mainly on the haem midpoint potential and the ability of the substrate L-Arg to provide a hydrogen bond for oxygen activation (O-O scission). We present a study of native iNOS compared with iNOS-mesohaem, and investigate the formation of a low-spin ferric haem-aquo or -hydroxo species (P) in iNOS mutant W188H substituted with mesohaem. iNOS-mesohaem and W188H-mesohaem were stable and dimeric, and presented substrate-binding affinities comparable to those of their native counterparts. Single turnover reactions catalysed by iNOSoxy with L-Arg (first reaction step) or N-hydroxy-L-arginine (second reaction step) showed that mesohaem substitution triggered higher rates of Fe(II)O? conversion and altered other key kinetic parameters. We elucidated the first crystal structure of a NOS substituted with mesohaem and found essentially identical features compared with the structure of iNOS carrying native haem. This facilitated the dissection of structural and electronic effects. Mesohaem substitution substantially reduced the build-up of species P in W188H iNOS during catalysis, thus increasing its proficiency towards NO synthesis. The marked structural similarities of iNOSoxy containing native haem or mesohaem indicate that the kinetic behaviour observed in mesohaem-substituted iNOS is most heavily influenced by electronic effects rather than structural alterations. PMID:25608846

  10. Dissection of a metastatic gene expression signature into distinct components

    PubMed Central

    Roepman, Paul; de Koning, Erica; van Leenen, Dik; de Weger, Roel A; Kummer, J Alain; Slootweg, Piet J; Holstege, Frank CP

    2006-01-01

    Background Metastasis, the process whereby cancer cells spread, is in part caused by an incompletely understood interplay between cancer cells and the surrounding stroma. Gene expression studies typically analyze samples containing tumor cells and stroma. Samples with less than 50% tumor cells are generally excluded, thereby reducing the number of patients that can benefit from clinically relevant signatures. Results For a head-neck squamous cell carcinoma (HNSCC) primary tumor expression signature that predicts the presence of lymph node metastasis, we first show that reduced proportions of tumor cells results in decreased predictive accuracy. To determine the influence of stroma on the predictive signature and to investigate the interaction between tumor cells and the surrounding microenvironment, we used laser capture microdissection to divide the metastatic signature into six distinct components based on tumor versus stroma expression and on association with the metastatic phenotype. A strikingly skewed distribution of metastasis associated genes is revealed. Conclusion Dissection of predictive signatures into different components has implications for design of expression signatures and for our understanding of the metastatic process. Compared to primary tumors that have not formed metastases, primary HNSCC tumors that have metastasized are characterized by predominant down-regulation of tumor cell specific genes and exclusive up-regulation of stromal cell specific genes. The skewed distribution agrees with poor signature performance on samples that contain less than 50% tumor cells. Methods for reducing tumor composition bias that lead to greater predictive accuracy and an increase in the types of samples that can be included are presented. PMID:17156469

  11. Dissecting gene expression at the blood-brain barrier

    PubMed Central

    Huntley, Melanie A.; Bien-Ly, Nga; Daneman, Richard; Watts, Ryan J.

    2014-01-01

    The availability of genome-wide expression data for the blood-brain barrier is an invaluable resource that has recently enabled the discovery of several genes and pathways involved in the development and maintenance of the blood-brain barrier, particularly in rodent models. The broad distribution of published data sets represents a viable starting point for the molecular dissection of the blood-brain barrier and will further direct the discovery of novel mechanisms of blood-brain barrier formation and function. Technical advances in purifying brain endothelial cells, the key cell that forms the critical barrier, have allowed for greater specificity in gene expression comparisons with other central nervous system cell types, and more systematic characterizations of the molecular composition of the blood-brain barrier. Nevertheless, our understanding of how the blood-brain barrier changes during aging and disease is underrepresented. Blood-brain barrier data sets from a wider range of experimental paradigms and species, including invertebrates and primates, would be invaluable for investigating the function and evolution of the blood-brain barrier. Newer technologies in gene expression profiling, such as RNA-sequencing, now allow for finer resolution of transcriptomic changes, including isoform specificity and RNA-editing. As our field continues to utilize more advanced expression profiling in its ongoing efforts to elucidate the blood-brain barrier, including in disease and drug delivery, we will continue to see rapid advances in our understanding of the molecular mediators of barrier biology. We predict that the recently published data sets, combined with forthcoming genomic and proteomic blood-brain barrier data sets, will continue to fuel the molecular genetic revolution of blood-brain barrier biology. PMID:25414634

  12. Predicting flow in aortic dissection: comparison of computational model with PC-MRI velocity measurements.

    PubMed

    Cheng, Z; Juli, C; Wood, N B; Gibbs, R G J; Xu, X Y

    2014-09-01

    Aortic dissection is a life-threatening process in which the weakened wall develops a tear, causing separation of wall layers. The dissected layers separate the original true aortic lumen and a newly created false lumen. If untreated, the condition can be fatal. Flow rate in the false lumen is a key feature for false lumen patency, which has been regarded as one of the most important predictors of adverse early and later outcomes. Detailed flow analysis in the dissected aorta may assist vascular surgeons in making treatment decisions, but computational models to simulate flow in aortic dissections often involve several assumptions. The purpose of this study is to assess the computational models adopted in previous studies by comparison with in vivo velocity data obtained by means of phase-contrast magnetic resonance imaging (PC-MRI). Aortic dissection geometry was reconstructed from computed tomography (CT) images, while PC-MRI velocity data were used to define inflow conditions and to provide distal velocity components for comparison with the simulation results. The computational fluid dynamics (CFD) simulation incorporated a laminar-turbulent transition model, which is necessary for adequate flow simulation in aortic conditions. Velocity contours from PC-MRI and CFD in the two lumens at the distal plane were compared at four representative time points in the pulse cycle. The computational model successfully captured the complex regions of flow reversal and recirculation qualitatively, although quantitative differences exist. With a rigid wall assumption and exclusion of arch branches, the CFD model over-predicted the false lumen flow rate by 25% at peak systole. Nevertheless, an overall good agreement was achieved, confirming the physiological relevance and validity of the computational model for type B aortic dissection with a relatively stiff dissection flap. PMID:25070022

  13. A mill based instrument and software system for dissecting slide-mounted tissue that provides digital guidance and documentation

    PubMed Central

    2013-01-01

    Background Dissection of specific Areas Of Interest (AOIs) of slide-mounted tumor samples is often used to enrich for cancer cells in order to generate better signal to noise ratios in subsequent biochemical characterization. Most clinical laboratories utilize manual dissection for practical reasons and to avoid the expense and difficulties of laser microdissection systems. Unfortunately, manual methods often lack resolution and process documentation. The goal of this project was to design a dissection system for slide-mounted tissue with better precision than manual methods that also provides digital image guidance and electronic process documentation. Methods An instrument that is essentially a micro tissue mill was developed. It employs a specialized disposable mill bit that simultaneously dispenses liquid, cuts tissue from the slide surface, and aspirates the liquid along with the displaced tissue fragments. A software package was also developed that is capable of transferring digitally annotated AOIs between images of serially cut tissue sections to guide dissection and generate an electronic record of the process. Results The performance of this “meso” dissection system was tested using post dissection visual examination for resolution and accuracy, fluorescence based DNA quantitation for recovery efficiency, and dissection of closely situated mouse-human tissue sections followed by PCR amplification for purity determination. The minimum resolution is a dissected circle smaller than 200 microns in diameter, edge dissection accuracy is tighter than 100 microns, recovery efficiency appears greater than 95%, and recovery purity is greater than 99% relative to a different tissue located 100 microns from the dissection boundary. The system can dissect from both paraffinized and deparaffinized FFPE tissue sections that are mounted on plain glass slides, and it is compatible with DNA, RNA, and protein isolation. Conclusions The mesodissection system is an effective alternative to manual dissection methods and is applicable for biomarker analysis of anatomical pathology samples, where enrichment of AOIs from the tissue section is helpful, but pure cell populations are not required. PMID:24188417

  14. 75 FR 56101 - Lauryl Sulfate Salts Registration Review Final Decision; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-15

    ...EPA-HQ-OPP-2009-0727; FRL-8839-6] Lauryl Sulfate Salts Registration Review Final Decision; Notice of...review decision for the pesticide, lauryl sulfate salts (also known as sodium lauryl salts), case 4061. Registration review is...

  15. 20 CFR 702.212 - Notice; when given; when given for certain occupational diseases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...For other than occupational diseases described in (b), the...the case of an occupational disease which does not immediately...between the employment, the disease and the death or disability...purposes of these occupational diseases, therefore, the notice...

  16. 37 CFR 211.6 - Methods of affixation and placement of mask work notice.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...is generally known. (c) Methods of affixation and placement of the notice. In the case of a mask work fixed in a semiconductor chip product, the following locations are acceptable: (1) A gummed or other label securely affixed or imprinted...

  17. 37 CFR 211.6 - Methods of affixation and placement of mask work notice.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...is generally known. (c) Methods of affixation and placement of the notice. In the case of a mask work fixed in a semiconductor chip product, the following locations are acceptable: (1) A gummed or other label securely affixed or imprinted...

  18. 77 FR 73456 - Notice of Intent To Grant Exclusive Patent License; Fiber Optic Sensor Systems Technology...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ...Grant Exclusive Patent License; Fiber Optic Sensor Systems Technology Corporation...notice of its intent to grant to Fiber Optic Sensor Systems Technology Corporation...020,354: Intensity Modulated Fiber Optic Pressure Sensor, Navy Case...

  19. 75 FR 34988 - Notice of Intent To Grant Exclusive Patent License; Fiber Optic Sensor Systems Technology...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ...Grant Exclusive Patent License; Fiber Optic Sensor Systems Technology Corporation...notice of its intent to grant to Fiber Optic Sensor Systems Technology Corporation...S. Patent No. 7,149,374: Fiber Optic Pressure Sensor, Navy Case...

  20. Patterns of expression of fibrinolytic genes and matrix metalloproteinase-9 in dissecting aortic aneurysms.

    PubMed Central

    Schneiderman, J.; Bordin, G. M.; Adar, R.; Smolinsky, A.; Seiffert, D.; Engelberg, I.; Dilley, R. B.; Thinnes, T.; Loskutoff, D. J.

    1998-01-01

    Although extensive tissue remodeling occurs during the various phases of aortic dissection, the underlying proteinases remain to be identified. Matrix metalloproteinase-9 (MMP-9) and components of the fibrinolytic system have been implicated in numerous tissue remodeling events and were therefore analyzed in surgical specimens of acute (n = 9), subacute (n = 4), and chronic (n = 7) aortic dissection by in situ hybridization. In the acute phase, intense plasminogen activator inhibitor 1 (PAI-1) gene expression was apparent in areas interfacing the dissecting hematoma, but no tissue-type PA (t-PA), urokinase-type PA (u-PA), or MMP-9 mRNAs were detected. Although PAI-1 mRNA was still present in the subacute phase, t-PA, u-PA, and MMP-9 mRNAs were now obvious, with PA gene expression co-localizing with areas of PAI-1 gene expression. In the chronic phase, PAI-1 mRNA was demonstrated around erythrocyte extravasations and surrounding bands of medial degeneration. However, there was little expression of PAs in these areas, and no MMP-9 was detected. Thus, fibrinolytic genes and MMP-9 are differentially expressed during the progression of aortic dissections. The kinetics of expression are consistent with acute fibrinolytic shutdown in response to the initial injury, a secondary subacute phase with active proteolysis, and finally, a chronic hypofibrinolytic state. Extensive neovascularization in the chronic phase may further reduce the physical stability of the dissected wall. Images Figure 1 Figure 2 Figure 3 PMID:9502412

  1. Connective tissue anomalies in patients with spontaneous cervical artery dissection

    PubMed Central

    Giossi, Alessia; Ritelli, Marco; Costa, Paolo; Morotti, Andrea; Poli, Loris; Del Zotto, Elisabetta; Volonghi, Irene; Chiarelli, Nicola; Gamba, Massimo; Bovi, Paolo; Tomelleri, Giampaolo; Carletti, Monica; Checcarelli, Nicoletta; Meneghetti, Giorgio; Morra, Michele; Chinaglia, Mauro; De Giuli, Valeria; Colombi, Marina; Padovani, Alessandro

    2014-01-01

    Objective: To investigate the prevalence of connective tissue abnormalities in patients with spontaneous cervical artery dissections (sCeAD). Methods: We systematically assessed clinically detectable signs of connective tissue aberration in a series of consecutive patients with sCeAD and of age- and sex-matched patients with ischemic stroke unrelated to CeAD (non-CeAD IS) by a standard examination protocol including 68 items, and performed extensive molecular investigation for hereditary connective tissue disorders in all patients with sCeAD. Results: The study group included 84 patients with sCeAD (mean age, 44.5 ± 7.8 years; 66.7% men) and 84 patients with non-CeAD IS. None of the patients with sCeAD met clinical or molecular diagnostic criteria for established hereditary connective tissue disorder. Connective tissue abnormalities were detected more frequently in the group of patients with sCeAD than in the group of those with non-CeAD IS (mean number of pathologic findings, 4.5 ± 3.5 vs 1.9 ± 2.3; p < 0.001). Eighty-one patients (96.4%) in the sCeAD group had at least one detectable sign compared with 55 patients (66.7%) in the group with non-CeAD IS (p < 0.001). Skeletal, ocular, and skin abnormalities, as well as craniofacial dysmorphisms, were the clinical signs more strongly associated with sCeAD. Signs suggesting connective tissue abnormality were also more frequently represented in patients with sCeAD than in patients with traumatic CeAD (28.6%, p < 0.001; mean number of pathologic findings, 1.7 ± 3.7, p = 0.045). Conclusions: Connective tissue abnormalities are frequent in patients with sCeAD. This reinforces the hypothesis that systemic aberrations of the connective tissue might be implicated in the pathogenesis of the disease. PMID:25355826

  2. In-hospital mortality and three-year survival after repaired acute type A aortic dissection

    PubMed Central

    Aalberts, J.J.J.; Boonstra, P.W.; van den Berg, M.P.; Waterbolk, T.W.

    2009-01-01

    Background. The results of acute type A dissection (AAD) surgery in the Netherlands are largely unknown, as was recently stated in a report by the Health Council of the Netherlands. In order to gain more insight into the Dutch situation we investigated predictors of in-hospital mortality of surgically treated AAD patients and assessed threeyear survival. Methods. 104 consecutive patients undergoing surgery for AAD in a 16-year period (1990–2006) were evaluated. Preoperative and intraoperative variables were analysed to identify predictors of early mortality. Results. Preoperative malperfusion (limb ischaemia or mesenteric ischaemia) was present in 15.4%, shock in 18.3%, and 6.7% were operated under cardiac massage. Marfan syndrome was present in four patients and four patients had a bicuspid aortic valve. In-hospital mortality was 22.1%. Seven patients died intraoperatively; other causes of inhospital mortality were major brain damage in ten patients, multiple organ failure in three patients, low cardiac output in two patients and sudden cardiac death in one patient. Multivariate logistic regression revealed preoperative malperfusion (p=0.004) to be the only independent predictor of in-hospital mortality. Three-year survival was 68.8±4.7% (including hospital mortality). Hospital survivors had a three-year survival of 88.3±3.9%. Conclusion. In-hospital mortality of our patients (22.1%) is comparable with the results of larger case series published in the literature. Prognosis after successful surgical treatment is relatively good with a three-year survival of 88.3% in our series. (Neth Heart J 2009;17:226-31.19789684) PMID:19789684

  3. Inferior myocardial infarction secondary to aortic dissection associated with bicuspid aortic valve

    PubMed Central

    Cai, Jingjing; Cao, Yu; Yuan, Hong; Yang, Kan; Zhu, Yuan-Shan

    2012-01-01

    Aortic dissection (AD) is a life-threatening condition and may present with symptoms which mimic myocardial infarction, leading to misdiagnosis and inappropriate use of anticoagulant and thrombolytic therapy. A 40-year-old woman with no prior history presented in our emergency department with sudden chest pain. Electrocardiography (ECG) showed a ST-segment elevation in leads II, III and avF, suggesting an acute inferior myocardial infarction. The patient was given anticoagulation and antiplatelet treatment. Coronary angiography, transthoracic echocardiography and computed tomography were performed. The patient was diagnosed with DeBakey I aortic dissection extending from ascending aorta to iliac artery, and associated with bicuspid aortic valve.Surgical treatments with a replacement of the ascending aorta, aortic valve replacement and coronary artery bypass grafting were successfully performed. Early imaging examination, if possible, might assist the diagnosis and guide the management of this disease. The condition of myocardial infarction secondary to aortic dissection is discussed. PMID:22629034

  4. Is extended selective supraomohyoid neck dissection indicated for treatment of oral cancer with clinically negative neck?

    PubMed

    Ferlito, A; Mannara, G M; Rinaldo, A; Politi, M; Robiony, M; Costa, F

    2000-10-01

    Oral cavity tumors may develop occult metastases to the cervical lymph nodes. Current imaging techniques and routine histopathologic methods may fail to detect lymph node micrometastases, but the surgeon has to electively dissect a neck at risk of developing clinical disease. Supraomohyoid neck dissection has been the elective surgery for treating a clinically negative neck in patients with oral cavity primaries. A literature review revealed that level IV nodes can be significantly affected by occult disease with and without metastases in level I-III lymph nodes. This means that level IV nodes have to be included in the supraomohyoid neck dissection, resulting in a more extensive surgical procedure to ensure a margin of oncological safety. PMID:11132709

  5. Resected gastric cancer with D2 dissection: advances in adjuvant chemoradiotherapy and radiotherapy techniques.

    PubMed

    Wu, Qiang; Li, Guangjun; Xu, Feng

    2015-06-01

    Surgery is the main treatment option for locally advanced gastric cancer. D2 dissection has been recommended worldwide as standard lymphadenectomy for resectable gastric cancer. Furthermore, the role of peri- or postoperative chemotherapy for D2-dissected gastric cancer has been established in both Western and European countries. It has been disputed whether adding radiotherapy to chemotherapy could further benefit those patients. Until recently, studies from Korea and China may have made it clear. In North America, however, the INT-0116 trial does not rule out that chemoradiotherapy is effective in patients with D2 dissection, but the ongoing CRITICS trial will, hopefully, clarify this. In addition, literature published in the past decade supports the theory that improved radiotherapy techniques are likely to accurately deliver radiation dose and significantly reduce radiation toxicity. Finally, the status of E2F-1 and HER-2 may be associated with efficacy of radiotherapy based on retrospective studies. PMID:26004039

  6. Muscular Variations During Axillary Dissection: A Clinical Study in Fifty Patients

    PubMed Central

    Upasna; Kumar, Ashwani; Singh, Bimaljot; Kaushal, Subhash

    2015-01-01

    Aim: The present study was conducted to detect the musculature variations during axillary dissection for breast cancer surgery. Methods: The anatomy of axilla regarding muscular variations was studied in 50 patients who had an axillary dissection for the staging and treatment of invasive primary breast cancer over one year. Results: In a period of one year, two patients (4%) with axillary arch and one patient (2%) with absent pectoralis major and minor muscles among fifty patients undergoing axillary surgery for breast cancer were identified. Conclusions: Axillary arch when present should always be identified and formally divided to allow adequate exposure of axillary contents, in order to achieve a complete lymphatic dissection. Complete absence of pectoralis major and minor muscles precludes the insertion of breast implants and worsens the prognosis of breast cancer. PMID:25838770

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

    PubMed Central

    Badel, Pierre; Avril, Stéphane; Sutton, Michael A.; Lessner, Susan M.

    2014-01-01

    Balloon angioplasty is a standard clinical treatment for symptomatic coronary artery disease. In this procedure, controlled damage is applied intraluminally to the wall of a stenotic artery. Dissection of the coronary artery is a commonly observed clinical complication of angioplasty; however, not all dissections can be detected angioscopically. This work focuses on studying the dissection mechanisms triggered during the early stages of angioplasty in an atherosclerotic coronary artery, addressing the problem by means of a parametric study based on a simplified finite element model and cohesive interface modeling. Our results emphasize the presence of several damage mechanisms, at different locations, that are triggered near the very beginning of the process and evolve competitively, depending on both geometry and material properties of the atherosclerotic vessel. Small-scale damage was evidenced, which would not be detectable by angiography or intravascular ultrasound, but could potentially be sufficient to stimulate smooth muscle cell activation, promoting late-onset complications such as restenosis. PMID:24480707

  8. Minimally invasive video-assisted functional lateral neck dissection for metastatic papillary thyroid carcinoma.

    PubMed

    Lombardi, Celestino Pio; Raffaelli, Marco; Princi, Pietro; De Crea, Carmela; Bellantone, Rocco

    2007-01-01

    Functional lateral neck dissection requires a large incision providing adequate exposure of the surgical field. We evaluated the feasibility of minimally invasive video-assisted functional lateral neck dissection (VALNED) in patients with papillary thyroid carcinoma (PTC). Low-risk PTC patients with lateral neck metastases <2 cm, in absence of any evidence of great vessels involvement, were considered eligible. After accomplishing total thyroidectomy and central neck clearance, dissection was performed under endoscopic vision by using a technique very similar to conventional surgery through the single 4-cm skin incision used for thyroidectomy. Two patients were selected: 1 underwent bilateral and 1 unilateral VALNED. The mean number of the removed nodes was 25 per side. Both patients experienced transient postoperative hypocalcemia. No other complication occurred. No evidence of residual or recurrent disease was found at follow-up. VALNED is feasible, and the results are encouraging. For definitive conclusions, larger series and comparative studies are necessary. PMID:17188101

  9. Changes in Inflammatory Response after Endovascular Treatment for Type B Aortic Dissection

    PubMed Central

    Cheuk, Bernice L. Y.; Chan, Y. C.; Cheng, Stephen W. K.

    2012-01-01

    This present study aims to investigate the changes in the inflammatory markers after elective endovascular treatment of Type B aortic dissection with aneurysm, as related to different anatomical features of the dissection flap in the paravisceral perfusion. Consecutive patients with type B aortic dissections with elective endovascular stent graft repair were recruited and categorized into different groups. Serial plasma levels of cytokines (Interleukin-1?, -6, -8, -10, TNF-?), chemokines (MCP-1), and serum creatinine were monitored at pre-, peri- and post-operative stages. The length of stent graft employed in each surgery was retrieved and correlated with the change of all studied biochemical parameters. A control group of aortic dissected patients with conventional medication management was recruited for comparing the baseline biochemical parameters. In total, 22 endovascular treated and 16 aortic dissected patients with surveillance were recruited. The endovascular treated patients had comparable baseline levels as the non-surgical patients. There was no immediate or thirty day-mortality, and none of the surgical patients developed post-operative mesenteric ischaemia or clinically significant renal impairment. All surgical patients had detectable pro-inflammatory mediators, but none of the them showed any statistical significant surge in the peri-operative period except IL-1? and IL-6. Similar results were obtained when categorized into different groups. IL-1? and IL-6 showed maximal levels within hours of the endovascular procedure (range, 3.93 to 27.3 higher than baseline; p?=?0.001), but returned to baseline 1 day post-operatively. The change of IL-1? and IL-6 at the stent graft deployment was statistically greater in longer stent graft (p>0.05). No significant changes were observed in the serum creatinine levels. In conclusion, elective endovascular repair of type B aortic dissection associated with insignificant changes in inflammatory mediators and creatinine. All levels fell toward basal levels post-operatively suggesting that thoracic endovascular aortic repair is rather less aggressive with insignificant inflammatory modulation. PMID:22655044

  10. Technical nuances of temporal muscle dissection and reconstruction for the pterional keyhole craniotomy.

    PubMed

    McLaughlin, Nancy; Cutler, Aaron; Martin, Neil A

    2013-02-01

    The supraorbital keyhole approach offers a limited access for aneurysms located at the middle cerebral artery (MCA) bifurcation with long M(1) segments or proximal M(2) aneurysms. Alternative minimally invasive routes centered on the pterion have been developed to address these aneurysms. Appropriate dissection and reconstruction of the temporal muscle are important for optimal exposure and best cosmetic results with the pterional keyhole craniotomy. The authors describe the technical nuances of temporal muscle dissection and reconstruction adapted to the pterional keyhole craniotomy. After incising the scalp in a curvilinear fashion behind the hairline, an interfascial dissection is performed, allowing anterior reflection of the superficial temporal fat pat and superficial temporal fascia. The temporal muscle is incised 7-10 mm below its insertion at the superior temporal line. The deep temporal fascia and temporal muscle are incised vertically, completing a T-shaped incision. Subperiosteal dissection of both muscle flaps preserves the deep temporal arteries and nerves. A craniotomy measuring 2.5-3 cm in diameter, based anteriorly at the pterion, is made over the sylvian fissure. Dissection of the sylvian fissure and of MCA aneurysms can proceed without the use of retractors. The bone flap and associated hardware is entirely covered by the temporal muscle, which is reconstructed in 2 layers: the temporal muscle/deep temporal fascia and the superficial temporal fascia. This dissection technique prevents damage to branches of the facial nerve and minimizes temporal muscle damage. Dividing the temporal muscle vertically and reflecting both parts anteriorly and posteriorly prevents suboptimal illumination and visualization under the microscope. Covering the bone flap and related hardware with a multilayer anatomical reconstruction optimizes cosmetic results. PMID:23140151

  11. Anatomists' views on human body dissection and donation: an international survey.

    PubMed

    Arráez-Aybar, Luis-Alfonso; Bueno-López, José Luis; Moxham, Bernard John

    2014-12-01

    A survey was conducted to test three hypotheses: anatomists believe that dissection by students conveys not just anatomical knowledge but also essential skills and attitudes, including professionalism; anatomists approve of the donation of their own bodies or body parts/organs for medical/health-care training and research; attitudes towards body dissection and donation are not dependent upon gender or upon the extent of teaching experience, but are related to transcendental convictions relating to beliefs in the afterlife. Eighty-one anatomists, from 29 countries responded to the survey; 80% indicated that they required medical/health-care students to dissect human cadavers (60% females-86% males, p=0.02). Most teachers recorded that dissection was an instrument for training undergraduate students, an instrument for the development of professional skills, and an instrument to help to control emotions in the future doctor rather than being only a means of teaching/learning anatomy facts. Males were more receptive to the concept that dissection helps to control emotions in the future doctor (p=0.02). Most teachers (75%) said they were willing to donate their bodies, 41% saying they would donate body organs only, 9% would donate their entire bodies only, 25% would separately donate organs and also the entire body. The willingness to donate increased significantly with the years of teaching experience (p=0.04). Teachers who were not believers in the afterlife were more likely to donate their organs/bodies than were believers (p=0.03). Our findings showed that anatomists' attitudes towards body dissection and donation are dependent upon gender, upon the extent of teaching experience, and upon transcendental convictions. PMID:25048843

  12. Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer

    Microsoft Academic Search

    Karen K. Swenson; Mary J. Nissen; Carolyn Ceronsky; Lindsey Swenson; Martin W. Lee; Todd M. Tuttle

    2002-01-01

    Background  Axillary lymph node dissection (ALND) is often associated with permanent arm side effects. Side effects after sentinel lymph\\u000a node dissection (SLND) should be less common, because the surgery is less extensive.\\u000a \\u000a \\u000a \\u000a Methods  The study compared side effects and interference with daily life between 169 women who underwent an SLND and 78 who underwent\\u000a an ALND for breast cancer. Patients rated symptom

  13. Familial aortic aneurysm and dissection due to transforming growth factor-beta receptor 2 mutation.

    PubMed

    Edelman, J James B; Ramponi, Fabio; Bannon, Paul G; Jeremy, Richmond

    2011-05-01

    This report describes the clinical course and management of a patient with Loeys-Dietz syndrome (LDS) type 2. In 2003, a 31-year-old male was diagnosed with acute aortic dissection type B; in the following six years he underwent multiple surgical and endovascular aortic procedures at different thoracic and abdominal levels secondary to progressive enlargement of both the non-dissected thoracic aorta and the false lumen distal to the left subclavian artery. LDS is characterized by arterial tortuosity and aneurysms as a result of heterozygous mutations in genes encoding transforming growth factor-? receptor 1 and 2. Further studies are required to establish the proper surgical management. PMID:21324918

  14. Hybrid procedure for acute stanford type a aortic dissection with aberrant right subclavian artery.

    PubMed

    Ren, Changwei; Sun, Lizhong; Huang, Lianjun; Lai, Yongqiang; Yang, Sheng; Xu, Shangdong

    2015-03-01

    Aberrant right subclavian artery (ARSA) is an uncommon congenital vascular abnormality. Acute Stanford type A aortic dissection with ARSA is rare. We report a strategy for Stanford type A aortic dissection with ARSA. The ascending aorta and the total aortic arch were replaced and a frozen elephant trunk was implanted into the descending aorta. The right subclavian artery was reconstructed with the perfusion branch of a four-branch prosthetic graft. Two weeks later, the proximal part of the ARSA was sealed with a vascular plug. PMID:24934385

  15. Cerebral hyperperfusion syndrome: a novel presentation of internal carotid artery dissection.

    PubMed

    Pinho, João; Rocha, Sofia; Varanda, Sara; Ribeiro, Manuel; Rocha, Jaime; Ferreira, Carla

    2013-08-01

    Cervical artery dissection (CeAD) occurs preferentially in the middle-aged, and its annual incidence rate is 2.6 to 3.0 per 100,000.(1) Manifestations of internal carotid artery dissection (ICAD) include ischemic stroke and TIA (>70% of patients), headache, neck pain, Horner syndrome, cranial nerve palsy, pulsatile tinnitus, and, rarely, subarachnoid hemorrhage.(2) Cerebral hyperperfusion syndrome is known to occur after carotid artery revascularization procedures and it is thought to result from the combination of several factors that impair cerebral vascular autoregulatory mechanisms.(3.) PMID:23825178

  16. Successful staged operation for acute aortic dissection and chronic thromboembolic pulmonary hypertension.

    PubMed

    Ishida, Keiichi; Masuda, Masahisa; Ishizaka, Toru; Matsumiya, Goro

    2015-03-01

    We describe surgical treatment for a patient with chronic thromboembolic pulmonary hypertension who developed acute type A aortic dissection. Acute aortic dissection is a life-threatening disease and must be operated emergently, and chronic thromboembolic pulmonary hypertension can be treated only by pulmonary endarterectomy. We performed a staged procedure consisting of hemiarch replacement with antegrade cerebral perfusion first and pulmonary endareterectomy with periods of deep hypothermic circulatory arrest a week later. We used extracorporeal membrane oxygenation after aortic surgery as a bridge to pulmonary endarterectomy. Our strategy was useful for patients with chronic thromboembolic pulmonary hypertension who require complicated aortic surgery. PMID:24819361

  17. Extended Lymph Node Dissection for Rectal Cancer with Radiologically Diagnosed Extramesenteric Lymph Node Metastasis

    Microsoft Academic Search

    Byung Soh Min; Jin Soo Kim; Nam Kyu Kim; Joon-Seok Lim; Kang Young Lee; Chang Hwan Cho; Seung Kook Sohn

    2009-01-01

    Background  The purpose of this study is to review the clinical outcomes of patients who received extended lymph node dissection for radiologically\\u000a diagnosed extramesenteric lymph node metastasis.\\u000a \\u000a \\u000a \\u000a \\u000a Patients and Methods  The authors reviewed clinical characteristics, short-term operative outcomes, and long-term oncologic outcomes of 151 patients\\u000a who had received total mesorectal excision plus extended lymph node dissection for the treatment of radiologically diagnosed

  18. Complex head and neck specimens and neck dissections. How to handle them

    PubMed Central

    Slootweg, P J

    2005-01-01

    Dissecting surgical specimens from the upper aerodigestive tract is often difficult because of their complicated anatomy. The local environment dictates the routes of tumour spread and surgical margins at risk, and these features differ for various subsites within this part of the body. The examination of surgical specimens of the upper aerodigestive tract should disclose whether postoperative adjuvant treatment is needed and allow the evaluation of preoperatively performed diagnostic imaging. The aim of this article is to provide a concise guideline for the dissection of specimens from this part of the body. PMID:15735153

  19. Investigation of bleeding focus in the intracranial vertebral artery with the use of posterior neck dissection method in traumatic basal subarachnoid hemorrhage.

    PubMed

    Kim, Seongho; Kim, Minjung; Lee, Bong Woo; Kim, Yu-Hoon; Choi, Young-Shik; Seo, Joong Seok

    2015-08-01

    Traumatic basal subarachnoid hemorrhage caused by minor blunt trauma to the head or neck can lead to rapid collapse and death. The vertebral arteries are the vessels most commonly involved in such cases, but it is very difficult to find the bleeding focus in the vertebral arteries in routine autopsy because of the location of these vessels. Using the posterior neck dissection method, which is relatively easy and avoids artificial damage to the intracranial portion of the vertebral arteries, authors have identified tear sites in the intracranial artery in four out of five consecutive traumatic basal subarachnoid hemorrhage cases. In this report we show that this new method is useful for cases of traumatic basal subarachnoid hemorrhage. PMID:26165675

  20. Quality control of lymph node dissection in the Dutch randomized trial of D1 and D2 lymph node dissection for gastric cancer

    Microsoft Academic Search

    J. J Bonenkamp; J. Hermans; M. Sasako

    1998-01-01

    Background.   Variability among surgeons and reduced protocol adherence threaten the conduct and outcome of surgical multicenter trials.\\u000a We introduced, in the Dutch Gastric Cancer Trial of D1 and D2 (extended) lymph node dissection for gastric cancer, a novel\\u000a way of managing instruction, quality control, and evaluation of protocol adherence.\\u000a \\u000a \\u000a Methods. Of 1078 patients entered in the Dutch trial, 711 patients

  1. Dissecting genome-wide association signals for loss-of-function phenotypes in sorghum flavonoid pigmentation traits

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Genome-wide association studies (GWAS) are a powerful method to dissect the genetic basis of traits, though in practice the effects of complex genetic architecture and population structure remain poorly understood. To compare mapping strategies we dissect the genetic control of flavonoid pigmentatio...

  2. Through the Looking Glass: Examining the Practice of Science Classroom Dissection with a Multi-Faceted Lens

    ERIC Educational Resources Information Center

    Witte, Melissa Marie

    2014-01-01

    Dissection of lab specimens is a common procedure in science classrooms, yet there are many unasked and unexamined questions relating to this practice. In addition to ethical considerations, there are personal and environmental health impacts of using conventional dissection, which has historically included animals and animal organs embalmed in…

  3. Reduction of Mental Distress in the Dissection Course by Introducing the Body Donor Experience through Anatomical Demonstrations of Organ Systems

    ERIC Educational Resources Information Center

    Bockers, Anja; Baader, Christoph; Fassnacht, Ulrich Kai; Ochsner, Wolfgang; Bockers, Tobias Maria

    2012-01-01

    The practice of dissection teaches students not only the foundations of anatomical knowledge but also encourages the development of professional competencies. Yet, the dissection of cadavers in the gross anatomy course can be a stress factor for medical students. There are a minor proportion of students who demonstrate strong emotional reactions…

  4. Dissecting the Species Energy Curve Geographically for Conservation Implications: A Case Study for North American Birds

    NASA Astrophysics Data System (ADS)

    Hansen, A. J.; Phillips, L. B.; Flather, C. H.

    2008-12-01

    Ecosystem energy is now recognized as a primary correlate and potential driver of global patterns of species richness. The increasingly well tested species energy relationship (SER) is now ripe for application to conservation management, and recent advances in satellite technology make this more feasible. The first step in using species energy theory (SET) as a management tool requires that we recognize the best energy correlates of species richness and the nature of the relationship across a wide range of energy levels. While this question has been addressed many times previously, this research utilizes recent advances in satellite data that show promise in improving our understanding of potential underlying mechanisms. We found that MODIS Annual average Gross Primary Production was the strongest correlated with avian richness, with a quadratic model as the strongest model. This negative slope of the quadratic model was tested and confirmed to have a significant negative slope at the highest energy levels. This finding demonstrates that there are three different slopes to the SER across the energy gradient of North America: positive, flat and negative. If energy has a causal relationship with richness, then in low energy areas energy causes richness to increase, energy has little effect in intermediate energy areas, and energy depresses richness in the highest energy areas. This information provides a basis for applications to conservation management, such as prioritizing land allocation to favor places of high conservation value. Knowledge of the mechanisms underlying the SER may provide a basis for manipulation of nutrients, vegetation structure, and/or disturbance regimes to favor higher levels of diversity in a given place. These strategies will likely be most effective if tailored to the local energy gradient.

  5. 24 CFR 35.1110 - Notices and pamphlet.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    In cases where evaluation or hazard reduction is undertaken, each public housing agency (PHA) shall provide a notice to residents in accordance with § 35.125. A visual assessment alone is not considered an evaluation for purposes of this part. (b) Lead hazard information...

  6. 32 CFR 644.449 - Requirement for notice by lessor.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...certiorari denied, 280 U.S. 574; Pac. Hardware Co. vs. United States, 49 Ct. CL 327, 335). However, it has been held in the case of Smith vs. United States, 96 Ct. CL 326, that a formal written notice of demand for restoration...

  7. Right procedure, wrong organ, an unusual case report of aortic trauma in a multiple injured patient

    Microsoft Academic Search

    Aristotelis P Mitsos; Jonathan Chantler; Evangelos Konstantinou; Theofanis Fotis; Ekaterini Lambrinou; Ramon Uberoi; Richard Stacey; James V Byrne

    2009-01-01

    Blunt traumatic injury and acute dissection of thoracic aorta is increasing in incidence in seriously multi-trauma patients, remaining highly lethal. Early identification and repair is the key to a successful outcome. We report an unusual case of a 62-year-old man involved in a motor vehicle accident after subarachnoid hemorrhage due to an intracranial artery aneurysm rupture. The post-traumatic aorta dissection

  8. A glimpse into the process of gaining permission for the educational dissection of human cadavers in the Ottoman Empire.

    PubMed

    Akkin, Salih Murat; Dinc, Gulten

    2014-10-01

    Dissection of the human body for educational purposes became officially permitted in the Ottoman Empire only after a long, difficult process. In the West, studies based on the findings of Galen had been taboo during a long period in which dissection of human bodies had been prohibited. Although the first dissection studies since ancient times began to appear in the Western literature in the late 13th and early 14th centuries, the post-Galen taboo against dissection was broken only in the 16th century by the studies of Vesalius. However, in the Eastern World, it was only fairly recently that the idea of the "sanctity of the human body" could be challenged. In the medieval Islamic world, as during the Middle Ages in the West, prohibitions against the dissection of human cadavers continued for social and religious reasons, although the Koran does not specifically ban such dissection. This prohibition also continued through the Ottoman era, which began in the 14th century. The first efforts to end the prohibition on dissection in the Ottoman Empire were made at the beginning of the 19th century during the reign of Sultan Selim III but official permission for dissection was given only in 1841 during the reign of Sultan Abdulmecid. Educational dissections in the Ottoman Empire officially began at the Istanbul Medical School following the granting of this permission. This article will discuss the attempts to end the prohibition of dissection in Ottomans within the scope of the history of anatomical study in Turkey. PMID:24913319

  9. Anatomo-functional study of the temporo-parieto-occipital region: dissection, tractographic and brain mapping evidence from a neurosurgical perspective.

    PubMed

    De Benedictis, Alessandro; Duffau, Hugues; Paradiso, Beatrice; Grandi, Enrico; Balbi, Sergio; Granieri, Enrico; Colarusso, Enzo; Chioffi, Franco; Marras, Carlo Efisio; Sarubbo, Silvio

    2014-08-01

    The temporo-parieto-occipital (TPO) junction is a complex brain territory heavily involved in several high-level neurological functions, such as language, visuo-spatial recognition, writing, reading, symbol processing, calculation, self-processing, working memory, musical memory, and face and object recognition. Recent studies indicate that this area is covered by a thick network of white matter (WM) connections, which provide efficient and multimodal integration of information between both local and distant cortical nodes. It is important for neurosurgeons to have good knowledge of the three-dimensional subcortical organisation of this highly connected region to minimise post-operative permanent deficits. The aim of this dissection study was to highlight the subcortical functional anatomy from a topographical surgical perspective. Eight human hemispheres (four left, four right) obtained from four human cadavers were dissected according to Klingler's technique. Proceeding latero-medially, the authors describe the anatomical courses of and the relationships between the main pathways crossing the TPO. The results obtained from dissection were first integrated with diffusion tensor imaging reconstructions and subsequently with functional data obtained from three surgical cases, all resection of infiltrating glial tumours using direct electrical mapping in awake patients. The subcortical limits for performing safe lesionectomies within the TPO region are as follows: within the parietal region, the anterior horizontal part of the superior longitudinal fasciculus and, more deeply, the arcuate fasciculus; dorsally, the vertical projective thalamo-cortical fibres. For lesions located within the temporal and occipital lobes, the resection should be tailored according to the orientation of the horizontal associative pathways (the inferior fronto-occipital fascicle, inferior longitudinal fascicle and optic radiation). The relationships between the WM tracts and the ventricle system were also examined. These results indicate that a detailed anatomo-functional awareness of the WM architecture within the TPO area is mandatory when approaching intrinsic brain lesions to optimise surgical results and to minimise post-operative morbidity. PMID:24975421

  10. Laparoscopic nephroureterectomy with transvesical single-port distal ureter and bladder cuff dissection: points of technique and initial surgical outcomes with five patients

    PubMed Central

    Markuszewski, Marcin; K??cz, Jakub; Sieczkowski, Marcin; Po?om, Wojciech; Piaskowski, Wojciech; Krajka, Kazimierz; Matuszewski, Marcin

    2014-01-01

    Although a variety of techniques have been used to manage the distal ureter during laparoscopic radical nephroureterectomy (LNU), a consensus has not yet been established. Recently, some authors have used a single-port transvesical approach to excise the distal ureter and bladder cuff following LNU. The aim of the study was to present our initial experience in „en bloc” dissection of the distal ureter and bladder cuff during LNU, using a transvesical single-port approach (T-LESS) and standard laparoscopic instruments. From April to October 2012, 5 patients aged 45 to 73 years with upper urinary tract urothelial tumors were subjected to LNU/T-LESS. After a standard LNU was performed, a TriPort+® device was introduced into the bladder and the pneumovesicum was established. A bladder cuff with a distal ureter was dissected and put in the paravesical tissue. The bladder wall defect was closed with the V-loc® 3/0 suture. The LNU was then completed in the flank position. All procedures were completed successfully. No significant blood loss or complications were observed. The mean operative time was 250 min (range: 200–370) for a total procedure and 59 min (range: 42–80) for the T-LESS stage. The postoperative hospital stay was 5.2 days (range: 4–9). Pathologic examination revealed no positive margin in any of the cases. The LNU/T-LESS approach is an efficient and safe procedure. A well-visualized dissection of the distal ureter, closing the defect of the bladder, the use of standard laparoscopic instruments and a good cosmesis are advantages of the method. PMID:25097698

  11. Dissection of Symbiosis and Organ Development by Integrated Transcriptome Analysis of Lotus japonicus

    E-print Network

    Schierup, Mikkel Heide

    Dissection of Symbiosis and Organ Development by Integrated Transcriptome Analysis of Lotus present an integrated genome-wide analysis of transcriptome landscapes in Lotus japonicus wild determinate Lotus root nodules, and eight mutants impaired at different stages of the symbiotic interaction

  12. Aortic dissection in children and adolescents with Turner syndrome: risk factors and management recommendations.

    PubMed

    Turtle, E J; Sule, A A; Webb, D J; Bath, L E

    2015-07-01

    There is a general lack of awareness of the risk of aortic dissection in Turner syndrome (TS) from both patients with TS and their physicians. Patients often ignore symptoms for up to 24?h before seeking medical advice, significantly increasing their risk of death. A clinical profile of those at risk of dissection is emerging and includes the presence of congenital heart defects, aortic dilatation and hypertension. MRI has revolutionised the visualisation of cardiovascular anatomy in TS but remains underutilised, especially in children and adolescents, and there is currently little guidance on blood pressure (BP) assessment or hypertension management. Children and adolescents with TS at risk of dissection could be easily identified by timely imaging and BP assessment. This would allow medical management or surgical intervention to be put in place to reduce the risk of this major, and often fatal, complication. Since guidance is lacking, we have reviewed the literature on the risk factors for dissection in TS during childhood and adolescence, and make recommendations on the assessment and management of these patients. PMID:25573747

  13. The role of axillary lymph node dissection in breast cancer patients with sentinel lymph node micrometastases

    Microsoft Academic Search

    M. Gipponi; G. Canavese; R. Lionetto; A. Catturich; C. Vecchio; A. Sapino; D. Friedman; F. Cafiero

    2006-01-01

    AimTo identify by means of clinical and histopathological features a subset of breast cancer patients with sentinel lymph-node (sN) micrometastases and metastatic disease confined only to the sN in order to spare them an unnecessary axillary lymph node dissection (ALND).

  14. Does Fibrin Glue Improve Drainage after Axillary Lymph Node Dissection? Prospective and Randomized Study in Humans

    Microsoft Academic Search

    F. Vaxman; A. Kolbe; F. Stricher; D. Zund; P. Volkmar; D. Gros; J. F. Grenier

    1995-01-01

    The aim of this prospective and randomized study was to establish whether the use of fibrin glue was beneficial after axillary lymph node dissection. From January 1990 to January 1991, 40 women were randomized before surgery for breast cancer: 20 patients (group A) underwent vaporization of fibrin glue (Tissucol®, 5 ml of 500 IU thrombin) only in the area of

  15. Sentinel lymph node biopsy as an indicator for axillary dissection in early breast cancer

    Microsoft Academic Search

    U Veronesi; V Galimberti; S Zurrida; F Pigatto; P Veronesi; C Robertson; G Paganelli; V Sciascia; G Viale

    2001-01-01

    Sentinel node biopsy (SNB) is a new component of the surgical treatment of breast cancer that accurately predicts axillary status. Although the procedure is still mainly investigational, many patients are requesting SNB to avoid axillary dissection if the sentinel node (SN) is negative. From March 1996 to December 1999, 373 patients with breast carcinoma and clinically negative axillary nodes underwent

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

    NSDL National Science Digital Library

    Theodoros Sergentanis (National and Kapodistrian University of Athens Forensic Medicine and Toxicology)

    2010-11-01

    This article describes a study aimed to determine risk factors for students' adverse physical and psychological reactions to forensic dissection. Considerations (regarding psychological reactions) are suggested based on the outcome of the survey given to 6th year medical students finishing this practical course.

  17. PCR and dissection as tools to monitor filarial infection of Aedes polynesiensis mosquitoes in French Polynesia

    Microsoft Academic Search

    Catherine Plichart; Yves Sechan; Neil Davies; Anne-Marie Legrand

    2006-01-01

    BACKGROUND: Entomological methods may provide important tools for monitoring the transmission of filariasis in French Polynesia. In order to standardize our PCR method and refine our protocol to assess filarial infection levels in mosquitoes, we compared dissection of the vector, Aedes polynesiensis, with the poolscreening polymerase chain reaction (PS-PCR) assay. METHODS: (1) Mosquitoes were collected in human landing catches in

  18. PCR and Mosquito dissection as tools to monitor filarial infection levels following mass treatment

    Microsoft Academic Search

    David S Goodman; Jean-Nicolas Orelus; Jacquelin M Roberts; Patrick J Lammie; Thomas G Streit

    2003-01-01

    BACKGROUND: Entomological methods may provide important tools for monitoring the progress of lymphatic filariasis elimination programs. In this study, we compared dissection of the vector, Culex quinquefasciatus, with the polymerase chain reaction (PCR) to assess filarial infection levels in mosquitoes in the context of a lymphatic filariasis elimination program in Leogane, Haiti. METHODS: Mosquitoes were collected using gravid traps located

  19. Dissecting Video Server Selection Strategies in the YouTube CDN

    E-print Network

    Dissecting Video Server Selection Strategies in the YouTube CDN Ruben Torres, Alessandro Finamore.finamore,marco.mellia,maurizio.munafo}@polito.it Abstract--In this paper, we conduct a detailed study of the YouTube CDN with a view to understanding-based geolo- cation techniques to find the geographical location of YouTube servers. A unique aspect of our

  20. Evaluation of extensive lymph node dissection for carcinoma of the stomach

    Microsoft Academic Search

    Yoshifumi Kodama; Keizo Sugimachi; Kazuhiko Soejima; Toshimitsu Matsusaka; Kiyoshi Inokuchi

    1981-01-01

    We compared the results of curative resection for carcinoma of the stomach in 254 patients who underwent simple resection (SR) and 454 patients who underwent extensive regional lymph node dissection (ELD). The 5-year survival rates of the 2 procedures were significantly different in carcinoma involving the serosa of the stomach; it was 45% in the ELD group and 18% in