Sample records for unilateral thoracic kidney

  1. The Management of Unilateral Poorly Functioning Kidneys in Patients With Posterior Urethral Valves

    Microsoft Academic Search

    Young H. Kim; Mark Horowitz; Andrew J. Combs; Victor W. Nitti; Kenneth I. Glassberg

    1997-01-01

    PurposeThere is no uniform agreement on how to manage the unilateral nonfunctioning or poorly functioning kidney associated with posterior urethral valves. We studied the results of treatment of our patients to make recommendations regarding management of these kidneys.

  2. Unilateral nephrectomy 24 hours after bilateral kidney irradiation reduces damage to the function and structure of the remaining kidney

    Microsoft Academic Search

    Z. X. Liao; E. L. Travis

    1994-01-01

    The effect of unilateral nephrectomy 24 h after irradiation on renal function and death with renal insufficiency as well as histopathological changes in the kidney was assessed. Single doses totaling 8-18 Gy were given bilaterally to unanesthetized female and male C3Hf\\/Kam mice. Renal function damage was assayed by blood urea nitrogen (BUN) and hematocrit (Hct). Histological damage was quantified by

  3. Unilateral nephrectomy 24 hours after bilateral kidney irradiation reduces damage to the function and structure of the remaining kidney

    SciTech Connect

    Liao, Z.X.; Travis, E.L. [Univ. of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

    1994-09-01

    The effect of unilateral nephrectomy 24 h after irradiation on renal function and death with renal insufficiency as well as histopathological changes in the kidney was assessed. Single doses totaling 8-18 Gy were given bilaterally to unanesthetized female and male C3Hf/Kam mice. Renal function damage was assayed by blood urea nitrogen (BUN) and hematocrit (Hct). Histological damage was quantified by two parameters: kidney area and number of surviving tubule cells along the renal capsule. The number of glomeruli was scored as an indication of the number of nephrons. Changes in the two functional parameters did not appear sooner after irradiation in the nephrectomized mice than in the non-nephrectomized mice. Rather, less impairment of function was measured by both parameters in the nephrectomized mice but only after radiation doses greater than 12 Gy. The LD{sub 50} at 424 days after irradiation was also higher in the nephrectomized mice than in the mice receiving only irradiation, 13.98 Gy (95% confidence limits = 12.03, 15.93) and 11.71 Gy (95% confidence limits = 10.4, 13.1), respectively, in agreement with the data on function. Unilateral nephrectomy alone induced a 10% increase in size of the contralateral kidney. The dose-response curve for the kidney area from nephrectomized mice was parallel to and displaced above that for non-nephrectomized mice, indicating that the increase in renal mass occurred independent of and was not compromised by radiation. Unilateral nephrectomy alone induced no increase in the number of proximal tubules in the contralateral kidney. 30 refs., 9 figs., 1 tab.

  4. Mayer-Rokintansky-Kuster-Hauser syndrome associated with atrial septal defect, partial anomalous pulmonary venous connection and unilateral kidney--an unusual triad of anomalies.

    PubMed

    Ganie, Mohd Ashraf; Laway, Bashir Ahmed; Ahmed, Sanjeed; Alai, Mohd Sultan; Lone, G N

    2010-10-01

    Mayer Rokintansky-Kuster-Hauser syndrome is characterized by the congenital absence of the vagina with a variety of Müllerian duct anomalies. Because of normal sexual development, the syndrome usually remains undetected until primary amenorrhea and/or difficulty in attempting sexual intercourse result in the diagnosis. MRKHS frequently is associated with anomalies of the urinary tract (unilateral agenesis, or ectopia of one or both kidneys, horse-shoe kidney), cervico-thoracic region (asymmetric, fused or wedged vertebrae, scoliosis and Klippel-Feil anomaly), congenital cardiac defects, hearing defects, and digital anomalies of varying severity. Congenital heart diseases in the form of atrial septal defect, Holt-Oram Syndrome with or without aorticopulmonary window, pulmonary stenosis etc in association with MRKHS have been described in the literature. We present a case of MRKHS with unilateral agenesis of the kidney and atrial septal defect with partial anomalous pulmonary venous connection. This combination of anomalies has not been reported in the literature so far. The various presentations and the pathogenesis of the condition are discussed. PMID:21158222

  5. Technical aspects of unilateral dual kidney transplantation from expanded criteria donors: experience of 100 patients.

    PubMed

    Ekser, B; Furian, L; Broggiato, A; Silvestre, C; Pierobon, E S; Baldan, N; Rigotti, P

    2010-09-01

    One option for using organs from donors with a suboptimal nephron mass, e.g. expanded criteria donors (ECD) kidneys, is dual kidney transplantation (DKT). In adult recipients, DKT can be carried out by several techniques, but the unilateral placement of both kidneys (UDKT) offers the advantages of single surgical access and shorter operating time. One hundred UDKT were performed using kidneys from ECD donors with a mean age of 72 years (Group 1). The technique consists of transplanting both kidneys extraperitoneally in the same iliac fossa. The results were compared with a cohort of single kidney transplants (SKT) performed with the same selection criteria in the same study period (Group 2, n = 73). Ninety-five percent of UDKTs were positioned in the right iliac fossa, lengthening the right renal vein with an inferior vena cava patch. In 69% of cases, all anastomoses were to the external iliac vessels end-to-side. Surgical complications were comparable in both groups. At 3-year follow-up, patient and graft survival rates were 95.6 and 90.9% in Group 1, respectively. UDKT can be carried out with comparable surgical complication rates as SKT, leaving the contralateral iliac fossa untouched and giving elderly recipients a better chance of receiving a transplant, with optimal results up to 3-years follow-up. PMID:20636454

  6. Screening and identification of the differential proteins in kidney with complete unilateral ureteral obstruction

    PubMed Central

    Zhao, Qi; Yang, Yi; Wang, Chang-Lin; Hou, Ying; Chen, Hui

    2015-01-01

    Obstructive nephropathy is a major cause of renal failure, particularly in infants and children, and indications for therapeutic intervention remain highly controversial. There is a great need for the development of new methods to monitor patients, and the biomarker research field is a promising approach for this purpose to be used as prognostic tools for early disease detection and the choice of the optimal treatment and monitoring. Here, we presented our comparative proteomics study of rat kidney with complete unilateral ureteral obstruction (CUUO). Proteins from the groups of CUUO and corresponding sham rat kidney tissues were subjected to 2-D gel electrophoresis, and then protein identification by mass spectrometry. We identified 39 proteins with differential expression between kidney tissues from sham operated group and those with CUUO. These identified proteins were reported to be involved in cell apoptosis, energy metabolism and injuries of mitochondrion and oxidative stress, and so on. We confirmed 3 identified proteins by immunoblot analysis and immunofluorescence staining and assessed their mRNA levels in renal tissues. Our results demonstrate protein alterations that reflect the pathological situation of the obstructed kidneys, which may help understand the relationship between oxidative stress and obstructive nephropathy. PMID:26045767

  7. Thoracic Aorta to Femoral Artery Bypass Allows Secondary Kidney Transplantation in Case of Major Iliac Artery Disease.

    PubMed

    Monnot, Antoine; Lebras, Marie Lainay; Rouer, Martin; Plissonnier, Didier

    2015-07-01

    Iliac artery major calcifications can compromise kidney graft. First-performed prosthetic arterial bypass from the thoracic aorta to the femoral artery allows secondary kidney transplantation. Four patients were submitted to this procedure. No patient died during the postoperative period or the follow-up. The median time to receive a kidney graft after the arterial surgery was 24 months (4-52). The normalization of the sera creatinine level was 6.4 days (2-15). The median follow-up was 38 months (7-79). In our experience, using lateral side clamping of the descendant thoracic aorta during the proximal implantation of the arterial graft avoids bleeding and visceral abdominal ischemia. The secondary performed kidney graft is safe on a very available arterial conduit. PMID:25958119

  8. Role of cyclooxygenase-2 in the development of interstitial fibrosis in kidneys following unilateral ureteral obstruction in mice.

    PubMed

    Kamata, Mariko; Hosono, Kanako; Fujita, Tomoe; Kamata, Kouju; Majima, Masataka

    2015-03-01

    Unilateral ureteral obstruction (UUO) induced tubulointerstitial fibrosis in kidneys mimics the pathogenesis of chronic kidney diseases and is considered a suitable model for studying the mechanisms leading to fibrosis. To study the role of cyclooxygenase-2 (COX-2) in kidney fibrosis, we investigated whether a selective COX-2 inhibitor, celecoxib, affected renal interstitial fibrosis during UUO in mice. To induce UUO, the left proximal ureter was ligated in male C57BL/6 mice. The mice were fed a diet with or without celecoxib from the day of UUO induction. Following UUO, the renal pelvis was observed to be dilated and the kidney cortex was significantly thinner than that of sham-operated mice. Immunofluorescent staining of type I, III, and IV collagen in UUO kidneys revealed that interstitial collagen deposition was significantly increased in the celecoxib-treated group. Expression of type I, III, and IV collagen in UUO kidneys was also significantly higher in the celecoxib-treated group than in the vehicle-treated group. In the celecoxib-treated group, mRNA levels of TGF-?/FGF-2 were also significantly higher than those in the vehicle-treated group. The present study demonstrates that COX-2 plays a protective role against fibrosis in UUO kidneys and suggests that supplementation of COX-2 products, such as PG analogues, will be a good option for preventing interstitial fibrosis. PMID:25776498

  9. Chitosan/siRNA Nanoparticles Targeting Cyclooxygenase Type 2 Attenuate Unilateral Ureteral Obstruction-induced Kidney Injury in Mice

    PubMed Central

    Yang, Chuanxu; Nilsson, Line; Cheema, Muhammad Umar; Wang, Yan; Frøkiær, Jørgen; Gao, Shan; Kjems, Jørgen; Nørregaard, Rikke

    2015-01-01

    Cyclooxygenase type 2 (COX-2) plays a predominant role in the progression of kidney injury in obstructive nephropathy. The aim of this study was to test the efficacy of chitosan/small interfering RNA (siRNA) nanoparticles to knockdown COX-2 specifically in macrophages to prevent kidney injury induced by unilateral ureteral obstruction (UUO). Using optical imaging techniques and confocal microscopy, we demonstrated that chitosan/siRNA nanoparticles accumulated in macrophages in the obstructed kidney. Consistent with the imaging data, the obstructed kidney contained a higher amount of siRNA and macrophages. Chitosan-formulated siRNA against COX-2 was evaluated on RAW macrophages demonstrating reduced COX-2 expression and activity after LPS stimulation. Injection of COX-2 chitosan/siRNA nanoparticles in mice subjected to three-day UUO diminished the UUO-induced COX-2 expression. Likewise, macrophages in the obstructed kidney had reduced COX-2 immunoreactivity, and histological examination showed lesser tubular damage in COX-2 siRNA-treated UUO mice. Parenchymal inflammation, assessed by tumor necrosis factor-alpha (TNF-?) and interleukin 6 mRNA expression, was attenuated by COX-2 siRNA. Furthermore, treatment with COX-2 siRNA reduced heme oxygenase-1 and cleaved caspase-3 in UUO mice, indicating lesser oxidative stress and apoptosis. Our results demonstrate a novel strategy to prevent UUO-induced kidney damage by using chitosan/siRNA nanoparticles to knockdown COX-2 specifically in macrophages. PMID:25553102

  10. Interstitial fibrosis of unilateral ureteral obstruction is exacerbated in kidneys of mice lacking the gene for inducible nitric oxide synthase.

    PubMed

    Hochberg, D; Johnson, C W; Chen, J; Cohen, D; Stern, J; Vaughan, E D; Poppas, D; Felsen, D

    2000-11-01

    Unilateral ureteral obstruction (UUO) is characterized by decreases in renal function and increases in interstitial fibrosis. Previous studies have indicated that pharmacologic manipulations that increase nitric oxide (NO) are beneficial to the obstructed kidneys. NO is produced from arginine by nitric oxide synthase (NOS), an enzyme that exists in both constitutive and inducible (iNOS) forms. To determine the role of the inducible form of NOS in UUO, we used mice with a targeted deletion of iNOS (iNOS -/- mice) and compared them with wild-type (WT) mice. Kidneys were obstructed for 2 weeks in both WT and iNOS -/- mice, and were then removed and bisected. Half of the kidney was embedded in paraffin and tissue sections were examined for interstitial volume or the presence of macrophages. The remainder was flash-frozen and samples were used to measure tissue collagen (hydroxyproline) or transforming growth factor-beta (TGF-beta). This study demonstrates that both cortex and medulla of obstructed kidneys of iNOS -/- mice exhibit significantly increased interstitial volume and interstitial macrophages as compared with their WT counterparts. Furthermore tissue collagen was increased to 9.2+/-1.3 microg/mg tissue in WT obstructed kidneys, whereas in iNOS -/- kidneys, collagen was increased to 13.2+/-0.8 microg/mg tissue. The profibrotic cytokine TGF-beta was also significantly increased in obstructed kidneys of iNOS -/- mice, as compared with WT mice. No differences were noted between the unobstructed kidneys of iNOS -/- mice compared with WT mice in any of the parameters examined. These results demonstrate that targeted deletion of the iNOS results in exacerbation of fibrotic events in the obstructed kidney. These results confirm previous pharmacologic studies, and suggest that NO produced via the inducible NOS normally serves a protective function in UUO. PMID:11092532

  11. Effect of stachydrine on endoplasmic reticulum stress-induced apoptosis in rat kidney after unilateral ureteral obstruction.

    PubMed

    Zhang, Cui; Lu, Ying; Tong, Qian-Qian; Zhang, Lan; Guan, Yu-Fei; Wang, Shu-Jing; Xing, Zhi-Hua

    2013-01-01

    Our study aimed at determining the effect of stachydrine on the PERK, CHOP, and caspase-3 in rat kidney with RIF. Rats were randomly divided into control group, model group, enalapril group, high stachydrine group, medium stachydrine group, and low stachydrine group. RIF models of five groups were developed by unilateral ureteral obstruction except the control group. The rats were sacrificed 12 days after surgery and blood samples were collected. Serum creatinine (Scr) and blood urea nitrogen (BUN) levels were detected. Renal tubular damage index was determined by HE staining. The area percentage of RIF was determined by the Masson method. Expressions of PERK, CHOP, and caspase-3 in kidney were determined by immunohistochemistry. Tubulointerstitial injury index, RIF, serum Scr, BUN level, and expressions of PERK, CHOP, and caspase-3 were different between the model and treatment groups (P < 0.05; P < 0.01). The expressions of PERK, CHOP, and caspase-3 in nephridial tissue were reduced (P < 0.05), tubulointerstitial injury and RIF were reduced (P < 0.05), and Scr and BUN were lower (P < 0.05) in the high stachydrine group than those in the enalapril group. The expressions of PERK, CHOP, and caspase-3 were reduced in the endoplasmic reticulum stress-related apoptosis pathway after stachydrine treatment. Consequently, apoptosis was prevented, and RIF was inhibited. PMID:23464629

  12. Ambulatory blood pressure monitoring in children with unilateral multicystic dysplastic kidney

    Microsoft Academic Search

    Tomáš Seeman; Ulrike John; Kv?ta Bláhová; Hana Vond?ichová; Jan Janda; Joachim Misselwitz

    2001-01-01

    Multicystic dysplastic kidney (MCDK) is one of the most common congenital renal anomalies. Arterial hypertension is a potential\\u000a complication of MCDK. Blood pressure (BP) has so far been measured only casually and the frequency of hypertension has been\\u000a estimated to be between 0%–8%. Ambulatory blood pressure monitoring (ABPM) provides more precise information on BP than the\\u000a casual BP measurement. The

  13. (99m)Tc Diethylenetriaminepentacetic Acid Angiotension-coverting Enzyme Inhibitor Renography as Screening Test for Renovascular Hypertension in Unilateral Small Kidney: A Prospective Study.

    PubMed

    Ul Hassan, Masood; Khan, Shoukat H; Ashraf, Mohd; Najar, Saleem; Shaheen, Feroz

    2014-09-01

    To know the probability of renal artery stenosis (RAS) in unilateral small kidney and function of the unilateral small kidney, which includes glomerular filtration rate, differential function, uptake, Tmax by (99m)Tc diethylenetriaminepentacetic acid (DTPA) base and (99m)Tc DTPA angiotensin converting enzyme (ACE) inhibition scan. All our patients were subjected to (99m)Tc DTPA ACE inhibition renal scintigraphy. All the patients underwent either computed tomography (CT) angiography and magnetic resonance (MR) angiography was done in those patients in which kidney function test was deranged. Renal angiography was subsequently performed in cases with the suggestion of RAS on CT or MR angiography. The quantitative data was expressed as the arithmetic mean, standard deviation and percentages. The intergroup comparisons for parametric data were done by Student's t-test, whereas non-parametric data was compared with Mann-Whitney U-test. The intergroup comparisons were made by paired t-test and Wilcoxon sign rank test. P <0.05 was considered to be significant, and data was analyzed by Statistical package for social sciences(SPSS-20) software. Out of 47 patients, 25 patients were in the low probability group out of which none was positive for RAS on CT/MR angiography. Out of 47 patients, 12 were in the intermediate group out of which none was positive for RAS. Ten, out of 47 patients were suspected of high probability for RAS by ACE inhibition scan out of which 4 were positive for RAS by CT/MR angiography including one with bilateral RAS. (99m)Tc DTPA angiotension-coverting enzyme inhibitor renography is a safe, non-invasive, sensitive, specific, and cost-effective test for excluding renovascular hypertension in patients who have normal or nearly normal renal function in unilateral small kidney. PMID:25538486

  14. Altered Regulation of Renin-Angiotensin, Endothelin and Natriuretic Peptide Systems in Rat Kidney with Chronic Unilateral Ureteral Obstruction

    Microsoft Academic Search

    Eun Hui Bae; In Jin Kim; Jeong Woo Park; Seong Kwon Ma; Ki Chul Choi; Jong Un Lee; Soo Wan Kim

    2007-01-01

    Background: The present study was designed to investigate the role of the local renin-angiotensin-aldosterone system (RAAS), endothelin (ET) and the natriuretic peptide system (NPS) for the development of renal fibrosis and progressive renal disease in experimental unilateral ureteral obstructed (UUO) rats. Methods: Male Sprague-Dawley rats (180–200 g) were unilaterally obstructed by ligation of the proximal ureters for 14 days. Control

  15. Unilateral Congenital Lacrimal Fistula with Renal Agenesis and Pelvic Kidney: A Case Report and Review of the Literature

    PubMed Central

    Altun, A.; Kurna, S. A.; Sengor, T.; Altun, G.; Oflaz, A.; Sonmez, H. S.

    2015-01-01

    A 12-year-old boy presented to the clinic of ophthalmology because of watering and discharge from his left lower eyelid. The inspection examination revealed an orifice that was associated with congenital lacrimal fistula (CLF). He underwent a complete ophthalmologic and systemic evaluation to explore possible associated findings. Systemic evaluation revealed multiple renal anomalies: right renal agenesis and left ectopic pelvic kidney. This case is unique because this is the first reported case of CLF accompanied with ectopic pelvic kidney in the literature.

  16. Relationship between acute kidney injury before thoracic endovascular aneurysm repair and in-hospital outcomes in patients with type B acute aortic dissection

    PubMed Central

    Ren, Hong-Mei; Wang, Xiao; Hu, Chun-Yan; Que, Bin; Ai, Hui; Wang, Chun-Mei; Sun, Li-Zhong; Nie, Shao-Ping

    2015-01-01

    Objective Acute kidney injury (AKI) frequently occurs after catheter-based interventional procedures and increases mortality. However, the implications of AKI before thoracic endovascular aneurysm repair (TEVAR) of type B acute aortic dissection (AAD) remain unclear. This study evaluated the incidence, predictors, and in-hospital outcomes of AKI before TEVAR in patients with type B AAD. Methods Between 2009 and 2013, 76 patients were retrospectively evaluated who received TEVAR for type B AAD within 36 h from symptom onset. The patients were classified into no-AKI vs. AKI groups, and the severity of AKI was further staged according to kidney disease: improving global outcomes criteria before TEVAR. Results The incidence of preoperative AKI was 36.8%. In-hospital complications was significantly higher in patients with preoperative AKI compared with no-AKI (50.0% vs. 4.2%, respectively; P < 0.001), including acute renal failure (21.4% vs. 0, respectively; P < 0.001), and they increased with severity of AKI (P < 0.001). The maximum levels of body temperature and white blood cell count were significantly related to maximum serum creatinine level before TEVAR. Multivariate analysis showed that systolic blood pressure on admission (OR: 1.023; 95% CI: 1.003–1.044; P = 0.0238) and bilateral renal artery involvement (OR: 19.076; 95% CI: 1.914–190.164; P = 0.0120) were strong predictors of preoperative AKI. Conclusions Preoperative AKI frequently occurred in patients with type B AAD, and correlated with higher in-hospital complications and enhanced inflammatory reaction. Systolic blood pressure on admission and bilateral renal artery involvement were major risk factors for AKI before TEVAR.

  17. Surgery for unilateral bronchiectasis: Results and prognostic factors

    Microsoft Academic Search

    M. Ashour; K. M. Al-Kattan; S. K. Jain; S. Al-Majed; F. Al-Kassimi; A. Mobaireek; M. Al-Hajjaj; A. Al-Zear

    1996-01-01

    Setting: King Khalid University Hospital referral centre for thoracic surgery, Riyadh, Saudi Arabia.Objective: To assess the results of surgery and factors influencing its outcome in patients with unilateral bronchiectasis.Design: A retrospective analysis of 40 patients with unilateral bronchiectasis who were operated upon consecutively at King Khalid Hospital, between July 1987 and May 1993.Results: Left-sided disease was seen in 60% (n

  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. Bilateral multicystic kidneys – an unusual case

    Microsoft Academic Search

    Lila Agrawal; Marie-Louise Millard; Joanna Fairhurst; Rodney D. Gilbert

    2002-01-01

    Multicystic dysplasia of the kidneys is a condition whose prognosis is good as it usually presents unilaterally. Bilateral cases are usually fatal in utero. We report a case of bilateral multicystic dysplasia of the kidneys where the lower moiety of the right kidney was spared cystic change. The patient had normal renal function and, following conservative management, remains alive and

  20. Society of Thoracic Surgeons

    MedlinePLUS

    ... a Thoracic Surgeon? Adult Cardiac Surgery What is Pediatric Heart Disease? What is Risk Adjustment? Valve Repair/Replacement Surgery Esophageal Surgery Lung/Thoracic Surgery Aneurysm Surgery Arrhythmia Surgery Other Types of Surgery Clinical ...

  1. Malignant seminoma in two unilaterally cryptorchid stallions.

    PubMed

    De Lange, V; Chiers, K; Lefère, L; Cools, M; Ververs, C; Govaere, J

    2015-06-01

    Two unilateral cryptorchid stallions were referred to the clinic because of chronic debilitating condition with emaciation. Rectal examination, and ultrasound and gross examination revealed in both animals an abdominal mass, caudally of the kidney, and multiple nodules spread over the abdomen. Histologic analysis revealed an intra-abdominal malignant seminoma with intraperitoneal and renal metastasis. Interestingly, a seminoma was also present in the descended testis of the draught horse. PMID:25759202

  2. [Unilateral borderline ovarian tumor and unilateral adenexectomy?].

    PubMed

    Boujenah, J; Bricou, A; Moreaux, G; Grynberg, M; Sifer, C; Hugues, J N; Poncelet, C

    2014-09-01

    To perform an adnexectomy in case of unilateral borderline tumor must consider the risk of recurrence, the preservation of fertility, and to integrate a global comprehensive management of a couple. Adnexectomy can be considering as a legitimate option when the woman desire a pregnancy. The risk of recurrence is low and the global survey high. Identification of woman with a high risk of recurrence is necessary. Adnexectomy can be considering as a legitimate option to preserve fertility in case of unilateral tumor. However, ovarian reserve data are missing after the surgery. Adnexectomy can be considering for the management of infertile woman with unilateral borderline tumor. IVF can be performed in the absence of any poor prognosis factor. Management with ovarian cryopreservation and In vitro Maturation remain unclear. PMID:25164163

  3. Effect of monoclonal anti-ANP antibodies on the acute functional adaptation to unilateral nephrectomy

    Microsoft Academic Search

    Jean-Pierre Valentin; Jean Ribstein; Dominik Neuser; Jürg Nüssberger; Albert Mimran

    1993-01-01

    Effect of monoclonal anti-ANP antibodies on the acute functional adaptation to unilateral nephrectomy. The role of endogenous atrial natriuretic peptide (ANP) in the immediate response of sodium excretion to unilateral nephrectomy (UNX) was investigated in anesthetized euvolemic rats through measurement of UNX-induced change in plasma ANP concentration and the response of the remaining kidney to UNX following administration of monoclonal

  4. Antegrade selective cerebral perfusion in operations on the proximal thoracic aorta

    Microsoft Academic Search

    Karl M Dossche; Marc A. A. M Schepens; Wim J Morshuis; Filip E Muysoms; Johanna J Langemeijer; Freddy E. E Vermeulen

    1999-01-01

    Background. To determine the factors that influence hospital death and neurologic complications after surgery on the thoracic aorta using circulatory arrest and antegrade selective cerebral perfusion.Methods. From May 1989 through April 1997, 106 patients underwent surgery on the thoracic aorta using circulatory arrest and antegrade selective cerebral perfusion. Mean age was 64.0 ± 11.5 years. Unilateral antegrade cerebral perfusion was

  5. [Thoracic duct cyst].

    PubMed

    Manasterski, J; Szmeja, Z; Kruk-Zagajewska, A; Turczuk-Bier?a, I

    1999-01-01

    Patient aged 48 with the cyst of the cervical part of thoracic duct was described. Cyst appeared as the result of inflammation. Histopathological examination excluded the cystic lymphangioma. PMID:10689924

  6. Thoracic outlet syndromes

    Microsoft Academic Search

    Harold C. Urschel; Amit Patel

    2003-01-01

    Opinion statement  The clinical presentation of thoracic outlet syndrome depends on which anatomic structure is compressed in the area of the\\u000a thoracic outlet (eg, the axillary-subclavian artery, vein [Paget-Schroetter syndrome, or effort thrombosis], brachial plexus,\\u000a or the sympathetic nerves). The clinical syndrome may be isolated to one or a mixture of these compressed anatomic structures.\\u000a Although there are multiple compressive forces,

  7. What Is a Thoracic Surgeon?

    MedlinePLUS

    ... thoracic aneurysms - Minimal access cardiac surgery - Ventricular remodeling - Heart transplant - Maze procedure A general thoracic surgeon could perform: - ... Nissen fundoplication - Laparoscopic Heller myotomy - Thoracoscopic sympathectomy - ... heart surgeon could perform: - Atrial septal defect repair - Ventricular ...

  8. Understanding Thoracic Outlet Syndrome

    PubMed Central

    Freischlag, Julie

    2014-01-01

    The diagnosis of thoracic outlet syndrome was once debated in the world of vascular surgery. Today, it is more understood and surprisingly less infrequent than once thought. Thoracic outlet syndrome (TOS) is composed of three types: neurogenic, venous, and arterial. Each type is in distinction to the others when considering patient presentation and diagnosis. Remarkable advances have been made in surgical approach, physical therapy, and rehabilitation of these patients. Dedicated centers of excellence with multidisciplinary teams have been developed and continue to lead the way in future research. PMID:25140278

  9. Case scenario - thoracic trauma.

    PubMed

    Michelet, P; Boussen, S

    2013-01-01

    Among trauma patients, blunt chest trauma remains a major cause of morbidity and mortality. We report the case of an 85-year old patient under new oral anticoagulant implicated in a multiple-vehicle accident. The patient presented a complex thoracic trauma involving multiple rib fractures, flail chest, hemothorax and lung contusions. All the thoracic lesions were situated at the left side. Despite the absence of neurological lesion and hemodynamic instability, the patient required the admission in our intensive care unit related to the worsening of a respiratory distress. This respiratory distress resulted from the association of the thoracic injuries with related hypoxemia and a high level of pain. The management of this case included the reversal of the anticoagulant therapy, use of non-invasive ventilation, the placement of a paravertebral block and the surgical fixation of the flail chest. We provide a discussion of the risk/benefit balance for all the medical and surgical strategies used in this case as the interest of chest ultrasonography in thoracic trauma situations. PMID:23916516

  10. Thoracic Endometriosis Syndrome

    Microsoft Academic Search

    Areti Augoulea; Irene Lambrinoudaki; George Christodoulakos

    2008-01-01

    Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity and is usually confined to the pelvis. Thoracic endometriosis syndrome (TES) is a rare disorder characterized by the presence of functioning endometrial tissue in the pleura, the lung parenchyma and the airways. TES may present with hemoptysis, due to the shedding of endometrial tissue in

  11. AT NORTHWESTERN THORACIC ONCOLOGY

    E-print Network

    Engman, David M.

    cancer research recruitment, and growth in clinical trial volume; and · Enhancing the patient experience in thoracic oncology care delivery, clinical research, and education that draws upon the strengths of diverse-impact lung cancer research linked to innovative, compassionate, and personalized clinical care. THE CANCER

  12. Kidney Disease

    MedlinePLUS

    ... Kidney Disease: What is Kidney Disease? In This Topic What is Kidney Disease? Risk Factors and Prevention ... for More Information National Institute on Aging Related Topics Diabetes High Blood Pressure Heart Failure The information ...

  13. Splint renal function after captopril in unilateral renal artery stenosis

    Microsoft Academic Search

    G J Wenting; H L Tan-Tjiong; F H Derkx; J H de Bruyn; A J Man in't Veld; M A Schalekamp

    1984-01-01

    The renal extraction ratios of 131I-sodium iodohippurate (131I-Hippuran) and 125I-thalamate were greatly reduced on the affected side by 50 mg captopril in seven out of 14 patients with unilateral renal artery stenosis. With long term captopril 150 mg daily the uptake of 99mTc-diethylenetriaminepenta-acetic acid by the affected kidney, which was determined by scintillation camera renography, became almost zero in these

  14. Venous thoracic outlet syndrome.

    PubMed

    Moore, Robert; Wei Lum, Ying

    2015-04-01

    Venous thoracic outlet syndrome is a complex but rare disease that often can have excellent outcomes if quickly recognized and treated. The syndrome results from compression of the subclavian vein along its exit from the thoracic cavity and frequently affects young otherwise healthy patients. Modern diagnosis is made with a combination of clinical exam, appropriate non-invasive imaging, and, finally, contrast venography, which can be both diagnostic and therapeutic. Treatments have evolved over time to the point where patients can undergo less extensive procedures than previously performed and still maintain excellent outcomes. One of the most important predictors of outcome is the initiation of treatment within 14 days of symptoms. Hence, the importance of the accurate and prompt diagnosis of this syndrome in patients with an upper-extremity deep vein thrombotic episode cannot be further underscored. This review is a concise summary of the background and treatment algorithm for this patient population. PMID:25832605

  15. [Surgery for thoracic tuberculosis].

    PubMed

    Kilani, T; Boudaya, M S; Zribi, H; Ouerghi, S; Marghli, A; Mestiri, T; Mezni, F

    2015-01-01

    Tuberculosis is mainly a medical disease. Surgery has been the unique therapeutic tool for a long time before the advent of specific antituberculous drugs, and the role of surgery was then confined to the treatment of the sequelae of tuberculosis and their complications. The resurgence of tuberculosis and the emergence of multidrug-resistant TB combined to immunosuppressed patients represent a new challenge for tuberculosis surgery. Surgery may be indicated for a diagnostic purpose in patients with pulmonary, pleural, mediastinal or thoracic wall involvement, or with a therapeutic purpose (drainage, resection, residual cavity obliteration). Modern imaging techniques and the advent of video-assisted thoracic surgery allowed a new approach of this pathology; the majority of diagnostic interventions and selected cases requiring lung resection can be performed through a mini-invasive approach. Patients proposed for aggressive surgery may be treated with the best results thanks to a good evaluation of the thoracic lesions, of the patients' nutritional, infectious and general status combined with a good coordination between the specialized medical team for an optimal preparation to surgery. PMID:24894967

  16. [Radiographic and ultrasonographic diagnosis of a left thoracic mass].

    PubMed

    Lougue-Sorgho, L C; Ouedraogo, M; Cisse, R; Ouédraogo, T; Bamouni, Y A; Siko, A; Napon, M; Kambou, S; Tapsoba, T L; Sanou, A

    2005-02-01

    A chest roentgenogram of a 69-year-old man undergoing a check-up before prostate surgery showed a mass in the antero-inferior zone of the lung, just above the diaphragm. At ultrasonography, it was considered to be a thoracic ectopic kidney. This radiological case illustrates the place of this anomaly in the differential diagnosis of lung solitary mass, which can be explored with ultrasonography when retroperitoneal herniation is suspected. PMID:15772578

  17. Aneurysms: thoracic aortic aneurysms.

    PubMed

    Chun, Kevin C; Lee, Eugene S

    2015-04-01

    Thoracic aortic aneurysms (TAAs) have many possible etiologies, including congenital heart defects (eg, bicuspid aortic valves, coarctation of the aorta), inherited connective tissue disorders (eg, Marfan, Ehlers-Danlos, Loeys-Dietz syndromes), and degenerative conditions (eg, medial necrosis, atherosclerosis of the aortic wall). Symptoms of rupture include a severe tearing pain in the chest, back, or neck, sometimes associated with cardiovascular collapse. Before rupture, TAAs may exert pressure on other thoracic structures, leading to a variety of symptoms. However, most TAAs are asymptomatic and are found incidentally during imaging for other conditions. Diagnosis is confirmed with computed tomography scan or echocardiography. Asymptomatic TAAs should be monitored with imaging at specified intervals and patients referred for repair if the TAAs are enlarging rapidly (greater than 0.5 cm in diameter over 6 months for heritable etiologies; greater than 0.5 cm over 1 year for degenerative etiologies) or reach a critical aortic diameter threshold for elective surgery (5.5 cm for TAAs due to degenerative etiologies, 5.0 cm when associated with inherited syndromes). Open surgery is used most often to treat asymptomatic TAAs in the ascending aorta and aortic arch. Asymptomatic TAAs in the descending aorta often are treated medically with aggressive blood pressure control, though recent data suggest that endovascular procedures may result in better long-term survival rates. PMID:25860136

  18. Solitary Kidney

    MedlinePLUS

    ... following signs of kidney damage: albuminuria decreased glomerular filtration rate (GFR) high blood pressure Albuminuria Testing Albuminuria ... kidneys filter each minute, called the estimated glomerular filtration rate (eGFR). The results of the test indicate ...

  19. Kidney transplant

    MedlinePLUS

    ... Saunders Elsevier; 2011:chap 44. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant . 2009 ...

  20. Long-Term Renal Function in the Posterior Urethral Valves, Unilateral Reflux and Renal Dysplasia Syndrome

    Microsoft Academic Search

    Peter M. Cuckow; M. D. Dinneen; R. A. Risdon; P. G. Ransley; P. G. Duffy

    1997-01-01

    PurposeThe syndrome of posterior urethral valves, persistent unilateral reflux and renal dysplasia (VURD) is said to be protective of the contralateral nonrefluxing kidney and the outcome for renal function is reported to be excellent. We tested this hypothesis in our patients by replicating previous studies but with longer followup and glomerular filtration rate data.

  1. Thoracic sarcomas in children.

    PubMed Central

    Andrassy, R J; Wiener, E S; Raney, R B; Lawrence, W; Lobe, T E; Corpron, C A; Maurer, H M

    1998-01-01

    OBJECTIVE: This study reviews the experience of the Intergroup Rhabdomyosarcoma Studies (IRS) II and III with thoracic sarcomas. SUMMARY BACKGROUND DATA: Thoracic sarcomas in children present special problems with histologic diagnosis, total resection of tumor, and local control. Previous studies have shown high rates of local and distant relapse. METHODS: Data from evaluable patients enrolled in IRS II and IRS III were reviewed. Progression-free and overall survival were estimated by the Kaplan-Meier method and statistical differences were calculated by the log-rank test. The multivariate regression analysis of data was performed using the Cox proportional hazards model. RESULTS: A total of 84 patients presented with thoracic sarcomas during IRS II (51 patients) and IRS III (33 patients). Of these, 76 were chest wall tumors, 3 were lung tumors, 4 were pleural tumors, and 1 arose from the heart. The average age at diagnosis was 8.5 years (range, 1 month-20.5 years). Thirty-three patients had alveolar histology, 17 had embryonal histology, and 12 had extraosseous Ewing's sarcoma, with indeterminate, undifferentiated, and pleomorphic histologies in the remaining 22 patients. Thirteen patients presented as group I (localized disease completely resected), 18 as group II (microscopic residual or nodal disease), 31 as group III (gross residual disease or biopsy only), and 22 as group IV (distant metastatic disease). Sixty patients (71%) achieved a complete response. Thirty-nine patients had a local relapse, and 22 had a distant relapse. Thirty-five patients (42%) survived with a mean follow-up of 1.8 years (range 0.7-11.7 years); 49 (58%) have died with an average survival of 1.1 years (range 0.3-11.7 years). Four patients (5%) died of infection or treatment complications. Progression-free survival was not significantly associated with histology, site, clinical group, or IRS study. Overall survival was significantly associated with clinical group, size, and local or distant recurrence, but not with histology or IRS study by univariate analysis. In a multivariate analysis, only clinical group and local and distant recurrence showed statistical significance (p < 0.002, < 0.006, and < 0.001, respectively). CONCLUSIONS: As expected, outcome was better for patients with totally resected or microscopically residual tumor after resection. A higher rate of recurrence in group I versus group II,although not statistically significant, suggests that identification of margin status may be difficult, and these patients may require more intensive efforts for local control. These patients continued to have a high rate of local and distant relapse, and new strategies for preventing these are under development. PMID:9488512

  2. Postoperative acute kidney injury.

    PubMed

    Romagnoli, S; Ricci, Z

    2015-06-01

    Acute kidney injury (AKI) represents 18-47% of all causes of hospital-acquired AKI and it is associated with a high incidence of morbidity and mortality especially in patients requiring dialysis. Only recently, with the application of new AKI classifications and guidelines (RIFLE, AKIN and KDIGO), a more accurate evaluation of the real incidence of kidney dysfunction in patients undergoing surgery has been detailed. In patients undergoing non-cardiac, non-vascular and non-thoracic surgery several independent preoperative and intraoperative predictors of AKI have been identified. Nonetheless, no measure for AKI prevention reached a high level of recommendation, although hemodynamic monitoring and goal-directed fluid management may limit perioperative AKI. Cardiac surgery-related AKI and cardiopulmonary bypass-related AKI have been extensively evaluated and several preventive and treatment strategies have been developed. Open and endovascular surgery-related AKI have been compared and hydration is currently the only preventive strategy with a substantial level of efficacy. In addition, AKI in thoracic surgery, overlooked in the past, has been evaluated, showing that it frequently complicates postoperative course of patients undergoing elective lung cancer resection. Multi-hit mechanisms (ischemia, inflammation, toxins) co-act on patients' predisposition (susceptibility). A multi-step approach is probably necessary to limit the incidence and the severity of postsurgery AKI patients, such as careful risk stratification, adoption of preventive measures and goal directed intraoperative algorithms. The present review will summarize the current literature about the epidemiology of postoperative AKI focusing on patient-related and technical-related risk factors, outcome and prevention strategies in different groups of surgeries. PMID:25057935

  3. 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

  4. Original article Thoracic trident pigmentation

    E-print Network

    Paris-Sud XI, Université de

    Original article Thoracic trident pigmentation in Drosophila melanogaster: latitudinal. Significant clines of increasing pigmentation were observed according to latitude and altitude. A multiple regression technique permitted improve- ment of the relationship between pigmentation and geographic

  5. Minimally Invasive Thoracic Microendoscopic Discectomy

    Microsoft Academic Search

    Kurt M. Eichholz; John E. O’Toole; Griffin R. Myers; Richard G. Fessler

    \\u000a Thoracic disc herniations present the spine surgeon with a distinctive set of challenges with regard to patient selection,\\u000a surgical anatomy, and potential complications. The reported incidences of thoracic disc herniations range from 1 in 1,000\\u000a to 1 in 1,000,0001–3 and are decreased in comparison with those of their cervical and lumbar counterparts; this is likely a result of the increased

  6. Thoracic endovascular aortic repair and off-pump coronary artery bypass grafting after renal transplantation: a case report.

    PubMed

    Yanase, Yohsuke; Muraki, Satoshi; Koyanagi, Tetsuya; Watanabe, Noriyasu; Kurimoto, Yoshihiko

    2011-01-01

    Twelve years after receiving a renal transplant, a 50-year-old woman developed asthmatic symptoms. Chest CT revealed a descending thoracic aortic aneurysm. She had undergone percutaneous coronary intervention to treat the left anterior descending artery 10 years earlier. Coronary artery angiography revealed restenosis of the left anterior descending artery (99%, #6 in-stent). Because cardiopulmonary bypass may cause problems for transplanted kidney, we performed off-pump coronary artery bypass grafting (left internal thoracic artery to left anterior descending artery) and thoracic endovascular graft placement to treat the aortic aneurysm. Considering that the artery of the transplanted kidney was attached to the right iliac artery, and then the left common femoral artery was selected as the access root for GORE TAG(®) endografts (34 × 200 and 34 × 150 mm) (stentgrafts were deployed for the descending aortic artery). Postoperative angiography showed a patent bypass graft. Postoperative CT confirmed the absence of endoleaks. The postoperative course was uneventful, and she was discharged without complications. Ischemic heart disease and descending thoracic aortic aneurysm in recipients of kidney transplants can be treated using off-pump coronary bypass grafting and thoracic endovascular graft placement. The transplanted kidney was protected without using cardiopulmonary bypass (CPB). PMID:21881367

  7. The dying thoracic patient.

    PubMed

    Krishna, G; Raffin, T A

    1998-08-01

    Health care providers should understand that the practice of good medicine includes not only diagnosing and curing diseases, but also effectively communicating with patients and families and helping terminally ill patients die a peaceful and dignified death. Patients in America come from varied backgrounds, and it is important for physicians to consider cultural and religious issues. Physicians should combine their clinical judgment with objective outcome data to provide optimal care for patients. Informed consent should be obtained from patients after offering a detailed plan of care that would include appropriate interventions and the consequences of no intervention. The physician should then assist the patient in making a decision that would provide the best possible future for that individual. The four fundamental principles of biomedical ethics, namely beneficence, nonmaleficence, autonomy, and justice, should be considered when analyzing an ethical problem. Voluntary active euthanasia, which means performing a deliberate act (e.g., administering a lethal injection) to end a patient's life, should not be performed by a physician. Withholding and withdrawing basic and advanced life support constitutes passive euthanasia. Good communication with patients early in the clinical course whenever possible results in an ethically correct decision. A nonconfrontational, sympathetic, and compassionate approach to family members and legal surrogates facing the immediate death of their loved ones leads to the best possible outcome. It is the duty of the physician to assure the patient and the family that he or she will not abandon the patient. Effective communication is the key to solving almost all ethical dilemmas when caring for the dying thoracic patient. PMID:9742345

  8. Renography with captopril. Changes in a patient with hypertension and unilateral renal artery stenosis

    SciTech Connect

    Geyskes, G.G.; Oei, H.Y.; Puylaert, C.B.; Dorhout Mees, E.J.

    1986-09-01

    In a 56-year-old man with severe familial hypertension and unilateral renal artery stenosis, captopril induced striking changes in the renograms of the affected kidney. After injection of orthoiodohippurate sodium I 131, the uptake phase was unchanged but the later curve showed continuous accumulation. In contrast, the uptake of technetium Tc 99m diethylenetriamine pentracetic acid was abolished. These changes are compatible with a cessation of filtration and maintenance of renal blood flow. After balloon dilatation of the stenosis, the blood pressure became lower, and these changes could no longer be demonstrated. The captopril renogram may provide useful information on the dependency of hypertension on unilateral renal artery stenosis.

  9. [Successful renal contraction therapy in polycystic kidney patient with renal transcatheter arterial embolization prior to ABO incompatible kidney transplantation].

    PubMed

    Kato, Taigo; Yazawa, Koji; Ichimaru, Naotsugu; Saito, Jun; Tsutahar, Koichi; Kakuta, Yoichi; Abe, Toyofumi; Nakai, Yasutomo; Nonomura, Norio; Takahara, Shiro; Okuyama, Akihiko

    2010-09-01

    28-year-old female received dialysis treatment due to chronic renal failure caused by polycystic kidney disease. Later, she underwent a laparoscopic splenectomy and ABO incompatible living kidney transplantation successfully following bilateral renal contraction therapy with renal transcatheter arterial embolization (renal TAE). A unilateral or bilateral native nephrectomy of a massively enlarged kidney performed at the time of renal transplantation is a common treatment in polycystic kidney patients scheduled for transplantation. On the other hand, when treated with renal TAE, such patients can avoid a laparotomy, which provides several advantages when undergoing peritoneal dialysis in the future or a laparoscopic splenectomy prior to ABO incompatible kidney transplantation. Furthermore, we consider that bilateral renal TAE is necessary for polycystic kidney patients prior to renal transplantation for a variety of reasons, including problems associated with contrast nephropathy if renal TAE for left kidney is remained after renal transplantation. PMID:20954380

  10. Phosphatidylinositol 3-kinase signaling determines kidney size.

    PubMed

    Chen, Jian-Kang; Nagai, Kojiro; Chen, Jianchun; Plieth, David; Hino, Masayo; Xu, Jinxian; Sha, Feng; Ikizler, T Alp; Quarles, C Chad; Threadgill, David W; Neilson, Eric G; Harris, Raymond C

    2015-06-01

    Kidney size adaptively increases as mammals grow and in response to the loss of 1 kidney. It is not clear how kidneys size themselves or if the processes that adapt kidney mass to lean body mass also mediate renal hypertrophy following unilateral nephrectomy (UNX). Here, we demonstrated that mice harboring a proximal tubule-specific deletion of Pten (PtenptKO) have greatly enlarged kidneys as the result of persistent activation of the class I PI3K/mTORC2/AKT pathway and an increase of the antiproliferative signals p21Cip1/WAF and p27Kip1. Administration of rapamycin to PtenptKO mice diminished hypertrophy. Proximal tubule-specific deletion of Egfr in PtenptKO mice also attenuated class I PI3K/mTORC2/AKT signaling and reduced the size of enlarged kidneys. In PtenptKO mice, UNX further increased mTORC1 activation and hypertrophy in the remaining kidney; however, mTORC2-dependent AKT phosphorylation did not increase further in the remaining kidney of PtenptKO mice, nor was it induced in the remaining kidney of WT mice. After UNX, renal blood flow and amino acid delivery to the remaining kidney rose abruptly, followed by increased amino acid content and activation of a class III PI3K/mTORC1/S6K1 pathway. Thus, our findings demonstrate context-dependent roles for EGFR-modulated class I PI3K/mTORC2/AKT signaling in the normal adaptation of kidney size and PTEN-independent, nutrient-dependent class III PI3K/mTORC1/S6K1 signaling in the compensatory enlargement of the remaining kidney following UNX. PMID:25985273

  11. Kidney Transplantation: The Use of Abnormal Kidneys

    Microsoft Academic Search

    Lauro Branding; Antonio Marcos Arnulf Fraga; Mauro Roberto Rufino Bergonse; Carl Kjellstrand; Anuar Michel Matni; Gilson Lacerda; Pedro Alejandro Gordan; Altair Jacob Mocelin

    1983-01-01

    We transplanted 6 anatomically abnormal kidneys: a horseshoe kidney that after division was transplanted into 2 recipients; 1 kidney with ureteral stones and hydronephrosis; 1 ectopic and 1 hydronephrotic kidney; 2 kidneys with extensive ureteric lesions, donated as free organs. All these kidneys ultimately had normal function in the recipients, long-term in 4. 2 patients died but in neither was

  12. Kidney disease - resources

    MedlinePLUS

    Resources - kidney disease ... The following organizations are good resources for information on kidney disease: National Kidney Disease Education Program - www.nkdep.nih.gov National Kidney Foundation - www.kidney.org National ...

  13. Chronic Kidney Disease (CKD)

    MedlinePLUS

    ... www.kidneyfund.org > Kidney Disease > Chronic Kidney Disease Chronic Kidney Disease (CKD) An estimated 31 million people in the United ... living with chronic kidney disease (CKD). What is CKD? The term “chronic kidney disease” (CKD) means lasting ...

  14. Thoracic radiologic manifestations of melioidosis.

    PubMed

    Burivong, Wanaporn; Wu, Xiaohua; Saenkote, Wipawadee; Stern, Eric J

    2012-01-01

    Melioidosis (Burkholderia pseudomallei) is a gram-negative bacterial infection that is highly endemic in Southeast Asia and Oceania. Pulmonary disease is the most common form of involvement. The clinical-radiologic thoracic manifestations of melioidosis can be classified as acute, subacute, subclinical, and chronic forms. Radiographic findings include nodular, alveolar, or mixed infiltration/consolidation with or without cavities. Pleural effusion, pneumothorax, and pericardial involvement can be seen. Melioidosis can easily be confused with other infections, especially tuberculosis. Suspicion of this disease in the proper clinical radiologic setting is important for early diagnosis and treatment. In this article, we provide a broad clinical overview of melioidosis, review the radiologic thoracic manifestations of melioidosis with appropriate clinical correlation, as well as compare and contrast the imaging findings of thoracic melioidosis with other similar pulmonary infections. PMID:23009770

  15. Managing advanced unilateral pseudoexfoliative glaucoma.

    PubMed

    Marques, André

    2014-01-01

    The only proven therapy for glaucoma is intraocular pressure (IOP) reduction, which can be accomplished by different means. Each should be properly discussed with patients in order to best preserve visual function and quality of life. We report a case of unilateral pseudoexfoliative glaucoma, treated for years with triple topical IOP-lowering drugs. The patient presented with advanced optic neuropathy and important ocular side effects secondary to the treatment. Having discussed his options and prognosis, laser trabeculoplasty was performed while maintaining the remaining therapy considering the advanced stage of glaucoma. His IOP was effectively reduced and no progression was noted after 1-year follow-up. Although medical therapy is the mainstream in glaucoma management, its side effects should not be ignored, especially in unilateral cases. Surgery might have been a better solution, but we chose to perform laser trabeculoplasty, an effective and safer alternative, considering the unlikely but serious risk of the "wipe-out phenomenon" in this case. PMID:24850557

  16. Kidney stones

    MedlinePLUS

    ... tests to check calcium, phosphorus, uric acid, and electrolyte levels Kidney function tests Urinalysis to see crystals and look for red blood cells in urine Examination of the stone to determine ...

  17. Your Kidneys

    MedlinePLUS

    ... filters that take the waste out of the blood and make urine the ureters: tubes that carry the urine from each kidney to the bladder the bladder: a bag that collects the urine the urethra: a tube ...

  18. Kidney Tumors

    Cancer.gov

    Kidney tumors are rare and generally curable in children. However, there are subsets of patients afflicted with these diseases that do not respond to treatment or eventually relapse. These patients usually have poor clinical outcomes as compared with the majority of children diagnosed with kidney tumors. All patients undergo therapy regimens that can be detrimental later in life. Through genome-wide characterization, TARGET investigators are identifying critical molecular alterations in these tumors, mostly from relapsed patients.

  19. Audiological assessment of unilateral deafness.

    PubMed

    Pruszewicz, A; Obrêbowski, A; Woznica, B; Sekula, A; Swidzi?ski, P; Karlik, M

    2001-01-01

    Unilateral deafness constitute medical (aetiological diagnosis, treatment, hearing aid fitting) and social problems (no certification of disability). Following audiological examinations were performed in the study: pure tone audiometry (PTA), impedance audiometry, auditory brainstem responses (ABR), otoacoustic emissions (OAE), as well as balance, taste, examinations and electric sensitivity of the acoustic nerve. In cases of tinnitus the parameters of its character were done. All of our patients underwent X-ray investigations, i.e. ear X-ray by Schüller and Stenvers methods, computerized tomography or magnetic resonance imaging. In some cases phoniatric and logopaedic examinations were performed. For aetiological diagnosis electrophoresis and immunological test (IgG and IgM against mumps) were carried out. The results were presented in two groups of patients with sudden and those of long lasting progressive unilateral deafness. Some of the patients were pharmacologically treated before the evaluation. It is concluded that the statistic analysis could be a basis for the management and prognosis of the unilateral deafness. PMID:11318476

  20. [A case of thoracic actinomycosis].

    PubMed

    Denisova, O A; Cherniavskaia, G M; Beloborodova, É I; Topol'nitski?, E B; Iakimenko, Iu V; Chernogoriuk, G É; Beloborodova, E V; Strezh, Iu A; Vil'danova, L R

    2014-01-01

    A case of thoracic actinomycosis manifest as round shadow in the lung is described. Diagnosis was based on the presence of actinomycetes in a transthoracic lung biopsy sample. Treatment for 3 months resulted in recovery. No relapse was documented during 1 year follow-up period. PMID:25265662

  1. Emergent Unilateral Renal Artery Stenting for Treatment of Flash Pulmonary Edema: Fact or Fiction?

    PubMed Central

    Khan, Asaad Akbar; McFadden, Eugene Patrick

    2015-01-01

    Flash pulmonary edema is characteristically sudden in onset with rapid resolution once appropriate therapy has been instituted (Messerli et al., 2011). Acute increase of left ventricular (LV) end diastolic pressure is the usual cause of sudden decompensated cardiac failure in this patient population. Presence of bilateral renal artery stenosis or unilateral stenosis in combination with a single functional kidney in the susceptible cohort is usually blamed for this condition. We describe a patient who presented with flash pulmonary edema in the setting of normal coronary arteries. Our case is distinct as our patient developed flash pulmonary edema secondary to unilateral renal artery stenosis in the presence of bilateral functioning kidneys. Percutaneous stent implantation in the affected renal artery resulted in rapid resolution of pulmonary edema. PMID:25793128

  2. Unilateral ureteral obstruction attenuates intrarenal angiotensin II generation induced by podocyte injury.

    PubMed

    Okabe, Masahiro; Miyazaki, Yoichi; Niimura, Fumio; Pastan, Ira; Nishiyama, Akira; Yokoo, Takashi; Ichikawa, Iekuni; Matsusaka, Taiji

    2015-04-15

    The renal tissue renin-angiotensin system is activated in chronic kidney diseases. We previously demonstrated that intrarenal ANG II is synthesized primarily from liver-derived angiotensinogen filtered through the glomerulus and that podocyte injury increases the passage of angiotensinogen into the tubular lumen and generation of ANG II. In the present study, we tested the effect of cessation of glomerular filtration by ureteral obstruction on renal ANG II generation in kidneys with podocyte injury under two experimental conditions. Ureteral obstruction is known to activate the renin-angiotensin system in nonproteinuric kidneys. Transgenic mice expressing hCD25 in podocyte (NEP25) were injected with 1.25 or 10 ng/g body wt of LMB2, a hCD25-targeted immunotoxin, subjected to unilateral ureteral ligation on the following day, and euthanized 7 and 4 days later, respectively. In both experiments, compared with the kidney in untreated wild-type mice, renal angiotensinogen protein, as assessed by immunostaining and Western blot analysis, was increased in the contralateral unobstructed kidney. However, it was markedly decreased in the obstructed kidney. Whereas intrarenal ANG II content was increased in the contralateral kidney compared with the untreated kidney (248 ± 83 vs. 106 ± 21 and 298 ± 185 vs. 64.8 ± 20 fmol/g kidney, respectively), this increase was suppressed in the obstructed kidney (161 ± 75 and 113 ± 34 fmol/g kidney, respectively), a pattern opposite to what we expected in obstructed kidneys without podocyte injury. Thus, our study indicates that the major source of increased renal ANG II in podocyte injury is filtered angiotensinogen. PMID:25673808

  3. Altered phospholipid profile in urine of rats with unilateral ureteral obstruction

    Microsoft Academic Search

    Yasuko Yoshioka; Toshihiko Tsutsumi; Mika Adachi; Akira Tokumura

    2009-01-01

    Little is known about renal damage to the contralateral kidney after unilateral ureteral obstruction (UUO). Using liquid chromatography-time\\u000a of flight-mass spectrometry combined with principal component analysis (PCA), we compared urinary phospholipid profiles before\\u000a and two weeks after UUO in rats. PCA revealed that negative ions corresponding to three molecular species of phosphatidylethanolamine\\u000a (PE) and two species of phosphatidylglycerol (PG) had

  4. Common and uncommon adult unilateral renal masses other than renal cell carcinoma

    PubMed Central

    Le, Ott; Roy, Anjali; Silverman, Paul M.; Kundra, Vikas

    2012-01-01

    Abstract Many different masses can involve the kidney other than the commonly encountered renal cell carcinoma (RCC). The purpose of this article is to review the characteristic clinical and imaging findings of common and uncommon masses that predominantly present unilaterally in the adult patient, other than RCC. Awareness of such lesions and knowing the clinical scenario is important for appropriate diagnosis and management, especially in a multidisciplinary care setting. PMID:22752221

  5. Consequences of Unilateral Hearing Loss: Cortical Adjustment to Unilateral Deprivation

    PubMed Central

    Hutson, K.A.; Durham, D.; Imig, T.; Tucci, D.L.

    2008-01-01

    The effect of unilateral hearing loss on 2-deoxyglucose (2-DG) uptake in the central auditory system was studied in post-natal day 21 gerbils. Three weeks following a unilateral conductive hearing loss (CHL) or cochlear ablation (CA), animals were injected with 2-DG and exposed to an alternating auditory stimulus (1 and 2 kHz tones). Uptake of 2-DG was measured in the inferior colliculus (IC), medial geniculate (MG), and auditory cortex (fields AI and AAF) of both sides of the brain in experimental animals and in anesthesia-only sham animals (SH). Significant differences in uptake, compared to SH, were found in the IC contralateral to the manipulated ear (CHL or CA) and in AAF contralateral to the CHL ear. We hypothesize that these findings may result from loss of functional inhibition in the IC contralateral to CA, but not CHL. Altered states of inhibition at the IC may affect activity in pathways ascending to auditory cortex, and ultimately activity in auditory cortex itself. Altered levels of activity in auditory cortex may explain some auditory processing deficits experienced by individuals with CHL. PMID:18261867

  6. UNILATERAL RENAL DISEASE AND HYPERTENSION

    PubMed Central

    Burns, Edgar

    1953-01-01

    Cure is obtained in about 20 per cent of patients with unilateral renal disease and hypertension who have nephrectomy primarily for relief of hypertension. Carrying out urologic studies on a larger number of hypertensive patients might result in tracing the condition to renal disease in more cases. Renal angiography more accurately indicates renal origin of hypertension than any other diagnostic study. When it can reasonably be established that hypertension is of renal origin, nephrectomy should be performed unless there is some general contraindication to an operative procedure. PMID:13106723

  7. [A hanger for thoracic surgery].

    PubMed

    Shimasaki, T; Ohira, H; Hosaka, J; Nagae, N; Washio, M

    1993-09-01

    A new hanger for thoracic operation is introduced. This hanger for draping cloth is made for the purpose 1) of isolating the operative field from the anesthetist, 2) of keeping the broad hygienic area around the operator, 3) of keeping the area to handle the endotracheal tube for the anesthetist, 4) of keeping the area on the cranial side of the patient where the second assistant is able to stand, 5) of keeping the area for the watcher to stand. PMID:8377312

  8. Kidney Problems

    MedlinePLUS

    ... working well, you may eventually develop problems requiring medical attention. These problems from kidney disease may include: Fluid and electrolyte imbalance – e.g., too much or too little sodium, potassium, or water in your body Build up of waste products in your body Loss of protein through ...

  9. Thoracic spine sports-related injuries.

    PubMed

    Menzer, Heather; Gill, G Keith; Paterson, Andrew

    2015-01-01

    Although sports-related injuries to the thoracic spine are relatively uncommon, they are among the most feared due to the potential for catastrophic neurologic injury. The increased biomechanical support of the thoracic spine makes injuries in this region particularly rare compared with the cervical and lumbar spine. As a result, thoracic spine injuries can be missed easily, difficult to diagnose, and problematic to treat. Recognition of mechanism and awareness of injury patterns help physicians determine a diagnosis and create an index of suspicion for unstable thoracic spine injuries. Aggressive full-contact sports receive the most attention for spinal injury; however several sports with repetitive loading of the spine can cause severe injuries, including rowing, gymnastics, and golf. The goal of this article was to provide an overview of the unique anatomic and biomechanical features of the thoracic spine and to discuss some of the more common thoracic injuries that can affect athletes. PMID:25574880

  10. Aberrent Thoracic Duct Cyst in Postrior Mediastinum

    PubMed Central

    Park, Soo Jin; Park, Seonng Yong; Choi, Ho

    2015-01-01

    Thoracic duct cysts in the upper portion of the diaphragm are mostly found in the neck and are rarely found in the mediastinum. Thoracic duct cysts should be differentiated from other mediastinal tumors or cysts, and surgical treatment is required to avoid the development of chylothorax if the cyst ruptures. Herein, we report the case of a patient with a thoracic cyst located just above the diaphragm that was treated with surgical resection.

  11. Follistatin, an Activin Antagonist, Ameliorates Renal Interstitial Fibrosis in a Rat Model of Unilateral Ureteral Obstruction

    PubMed Central

    Maeshima, Akito; Mishima, Keiichiro; Yamashita, Shin; Miya, Masaaki; Sakurai, Noriyuki; Sakairi, Toru; Hiromura, Keiju; Hasegawa, Yoshihisa; Kojima, Itaru; Nojima, Yoshihisa

    2014-01-01

    Activin, a member of the TGF-? superfamily, regulates cell growth and differentiation in various cell types. Activin A acts as a negative regulator of renal development as well as tubular regeneration after renal injury. However, it remains unknown whether activin A is involved in renal fibrosis. To clarify this issue, we utilized a rat model of unilateral ureteral obstruction (UUO). The expression of activin A was significantly increased in the UUO kidneys compared to that in contralateral kidneys. Activin A was detected in glomerular mesangial cells and interstitial fibroblasts in normal kidneys. In UUO kidneys, activin A was abundantly expressed by interstitial ?-SMA-positive myofibroblasts. Administration of recombinant follistatin, an activin antagonist, reduced the fibrotic area in the UUO kidneys. The number of proliferating cells in the interstitium, but not in the tubules, was significantly lower in the follistatin-treated kidneys. Expression of ?-SMA, deposition of type I collagen and fibronectin, and CD68-positive macrophage infiltration were significantly suppressed in the follistatin-treated kidneys. These data suggest that activin A produced by interstitial fibroblasts acts as a potent profibrotic factor during renal fibrosis. Blockade of activin A action may be a novel approach for the prevention of renal fibrosis progression. PMID:24883308

  12. At Risk for Kidney Disease?

    MedlinePLUS Videos and Cool Tools

    ... prevent kidney failure by treating kidney disease early. Diabetes and Kidney Disease Diabetes is the leading cause of kidney failure. In ... people starting dialysis have kidney failure caused by diabetes. Diabetes can damage your kidneys. This damage can ...

  13. Prepubertal Unilateral Gynecomastia: Report of 2 Cases

    PubMed Central

    Demirbilek, Hüseyin; Bacak, Gökhan; Baran, R?za Taner; Avc?, Yahya; Baran, Ahmet; Kele?, Ay?enur; Özbek, Mehmet Nuri; Alanay, Yasemin; Hussain, Khalid

    2014-01-01

    Prepubertal unilateral gynecomastia is an extremely rare condition. At present, its etiology and management strategy are not well known. Two unrelated prepubertal boys of ages 8 and 9 who presented with complaints of unilateral enlargement of breast tissue are reported. Physical examination, biochemical, hormonal and oncologic work-up findings were normal. Both patients were treated with peripheral liposuction successfully. Histopathological and immunohistochemical examinations showed benign fibroglandular gynecomastia and intensive (3+) estrogen receptor expression in 100% of periductal epithelial cells. Although an extremely rare and generally benign condition, patients with prepubertal unilateral gynecomastia should have a full endocrine and oncologic work-up. PMID:25541897

  14. [Secondary cubital paralysis from prolonged thoracic drainage].

    PubMed

    Olivier, L; Peillon, D; David, G; Girard-Madoux, P; Combe, C

    1998-01-01

    In intensive therapy patients, thoracic drains are usually inserted in the lateral part of thorax with the extension tube crossing the posterior aspect of the upper limb. We report the cases of two sedated patients who experienced ulnar palsy from a thoracic drain located behind their elbow. PMID:9750685

  15. Surgical approaches to thoracic disc herniations

    Microsoft Academic Search

    M. El-Kalliny; J. M. Tew; H. van Loveren; S. Dunsker

    1991-01-01

    Summary Early diagnosis of thoracic disc herniations has become more common with the advent of spinal magnetic resonance imaging (MRI). This early diagnosis combined with choosing the optimal surgical approach, to ensure adequate decompression without excessive cord and root manipulation, will achieve the optimum results. It is now clear that more lateral and anterior approaches to the thoracic spine are

  16. Thoracic spondylosis presenting with spastic paraparesis

    Microsoft Academic Search

    J. S. Chana; F. Afshar

    1996-01-01

    Spondylotic change of the spine is common in the cervical and lumbar regions and may present with compression of the spinal cord and nerve roots. Myelopathy due to degenerative disease in the thoracic spine is exceptional. Only a few cases have been reported in the literature and these reports have described disease in the lower four thoracic segments. We report

  17. Spontaneous Intracranial Hypotension Manifesting as a Unilateral Subdural Hematoma with a Marked Midline Shift

    PubMed Central

    Inamasu, Joji; Moriya, Shigeta; Shibata, Junpei; Kumai, Tadashi; Hirose, Yuichi

    2015-01-01

    Spontaneous intracranial hypotension (SIH) is a syndrome in which hypovolemia of the cerebrospinal fluid (CSF) results in various symptoms. Although its prognosis is usually benign, cases with a rapid neurologic deterioration resulting in an altered mental status have been reported. One of the characteristic radiographic findings in such cases is the presence of bilateral accumulation of subdural fluid (hematoma/hygroma). When SIH-related subdural hematoma is present only unilaterally with a concomitant midline shift, making an accurate diagnosis may be challenging, and inadvertent hematoma evacuation may result in further neurologic deterioration. We report a 58-year-old woman with an altered mental status who had visited a local hospital and in whom a brain CT showed a unilateral subdural hematoma with a marked midline shift. She was referred to our department because of her neurologic deterioration after hematoma evacuation. A CT myelography revealed a massive CSF leakage in the entire thoracic epidural space. She made a full neurologic recovery following blood patch therapy. Our case is unique and educational because the suspicion for SIH as an underlying cause of subdural hematoma is warranted in nongeriatric patients not only with bilateral but also unilateral lesions. An immediate search for CSF leakage may be important in cases with failed hematoma evacuation surgery. PMID:25969682

  18. All internal thoracic artery composite graft revascularization.

    PubMed

    Izumoto, Hiroshi; Ishihara, Kazuaki; Kawase, Tetsunori; Nakajima, Takayuki; Satoh, Hiroshi; Kawazoe, Kohei

    2005-12-01

    The aim of this study was to determine the most efficient design of composite grafts and clarify the technical feasibility rate of composite grafting using internal thoracic artery exclusively in patients undergoing triple-vessel revascularization. Retrospective analysis of 104 consecutive patients was carried out. An in situ left internal thoracic artery graft for the left anterior descending artery area, with attachment of the right internal thoracic artery to the side of the left internal thoracic artery to revascularize the circumflex and right coronary vessels, was the most efficient graft design. The technical feasibility rate was 80% (83/104 patients). The mean number of distal anastomoses for the entire group was 3.8+/-0.8 per patient. Intraoperative left internal thoracic artery flow rate was 91.6+/-37.8 mL.min-1. With more experience, it is thought that the technical feasibility rate could be increased. PMID:16304225

  19. Captopril induced renographic alteration in unilateral renal artery stenosis

    SciTech Connect

    Oei, H.Y.; Geyskes, G.G.; Dorhout Mees, E.J.; Puijlaert, C.B.A.J.

    1984-01-01

    In patients with unilateral renal artery stenosis (URAS) captopril administration will deteriorate glomerular filtration in the affected kidney by interruption of autoregulatory mechanisms. This effect might be detectable on renography and could be useful for the diagnosis of renovascular hypertension. After discontinuation of all medication, Tc-99m diethylene triamine pentaacetic acid (DTPA) gammacamera renography, followed by I-131 orthoiodohippurate (OIH) renography were performed in 15 hypertensive patients who were poorly controlled with medical therapy. This double examination was repeated some days later after administration of 25 mg captopril one hour prior to the examination. After this, angiography was done and patients with stenosis of the renal artery were treated by percutaneous transluminal dilatation (PTD). Five patients were excluded due to bilateral or segmental stenosis of the renal artery. Four URAS-patients, in whom the blood pressure improved after PTD, showed after administration of captopril a striking renographic alteration in the affected kidney. The DTPA-renogram which initially had an upslope phase, showed a blood disappearance curve and the OIH-renogram, which still had an upslope phase, showed a slower excretion. These renographic alteration did not occur in the other 2 URAS-patients, who had no benefit of the PTD and in the 4 remaining patients without stenosis. These findings suggest that captopril induced renographic alterations may be important for the diagnosis of hemodynamic significant URAS. For this purpose either DTPA or OIH can be used.

  20. Chronic Kidney Disease

    MedlinePLUS

    ... well as they should. Normal, healthy kidneys remove waste from the blood. The waste then leaves your body in your urine. The ... have chronic kidney disease, your kidneys cannot remove waste from the blood as well as they should. ...

  1. Chronic kidney disease, severe arterial and arteriolar sclerosis and kidney neoplasia: on the spectrum of kidney involvement in MELAS syndrome

    PubMed Central

    2012-01-01

    Background MELAS syndrome (MIM ID#540000), an acronym for Mitochondrial Encephalopathy, Lactic Acidosis and Stroke-like episodes, is a genetically heterogeneous mitochondrial disorder with protean manifestations and occasional kidney involvement. Interest in the latter is rising due to the identification of cases with predominant kidney involvement and to the hypothesis of a link between mitochondrial DNA and kidney neoplasia. Case presentation We report the case of a 41-year-old male with full blown MELAS syndrome, with lactic acidosis and neurological impairment, affected by the "classic" 3243A > G mutation of mitochondrial DNA, with kidney cancer. After unilateral nephrectomy, he rapidly developed severe kidney functional impairment, with nephrotic proteinuria. Analysis of the kidney tissue at a distance from the two tumor lesions, sampled at the time of nephrectomy was performed in the context of normal blood pressure, recent onset of diabetes and before the appearance of proteinuria. The morphological examination revealed a widespread interstitial fibrosis with dense inflammatory infiltrate and tubular atrophy, mostly with thyroidization pattern. Vascular lesions were prominent: large vessels displayed marked intimal fibrosis and arterioles had hyaline deposits typical of hyaline arteriolosclerosis. These severe vascular lesions explained the different glomerular alterations including ischemic and obsolescent glomeruli, as is commonly observed in the so-called "benign" arteriolonephrosclerosis. Some rare glomeruli showed focal segmental glomerulosclerosis; as the patient subsequently developed nephrotic syndrome, these lesions suggest that silent ischemic changes may result in the development of focal segmental glomerulosclerosis secondary to nephron loss. Conclusions Nephron loss may trigger glomerular sclerosis, at least in some cases of MELAS-related nephropathy. Thus the incidence of kidney disease in the "survivors" of MELAS syndrome may increase as the support therapy of these patients improves. PMID:22353239

  2. Management of thoracic outlet syndrome.

    PubMed Central

    Dale, W A; Lewis, M R

    1975-01-01

    This overall management program for thoracic outlet compression syndrome is based upon experience with 153 extremities in 149 patients and the results of others. The following conclusions are documented and discussed. 1) Diagnosis is based chiefly upon history; physical signs are inconstant and often absent. 2) Major vascular problems are unusual; angiography is not always necessary. 3) Electromyography is not always critical but does aid in diagnosis of carpal tunnel syndrome. 4) Non-operative treatment relieves most patients; operative decompression is indicated for a minority. 5) Transxillary first rib resection, with removal of cervical rib is the best operation. 6) Carpal tunnel decompression should be done concomitantly when needed. 7) Operation is relatively safe. Images Fig. 2. Fig. 3A. Fig. 3B. Fig. 4. Fig. 6. Fig. 7. Fig. 8. Fig. 9. Fig. 10. PMID:1130876

  3. Thoracic Extraosseous Epidural Cavernous Hemangioma

    PubMed Central

    Asil, Kiyasettin; Ceylan, Davut; Erdem, Sahin

    2015-01-01

    Cavernous hemangiomas were first reported in 1929 by Globus and Doshay, and are defined as benign vascular structures developed between the neural tissues occurring in the central nervous system, consisting of a dilated vascular bed. Cavernous hemangiomas comprise nearly 5-12% of all spinal vascular malformations; however, existence in the epidural space without bone involvement is rare. Only 4% of all cavernous hemangiomas (0.22/1.000.000) are purely epidural cavernous hemangiomas. In this case report, we removed a hemorrhagic thoracic mass presenting with progressive neurological deficits in a 55-year-old male patient. We found this case to be appropriate for presentation due to the rare occurrence of this type of cavernous hemangioma. PMID:25674348

  4. Extraintestinal Complications: Kidney Disorders

    MedlinePLUS

    ... kidney dialysis or transplantation may be required. Drug toxicity This is occasionally responsible for kidney complications, although toxicity issues generally resolve when the drug in question ...

  5. Thoracic Wall Reconstruction in Advanced Breast Tumours

    PubMed Central

    Daigeler, A.; Harati, K.; Goertz, O.; Hirsch, T.; Behr, B.; Lehnhardt, M.; Kolbenschlag, J.

    2014-01-01

    In advanced mammary tumours, extensive resections, sometimes involving sections of the thoracic wall, are often necessary. Plastic surgery reconstruction procedures offer sufficient opportunities to cover even large thoracic wall defects. Pedicled flaps from the torso but also free flap-plasties enable, through secure defect closure, the removal of large, ulcerated, painful or bleeding tumours with moderate donor site morbidity. The impact of thoracic wall resection on the respiratory mechanism can be easily compensated for and patients? quality of life in the palliative stage of disease can often be improved. PMID:24976636

  6. Incorporating research into thoracic surgery practice.

    PubMed

    D'Amico, Thomas A; Tong, Betty C; Berry, Mark F; Burfeind, William R; Onaitis, Mark W

    2011-08-01

    The incorporation of research into a career in thoracic surgery is a complex process. Ideally, the preparation for a career in academic thoracic surgery begins with a research fellowship during training. In the academic setting, a research portfolio might include clinical research, translational research, or basic research. Using strategies for developing collaboration, thoracic surgeons in community-based programs may also be successful clinical investigators. In addition to the rigors of conducting research, strategies for reserving protected time and obtaining grant support must be considered to be successful in academic surgery. PMID:21762860

  7. Investigating mechanisms of chronic kidney disease in mouse models

    Microsoft Academic Search

    Allison A. Eddy; Jesús M. López-Guisa; Daryl M. Okamura; Ikuyo Yamaguchi

    Animal models of chronic kidney disease (CKD) are important experimental tools that are used to investigate novel mechanistic\\u000a pathways and to validate potential new therapeutic interventions prior to pre-clinical testing in humans. Over the past several\\u000a years, mouse CKD models have been extensively used for these purposes. Despite significant limitations, the model of unilateral\\u000a ureteral obstruction (UUO) has essentially become

  8. Modulation and Redistribution of Proteinase Inhibitor 8 (Serpinb8) during Kidney Regeneration

    Microsoft Academic Search

    Anneliese Gillard; Kate Scarff; Kate L. Loveland; Sharon D. Ricardo; Phillip I. Bird

    2006-01-01

    Background: The intracellular serpin, proteinase inhibitor 8 (PI8\\/Serpinb8), can inhibit furin, a prohormone convertase involved in inflammation, prohormone processing and extracellular matrix remodeling. Unilateral ureteral obstruction (UUO) is a well-characterized model of kidney disease associated with interstitial fibrosis, where recovery involves cellular proliferation and extracellular matrix remodeling. Given the presence of mouse PI8 (mPI8) in kidney, the UUO technique was

  9. Cyclic Nucleotide Metabolism in Compensatory Renal Hypertrophy and Neonatal Kidney Growth

    Microsoft Academic Search

    Detlef Schlondorff; Herbert Weber

    1976-01-01

    Cyclic nucleotide metabolism was investigated in growing kidneys of rats during compensatory hypertrophy and during neonatal development. After unilateral nephrectomy a mild and short-lasting decrease in cyclic 3':5' adenosine monophosphate (cAMP) was observed in the hypertrophying kidney. In contrast, cyclic 3':5' guanosine monophosphate (cGMP) showed a sharp decline to 20% of control at 15 min and a rapid rise to

  10. Continuous thoracic paravertebral nerve block in a working anesthesia resident-when opioids are not an option.

    PubMed

    Buckley, Michael; Edwards, Hisani; Buckenmaier, Chester C; Plunkett, Anthony R

    2011-05-01

    Multiple unilateral rib fractures can cause significant pain and morbidity. Continuous nerve block catheters are often maintained while inpatient, and patients are discharged with oral analgesics. However, in many institutions, this dynamic is changing and patients are being managed effectively with outpatient catheters. A 45-year-old male was presented with fractured right ribs 6 through 9. The patient was an anesthesiology resident and was unable to perform his clinical duties. Single paravertebral nerve blocks were performed at right thoracic levels 6-9. At the T7 level, an indwelling catheter was placed. On post-injury day 18, he was able to discontinue the catheter and there were no associated complications. We report a unique case of a patient with multiple rib fractures who was not able to be exposed to potential side effects of opioids. The use of a continuous thoracic paravertebral nerve in an outpatient setting allowed a faster return to function with no adverse events. PMID:21634305

  11. Thoracic radiculopathy caused by a myodil cyst.

    PubMed

    Fitzpatrick, M O; Goyal, K; Johnston, R A

    2000-08-01

    We report the case of a myodil cyst causing a thoracic radiculopathy in a patient who had undergone a myelogram 30 years previously. Although myodil is no longer used, sequelae can continue to be seen for many years. PMID:11045204

  12. Nonintubated anesthesia in thoracic surgery: general issues.

    PubMed

    Kiss, Gabor; Castillo, Maria

    2015-05-01

    Anesthetic management for awake thoracic surgery (ATS) is more difficult than under general anesthesia (GA), being technically extremely challenging for the anesthesiologist. Therefore, thorough preparation and vigilance are paramount for successful patient management. In this review, important considerations of nonintubated anesthesia for thoracic surgery are discussed in view of careful patient selection, anesthetic preparation, potential perioperative difficulties and the management of its complications. PMID:26046051

  13. Thoracic aorta imaging with multisclice CT.

    PubMed

    Gotway, Michael B; Dawn, Samuel K

    2003-05-01

    Multislice CT aortography represents a major advance in the noninvasive evaluation of thoracic aortic disease. MSTCA is rapidly becoming the preferred modality for the initial investigation of acute aortic syndromes. Although scan quality is usually excellent, special attention to various technical parameters is required to optimize image quality. Familiarity with diagnostic pitfalls and the common imaging presentations of various thoracic aortic syndromes is necessary for accurate diagnosis. PMID:12797604

  14. Nonintubated anesthesia in thoracic surgery: general issues

    PubMed Central

    Castillo, Maria

    2015-01-01

    Anesthetic management for awake thoracic surgery (ATS) is more difficult than under general anesthesia (GA), being technically extremely challenging for the anesthesiologist. Therefore, thorough preparation and vigilance are paramount for successful patient management. In this review, important considerations of nonintubated anesthesia for thoracic surgery are discussed in view of careful patient selection, anesthetic preparation, potential perioperative difficulties and the management of its complications. PMID:26046051

  15. Kidney Disease of Diabetes

    E-print Network

    Baker, Chris I.

    Kidney Disease of Diabetes National Kidney and Urologic Diseases Information Clearinghouse is the final stage of chronic kidney disease (CKD). Diabetes is the most common cause of kidney failure, accounting for nearly 44 percent of new cases.1 Even when diabetes is controlled, the disease can lead to CKD

  16. Detecting Unilateral Phrenic Paralysis by Acoustic Respiratory Analysis

    PubMed Central

    Fiz, José Antonio; Jané, Raimon; Lozano, Manuel; Gómez, Rosa; Ruiz, Juan

    2014-01-01

    The consequences of phrenic nerve paralysis vary from a considerable reduction in respiratory function to an apparently normal state. Acoustic analysis of lung sound intensity (LSI) could be an indirect non-invasive measurement of respiratory muscle function, comparing activity on the two sides of the thoracic cage. Lung sounds and airflow were recorded in ten males with unilateral phrenic paralysis and ten healthy subjects (5 men/5 women), during progressive increasing airflow maneuvers. Subjects were in sitting position and two acoustic sensors were placed on their back, on the left and right sides. LSI was determined from 1.2 to 2.4 L/s between 70 and 2000 Hz. LSI was significantly greater on the normal (19.3±4.0 dB) than the affected (5.7±3.5 dB) side in all patients (p?=?0.0002), differences ranging from 9.9 to 21.3 dB (13.5±3.5 dB). In the healthy subjects, the LSI was similar on both left (15.1±6.3 dB) and right (17.4±5.7 dB) sides (p?=?0.2730), differences ranging from 0.4 to 4.6 dB (2.3±1.6 dB). There was a positive linear relationship between the LSI and the airflow, with clear differences between the slope of patients (about 5 dB/L/s) and healthy subjects (about 10 dB/L/s). Furthermore, the LSI from the affected side of patients was close to the background noise level, at low airflows. As the airflow increases, the LSI from the affected side did also increase, but never reached the levels seen in healthy subjects. Moreover, the difference in LSI between healthy and paralyzed sides was higher in patients with lower FEV1 (%). The acoustic analysis of LSI is a relevant non-invasive technique to assess respiratory function. This method could reinforce the reliability of the diagnosis of unilateral phrenic paralysis, as well as the monitoring of these patients. PMID:24718599

  17. Anesthesia Management of a 20-Month-Old Patient with Giant Unilateral Wilms Tumor

    PubMed Central

    Matinyan, Nune; Saltanov, Alexander; Martynov, Leonid; Kazantsev, Anatolij

    2015-01-01

    Wilms tumour (WT) (or nephroblastoma) is one of the most common malignant kidney tumors in children. On subsequent stages clinically it is often characterized by abdominal hypertension syndrome, which, in turn, leads to development of respiratory insufficiency. Other symptoms comprise renal deficiency, hypertension, and abnormalities of hemostasis and hemogram. Treatment includes rounds of preoperative chemotherapy and subsequent surgery. We report a case of perioperative management for nephrectomy in 20-month-old patient with a giant unilateral WT. The complexity of anesthesia was determined by the size of tumor, increased intra-abdominal pressure, respiratory deficiency, and hypercoagulation. PMID:25815216

  18. Kidney Stones

    PubMed Central

    Kleeman, Charles R.; Coburn, Jack W.; Brickman, Arnold S.; Lee, David B. N.; Narins, Robert G.; Ehrlich, Richard M.

    1980-01-01

    The prevalence of kidney stones has steadily risen during this century; passage of a calculus and a positive family history increase the probability of recurrence. Findings from recent studies on the cause of renal calculi have stressed crystallization and crystal aggregation of stone minerals from supersaturated urine, rather than excessive organic matrix. Absence of normal urine inhibitors of calcium salts is also stressed. Formation of calcium oxalate stones is the major problem. Therapy with decreased calcium and oxalate intake, thiazides, phosphate salts and allopurinol in various combinations has substantially decreased the prevalence of recurrent stones. The rationale for the use of allopurinol is that uric acid salts enhance the tendency for calcium oxalate to crystallize from supersaturated urine. The hypercalciuria seen in 30 percent to 40 percent of patients with oxalate stones is usually caused by intestinal hyperabsorption of calcium. Although patients with uric acid calculi constitute only a small fraction of those in whom stones form, they represent a group in whom good medical therapy, based on sound physiologic principles, has proved extremely successful. Renal tubular syndromes lead to nephrocalcinosis and lithiasis through hypercalciuria, alkaline urine and hypocitraturia, the latter an inhibitor of calcium salt precipitation. Recent advances in surgical techniques are discussed, including the rationale for removing staghorn calculi. The ileal ureter and coagulum pyelolithotomy deserve special emphasis. ImagesFigure 2.Figure 4.Figure 5.Figure 7. PMID:7385835

  19. Outcomes following unilateral uterine artery embolisation.

    PubMed

    McLucas, B; Reed, R A; Goodwin, S; Rappaport, A; Adler, L; Perrella, R; Dalrymple, J

    2002-02-01

    Uterine artery embolisation has been described as successful only when both arteries are embolised. However, results in patients with one congenitally absent or previously ligated artery are unknown. Women suffering from symptomatic uterine myomata were treated at a university teaching hospital, a community hospital and an outpatient surgery centre. Retrospective review of patient response to embolisation was assessed by chart review and questionnaire. Uterine and dominant fibroid size response was assessed by comparing pre- and post-embolisation ultrasound examinations. This study analysed three patient groups within the general population: those who underwent unilateral embolisation because of technical failure, those who ultimately underwent bilateral embolisation after initial technical failure and those who underwent unilateral embolisation because of an absent uterine artery. 12 patients underwent unilateral embolisation, 4 of whom underwent this procedure because of an absent uterine artery. Three of these four patients had a congenitally absent uterine artery arising from the internal iliac artery and all three experienced successful outcomes. The fourth patient had a previously ligated internal iliac artery and her symptoms worsened after the procedure. Eight patients had unilateral embolisation due to technical failure. Five of these patients underwent a subsequent procedure during which the contralateral uterine artery was embolised. Four of these five patients had successful outcomes and one was lost to follow-up. Another of the eight patients suffered an arterial injury leading to technical failure, and was lost to follow-up. Of the two remaining patients with unilateral technical failure, only one had a successful outcome. This study concluded that patients who undergo unilateral embolisation for technical reasons should be offered a second embolisation procedure shortly after the initial procedure. Patients with a congenitally absent uterine artery may respond with similar success to those who underwent bilateral embolisation. In contrast, the patient with a previously ligated internal iliac artery failed. The numbers in this study are too small for statistical analysis and subsequent studies should be performed to confirm these findings. PMID:11893635

  20. Case report: unilateral mydriasis following nasal cautery.

    PubMed

    Koo Ng, Nigel K F; Calder, Nick

    2010-12-01

    We report a case of unilateral mydriasis following nasal electrocautery presumed to be the result of retrograde flow of adrenaline and/or xylometazoline hydrochloride (Otrivine) through the nasolacrimal duct into the eye. We review the literature and highlight the importance of correct interpretation of finding a dilated pupil post-operatively. To our knowledge. we report the first such case involving xylometazoline hydrochloride and also following nasal electrocautery. Unilateral mydriasis is alarming after nasal surgery but must be interpreted with caution. During minimally invasive procedures it is likely to be due to the effects of topical medication to the nose rather than surgical trauma. PMID:21158576

  1. Unilateral Pedicle Fracture Accompanying Spondylolytic Spondylolisthesis

    PubMed Central

    Kim, Hyeun Sung; Ju, Chang Il; Kim, Yun Sung

    2015-01-01

    Unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis is rare even in the elderly. Most are associated with major trauma, previous spine surgery, or stress-related activity. Here, the authors describe an unique case of unilateral pedicle fracture associated with spondylolytic spondylolisthesis at the L5 level, which was successfully treated by posterior lumbar interbody fusion with screw fixation at the L5-S1 level. As far as the authors' knowledge, no such case has been previously reported in the literature. The pathophysiological mechanism of this uncommon entity is discussed and a review of relevant literature is included. PMID:26180621

  2. Asymmetric and unilateral hearing loss in children.

    PubMed

    Vila, Peter M; Lieu, Judith E C

    2015-07-01

    Asymmetric and unilateral hearing losses in children have traditionally been underappreciated, but health care practitioners are now beginning to understand their effect on development and the underlying pathophysiologic mechanisms. The common wisdom among medical and educational professionals has been that at least one normal-hearing or near-normal-hearing ear was sufficient for typical speech and language development in children. The objective of this review is to illustrate, to the non-otolaryngologist, the consequences of asymmetric and unilateral hearing loss in children on developmental and educational outcomes. Etiology, detection, and management are also discussed. Lastly, implications for further research are considered. PMID:26004144

  3. Contralateral Ureteral Meatal Advancement in Unilateral Antireflux Surgery

    Microsoft Academic Search

    Paolo Caione; Nicola Capozza; Alberto Lais; Simona Nappo; Ennio Matarazzo; Fabio Ferro

    1997-01-01

    PurposeContralateral vesicoureteral reflux is a well-known development after successful unilateral ureteral reimplantation that is not apparently influenced by the reimplantation technique. We sought to determine whether bilateral reimplantation should be performed routinely in unilateral cases.

  4. Pigmented villonodular synovitis of the thoracic spine.

    PubMed

    Roguski, Marie; Safain, Mina G; Zerris, Vasilios A; Kryzanski, James T; Thomas, Christine B; Magge, Subu N; Riesenburger, Ron I

    2014-10-01

    Pigmented villonodular synovitis (PVNS) is a proliferative lesion of the synovial membranes. Knees, hips, and other large weight-bearing joints are most commonly affected. PVNS rarely presents in the spine, in particular the thoracic segments. We present a patient with PVNS in the thoracic spine and describe its clinical presentation, radiographic findings, pathologic features, and treatment as well as providing the first comprehensive meta-analysis and review of the literature on this topic, to our knowledge. A total of 28 publications reporting 56 patients were found. The lumbar and cervical spine were most frequently involved (40% and 36% of patients, respectively) with infrequent involvement of the thoracic spine (24% of patients). PVNS affects a wide range of ages, but has a particular predilection for the thoracic spine in younger patients. The mean age in the thoracic group was 22.8 years and was significantly lower than the cervical and lumbar groups (42.4 and 48.6 years, respectively; p=0.0001). PVNS should be included in the differential diagnosis of osteodestructive lesions of the spine, especially because of its potential for local recurrence. The goal of treatment should be complete surgical excision. Although the pathogenesis is not clear, mechanical strain may play an important role, especially in cervical and lumbar PVNS. The association of thoracic lesions and younger age suggests that other factors, such as neoplasia, derangement of lipid metabolism, perturbations of humoral and cellular immunity, and other undefined patient factors, play a role in the development of thoracic PVNS. PMID:24938389

  5. Unilateral pulmonary artery agenesis with vertebral anomaly

    PubMed Central

    Prasad, Rajniti; Srivastava, G N; Mishra, O P; Singh, Utpal Kant

    2013-01-01

    We report a two-and-half–year-old boy who presented with recurrent respiratory tract infections. He had cortriatum of right atrium, spina bifida occulta, hemivertebra and dysplastic right thumb. On CT of chest, he had also unilateral pulmonary artery agenesis. The case is being reported because of common manifestations of rare disease and its associated cardiac and skeletal abnormalities. PMID:23784756

  6. Unilateral vs. Bilateral Damage 1 Running head: UNILATERAL VS. BILATERAL DAMAGE

    E-print Network

    McClelland, James L. "Jay"

    Scoville produced a profound memory loss in patient HM by removing the hippocampus bilaterally. Scoville, 1955; Scoville & Milner, 2000). Why are there such different consequences of unilateral and bilateral

  7. Bilateral multicystic dysplastic kidneys -- an unusual case diagnosed on antenatal ultrasound.

    PubMed

    Sethi, Sumer Kumar; Jagmohan, Pooja; Solanki, R S; Sangwan, Sunita; Toppo, Suresh

    2011-07-01

    While it is true that unilateral multicystic dysplastic kidney is commonly associated with abnormalities in the contralateral kidney, it is not widely known that the condition may be bilateral. The recognition of the bilaterality of the multicystic dysplastic kidney by ultrasound has grave prognostic implications as this condition is uniformly fatal. High resolution ultrasound examination of the foetus enables early detection of congenital malformations of the urinary tract. This information is of value in determining foetalprognosis, in deciding the method of delivery, and in alerting the paediatricians to supportive and corrective measures which may need to be taken in postnatal period. PMID:22315850

  8. Evaluation of hypertension by ambulatory blood pressure monitoring in children with solitary kidney.

    PubMed

    Tabel, Yilmaz; Aksoy, Özlem; Elmas, Ahmet Taner; Çelik, Serkan Fazli

    2015-04-01

    In this study, we aimed to investigate the blood pressure (BP) profile in children with a unilateral functioning solitary kidney (UFSK). A group of 49 patients between the ages of 5 and 18 years, and 30 healthy controls between the ages of 6 and 16 years were investigated. Gender, weight, height and body mass index (BMI) of patients and controls were recorded. BP profile was determined by ambulatory BP monitoring (ABPM). We have observed a higher risk of hypertension compared with healthy children. Also, masked hypertension is more frequently in the patients group and white-coat hypertension was observed in the control group. The mean night-time systolic BP (SBP) load (p = 0.01) and 24-h diastolic BP (DBP) load (p = 0.008) of children with multicystic dysplastic kidney (MCDK) was significantly higher than the healthy group. The mean night-time SBP load (p = 0.001) of children with unilateral renal agenesis (URA) and 24-h DBP load (p = 0.003) of children with unilateral atrophic or hypoplastic kidney were significantly higher than healthy group. We showed that the children with a solitary kidney had increased risk of hypertension. ABPM reflects the BP profile more precisely than casual BP measurement and it can be used to evaluate white-coat and masked hypertension in children with a solitary kidney. PMID:25580841

  9. Acute arterial occlusion - kidney

    MedlinePLUS

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidneys need a good blood supply. The main artery to the kidney is called the renal artery. ...

  10. Cowden disease and multicystic dysplastic kidney: increased risk of renal cancer?

    PubMed Central

    Teixeira, Ana; Edery, Patrick; Cochat, Pierre

    2012-01-01

    Unilateral multicystic dysplastic kidney is one of the most frequently identified urinary tract abnormalities in children. Although it can be an isolated finding, it is often associated with other anomalies of the kidney and urinary tract. It has also been described in association with other multisystemic disorders of known genetic aetiologies. Cowden disease (CD) is a rare autosomal-dominant disorder with age-related penetrance characterized by benign and malignant hamartomatous lesions affecting derivatives of all three germ cell layers. Hamartomas can emerge in virtually every organ, but are mostly found in the skin and gastrointestinal tract. We report a 7-year-old patient presenting with unilateral multicystic dysplastic kidney and CD, a hitherto unknown association in paediatrics, which raises the question of an increased risk of renal cancer. PMID:26019827

  11. Akt2 is involved in loss of epithelial cells and renal fibrosis following unilateral ureteral obstruction.

    PubMed

    Lan, Aiping; Zhang, Jing; Xiao, Zhicheng; Peng, Xiaogang; Qi, Yongfen; Du, Jie

    2014-01-01

    Obstructive nephropathy is an aggressive form of chronic kidney disease (CKD), which is characterized by an epithelial-to-mesenchymal transition (EMT) and interstitial fibrosis. However, the molecular mechanisms of EMT and fibrosis are complex and not fully understood. In this study, we investigated the contribution of Akt2 to experimental renal EMT and fibrosis using the well-established model of unilateral ureteral obstruction (UUO). We found that Akt2 and phosphor (p)-Akt protein levels were increased in the obstructed kidneys. UUO induced activation of transforming growth factor-?1 (TGF-?1) signaling. Importantly, knockout of Akt2 suppressed UUO-induced EMT, kidney fibrosis, increased GSK3? activity, and decreased expression of Snail and ?-catenin. Inhibition of GSK3? with LiCl (the inhibitor of GSK3?) increased the expression of Snail and ?-catenin in cultured kidney epithelial cells. Our findings suggest that Akt2 partially contributes to interstitial fibrosis following UUO and that inhibition of this signaling pathway may provide a novel approach of prevent progression of renal fibrosis. PMID:25148525

  12. Unilateral Cervical Nodal Metastasis Is an Independent Prognostic Factor for Esophageal Squamous Cell Carcinoma Patients Undergoing Chemoradiotherapy: A Retrospective Study

    PubMed Central

    Zhao, Lei; Li, Qiao-Qiao; He, Liru; Liu, Shiliang; Shen, Jingxian; Liu, Meng-Zhong

    2014-01-01

    Purpose To determine the prognostic significance of unilateral cervical lymph nodal metastasis (CLNM) in patients with inoperable thoracic esophageal squamous cell carcinoma (SCC) and to identify significant prognostic factors in these patients. Patients and methods This retrospective study involved 395 patients with inoperable esophageal SCC treated with concurrent chemoradiotherapy. The patients were classified into three groups according to their cervical lymph node status: group A, no evidence of CLNM; group B, unilateral CLNM; group C, other distant metastases. Overall survival (OS) and progression-free survival (PFS) were calculated. Significant prognostic factors were identified using univariate and multivariate analyses. Results The 3-year OS rates in groups A, B and C were 46.7%, 33.5% and 8.3%, respectively (p<0.001, log-rank test). The corresponding PFS rates were 40.7%, 26.4% and 4.7% (p<0.001, log-rank test). Group B had a similar prognosis to that of group A and better 3-year OS (p?=?0.009) and PFS (p?=?0.006) rates than those of group C. Multivariate analysis demonstrated that T stage, chemotherapy regimen and cervical lymph node involvement were independent prognostic factors affecting OS and PFS. Conclusions Compared to other distant metastases, unilateral CLNM is associated with longer OS in esophageal SCC and should be regarded as a regional disease. Sex, T stage, concurrent chemotherapy modality and cervical lymph node involvement are independent predictors of survival in esophageal SCC. PMID:24979040

  13. Kidney and hypertension

    Microsoft Academic Search

    Marcin Adamczak; Martin Zeier; Ralf Dikow; Eberhard Ritz

    2002-01-01

    Kidney and hypertension. There is a unique relationship between the kidney and blood pressure (BP): on the one hand, renal dysfunction and particularly renal disease cause an increase in BP, while on the other hand, high BP accelerates loss of function of the diseased kidney. Transplantation studies, both in experimental animals and humans, documented that “blood pressure goes with the

  14. Acquired Cystic Kidney Disease

    MedlinePLUS

    ... Catherine Kelleher, M.D., University of Colorado Health Sciences Center, Denver. About the Kidney Failure Series The NIDDK Kidney Failure Series includes booklets and fact sheets that can help you learn more about treatment methods for kidney failure, complications of dialysis, financial help ...

  15. VASCULAR-INTERVENTIONAL Haemodynamic imaging of thoracic stent-grafts

    E-print Network

    Nicoud, Franck

    VASCULAR-INTERVENTIONAL Haemodynamic imaging of thoracic stent-grafts by computational fluid after stent-graft implantation. Key Points · Functional vascular imaging of the thoracic aorta offers- tional vascular imaging of the thoracic aorta. The purpose of this paper is to present an imaging method

  16. Racial Differences in Thoracic Aorta Atherosclerosis Among Ischemic Stroke Patients

    Microsoft Academic Search

    Vishal Gupta; Navin C. Nanda; Dilek Yesilbursa; Wen Ying Huang; Vijaya Gupta; Qing Li; Camilo R. Gomez

    Background and Purpose—Atherosclerosis of the thoracic aorta is an independent risk factor for stroke. There is little information on the impact of race in the prevalence of thoracic aorta atherosclerotic plaques among ischemic stroke patients. This study was an attempt to objectively assess the prevalence, thickness, and burden of thoracic aorta atherosclerotic plaques in a large population of ischemic stroke

  17. Endovascular Repair of the Thoracic Aorta: Lessons Learned

    Microsoft Academic Search

    Frank J. Criado; Omran R. Abul-Khoudoud; Gregory S. Domer; Christine McKendrick; Mark Zuzga; Nancy S. Clark; Kerry Monaghan; Marcos F. Barnatan

    2005-01-01

    Background. Available information on outcome and best strategies for thoracic endovascular repair is some- what limited and unclear. We sought to gain a better understanding of these issues through a retrospective review of our 8-year clinical experience in the treatment of thoracic aortic aneurysms and dissections. Methods. A retrospective chart review of 186 patients undergoing stent-graft repair of thoracic aortic

  18. Unilateral Punctate Keratitis Secondary to Wallenberg Syndrome

    PubMed Central

    Boto, Ana; Del Hierro, Almudena; Capote, Maria; Noval, Susana; Garcia, Amanda; Santiago, Susana

    2014-01-01

    We studied three patients who developed left unilateral punctate keratitis after suffering left-sided Wallenberg Syndrome. A complex evolution occurred in two of them. In all cases, neurophysiological studies showed damage in the trigeminal sensory component at the bulbar level. Corneal involvement secondary to Wallenberg syndrome is a rare cause of unilateral superficial punctate keratitis. The loss of corneal sensitivity caused by trigeminal neuropathy leads to epithelial erosions that are frequently unobserved by the patient, resulting in a high risk of corneal-ulcer development with the possibility of superinfection. Neurophysiological studies can help to locate the anatomical level of damage at the ophthalmic branch of the trigeminal nerve, confirming the suspected etiology of stroke, and demonstrating that prior vascular involvement coincides with the location of trigeminal nerve damage. In some of these patients, oculofacial pain is a distinctive feature. PMID:24882965

  19. Smell sparing unilateral intracranial dermoid resection.

    PubMed

    Grayson, Jessica W; Chaaban, Mohamad R; Riley, Kristen O; Woodworth, Bradford A

    2014-03-01

    Intracranial dermoid cysts are congenital ectodermal inclusion cysts that have a propensity to occur in the midline sellar, parasellar, or frontonasal regions. These cysts enlarge by means of glandular secretion and epithelial desquamation. Surgical resection has traditionally included a craniotomy, but endoscopic approaches are now used with increasing regularity. A binostril approach is normally used to access dermoid cysts due to the midline nature of the lesions. In this case report, we describe the successful surgical resection of a dermoid with 1.5-cm of intracranial extension using a unilateral endonasal endoscopic approach with no complications and with no postoperative anosmia. Although the unilateral endoscopic technique is not plausible for all epidermoid or dermoid cysts of the anterior cranial fossa, it should be considered a viable alternative technique when faced with a dermoid limited to one side of the falx cerebri. PMID:24612984

  20. Smell sparing unilateral intracranial dermoid resection

    PubMed Central

    Grayson, Jessica W.; Chaaban, Mohamad R.; Riley, Kristen O.

    2014-01-01

    Intracranial dermoid cysts are congenital ectodermal inclusion cysts that have a propensity to occur in the midline sellar, parasellar, or frontonasal regions. These cysts enlarge by means of glandular secretion and epithelial desquamation. Surgical resection has traditionally included a craniotomy, but endoscopic approaches are now used with increasing regularity. A binostril approach is normally used to access dermoid cysts due to the midline nature of the lesions. In this case report, we describe the successful surgical resection of a dermoid with 1.5-cm of intracranial extension using a unilateral endonasal endoscopic approach with no complications and with no postoperative anosmia. Although the unilateral endoscopic technique is not plausible for all epidermoid or dermoid cysts of the anterior cranial fossa, it should be considered a viable alternative technique when faced with a dermoid limited to one side of the falx cerebri. PMID:24612984

  1. [Unilateral nasal obstruction in children: Pai syndrome].

    PubMed

    Zanetta, Adrián; Cuestas, Giselle; Oviedo, Maricruz; Tiscorni, Carlos

    2011-10-01

    Unilateral obstruction of the nasal cavity in children is mainly caused by the introduction of foreign bodies further stated with rhinorrhea and fetid odor. Less commonly, it can be traumatic, neoplastic, due to congenital malformation or iatrogenic. Symptoms of congenital intranasal mass may present at birth, or go unnoticed and be a finding in a routine pediatric examination. Patient evaluation should include imaging studies to guide the diagnosis and rule out intracranial extension. A syndrome associated with congenital nasal tumor should be suspected when other abnormalities are present. Pai syndrome is a rare genetic disorder. Its manifestations are craniofacial being congenital nasal polyp his main marker. We present a patient with unilateral nasal respiratory failure secondary to congenital nasal lipoma, with craniofacial anomalies belonging to Pai syndrome. Nasal obstruction was successfully surgically resolved. PMID:22042063

  2. Spontaneous unilateral brainstem infarction in Swiss mice.

    PubMed

    Southard, T; Brayton, C F

    2011-05-01

    Spontaneous vestibular syndrome in mice, characterized clinically by head tilt, circling or rolling, can be caused by otitis media, arteritis or central nervous system lesions. Postmortem examination of eleven non-inbred Swiss mice submitted for necropsy due to acute onset of vestibular signs revealed lesions consistent with brainstem infarction. The lesions were characterized by unilateral, well-demarcated areas of necrosis, malacia, and gliosis, with variable amounts of hemorrhage, in the lateral aspect of the medulla and caudal pons. The affected area included the medial, lateral and superior vestibular nuclei, the facial nucleus and the spinal trigeminal nucleus. While vestibular disease secondary to otitis media, periarteritis, and central nervous system neoplasia has been reported in many mouse strains, these unilateral brainstem infarctions were only seen in Swiss mice. These lesions share features with Wallenberg's Lateral Medullary Syndrome, the most common type of brainstem infarct in humans. PMID:20466861

  3. Transcatheter Arterial Embolization Therapy for a Hypoplastic Pelvic Kidney with a Single Vaginal Ectopic Ureter to Control Incontinence: The Usefulness of Three-Dimensional CT Angiography Using Multidetector-Row Helical CT

    SciTech Connect

    Kudoh, Kouichi, E-mail: cdk70770@par.odn.ne.jp; Kadota, Masataka; Nakayama, Yoshiharu; Imuta, Masanori; Yasuda, Tsuyoshi; Yamashita, Yasuyuki [Kumamoto University School of Medicine, Kumamoto, Department of Radiology (Japan); Inadome, Akito; Yoshida, Masaki; Ueda, Shouichi [Kumamoto University School of Medicine, Kumamoto, Department of Urology (Japan)

    2003-09-15

    A girl with continuous urinary incontinence was successfully treated by angiographic embolization of a hypoplastic pelvic kidney with a single unilateral vaginal ectopic opening of the ureter. For this intervention, CT angiography was useful for detecting the corresponding renal artery of the hypoplastic kidney.

  4. Computed tomography of thoracic aortic trauma

    Microsoft Academic Search

    J.-F. Biquet; R. F. Dondelinger; D. Roland

    1996-01-01

    During a 63-month period, 28 consecutive patients suspicious for injury of the thoracic aorta were examined by computed tomography (CT) Twelve ve aortic ruptures were evidenced; pseudoaneurysm and mediastinal haematoma III close contact with the aorta were present In 12 atients, marginal lucency in 9, marginal irregularity in 8 and intimal flap in 6. CT was falsely negative in 1

  5. Mediastinal Castleman's disease mimicking thoracic paravertebral schwannoma.

    PubMed

    Paci, Massimiliano; Valli, Riccardo; Tenconi, Sara; Sgarbi, Giorgio

    2011-09-01

    A 51-year-old female underwent resection of a solid lesion in the posterior mediastinum, preoperatively interpreted at imaging as thoracic schwannoma, requiring double sequential surgical procedure to be resected. The histologic examination of the resected mass diagnosed a hyaline-vascular Castleman's disease. PMID:21632863

  6. Does the frontal airbag avoid thoracic injury?

    Microsoft Academic Search

    G. Matthes; U. Schmucker; E. Lignitz; M. Huth; A. Ekkernkamp; J. Seifert

    2006-01-01

    Introduction  The airbag is an established car safety device. However, recent studies pointed out that even the airbag might cause injuries. Nevertheless, most physicians do consider a lower risk in accident victims sustaining severe injury of the chest, when a deployed frontal airbag has been reported. We set out to verify the frequency and pattern of thoracic injury in car drivers

  7. Thoracic Epidural Anesthesia Combined with General Anesthesia: The Preferred Anesthetic Technique for Thoracic Surgery

    Microsoft Academic Search

    Vera Von Dossow; Martin Welte; Ulrich Zaune; Eike Martin; Michael Walter; Wolfgang J. Kox; Claudia D. Spies

    2001-01-01

    Thoracic epidural anesthesia (TEA) combined with general anesthesia (GA) as well as total-IV anesthesia (TIVA) are both established anesthetic managements for thoracic surgery. We compared them with respect to hypoxic pulmonary vasoconstriction, shunt fraction and oxygenation during one-lung ventilation. Fifty pa- tients, ASA physical status II-III undergoing pulmo- nary resection were randomly allocated to two groups. In the TIVA group,

  8. Enhancement of bilateral cortical somatosensory evoked potentials to intact forelimb stimulation following thoracic contusion spinal cord injury in rats.

    PubMed

    Bazley, Faith A; Maybhate, Anil; Tan, Chuen Seng; Thakor, Nitish V; Kerr, Candace; All, Angelo H

    2014-09-01

    The adult central nervous system is capable of significant reorganization and adaptation following neurotrauma. After a thoracic contusive spinal cord injury (SCI) neuropathways that innervate the cord below the epicenter of injury are damaged, with minimal prospects for functional recovery. In contrast, pathways above the site of injury remain intact and may undergo adaptive changes in response to injury. We used cortical somatosensory evoked potentials (SSEPs) to evaluate changes in intact forelimb pathways. Rats received a midline contusion SCI, unilateral contusion SCI, or laminectomy with no contusion at the T8 level and were monitored for 28 days post-injury. In the midline injury group, SSEPs recorded from the contralateral forelimb region of the primary somatosensory cortex were 59.7% (CI 34.7%, 84.8%; c(2) = 21.9; dof = 1; p = 2.9 ×10(-6)) greater than the laminectomy group; SSEPs from the ipsilateral somatosensory cortex were 47.6% (CI 18.3%, 77%; c(2) = 10.1; dof = 1; p = 0.001) greater. Activation of the ipsilateral somatosensory cortex was further supported by BOLD-fMRI, which showed increased oxygenation at the ipsilateral hemisphere at day seven post-injury. In the unilateral injury group, ipsilesional side was compared to the contralesional side. SSEPs on day 14 (148%; CI 111%, 185%) and day 21 (137%; CI 110%, 163%) for ipsilesional forelimb stimulation were significantly increased over baseline (100%). SSEPs recorded from the hindlimb sensory cortex upon ipsilesional stimulation were 33.9% (CI 14.3%, 53.4%; c(2) = 11.6; dof = 1; p = 0.0007) greater than contralesional stimulation. Therefore, these results demonstrate the ability of SSEPs to detect significant enhancements in the activation of forelimb sensory pathways following both midline and unilateral contusive SCI at T8. Reorganization of forelimb pathways may occur after thoracic SCI, which SSEPs can monitor to aid the development of future therapies. PMID:24801738

  9. Non-intubated anesthesia in thoracic surgery—technical issues

    PubMed Central

    2015-01-01

    Performing awake thoracic surgery (ATS) is technically more challenging than thoracic surgery under general anesthesia (GA), but it can result in a greater benefit for the patient. Local wound infiltration and lidocaine administration in the pleural space can be considered for ATS. More invasive techniques are local wound infiltration with wound catheter insertion, thoracic wall blocks, selective intercostal nerve blockade, thoracic paravertebral blockade and thoracic epidural analgesia, offering the advantage of a catheter placement which can also be continued for postoperative analgesia. PMID:26046050

  10. Non-intubated anesthesia in thoracic surgery-technical issues.

    PubMed

    Kiss, Gabor; Castillo, Maria

    2015-05-01

    Performing awake thoracic surgery (ATS) is technically more challenging than thoracic surgery under general anesthesia (GA), but it can result in a greater benefit for the patient. Local wound infiltration and lidocaine administration in the pleural space can be considered for ATS. More invasive techniques are local wound infiltration with wound catheter insertion, thoracic wall blocks, selective intercostal nerve blockade, thoracic paravertebral blockade and thoracic epidural analgesia, offering the advantage of a catheter placement which can also be continued for postoperative analgesia. PMID:26046050

  11. Simultaneous Bilateral or Unilateral Carpal Tunnel Release?

    PubMed Central

    Osei, Daniel A.; Calfee, Ryan P.; Stepan, Jeffrey G.; Boyer, Martin I.; Goldfarb, Charles A.; Gelberman, Richard H.

    2014-01-01

    Background: Over 60% of patients with carpal tunnel syndrome present with symptoms and findings of nerve compression in both hands. Our goal was to compare patient-rated difficulties in performing activities of daily living in the early postoperative period between those undergoing bilateral carpal tunnel release and those undergoing unilateral carpal tunnel release. Methods: This prospective cohort study enrolled consecutive patients with bilateral carpal tunnel syndrome undergoing bilateral carpal tunnel release (n = 47) or unilateral carpal tunnel release (n = 41). Patient function and disease severity were measured by an abbreviated form of the Disabilities of the Arm, Shoulder and Hand questionnaire, QuickDASH, and the Boston Carpal Tunnel Questionnaire at baseline, at postoperative visit 1 at a mean time (and standard deviation) of 10 ± 3 days, and at postoperative visit 2 at a mean time (and standard deviation) of 30 ± 6 days. Patients rated their difficulty in completing fifteen activities of daily living each day for the first postoperative week. Patients reported the factors that influenced their choice of surgery. Results: There was no difference in baseline function or disease severity between the two groups with regard to QuickDASH and the Boston Carpal Tunnel Questionnaire. Patients in both groups improved after carpal tunnel release with no difference between groups either at postoperative visit 1 for QuickDASH (p = 0.97) and the Boston Carpal Tunnel Questionnaire (p = 0.86) or at postoperative visit 2 for QuickDASH (p = 0.43) and the Boston Carpal Tunnel Questionnaire (p = 0.34). Patients undergoing bilateral carpal tunnel release had more difficulty only during postoperative days 1 to 2 in opening jars (p = 0.03), cooking (p = 0.008), and doing household chores (p = 0.02). Patients in the two groups did not differ (p > 0.05) in their abilities to perform activities of daily living necessary for personal hygiene or independence on any day during the first seven days following surgery with regard to using the bathroom, bathing, dressing, or eating. Although the most common reason why patients chose bilateral carpal tunnel release was to avoid two surgical procedures (42%), the most common reason why patients chose unilateral carpal tunnel release was concern for self-care (36%). Conclusions: Patients with bilateral carpal tunnel syndrome can anticipate more severe functional impairment during the first few postoperative days with bilateral carpal tunnel release compared with unilateral carpal tunnel release, but limitations beyond postoperative day 2 or 3 are similar for bilateral and unilateral carpal tunnel release. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. PMID:24897736

  12. Continuous paravertebral infusion of ropivacaine with or without fentanyl for pain relief in unilateral multiple fractured ribs

    PubMed Central

    Mohta, Medha; Ophrii, Emeni L; Sethi, Ashok Kumar; Agarwal, Deepti; Jain, Bhupendra Kumar

    2013-01-01

    Background: Continuous thoracic paravertebral block (TPVB) provides effective analgesia for unilateral multiple fractured ribs (MFR). However, prolonged infusion of local anaesthetic (LA) in high doses can predispose to risk of LA toxicity, which may be reduced by using safer drugs or drug combinations. This study was conducted to assess efficacy and safety of paravertebral infusion of ropivacaine and adrenaline with or without fentanyl to provide analgesia to patients with unilateral MFR. Methods: Thirty adults, having ?3 unilateral MFR, with no significant trauma outside chest wall, were studied. All received bolus of 0.5% ropivacaine 0.3 ml/kg through paravertebral catheter, followed by either 0.1-0.2 ml/kg/hr infusion of ropivacaine 0.375% with adrenaline 5 ?g/ml in group RA or ropivacaine 0.2% with adrenaline 5 ?g/ml and fentanyl 2 ?g/ml in group RAF. Rescue analgesia was provided by IV morphine. Results: Statistical analysis was performed using unpaired Student t-test, Chi-square test and repeated measures ANOVA. After TPVB, VAS scores, respiratory rate and PEFR improved in both groups with no significant inter-group differences. Duration of ropivacaine infusion, morphine requirements, length of ICU and hospital stay, incidence of pulmonary complications and opioid-related side-effects were similar in both groups. Ropivacaine requirement was higher in group RA than group RAF. No patient showed signs of LA toxicity. Conclusion: Continuous paravertebral infusion of ropivacaine 0.375% with adrenaline 5 ?g/ml at 0.1-0.2 ml/kg/hr provided effective and safe analgesia to patients with unilateral MFR. Addition of fentanyl 2 ?g/ml allowed reduction of ropivacaine concentration to 0.2% without decreasing efficacy or increasing opioid-related side-effects. PMID:24403614

  13. Pseudotumour of the kidney secondary to posterior urethral valves: the role of renal backflow and perirenal extravasation

    Microsoft Academic Search

    O. Eklöf; B. Elle; S. Thönell

    1984-01-01

    In three male neonates, successfully treated for posterior urethral valves, unilateral “pseudotumour” deformity of the collecting system ensued. Two of them had, preoperatively, a marked ipsilateral perirenal urinary extravasation (urinoma), one in addition gross contralateral renal backflow with moderate leakage to the renal capsule. The other one had slight contralateral backflow to the kidney parenchyma but also urinary ascites. The

  14. The European educational platform on thoracic surgery

    PubMed Central

    Rocco, Gaetano; Venuta, Federico

    2014-01-01

    As the largest scientific organisation world-wide exclusively dedicated to general thoracic surgery (GTS), the European Society of Thoracic Surgeons (ESTS) recognized that one of its priorities is education. The educational platform designed ESTS addresses not only trainees, but also confirmed thoracic surgeons. The two main aims are (I) to prepare trainees to graduation and to the certification by the European Board of Thoracic Surgery and (II) to offer opportunities for continuous medical education in the perspective of life-long learning and continuous professional development to certified thoracic surgeons. It is likely that recertification will become an obligation during the coming decade. At its inception, the platform differentiated two different events. A 6-day course emphasizing on theoretic knowledge was created in Antalya in 2007. The same year, a 2-day school oriented to practical issues with hands-on in the animal lab was launched in Antalya. These two teaching tracks need further development. In the knowledge track, we intend to organize highly specialized 2-day courses to deepen insight into theoretical questions. The skill track will be implemented by specialized courses for high technology such as tracheal surgery, ECMO, robotics or chest wall reconstruction. In order to promote tomorrows’ leadership, we created an academic competence track giving an insight into medical communication, methodology and management. We also had to respond to an increasing demand from the Russian speaking countries, where colleagues may face problems to attend western meetings, and where the language bareer may be a major impediment. We initiated a Russian school with three events yearly in 2012. Contemporary teaching must be completed with an e-learning platform, which is currently under development. The school activities are organized by the educational committee, which is headed by the ESTS Director of Education, assisted by coordinators of the teaching tracks and e-learning platform. Ongoing discussions concern development of contemporary teaching techniques and measure of outcome. The major challenge for the coming years is harmonisation of training and certification in thoracic surgery in the European space. PMID:24868446

  15. Kidney and Urologic Diseases

    MedlinePLUS

    ... diagnosis, and treatment of erectile dysfunction. Estimated Glomerular Filtration Rate (eGFR) (for health care professionals) Estimated Glomerular Filtration Rate (for patients) Explaining Your Kidney Test Results: ...

  16. Acute Aortic Syndromes and Thoracic Aortic Aneurysm

    PubMed Central

    Ramanath, Vijay S.; Oh, Jae K.; Sundt, Thoralf M.; Eagle, Kim A.

    2009-01-01

    Acute and chronic aortic diseases have been diagnosed and studied by physicians for centuries. Both the diagnosis and treatment of aortic diseases have been steadily improving over time, largely because of increased physician awareness and improvements in diagnostic modalities. This comprehensive review discusses the pathophysiology and risk factors, classification schemes, epidemiology, clinical presentations, diagnostic modalities, management options, and outcomes of various aortic conditions, including acute aortic dissection (and its variants intramural hematoma and penetrating aortic ulcers) and thoracic aortic aneurysms. Literature searches of the PubMed database were conducted using the following keywords: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies performed within the past 20 years were included in the review; however, most data are from the past 15 years. PMID:19411444

  17. [Digital thoracic radiology: devices, image processing, limits].

    PubMed

    Frija, J; de Géry, S; Lallouet, F; Guermazi, A; Zagdanski, A M; De Kerviler, E

    2001-09-01

    In a first part, the different techniques of digital thoracic radiography are described. Since computed radiography with phosphore plates are the most commercialized it is more emphasized. But the other detectors are also described, as the drum coated with selenium and the direct digital radiography with selenium detectors. The other detectors are also studied in particular indirect flat panels detectors and the system with four high resolution CCD cameras. In a second step the most important image processing are discussed: the gradation curves, the unsharp mask processing, the system MUSICA, the dynamic range compression or reduction, the soustraction with dual energy. In the last part the advantages and the drawbacks of computed thoracic radiography are emphasized. The most important are the almost constant good quality of the pictures and the possibilities of image processing. PMID:11567193

  18. Video-assisted thoracic surgery and pneumothorax

    PubMed Central

    Paliouras, Dimitrios; Barbetakis, Nikolaos; Lazaridis, George; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Papaiwannou, Antonis; Karavergou, Anastasia; Lampaki, Sofia; Katsikogiannis, Nikolaos; Mpakas, Andreas; Tsakiridis, Kosmas; Korantzis, Ipokratis; Fassiadis, Nikolaos; Zarogoulidis, Konstantinos

    2015-01-01

    Video-assisted thoracoscopic surgery (VATS) is a type of thoracic surgery performed using a small video camera that is introduced into the patient’s chest via a scope. It is considered a minimally invasive technique where the surgeon is able to view the instruments that are being used along with the anatomy on which the surgeon is operating. The camera and instruments are inserted through separate holes in the chest wall also known as “ports”, depending on the patient and problem there are surgeries with one port “uniport”, two or three ports. These small ports have the advantage that fewer infections are observed. This allows for a faster recovery. Traditionally, thoracic surgery performed for diagnosis or treatment of chest conditions has required access to the chest through thoracotomy or sternotomy incisions. Vats minimally invasive technique has replaced in many cases thoracotomy or sternotomy. In our current review we will present this technique in detail. PMID:25774310

  19. Unilateral hearing loss following shunt placement for normal pressure hydrocephalus with a unilateral patent cochlear aqueduct

    Microsoft Academic Search

    Sun-Ho Lee; Seong-Hyun Park; Sung-Kyoo Hwang

    2007-01-01

    Hearing loss in patients who have undergone shunt placement for a hydrocephalus is perhaps an underestimated complication rather than a rare event. There appears to be a correlation between the occurrence of hearing loss and patient characteristics consistent with excessive drainage of cerebrospinal fluid (CSF) and patent cochlear aqueduct (CA). We present the case of a 77-year-old man with unilateral

  20. Anti-fibrotic effect of natural toxin bee venom on animal model of unilateral ureteral obstruction.

    PubMed

    An, Hyun Jin; Kim, Kyung Hyun; Lee, Woo Ram; Kim, Jung Yeon; Lee, Sun Jae; Pak, Sok Cheon; Han, Sang Mi; Park, Kwan Kyu

    2015-01-01

    Progressive renal fibrosis is the final common pathway for all kidney diseases leading to chronic renal failure. Bee venom (BV) has been widely used as a traditional medicine for various diseases. However, the precise mechanism of BV in ameliorating the renal fibrosis is not fully understood. To investigate the therapeutic effects of BV against unilateral ureteral obstruction (UUO)-induced renal fibrosis, BV was given intraperitoneally after ureteral ligation. At seven days after UUO surgery, the kidney tissues were collected for protein analysis and histologic examination. Histological observation revealed that UUO induced a considerable increase in the number of infiltrated inflammatory cells. However, BV treatment markedly reduced these reactions compared with untreated UUO mice. The expression levels of TNF-? and IL-1? were significantly reduced in BV treated mice compared with UUO mice. In addition, treatment with BV significantly inhibited TGF-?1 and fibronectin expression in UUO mice. Moreover, the expression of ?-SMA was markedly withdrawn after treatment with BV. These findings suggest that BV attenuates renal fibrosis and reduces inflammatory responses by suppression of multiple growth factor-mediated pro-fibrotic genes. In conclusion, BV may be a useful therapeutic agent for the prevention of fibrosis that characterizes progression of chronic kidney disease. PMID:26035488

  1. Mefunidone Attenuates Tubulointerstitial Fibrosis in a Rat Model of Unilateral Ureteral Obstruction

    PubMed Central

    Liu, Chunyan; Mei, Wenjuan; Tang, Juan; Yuan, Qiongjing; Huang, Ling; Lu, Miaomiao; Wu, Lin; Peng, Zhangzhe; Meng, Jie; Yang, Huixiang; Shen, Hong; Lv, Ben; Hu, Gaoyun; Tao, Lijian

    2015-01-01

    Background Inflammation has a crucial role in renal interstitial fibrosis, which is the common pathway of chronic kidney diseases. Mefunidone (MFD) is a new compound which could effectively inhibit the proliferation of renal fibroblasts in vitro. However, the overall effect of Mefunidone in renal fibrosis remains unknown. Methods Sprague-Dawley rats were randomly divided intro 6 groups: sham operation, unilateral ureteral obstruction (UUO), UUO/Mefunidone (25, 50, 100mg/kg/day) and UUO/PFD (500mg/kg/day). The rats were sacrificed respectively on days 3, 7, and 14 after the operation. Tubulointerstitial injury index, interstitial collagen deposition, expression of fibronectin (FN), ?-smooth muscle actin (?-SMA), type I and III collagen and the number of CD3+ and CD68+ cells were determined. The expressions of proinflammatory cytokines, p-ERK, p-I?B, and p-STAT3 were measured in human renal proximal tubular epithelial cells of HK-2 or macrophages. Results Mefunidone treatment significantly attenuated tubulointerstitial injury, interstitial collagen deposition, expression of FN, ?-SMA, type I and III collagen in the obstructive kidneys, which correlated with significantly reduced the number of T cells and macrophages in the obstructive kidneys. Mechanistically, Mefunidone significantly inhibited tumor necrosis factor-? (TNF-?-) or lipopolysaccharide (LPS)-induced production of proinflammatory cytokines. This effect is possibly due to the inhibition of phosphorylation of ERK, I?B, and STAT3. Conclusion Mefunidone treatment attenuated tubulointerstitial fibrosis in a rat model of UUO, at least in part, through inhibition of inflammation. PMID:26042668

  2. Anti-Fibrotic Effect of Natural Toxin Bee Venom on Animal Model of Unilateral Ureteral Obstruction

    PubMed Central

    An, Hyun Jin; Kim, Kyung Hyun; Lee, Woo Ram; Kim, Jung Yeon; Lee, Sun Jae; Pak, Sok Cheon; Han, Sang Mi; Park, Kwan Kyu

    2015-01-01

    Progressive renal fibrosis is the final common pathway for all kidney diseases leading to chronic renal failure. Bee venom (BV) has been widely used as a traditional medicine for various diseases. However, the precise mechanism of BV in ameliorating the renal fibrosis is not fully understood. To investigate the therapeutic effects of BV against unilateral ureteral obstruction (UUO)-induced renal fibrosis, BV was given intraperitoneally after ureteral ligation. At seven days after UUO surgery, the kidney tissues were collected for protein analysis and histologic examination. Histological observation revealed that UUO induced a considerable increase in the number of infiltrated inflammatory cells. However, BV treatment markedly reduced these reactions compared with untreated UUO mice. The expression levels of TNF-? and IL-1? were significantly reduced in BV treated mice compared with UUO mice. In addition, treatment with BV significantly inhibited TGF-?1 and fibronectin expression in UUO mice. Moreover, the expression of ?-SMA was markedly withdrawn after treatment with BV. These findings suggest that BV attenuates renal fibrosis and reduces inflammatory responses by suppression of multiple growth factor-mediated pro-fibrotic genes. In conclusion, BV may be a useful therapeutic agent for the prevention of fibrosis that characterizes progression of chronic kidney disease. PMID:26035488

  3. Endoscopic transforaminal thoracic foraminotomy and discectomy for the treatment of thoracic disc herniation.

    PubMed

    Nie, Hong-Fei; Liu, Kai-Xuan

    2013-01-01

    Thoracic disc herniation is a relatively rare yet challenging-to-diagnose condition. Currently there is no universally accepted optimal surgical treatment for symptomatic thoracic disc herniation. Previously reported surgical approaches are often associated with high complication rates. Here we describe our minimally invasive technique of removing thoracic disc herniation, and report the primary results of a series of cases. Between January 2009 and March 2012, 13 patients with symptomatic thoracic disc herniation were treated with endoscopic thoracic foraminotomy and discectomy under local anesthesia. A bone shaver was used to undercut the facet and rib head for foraminotomy. Discectomy was achieved by using grasper, radiofrequency, and the Holmium-YAG laser. We analyzed the clinical outcomes of the patients using the visual analogue scale (VAS), MacNab classification, and Oswestry disability index (ODI). At the final follow up (mean: 17 months; range: 6-41 months), patient self-reported satisfactory rate was 76.9%. The mean VAS for mid back pain was improved from 9.1 to 4.2, and the mean ODI was improved from 61.0 to 43.8. One complication of postoperative spinal headache occurred during the surgery and the patient was successfully treated with epidural blood patch. No other complications were observed or reported during and after the surgery. PMID:24455232

  4. Endoscopic thoracic laminoforaminoplasty for the treatment of thoracic radiculopathy: report of 12 cases

    PubMed Central

    Haufe, Scott M.W.; Baker, Ryan A.; Pyne, Morgan L.

    2009-01-01

    Background: Spinal stenosis of the thoracic spine is less common than that of the cervical and lumbar regions. Due to the close proximity to thoracic and abdominal organs, surgical operations can be difficult and carry a greater risk of complications. The most efficacious intervention for thoracic stenosis, whether central or foraminal, refractory to conservative management is uncertain. We aimed to evaluate the efficacy of endoscopic laminoforaminoplasty (ELFP) in the treatment of thoracic radiculopathy. Methods: Twelve patients with radicular pain involving the lower thoracic levels (at or below T6) were treated with ELFP. Results: Seven of twelve patients showed marked improvement in pain scores. Average follow-up scores were 2.9 and 12.08 on the Visual Analog Scale (VAS) and Oswestry Disability Index, respectively. The significance was 0.005 between the pre and post surgical data. One patient with moderate symptoms, two with severe symptoms, and two with crippling symptoms did not report significant improvement on VAS or Oswestry. No complications were encountered. Conclusions: Endoscopic laminoforaminoplasty offers an alternative to fusion or conventional laminotomy with similar success rates. Patients additionally benefit from a decrease risk of complications, short hospital stay, and faster recovery. PMID:19742241

  5. Fractures of the Thoracic and Lumbar Spine

    Microsoft Academic Search

    Robert N. Hensinger; Clifford L. Craig

    \\u000a Injuries of the thoracic and lumbar spine in children are rare. The potential for continued growth, the presence of healthy\\u000a disc tissue, the elasticity of the soft tissues, and well-mineralized bone distinguish these injuries from those in the adult.\\u000a The immature spine has the capacity to remodel the vertebral body, but not the posterior elements. Restoration of height of\\u000a a

  6. Unsuspected tracheal rupture in blunt thoracic trauma

    Microsoft Academic Search

    Jane Huang; Ronald E. Needs; Hensley A. B. Miller; J. Hugh Devitt

    1994-01-01

    The purpose of this report is to describe the discovery and management of an unanticipated injury during fibreoptic tracheal\\u000a intubation. A 23-yr-old man sustained blunt cervical, thoracic and abdominal trauma in a motor vehicle accident. He was brought\\u000a to the operating room for urgent management of his abdominal and cervical spine injuries. Examination of his airway during\\u000a awake fibreoptic tracheal

  7. Thoracic actinomycosis--review of 9 cases.

    PubMed

    Lee, C H; Lin, M C; Tsai, Y H; Tsao, T C; Lan, R S; Chiang, Y C

    1991-12-01

    Nine cases of thoracic actinomycosis treated in the period from 1976 to 1990 were reviewed. Among them, 4 cases were children. The clinical symptoms and laboratory examinations were non-specific. Chest roentgenographic manifestations including nodular (3 cases), infiltrations (4 cases), and infiltrations with pleural changes (2 cases) were also non-specific. Chest wall masses were noted in four patients. There were no cases correctly diagnosed on admission. The diagnosis of thoracic actinomycosis was made from thoracotomy in 6 cases, from culture of chest wall mass incisional specimens in 2 cases and from bronchoscopic biopsy in 1. All the patients received antibiotics, however the varied duration of postoperative antibiotics did not change the outcome. No mortality or recurrence was noted in our 9 patients with a mean follow-up of 1.9 years (from 2 months to 6 years.) We conclude that surgical intervention is still the cardinal method for diagnosis and treatment. Establishment of the role of postoperative antibiotics will need further prospective study. The prognosis of thoracic actinomycosis is fairly good. PMID:1797368

  8. Idiopathic chylopericardium treated by percutaneous thoracic duct embolization after failed surgical thoracic duct ligation.

    PubMed

    Courtney, Malachi; Ayyagari, Raj R

    2015-06-01

    Chylopericardium rarely occurs in pediatric patients, but when it does it is most often a result of lymphatic injury during cardiothoracic surgery. Primary idiopathic chylopericardium is especially rare, with few cases in the pediatric literature. We report a 10-year-old boy who presented with primary idiopathic chylopericardium after unsuccessful initial treatment with surgical lymphatic ligation and creation of a pericardial window. Following readmission to the hospital for a right-side chylothorax resulting from the effluent from the pericardial window, he had successful treatment by interventional radiology with percutaneous thoracic duct embolization. This case illustrates the utility of thoracic duct embolization as a less-invasive alternative to surgical thoracic duct ligation, or as a salvage procedure when surgical ligation fails. PMID:25249390

  9. Sexuality and Chronic Kidney Disease

    MedlinePLUS

    ... with kidney disease or kidney failure still enjoy sex? It's important to remember that people with kidney ... healthcare professional. What if I lose interest in sex? Your interest in sex may change when you ...

  10. Molecular Karyotype of Sporadic Unilateral Retinoblastoma Tumors

    PubMed Central

    Ganguly, Arupa; Nichols, Kim E.; Grant, Gregory; Rappaport, Eric; Shields, Carol

    2009-01-01

    Background Retinoblastoma (RB) is a childhood ocular malignancy associated with mutations in RB1, a tumor susceptibility gene. Inactivation of both copies of the RB1 gene in a retinal cell is followed by the sequential acquisition of additional genetic changes that define the course to tumor formation. Methods To identify the genetic events that cooperate with loss of the RB1 gene function, we performed a whole genome sampling assay (WGSA) based on SNP genotyping. We used DNA isolated from 25 sporadic, unilateral RB tumors and matched blood samples. Results Genomic profiles were analyzed to identify regions of loss of heterozygosity (LOH) and/or amplification. Two major subclasses of RB tumors were defined by the presence (n=18) or absence (n=7) of LOH of chromosome 13. LOH in most cases was due to copy neutral events caused by mitotic recombination and mitotic non-disjunction. Tumors harbored novel regions of amplification at 1q44, 3p25, 11q14, 11q25, 14q23, 15q21, 16p13, 17p11.2, 19q13, and 20q13 while regions of loss included 6q22, 7q21and 21q2. Conclusion WGSA-based analysis of unilateral RB tumors revealed novel regions as significant. These minimum critical regions that are lost or amplified are expected to harbor genes that aid the process of tumorigenesis. PMID:19491728

  11. Unilateral diaphragmatic dysfunction in blunt chest trauma.

    PubMed

    Gastinne, H; Venot, J; Dupuy, J P; Gay, R

    1988-03-01

    This study was undertaken to evaluate unilateral diaphragmatic dysfunction within ten days after blunt chest trauma. Thirty patients with unilateral chest injury, or predominantly one-sided injuries, were investigated in the supine position, under analgesia. Right and left hemidiaphragm displacement (DD) was measured, using digital subtraction radiography, during quiet and forced breathing. The diaphragmatic contribution to breathing was determined by rib cage and abdominal circumference measurement changes. In both breathing modes, DD of the injured side was lower than DD of the uninjured side (p less than 0.01, p less than 0.001). Six patients had complete diaphragmatic motionlessness. The inspired air volume due to diaphragmatic motion (Vab) was reduced when compared to normal subjects and Vab/VT ratio was always found to be less than 0.65. The degree of diaphragmatic dysfunction appeared related to injury location and is most severe in injuries of the lower chest which implies direct diaphragm muscle injury, although other mechanisms may be implicated. Diaphragmatic dysfunction can contribute to respiratory failure in these patients, and should be considered. PMID:3277805

  12. Hypertropia in unilateral isolated abducens palsy

    PubMed Central

    Pihlblad, Matthew S.; Demer, Joseph L.

    2014-01-01

    Purpose To evaluate the incidence and features of hypertropia in abducens nerve palsy. Methods The records of consecutive patients with unilateral, isolated, previously unoperated abducens nerve palsy were reviewed for binocular alignment on cover testing, Krimsky measurement, or Hess screen testing. Patients with associated cranial nerve palsy (including bilateral abducens palsies), orbital disease, myasthenia gravis, Horner syndrome, hemiplegia, cerebellar signs, arteritis, or previous strabismus surgery were excluded. Control subjects underwent complete examination to confirm normality. Results A total of 79 patients were included (40 males; mean age 49.2 years). Hypertropia in lateral or central gazes was present in 15 of 79 cases (19%) on alternate cover or Krimsky testing, in 32 of 56 cases (57%) on Hess screen testing, and absent in all 30 normal controls. Of cases with hypertropia, the mean of the greatest hypertropia in lateral or central gaze on was 5.0? ± 2.3? (standard deviation; range, 1?–8?) routine clinical examination, and 5.8? ± 4.2? (range, 2?–24?) on Hess screen testing. Of 39 cases with partial abducens palsy evaluated by Hess screen testing, the ipsilesional eye was hypertropic in 24 (61%) and hypotropic in 15 cases (39%). Conclusions Small-angle hypertropia is common in isolated, unilateral abducens and does not necessarily imply existence of multiple cranial neuropathies or skew deviation. PMID:24924275

  13. Acute kidney injury during pregnancy.

    PubMed

    Van Hook, James W

    2014-12-01

    Acute kidney injury complicates the care of a relatively small number of pregnant and postpartum women. Several pregnancy-related disorders such as preeclampsia and thrombotic microangiopathies may produce acute kidney injury. Prerenal azotemia is another common cause of acute kidney injury in pregnancy. This manuscript will review pregnancy-associated acute kidney injury from a renal functional perspective. Pathophysiology of acute kidney injury will be reviewed. Specific conditions causing acute kidney injury and treatments will be compared. PMID:25264696

  14. Persistent High Level of Urinary Tumor Marker Carbohydrate Antigen 19-9 in Prenatally Diagnosed Dysplastic Kidney

    PubMed Central

    Ebadi, Maryam; Rahimi Sherbaf, Fatemeh; Kajbafzadeh, Abdol-Mohammad

    2014-01-01

    Tumor marker carbohydrate antigen 19-9 (CA 19-9) level has gained clinical significance in gastrointestinal malignancies and in various solid and cystic diseases. Dysplastic kidney is a congenital abnormality resulting from atresia of the ureteral bud during the embryogenesis which can be unilateral or bilateral. We report unilateral dysplastic kidney with extremely large cyst diagnosed by routine ultrasonography in the 32nd week of gestational age with high levels of CA 19-9 in cystic and amniotic fluid, as well as persistent high urinary levels of this tumor marker during the 1-year follow-up. Persistent high urinary CA 19-9 level even after cyst aspiration may be attributable to remained function of dysplastic kidney due to remained epithelial lining. PMID:25614848

  15. CT and MRI in the Evaluation of Thoracic Aortic Diseases

    PubMed Central

    2013-01-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly used imaging examinations to evaluate thoracic aortic diseases because of their high spatial and temporal resolutions, large fields of view, and multiplanar imaging reconstruction capabilities. CT and MRI play an important role not only in the diagnosis of thoracic aortic disease but also in the preoperative assessment and followup after treatment. In this review, the CT and MRI appearances of various acquired thoracic aortic conditions are described and illustrated. PMID:24396601

  16. Bioengineering Kidneys for Transplantation

    PubMed Central

    Madariaga, Maria Lucia L.; Ott, Harald C.

    2014-01-01

    One in ten Americans suffer from chronic kidney disease, and close to 90,000 people die each year from causes related to kidney failure. Patients with end-stage renal disease are faced with two options: hemodialysis or transplantation. Unfortunately, the reach of transplantation is limited because of the shortage of donor organs and the need for immunosuppression. Bioengineered kidney grafts theoretically present a novel solution to both problems. Herein we discuss the history of bioengineering organs, the current status of bioengineered kidneys, considerations for the future of the field, and challenges to clinical translation. We hope that by integrating principles of tissue engineering, and stem cell and developmental biology, bioengineered kidney grafts will advance the field of regenerative medicine while meeting a critical clinical need. PMID:25217267

  17. Unilateral choanal atresia: initial presentation and endoscopic repair

    Microsoft Academic Search

    Brian J. Wiatrak

    1998-01-01

    The purpose of this study was to investigate the severity of presenting symptomatology in patients with unilateral choanal atresia and to assess the surgical results of patients undergoing transnasal endoscopic repair. A retrospective review of all patients with choanal atresia presenting to the author between 1990 and 1997 was performed, identifying 13 patients with unilateral choanal atresia. These patients were

  18. Postural fluctuations during pointing from a unilateral or bilateral stance

    Microsoft Academic Search

    Ing-Shiou Hwang; Chien-Ting Huang; Rong-Ju Cherng; Chien-Chun Huang

    2006-01-01

    An experiment was conducted to compare the effects of bilateral and unilateral stance on postural fluctuations and intralimb coordination during active balance control. Fifteen participants stood bilaterally and unilaterally while conducting a pointing task with an outstretched arm. Excursion of center of foot pressure (CoP) and limb movements were recorded with a force plate and eight dual-axis accelerometers, respectively. Compared

  19. Bilateral Effects of Unilateral Cochlear Implantation in Congenitally Deaf Cats

    E-print Network

    Ryugo, David K.

    Bilateral Effects of Unilateral Cochlear Implantation in Congenitally Deaf Cats Jahn N. O'Neil,1 system via cochlear implants would restore the endbulb synapses to their normal morphology. Three and 6-month-old con- genitally deaf cats received unilateral cochlear implants and were stimulated

  20. Should lung volume reduction for emphysema be unilateral or bilateral?

    Microsoft Academic Search

    Robert J. McKenna; Matthew Brenner; Richard J. Fischel; Arthur F. Gelb

    1996-01-01

    Both unilateral and bilateral lung volume reduction procedures are being advocated for treatment of severe, generalized emphysema. We analyzed the results of 166 consecutive patients who underwent unilateral (n = 87) or bilateral (n = 79) thoracoscopic stapled lung volume reductions to help define the role for these procedures. There was no statistically significant difference in the operative mortality (3.5%

  1. GENERALIZATION OF USUAL CAPABILITY INDICES FOR UNILATERAL DANIEL GRAU

    E-print Network

    Boyer, Edmond

    of the usual family. Key words: Process Capability Indices, Unilateral Tolerances, Non-normal Processes. 1 target value T. Accordingly, the capability indices used to measure the quality of the process are linkedGENERALIZATION OF USUAL CAPABILITY INDICES FOR UNILATERAL TOLERANCES DANIEL GRAU Laboratory

  2. Reproducibility of Tactile Assessments for Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Auld, Megan Louise; Ware, Robert S.; Boyd, Roslyn Nancy; Moseley, G. Lorimer; Johnston, Leanne Marie

    2012-01-01

    A systematic review identified tactile assessments used in children with cerebral palsy (CP), but their reproducibility is unknown. Sixteen children with unilateral CP and 31 typically developing children (TDC) were assessed 2-4 weeks apart. Test-retest percent agreements within one point for children with unilateral CP (and TDC) were…

  3. Neuromuscular fatigue differs following unilateral vs bilateral sustained submaximal

    E-print Network

    Paris-Sud XI, Université de

    Neuromuscular fatigue differs following unilateral vs bilateral sustained submaximal contractions 1 of Medicine & Science in Sports Volume 21, Issue 2, pages 268­276, April 2011 Additional Information(Show All. and Lepers, R. (2011), Neuromuscular fatigue differs following unilateral vs bilateral sustained submaximal

  4. Thoracic spine spasms secondary to hemorrhagic intestinal ulcer.

    PubMed

    Slipman, C W; Whyte Ii, W S; Lichtenstein, G R; Lenrow, D; Braverman, D; Ellen, M; Vresilovic, E J

    2001-01-01

    A case of thoracic spine spasms secondary to a bleeding duodenal ulcer is presented. A 41-year-old male with 14-week history of thoracic spine spasm was treated with bed rest, spinal manipulation, physical therapy, medication, and a thoracolumbar brace. Subsequently, a provocative thoracic discogram performed at T9-T10 created periscapular pain and also reproduced the presenting thoracic spasms. Intradiscal electrothermal annuloplasty (IDET) was performed at the T9-T10 level, but without sustained relief. The patient presented to a spine center for evaluation. The diagnosis of thoracic discogenic disease was suspected. A second provocative thoracic discogram was performed and failed to reproduce his thoracic spasms. Three weeks after being referred to a chronic pain management physician, the patient presented to a local emergency room with hema-temesis. An endoscopic evaluation revealed a bleeding duodenal ulcer. Following medical treatment of the duodenal ulcer with a proton pump inhibitor the patient had complete resolution of his thoracic spasms. This represents the first reported case of thoracic spine spasms as an initial presenting symptom of a bleeding peptic ulcer. PMID:16906172

  5. A revised model of the kidney for medical internal radiation dose calculations 

    E-print Network

    Patel, Jyoti Shivabhai

    1988-01-01

    of the base of the trunk, with the positive Z-axis directed upward toward the head, the X-axis is directed to the phantom's left, and the Y-axis is directed toward the posterior side of the phantom. The computer program simulates the transport of photons...Kidne s Adult human kidneys (Fr70) are considered as identical paired structures of reddish-brown organs lying against the posterior wall of the abdominal cavity, near the level of the last thoracic vertebrae and the first lumbar vertebrae. The right kidney...

  6. Obstruction of the superior mesenteric artery due to emboli from the thoracic aorta in a patient with thromboangiitis obliterans.

    PubMed

    Kamiya, Chiaki; Deguchi, Juno; Kitaoka, Tadashi; Suzuki, Jun; Abe, Keiko; Sato, Osamu

    2014-01-01

    A 48-year-old woman presented at our hospital with acute abdominal pain 3 years after being diagnosed with thromboangiitis obliterans (TAO). Computed tomography revealed occlusion of the superior mesenteric artery (SMA) and multiple kidney infarction with thrombus floating in the thoracic aorta connected with the intercostal artery. Despite emergency embolectomy, further thromboembolism eventually required massive resection of the intestine with jejunostomy and colostomy and permanent intravenous hyper-alimentation therapy. Although TAO rarely involves the large artery, the aorta could be the source of embolization in patients with TAO. PMID:25298837

  7. Evaluation of unilateral cage-instrumented fixation for lumbar spine

    PubMed Central

    2010-01-01

    Background To investigate how unilateral cage-instrumented posterior lumbar interbody fusion (PLIF) affects the three-dimensional flexibility in degenerative disc disease by comparing the biomechanical characteristics of unilateral and bilateral cage-instrumented PLIF. Methods Twelve motion segments in sheep lumbar spine specimens were tested for flexion, extension, axial rotation, and lateral bending by nondestructive flexibility test method using a nonconstrained testing apparatus. The specimens were divided into two equal groups. Group 1 received unilateral procedures while group 2 received bilateral procedures. Laminectomy, facectomy, discectomy, cage insertion and transpedicle screw insertion were performed sequentially after testing the intact status. Changes in range of motion (ROM) and neutral zone (NZ) were compared between unilateral and bilateral cage-instrumented PLIF. Results Both ROM and NZ, unilateral cage-instrumented PLIF and bilateral cage-instrumented PLIF, transpedicle screw insertion procedure did not revealed a significant difference between flexion-extension, lateral bending and axial rotation direction except the ROM in the axial rotation. The bilateral group's ROM (-1.7 ± 0. 8) of axial rotation was decreased significantly after transpedicle screw insertion procedure in comparison with the unilateral group (-0.2 ± 0.1). In the unilateral cage-instrumented PLIF group, the transpedicle screw insertion procedure did not demonstrate a significant difference between right and left side in the lateral bending and axial rotation direction. Conclusions Based on the results of this study, unilateral cage-instrumented PLIF and bilateral cage-instrumented PLIF have similar stability after transpedicle screw fixation in the sheep spine model. The unilateral approach can substantially reduce exposure requirements. It also offers the biomechanics advantage of construction using anterior column support combined with pedicle screws just as the bilateral cage-instrumented group. The unpleasant effect of couple motion resulting from inherent asymmetry was absent in the unilateral group. PMID:21070626

  8. Nephron Deficiency and Predisposition to Renal Injury in a Novel One-Kidney Genetic Model.

    PubMed

    Wang, Xuexiang; Johnson, Ashley C; Williams, Jan M; White, Tiffani; Chade, Alejandro R; Zhang, Jie; Liu, Ruisheng; Roman, Richard J; Lee, Jonathan W; Kyle, Patrick B; Solberg-Woods, Leah; Garrett, Michael R

    2015-07-01

    Some studies have reported up to 40% of patients born with a single kidney develop hypertension, proteinuria, and in some cases renal failure. The increased susceptibility to renal injury may be due, in part, to reduced nephron numbers. Notably, children who undergo nephrectomy or adults who serve as kidney donors exhibit little difference in renal function compared with persons who have two kidneys. However, the difference in risk between being born with a single kidney versus being born with two kidneys and then undergoing nephrectomy are unclear. Animal models used previously to investigate this question are not ideal because they require invasive methods to model congenital solitary kidney. In this study, we describe a new genetic animal model, the heterogeneous stock-derived model of unilateral renal agenesis (HSRA) rat, which demonstrates 50%-75% spontaneous incidence of a single kidney. The HSRA model is characterized by reduced nephron number (more than would be expected by loss of one kidney), early kidney/glomerular hypertrophy, and progressive renal injury, which culminates in reduced renal function. Long-term studies of temporal relationships among BP, renal hemodynamics, and renal function demonstrate that spontaneous single-kidney HSRA rats are more likely than uninephrectomized normal littermates to exhibit renal impairment because of the combination of reduced nephron numbers and prolonged exposure to renal compensatory mechanisms (i.e., hyperfiltration). Future studies with this novel animal model may provide additional insight into the genetic contributions to kidney development and agenesis and the factors influencing susceptibility to renal injury in individuals with congenital solitary kidney. PMID:25349207

  9. Concentration of phosphoribosyl pyrophosphate in renal hypertrophy. Contrasting effects of early diabetes and unilateral nephrectomy.

    PubMed Central

    Kunjara, S; Sochor, M; Greenbaum, A L; McLean, P

    1986-01-01

    Studies were made of the renal phosphoribosyl pyrophosphate (PPRibP) content and PPRibP synthetase (EC 2.7.6.1) activity in rats diabetic for 5, 14 or 20 days, or unilaterally nephrectomized (UN) for 5 days, and in doubly lesioned animals. Approximately equal degrees of renal enlargement were found after 5 days diabetes or 5 days UN. In the doubly lesioned animals the increment of growth was additive. Unilateral nephrectomy of 5 days duration, in contrast with diabetes, had no effect on the PPRibP content of the contralateral kidney, nor did it modify the renal PPRibP content when performed on animals diabetic for 5, 14 or 20 days. The activity of PPRibP synthetase was unaffected by diabetes, UN or diabetes +UN. The results pinpoint a stage of nucleotide synthesis which is differentially affected by the two stimuli, in line with evidence for differences in regulation of nucleic acid turnover in the two conditions. PMID:2432888

  10. Diminished Expression of Sodium Transporters in the Ureteral Obstructed Kidney in Rats

    Microsoft Academic Search

    Soo Wan Kim; JongUn Lee; Kwon Jung; Seong Kwon Ma; YoonWha Oh; Wan-Young Kim; Ki Chul Choi; Jin Kim

    2004-01-01

    Background\\/Aims: Whether the postobstructive natriuresis and diuresis is related with an altered regulation of sodium transporters in the kidney was examined. Methods: Male Sprague-Dawley rats underwent either bilateral (BUO) or unilateral obstruction (UUO) of the proximal ureters for 24 h. The expression of Na,K-ATPase, type-3 sodium-hydrogen exchanger (NHE3), type-1 bumetanide-sensitive sodium cotransporter (BSC1), and thiazide-sensitive sodium cotransporter (TSC) proteins was

  11. Congenital unilateral fibrosis, blepharoptosis, and enophthalmos syndrome.

    PubMed

    Hertle, R W; Katowitz, J A; Young, T L; Quinn, G E; Farber, M G

    1992-03-01

    The authors report four cases of the rarest form of the congenital fibrosis syndrome. This disorder is exhibited in infancy as unilateral blepharoptosis, strabismus, limited ductions, globe displacement (enophthalmos and blepharoptosis), and decreased vision, usually due to amblyopia. Forced ductions are positive and surgical exploration confirms anomalous muscle structure. Computed tomography and magnetic resonance imaging studies in these four patients were diagnostically beneficial, showing extraocular muscle and tendinous insertion involvement, and poorly defined intraconal and extraconal masses that had the appearance of scar or inflammatory tissue. All patients had globe displacement. The opposite eye and intracranial contents were normal in all of our patients. Results of histopathologic examination obtained at surgery in three of these patients show replacement of affected structures by fibrous tissue and included the extraocular muscles, orbital fat, Tenon's capsule, and conjunctiva. PMID:1565446

  12. Spontaneous Idiopathic Unilateral Adrenal Haemorrhage (SIAH).

    PubMed

    Naqvi, Syed Ali; Zaman, Shamas; Ahmed, Irfan

    2015-04-01

    Spontaneous Idiopathic Adrenal Haemorrhage (SIAH) is an unusual surgical emergency which can present with life threatening massive retroperitoneal bleeding. Most of the cases reported in the literature are associated with use of anticoagulation or underlying adrenal pathology such as tumors or cysts. Since this clinical entity is uncommon and clinical presentation is very indistinct, the diagnosis can be easily missed and can be challenging for the treating physicians. Nevertheless a raised clinical suspicion coupled with advances in radiological imaging have considerably improved the detection of SIAH in recent times. We report an unusual case of a 20 years old healthy female student who presented to our hospital with sudden onset of abdominal pain and shock. She was diagnosed as a case of massive spontaneous idiopathic unilateral adrenal haemorrhage, unaccompanied by any hematologic disorder, trauma or underlying pathology. Although patient was hemodynamically unstable at presentation, she was resuscitated promptly, investigated appropriately, hence recovered uneventfully with conservative management alone. PMID:25933454

  13. Unilateral corneal leukoplakia without limbal involvement

    PubMed Central

    Hirano, Koji; Koide, Mihoko; Mizoguchi, Yoshikazu; Osakabe, Yasuhiro; Sasaki, Kaoru-Araki

    2015-01-01

    Purpose Leukoplakia is the term given to a white patch or plaque that is found mainly on the oral mucus membrane. It can occasionally be seen on the corneal surface. We report our clinical and histopathological findings in a case of unilateral corneal leukoplakia. Methods A 26-year-old woman was referred to our hospital because of a white patch on her right cornea that continued to expand. She first noticed the white patch when she was 20 years old, and the white patch had expanded to cover the pupillary area affecting her vision. After plastic surgery on both eyelids for bilateral entropion to alleviate the pain caused by the eyelashes rubbing the cornea, the white corneal patch decreased in size. Because of this reduction, we performed surgery to remove the patch with microforceps under topical anesthesia. The plaque was removed easily and completely, and submitted for histopathological examination. Results Histopathological examination showed that the specimen had characteristics of epidermis with a basal cell layer, spinous cell layer, granular cell layer, and horny layer with hyperkeratosis. She was diagnosed with leukoplakia of the corneal surface. The basic structure of the squamous cell layer was preserved, and there were no signs of metaplasia. Six months after the removal of the leukoplakia, no recurrence was seen and her corrected decimal visual acuity recovered to 1.0. Conclusion Our case of unilateral corneal leukoplakia without limbal involvement was most likely caused by chronic irritation of the cornea by the eyelashes. Although it was totally removed with good recovery of vision, we continue to follow the patient because of the potential of malignant transformation. PMID:26056494

  14. Isolated unilateral rupture of the alar ligament.

    PubMed

    Wong, Sui-To; Ernest, Kimberly; Fan, Grace; Zovickian, John; Pang, Dachling

    2014-05-01

    Only 6 cases of isolated unilateral rupture of the alar ligament have been previously reported. The authors report a new case and review the literature, morbid anatomy, and pathogenesis of this rare injury. The patient in their case, a 9-year-old girl, fell head first from a height of 5 feet off the ground. She presented with neck pain, a leftward head tilt, and severe limitation of right rotation, extension, and right lateral flexion of the neck. Plain radiographs and CT revealed no fracture but a shift of the dens toward the right lateral mass of C-1. Magnetic resonance imaging of the cervical spine showed signal hyperintensity within the left dens-atlas space on both T1- and T2-weighted sequences and interruption of the expected dark signal representing the left alar ligament, suggestive of its rupture. After 12 weeks of immobilization in a Guilford brace, MRI showed lessened dens deviation, and the patient attained full and painless neck motion. Including the patient in this case, the 7 patients with this injury were between 5 and 21 years old, sustained the injury in traffic accidents or falls, presented with marked neck pain, and were treated with external immobilization. All patients had good clinical outcome. The mechanism of injury is hyperflexion with rotation. Isolated unilateral alar ligament rupture is a diagnosis made by excluding associated fracture, dislocation, or disruption of other major ligamentous structures in the craniovertebral junction. CT and MRI are essential in establishing the diagnosis. External immobilization is adequate treatment. PMID:24679079

  15. Video-assisted thoracic surgery complications

    PubMed Central

    Kozak, Józef

    2014-01-01

    Video-assisted thoracic surgery (VATS) is a miniinvasive technique commonly applied worldwide. Indications for VATS are very broad and include the diagnosis of mediastinal, lung and pleural diseases, as well as large resection procedures such as pneumonectomy. The most frequent complication is prolonged postoperative air leak. The other significant complications are bleeding, infections, postoperative pain and recurrence at the port site. Different complications of VATS procedures can occur with variable frequency in various diseases. Despite the large number of their types, such complications are rare and can be avoided through the proper selection of patients and an appropriate surgical technique. PMID:25561984

  16. Thoracic outlet syndrome following breast implant rupture.

    PubMed

    Mistry, Raakhi; Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus

    2015-03-01

    We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient. PMID:25878942

  17. Bypass Surgery in Arterial Thoracic Outlet Syndrome

    PubMed Central

    Bae, Miju; Lee, Chung Won; Chung, Sung Woon; Choi, Jinseok; Kim, Min Su

    2015-01-01

    Arterial thoracic outlet syndrome (TOS) causes ischemic symptoms; it is the rarest type, occurring in 5% of all TOS cases. This paper is a case report of a 38-year-old male patient diagnosed with arterial TOS, displaying symptoms of acute critical limb ischemia caused by thromboembolism. Brachial artery of the patient has been diffusely damaged by repeated occurrence of thromboembolism. It was thought to be not enough only decompression of subclavian artery to relieve the symptoms of hand ischemia; therefore, bypass surgery using reversed great saphenous vein was performed. PMID:25883901

  18. Thoracic Outlet Syndrome Following Breast Implant Rupture

    PubMed Central

    Caplash, Yugesh; Giri, Pratyush; Kearney, Daniel; Wagstaff, Marcus

    2015-01-01

    Summary: We present a patient with bilateral breast implant rupture who developed severe locoregional silicone granulomatous lymphadenopathy. Poly Implant Prothese silicone implants had been used for bilateral breast augmentation 5 years prior. Extracapsular implant rupture and bilateral axillary lymphadenopathy indicated explantation, capsulectomy, and selective lymph node excision. Histology demonstrated silicone lymphadenopathy with no evidence of malignancy. Over the subsequent 12 months, she developed progressive locoregional lymphadenopathy involving bilateral cervical, axillary, and internal mammary groups, resulting in bilateral thoracic outlet syndrome. We report the unusual presentation, progression, and the ultimate surgical management of this patient. PMID:25878942

  19. Assessment of Renal Function in Patients with Unilateral Ureteral Obstruction Using Whole-Organ Perfusion Imaging with 320-Detector Row Computed Tomography

    PubMed Central

    Yu, Juan; Feng, You-Zhen; Xian, Zhao-Hui; Yang, Wen-Cai; Mo, Xu-Kai

    2015-01-01

    Background Obstructed nephropathy is a common complication of several disease processes. Accurate evaluation of the functional status of the obstructed kidney is important to achieve a good outcome. The purpose of this study was to investigate renal cortical and medullary perfusion changes associated with unilateral ureteral obstruction (UUO) using whole-organ perfusion imaging with 320-detector row computed tomography (CT). Methodology/Principle Findings Sixty-four patients with UUO underwent whole-organ CT perfusion imaging. Patients were divided into 3 groups, mild, moderate, and severe, based on hydronephrosis severity. Twenty sex- and age-matched patients without renal disease, who referred to abdominal CT, were chosen as control subjects. Mean cortical and medullary perfusion parameters of obstructed and contralateral kidneys were compared, and mean perfusion ratios between obstructed and contralateral kidneys were calculated and compared. Mean cortical or medullary blood flow (BF) and blood volume (BV) of the obstructed kidneys in the moderate UUO and BF, BV, and clearance (CL) in the severe UUO were significantly lower than those of the contralateral kidneys (p < 0.05). The mean cortical or medullary BF of the obstructed kidney in the moderate UUO, and BF, BV, and CL in the severe UUO were significantly lower than those of the kidneys in control subjects (p < 0.05). Mean cortical or medullary BF of the non-obstructed kidneys in the severe UUO were statistically greater than that of normal kidneys in control subjects (p < 0.05). An inverse correlation was observed between cortical and medullary perfusion ratios and grades of hydronephosis (p < 0.01). Conclusions/Significance Perfusion measurements of the whole kidney can be obtained with 320-detector row CT, and estimated perfusion ratios have potential for quantitatively evaluating UUO renal injury grades. PMID:25874690

  20. Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review

    PubMed Central

    Molinari, Robert W.; Saleh, Ahmed; Molinari, Robert; Hermsmeyer, Jeff; Dettori, Joseph R.

    2015-01-01

    Study Design?Systematic review. Clinical Questions?(1) What is the comparative efficacy of unilateral instrumentation compared with bilateral instrumentation in spine surgery? (2) What is the safety of unilateral instrumentation compared with bilateral instrumentation in spine surgery? Methods?Electronic databases and reference lists of key articles were searched up to September 30, 2014, to identify studies reporting the comparative efficacy and safety of unilateral versus bilateral instrumentation in spine surgery. Studies including recombinant human bone morphogenetic protein 2 as adjunct therapy and those with follow-up of less than 2 years were excluded. Results?Ten randomized controlled trials met the inclusion criteria: five compared unilateral with bilateral instrumentation using open transforaminal or posterior lumbar interbody fusion (TLIF/PLIF), one used open posterolateral fusion, and four used minimally invasive TLIF/PLIF. There were no significant differences between unilateral and bilateral screw instrumentation with respect to nonunion, low back or leg pain scores, Oswestry Disability Index, reoperation, or complications. Conclusions?The existing literature does not identify significant differences in clinical outcomes, union rates, and complications when unilateral instrumentation is used for degenerative pathologic conditions in the lumbar spine. The majority of published reports involve single-level lumbar unilateral instrumentation.

  1. Intramedullary spinal epidermoid presenting after thoracic meningocele repair: case report.

    PubMed

    Grobelny, Bartosz T; Weiner, Howard L; Harter, David H

    2015-06-01

    A 4-year-old girl with a history of thoracic meningocele repair at the age of 3 months presented with progressive myelopathy. An intramedullary thoracic epidermoid was identified on MRI. The patient underwent excision of the epidermoid and subsequently returned to neurological baseline. This case illustrates the potential for delayed development of intraspinal epidermoid after initial repair of a simple meningocele. PMID:25815631

  2. Technical Note Functional MRI of the Thoracic Spinal Cord During

    E-print Network

    Smith, Stephen D.

    Technical Note Functional MRI of the Thoracic Spinal Cord During Vibration Sensation Jennifer functional magnetic resonance images from thoracic spinal cord neurons. Materials and Methods: The lower spinal cord using a HASTE sequence on a 3 Tesla MRI system. Results: Signal increases were observed

  3. Thoracic epaxial muscles in living archosaurs and ornithopod dinosaurs

    Microsoft Academic Search

    Christopher Lee Organ

    2006-01-01

    Crocodylians possess the same thoracic epaxial muscles as most other saurians, but M. transversospinalis is modified by overlying osteoderms. Com- pared with crocodylians, the thoracic epaxial muscles of birds are reduced in size, disrupted by the synsacrum, and often modified by intratendinous ossifi- cation and the notarium. A phylogenetic perspective is used to determine muscle homologies in living archosaurs (birds

  4. Kidney (Renal) Failure

    MedlinePLUS

    ... frequency sound waves to view the kidneys in real time, and is often the first test obtained to ... radiation oncology provider in your community, you can search the ACR-accredited facilities database. This website does ...

  5. Diabetes and Kidney Disease

    MedlinePLUS

    ... NKF Newsroom Contact Us You are here Home » Diabetes - A Major Risk Factor for Kidney Disease Diabetes ... of your body. Are there different types of diabetes? The most common ones are Type 1 and ...

  6. Keep Your Kidneys Healthy

    MedlinePLUS

    ... what to do if you have kidney disease . Healthy Eating Tips Small changes to your diet can make a big difference. See Food Tips and Healthy Eating Ideas fact sheet for inspiration. Learn about healthy ...

  7. Amyloidosis and Kidney Disease

    MedlinePLUS

    ... of life for people with chronic illnesses. To learn more about clinical trials, why they matter, and ... and fact sheets that can help the reader learn more about treatment methods for kidney failure, complications ...

  8. Limitation of imaging in identifying iatrogenic aortic coarctation following thoracic endovascular aortic repair.

    PubMed

    Thakkar, Rajiv N; Thomaier, Lauren; Qazi, Umair; Verde, Franco; Malas, Mahmoud B

    2015-04-01

    A 21-year-old male suffered blunt trauma from a motor vehicle accident causing thoracic aorta tear. The smallest available stent graft was deployed. Definitive repair was later performed using a 22 × 22 × 116 mm Talent Thoracic Stent Graft. The postoperative course was uneventful. Seventeen months later, he presented with dizziness, chest pain, acute renal failure, malignant hypertension, and troponin elevation. Computed tomography (CT) angiogram and transesophageal echocardiogram did not reveal any dissection, stent stenosis or collapse. Cardiac catheterization showed normal coronary arteries but a 117 mm Hg gradient across the stent graft. Iatrogenic coarctation of the aorta was confirmed with a second measurement during arch angiogram. A Palmaz stent was deployed over the distal end of the previous stent graft with complete resolution of symptoms and gradual normalization of kidney function. This case report demonstrates a need for wider availability and selecting appropriate stent graft in treating traumatic aortic injuries in young patients. It is the first case report of the inability of current imaging modalities in confirming stent collapse. Pressure gradient is a useful tool in confirming stent collapse when clinical scenario does not match CT findings. PMID:25637574

  9. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P. W.

    1985-01-01

    Tasks were undertaken in support of two objectives. They are: (1) to carry out electrophoresis experiments on cells in microgravity; and (2) assess the feasibility of using purified kidney cells from embryonic kidney cultures as a source of important cell products. Investigations were carried out in the following areas: (1) ground based electrophoresis technology; (2) cell culture technology; (3) electrophoresis of cells; (4) urokinase assay research; (5) zero-g electrophoresis; and (6) flow cytometry.

  10. Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis

    PubMed Central

    Singh, Paul; Jodicke, Cristiano; Swanson, Tara; Maulik, Dev

    2014-01-01

    Introduction?Most often, ganglioneuromas affect older pediatric and adult patients. They are typically slow growing tumors that remain clinically silent until they become large enough to cause symptoms by compression of adjacent structures. Case?We report a case of a 22-year-old Hispanic gravida 2 para 1 female patient who was found to have massive hydrops fetalis at 20 completed gestational weeks. Fetal echocardiography revealed a narrowed distal ductal arch and proximal descending aorta. Cesarean delivery was undertaken at 29 completed gestational weeks for refractory labor and nonreassuring fetal status. The neonate expired at 47 minutes of life despite aggressive resuscitation. At autopsy, multiple thoracic masses were found adjacent to a compressed proximal descending aorta. Histological and immunohistochemical analysis confirmed the diagnosis of a ganglioneuroma, a rare type of neural crest tumor. Discussion?A variety of intrathoracic masses have previously been reported to cause hydrops fetalis including teratomas, fibrosarcomas, and lymphangiomas. To our knowledge, this case is the first description of hydrops fetalis caused by ganglioneuromas. We propose that multiple thoracic ganglioneuromas led to biventricular distal outflow tract obstruction and hydrops fetalis. PMID:25032061

  11. Pharmacological and genetic depletion of fibrinogen protects from kidney fibrosis.

    PubMed

    Craciun, Florin L; Ajay, Amrendra K; Hoffmann, Dana; Saikumar, Janani; Fabian, Steven L; Bijol, Vanesa; Humphreys, Benjamin D; Vaidya, Vishal S

    2014-08-15

    Fibrinogen (Fg) has been implicated in the pathogenesis of several fibrotic disorders by acting as a profibrotic ligand for a variety of cellular surface receptors and by modulating the provisional fibrin matrix formed after injury. We demonstrated increased renal Fg expression after unilateral ureteral obstruction and folic acid (FA) nephropathy in mice, respectively. Urinary Fg excretion was also increased in FA nephropathy. Using in vitro and in vivo approaches, our results suggested that IL-6 mediates STAT3 activation in kidney fibrosis and that phosphorylated (p)STAT3 binds to Fg?, Fg?, and Fg? promoters in the kidney to regulate their transcription. Genetically modified Fg heterozygous mice (?75% of normal plasma Fg levels) exhibited only 3% kidney interstitial fibrosis and tubular atrophy after FA nephropathy compared with 24% for wild-type mice. Fibrinogenolysis through Ancrod administration after FA reduced interstitial fibrosis more than threefold compared with vehicle-treated control mice. Mechanistically, we show that Fg acts synergistically with transforming growth factor (TGF)-?1 to induce fibroblast proliferation and activates TGF-?1/pSMAD2 signaling. This study offers increased understanding of Fg expression and molecular interactions with TGF-?1 in the progression to kidney fibrosis and, importantly, indicates that fibrinogenolytics like Ancrod present a treatment opportunity for a yet intractable disease. PMID:25007874

  12. Unilateral pupillary dilatation following septoplasty: cause for concern?

    PubMed

    Shakeel, Muhammad; Trinidade, Aaron; Khan, Imran; Johnston, Graham; Hussain, Akhtar

    2013-07-01

    We report and explain unilateral pupillary dilatation following routine septoplasty and trimming of inferior turbinates. The unilateral pupillary dilatation was caused by inadvertent instillation of sympathomimetic, (xylometazoline hydrochloride) in the eye during preparation for nasal surgery. The effect was short-lived and the patient made a full recovery. Unilateral pupillary dilatation after sinonasal surgery can be alarming due to the possibility of injury to the globe and intracranial haemorrhage but can also be explained by the mydriatic effect of the sympathomimetic nasal drops and sprays used to decongest the nose. Such possibility should be borne in mind and would help to explain and reduce the anxiety and avoid unnecessary investigations. PMID:23823962

  13. Asymmetric vestibular evoked myogenic potentials in unilateral Menière patients

    PubMed Central

    Wit, H. P.

    2010-01-01

    Vestibular evoked myogenic potentials (VEMPs) were measured in 22 unilateral Menière patients with monaural and binaural stimulation with 250 and 500 Hz tone bursts. For all measurement situations significantly lower VEMP amplitudes were on average measured at the affected side compared to the unaffected side. Unilateral Menière patients have, in contrast to normal subjects, asymmetric VEMPs, indicating a permanently affected vestibular (most likely otolith) system at the side of hearing loss. The diagnostic value of VEMP amplitude asymmetry measurement in individual patients is low, because of the large overlap of the VEMP amplitude asymmetry range for unilateral Menière patients with that for normal subjects. PMID:20665043

  14. Signaling during Kidney Development

    PubMed Central

    Krause, Mirja; Rak-Raszewska, Aleksandra; Pietilä, Ilkka; Quaggin, Susan E.; Vainio, Seppo

    2015-01-01

    The kidney plays an essential role during excretion of metabolic waste products, maintenance of key homeostasis components such as ion concentrations and hormone levels. It influences the blood pressure, composition and volume. The kidney tubule system is composed of two distinct cell populations: the nephrons forming the filtering units and the collecting duct system derived from the ureteric bud. Nephrons are composed of glomeruli that filter the blood to the Bowman’s capsule and tubular structures that reabsorb and concentrate primary urine. The collecting duct is a Wolffian duct-derived epithelial tube that concentrates and collects urine and transfers it via the renal pelvis into the bladder. The mammalian kidney function depends on the coordinated development of specific cell types within a precise architectural framework. Due to the availability of modern analysis techniques, the kidney has become a model organ defining the paradigm to study organogenesis. As kidney diseases are a problem worldwide, the understanding of mammalian kidney cells is of crucial importance to develop diagnostic tools and novel therapies. This review focuses on how the pattern of renal development is generated, how the inductive signals are regulated and what are their effects on proliferation, differentiation and morphogenesis. PMID:25867084

  15. Kidney Disease of Diabetes

    NSDL National Science Digital Library

    The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) is a service provided by a related department of the National Institutes of Health (NIH). Visitors will find that the NKUDIC website has a special page on Kidney Disease of Diabetes which includes articles on the homepage about "The Course of Kidney Disease", "Preventing and Slowing Kidney Disease", and "Good Care Makes a Difference". On the left side of the homepage visitors will find some very interesting research timelines by the NIH, titled "Yesterday, Today and Tomorrow". There is a timeline for "Chronic Kidney Disease and Kidney Failure", "Diabetes, Type 1", and "Diabetes, Type 2". The "Yesterday" section explain to visitors the past methods of treating the disease, as well as past statistics about death and diseases caused by diabetes. The "Today" section explains how the disease is treated presently, and how statistics have improved regarding survival and occurrence of diabetes-related disease. Finally, the "Tomorrow" section highlights research studies that aim to improve the lives of diabetics, and interested visitors will find links to relevant websites.

  16. Unilateral Altruism in Network Routing Games with Atomic Players Amar Prakash Azad John Musacchio

    E-print Network

    Paris-Sud XI, Université de

    Unilateral Altruism in Network Routing Games with Atomic Players Amar Prakash Azad John Musacchio of Unilateral Altruism (VoU) to be the ratio of the equilibrium utility of the altruistic user of unilateral altruism. We find by way of example that the effect of unilateral altruism can be arbitrarily

  17. Unilateral Altruism in Network Routing Games with Atomic Players Amar Prakash Azad John Musacchio

    E-print Network

    Boyer, Edmond

    1 Unilateral Altruism in Network Routing Games with Atomic Players Amar Prakash Azad John Musacchio of Unilateral Altruism (VoU) to be the ratio of the equilibrium utility of the altruistic user of unilateral altruism. We find by way of example that the effect of unilateral altruism can be arbitrarily

  18. A transaction cost approach to unilateral presidential action 

    E-print Network

    Marchbanks, Miner Peek, III

    2006-04-12

    chooses between seeking congressional action versus acting unilaterally through executive orders to accomplish policy change. The theory holds that when presidents desire policy change, they balance the transaction costs executive orders and legislative...

  19. Asymmetric vestibular evoked myogenic potentials in unilateral Menière patients

    Microsoft Academic Search

    C. M. Kingma; H. P. Wit

    2011-01-01

    Vestibular evoked myogenic potentials (VEMPs) were measured in 22 unilateral Menière patients with monaural and binaural stimulation\\u000a with 250 and 500 Hz tone bursts. For all measurement situations significantly lower VEMP amplitudes were on average measured\\u000a at the affected side compared to the unaffected side. Unilateral Menière patients have, in contrast to normal subjects, asymmetric\\u000a VEMPs, indicating a permanently affected vestibular

  20. Grip Force Coordination during Bimanual Tasks in Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Islam, Mominul; Gordon, Andrew M.; Skold, Annika; Forssberg, Hans; Eliasson, Ann-Christin

    2011-01-01

    Aim: The aim of the study was to investigate coordination of fingertip forces during an asymmetrical bimanual task in children with unilateral cerebral palsy (CP). Method: Twelve participants (six males, six females; mean age 14y 4mo, SD 3.3y; range 9-20y;) with unilateral CP (eight right-sided, four left-sided) and 15 age-matched typically…

  1. Advances of unilateral mobile NMR in nondestructive materials testing

    Microsoft Academic Search

    Bernhard Blümich; Federico Casanova; Juan Perlo; Sophia Anferova; Vladimir Anferov; Kai Kremer; Nicolae Goga; Klaus Kupferschläger; Michael Adams

    2005-01-01

    Unilateral mobile NMR employs portable instrumentation with sensors, which are applied to the object from one side. Based on the principles of well-logging NMR, a hand-held sensor, the NMR-MOUSE (MObile Universal Surface Explorer) has been developed for nondestructive materials testing. In the following, a number of new applications of unilateral NMR in materials science are reviewed. They are the state

  2. Unilateral Mydriasis After Mandibular Fracture Fixation Surgery

    PubMed Central

    Nesioonpour, Sholeh; Khiabani, Kazem; Hassanijirdehi, Marzieh

    2014-01-01

    Introduction: Unilateral mydriasis is a seriously significant finding in neurologic examinations indicating life-threatening conditions such as cerebral vascular injuries. Case Presentation: A 24 year old woman with mandibular trauma was referred to our center after five days for a reduction of the right mandibular angle fracture. The patient had no history of any loss of consciousness after the accident. Her physical examination showed no abnormalities, except those related to her mandibular fracture. The laboratory results were normal as well. At 8:30 am a general anesthesia was induced. The patient’s eyes were kept shut throughout the surgical procedure. The operation included an intraoral open reduction and fixation using two miniplates without any complications. After the operation, it was noticed that the left eye was completely dilated with no reaction to light, while the right eye was normal. The management and outcomes in this patient were described in the present case report. Conclusions: Evaluating the size of the patient’s pupils before, during and after the operation, careful history, consult, CT scan and MRI would help to diagnosis. Although no probable cause was found to explain the transient mydriasis in our patient. PMID:24829881

  3. Unilateral cryptorchidism in mice mutant for Ptgds.

    PubMed

    Philibert, Pascal; Boizet-Bonhoure, Brigitte; Bashamboo, Anu; Paris, Françoise; Aritake, Kosuke; Urade, Yoshihiro; Leger, Juliane; Sultan, Charles; Poulat, Francis

    2013-02-01

    The pathophysiology of cryptorchidism, abnormal testicular descent, remains poorly understood. In this study, we show that both heterozygous and homozygous mice deficient for lipocalin-type prostaglandin D(2) (PGD(2) ) synthase (Ptgds) presented unilateral cryptorchidism affecting the second phase of testicular descent in 16% and 24% of cases, respectively. The adult cryptorchid testes show an increase in spermatogonia apoptosis along with a global decrease in the tubule size parameters, whereas the gubernaculum of newborn mutants present some histological abnormalities. Disruption of the inguinoscrotal phase did not present impairment of the androgen pathway but rather a decrease in Rxfp2 mRNA expression in the gubernaculum. These observations led us to investigate the role of the PGD(2) signaling pathway in human testicular migration through PTGDS sequencing of DNA from 29 children with cryptorchidism. However, none of the investigated cases presented mutations in the PTGDS gene. Nevertheless, our results identify the PTGDS enzyme as a novel component in the cryptorchidism puzzle. PMID:23076868

  4. Trigeminal Neuralgia: Unilateral Episodic Facial Pain.

    PubMed

    Zakrzewska, Joanna M

    2015-06-01

    Trigeminal neuralgia is a rare cause of episodic unilateral facial pain and often in the initial presentation dental causes need to be eliminated, as it frequently presents in the lower trigeminal divisions. The pain description is characteristic of electric shock-like pain that is light-touch provoked, paroxysmal, and occurring daily; the condition can go into remission for weeks or months, however. The first-line drug is either carbamazepine or oxcarbazepine and has to be started in low doses. Over 70% of patients will initially obtain immediate relief. If efficacy or tolerability becomes a problem, then referral to a secondary care specialist should be made. Magnetic resonance imaging (MRI) scans can determine if there is a symptomatic cause and whether surgery is indicated. Surgical options provide longest pain relief periods. Patients need to be given information about all treatment options so they can make a decision about treatment. This report is adapted from paineurope 2014; Issue 4, © Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International, Ltd., and is distributed free of charge to health care professionals in Europe. Archival issues can be viewed via the Web site: www.paineurope.com , at which health professionals can find links to the original articles and request copies of the quarterly publication and access additional pain education and pain management resources. PMID:26095494

  5. Ventriloquism in patients with unilateral visual neglect.

    PubMed

    Bertelson, P; Pavani, F; Ladavas, E; Vroomen, J; de Gelder B

    2000-01-01

    Can visual stimuli that go undetected, because they are presented in the extinguished region of neglect patients' visual field, nevertheless shift in their direction the apparent location of simultaneous sounds (the well-known 'ventriloquist effect')? This issue was examined using a situation in which each trial involved the simultaneous presentation of a tone over loudspeakers, together with a bright square area on either the left, the right or both sides of fixation. Participants were required to report the presence of squares, and indicate by hand pointing the apparent location of the tone. Five patients with left hemineglect consistently failed to detect the left square, either presented alone or together with another square on the right. Nevertheless, on bimodal trials with a single undetected square to the left, their sound localization was significantly shifted in the direction of that undetected square. By contrast, in bimodal trials with either a single square on the right or a square on each side, their sound localization showed only small and non-significant shifts. This particular result might be due to a combination of low discrimination of lateral sound deviations with variable individual strategies triggered by conscious detection of the right square. The important finding is the crossmodal bias produced by the undetected left visual distractors. It provides a new example of implicit processing of inputs affected by unilateral visual neglect, and on the other hand is consistent with earlier demonstrations of the automaticity of crossmodal bias. PMID:11074086

  6. Non-intubated thoracic surgery—A survey from the European Society of Thoracic Surgeons

    PubMed Central

    Sorge, Roberto; Akopov, Andrej; Congregado, Miguel; Grodzki, Tomasz

    2015-01-01

    Background A survey amongst the European Society of Thoracic Surgeons (ESTS) members has been performed to investigate the currents trends, rates of adoption as well as potential for future expansion of non-intubated thoracic surgery (NITS) performed under spontaneous ventilation. Methods A 14-question-based questionnaire has been e-mailed to ESTS members. To facilitate the completion of the questionnaire, questions entailed either quantitative or multiple-choice answers. Investigated issues included previous experience with NITS and number of procedures performed, preferred types of anesthesia protocols (i.e., thoracic epidural anesthesia, intercostal or paravertebral blocks, laryngeal mask, use of additional sedation), type of procedures, ideal candidates for NITS, main advantages and technical disadvantages. Non-univocal answer to multiple-choice questions was permitted. Results Out of 105 responders, 62 reported an experience with NITS. The preferred types of anesthesia were intercostal blocks with (59%) or without (50%) sedation, followed by laryngeal mask with sedation (43%) and thoracic epidural anesthesia with sedation (20%). The most frequently performed procedures included thoracoscopic management of recurrent pleural effusion (98%), pleural decortication for empyema thoracis and lung biopsy for interstitial lung disease (26% each); pericardial window and mediastinal biopsy (20% each). More complex procedures such as lobectomy, lung volume reduction surgery and thymectomy have been performed by a minority of responders (2% each). Poor-risk patients due to co-morbidities (70%) and patients with poor pulmonary function (43%) were considered the ideal candidates. Main advantages included faster, recovery (67%), reduced morbidity (59%) and shorter hospital stay with decreased costs (43% each). Reported technical disadvantages included coughing (59%) and poor maneuverability due to diaphragmatic and lung movements (56%). Overall, 69% of responders indicated that NITS procedures will be likely to increase in the near future. Conclusions Results of this survey, suggest that NITS is already quite widely adopted by ESTS members to perform simple thoracoscopic procedures. A future expanded adoption of this strategy is also hypothesized. PMID:25815298

  7. Horseshoe kidney transplantation

    PubMed Central

    Kanyári, Zsolt; Zádori, Gergely; Zsom, Lajos; Berhés, Mariann; Hamar, Mátyás; Kóbor, Krisztina; Péter, Antal

    2015-01-01

    Horseshoe kidney is a fusion anomaly found in approximately one in 400–600 people. Due to vascular and ureteral variations, transplantation with a horseshoe kidney presents a technical challenge. In our case, the isthmus connected the upper poles and contained parenchyma. It consisted of three renal arteries, five veins collected to the inferior vena cava, and two ureters and pyelons. It was implanted en bloc to the left side retroperitoneally. During the early period, cellular and humoral rejection was confirmed and treated. For a urine leak, double J catheters were implanted into both ureters. Later, the first catheter was removed. Subsequently, urinary sepsis developed, necessitating graftectomy. The uncommon anatomy of ureters and antibody-mediated rejection (AMR) may both be factors for a ureter tip necrosis led to an infected urinoma. After other Hungarian authors, we also report a horseshoe kidney transplantation that was technically successful. However, after an adequately treated but severe acute humoral rejection, the patient developed sepsis, and the kidney had to be removed. We conclude that transplantation with horseshoe kidney is technically feasible but may increase the risk for urinary complications and resultant infections. Careful consideration of risk and benefit is advised when a transplant professional is faced with this option. PMID:26120481

  8. Women and kidney transplantation.

    PubMed

    Adey, Deborah B

    2013-09-01

    Kidney transplant is the best kidney replacement treatment for end-stage kidney disease. The first step in moving toward kidney transplantation is referral to a transplant center for transplant evaluation. Education of dialysis staff and health-care providers may help increase referrals for evaluation. Patient education has been shown to enhance patient completion of the evaluation process. Patients have difficulty asking others to donate a kidney, but this process can be improved with home and community education. Living donors are more likely to be women than men, especially spousal donors. Deceased donors are more likely to be males younger than 35 years of age. There is a slight decrease in the rate of transplantation of women as compared with men, although not statistically significant. Pretransplant development of anti-human leukocyte antigen antibodies is more common amongst women and can be a barrier to successful transplantation and may prolong the waiting time for transplant. The long-term management of cardiovascular risk factors, osteoporosis, and age-appropriate cancer screening need to be addressed with posttransplant recipients. Women have an overall increased patient and graft survival as compared with men after transplant. PMID:23978549

  9. Noninvasive photoacoustic imaging of the thoracic cavity and the kidney in small and large animals

    E-print Network

    Wang, Lihong

    optical energy in ab- sorbers causes thermoelastic expansion of the absorbers, gen- erating ultrasonic,15 and human breast cancer imaging.16 Par- ticularly in small animal studies, it has produced remarkable brain

  10. Thoracic Computed Tomography Findings in Malignant Mesothelioma

    PubMed Central

    Tamer Dogan, Omer; Salk, Ismail; Tas, Fikret; Epozturk, Kursat; Gumus, Cesur; Akkurt, Ibrahim; Levent Ozsahin, Sefa

    2012-01-01

    Background Malignant pleural mesothelioma (MPM) is an uncommon neoplasm. MPM occurs more frequently in patients born or living in certain villages of Turkey. Objectives We aimed to review radiological findings of MPM. Patients and Methods We reviewed the CT findings in 219 biopsy-proven MPM patients admitted to our clinic between 1993 and 2008. Results The most common CT findings included pleural thickening (n=197, 90%) classified as diffuse (n=138, 63%), nodular (n=49, 22%) and mass-type (n=16, 7%). Pleural effusion was found in 173 patients (79%), involvement of the interlobar fissures in 159 (73%), mediastinal pleural involvement in 170 (78%), volume contraction in 142 (65%), mediastinal shift in 102 (47%) and mediastinal lymphadenopathy in 54 (25%). Conclusion MPM may present with diverse radiological features. Pleural thickening and pleural effusion were the most frequent radiological findings. Thoracic CT scans might be assessed more cautiously in patients with environmental exposure to asbestos. PMID:23407863

  11. Vasohibin?1 deficiency enhances renal fibrosis and inflammation after unilateral ureteral obstruction

    PubMed Central

    Watatani, Hiroyuki; Maeshima, Yohei; Hinamoto, Norikazu; Yamasaki, Hiroko; Ujike, Haruyo; Tanabe, Katsuyuki; Sugiyama, Hitoshi; Otsuka, Fumio; Sato, Yasufumi; Makino, Hirofumi

    2014-01-01

    Abstract Tubulointerstitial injuries are known to predict the deterioration of renal function in chronic kidney disease (CKD). We recently reported the protective role of Vasohibin?1(VASH?1), a negative feedback regulator of angiogenesis, in diabetic nephropathy, but its impact on tubulointerstitial injuries remains to be elucidated. In the present study, we evaluated the role of endogenous VASH?1 in regulating the tubulointerstitial alterations induced by unilateral ureteral obstruction (UUO), and assessed its role on fibrogenesis and the activation of Smad3 signaling in renal fibroblasts. UUO was induced in female Vasohibin?1 heterozygous knockout mice (VASH?1+/?) or wild?type (WT) (VASH?1+/+) littermates. Mice were sacrificed on Day 7 after left ureter ligation, and the kidney tissue was obtained. Interstitial fibrosis, the accumulation of type I and type III collagen and monocytes/macrophages infiltration in the obstructed kidneys (OBK) were significantly exacerbated in VASH?1+/? mice compared with WT mice (Day 7). The increases in the renal levels of TGF??1, pSmad3, NF??B pp65, CCL2 mRNA, and the number of interstitial fibroblast?specific protein?1 (FSP?1)+ fibroblasts in the OBK were significantly aggravated in VASH?1+/? mice. In addition, treatment with VASH?1 siRNA enhanced the TGF??1?induced phosphorylation of Smad3, the transcriptional activation of the Smad3 pathway and the production of type I/type III collagen in fibroblasts, in vitro. Taken together, our findings demonstrate a protective role for endogenous VASH?1 on tubulointerstitial alterations via its regulation of inflammation and fibrosis and also show the direct anti?fibrotic effects of VASH?1 on renal fibroblasts through its modulation of TGF??1 signaling. PMID:24973329

  12. Use of ultrasound to assess renal reperfusion and P-selectin expression following unilateral renal ischemia

    PubMed Central

    Boesen, Erika I.; Crislip, G. Ryan

    2012-01-01

    Renal ischemia-reperfusion injury is a major cause of acute kidney injury that carries a high mortality rate and increases the risk of later development of hypertension and chronic kidney disease. Although mouse models have contributed much to our understanding of the mechanisms involved, studying aspects of the injury process in vivo remains technically challenging. This study validates the use of noninvasive ultrasound imaging to assess both renal perfusion and vascular adhesion molecule expression following 1-h unilateral renal ischemia in male and female mice. Pulsed-wave Doppler measurements of renal arterial blood velocity revealed renal perfusion recoveries of 56 ± 9% in male and 69 ± 10% in female mice 1 h after the commencing of reperfusion, which is similar to what we have previously published using conventional invasive methodology. At 24 h postischemia, renal perfusion was 40 ± 8% in male and 46 ± 7% in female mice, representing a further significant reduction of perfusion (PTime < 0.001). Using ultrasound imaging of a P-selectin-targeted contrast agent, a significant increase in vascular P-selectin protein expression was observed after 1-h reperfusion in the cortex of the postischemic compared with contralateral kidney in both male and female mice (18 ± 5 vs. 3 ± 3 intensity units in male and 30 ± 6 vs. 0 ± 4 in female mice, PIschemia < 0.01). An approximately sixfold increase in P-selectin mRNA was observed ex vivo in the renal vasculature of male and female mice at this time point (P < 0.01). In conclusion, ultrasound represents an effective and noninvasive method for the measurement of both renal perfusion and vascular adhesion molecule expression in mice. PMID:22933301

  13. Trans-arterial Onyx Embolization of a Functional Thoracic Paraganglioma.

    PubMed

    Chacón-Quesada, Tatiana; Rodriguez, Gustavo J; Maud, Alberto; Ramos-Duran, Luis; Torabi, Alireza; Fitzgerald, Tamara; Akle, Nassim; Cruz Flores, Salvador; Trier, Todd

    2015-02-01

    Paragangliomas are rare tumors of the endocrine system. They are highly vascular and in some cases hormonally active, making their management challenging. Although there is strong evidence of the safety and effectiveness of preoperative embolization in the management of spinal tumors, only five cases have been reported in the setting of thoracic paragangliomas. We present the case of a 19-year-old man with a large, primary, functional, malignant paraganglioma of the thoracic spine causing a vertebral fracture and spinal cord compression. To our knowledge this is the first report of preoperative trans-arterial balloon augmented Onyx embolization of a thoracic paraganglioma. PMID:25763296

  14. Optimal exposure of thoracic inlet vascular structures: transmanubrial approach.

    PubMed

    Smythe, W Roy; Reznik, Scott I

    2008-03-01

    Exposure of the neurovascular structures of the thoracic inlet is limited by the bony thorax and clavicle. A cervicothoracic approach with resection of the medial one third of the clavicle or total claviculectomy provide excellent exposure but may render the patient with a significant cosmetic and functional defect. We describe a transmanubrial approach that preserves rigid fixation of the shoulder girdle and allows full access to the thoracic inlet. This technique is straightforward and may be easily modified to fit the particular needs of the patient, including access to the proximal brachiocephalic vessels, the hilum of the lung and the vertebral bodies of the lower cervical and upper thoracic spine. PMID:18342731

  15. Thoracic endometriosis syndrome: case report and review of the literature.

    PubMed

    Azizad-Pinto, Parisa; Clarke, David

    2014-01-01

    Thoracic endometriosis syndrome is the presence of endometrial tissue in or around the lung. Thoracic endometriosis syndrome consists of four distinct clinical entities: catamenial pneumothorax, catamenial hemothorax, hemoptysis, and pulmonary nodules. Thoracic endometriosis syndrome is a rare and complex condition, and diagnosis is often delayed or missed by clinicians, which can result in recurrent hospitalizations and other complications. Current treatments include hormone therapy and, where warranted, surgical intervention. We report the case of a 48-year-old woman with endometriosis causing bowel obstruction and concurrent catamenial pneumothorax. PMID:25102519

  16. Brain–kidney crosstalk

    PubMed Central

    2014-01-01

    Encephalopathy and altered higher mental functions are common clinical complications of acute kidney injury. Although sepsis is a major triggering factor, acute kidney injury predisposes to confusion by causing generalised inflammation, leading to increased permeability of the blood–brain barrier, exacerbated by hyperosmolarity and metabolic acidosis due to the retention of products of nitrogen metabolism potentially resulting in increased brain water content. Downregulation of cell membrane transporters predisposes to alterations in neurotransmitter secretion and uptake, coupled with drug accumulation increasing the risk of encephalopathy. On the other hand, acute brain injury can induce a variety of changes in renal function ranging from altered function and electrolyte imbalances to inflammatory changes in brain death kidney donors. PMID:25043644

  17. Rib fracture patterns predict thoracic chest wall and abdominal solid organ injury.

    PubMed

    Al-Hassani, Ammar; Abdulrahman, Husham; Afifi, Ibrahim; Almadani, Ammar; Al-Den, Ahmed; Al-Kuwari, Abdulaziz; Recicar, John; Nabir, Syed; Maull, Kimball I

    2010-08-01

    Blunt trauma patients with rib fractures were studied to determine whether the number of rib fractures or their patterns were more predictive of abdominal solid organ injury and/or other thoracic trauma. Rib fractures were characterized as upper zone (ribs 1 to 4), midzone (ribs 5 to 8), and lower zone (ribs 9 to 12). Findings of sternal and scapular fractures, pulmonary contusions, and solid organ injures (liver, spleen, kidney) were characterized by the total number and predominant zone of ribs fractured. There were 296 men and 14 women. There were 38 patients with scapular fracture and 19 patients with sternal fractures. There were 90 patients with 116 solid organ injuries: liver (n = 42), kidney (n = 27), and spleen (n = 47). Lower rib fractures, whether zone-limited or overlapping, were highly predictive of solid organ injury when compared with upper and midzones. Scapular and sternal fractures were more common with upper zone fractures and pulmonary contusions increased with the number of fractured ribs. Multiple rib fractures involving the lower ribs have a high association with solid organ injury, 51 per cent in this series. The increasing number of rib fractures enhanced the likelihood of other chest wall and pulmonary injuries but did not affect the incidence of solid organ injury. PMID:20726423

  18. The impacts of Unilateral Stratospheric Geoengineering

    NASA Astrophysics Data System (ADS)

    Jones, A.; Haywood, J. M.; Bellouin, N.; Stephenson, D.

    2013-12-01

    Stratospheric geoengineering proposals have been suggested on the premise that the cooling impacts of volcanic eruptions could be deliberately mimicked to offset the impacts of increased greenhouse gas concentrations in the future by counterbalance global warming. Here, we examine both the impacts of hemispherically asymmetric volcanoes in the observational record and the impact of prolonged deliberate injection of stratospheric aerosol into either the northern or southern hemisphere stratosphere or into both hemispheres equally to assess the impacts on Sahelian rainfall and agriculture (Haywood et al., 2013). While the frequency of volcanic eruptions during the past 100 years is too sparse for definitive attribution, there is a suggestion that volcanic eruptions that preferentially load the northern hemisphere are the harbinger of Sahelian drought. Simulations are then performed with the HadGEM2 couple atmospheric-ocean model to assess the impacts of these volcanic eruptions and deliberate unilateral stratospheric geoengineering. Figure 1 shows the impacts of the geoengineering simulations which show that stratospheric injection into the northern hemisphere induces a severe and prolonged Sahelian drought with undoubted detrimental consequences for the local population. Conversely injection into the southern hemisphere causes a significant greening of the Sahel with vegetation productivity enhanced by over 100%. On the face of it, this suggests potential advocacy of injection into the southern hemisphere: we will investigate potential other side-effects from such a strategy...... Haywood, J.M., A. Jones, N. Bellouin, and D.B. Stephenson, Asymmetric forcing from stratospheric aerosols impacts Sahelian drought, Nature Climate Change, Vol 3, No 7, 660-665, doi: 10.1038/NCLIMATE1857, 2013.

  19. Perception of colour in unilateral tritanopia.

    PubMed Central

    Alpern, M; Kitahara, K; Krantz, D H

    1983-01-01

    The unilateral tritanope described in the previous paper (Alpern, Kitahara & Krantz, 1983) was able to match every narrow-band light presented to his tritanopic eye with lights from a tristimulus colorimeter viewed in the adjacent field by the normal eye. In two regions of the spectrum (called isochromes) physically identical lights appeared identical to the observer's two eyes. One isochrome was close to 'blue' for the normal eye, the other was in the long-wave spectral region seen by the normal eye predominantly as 'red'. Between these isochromes the normal eye required less than spectral purity to match, dropping to near zero purity at 560-570 nm. A mixture of the two isochromes that appeared purple to the normal eye appeared neutral to the tritanopic eye. Hence dichoptic matches grossly violate Grassmann's additivity law. For the normal eye colour naming conformed to typical normal results. For the tritanopic eye the results were coherent with those found by dichoptic matching: the spectrum was divided into two regions by the achromatic neutral band. To the short-wave side, only the colour names 'blue' and 'white' were ever used. To the long-wave side the predominant colour names were 'red' and 'white' with some 'yellow'. Spectral lights appeared neither 'red-blue' nor greenish. Surrounding the test with an annulus either 430 nm, 650 nm, or a mixture of these, fails to induce any greenish appearance, although the achromatic band shifted in the expected directions. It is concluded that there must be exactly three functionally independent, essentially non-linear central codes for colour perception, and that these codes are different from those suggested in existing theories of colour perception. PMID:6603509

  20. Impact of unilateral denervation on transdiaphragmatic pressure.

    PubMed

    Gill, Luther C; Mantilla, Carlos B; Sieck, Gary C

    2015-05-01

    The diaphragm muscle (DIAm) has a large reserve capacity for force generation such that in rats, the transdiaphragmatic pressure (Pdi) generated during ventilatory behaviors is less than 50% of maximal Pdi (Pd(imax)) elicited by bilateral phrenic nerve stimulation. Accordingly, we hypothesized that following unilateral denervation (DNV), the ability of the contralateral DIAm to generate sufficient Pdi to accomplish ventilatory behaviors will not be compromised and normal ventilation (as determined by arterial blood gas measurements) will not be impacted, although neural drive to the DIAm increases. In contrast, we hypothesized that higher force, non-ventilatory behaviors requiring Pdi generation greater than 50% of Pd(imax) will be compromised following DIAm hemiparalysis, i.e., increased neural drive cannot fully compensate for lack of force generating capacity. Pdi generated during ventilatory behaviors (eupnea and hypoxia (10% O2)-hypercapnia (5% CO2)) did not change after DNV and arterial blood gases were unaffected by DNV. However, neural drive to the contralateral DIAm, assessed by the rate of rise of root mean squared (RMS) EMG at 75 ms after onset of inspiratory activity (RMS75), increased after DNV (p<0.05). In contrast, Pdi generated during higher force, non-ventilatory behaviors was significantly reduced after DNV (p < 0.01), while RMS75 was unchanged. These findings support our hypothesis that only non-ventilatory behaviors requiring Pdi generation greater than 50% of Pd(imax) are impacted after DNV. Clinically, these results indicate that an evaluation of DIAm weakness requires examination of Pdi across multiple motor behaviors, not just ventilation. PMID:25641347

  1. Chronic Kidney Disease and Medicines

    MedlinePLUS

    ... Disease and Medicines (Brochure) Chronic Kidney Disease and Medicines (Brochure) What You Need to Know Because you ... pharmacist and provider need to know about your medicine and supplement use Your kidneys do not filter ...

  2. Living Donor Kidney Transplant Surgery

    MedlinePLUS Videos and Cool Tools

    ... Absolutely. All of our patients take three immunosuppressive drugs to keep them from rejecting the kidney. Even ... the recipient that the recipient could have fewer drugs to take to keep from rejecting the kidney. ...

  3. JAMA Patient Page: Kidney Transplantation

    MedlinePLUS

    ... with renal failure is a candidate for a kidney transplant, so treatment options should be discussed with your ... 2011, issue of JAMA includes an article about kidney transplantation. This Patient Page is based on one published ...

  4. Sleep Disordered Breathing in Isolated Unilateral and Bilateral Diaphragmatic Dysfunction

    PubMed Central

    Khan, Akram; Morgenthaler, Timothy I.; Ramar, Kannan

    2014-01-01

    Introduction: The effect of isolated unilateral or bilateral diaphragmatic dysfunction (DD), in the absence of a generalized neuromuscular disorder, on sleep disordered breathing (SDB) is not well understood. The type of positive airway pressure (PAP) device needed to treat SDB in patients with isolated DD is also not well established. Methods: We retrospectively analyzed data on patients with isolated unilateral or bilateral DD who were referred for polysomnography (PSG) for clinical symptoms or abnormal oximetry between 1994 and 2006. Results: We found 66 patients who met criteria, of whom 74.2% were males with an average age of 58.8 ± 10.9 years. 56 had isolated unilateral DD, and 10 had isolated bilateral DD. All had significant SDB with an apnea-hypopnea index (AHI) of 26.6 ± 28.4. There were no significant differences in PSG measures, arterial blood gas analysis, pulmonary function tests, or echocardiographic data, except for lower maximal inspiratory pressure in patients with bilateral DD compared to unilateral DD (40.2% ± 17.8% vs. 57.7% ± 20.5%, p = 0.02). Control of SDB with continuous PAP (CPAP) was possible in only 37.9% of patients with the rest requiring bilevel PAP (BPAP). Patients with isolated bilateral DD and SDB were 6.8 times more likely to fail CPAP than those with unilateral DD (p = 0.03). Conclusions: Most patients with isolated DD failed CPAP and required BPAP. Patients with bilateral DD were more likely to require BPAP than those with unilateral DD. Patients with isolated DD should be considered for in-lab titration to determine adequacy of therapy. Citation: Khan A, Morgenthaler TI, Ramar K. Sleep disordered breathing in isolated unilateral and bilateral diaphragmatic dysfunction. J Clin Sleep Med 2014;10(5):509-515. PMID:24910552

  5. Measurement of aerosol penetration through six personal thoracic samplers under calm air conditions

    Microsoft Academic Search

    A. D. Maynard

    1999-01-01

    The performance of six thoracic sampler types has been assessed against the CEN\\/ISO thoracic convention. Samplers tested included the CATHIA thoracic sampler, a modified form of the SIMPEDS cyclone, the IOM thoracic sampler, the GK2.69 thoracic cyclone, a modified IOM inhalable sampler with a foam plug insert and a modified cowled sampler of the type usually used for sampling fibres.

  6. [Tension pneumopericardium: a rare complication after thoracic stab wound].

    PubMed

    Faroudy, M; Marzouk, N; Ababou, A; Lazreq, C; Sbihi, A

    2002-11-01

    The authors report a case involving a patient with thoracic stab wound. The patient developed tension pneumopericardium with acute cardiac tamponade. The clinical and radiological features of tension pneumopericardium and its treatment are discussed. PMID:12494808

  7. Nael Martini: a leader in thoracic surgical oncology.

    PubMed

    Rusch, Valerie W; Bains, Manjit S

    2010-03-01

    Nael Martini was one of the leading academic general thoracic surgeons of the late 20th century. His most notable contributions related to the surgical and multimodality treatment of lung cancer. PMID:20172188

  8. Robotic thoracic surgery: from the perspectives of European chest surgeons

    PubMed Central

    2014-01-01

    Although thoracic surgery is one of the fastest growing programs, the results of robotic thoracic surgery reports are presented very rarely. In this manuscript, the development of robotic thoracic surgery programs in Europe and the initial results are discussed. Several European countries lead the development of robotic surgery in the world, especially for lung cancer surgery and for thymus—thymoma surgery. Yet, we may not recognize any major advantage in the outcome when compared to video-assisted thoracic surgery (VATS). But, certainly, the superior capabilities of the intraoperative instrumentation of robotic surgery will be beneficial. More experience in robotic surgery may provide superior results in oncological, physiological and life quality measurements. PMID:24868438

  9. Thoracic trident pigmentation in Drosophila melanogaster : Differentiation of geographical populations

    E-print Network

    Paris-Sud XI, Université de

    Thoracic trident pigmentation in Drosophila melanogaster : Differentiation of geographical A phenotypic classification of trident pigmentation allowed the characterization ol any natural population by a pigmentation score, ranging from 0 to 3. After some training, independent observers could produce very similar

  10. Living with Kidney Cancer

    MedlinePLUS

    Living With Cancer Day to Day The impact of kidney cancer on your life is complex. Here are suggestions on what to expect — from employment matters and ... least one half hour of exercise every other day. Vigorous walking, jogging, swimming, or other aerobic exercise ...

  11. Kidney Disease and Diabetes

    MedlinePLUS

    Kidney Disease & Diabetes Updated:Jan 31,2013 One of the more common long-term complications of diabetes is diabetic renal disease (" ... content was last reviewed on 7/5/2012. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  12. Neurology and the kidney

    Microsoft Academic Search

    D J Burn; D Bates

    1998-01-01

    Renal failure is relatively common, but except in association with spina bifida or paraplegia it is unlikely to occur as a result of disease of the CNS. Renal failure, however, commonly affects the nervous system. The effects of kidney failure on the nervous system are more pronounced when failure is acute. In addition to the important problems related to renal

  13. Hypoxia in Diabetic Kidneys

    PubMed Central

    Takiyama, Yumi; Haneda, Masakazu

    2014-01-01

    Diabetic nephropathy (DN) is now a leading cause of end-stage renal disease. In addition, DN accounts for the increased mortality in type 1 and type 2 diabetes, and then patients without DN achieve long-term survival compatible with general population. Hypoxia represents an early event in the development and progression of DN, and hypoxia-inducible factor- (HIF-) 1 mediates the metabolic responses to renal hypoxia. Diabetes induces the “fraternal twins” of hypoxia, that is, pseudohypoxia and hypoxia. The kidneys are susceptible to hyperoxia because they accept 20% of the cardiac output. Therefore, the kidneys have specific vasculature to avoid hyperoxia, that is, AV oxygen shunting. The NAD-dependent histone deacetylases (HDACs) sirtuins are seven mammalian proteins, SIRTs 1–7, which are known to modulate longevity and metabolism. Recent studies demonstrated that some isoforms of sirtuins inhibit the activation of HIF by deacetylation or noncatalyzing effects. The kidneys, which have a vascular system that protects them against hyperoxia, unfortunately experience extraordinary hypernutrition today. Then, an unexpected overload of glucose augments the oxygen consumption, which ironically results in hypoxia. This review highlights the primary role of HIF in diabetic kidneys for the metabolic adaptation to diabetes-induced hypoxia. PMID:25054148

  14. Treatment of Thoracic Outlet Syndromes and Cervical Sympathectomy

    Microsoft Academic Search

    Robert W. Thompson

    The thoracic outlet is a unique anatomic region dominated by the first rib, the anterior and middle scalene muscles, and their\\u000a associated neurovascular structures. Within this relatively confined space, the subclavian artery, subclavian vein, and nerve\\u000a roots of the brachial plexus are all potentially subject to extrinsic compression. Whereas vascular lesions associated with\\u000a thoracic outlet compression give rise to easily

  15. Surgical treatment of thoracic disc herniations via tailored posterior approaches

    Microsoft Academic Search

    Wolfgang Börm; U. Bäzner; R. W. König; T. Kretschmer; G. Antoniadis; J. Kandenwein

    We present clinical findings, radiological characteristics and surgical modalities of various posterior approaches to thoracic\\u000a disc herniations and report the clinical results in 27 consecutive patients. Within an 8-year period 27 consecutive patients\\u000a (17 female, 10 male) aged 30–83 years (mean 53 years.) were surgically treated for 28 symptomatic herniated thoracic discs\\u000a in our department. Six of these lesions (21%) were calcified.

  16. Tracheobronchial ruptures from blunt thoracic trauma in children

    Microsoft Academic Search

    M Ait Ali Slimane; F Becmeur; D Aubert; B Bachy; F Varlet; Y Chavrier; S Daoud; B Fremond; J. M Guys; P de Lagausie; Y Aigrain; O Reinberg; P Sauvage

    1999-01-01

    Background\\/Purpose: Tracheobronchial ruptures in blunt thoracic trauma in children are rare. The aim of this study was to suggest the means of an early diagnosis and a conservative management as often as possible.Methods: Sixteen cases of tracheobronchial ruptures by blunt thoracic trauma were observed over 26 years in 9 regional pediatric centers.Results: There were 12 boys and 4 girls, from

  17. Lymphoscintigraphic evaluation of the thoracic duct in the canine 

    E-print Network

    Hodges, Carlos Cintron

    1990-01-01

    LYMPHOSCINTIGRAPHIC EVALUATION OF THE THORACIC DUCT IN THE CANINE A Thesis by CARLOS CINTRON HODGES Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the degree of MASTER... OF SCIENCE December 1990 Major Subject: Veterinary Medicine and Surgery LYMPHOSCINTIGRAPHIC EVALUATION OF THE THORACIC DUCT IN THE CANINE A Thesis by CARLOS CINTRON HODGES Approved as to style and content by: H W. Boothe (Chair of Committee) D...

  18. Posttransplantation lymphoproliferative disorders in pediatric thoracic organ recipients

    Microsoft Academic Search

    Gerard J. Boyle; Marian G. Michaels; Steven A. Webber; A. S. Knisely; Geoffrey Kurland; Lynne A. Cipriani; Bartley P. Griffith; Frederick J. Fricker

    1997-01-01

    Objective: To determine the frequency, predisposing factors, clinical presentation, and outcome of posttransplantation lymphoproliferative disorders (PTLDs) in pediatric thoracic organ transplant recipients.Methods: Retrospective review of the medical records of all 120 children who survived longer than 1 month after thoracic organ transplantation at our center.Results: PTLD was diagnosed in 14 patients (11.7%), including 7.7% of heart and 19.5% of heart-lung\\/lung

  19. Unusual thoracic CT manifestations of osteosarcoma: review of 16 cases

    Microsoft Academic Search

    Ruchi Rastogi; Rachana Garg; Sanjay Thulkar; Sameer Bakhshi; Ajay Gupta

    2008-01-01

    Pulmonary metastases are common in osteosarcoma and the most common appearance is of multiple well-defined nodules in the\\u000a lung parenchyma. However, a variety of atypical locations and presentations of osteosarcoma metastasis can occur in the thorax.\\u000a We present a review of the thoracic CT findings in 16 patients with histopathologically confirmed osteosarcoma with unusual\\u000a thoracic manifestations. The 16 patients were

  20. Endovascular Repair of Descending Thoracic Aortic Aneurysm

    PubMed Central

    2005-01-01

    Executive Summary Objective To conduct an assessment on endovascular repair of descending thoracic aortic aneurysm (TAA). Clinical Need Aneurysm is the most common condition of the thoracic aorta requiring surgery. Aortic aneurysm is defined as a localized dilatation of the aorta. Most aneurysms of the thoracic aorta are asymptomatic and incidentally discovered. However, TAA tends to enlarge progressively and compress surrounding structures causing symptoms such as chest or back pain, dysphagia (difficulty swallowing), dyspnea (shortness of breath), cough, stridor (a harsh, high-pitched breath sound), and hoarseness. Significant aortic regurgitation causes symptoms of congestive heart failure. Embolization of the thrombus to the distal arterial circulation may occur and cause related symptoms. The aneurysm may eventually rupture and create a life-threatening condition. The overall incidence rate of TAA is about 10 per 100,000 person-years. The descending aorta is involved in about 30% to 40% of these cases. The prognosis of large untreated TAAs is poor, with a 3-year survival rate as low as 25%. Intervention is strongly recommended for any symptomatic TAA or any TAA that exceeds twice the diameter of a normal aorta or is 6 cm or larger. Open surgical treatment of TAA involves left thoracotomy and aortic graft replacement. Surgical treatment has been found to improve survival when compared with medical therapy. However, despite dramatic advances in surgical techniques for performing such complex operations, operative mortality from centres of excellence are between 8% and 20% for elective cases, and up to 50% in patients requiring emergency operations. In addition, survivors of open surgical repair of TAAs may suffer from severe complications. Postoperative or postprocedural complications of descending TAA repair include paraplegia, myocardial infarction, stroke, respiratory failure, renal failure, and intestinal ischemia. The Technology Endovascular aortic aneurysm repair (EVAR) using a stent graft, a procedure called endovascular stent-graft (ESG) placement, is a new alternative to the traditional surgical approach. It is less invasive, and initial results from several studies suggest that it may reduce mortality and morbidity associated with the repair of descending TAAs. The goal in endovascular repair is to exclude the aneurysm from the systemic circulation and prevent it from rupturing, which is life-threatening. The endovascular placement of a stent graft eliminates the systemic pressure acting on the weakened wall of the aneurysm that may lead to the rupture. However, ESG placement has some specific complications, including endovascular leak (endoleak), graft migration, stent fracture, and mechanical damage to the access artery and aortic wall. The Talent stent graft (manufactured by Medtronic Inc., Minneapolis, MN) is licensed in Canada for the treatment of patients with TAA (Class 4; licence 36552). The design of this device has evolved since its clinical introduction. The current version has a more flexible delivery catheter than did the original system. The prosthesis is composed of nitinol stents between thin layers of polyester graft material. Each stent is secured with oversewn sutures to prevent migration. Review Strategy Objectives To compare the effectiveness and cost-effectiveness of ESG placement in the treatment of TAAs with a conventional surgical approach To summarize the safety profile and effectiveness of ESG placement in the treatment of descending TAAs Measures of Effectiveness Primary Outcome Mortality rates (30-day and longer term) Secondary Outcomes Technical success rate of introducing a stent graft and exclusion of the aneurysm sac from systemic circulation Rate of reintervention (through surgical or endovascular approach) Measures of Safety Complications were categorized into 2 classes: Those specific to the ESG procedure, including rates of aneurysm rupture, endoleak, graft migration, stent fracture, and kinking; and Those due to the intervention, either surgical or endovascular. These in

  1. Acute kidney injury

    PubMed Central

    2011-01-01

    Introduction Acute renal failure is characterised by abrupt and sustained decline in glomerular filtration rate, which leads to accumulation of urea and other chemicals in the blood. The term acute kidney injury has been introduced to encompass a wide spectrum of acute alterations in kidney function from mild to severe. Acute kidney injury is classified according to the RIFLE criteria, in which a change from baseline serum creatinine or urine output determines the level of renal dysfunction. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent acute kidney injury in people at high risk? What are the effects of treatments for critically ill people with acute kidney injury? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 82 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: albumin supplementation plus loop diuretics (intravenous), aminoglycosides, aminophylline, amphotericin B, calcium channel blockers, contrast media, dialysis membranes, dopamine, early versus late dialysis, extended daily dialysis, fenoldopam, loop diuretics, mannitol, N-acetylcysteine, natriuretic peptides, renal replacement therapy, sodium bicarbonate-based fluids, sodium chloride-based fluids, and theophylline. PMID:21443811

  2. [Examination of the thoracic duct using fast advanced spin echo].

    PubMed

    Nagata, Koji; Yamashita, Hironori; Miyazaki, Mitsue

    2004-02-01

    Recent reports have indicated that depiction of the thoracic duct is possible without administration of a contrast agent using fast advanced spin echo (FASE), ECG-triggered, half-Fourier fast spin echo (FSE), by depicting blood vessels. In this study, we attempted to depict the thoracic duct using FASE, which is generally used for MR-hydrography. By varying effective echo time (effective TE), the contrast-to-noise ratios (CNR) for saline and baby oil were measured with and without fat suppression. Without fat suppression, the effective TE of 500 msec yielded the highest CNR. With fat suppression, the effective TE of 250 msec provided the highest CNR. Next, examinations of the thoracic duct were performed in volunteers in order to obtain the highest CNR. Results indicated that the best depiction of the thoracic duct was obtained using the effective TE of 500 msec in 3D-FASE without fat suppression. Thoracic duct imaging using heavily T(2)-weighted parameters allows better control of signal intensities of background and surrounding tissues than can be obtained with fat suppression. Furthermore, the heavily T(2)-weighted parameter only depicts the long T(2) components of the thoracic duct. PMID:15054318

  3. Faster imaging with a portable unilateral NMR device.

    PubMed

    Liberman, Asaf; Bergman, Elad; Sarda, Yifat; Nevo, Uri

    2013-06-01

    Unilateral NMR devices are important tools in various applications such as non-destructive testing and well logging, but are not applied routinely for imaging, primarily because B0 inhomogeneity in these scanners leads to a relatively low signal and requires use of the slow single point imaging scan scheme. Enabling high quality, fast imaging could make this affordable and portable technology practical for various imaging applications as well as for new applications that are not yet feasible with MRI technology. The goal of this work was to improve imaging times in a portable unilateral NMR scanner. Both Compressed Sensing and Fast Spin Echo were modified and applied to fit the unique characteristics of a unilateral device. Two printed phantoms, allowing high resolution images, were scanned with both methods and compared to a standard scan and to a low pass scan to evaluate performance. Both methods were found to be feasible with a unilateral device, proving ways to accelerate single point imaging in such scanners. This outcome encourages us to explore how to further accelerate imaging times in unilateral NMR devices so that this technology might become clinically applicable in the future. PMID:23597948

  4. Transcriptional analysis of infiltrating T cells in kidney ischemia-reperfusion injury reveals a pathophysiological role for CCR5

    PubMed Central

    Ko, Gang Jee; Linfert, Douglas; Jang, Hye Ryoun; Higbee, Elizabeth; Watkins, Tonya; Cheadle, Chris; Liu, Manchang; Racusen, Lorraine; Grigoryev, Dmitry N.

    2012-01-01

    Although T cells have been shown to play a direct role in kidney ischemia-reperfusion injury (IRI), little is known about the underlying mechanisms. We hypothesized that studying the transcriptional responses in kidney-infiltrating T cells would help elucidate novel therapeutic targets for kidney IRI. Unilateral renal pedicle clamping for 45 min was performed in male C57BL/6 mice, and CD3+ T cells were isolated from the kidney and purified. Transcriptional activities of T cell were measured by array-based PCR compared between ischemic kidneys and contralateral nonischemic kidneys. Among total of 89 genes analyzed, 24, 22, 24, and 37 genes were significantly changed at 6 h, day 3, day 10, and day 28 after IRI. Genes associated with cytokines, chemokines, and costimulatory molecules were upregulated. Pathway analysis identified CC motif chemokine receptor 5 (CCR5) as a candidate pathophysiological pathway. CCR5 upregulation was validated at the protein level, and CCR5 blockade improved renal function after kidney IRI. Using discovery techniques to identify transcriptional responses in purified kidney-infiltrating cells enabled the elucidation of novel mechanisms and therapeutic targets for IRI. PMID:22160774

  5. Computer modeling of thoracic response to blast.

    PubMed

    Stuhmiller, J H; Chuong, C J; Phillips, Y Y; Dodd, K T

    1988-01-01

    Primary blast injury affects the gas-containing structures of the body. Damage to the lungs with resultant respiratory insufficiency and arterial embolization of air from alveolar pulmonary venous fistulae is the predominant cause of morbidity and mortality following high-level blast exposure. In an effort to generate a widely applicable damage-risk criterion for thoracic injury from blast we are developing a complex computer finite element model (FEM) of the thorax. Taking an engineering approach, a horizontal cross-section of the thorax is divided into small discrete units (finite elements) of homogeneous structure. The necessary physical properties (density, bulk modulus, etc.) are then determined for each element. Specifying the material constants and geometry of the elements, the computer can load the surface of the structure with some force-time function (blast pressure-time history) and calculate the resultant physical events such as displacement, compression, stress, strain, etc. Computer predictions of pressure wave phenomena in the lung parenchyma are compared with trans-bronchially measured pressures in blast-exposed animals. The model should prove useful in assessing the risk of blast injury in diverse overpressure environments and may give insight into pathophysiologic mechanisms and strategies for protection. PMID:3339675

  6. 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

  7. Infraclavicular subpectoral lipoma causing thoracic outlet syndrome

    PubMed Central

    Elia, Stefano; Cerioli, Alessandra; Fiaschetti, Valeria; Granai, Alessandra Vittoria

    2015-01-01

    Introduction Thoracic outlet syndrome (TOS) includes a group of disorders caused by extrinsic compression of neurovascular structures between the 1st rib and clavicle. It usually presents as an enlarging neck mass, with shoulder or upper limb pain, weakness, paresthesias and impalpable radial pulse (Raynaud’s phenomenon). Presentation of case We report a rare case of TOS caused by an infraclavicular subpectoral lipoma that, although challenging because of limited access and proximity of vital neurovascular structures, was successfully removed through a simple transaxillary incision with an excellent esthetic result. The patients is symptom-free 6 months after surgery. Discussion Multiplicity of symptoms makes causes, diagnosis, and treatment of TOS controversial. Accurate diagnosis of TOS can be a substantial challenge in practice, because of a lack of physician awareness, overlapping of clinical features, and an absence of clearly defined diagnostic criteria. TOS may be associated with the presence of a benign subpectoral mass like lipomas, that seldom have an irregular distribution that involve neurovascular structures. Conclusion Although benign soft tissue tumors infraclavicular subpectoral lipomas may exert pressure on neurovascular surrounding structures during their progressive expansion and cause TOS. Therefore, a thorough preoperative study by radiological imaging such as MRI or neurophysiological test should always be performed in order to prevent unintentional lesions of the involved axillo-subclavicular plexus and plan correct surgical procedure. PMID:25746951

  8. Renal denervation has blood pressure-independent protective effects on kidney and heart in a rat model of chronic kidney disease.

    PubMed

    Eriguchi, Masahiro; Tsuruya, Kazuhiko; Haruyama, Naoki; Yamada, Shunsuke; Tanaka, Shigeru; Suehiro, Takaichi; Noguchi, Hideko; Masutani, Kosuke; Torisu, Kumiko; Kitazono, Takanari

    2015-01-01

    We elucidate the underlying mechanisms of bidirectional cardiorenal interaction, focusing on the sympathetic nerve driving disruption of the local renin-angiotensin system (RAS). A rat model of N(?)-nitro-L-arginine methyl ester (L-NAME; a nitric oxide synthase inhibitor) administration was used to induce damage in the heart and kidney, similar to cardiorenal syndrome. L-NAME induced sympathetic nerve-RAS overactivity and cardiorenal injury accompanied by local RAS elevations. These were suppressed by bilateral renal denervation, but not by hydralazine treatment, despite the blood pressure being kept the same between the two groups. Although L-NAME induced angiotensinogen (AGT) protein augmentation in both organs, AGT mRNA decreased in the kidney and increased in the heart in a contradictory manner. Immunostaining for AGT suggested that renal denervation suppressed AGT onsite generation from activated resident macrophages of the heart and circulating AGT excretion from glomeruli of the kidney. We also examined rats treated with L-NAME plus unilateral denervation to confirm direct sympathetic regulation of intrarenal RAS. The levels of urinary AGT and renal angiotensin II content and the degrees of renal injury from denervated kidneys were less than those from contralateral innervated kidneys within the same rats. Thus, renal denervation has blood pressure-independent beneficial effects associated with local RAS inhibition. PMID:24940798

  9. Advances of unilateral mobile NMR in nondestructive materials testing.

    PubMed

    Blümich, Bernhard; Casanova, Federico; Perlo, Juan; Anferova, Sophia; Anferov, Vladimir; Kremer, Kai; Goga, Nicolae; Kupferschläger, Klaus; Adams, Michael

    2005-02-01

    Unilateral mobile NMR employs portable instrumentation with sensors, which are applied to the object from one side. Based on the principles of well-logging NMR, a hand-held sensor, the NMR-MOUSE (MObile Universal Surface Explorer) has been developed for nondestructive materials testing. In the following, a number of new applications of unilateral NMR in materials science are reviewed. They are the state assessment of polyethylene pipes, the characterization of wood, the in situ evaluation of stone conservation treatment, high-resolution profiling of rubber tubes and 2-D imaging for defect analysis in rubber products. PMID:15833612

  10. A unilateral optic perineuritis in a teenager - A case report.

    PubMed

    Ameilia, Ahmad; Shatriah, Ismail; Wan-Hitam, Wan Hazabbah; Yunus, Rohaizan

    2015-06-01

    Optic perineuritis is an uncommon inflammatory disorder that involves optic nerve sheath. Numerous case reports have been published on optic perineuritis in adults, the majority of whom had bilateral presentation. There are limited data on optic perineuritis occurring in pediatric patients. We report a teenager who presented with a unilateral sign that mimicked the presentation of optic neuritis. The orbit and brain magnetic resonance imaging confirmed features of unilateral optic perineuritis. She was treated with a high dose of corticosteroids for 2weeks, and her final visual outcome was satisfactory. No signs of relapse were noted during follow-up visits. PMID:25457086

  11. Teaching neuroimages: anoxic brain injury with unilateral hemispheric cortical involvement.

    PubMed

    Kim, Yong-Won; Seo, Ji-Hye; Park, Sung-Pa; Hwang, Yang-Ha

    2013-04-01

    A 55-year-old woman collapsed with chest pain and cardiac arrest. Her pulse was restored after 6 minutes of cardiopulmonary resuscitation, but she remained comatose. Brain MRI (figure) revealed bilateral basal ganglia and right hemispheric cortical lesion, which was typical for anoxic brain injury except for the unilateral cortical involvement. Neck CT angiography showed severe stenosis in the right proximal internal carotid artery. The unilateral cortical injury could be explained by compromised cerebral blood flow due to preexisting carotid stenosis. This case demonstrates an atypical pattern of anoxic brain injury secondary to focal vascular stenosis. PMID:23547273

  12. The Kidney Research Predicament

    PubMed Central

    Bryan, Lisa; Ibrahim, Tod; Fischer, Michael J.

    2014-01-01

    Research funding from public and private sources has reached an all-time low. Economic conditions, sequestration, and a trend of low award success rates have created an imbalance between the supply of highly qualified research investigators and the availability of critically necessary research dollars. This grim environment continues to hinder the success of established investigators and deter potential investigators from joining the research workforce. Without action and support of innovative science, the future of the US health care system is in jeopardy, and its leadership role in medical research will decrease. This work discusses the effects of the decline in research funding, the plight of kidney research, and the impact of the American Society of Nephrology Grants Program on scientists. The ASN also calls on the entire nephrology community to rejuvenate the research environment, improve the lives of millions of people with kidney disease, and ultimately, find a cure. PMID:24652790

  13. Kidney amino acid transport

    Microsoft Academic Search

    François Verrey; Dustin Singer; Tamara Ramadan; Raphael N. Vuille-dit-Bille; Luca Mariotta; Simone M. R. Camargo

    2009-01-01

    Near complete reabsorption of filtered amino acids is a main specialized transport function of the kidney proximal tubule.\\u000a This evolutionary conserved task is carried out by a subset of luminal and basolateral transporters that together form the\\u000a transcellular amino acid transport machinery similar to that of small intestine. A number of other amino acid transporters\\u000a expressed in the basolateral membrane

  14. Myeloperoxidase in kidney disease

    Microsoft Academic Search

    ERNST MALLE; THOMAS BUCH; HERMANN-JOSEF GRONE

    2003-01-01

    Myeloperoxidase in kidney disease.In glomerular and tubulointerstitial disease, polymorphonuclear- and monocyte-derived reactive oxygen species may contribute to oxidative modification of proteins, lipids, and nucleic acids. In part, the processes instigated by reactive oxygen species parallel events that lead to the development of atherosclerosis. Myeloperoxidase (MPO), a heme protein and catalyst for (lipo)protein oxidation is present in these mononuclear cells. The

  15. Connexins and the kidney

    PubMed Central

    Hanner, Fiona; Sorensen, Charlotte Mehlin; Holstein-Rathlou, Niels-Henrik

    2010-01-01

    Connexins (Cxs) are widely-expressed proteins that form gap junctions in most organs, including the kidney. In the renal vasculature, Cx37, Cx40, Cx43, and Cx45 are expressed, with predominant expression of Cx40 in the endothelial cells and Cx45 in the vascular smooth muscle cells. In the tubules, there is morphological evidence for the presence of gap junction plaques only in the proximal tubules. In the distal nephron, Cx30, Cx30.3, and Cx37 are expressed, but it is not known whether they form gap junctions connecting neighboring cells or whether they primarily act as hemichannels. As in other systems, the major function of Cxs in the kidney appears to be intercellular communication, although they may also form hemichannels that allow cellular secretion of large signaling molecules. Renal Cxs facilitate vascular conduction, juxtaglomerular apparatus calcium signaling, and tubular purinergic signaling. Accordingly, current evidence points to roles for these Cxs in several important regulatory mechanisms in the kidney, including the renin angiotensin system, tubuloglomerular feedback, and salt and water reabsorption. At the systemic level, renal Cxs may help regulate blood pressure and may be involved in hypertension and diabetes. PMID:20164205

  16. Endovascular Repair versus Open Repair for Isolated Descending Thoracic Aortic Aneurysm

    PubMed Central

    Lee, Hyung Chae; Joo, Hyun-Chel; Lee, Seung Hyun; Lee, Sak; Chang, Byung-Chul; Yoo, Kyung-Jong

    2015-01-01

    Purpose To compare the outcomes of thoracic endovascular aortic repair (TEVAR) with those of open repair for descending thoracic aortic aneurysms (DTAA). Materials and Methods We compared the outcomes of 114 patients with DTAA and proximal landing zones 3 or 4 after TEVAR to those of 53 patients after conventional open repairs. Thirty-day and late mortality were the primary endpoints, and early morbidities, aneurysm-related death, and re-intervention were the secondary endpoints. Results The TEVAR group was older and had more incidences of dissecting aneurysm. The mean follow-up was 36±26 months (follow-up rate, 97.8%). The 30-day mortality in the TEVAR and open repair groups were 3.5% and 9.4% (p=0.11). Perioperative stroke and paraplegia incidences were similar between the groups [5.3% vs. 7.5% (p=0.56) and 7.5% vs. 3.5% (p=0.26), respectively]. Respiratory failure occurred more in the open repair group (1.8% vs. 26.4%, p<0.01). The incidence of acute kidney injury requiring dialysis was higher in the open repair group (1.8% vs. 9.4%, p<0.01). The cumulative survival rate was higher in the TEVAR group at 2 to 5 years (79.6% vs. 58.3%, p=0.03). The free from re-intervention was lower in the TEVAR group (65.3% vs. 100%, p=0.02), and the free from aneurysm-related death in the TEVAR and open repair groups were 88.5% and 86.1% (p=0.45). Conclusion TEVAR is safe and effective for treating DTAAs with improved perioperative and long-term outcomes compared with open repair. PMID:26069110

  17. [Unilateral isolated Raynaud's phenomenon leading to diagnosis of multifocal giant-cell arteritis complicated with renal ischemia].

    PubMed

    Goupil de Bouillé, J; Lecouffe-Desprets, M; Bigot, A; Halimi, J-M; Courtehoux, M; Guilmot, J-L; Breteau, C; Diot, E

    2015-05-01

    We report a case of a 76-year-old woman with isolated unilateral Raynaud phenomenon revealing giant-cell arteritis with diffuse arterial lesions and bilateral renal artery stenosis. Doppler ultrasonography showed bilateral stenosis of the subclavian and axillary arteries. Angio-CT PET enlightened diffuse arterial lesions, mainly involving the aorta and the brachial and femoral arteries as well as bilateral renal ostial stenosis with right kidney ischemia. Diagnosis of giant-cell arteritis was made on the temporal artery biopsy. Corticosteroid therapy led to rapid clinical and radiological improvement. Clinical manifestations of giant-cell arteritis may be atypical. Diffuse arterial disease may exist in the absence of cephalic symptoms or significant inflammatory biological features. Ostial renal artery stenosis may induce potentially threatening renal ischemia. PMID:25790900

  18. Challenges of endovascular tube graft repair of thoracic aortic aneurysm: midterm follow-up and lessons learned

    Microsoft Academic Search

    Sharif H Ellozy; Alfio Carroccio; Michael Minor; Tikva Jacobs; Kristina Chae; Andrew Cha; Gautam Agarwal; Bethany Goldstein; Nicholas Morrissey; David Spielvogel; Robert A Lookstein; Victoria Teodorescu; Larry H Hollier; Michael L Marin

    2003-01-01

    ObjectivesEndovascular stent-graft repair has great potential in treatment of thoracic aortic aneurysms. This study analyzed a single center's experience with first-generation commercially produced thoracic stent grafts used to treat descending thoracic aortic aneurysms.

  19. Mechanism of the formation for thoracic impedance change.

    PubMed

    Kuang, Ming-Xing; Xiao, Qiu-Jin; Cui, Chao-Ying; Kuang, Nan-Zhen; Hong, Wen-Qin; Hu, Ai-Rong

    2010-03-01

    The purpose of this study is to investigate the mechanism of the formation for thoracic impedance change. On the basis of Ohm's law and the electrical field distribution in the cylindrical volume conductor, the formula about the thoracic impedance change are deduced, and they are demonstrated with the model experiment. The results indicate that the thoracic impedance change caused by single blood vessel is directly proportional to the ratio of the impedance change to the basal impedance of the blood vessel itself, to the length of the blood vessel appearing between the current electrodes, and to the basal impedance between two detective electrodes on the chest surface, while it is inversely proportional to the distance between the blood vessel and the line joining two detective electrodes. The thoracic impedance change caused by multiple blood vessels together is equal to the algebraic addition of all thoracic impedance changes resulting from the individual blood vessels. That is, the impedance changes obey the principle of adding scalars in the measurement of the electrical impedance graph. The present study can offer the theoretical basis for the waveform reconstruction of Impedance cardiography (ICG). PMID:20336823

  20. Exaggerated renal fibrosis in P2X4 receptor-deficient mice following unilateral ureteric obstruction

    PubMed Central

    Kim, Min Jeong; Turner, Clare M.; Hewitt, Reiko; Smith, Jennifer; Bhangal, Gurjeet; Pusey, Charles D.; Unwin, Robert J.; Tam, Frederick W.K.

    2014-01-01

    Background The ATP-sensitive P2X7 receptor (P2X7R) has been shown to contribute to renal injury in nephrotoxic nephritis, a rodent model of acute glomerulonephritis, and in unilateral ureteric obstruction (UUO), a rodent model of chronic interstitial inflammation and fibrosis. Renal tubular cells, endothelial cells and macrophages also express the closely related P2X4 receptor (P2X4R), which is chromosomally co-located with P2X7R and has 40% homology; it is also pro-inflammatory and has been shown to interact with P2X7R to modulate its pro-apoptotic and pro-inflammatory effects. Therefore, we chose to explore the function of P2X4R in the UUO model of renal injury using knockout mice. We hypothesized that UUO-induced tubulointerstitial damage and fibrosis would also be attenuated in P2X4R?/? mice. Method P2X4R?/? and wild-type (WT) mice were subjected to either UUO or sham operation. Kidney samples taken on Days 7 and 14 were evaluated for renal inflammation and fibrosis, and expression of pro-fibrotic factors. Results To our surprise, the obstructed kidney in P2X4R?/? mice showed more severe renal injury, more collagen deposition (picrosirius red staining, increase of 53%; P < 0.05) and more type I collagen staining (increase of 107%; P < 0.01), as well as increased mRNA for TGF-? (increase of 102%, P < 0.0005) and CTGF (increase of 157%; P < 0.05) by Day 14, compared with the UUO WT mice. Conclusion These findings showed that lack of P2X4R expression leads to increased renal fibrosis, and increased expression of TGF-? and CTGF in the UUO model. PMID:24574541

  1. On unilateral divorce and the “selection of marriages” hypothesis

    Microsoft Academic Search

    Eric Langlais

    2010-01-01

    In this paper, the unilateral divorce law is modelled through the combination of exclusive rights on the marriage dissolution and alternative compensation rules benefiting to the parent having custody of the children. Their influence are studied both in the short run (probability and efficiency of divorce) and in the long run (selection of marriages). We show that a decrease in

  2. Channel Incentives as Unilateral and Bilateral Governance Processes

    Microsoft Academic Search

    David I. Gilliland; Daniel C. Bello

    2001-01-01

    The authors investigate channel incentives as extra-contractual governance processes that maintain and extend marketing channel relationships. More specifically, instrumental incentives are monetary-based payments made by a manufacturer in a unilateral channel arrangement to motivate distributor compliance, while equity incentives are bilateral expectations of fair treatment that motivate both parties to continue to cooperate with one another. A model of the

  3. Epileptic Features of Patients With Unilateral and Bilateral Schizencephaly

    Microsoft Academic Search

    Camila F. Lopes; Fernando Cendes; Ana Maria S. G. Piovesana; Fábio Torres; Iscia Lopes-Cendes; Maria Augusta Montenegro; Marilisa M. Guerreiro

    2006-01-01

    The extent of cortical maldevelopment might correlate with the severity of the clinical manifestation, such as cognitive delay or motor dysfunction. The objective of this study was to investigate the clinical features of epilepsy in patients with unilateral and bilateral schizencephaly. We studied 44 consecutive patients with schizencephaly diagnosed by magnetic resonance imaging (MRI). The epileptic features were analyzed in

  4. Traumatic glaucoma with features of unilateral pigment dispersion

    PubMed Central

    Bowler, Gordon; Ellul, Antony; Gouws, Pieter

    2014-01-01

    Summary We report a patient with traumatic glaucoma with features of unilateral pigment dispersion. This rare form of secondary glaucoma has only been reported twice previously, with both patients demonstrating angle recession, indicating associated damage to the trabecular meshwork. To our knowledge, this is the first such case reported in which angle recession was absent. PMID:25097455

  5. Unilateral Forced Nostril Breathing Affects Dichotic Listening for Emotional Tones

    ERIC Educational Resources Information Center

    Saucier, Deborah M.; Tessem, Farzana Karim; Sheerin, Aaron H.; Elias, Lorin

    2004-01-01

    Unilateral forced nostril breathing (UFNB) through the left nostril is associated with enhanced spatial abilities, whereas UFNB through the right nostril is associated with enhanced verbal abilities. However, the effects of UFNB on standard tasks of laterality (e.g., dichotic listening) are unknown. This study employed dichotic listening for word…

  6. Unilateral convulsion after induction of anaesthesia with propofol

    Microsoft Academic Search

    D. COCHRAN; C. L. GWINNUTT

    Summary We report a case in which a 42-yr-old man suffered a unilateral convulsion immediately after i.v. in- jection of propofol, and was discovered subse- quently to have an old contralateral cerebral infarct. This complication and the current information on the relationship between propofol and abnormal neurological activity are discussed. (Br. J. Anaesth. 1996; 76: 570-572)

  7. Unilateral Subcortical Calcification: A Manifestation of Dural Arteriovenous Fistula

    Microsoft Academic Search

    Ming-Shiang Yang; Clayton Chi-Chang Chen; Yung-Yi Cheng; Da-Ming Yeh; San-Kan Lee; Yeu-Sheng Tyan

    Summary: We describe the imaging findings in a dural arteriovenous fistula (AVF) with unilateral subcortical calcification. A 50-year-old woman patient suffered from hypertension and chronic headache. Recently, marked headache and a changed consciousness level were noted. The imaging studies demonstrated left subcortical calci- fication and cerebral sulcus effacement. MR imaging and angiography revealed multiple abnormal tortuous vessels, mainly from left

  8. Unilateral internuclear ophthalmoplegia as an isolated presentation of metastatic melanoma.

    PubMed

    Kumar, Sunil; Kent, Shefalee S; Sundaram, Arun N; Sharma, Manas

    2015-03-01

    Multiple sclerosis in younger patients and brainstem infarction in the elderly are the most common causes of internuclear ophthalmoplegia (INO). We report unilateral INO as the isolated clinical manifestation of a large, solitary, metastatic melanoma in the pons. Brain metastasis can present as INO. PMID:25232840

  9. Coupling of FM Systems to Individuals with Unilateral Hearing Loss.

    ERIC Educational Resources Information Center

    Kopun, Judy G.; And Others

    1992-01-01

    This study examined the attenuation characteristics of 5 Frequency Modulation system sound delivery options for 25 adults and children (ages 5-13). Degree of ear canal occlusion was a major factor in degree of attenuation. For children with unilateral hearing impairments, the most acoustically appropriate option was the tube-fitting. (Author/JDD)

  10. Power as a Factor in Unilaterally and Bilaterally Coercive Situations.

    ERIC Educational Resources Information Center

    Bonoma, Thomas V.

    This paper discusses the concept and definition of social power as it relates to an understanding of social behavior at all levels. The author attempts to differentiate power situations in which the flow of influence is primarily unilateral from an identifiable source to a target, from those in which there is a more dynamic give-and-take between…

  11. Shipping and climate change: Scope for unilateral action

    E-print Network

    Matthews, Adrian

    Shipping and climate change: Scope for unilateral action Paul Gilbert, Tyndall Manchester Alice on international shipping emissions and climate change undertaken at The University of Manchester by the Tyndall considers the role that the shipping sector could play in mitigating total global emissions

  12. Oleanolic acid attenuates renal fibrosis in mice with unilateral ureteral obstruction via facilitating nuclear translocation of Nrf2

    PubMed Central

    2014-01-01

    Background Renal interstitial fibrosis is a common final pathological process in the progression of kidney disease. This is primarily due to oxidative stress, which contributes to renal inflammation and fibrosis. Nuclear factor-erythroid-2-related factor 2 (Nrf2) is known to coordinate induction of genes that encode antioxidant enzymes. We investigated the effects of oleanolic acid, a known Nrf2 activator, on oxidative stress-induced renal inflammation and fibrosis. Methods One day before unilateral ureteral obstruction (UUO) performed in C57BL/6 mice, oleanolic acid treatment was initiated and was continued until 3 and 7 days after UUO. Renal inflammation and fibrosis, markers of oxidative stress, and changes in Nrf2 expression were subsequently evaluated. Results In the obstructed kidneys of UUO mice, oleanolic acid significantly attenuated UUO-induced collagen deposition and fibrosis on day 7. Additionally, significantly less inflammatory cell infiltration, a lower ratio of Bax to Bcl-2 expression, and fewer apoptotic cells on TUNEL staining were observed in the obstructed kidneys of oleanolic acid-treated mice. Oleanolic acid increased the expression of nuclear Nrf2, heme oxygenase-1, NAD(P)H:quinone oxidoreductase 1 and heat shock protein 70, and decreased lipid peroxidation in the obstructed kidney of UUO mice. There were no changes in the expression of total Nrf2 and Kelch-like ECH-associated protein 1, indicating that oleanolic acid enhanced nuclear translocation of Nrf2. Conclusions These results suggest that oleanolic acid may exert beneficial effects on renal fibrosis by increasing nuclear translocation of Nrf2 and subsequently reducing renal oxidative stress. PMID:24393202

  13. Akt1-mediated fast/glycolytic skeletal muscle growth attenuates renal damage in experimental kidney disease.

    PubMed

    Hanatani, Shinsuke; Izumiya, Yasuhiro; Araki, Satoshi; Rokutanda, Taku; Kimura, Yuichi; Walsh, Kenneth; Ogawa, Hisao

    2014-12-01

    Muscle wasting is frequently observed in patients with kidney disease, and low muscle strength is associated with poor outcomes in these patients. However, little is known about the effects of skeletal muscle growth per se on kidney diseases. In this study, we utilized a skeletal muscle-specific, inducible Akt1 transgenic (Akt1 TG) mouse model that promotes the growth of functional skeletal muscle independent of exercise to investigate the effects of muscle growth on kidney diseases. Seven days after Akt1 activation in skeletal muscle, renal injury was induced by unilateral ureteral obstruction (UUO) in Akt1 TG and wild-type (WT) control mice. The expression of atrogin-1, an atrophy-inducing gene in skeletal muscle, was upregulated 7 days after UUO in WT mice but not in Akt1 TG mice. UUO-induced renal interstitial fibrosis, tubular injury, apoptosis, and increased expression of inflammatory, fibrosis-related, and adhesion molecule genes were significantly diminished in Akt1 TG mice compared with WT mice. An increase in the activating phosphorylation of eNOS in the kidney accompanied the attenuation of renal damage by myogenic Akt1 activation. Treatment with the NOS inhibitor L-NAME abolished the protective effect of skeletal muscle Akt activation on obstructive kidney disease. In conclusion, Akt1-mediated muscle growth reduces renal damage in a model of obstructive kidney disease. This improvement appears to be mediated by an increase in eNOS signaling in the kidney. Our data support the concept that loss of muscle mass during kidney disease can contribute to renal failure, and maintaining muscle mass may improve clinical outcome. PMID:25012168

  14. Outcomes After Unilateral Uterine Artery Embolization: A Retrospective Review

    SciTech Connect

    Bratby, M. J. [St George's Hospital, Radiology Department (United Kingdom); Hussain, F. F.; Walker, W. J. [Royal Surrey County Hospital, Radiology Department (United Kingdom)], E-mail: wj.walker@virgin.net

    2008-03-15

    Purpose. Bilateral uterine artery embolization (UAE) is considered necessary to provide effective treatment for symptomatic uterine fibroids. Occasionally, only unilateral embolization is performed, and this study evaluates these outcomes. Materials and Methods. As part of a prospective observational study of more than 1600 patients treated with UAE since 1996, there have been 48 patients in whom unilateral embolization has been performed. This study retrospectively reviews clinical response as assessed by our standard questionnaire and radiological response assessed by either magnetic resonance imaging or ultrasound. Results. Two principal groups emerged: the largest, where only the dominant unilateral arterial supply was electively embolized (30 patients); and the second, where there was technical failure to catheterize the second uterine artery as a result of anatomical constraints (12 patients). Favorable clinical response with a reduction in menorrhagia at 1 year was seen in 85.7% (18/21) of those patients with a dominant arterial supply to the fibroid(s). In contrast, in those patients where there was technical failure to embolize one uterine artery, there was a high rate of clinical failure requiring further intervention in 58.3% (7/12). Comparison of the technical failure group with the dominant uterine artery group demonstrated a statistically significant (Fisher's exact test) difference in the proportion of patients with evidence of persistent fibroid vascularity (p < 0.001) and requiring repeat intervention (p < 0.01). Conclusion. We conclude that unilateral UAE can achieve a positive clinical result in the group of patients where there is a dominant unilateral artery supplying the fibroid(s), in contrast to the poor results seen following technical failure.

  15. An analytical methodology for magnetic field control in unilateral NMR

    NASA Astrophysics Data System (ADS)

    Marble, Andrew E.; Mastikhin, Igor V.; Colpitts, Bruce G.; Balcom, Bruce J.

    2005-05-01

    Traditionally, unilateral NMR systems such as the NMR-MOUSE have used the fringe field between two bar magnets joined with a yoke in a 'U' geometry. This allows NMR signals to be acquired from a sensitive volume displaced from the magnets, permitting large samples to be investigated. The drawback of this approach is that the static field ( B0) generated in this configuration is inhomogeneous, and has a large, nonlinear, gradient. As a consequence, the sensitive volume of the instrument is both small and ill defined. Empirical redesign of the permanent magnet array producing the B0 field has yielded instruments with magnetic field topologies acceptable for varying applications. The drawback of current approaches is the lack of formalism in the control of B0. Rather than tailoring the magnet geometry to NMR investigations, measurements must be tailored to the available magnet geometry. In this work, we present a design procedure whereby the size, shape, field strength, homogeneity, and gradients in the sensitive spot of a unilateral NMR sensor can be controlled. Our design uses high permeability pole pieces, shaped according to the contours of an analytical expression, to control B0, allowing unilateral NMR instruments to be designed to generate a controlled static field topology. We discuss the approach in the context of previously published design techniques, and explain the advantages inherent in our strategy as compared to other optimization methods. We detail the design, simulation, and construction of a unilateral magnet array using our approach. It is shown that the fabricated array exhibits a B0 topology consistent with the design. The utility of the design is demonstrated in a sample nondestructive testing application. Our design methodology is general, and defines a class of unilateral permanent magnet arrays in which the strength and shape of B0 within the sensitive volume can be controlled.

  16. An analytical methodology for magnetic field control in unilateral NMR.

    PubMed

    Marble, Andrew E; Mastikhin, Igor V; Colpitts, Bruce G; Balcom, Bruce J

    2005-05-01

    Traditionally, unilateral NMR systems such as the NMR-MOUSE have used the fringe field between two bar magnets joined with a yoke in a 'U' geometry. This allows NMR signals to be acquired from a sensitive volume displaced from the magnets, permitting large samples to be investigated. The drawback of this approach is that the static field (B0) generated in this configuration is inhomogeneous, and has a large, nonlinear, gradient. As a consequence, the sensitive volume of the instrument is both small and ill defined. Empirical redesign of the permanent magnet array producing the B0 field has yielded instruments with magnetic field topologies acceptable for varying applications. The drawback of current approaches is the lack of formalism in the control of B0. Rather than tailoring the magnet geometry to NMR investigations, measurements must be tailored to the available magnet geometry. In this work, we present a design procedure whereby the size, shape, field strength, homogeneity, and gradients in the sensitive spot of a unilateral NMR sensor can be controlled. Our design uses high permeability pole pieces, shaped according to the contours of an analytical expression, to control B0, allowing unilateral NMR instruments to be designed to generate a controlled static field topology. We discuss the approach in the context of previously published design techniques, and explain the advantages inherent in our strategy as compared to other optimization methods. We detail the design, simulation, and construction of a unilateral magnet array using our approach. It is shown that the fabricated array exhibits a B0 topology consistent with the design. The utility of the design is demonstrated in a sample nondestructive testing application. Our design methodology is general, and defines a class of unilateral permanent magnet arrays in which the strength and shape of B0 within the sensitive volume can be controlled. PMID:15809175

  17. Analgesia for thoracic surgery: the role of paravertebral block.

    PubMed

    Piraccini, E; Pretto, E A; Corso, R M; Gambale, G

    2011-01-01

    An appropriate post operative analgesia after thoracotomies is mandatory to improve the patient's outcome, reduce complications rate, morbidity, hospital cost and length of stay. In this paper we review the evidences regarding the use of paravertebral block for thoracic surgery. In particular we examine the effect of paravertebral block compared to the other technique in four major issues: analgesia, complications rate, postoperative pulmonary function and transition from acute to chronic pain. We conclude that paravertebral block is superior to intravenous analgesia in providing pain control and preserving postoperative pulmonary function while it is equal to thoracic epidural analgesia regarding this two issues. Paravertebral block has a better safety profile when compared to intravenous and thoracic epidural analgesia. Its effect on chronic pain incidence still needs further studies. PMID:23439717

  18. Repair of a complex thoracic aneurysm from relapsing polychondritis.

    PubMed

    Jacobs, Chad E; March, Robert J; Hunt, Peter J; Rivera, Aksim G; Cavanagh, Sherry; McCarthy, Walter J

    2013-07-01

    A 29-year-old female with a history of relapsing polychondritis (RP) and open repair of a proximal descending thoracic aneurysm presented with 2 areas of asymptomatic thoracic aortic aneurysmal dilatation. The patient returned 3 months later with symptomatic aneurysm expansion, and she underwent ascending aortic arch replacement. She subsequently underwent staged endovascular repair of the distal descending thoracic aorta. RP is a rare disorder with an incidence of 3.5 per million persons annually, 4% to 7% of whom develop aneurysmal disease. Because of the aneurysmal potential of this disease, it is important for vascular surgeons to be aware of its presentation and treatment. To our knowledge, this is the first reported case describing endovascular technique to treat such a patient. PMID:23657635

  19. Laparoscopic en bloc kidney transplantation

    PubMed Central

    Modi, Pranjal; Thyagaraj, Krishnaprasad; Rizvi, Syed Jamal; Vyas, Jigish; Padhi, Sukant; Shah, Kamlesh; Patel, Ram

    2012-01-01

    Laparoscopic donor nephrectomy is well establish procedure and having advantages over open donor nephrectomy in terms of having less pain, early ambulation and rapid post operative recovery. To extend the advantages of laparoscopic surgery to the recipient, recently we have performed laparoscopic kidney transplantations when kidney was procured from deceased donors. As a further extension of the procedure, here we present a case of laparoscopic en bloc kidney transplantation in obese diabetic recipient who received kidneys from 70 year old non-heart beating donor. PMID:23204675

  20. A comparison of thoracic or lumbar patient-controlled epidural analgesia methods after thoracic surgery

    PubMed Central

    2014-01-01

    Background We aimed to compare patient-controlled thoracic or lumbar epidural analgesia methods after thoracotomy operations. Methods One hundred and twenty patients were prospectively randomized to receive either thoracic epidural analgesia (TEA group) or lumbar epidural analgesia (LEA group). In both groups, epidural catheters were administered. Hemodynamic measurements, visual analog scale scores at rest (VAS-R) and after coughing (VAS-C), analgesic consumption, and side effects were compared at 0, 2, 4, 8, 16, and 24 hours postoperatively. Results The VAS-R and VAS-C values were lower in the TEA group in comparison to the LEA group at 2, 4, 8, and 16 hours after surgery (for VAS-R, P?=?0.001, P?=?0.01, P?=?0.008, and P?=?0.029, respectively; and for VAS-C, P?=?0.035, P?=?0.023, P?=?0.002, and P?=?0.037, respectively). Total 24-hour analgesic consumption was different between groups (175 +/- 20 mL versus 185 +/- 31 mL; P?=?0.034). The comparison of postoperative complications revealed that the incidence of hypotension (21/57, 36.8% versus 8/63, 12.7%; P?=?0.002), bradycardia (9/57, 15.8% versus 2/63, 3.2%; P?=?0.017), atelectasis (1/57, 1.8% versus 7/63, 11.1%; P?=?0.04), and the need for intensive care unit (ICU) treatment (0/57, 0% versus 5/63, 7.9%; P?=?0.03) were lower in the TEA group in comparison to the LEA group. Conclusions TEA has beneficial hemostatic effects in comparison to LEA after thoracotomies along with more satisfactory pain relief profile. PMID:24885545

  1. Unilateral nephrectomy in the rat as a teaching model of renal function.

    PubMed

    Zwemer, C F

    1999-06-01

    The white rat offers a valuable teaching model to demonstrate the in situ anatomy, homeostatic control, and function of the mammalian renal system. Students in the upper-level physiology class at Dickinson College are responsible for formulating a set of testable hypotheses as to the possible compensatory mechanisms that will result from a unilateral nephrectomy in the rat. To test their hypotheses, each group of students is made responsible for induction and maintenance of anesthesia, removal of the left kidney, closure, and recovery of the animal in their experiment. Before and 1 wk after nephrectomy, blood samples are collected via tail section for measurement of hematocrit and plasma creatinine concentrations. Pooling data across all student groups (n = 6) for pre- and postnephrectomy hematocrit and creatinine values allows students to run statistical comparisons testing their hypotheses. This laboratory experience in integrative physiology is a successful exercise in introducing fundamentals of experimental design and, most importantly, provides students with an appreciation for the process of humane use of animals in research and teaching. PMID:16211671

  2. Evaluation of aqueous extract of Murraya koenigii in unilateral renal ischemia reperfusion injury in rats

    PubMed Central

    Punuru, Priyanka; Sujatha, D.; Kumari, B. Pushpa; Charisma, V. V. L.

    2014-01-01

    Aim: The aqueous extract of leaves of Murraya koenigii was studied for its renoprotective potential against unilateral renal ischemia reperfusion (RIR) injury in male Wistar rats. Materials and Methods: Healthy adult male Wistar rats were divided into five groups (n = 8) and were treated with 200 mg/kg., p.o. of aqueous extract of M. koenigii (AEMK) for 30 days to assess both preventive and curative effects of AEMK. Except Group I, RIR was induced to all the groups by clamping the left renal artery using artery clamp for 1 h followed by reperfusion by removing the clamp. Groups II and III underwent RIR at 30th day whereas RIR was induced in Groups IV and V at 1st day of treatment schedule. Biochemical parameters (serum creatinine, blood urea nitrogen, serum total protein and serum Na+), urinary parameters (urine output, urinary creatinine, urinary urea, urinary total protein, urinary Na+), in vivo anti-oxidants, renal myeloperoxidase (MPO) activity and histopathology of kidneys were monitored. Statistical significance was set at P < 0.05. Results: Rats were treated with AEMK significantly (P < 0.05) restored the serum and urinary parameters with significant (P < 0.05) improvement in endogenous anti-oxidants such as superoxide dismutase, catalase and reduced glutathione and decreased levels of malondialdehyde and renal MPO when compared with the control groups. Histopathological examination also supported the biochemical and urinary tests. Conclusions: Aqueous extract of M. koenigii possesses both preventive and curative effects against RIR injury. PMID:24741188

  3. Herz-, Thorax-, Transplantations-und Gefchirurgie PD Dr. A. R. Simon Hannover Thoracic Transplant Program

    E-print Network

    Manstein, Dietmar J.

    Gefäßchirurgie, Hannover Thoracic Transplant Program PD Dr. A. R. Simon Hintergrund Das Organ Care System (OCSHerz-, Thorax-, Transplantations- und Gefäßchirurgie PD Dr. A. R. Simon Hannover Thoracic Transplant Program Breathing Lung Graft: Vorteile neuer Konservierungsmethoden bei Lungentransplantation #12

  4. Residual Stresses in Oscillating Thoracic Arteries Reduce Circumferential Stresses and Stress Gradients

    E-print Network

    Bukiet, Bruce

    REVISION Residual Stresses in Oscillating Thoracic Arteries Reduce Circumferential Stresses, Oscillations, Arteries, Atherosclerosis 1 #12; REVISION Residual Stresses in Oscillating Thoracic Arteries of residual stresses and strains in the oscillating arteries on the stress distribution in the vascular wall

  5. MAT2A mutations predispose individuals to thoracic aortic aneurysms.

    PubMed

    Guo, Dong-chuan; Gong, Limin; Regalado, Ellen S; Santos-Cortez, Regie L; Zhao, Ren; Cai, Bo; Veeraraghavan, Sudha; Prakash, Siddharth K; Johnson, Ralph J; Muilenburg, Ann; Willing, Marcia; Jondeau, Guillaume; Boileau, Catherine; Pannu, Hariyadarshi; Moran, Rocio; Debacker, Julie; Bamshad, Michael J; Shendure, Jay; Nickerson, Deborah A; Leal, Suzanne M; Raman, C S; Swindell, Eric C; Milewicz, Dianna M

    2015-01-01

    Up to 20% of individuals who have thoracic aortic aneurysms or acute aortic dissections but who do not have syndromic features have a family history of thoracic aortic disease. Significant genetic heterogeneity is established for this familial condition. Whole-genome linkage analysis and exome sequencing of distant relatives from a large family with autosomal-dominant inheritance of thoracic aortic aneurysms variably associated with the bicuspid aortic valve was used for identification of additional genes predisposing individuals to this condition. A rare variant, c.1031A>C (p.Glu344Ala), was identified in MAT2A, which encodes methionine adenosyltransferase II alpha (MAT II?). This variant segregated with disease in the family, and Sanger sequencing of DNA from affected probands from unrelated families with thoracic aortic disease identified another MAT2A rare variant, c.1067G>A (p.Arg356His). Evidence that these variants predispose individuals to thoracic aortic aneurysms and dissections includes the following: there is a paucity of rare variants in MAT2A in the population; amino acids Glu344 and Arg356 are conserved from humans to zebrafish; and substitutions of these amino acids in MAT I? are found in individuals with hypermethioninemia. Structural analysis suggested that p.Glu344Ala and p.Arg356His disrupt MAT II? enzyme function. Knockdown of mat2aa in zebrafish via morpholino oligomers disrupted cardiovascular development. Co-transfected wild-type human MAT2A mRNA rescued defects of zebrafish cardiovascular development at significantly higher levels than mRNA edited to express either the Glu344 or Arg356 mutants, providing further evidence that the p.Glu344Ala and p.Arg356His substitutions impair MAT II? function. The data presented here support the conclusion that rare genetic variants in MAT2A predispose individuals to thoracic aortic disease. PMID:25557781

  6. Endovascular repair of thoracic aortic pathologies: postoperative nursing implications.

    PubMed

    Chen, Tanghua; Crozier, John A

    2014-06-01

    Endovascular stent grafting is increasingly used to manage descending thoracic aortic pathologies. The procedure was introduced at the study hospital in 2001. We sought to examine the short-term clinical outcomes of patients who underwent this endovascular stent grafting, with the aim of using the result as baseline for development of an in-center clinical management protocol. We undertook a single-center, retrospective review of health care records of patients managed with thoracic stent grafts from 2001 to 2009. Patient characteristics, in-hospital data, and procedural data were obtained. SPSS was used to analyze the data. A total of 30 patients were treated with thoracic stent; 23 were male, 7 were female, and the mean age was 55.0. Aortic pathologies treated were traumatic aortic dissection/transection (n = 15), acute/chronic aortic dissection (n = 9), and degenerative aneurysms (n = 6). Endoleak occurred in 3 patients, with 1 requiring further endograft repair. Two patients underwent combined open and endovascular repair of acute thoracic aortic dissection; 1 died 4 days after the procedure, and the other developed stroke and acute renal failure not requiring dialysis. Of the 28 patients who underwent endovascular repair, paraplegia and paraparesis occurred in 2 patients but resolved with cerebrospinal fluid drainage. Stroke occurred in 1 patient. Patients who underwent combined procedure of open and endovascular repair of thoracic aortic dissection had a greater risk of developing major adverse events than patients who underwent endovascular repair alone (Fisher's exact test P = .023). There was no association between the risk of stroke and the coverage of left subclavian artery in this series (P = .483). Graft stenting treatment for descending thoracic aortic pathologies has been shown to result in high in-hospital survival rates. It is essential for nurses who work in acute care settings to have knowledge of this procedure and potential complications associated with the procedure to enable postoperative assessment and immediate action if any deviation is observed. PMID:24944173

  7. Prospective Evaluation of Thoracic Ultrasound in the Detection of Pneumothorax

    NASA Technical Reports Server (NTRS)

    Schwarz, K. W.; Hamilton, D. R.; Kirkpatrick, A. W.; Billica, R. D.; Williams, D. R.; Diebel, L. N.; Sargysan, A. E.; Dulchavsky, S. A.

    2000-01-01

    Introduction: Pneumothorax (PTX) occurs commonly in trauma patients and is confirmed by examination and radiography. Thoracic ultrasound (VIS) has been suggested as an alternative method for rapidly diagnosing PTX when X-ray is unavailable as in rural, military, or space flight settings; however, its accuracy and specificity are not known. Methods: We evaluated the accuracy of thoracic U/S detection of PTX compared to radiography in stable, emergency patients with a high suspicion of PTX at a Level-l trauma center over a 6-month period. Following University and NASA Institutional Review Board approval, informed consent was obtained from patients with penetrating or blunt chest trauma, or with a history consistent with PTX. Whenever possible, the presence or absence of the " lung sliding" sign or the "comet tail" artifact were determined by U/S in both hemithoraces by residents instructed in thoracic U/S before standard radiologic verification of PTX. Results were recorded on data sheets for comparison to standard radiography. Results: Thoracic VIS had a 94% sensitivity; two PTX could not be reliably diagnosed due to subcutaneous air; the true negative rate was 100%. In one patient, the VIS exam was positive while X ray did not confirm PTX; a follow-up film 1 hour later demonstrated a small PTX. The average time for bilateral thoracic VIS examination was 2 to 3 minutes. Conclusions: Thoracic ultrasound reliably diagnoses pneumothorax. Presence of the "lung sliding" sign conclusively excludes pneumothorax. Expansion of the FAST examination to include the thorax should be investigated.

  8. Helical CT angiography of the thoracic aorta.

    PubMed

    Rubin, G D

    1997-04-01

    Five years after its introduction (11,36), spiral or helical CTA is being embraced as an important noninvasive tool for imaging the thoracic aorta and its branches. The high degree of accessibility and ease with which the studies are performed make it a viable alternative to aortography in the acute setting. Once the examiner is familiar with the principles of CTA, the acquisition phase of the examination can be completed in as little as 15 minutes, but it is critical that a thorough understanding of these principles guide the radiologist to maximize information gained by the technique. Several important challenges remain for CTA. First, the proliferation of image-processing workstations and software is improving our ability to exploit these CT data by allowing us to visualize them in novel ways (37) and create alternative renderings with greater ease and speed. Before relying on these alternative visualization techniques, their accuracy and pitfalls, and the incremental gain they achieve over interpretation of the primary transverse sections must be fully established. This requires that carefully designed studies with multiple blinded and independent reviewers isolate interpretative variations based on rendering technique alone, and not a combination of rendering and acquisition techniques where variables readily are confounded (38). Second, more investigators must step forward with results of the clinical utility of CTA to triage patients appropriately and direct medical and surgical therapy. Although well designed prospective comparisons of imaging examinations and measurement of patient outcomes are challenging to implement, they are critical to the rational selection of appropriate diagnostic tests. This is particularly true for the application of helical CTA to imaging of the posttraumatic aortic and aortic dissection. Finally, helical CT technology is far from static. Every year, new advances in engineering bring better image quality, improved resolution, and faster scan times. As medical imagers, we must not become complacent, but rather constantly challenge ourselves to consider how we might further improve on our use of CT equipment to maximize the collection of information relevant to diagnosis and therapy. PMID:9179826

  9. Place of Video-thoracoscopy in Thoracic Surgical Practice

    Microsoft Academic Search

    2001-01-01

      The advent of video-endoscopy\\u000a revolutionizes the practice of surgery. Within a short span of time,\\u000a video-assisted thoracic surgery (VATS) has become an acceptable\\u000a approach to a wide range of thoracic procedures. The use of VATS as a\\u000a diagnostic modality is now well established. For therapeutic\\u000a procedures, VATS has also been generally accepted for the treatment of\\u000a such conditions as primary

  10. Reasons to participate in European Society of Thoracic Surgeons database.

    PubMed

    Salati, Michele

    2015-04-01

    The process of data collection inevitably involves costs at various levels. Nevertheless, this effort is essential to base our knowledge and the consequent decision making on solid foundations. The European Society of Thoracic Surgeons (ESTS) database collects a large amount of data on general thoracic surgery derived from about 60 units representative of 11 nations. Since its beginning in 2001, the ESTS database has contributed to increase the knowledge and the quality of care in our specialty. The present paper illustrates the ultimate finalities and the obtained results of this data collection, providing a broad overview of the motivations to participate to the ESTS database. PMID:25984355

  11. A unique approach to fixed occipito-cervico-thoracic deformity.

    PubMed

    Aw, G E; Mobbs, R J

    2013-04-01

    We discuss a unique approach to a patient who presented with severe kyphosis and laterolisthesis of the cranio-cervico-thoracic spine, following a history of neck trauma 24months prior to presentation. The patient had organized voluntary euthanasia if no treatment could be performed. Our approach included a three-part procedure over a 3-week time interval, including: initial traction, division of anterior neck muscles, multilevel anterior fusion and, finally, posterior occipito-cervico-thoracic fusion. Follow-up at 6months revealed a patient in neutral sagittal and coronal balance of the neck. PMID:23313528

  12. [Boerhaave syndrome: a rare cause of acute thoracic pain].

    PubMed

    Anastasiadou, K; Pilavaki, M; Vafiadis, E; Petridis, A; Drevelengas, A

    1998-03-01

    In a 74-year old female patient suffering from acute thoracic pain, vomiting, and dyspnoea, the diagnosis of Boerhaave's syndrome was made. After medical treatment the patient was dismissed in a sufficiently satisfactory condition. If symptoms like vomiting, severe thoracic pain, pneumomediastinum, pneumothorax or hydropneumothorax on the left side occur, a rupture of the oesophagus should be taken into account especially in case of abuse of alcohol. The early diagnosis is decisive for the course of the disease and a lethality reduction. PMID:9564186

  13. Reasons to participate in European Society of Thoracic Surgeons database

    PubMed Central

    2015-01-01

    The process of data collection inevitably involves costs at various levels. Nevertheless, this effort is essential to base our knowledge and the consequent decision making on solid foundations. The European Society of Thoracic Surgeons (ESTS) database collects a large amount of data on general thoracic surgery derived from about 60 units representative of 11 nations. Since its beginning in 2001, the ESTS database has contributed to increase the knowledge and the quality of care in our specialty. The present paper illustrates the ultimate finalities and the obtained results of this data collection, providing a broad overview of the motivations to participate to the ESTS database. PMID:25984355

  14. "Lower Limbs Revascularization from Supraceliac and Thoracic Aorta".

    PubMed

    Wistuba, Mariel Riedemann; Alonso-Pérez, Manuel; Al-Sibbai, Amer Zanabili; González-Gay, Mario; Alvarez Marcos, Francisco; Camblor, Lino A; Llaneza-Coto, José Manuel

    2015-07-01

    Revascularization of femoral arteries from descending thoracic or supraceliac aorta is an uncommon procedure, in part because of the popularization of the technically easier extra-anatomic bypasses. However, using those aortic levels as the source of the bypass inflow is a useful alternative in selected patients with aortoiliac disease, with excellent results. We report long-term results in 4 patients with revascularization from thoracic aorta and another 2 cases from aorta at supraceliac level. This technique should be considered as a good alternative in patients with adverse abdominal conditions or with a severely diseased infrarenal aorta due to heavy calcification. PMID:25771745

  15. The Bioartificial Kidney and Bioengineered Membranes in Acute Kidney Injury

    Microsoft Academic Search

    Feng Ding; H. David Humes

    2008-01-01

    The treatment of severe acute kidney injury (AKI) with dialysis or hemofiltration remains suboptimal with high levels of morbidity and mortality. Current renal replacement therapies substitute for the small solute clearance function of the kidney but do not replace the lost reclamation, metabolic and endocrine functions of this organ. Cell therapy and tissue engineering offer hope of fuller replacement of

  16. Kidney scintigraphy after ACE inhibition in the diagnosis of renovascular hypertension

    SciTech Connect

    Ghione, S.; Fommei, E.; Palombo, C.; Giaconi, S.; Mantovanelli, A.; Ragazzini, A.; Palla, L.

    1986-01-01

    Suppression of the renin-angiotensin system (RAS) by angiotensin converting enzyme (ACE) inhibition may induce renal failure in patients with bilateral renal artery stenosis. Recent scintigraphic studies with the glomerular tracer technetium-99m-diethylenetriaminepenta-acetate (99m-Tc DTPA) indicate that in patients with unilateral renal artery stenosis, glomerular filtration rate (GFR) may be markedly reduced in the affected kidney after inhibition of ACE. This finding reflects the important role of the RAS in maintaining GFR (by increasing postglomerular resistance) in states of low renal perfusion pressure. Preliminary observations suggest that this scintigraphic test might be useful in the detection of renovascular hypertension.

  17. Spontaneous peri-nephric hematoma in a patient with acute kidney injury following Russell's viper envenomation.

    PubMed

    Golay, Vishal; Roychowdhary, Arpita; Pandey, Rajendra

    2015-03-01

    Snake bite envenomation is a common cause of acute kidney injury (AKI) in the tropics and severe coagulopathy with bleeding manifestations is usually seen, especially with viperine bites. We present a case of a 34-year-old male who had developed AKI following Russell's viper envenomation along with disseminated intravascular coagulation. The patient was seemingly improving during the course of his treatment but subsequently developed a spontaneous unilateral peri-nephric hematoma and finally succumbed to this complication. This is a rare presentation that can be clinically innoccuous in a disease where there are multiple bleeding manifestations and, carries a very poor outcome. PMID:25758885

  18. Electrophysiological and Morphological Characterization of Propriospinal Interneurons in the Thoracic Spinal Cord

    PubMed Central

    Saywell, S. A.; Ford, T. W.; Meehan, C. F.; Todd, A. J.

    2011-01-01

    Propriospinal interneurons in the thoracic spinal cord have vital roles not only in controlling respiratory and trunk muscles, but also in providing possible substrates for recovery from spinal cord injury. Intracellular recordings were made from such interneurons in anesthetized cats under neuromuscular blockade and with the respiratory drive stimulated by inhaled CO2. The majority of the interneurons were shown by antidromic activation to have axons descending for at least two to four segments, mostly contralateral to the soma. In all, 81% of the neurons showed postsynaptic potentials (PSPs) to stimulation of intercostal or dorsal ramus nerves of the same segment for low-threshold (?5T) afferents. A monosynaptic component was present for the majority of the peripherally evoked excitatory PSPs. A central respiratory drive potential was present in most of the recordings, usually of small amplitude. Neurons depolarized in either inspiration or expiration, sometimes variably. The morphology of 17 of the interneurons and/or of their axons was studied following intracellular injection of Neurobiotin; 14 axons were descending, 6 with an additional ascending branch, and 3 were ascending (perhaps actually representing ascending tract cells); 15 axons were crossed, 2 ipsilateral, none bilateral. Collaterals were identified for 13 axons, showing exclusively unilateral projections. The collaterals were widely spaced and their terminations showed a variety of restricted locations in the ventral horn or intermediate area. Despite heterogeneity in detail, both physiological and morphological, which suggests heterogeneity of function, the projections mostly fitted a consistent general pattern: crossed axons, with locally weak, but widely distributed terminations. PMID:21106900

  19. Hypertension and the kidney.

    PubMed

    Weir, M R; Wolfsthal, S D

    1991-09-01

    Pathophysiologic and hereditary mechanisms impacting on the kidneys are crucial for the initiation and maintenance of essential hypertension. An appreciation of these renal mechanisms is important for the institution of appropriate antihypertensive therapy. The clinician must develop a physiologic algorithm to control systemic blood pressure while maintaining adequate blood supply to the kidneys. This approach is particularly important in patients at higher risk for progressive renal insufficiency (i.e., older patients, blacks, diabetics, and those with chronic renal failure). Better perfusion reduces the likelihood of activating the compensatory neurohormonal systems that augment the intrarenal effects of the renin-angiotensin-aldosterone and sympathetic nervous systems, which ultimately may be responsible for renal structural changes leading to nephrosclerosis. In addition, dietary concerns are also important, particularly in the patients with evidence of early renal disease. Controlling blood pressure in a physiologic way by using drugs that can potentially dampen neurohormonal systems may prevent or at least delay the development of nephrosclerosis. Thus, the clinician should use an individualized therapeutic approach to the patient with hypertension. If nonpharmacologic means of blood pressure control are unsuccessful, an attempt should be made to blend the specific physiologic needs of the patient with specified pharmacologic antihypertensive mechanisms, paying particular attention to the preservation of renal function and perfusion. PMID:1946786

  20. Obesity and kidney protection

    PubMed Central

    Chandra, Aravind; Biersmith, Michael; Tolouian, Ramin

    2014-01-01

    Context: Obesity, both directly and indirectly, increases the risk for a variety of disease conditions including diabetes, hypertension, liver disease, and certain cancers, which in turn, decreases the overall lifespan in both men and women. Though the cardiovascular risks of obesity are widely acknowledged, less often identified is the relationship between obesity and renal function. Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO and Web of Science has been searched. Results: The concept of the “Metabolic Syndrome“ helps us to understand this close link between obesity, diabetes, hypertension, and renal dysfunction. An elevated body mass index has shown to be one of the major determinants of glomerular hyperfiltration that lead to the development of chronic kidney disease. Interestingly, weight loss can lead to attenuation of hyperfiltration in severely obese patients suggesting a possible therapeutic option to combat obesity-related hyperfiltration. Conclusions: Various treatment strategies had been suggested to decrease impact of obesity on kidneys. These are blood pressure controling, inhibition of the renin-angiotensinaldosterone axis, improving glycemic control, improving dyslipidemia, improving protein uriaand lifestyle modifications. Regardless of the numerous pharmacotherapies, the focus should be on the root cause: obesity. PMID:25093156

  1. A novel approach toward pedicle screw placement in the thoracic spine

    Microsoft Academic Search

    John Thalgott; Mark Kabins; James Giuffre

    2002-01-01

    Purpose of study: Because of the smaller size of the thoracic pedicle, primarily in the coronal plane, most surgeons have opted to avoid the used of transpedicular screws in the thoracic spine. A new technique for placement of screws through thoracic pedicles with and without lateral wall violation is described.Methods used: From April 1992 through February 1999, 1,064 pedicle screws

  2. Lymphocoele of the thoracic duct: a cause of left supraclavicular fossa.

    PubMed

    Offiah, C E; Twigg, S

    2011-02-01

    Lymphocoele of the thoracic duct, alternatively referred to as thoracic duct cyst, is an uncommon abnormality that can present occasionally as a left supraclavicular fossa mass. Recognition of the origin of such a neck mass on imaging is crucial to avert unnecessary intervention. A case of such a mass is presented with discussion of the fascinating variable anatomy of the thoracic duct. PMID:21257831

  3. A normalized thoracic coordinate system for atlas mapping in 3D CT images

    Microsoft Academic Search

    Hongkai Wang; Jing Bai; Yonghong Zhang

    2008-01-01

    In this paper, a normalized thoracic coordinate system (NTCS) is defined for rapidly mapping the 4D thoracic organ atlas into individual CT volume images. This coordinate system is defined based on the thoracic skeleton. The coordinate values are normalized by the size of the individual thorax so that this coordinate system is universal to different individuals. For compensating the respiratory

  4. Tubulocystic carcinoma of the kidney

    PubMed Central

    Adair, Carol F.; Zhang, Haiying

    2015-01-01

    Tubulocystic carcinoma (TCC) of the kidney is a unique, rare, and recently recognized neoplasm. Although originally considered a low-grade collecting duct carcinoma, TCC is now considered to be a distinct entity. TCC should be considered in the differential diagnosis of cystic renal neoplasms. We report a case of TCC arising in the left kidney. PMID:26130898

  5. Kidney modelling: status and perspectives

    Microsoft Academic Search

    S. Randall Thomas; Anita T. Layton; Harold E. Layton; Leon C. Moore

    2006-01-01

    Mathematical models have played an essential role in elucidating various functions of the kidney, including the mech- anism by which the avian and mammalian kidney can produce a urine that is more concentrated than blood plasma, quasi- isosmotic reabsorption along the proximal tubule, and the control and regulation of glomerular filtration by the myogenic and tubuloglomerular feedback mechanisms. This review

  6. The Kidney in Lead Poisoning

    Microsoft Academic Search

    Zdenko Radoševi?; Marko Šari?; Tihomil Beriti?; Jelica Kneževi?

    1961-01-01

    Kidney damage due to lead is still an interesting problem of industrial toxicology. In spite of abundant literature data, much still remains to be explained. There are controversial opinions, not only on the type of renal lesions due to lead, but also on whether lead affects the kidney at all.In this paper our clinical observations on the effect of lead

  7. Keeping Your Single Kidney Healthy

    MedlinePLUS

    ... Page 1 of 3 The kidneys are vital organs responsible for filtering out waste products from the blood, controlling blood pressure, and stimulating red blood cell production. Treatment for childhood cancer sometimes requires removal of one kidney (nephrectomy). Although you can live ...

  8. Genetics of Chronic Kidney Disease

    Microsoft Academic Search

    Conall M. O’Seaghdha; Caroline S. Fox

    2011-01-01

    The current review collates what is already known of the genetics of chronic kidney disease (CKD), and focuses on new trends in genome-wide assessment of the inherited component of susceptibility to this condition. Early efforts to identify kidney disease susceptibility genetic loci using linkage and candidate gene strategies proved disappointing. More recently, genome-wide association studies have yielded highly promising results

  9. Macrophage polarization in kidney diseases

    PubMed Central

    Tian, Shaojiang; Chen, Shi-You

    2015-01-01

    Macrophage accumulation associates closely with the degree of renal structural injury and renal dysfunction in human kidney diseases. Depletion of macrophages reduces while adoptive transfer of macrophages worsens inflammation in animal models of the renal injury. However, emerging evidence support that macrophage polarization plays a critical role in the progression of a number of kidney diseases including obstructive nephropathy, ischemia-reperfusion injury, glomerulonephritis, diabetic nephropathy, and other kidney diseases. In this mini-review, we briefly summarize the macrophage infiltration and polarization in these inflammatory and fibrotic kidney diseases, discussing the results mostly from studies in animal models. In view of the critical role of macrophage in the progression of these diseases, manipulating macrophage phenotype may be a potential effective strategy to treat various kidney diseases.

  10. Kidney Failure - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... Arabic) ????? ?????? - ??????? Bilingual PDF Health Information Translations Kidney Failure English (Arabic) ????? ?????? - ??????? Multimedia ... rada bubrega - Bosanski (Bosnian) Bilingual PDF Health Information Translations Chinese - Simplified (????) Kidney Failure ?? - ???? (Chinese - ...

  11. Quantitative autoradiography of angiotensin II receptors in brain and kidney: focus on cardiovascular implications

    SciTech Connect

    Gehlert, D.R.; Speth, R.C.; Wamsley, J.K.

    1985-01-01

    Quantitative techniques of receptor autoradiography have been applied to localize (/sup 125/I)-angiotensin II binding sites in brain and kidney. High densities of autoradiographic grains, indicating the presence of angiotensin II receptors, have been localized to several rat brain nuclei including the dorsal motor nucleus of the vagus, nucleus of the solitary tract, anterior pituitary, locus coeruleus and several hypothalamic nuclei. Cat thoracic spinal cord exhibited a high density of sites over the intermedio-lateral cell column. In sections of rat kidney, angiotensin II receptors were detected in the glomerulus, vasa recta and ureter. The cardiovascular implications of these results are apparent and relate angiotensin II to hypertensive mechanisms. Thus, angiotensin II represents an endocoid which is involved in control of blood pressure through its effects on peripheral organs as well as the central nervous system.

  12. Intercostal bleeding that developed during thoracic epidural catheterization

    Microsoft Academic Search

    Sumio Amagasa; Ayuko Igarashi; Noriko Yokoo; Masayoshi Sato

    2008-01-01

    To the editor: Various complications related to thoracic epidural catheterization have been reported, including epidural hematoma or abscess, dural puncture, nerve injuries, intrapleural catheter placement, and pneumothorax (1,2). However, to our knowledge, intercostal bleeding has not been reported; this complication may be rare. We report a case of intercostal bleeding associated with hemothorax and a hematoma external to the parietal

  13. Case report - Vascular thoracic Traumatic transection of the innominate artery

    Microsoft Academic Search

    Devendran Veerasingam; Mihai Vioreanu; Martin O' Donohue; James F. McCarthy

    A case of transection of the origin of the innominate artery with an associated head injury following blunt thoracic injury is presented. The patient had been the unrestrained driver in a road traffic accident. Investigation demonstrated embolic damage to the brain parenchyma. Early surgical repair employing cardiopulmonary bypass and hypothermic circulatory arrest was successfully performed without extension of the neurological

  14. Open Thoracic Meningocele Associated with Amniotic Band Syndrome

    Microsoft Academic Search

    Thad Jackson

    2001-01-01

    We present a case of an infant born with an open thoracic meningocele secondary to an amniotic band. Although there have been several case reports of encephalocele, anencephaly, closed meningocele and a case of tethered cord associated with amniotic band syndrome (ABS), there has yet to be a report of an open meningocele associated with ABS. The patient remained neurologically

  15. THE ORIGIN AND SIGNIFICANCE OF MACROPHAGES IN THORACIC DUCT LYMPH

    Microsoft Academic Search

    Bruce J Roser

    1976-01-01

    Efferent lymph collected from a thoracic duct fistula initially contains no macrophages. However, the surgical procedures used to insert plastic cannulae into efferent lymphatics incite a vigorous foreign body reaction leading to the contamination of collected lymph with significant numbers of these cells. A sensitive and specific assay for the presence of macrophages in lymphocyte populations was used to quantitate

  16. Thoracic complications of illicit drug use: an organ system approach.

    PubMed

    Gotway, Michael B; Marder, Shelley R; Hanks, Douglas K; Leung, Jessica W T; Dawn, Samuel K; Gean, Alisa D; Reddy, Gautham P; Araoz, Philip A; Webb, W Richard

    2002-10-01

    Illicit drug use constitutes a major health problem and may be associated with various thoracic complications. These complications vary depending on the specific drug used and the route of administration. Commonly abused drugs that may play a role in causing thoracic disease include cocaine, opiates, and methamphetamine derivatives. Intravenously abused oral medications may contain filler agents that may be responsible for disease. Thoracic complications may be categorized as pulmonary, pleural, mediastinal, cardiovascular, and chest wall complications. Pulmonary complications of drug abuse include pneumonia, cardiogenic edema, acute lung injury, pulmonary hemorrhage, and aspiration pneumonia. Filler agents such as talc may result in panacinar emphysema or high-attenuation upper-lobe conglomerate masses. The primary pleural complication of illicit drug use is pneumothorax. Mediastinal and cardiovascular complications of illicit drug use include pneumomediastinum, cardiomyopathy, myocardial infarction, aortic dissection, and injection-related pseudoaneurysms. Chest wall complications include diskitis and vertebral osteomyelitis, epidural abscess, necrotizing fasciitis, costochondritis, and septic arthritis. Categorization of thoracic complications of illicit drug use may facilitate understanding of these disorders and allow accurate diagnosis. PMID:12376606

  17. Surgical treatment of infected thoracic and abdominal aortic aneurysms

    Microsoft Academic Search

    Y Chiba; R Muraoka; A Ihaya; T Kimura; K Morioka; M Nara; H Niwa

    1996-01-01

    Twelve patients with infected aneurysms of the thoracic and abdominal aorta were evaluated. Aneurysmal location, aetiology, bacteriology and treatment modality were analysed to determine the relationship between these factors and outcome. Patients were divided into two groups based on the preoperative states of their infections. Group 1 patients (n = 7) underwent resection after resolution of their active infection. The

  18. Use of extracorporeal membrane oxygenation in pediatric thoracic organ transplantation

    Microsoft Academic Search

    Paul M Kirshbom; Nancy D Bridges; Richard J Myung; J. William Gaynor; Bernard J Clark; Thomas L Spray

    2002-01-01

    Objective: Mechanical cardiorespiratory support is occasionally required before or after pediatric thoracic organ transplantation. Extracorporeal membrane oxygenation is the most commonly used mechanical support technique in children. The goal of this study was to examine the indications for initiation and outcomes after peritransplant use of extracorporeal membrane oxygenation. Methods: A retrospective study was conducted of 65 patients who received peritransplant

  19. Thoracic succussion splash: a new symptom and sign of achalasia.

    PubMed

    Sullivan, S N

    1990-12-01

    A patient with a "thoracic succussion splash" due to achalasia is described. She noted a splashing or sloshing sensation in her chest related to jogging and bending. On examination a splashing sound could be heard over the mid sternum and the posterior chest when the patient was rocked vigorously back and forth. PMID:2266244

  20. Transcatheter thoracic duct embolization in the dog. An experimental study.

    PubMed

    Pardo, A D; Bright, R M; Walker, M A; Patton, C S

    1989-01-01

    Thoracic duct embolization was created by injecting an isobutyl 2-cyanoacrylate/iophendylate (IBCA) mixture through a cannulated mesenteric lymphatic vessel in eight normal dogs. Aqueous contrast lymphangiography was repeated at minute 10 and week 6. Six dogs were euthanatized at week 6 and two dogs at month 6. Embolization with 1.5 to 3.9 ml of the mixture resulted in complete obstruction of the thoracic duct in all eight dogs. Results of lymphangiography in six dogs at week 6 showed a persistent, complete obstruction of the thoracic duct in six dogs and alternate lymphaticovenous anastomoses in four dogs. Histologically, there were a sclerosing granulomatous response surrounding the lymphatic embolus, mild congestive changes in the mesenteric lymph nodes, and mild lacteal dilatation in the jejunum. The procedure was well tolerated with only a few complications. One dog suffered partial thrombosis of the cranial vena cava by the injected material with later dislodgement and embolization of a pulmonary artery branch. Modifications have been made in the injection procedure to avoid this complication. This technique for occlusion of the thoracic duct shows potential for clinical use in the management of canine chylothorax. The obstruction appears to be complete and permanent, and surgical/anesthetic time is decreased greatly from previously described procedures. PMID:2773291

  1. Cellular and molecular mechanisms of thoracic aortic aneurysms

    Microsoft Academic Search

    Ismail El-Hamamsy; Magdi H. Yacoub

    2009-01-01

    Thoracic aortic aneurysms (TAA) increase the risk of aortic dissection or rupture and represent an important source of morbidity and mortality. Inherited forms of the disease, including Marfan syndrome, have been recognized for a long time but were considered degenerative diseases characterized by cystic medial necrosis of the aortic wall. Improved definition of the structure and function of the normal

  2. Xanthorrhizol induces endothelium-independent relaxation of rat thoracic aorta.

    PubMed

    Campos, M G; Oropeza, M V; Villanueva, T; Aguilar, M I; Delgado, G; Ponce, H A

    2000-06-01

    Xanthorrhizol, a bisabolene isolated from the medicinal plant Iostephane heterophylla, was assayed on rat thoracic aorta rings to elucidate its effect and likely mechanism of action, by measuring changes of isometric tension. Xanthorrhizol (1, 3, 10, 30 and 100 microg/mL) significantly inhibited precontractions induced by KCI-; (60mM), noradrenaline (10(-6) M) or CaCl2 (1.0 mM). Increasing concentrations of external calcium antagonized the inhibitory effect on KCl-induced contractions. The vasorelaxing effect of xanthorrhizol was not affected by indomethacin (10 microM) or L-NAME (100 microM) in intact rat thoracic aorta rings precontracted by noradrenaline, which suggested that the effect was not mediated through either endothelium-derived prostacyclin (PGI2) or nitric oxide release from endothelial cells. Endothelium removal did not affect the relaxation induced by xanthorrhizol on rat thoracic aorta rings, discarding the participation of any substance released by the endothelium. Xanthorrhizol inhibitory effect was greater on KCI- and CaCl2-induced contractions than on those induced by noradrenaline. Xanthorrhizol inhibitory effect in rat thoracic aorta is likely explained for interference with calcium availability by inhibiting calcium influx through both voltage- and receptor-operated channels. PMID:10983876

  3. Two internal thoracic artery grafts are better than one

    Microsoft Academic Search

    Bruce W. Lytle; Eugene H. Blackstone; Floyd D. Loop; Penny L. Houghtaling; John H. Arnold; Rami Akhrass; Patrick M. McCarthy; Delos M. Cosgrove

    1999-01-01

    Objective: Does the use of bilateral internal thoracic artery (ITA) grafts provide incremental benefit relative to the use of a single ITA graft? Methods: We conducted a retrospective, nonrandomized, long-term (mean follow-up interval of 10 postoperative years) study of patients undergoing elective primary isolated coronary bypass surgery who received either single (8123 patients) or bilateral ITA grafts (2001 patients), with

  4. APOL1 Localization in Normal Kidney and Nondiabetic Kidney Disease

    PubMed Central

    Madhavan, Sethu M.; O'Toole, John F.; Konieczkowski, Martha; Ganesan, Santhi; Bruggeman, Leslie A.

    2011-01-01

    In patients of African ancestry, genetic variants in APOL1, which encodes apolipoprotein L1, associate with the nondiabetic kidney diseases, focal segmental glomerulosclerosis (FSGS), HIV-associated nephropathy (HIVAN), and hypertensive nephropathy. Understanding the renal localization of APOL1 may provide clues that will ultimately help elucidate the mechanisms by which APOL1 variants promote nephropathy. Here, we used immunohistology to examine APOL1 localization in normal human kidney sections and in biopsies demonstrating either FSGS (n = 8) or HIVAN (n = 2). Within normal glomeruli, APOL1 only localized to podocytes. Compared with normal glomeruli, fewer cells stained for APOL1 in FSGS and HIVAN glomeruli, even when expression of the podocyte markers GLEPP1 and synaptopodin appeared normal. APOL1 localized to proximal tubular epithelia in normal kidneys, FSGS, and HIVAN. We detected APOL1 in the arteriolar endothelium of normal and diseased kidney sections. Unexpectedly, in both FSGS and HIVAN but not normal kidneys, the media of medium artery and arterioles contained a subset of ?-smooth muscle actin-positive cells that stained for APOL1. Comparing the renal distribution of APOL1 in nondiabetic kidney disease to normal kidney suggests that a previously unrecognized arteriopathy may contribute to disease pathogenesis in patients of African ancestry. PMID:21997392

  5. Unilateral Loss of Spontaneous Venous Pulsations in an Astronaut

    NASA Technical Reports Server (NTRS)

    Mader, Thomas H.; Gibson, C. Robert; Lee, Andrew G.; Patel, Nimesh; Hart, Steven; Pettit, Donald R.

    2014-01-01

    Spontaneous venous pulsations seen on the optic nerve head (optic disc) are presumed to be caused by fluctuations in the pressure gradient between the intraocular and retrolaminar venous systems. The disappearance of previously documented spontaneous venous pulsations is a well-recognized clinical sign usually associated with a rise in intracranial pressure and a concomitant bilateral elevation of pressure in the subarachnoid space surrounding the optic nerves. In this correspondence we report the unilateral loss of spontaneous venous pulsations in an astronaut 5 months into a long duration space flight. We documented a normal lumbar puncture opening pressure 8 days post mission. The spontaneous venous pulsations were also documented to be absent 21 months following return to Earth.. We hypothesize that these changes may have resulted from a chronic unilateral rise in optic nerve sheath pressure caused by a microgravity-induced optic nerve sheath compartment syndrome.

  6. Framework Surgery for Treatment of Unilateral Vocal Fold Paralysis

    PubMed Central

    Daniero, James J.; Garrett, C. Gaelyn; Francis, David O.

    2014-01-01

    Laryngeal framework surgery is the current gold standard treatment for unilateral vocal fold paralysis. It provides a permanent solution to glottic insufficiency caused by injury to the recurrent laryngeal nerve. Various modifications to the original Isshiki type I laryngoplasty procedure have been described to improve voice and swallowing outcomes. The success of this procedure is highly dependent on the experience of the surgeon as it epitomizes the intersection of art and science in the field. The following article reviews the evidence, controversies, and complications related to laryngoplasty for unilateral vocal fold paralysis. It also provides a detailed analysis of how and when arytenoid-positioning procedures should be considered, and summarizes the literature on postoperative outcomes. PMID:24883239

  7. Global suppression of electrocortical activity in unilateral perinatal thalamic stroke

    PubMed Central

    Kharoshankaya, Liudmila; Filan, Peter M; Bogue, Conor O; Murray, Deirdre M; Boylan, Geraldine B

    2014-01-01

    We present an unusual case of persistent generalized electroencephalography (EEG) suppression and right-sided clonic seizures in a male infant born at 40+2 weeks' gestation, birthweight 3240g, with an isolated unilateral thalamic stroke. The EEG at 13 hours after birth showed a generalized very low amplitude background pattern, which progressed to frequent electrographic seizures over the left hemisphere. The interictal background EEG pattern remained grossly abnormal over the next 48 hours, showing very low background amplitudes (<10?V). Magnetic resonance imaging revealed an isolated acute left-sided thalamic infarction. This is the first description of severe global EEG suppression caused by an isolated unilateral thalamic stroke and supports the role of the thalamus as the control centre for cortical electrical activity. PMID:24410068

  8. Clinical presentation of a patient with thoracic myelopathy at a chiropractic clinic

    PubMed Central

    Gay, Charles W.; Bishop, Mark D.; Beres, Jacqueline L.

    2012-01-01

    Introduction The purpose of this case report is to describe the clinical presentation, examination findings, and management decisions of a patient with thoracic myelopathy who presented to a chiropractic clinic. Case Report/Methods After receiving a diagnosis of a diffuse arthritic condition and kidney stones based on lumbar radiograph interpretation at a local urgent care facility, a 45-year-old woman presented to an outpatient chiropractic clinic with primary complaints of generalized low back pain, bilateral lower extremity paresthesias, and difficulty walking. An abnormal neurological examination result led to an initial working diagnosis of myelopathy of unknown cause. The patient was referred for a neurological consult. Results Computed tomography revealed severe multilevel degenerative spondylosis with diffuse ligamentous calcification, facet joint hypertrophy, and disk protrusion at T9-10 resulting in midthoracic cord compression. The patient underwent multilevel spinal decompressive surgery. Following surgical intervention, the patient reported symptom improvement. Conclusion It is important to include a neurologic examination on all patients presenting with musculoskeletal complaints, regardless of prior medical attention. The ability to recognize myelopathy and localize the lesion to a specific spinal region by clinical examination may help prioritize diagnostic imaging decisions as well as facilitate diagnosis and treatment. PMID:23204955

  9. Leonurine ameliorates kidney fibrosis via suppressing TGF-? and NF-?B signaling pathway in UUO mice.

    PubMed

    Cheng, Haibo; Bo, Yun; Shen, Weixing; Tan, Jiani; Jia, Zhirong; Xu, Changliang; Li, Furong

    2015-04-01

    Fibrosis is one of the characteristic features of chronic kidney disease (CKD). Inflammatory reactions and oxidative stress are implicated in the pathogenesis of fibrosis of CKD. Leonurine (LEO) is one of the active compounds from Herba leonuri. In this study, we further evaluated its renoprotective effect in a mouse unilateral urethral obstruction (UUO), featuring the renal tubulointerstitial fibrosis and inflammation. In this model, pretreat of LEO before ureteral obstruction abolished the expression of fibronectin, suppressed the expression of ?-SMA and type I/III collagen and down-regulated vimentin. LEO also modified the cytokine expression of TGF-?, TNF-?, IL-6 and IL-1? and suppressed the phosphorylation of Smad3. Moreover, LEO blocked phosphorylation of NF-?B, and inactivated the signaling pathways associated with the progression of kidney inflammatory response. Our data support that LEO is a candidate renoprotective compound for renal fibrosis through targeting the TGF-?/Smad3 and NF-?B pathway. PMID:25727888

  10. Perioperative acute kidney injury

    PubMed Central

    2012-01-01

    Acute kidney injury (AKI) is a serious complication in the perioperative period, and is consistently associated with increased rates of mortality and morbidity. Two major consensus definitions have been developed in the last decade that allow for easier comparison of trial evidence. Risk factors have been identified in both cardiac and general surgery and there is an evolving role for novel biomarkers. Despite this, there has been no real change in outcomes and the mainstay of treatment remains preventive with no clear evidence supporting any therapeutic intervention as yet. This review focuses on definition, risk factors, the emerging role of biomarkers and subsequent management of AKI in the perioperative period, taking into account new and emerging strategies. PMID:24764522

  11. Chronic kidney disease.

    PubMed

    Drawz, Paul; Rahman, Mahboob

    2015-06-01

    This issue provides a clinical overview of chronic kidney disease, focusing on prevention, diagnosis, treatment, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, http://mksap.acponline.org, and other resources referenced in each issue of In the Clinic. PMID:26030647

  12. Magnetic Vestibular Stimulation in Subjects with Unilateral Labyrinthine Disorders

    PubMed Central

    Ward, Bryan K.; Roberts, Dale C.; Della Santina, Charles C.; Carey, John P.; Zee, David S.

    2014-01-01

    We recently discovered that static magnetic fields from high-strength MRI machines induce nystagmus in all normal humans, and that a magneto-hydrodynamic Lorentz force, derived from ionic currents in the endolymph and pushing on the cupula, best explains this effect. Individuals with no labyrinthine function have no nystagmus. The influence of magnetic vestibular stimulation (MVS) in individuals with unilateral deficits in labyrinthine function is unknown and may provide insight into the mechanism of MVS. These individuals should experience MVS, but with a different pattern of nystagmus consistent with their unilateral deficit in labyrinthine function. We recorded eye movements in the static magnetic field of a 7 T MRI machine in nine individuals with unilateral labyrinthine hypofunction, as determined by head impulse testing and vestibular-evoked myogenic potentials (VEMP). Eye movements were recorded using infrared video-oculography. Static head positions were varied in pitch with the body supine, and slow-phase eye velocity (SPV) was assessed. All subjects exhibited predominantly horizontal nystagmus after entering the magnet head-first, lying supine. The SPV direction reversed when entering feet-first. Pitching chin-to-chest caused subjects to reach a null point for horizontal SPV. Right unilateral vestibular hypofunction (UVH) subjects developed slow-phase-up nystagmus and left UVH subjects, slow-phase-down nystagmus. Vertical and torsional components were consistent with superior semicircular canal excitation or inhibition, respectively, of the intact ear. These findings provide compelling support for the hypothesis that MVS is a result of a Lorentz force and suggest that the function of individual structures within the labyrinth can be assessed with MVS. As a novel method of comfortable and sustained labyrinthine stimulation, MVS can provide new insights into vestibular physiology and pathophysiology. PMID:24659983

  13. Magnetic vestibular stimulation in subjects with unilateral labyrinthine disorders.

    PubMed

    Ward, Bryan K; Roberts, Dale C; Della Santina, Charles C; Carey, John P; Zee, David S

    2014-01-01

    We recently discovered that static magnetic fields from high-strength MRI machines induce nystagmus in all normal humans, and that a magneto-hydrodynamic Lorentz force, derived from ionic currents in the endolymph and pushing on the cupula, best explains this effect. Individuals with no labyrinthine function have no nystagmus. The influence of magnetic vestibular stimulation (MVS) in individuals with unilateral deficits in labyrinthine function is unknown and may provide insight into the mechanism of MVS. These individuals should experience MVS, but with a different pattern of nystagmus consistent with their unilateral deficit in labyrinthine function. We recorded eye movements in the static magnetic field of a 7 T MRI machine in nine individuals with unilateral labyrinthine hypofunction, as determined by head impulse testing and vestibular-evoked myogenic potentials (VEMP). Eye movements were recorded using infrared video-oculography. Static head positions were varied in pitch with the body supine, and slow-phase eye velocity (SPV) was assessed. All subjects exhibited predominantly horizontal nystagmus after entering the magnet head-first, lying supine. The SPV direction reversed when entering feet-first. Pitching chin-to-chest caused subjects to reach a null point for horizontal SPV. Right unilateral vestibular hypofunction (UVH) subjects developed slow-phase-up nystagmus and left UVH subjects, slow-phase-down nystagmus. Vertical and torsional components were consistent with superior semicircular canal excitation or inhibition, respectively, of the intact ear. These findings provide compelling support for the hypothesis that MVS is a result of a Lorentz force and suggest that the function of individual structures within the labyrinth can be assessed with MVS. As a novel method of comfortable and sustained labyrinthine stimulation, MVS can provide new insights into vestibular physiology and pathophysiology. PMID:24659983

  14. Unilateral retinopathy secondary to occult primary intraocular lymphoma

    PubMed Central

    Barile, Gaetano R.; Hood, Donald C.; Marr, Brian; Hussein, Shafinaz; Tsang, Stephen H.

    2014-01-01

    Purpose The purpose of the study is to report the clinical case of a 53-year-old woman whose presenting manifestation of primary intraocular lymphoma (PIOL) was unilateral retinal degeneration. Method A case report was created with review of clinical, imaging, electrophysiologic, and pathological investigations. Results A 53-year-old woman with a distant history of ocular herpes simplex developed progressive central visual loss and intermittent photopsia over 4 years in her right eye. Ophthalmic examination revealed reduced visual acuity OD, central scotoma, and minimal ocular findings. Autofluorescence and infrared imaging revealed mild reflectance changes in the temporal macula, and spectral-domain optical coherence tomography identified mild disruptions of inner segment/outer segment junctions in the subfoveal region of the right eye. A mild window defect was seen on fluorescein angiography. Electrophysiology with multifocal electroretinogram (ERG) revealed evidence of unilateral macular dysfunction. Full-field ERGs revealed progressive global retinal dysfunction over 6 months, with unilateral decreases in amplitude and implicit time shifts, as seen in cases of autoimmune retinopathies. The eye eventually exhibited mild vitreous cellular infiltration on ophthalmoscopic examination, and vitrectomy diagnosed B cell non-Hodgkin’s lymphoma. Further evaluation revealed no evidence of central nervous system or systemic disease, consistent with occult PIOL. Conclusions This case illustrates an atypical presentation of PIOL characterized by unilateral retinal disease presenting with symptoms and signs of macular dysfunction. Clinical and ERG features evolved into an acute zonal occult outer retinopathy (AZOOR)-like phenotype. PIOL should be considered in atypical cases of AZOOR with vitreal reactions, and some cases of AZOOR may be related to B cell lymphocyte disorders. PMID:24081663

  15. Unilateral hearing during development: hemispheric specificity in plastic reorganizations

    PubMed Central

    Kral, Andrej; Heid, Silvia; Hubka, Peter; Tillein, Jochen

    2013-01-01

    The present study investigates the hemispheric contributions of neuronal reorganization following early single-sided hearing (unilateral deafness). The experiments were performed on ten cats from our colony of deaf white cats. Two were identified in early hearing screening as unilaterally congenitally deaf. The remaining eight were bilaterally congenitally deaf, unilaterally implanted at different ages with a cochlear implant. Implanted animals were chronically stimulated using a single-channel portable signal processor for two to five months. Microelectrode recordings were performed at the primary auditory cortex under stimulation at the hearing and deaf ear with bilateral cochlear implants. Local field potentials (LFPs) were compared at the cortex ipsilateral and contralateral to the hearing ear. The focus of the study was on the morphology and the onset latency of the LFPs. With respect to morphology of LFPs, pronounced hemisphere-specific effects were observed. Morphology of amplitude-normalized LFPs for stimulation of the deaf and the hearing ear was similar for responses recorded at the same hemisphere. However, when comparisons were performed between the hemispheres, the morphology was more dissimilar even though the same ear was stimulated. This demonstrates hemispheric specificity of some cortical adaptations irrespective of the ear stimulated. The results suggest a specific adaptation process at the hemisphere ipsilateral to the hearing ear, involving specific (down-regulated inhibitory) mechanisms not found in the contralateral hemisphere. Finally, onset latencies revealed that the sensitive period for the cortex ipsilateral to the hearing ear is shorter than that for the contralateral cortex. Unilateral hearing experience leads to a functionally-asymmetric brain with different neuronal reorganizations and different sensitive periods involved. PMID:24348345

  16. Sulfasalazine reduces inflammatory renal injury in unilateral ureteral obstruction

    Microsoft Academic Search

    Savas Demirbilek; Memet Hanefi Emre; Engin Nasuhi Ayd?n; Mehmet Naci Edali; Rauf Tu?rul Aksoy; Melih Ak?n; Kubilay Gürünlüo?lu; Erkan Tas; Selma Ay; Zümrüt Yilmaz

    2007-01-01

    The purpose of this study was to test whether sulfasalazine has a protective action against interstitial inflammation and\\u000a the development of renal fibrosis in obstructive nephropathy. Female rats were subjected to a sham (n?=?10) or unilateral ureteral obstruction (UUO, n?=?30). UUO was induced in rats by ligating the left ureter. Three days after operation, rats subjected to UUO were randomized

  17. Wms-r patterns among patients with unilateral brain lesions

    Microsoft Academic Search

    Gordon J. Chelune; Robert A. Bornstein

    1988-01-01

    The effects of unilateral brain lesions on memory functioning were examined among a sample of 115 patients with well lateralized lesions using the new Wechsler Memory Scale-Revised (WMS-R). Multivariate analysis of the WMS-R age-corrected summary indexes for the patients with right-(n = 56) and left-(n = 59) hemisphere lesions was significant (p<.008), although subsequent univariate comparisons revealed that only the

  18. Insufficient unilateral cerebral perfusion during emergent aortic arch surgery

    PubMed Central

    Urbanski, Paul P.; Babin-Ebell, Jörg; Fröhner, Steffen; Diegeler, Anno

    2012-01-01

    A rare case of insufficient right-sided unilateral cerebral perfusion during emergent aortic arch replacement in a patient with an acute aortic dissection is reported. On the basis of intraoperative monitoring using near-infrared spectroscopy, the insufficient perfusion of the contralateral hemisphere was detected and the bilateral perfusion was performed, which led to normalization of cerebral perfusion and an uncomplicated neurological outcome. PMID:22108941

  19. Unilateral retinal hemorrhages in documented cases of child abuse

    Microsoft Academic Search

    Arlene V Drack; Joseph Petronio; Antonio Capone

    1999-01-01

    PURPOSE:To describe the occurrence of unilateral retinal hemorrhages in four cases of documented child abuse, including a case in which retinal hemorrhages were an incidental finding on routine examination.METHODS:Case reports.RESULTS:Three children, 5 to 17 months of age, with suspected child abuse had fundus examinations with a dilated pupil as part of their evaluation. An additional child, 6 months of age,

  20. Metals and kidney autoimmunity.

    PubMed Central

    Bigazzi, P E

    1999-01-01

    The causes of autoimmune responses leading to human kidney pathology remain unknown. However, environmental agents such as microorganisms and/or xenobiotics are good candidates for that role. Metals, either present in the environment or administered for therapeutic reasons, are prototypical xenobiotics that cause decreases or enhancements of immune responses. In particular, exposure to gold and mercury may result in autoimmune responses to various self-antigens as well as autoimmune disease of the kidney and other tissues. Gold compounds, currently used in the treatment of patients with progressive polyarticular rheumatoid arthritis, can cause a nephrotic syndrome. Similarly, an immune-mediated membranous nephropathy frequently occurred when drugs containing mercury were commonly used. Recent epidemiologic studies have shown that occupational exposure to mercury does not usually result in autoimmunity. However, mercury induces antinuclear antibodies, sclerodermalike disease, lichen planus, or membranous nephropathy in some individuals. Laboratory investigations have confirmed that the administration of gold or mercury to experimental animals leads to autoimmune disease quite similar to that observed in human subjects exposed to these metals. In addition, studies of inbred mice and rats have revealed that a few strains are susceptible to the autoimmune effects of gold and mercury, whereas the majority of inbred strains are resistant. These findings have emphasized the importance of genetic (immunogenetic and pharmacogenetic) factors in the induction of metal-associated autoimmunity. (italic)In vitro(/italic) and (italic)in vivo(/italic) research of autoimmune disease caused by mercury and gold has already yielded valuable information and answered a number of important questions. At the same time it has raised new issues about possible immunostimulatory or immunosuppressive mechanisms of xenobiotic activity. Thus it is evident that investigations of metal-induced renal autoimmunity have the potential to produce new knowledge with relevance to autoimmune disease caused by xenobiotics in general as well as to idiopathic autoimmunity. PMID:10502542

  1. Anode heel affect in thoracic radiology: a visual grading analysis

    NASA Astrophysics Data System (ADS)

    Mearon, T.; Brennan, P. C.

    2006-03-01

    For decades, the antero-posterior (AP) projection of the thoracic spine has represented a substantial challenge. Patient thickness varies substantially along the cranio-caudal axis resulting in images that are too dark for the upper vertebrae and too light, or with excessive quantum mottle, towards the 9th to 12th thoracic vertebra. The anode heel affect is a well known phenomenon, however there is a paucity of reports demonstrating its exploitation in clinical departments for optimising images. The current work, using an adult, tissue-equivalent anthropomorphic phantom, explores if appropriate positioning ofthe anode can improve image quality for thoracic spine radiology. At each of 5 kVps (70, 81, 90, 102, 109) thirty AP thoracic spine images were produced, 15 with the anode end of the tube towards the cranial part of the phantom and 15 with the anode end of the tube facing caudally. Visual grading analysis of the resultant images demonstrated significant improvements in overall image quality and visualisation of specific anatomical features for the cranially facing anode compared with the alternative position, which were most pronounced for the 1st to 4th and 9th to 12th vertebrae. These improvements were evident at 70, 81 and 90 kVp, but not for the higher beam energies. The results demonstrate that correct positioning of the X-ray tube can improve image quality for thoracic radiology at specific tube potentials. Further work is ongoing to investigate whether this easy to implement and cost-free technique can be employed for other examinations.

  2. Feasibility of endoscopic transumbilical thoracic sympathectomy in a porcine model

    PubMed Central

    Zhang, Jixue; Zhu, Lihuan; Yang, Shengsheng; Chen, Long; Li, Dazhou; Zheng, Heping; Chen, Weisheng

    2013-01-01

    OBJECTIVES Thoracoscopic sympathectomy is an effective treatment for palmar hyperhidrosis. Current methods are associated with risks of chronic neuropathic pain and a visible chest scar. We developed a novel surgical technique for the performance of sympathectomy by embryonic natural orifice transumbilical endoscopic surgery with a flexible endoscope in a porcine model. METHODS Transumbilical flexible endoscopic thoracic sympathectomies were performed in seven farm pigs (three acute and four 4-week survivals). Under general anaesthesia, animals were intubated and mechanically ventilated with a dual lumen endotracheal tube through tracheostomy. A newly developed long transabdominal trocar was placed through the umbilicus. After insertion of a gastroscope through this trocar, a small incision was created on both sides of the diaphragm by a needle-knife. Then the gastroscope was inserted into the thoracic cavity, and the sympathetic chain was identified at the desired thoracic level and ablated. Operation time, safety and feasibility were recorded in all animals. RESULTS The transumbilical thoracic sympathectomies were successfully completed in all pigs with a mean operation time of 66.7 ± 9.4 min. Intraoperative bleeding occurred in one pig during the electrosurgical incision of diaphragm tissue, which was successfully controlled by hot biopsy forceps. No other acute intraoperative complications were observed in any cases. In the acute group, the length of the diaphragm incision ranged from 4 to 5 mm in three pigs. In the survival group, the animals recovered promptly from surgery. In three pigs, a small pneumothorax was found in the postoperative chest X-ray, but all of them were completely resolved with conservative treatment. Autopsy showed all bilateral T3 sympathetic chains were successfully ablated and no evidence of vital structure injury or diaphragmatic hernia. CONCLUSIONS Transumbilical flexible endoscopic thoracic sympathectomy is technically feasible, simple and safe in a porcine model. This technique can be used as a novel experimental platform for studies of natural orifice transluminal endoscopic surgery (NOTES) for intrathoracic surgery. PMID:23579034

  3. Coordinate changes of renin and brain-type nitric-oxide-synthase (b-NOS) mRNA levels in rat kidneys

    Microsoft Academic Search

    Karin Schricker; Bernhard Pötzl; Marlies Hamann; Armin Kurtz

    1996-01-01

    In our study we have examined the mRNA levels of nitric-oxide-(NO-)synthases in rat kidneys during states of stimulated and\\u000a reduced renin gene expression, to find out whether renal mRNA levels of NO-synthases are correlated with the activity of the\\u000a renin system. Stimulation of the renin system was achieved by unilateral renal artery clipping (2-kidney\\/1-clip rats), treatment\\u000a with the angiotensin II

  4. The effect of thoracic kyphosis and sagittal plane alignment on vertebral compressive loading

    PubMed Central

    Bruno, Alexander G.; Anderson, Dennis E.; D’Agostino, John; Bouxsein, Mary L.

    2012-01-01

    To better understand the biomechanical mechanisms underlying the association between hyperkyphosis of the thoracic spine and risk of vertebral fracture and other degenerative spinal pathology, we used a previously validated musculoskeletal model of the spine to determine how thoracic kyphosis angle and spinal posture affect vertebral compressive loading. We simulated an age-related increase in thoracic kyphosis (T1-T12 Cobb angle 50° to 75°) during two different activities (relaxed standing and standing with 5 kg weights in the hands) and three different posture conditions: 1) an increase in thoracic kyphosis with no postural adjustment (uncompensated posture), 2) an increase in thoracic kyphosis with a concomitant increase in pelvic tilt that maintains a stable center of mass and horizontal eye gaze (compensated posture), and 3) an increase in thoracic kyphosis with a concomitant increase in lumbar lordosis that also maintains a stable center of mass and horizontal eye gaze (congruent posture). For all posture conditions, compressive loading increased with increasing thoracic kyphosis, with loading increasing more in the thoracolumbar and lumbar regions than in the mid-thoracic region. Loading increased the most for the uncompensated posture, followed by the compensated posture, with the congruent posture almost completely mitigating any increases in loading with increased thoracic kyphosis. These findings indicate that thoracic kyphosis and spinal posture both influence vertebral loading during daily activities, implying that thoracic kyphosis measurements alone are not sufficient to characterize the impact of spinal curvature on vertebral loading. PMID:22589006

  5. Different regulation of left ventricular ANP, BNP and adrenomedullin mRNA in the two-kidney, one-clip model of renovascular hypertension

    Microsoft Academic Search

    Konrad Wolf; Armin Kurtz; Michael Pfeifer; Klaus Höcherl; Günter A. J. Riegger; Bernhard K. Krämer

    2001-01-01

    The aim of our study was to clarify whether atrial (ANP) and brain (BNP) natriuretic peptides and the hypotensive peptide adrenomedullin (ADM) are regulated differently in the rat heart in the two-kidney, one-clip model of renovascular hypertension. We assessed messenger ribonucleic acid (mRNA) abundance and distribution of ANP, BNP and ADM in the ventricles and atria of rats after unilateral

  6. Kidney donation after cardiac death

    PubMed Central

    Akoh, Jacob A

    2012-01-01

    There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death (DCD) and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to controlled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function (DGF) and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that significantly influences the outcome of allografts, for example, limiting it to < 12 h markedly reduces DGF. DCD kidneys from donors < 50 function like standard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled donation, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kidneys from DCD include: implementing organ recovery from emergency department setting; improving family consent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function. PMID:24175245

  7. Suramin Alleviates Glomerular Injury and Inflammation in the Remnant Kidney

    PubMed Central

    Liu, Na; He, Song; Tolbert, Evelyn; Gong, Rujun; Bayliss, George; Zhuang, Shougang

    2012-01-01

    Background Recently, we demonstrated that suramin, a compound that inhibits the interaction of multiple cytokines/growth factors with their receptors, inhibits activation and proliferation of renal interstitial fibroblasts, and attenuates the development of renal interstitial fibrosis in the murine model of unilateral ureteral obstruction (UUO). However, it remains unclear whether suramin can alleviate glomerular and vascular lesions, which are not typical pathological changes in the UUO model. So we tested the efficacy of suramin in the remnant kidney after 5/6 nephrectomy, a model characterized by the slow development of glomerulosclerosis, vascular sclerosis, tubulointerstitial fibrosis and renal inflammation, mimicking human disease. Methods/Findings 5/6 of normal renal mass was surgically ablated in male rats. On the second week after surgery, rats were randomly divided into suramin treatment and non-treatment groups. Suramin was given at 10 mg/kg once per week for two weeks. In the remnant kidney of mice receiving suramin, glomerulosclerosis and vascular sclerosis as well as inflammation were ameliorated. Suramin also attenuated tubular expression of two chemokines, monocyte chemoattractant protein-1 and regulated upon expression normal T cell expressed and secreted (RANTES). After renal mass ablation, several intracellular molecules associated with renal fibrosis, including NF-kappaB p65, Smad-3, signal transducer and activator of transcription-3 and extracellular regulated kinase 1/2, are phosphorylated; suramin treatment inhibited their phosphorylation. Futhermore, suramin abolished renal ablation-induced phosphorylation of epidermal growth factor receptor and platelet derived growth factor receptor, two receptors that mediate renal fibrosis. Conclusions and Significance These findings suggest that suramin attenuates glomerular and vascular injury and reduces inflammatory responses by suppression of multiple growth factor receptor-mediated profibrotic signaling pathways. Therefore, suramin may be a useful drug in preventing the fibrosis and sclerosis that characterizes progression of chronic kidney disease. PMID:22558380

  8. Role of Nox4 in murine models of kidney disease.

    PubMed

    Babelova, Andrea; Avaniadi, Despina; Jung, Oliver; Fork, Christian; Beckmann, Janet; Kosowski, Judith; Weissmann, Norbert; Anilkumar, Narayana; Shah, Ajay M; Schaefer, Liliana; Schröder, Katrin; Brandes, Ralf P

    2012-08-15

    Nox4 is a hydrogen peroxide-producing NADPH oxidase highly expressed in the kidney which has been linked to epithelial cell injury and diabetic-induced cellular dysfunction in cultured cells. The role of the enzyme for renal pathology in vivo, however, is unclear. To address this, three experimental animal models of renal injury (streptozotocin diabetes I, unilateral ureteral ligation (UUO), and 5/6 nephrectomy (5/6Nx)) were studied in either Nox4-inducible (Nox4(*/*)) or constitutive knockout (Nox4(-/-)) mice. Nox4 contributed more than 80% of diphenylene iodonium-sensitive H(2)O(2) formation of freshly isolated tubules determined by Amplex Red assay. In streptozotocin diabetes, acute deletion of Nox4 by tamoxifen-activated cre-recombinase increased albuminuria, whereas matrix deposition was similar between WT and Nox4(*/*) mice. Interestingly, renal Nox4 expression, mainly localized to tubular cells, decreased in the course of diabetes and this was not associated with a compensatory upregulation of Nox1 or Nox2. In the UUO model, renal expression of ICAM1, connective tissue growth factor, and fibronectin were higher in kidneys of Nox4(*/*) than control mice. Also in this model, levels of Nox4 decreased in the course of the disease. In the 5/6Nx model, which was performed in SV129 and SV129-Nox4(-/-) mice, no difference in the development of hypertension and albuminuria was found between the strains. Collectively, the first in vivo data of the kidney do not support the view that Nox4 is a main driver of renal disease. It rather appears that under specific conditions Nox4 may even slightly limit injury and disease progression. PMID:22749956

  9. Biomarkers in chronic kidney disease, from kidney function to kidney damage

    PubMed Central

    Lopez-Giacoman, Salvador; Madero, Magdalena

    2015-01-01

    Chronic kidney disease (CKD) typically evolves over many years, with a long latent period when the disease is clinically silent and therefore diagnosis, evaluation and treatment is based mainly on biomarkers that assess kidney function. Glomerular filtration rate (GFR) remains the ideal marker of kidney function. Unfortunately measuring GFR is time consuming and therefore GFR is usually estimated from equations that take into account endogenous filtration markers like serum creatinine (SCr) and cystatin C (CysC). Other biomarkers such as albuminuria may precede kidney function decline and have demonstrated to have strong associations with disease progression and outcomes. New potential biomarkers have arisen with the promise of detecting kidney damage prior to the currently used markers. The aim of this review is to discuss the utility of the GFR estimating equations and biomarkers in CKD and the different clinical settings where these should be applied. The CKD-Epidemiology Collaboration equation performs better than the modification of diet in renal disease equation, especially at GFR above 60 mL/min per 1.73 m2. Equations combining CysC and SCr perform better than the equations using either CysC or SCr alone and are recommended in situations where CKD needs to be confirmed. Combining creatinine, CysC and urine albumin to creatinine ratio improves risk stratification for kidney disease progression and mortality. Kidney injury molecule and neutrophil gelatinase-associated lipocalin are considered reasonable biomarkers in urine and plasma to determine severity and prognosis of CKD. PMID:25664247

  10. Living Kidney Donor Decision Making and Communication

    Microsoft Academic Search

    Sandi W. Smith; Samantha Nazione; Carolyn LaPlante; Rose Clark-Hitt; Hee Sun Park; Randall Sung; Alan Leichtman

    2011-01-01

    There is high demand for kidney donors in the United States, and it is widely accepted that living donation is optimal for individuals who need a kidney. Much research has focused on the potential recipient, but little has been studied about the communication and decision making of living kidney donors. Interviews assessed the communication and decision-making processes of 43 kidney

  11. JAMA Patient Page: Kidney Failure

    MedlinePLUS

    ... failure occurs when the kidneys cannot properly remove wastes, causing buildup of waste and fluid in the body. By checking blood ... sent through a machine that filters away the waste products and returns the clean blood to the ...

  12. The kidney tight junction (Review)

    PubMed Central

    HOU, JIANGHUI

    2014-01-01

    The tight junction is an important subcellular organelle which plays a vital role in epithelial barrier function. Claudin, as the integral membrane component of tight junctions, creates a paracellular transport pathway for various ions to be reabsorbed by the kidneys. This review summarizes advances in claudin structure, function and pathophysiology in kidney diseases. Different claudin species confer selective paracellular permeability to each of three major renal tubular segments: the proximal tubule, the thick ascending limb of Henle’s loop and the distal nephron. Defects in claudin function can cause a wide spectrum of kidney diseases, such as hypomagnesemia, hypercalciuria, kidney stones and hypertension. Studies using transgenic mouse models with claudin mutations have recapitulated several of these renal disease phenotypes and have elucidated the underlying biological mechanisms. Modern recording approaches based upon scanning ion conductance microscopy may resolve the biophysical nature of claudin transport function and provide novel insight into tight junction architecture. PMID:25319473

  13. End-stage kidney disease

    MedlinePLUS

    ... longer support your body’s needs. The kidneys remove waste and excess water from the body. ... stop working well. Dialysis can: Remove extra salt, water, and waste products so they don't build up in ...

  14. How Is Kidney Cancer Diagnosed?

    MedlinePLUS

    ... a person is healthy enough for surgery . Blood chemistry tests Blood chemistry tests are usually done in people who might ... a doctor to order a bone scan. Blood chemistry tests also look at kidney function, which is ...

  15. Kidney transplantation during autoimmune diseases.

    PubMed

    Ounissi, M; Abderrahim, E; Hedri, H; Sfaxi, M; Fayala, H; Turki, S; Ben Maïz, H; Ben Abdallah, T; Chebil, M; Kheder, A

    2009-09-01

    Herein, we report the results of kidney transplantation in 9 of 376 patients who underwent kidney transplantation at our center between 1986 and 2007 because of chronic renal failure associated with autoimmune disease. Four of the 9 patients had systemic lupus erythematosus, 3 had Wegener granulomatosis, and 2 had Goodpasture syndrome. Six patients received organs from living donors, and 3 received cadaver organs. Infections were frequent and included cytomegalovirus and urinary tract infection in most cases. There was no difference in occurrence of metabolic and cardiovascular complications in our study patients compared with other transplant recipients. Incidence of allograft loss (n = 1) was similar to that in our entire transplantation population, with an overall rate of 2.9%. We conclude that kidney transplantation is a reasonable therapeutic option in patients with autoimmune disease with end-stage renal disease because of good graft and patient survival compared with kidney recipients without autoimmune diseases. PMID:19765434

  16. Increased circulating miR-21 levels are associated with kidney fibrosis.

    PubMed

    Glowacki, François; Savary, Grégoire; Gnemmi, Viviane; Buob, David; Van der Hauwaert, Cynthia; Lo-Guidice, Jean-Marc; Bouyé, Sébastien; Hazzan, Marc; Pottier, Nicolas; Perrais, Michaël; Aubert, Sébastien; Cauffiez, Christelle

    2013-01-01

    MicroRNAs (miRNAs) are a class of noncoding RNA acting at a post-transcriptional level to control the expression of large sets of target mRNAs. While there is evidence that miRNAs deregulation plays a causative role in various complex disorders, their role in fibrotic kidney diseases is largely unexplored. Here, we found a strong up-regulation of miR-21 in the kidneys of mice with unilateral ureteral obstruction and also in the kidneys of patients with severe kidney fibrosis. In addition, mouse primary fibroblasts derived from fibrotic kidneys exhibited higher miR-21 expression level compared to those derived from normal kidneys. Expression of miR-21 in normal primary kidney fibroblasts was induced upon TGF? exposure, a key growth factor involved in fibrogenesis. Finally, ectopic expression of miR-21 in primary kidney fibroblasts was sufficient to promote myofibroblast differentiation. As circulating miRNAs have been suggested as promising non-invasive biomarkers, we further assess whether circulating miR-21 levels are associated with renal fibrosis using sera from 42 renal transplant recipients, categorized according to their renal fibrosis severity, evaluated on allograft biopsies (Interstitial Fibrosis/Tubular Atrophy (IF/TA). Circulating miR-21 levels are significantly increased in patients with severe IF/TA grade (IF/TA grade 3: 3.0±1.0 vs lower grade of fibrosis: 1.5±1.2; p?=?0.001). By contrast, circulating miR-21 levels were not correlated with other renal histological lesions. In a multivariate linear regression model including IF/TA grade and estimated GFR, independent associations were found between circulating miR-21 levels and IF/TA score (ß?=?0.307, p?=?0.03), and between miR-21 levels and aMDRD (ß?=?-0.398, p?=?0.006). Altogether, these data suggest miR-21 has a key pathogenic role in kidney fibrosis and may represent a novel, predictive and reliable blood marker of kidney fibrosis. PMID:23469132

  17. Increased Circulating miR-21 Levels Are Associated with Kidney Fibrosis

    PubMed Central

    Gnemmi, Viviane; Buob, David; Van der Hauwaert, Cynthia; Lo-Guidice, Jean-Marc; Bouyé, Sébastien; Hazzan, Marc; Pottier, Nicolas; Perrais, Michaël

    2013-01-01

    MicroRNAs (miRNAs) are a class of noncoding RNA acting at a post-transcriptional level to control the expression of large sets of target mRNAs. While there is evidence that miRNAs deregulation plays a causative role in various complex disorders, their role in fibrotic kidney diseases is largely unexplored. Here, we found a strong up-regulation of miR-21 in the kidneys of mice with unilateral ureteral obstruction and also in the kidneys of patients with severe kidney fibrosis. In addition, mouse primary fibroblasts derived from fibrotic kidneys exhibited higher miR-21 expression level compared to those derived from normal kidneys. Expression of miR-21 in normal primary kidney fibroblasts was induced upon TGF? exposure, a key growth factor involved in fibrogenesis. Finally, ectopic expression of miR-21 in primary kidney fibroblasts was sufficient to promote myofibroblast differentiation. As circulating miRNAs have been suggested as promising non-invasive biomarkers, we further assess whether circulating miR-21 levels are associated with renal fibrosis using sera from 42 renal transplant recipients, categorized according to their renal fibrosis severity, evaluated on allograft biopsies (Interstitial Fibrosis/Tubular Atrophy (IF/TA). Circulating miR-21 levels are significantly increased in patients with severe IF/TA grade (IF/TA grade 3: 3.0±1.0 vs lower grade of fibrosis: 1.5±1.2; p?=?0.001). By contrast, circulating miR-21 levels were not correlated with other renal histological lesions. In a multivariate linear regression model including IF/TA grade and estimated GFR, independent associations were found between circulating miR-21 levels and IF/TA score (ß?=?0.307, p?=?0.03), and between miR-21 levels and aMDRD (ß?=??0.398, p?=?0.006). Altogether, these data suggest miR-21 has a key pathogenic role in kidney fibrosis and may represent a novel, predictive and reliable blood marker of kidney fibrosis. PMID:23469132

  18. Appropriate kidney stone size for ureteroscopic lithotripsy: When to switch to a percutaneous approach

    PubMed Central

    Takazawa, Ryoji; Kitayama, Sachi; Tsujii, Toshihiko

    2015-01-01

    Flexible ureteroscopy (fURS) has become a more effective and safer treatment for whole upper urinary tract stones. Percutaneous nephrolithotomy (PNL) is currently the first-line recommended treatment for large kidney stones ? 20 mm and it has an excellent stone-free rate for large kidney stones. However, its invasiveness is not negligible considering its major complication rates. Staged fURS is a practical treatment for such large kidney stones because fURS has a minimal blood transfusion risk, short hospitalization and few restrictions on daily routines. However, as the stone size becomes larger, the stone-free rate decreases, and the number of operations required increases. Therefore, in our opinion, staged fURS is a practical option for kidney stones 20 to 40 mm. Miniaturized PNL combined with fURS should be considered to be a preferred option for stones larger than 40 mm. Moreover, URS is an effective treatment for multiple upper urinary tract stones. Especially for patients with a stone burden < 20 mm, URS is a favorable option that promises a high stone-free rate after a single session either unilaterally or bilaterally. However, for patients with a stone burden ? 20 mm, a staged operation should be considered to achieve stone-free status. PMID:25664253

  19. A Right Ectopic Kidney with Bilateral Multiple Anomalies of the Renal Vasculature – A Case Report

    PubMed Central

    C, Krishnaveni; Kulkarni, Roopa

    2013-01-01

    The renal anatomy and its development is complex. This complexity is associated with numerous variations. Each renal variation has its own clinical and surgical importance. There is a good correlation between the ascent of the kidney, the level of its origin and number of the renal arteries. Any anomaly in the renal artery development may be due to a delay in the kidney ascension and it can lead to an ectopic kidney. Ectopic kidneys are more frequent in males and they are observed commonly on the left side. In the present study, we came across a rare case of a unilateral right renal ectopia and bilateral multiple renal arteries, with 5 renal arteries on the right side and 2 on the left side. The renal veins were 3 on the right side and two on the left side, with the retro aortic left renal vein, which were observed during the routine dissection of a male cadaver. This observation would be of immense importance for surgeons, interventional radiologists, nephrologists and vascular surgeons. PMID:23450664

  20. Unilateral divorce versus child custody and child support in the U.S

    Microsoft Academic Search

    2012-01-01

    â–º We explore the response of the divorce rate to unilateral divorce reforms. â–º We control for joint custody regime and the Child Support Enforcement program. â–º They counteract the allocation of rights generated by the unilateral divorce. â–º We do not find a reverse response of divorce rates to the unilateral divorce. â–º The decline in divorce rates is

  1. Midterm outcome after unilateral approach for bilateral decompression of lumbar spinal stenosis: 5-year prospective study

    Microsoft Academic Search

    Halit Çavu?o?lu; Ramazan Alper Kaya; Osman Nuri Türkmenoglu; Cengiz Tuncer; ?brahim Çolak; Yunus Ayd?n

    2007-01-01

    The aim of our study is to evaluate the results and effectiveness of bilateral decompression via a unilateral approach in\\u000a the treatment of degenerative lumbar spinal stenosis. We have conducted a prospective study to compare the midterm outcome\\u000a of unilateral laminotomy with unilateral laminectomy. One hundred patients with 269 levels of lumbar stenosis without instability\\u000a were randomized to two treatment

  2. Patient safety in thoracic surgery and European Society of Thoracic Surgeons checklist

    PubMed Central

    2015-01-01

    Improving patient safety seems to be a new interesting clinical subject but, in fact, it is no new. It has to do with one of the oldest ethical principles of our profession: curing and not harming. The important research that has been done in a short period of time has brought in new insight to this complex area that is fast developing. The creation of safety managing systems will allow coordinating efforts from very different, although complementary, areas to create real safety culture and safety climate in every organization. In the surgical settings, teamwork is basic to provide good quality of care. Safety leaders in every team have an important role in establishing priorities, summarizing proposals, coordinating efforts, launching new initiatives and transmitting that safety efforts are worth taken. Preparedness and anticipation are key points for avoiding most of the diverse types of patient harm that can occur. As has been published, a great number of errors can be avoided simply using crosscheck based on specialized checklist that reviews every important detail of the procedure. This strategy has been demonstrated very useful at other high risk industries such as aviation, nuclear or food management. The Safe Surgery Saves Lives program launched in 2002 by the WHO has taught us that improvement is possible using a simple checklist. More complex and detail checklist can be more adequate for more complex procedures and settings. The proposed ESTS checklist reviews different areas of possible error in deeper detail allowing the finest adjustment of the patient before the skin incision. It has been recently released to the general thoracic community and monitors its use and usefulness has to be warrantied. PMID:25984360

  3. Cystic Kidney Disease: A Primer.

    PubMed

    Cramer, Monica T; Guay-Woodford, Lisa M

    2015-07-01

    Renal cystic diseases encompass a broad group of disorders with variable phenotypic expression. Cystic disorders can present during infancy, childhood, or adulthood. Often, but not always, they can be distinguished by the clinical features including age at presentation, renal imaging characteristics, including cyst distribution, and the presence/distribution of extrarenal manifestations. It is important to take the clinical context into consideration when assessing renal cystic disease in children and adults. For example, solitary kidney cysts may be completely benign when they develop during adulthood but may represent early polycystic kidney disease when observed during childhood. In this review, we have categorized renal cystic disease according to inherited single-gene disorders, for example, autosomal recessive polycystic kidney disease; syndromic disorders associated with kidney cysts, for example, tuberous sclerosis complex; and nongenetic forms of renal cystic disease, for example, simple kidney cysts. We present an overview of the clinical characteristics, genetics (when appropriate), and molecular pathogenesis and the diagnostic evaluation and management of each renal cystic disease. We also provide an algorithm that distinguishes kidney cysts based on their clinical features and may serve as a helpful diagnostic tool for practitioners. A review of Autosomal Dominant Polycystic Disease was excluded as this disorder was reviewed in this journal in March 2010, volume 17, issue 2. PMID:26088074

  4. Descending Thoracic Aorta Remodeling after Multilayer Stent Release.

    PubMed

    Bozzani, Antonio; Arici, Vittorio; Bonalumi, Giovanni; Argenteri, Angelo

    2015-07-01

    The multilayer flow modulator (MFM) is a device whose real effectiveness in the treatment of thoracoabdominal aortic aneurysms is not clear yet. A 68-year-old man with a 18-mm blister-like aneurysm of the descending thoracic aorta underwent endovascular exclusion, complicated by the thrombosis of a previous aortobi-iliac prosthesis, treated with embolectomy and femorofemoral bypass. Therefore, an MFM placement was planned. The postoperative course was uneventful and the 6-month computed tomography scan showed a complete thrombosis and remodeling of the aneurysm. The MFM stent could be an alternative treatment for saccular thoracic aortic aneurysm in high-risk patients but should not be used indiscriminately when other modalities of aortic repair are not feasible. Longer follow-up is mandatory to prove the efficacy of this technology. PMID:25765638

  5. Post-myelography paraplegia in a woman with thoracic stenosis

    PubMed Central

    Soliman, Hesham M.; Arnold, Paul M.; Madarang, Ernest J.

    2013-01-01

    Context Myelography is a commonly performed diagnostic test used to assess spine pathology. Complications are unusual and usually self-limited. We report a rare case of transient paraplegia following myelography in a woman with thoracic stenosis. Findings A 51-year-old woman, 20 months status post-thoracic laminectomy, presented with progressive lower extremity weakness. The patient underwent myelography and post-myelography CT, and became paraplegic after the lumbar injection. Intravenous steroids were administered and a lumbar puncture was performed. The patient's neurologic function returned to baseline over the next 96 hours. Conclusion and clinical relevance Myelography is generally a safe procedure, but on rare occasions serious complications can arise. Therapeutic maneuvers may be helpful in reversing neurologic deficit. PMID:23809597

  6. Jeune syndrome: considerations for management of asphyxiating thoracic dystrophy.

    PubMed

    Poyner, Sabrina E; Bradshaw, Wanda T

    2013-01-01

    Jeune syndrome (JS), or asphyxiating thoracic dystrophy, is a rare genetic disorder characterized by a small, narrow thorax, with associated shortening of limbs. Children with JS present with variable degrees of respiratory distress, frequently lethal in the neonatal period. Other associated complications include renal, hepatic, gastrointestinal, and retinal dysfunction. Management focuses on stabilization and support of respiratory function. Treatment may be palliative in nature or corrective. In recent years, the advance in surgical treatment of the thoracic hypoplasia in JS offers hope to those families with a child suffering from the syndrome. Even with increased research into treatment of this disorder, prognosis is usually poor. Comorbidities associated with JS lead to serious organ dysfunction in later years. Families who have a child with JS need genetic counseling and education focusing on the seriousness of the disorder, the risks and benefits of treatment, and the lifelong needs of those with JS. PMID:23985472

  7. Gallium-67 thoracic scan and pleural disease in asbestos workers

    SciTech Connect

    Lambert, R.; Bisson, G.; Lamoureux, G.; Begin, R.

    1985-06-01

    The authors have recently reported that /sup 67/Ga scanning in asbestos workers can document excessive uptake of the marker among workers without sufficient criteria for asbestosis, but in their initial report they could not exclude definitely that /sup 67/Ga uptake could be related to pleural disease. To further test this hypothesis, they analyzed the /sup 67/Ga thoracic scan in relation to profusion scores of pleural disease on chest roentgenogram and CT scan of the thorax in 171 asbestos workers. They found no significant correlation between the /sup 67/Ga lung uptake and the radiographic scores of pleural disease. They concluded that pleural plaques are not an active site of /sup 67/Ga accumulation and do not contribute significantly to the thoracic uptake of the marker.

  8. [Prevention and treatment of intraoperative complications of thoracic surgery].

    PubMed

    Lampl, L

    2015-05-01

    In order to achieve a minimal complication rate there is a need for a comprehensive strategy. This means in the first line preventive steps which include patient positioning, suitable approaches and access, an appropriately qualified surgical team as well as a carefully planned dissection and preparation. Furthermore, a supply of additional instrumentation, such as thrombectomy catheters, special vascular clamps and even extracorporeal membrane oxygenation (ECMO) and a heart-lung machine (HLM) in cases of centrally located lesions should be on stand-by. Control instruments, such as a bronchoscope and esophagoscope should not be forgotten. In selected cases a preoperative embolization (vascular malformation) or cream swallow (thoracic duct injury) can be helpful. Special interventions to overcome complications arising are described for the chest wall, lung parenchyma, pulmonary vessels, great vessels, bronchial arteries, trachea and bronchi, esophagus, thoracic duct, heart, vertebral column and sternum corresponding to the topography. PMID:25691227

  9. Validation of thoracic electrical bioimpedance as a porcine research tool.

    PubMed

    Broomhead, C J; Wright, S J; Kiff, K M; Withington, P S

    1997-03-01

    We have compared the accuracy of two methods of measuring cardiac output, thoracic electrical bioimpedance (TEB) and thermodilution (TD), in pigs. We studied four anaesthetized pigs, producing 145 paired cardiac output values over a range of TD cardiac outputs of 2.6-12.6 litre min-1. TEB cardiac output was less than that measured by TD, by a constant factor throughout the observed range of values, because of differences in porcine thoracic shape. The Pearson product moment correlation coefficient suggested a good correlation (r = 0.984, P < 0.001). More importantly, analysis by the Bland and Altman statistical method suggested a high level of agreement, with 95% confidence intervals of +/- 1.0 litre min-1. These results suggest that TEB can be used as a satisfactory method to measure cardiac output in porcine models. PMID:9135316

  10. Respiratory acoustic thoracic imaging (RATHI): Assessing deterministic interpolation techniques

    Microsoft Academic Search

    S. Charleston-Villalobos; S. Cortés-Rubiano; R. González-Camerena; G. Chi-Lem; T. Aljama-Corrales

    2004-01-01

    As respiratory sounds contain mechanical and clinical pulmonary information, technical efforts have been devoted during the\\u000a past decades to analysing, processing and visualising them. The aim of this work was to evaluate deterministic interpolating\\u000a functions to generate surface respiratory acoustic thoracic images (RATHIs), based on multiple acoustic sensors. Lung sounds\\u000a were acquired from healthy subjects through a 55 microphone array

  11. Cystic spinal dysraphism of the cervical and upper thoracic region

    Microsoft Academic Search

    J. Francisco Salomão; Sérgio Cavalheiro; René D. Leibinger; Antonio R. Bellas; Elide Vanazzi; Luiz A. M. de Souza; Andréa G. Nardi

    2006-01-01

    Background  Cystic dysraphic lesions of the cervical and upper thoracic region are rare and only a few series have been published about the topic. These malformations can be divided into categories that include both myelocystoceles and the so-called cervical meningoceles or myelomeningoceles.Methods  A retrospective study of 18 patients was conducted.Results  In 17 patients a squamous or a cicatricial epithelium of variable thickness covered

  12. Thoracic sympathectomy: effects on hemodynamics and baroreflex control

    Microsoft Academic Search

    René Kingma; Ben J. TenVoorde; Gert Jan Scheffer; John M. Karemaker; Albert J. C. Mackaay; Karel H. Wesseling; Jaap J. de Lange

    2002-01-01

    Endoscopic thoracic sympathectomy at T2-T4 is an effective and safe treatment for primary axillary and palmar hyperhidrosis\\u000a and facial blushing refractory to conventional treatment. T2 and T4 ganglia however are in the direct pathway of sympathetic\\u000a innervation of the heart and part of the vasomotor nerves. In this study we investigate possible changes in steady-state hemodynamics\\u000a as well as in

  13. Surgical Treatment of Thoracic Outlet Syndrome Secondary to Clavicular Malunion

    PubMed Central

    Yoo, Moon Jib; Seo, Joong Bae; Lee, Ju Hong

    2009-01-01

    According to the literature, thoracic outlet syndrome (TOS) secondary to the malunion of displaced fractures of the clavicle is rare. Various surgical methods, including simple neurolysis, resection of the first rib or clavicle and corrective osteotomy, have been reported. We report a case of TOS secondary to malunion of the clavicle that was treated by an anterior and middle scalenectomy without a rib resection. PMID:19884998

  14. Gd-DTPA-enhanced MR in thoracic disc herniations

    Microsoft Academic Search

    P. M. Parizel; G. Rodesch; D. Balériaux; D. Zegers de Beyl; J. D'Haens; J. Noterman; C. Segebarth

    1989-01-01

    The Gd-DTPA-enhanced magnetic resonance findings in two patients with herniated thoracic intervertebral discs are reported. The first patient was a 56-year-old woman with a small subligamentous T6-7 disc herniation, slightly lateralized to the right. The second patient was a 51-year-old man with a central and right posterolateral disc herniation, including a large calcified fragment, at the T8-9 level. The nonenhanced

  15. Screening for Cardiovascular Disease in Survivors of Thoracic Radiation

    Microsoft Academic Search

    M. Jacob Adams; Robert G. Prosnitz; Louis S. Constine; Lawrence B. Marks; Steven E. Lipshultz

    \\u000a \\u000a Background and purpose  A solid body of evidence demonstrates that therapeutic thoracic radiotherapy can injure the cardiovascular system. However,\\u000a there is little consensus on how to screen survivors who received this therapy. This review intends to assess recent evidence\\u000a on radiotherapy-related cardiac injury with the goal of formulating evidence-based guidelines.

  16. Validation of thoracic electrical bioimpedance as a porcine research tool

    Microsoft Academic Search

    C. J. BROOMHEAD; S. J. WRIGHT; K. M. KIFF; P. S. WITHINGTON

    1997-01-01

    Summary We have compared the accuracy of two methods of measuring cardiac output, thoracic electrical bioimpedance (TEB) and thermodilution (TD), in pigs. We studied four anaesthetized pigs, produc- ing 145 paired cardiac output values over a range of TD cardiac outputs of 2.6-12.6 litre min1. TEB cardiac output was less than that measured by TD, by a constant factor throughout

  17. Thoracic and lumbar spine accelerations in everyday activities.

    PubMed

    Ng, Tracy P; Bussone, William R; Duma, Stefan M; Kress, Tyler A

    2006-01-01

    The purpose of this study was to quantify thoracic and lumbar spine accelerations for men and women of different body sizes during daily activities. Measured spine accelerations were compared to determine if there were significant differences in peak accelerations based on gender, size, and spine location. Each subject performed seven activities, which included sitting in a chair, sitting quickly in a chair, walking at 1.3 m/s, running at 2.7 m/s, performing jumping jacks, achieving maximum vertical leap, and jumping off a step approximately 20 cm high. Overall, the peak lumbar spine accelerations were significantly greater than the thoracic spine accelerations. Based on the statistical analysis, it was determined that gender and body size did not have a significant effect on peak accelerations of the thoracic and lumbar spine. The findings from the present study are of great value to researchers in order to understand the acceleration patterns of the human body during low impact accelerations. PMID:16817643

  18. Effect of Massage on Pain Management for Thoracic Surgery Patients

    PubMed Central

    Dion, Liza; Rodgers, Nancy; Cutshall, Susanne M.; Cordes, Mary Ellen; Bauer, Brent; Cassivi, Stephen D.; Cha, Stephen

    2011-01-01

    Background: Integrative therapies such as massage have gained support as interventions that improve the overall patient experience during hospitalization. Thoracic surgery patients undergo long procedures and commonly have postoperative back, neck, and shoulder pain. Purpose: Given the promising effects of massage therapy for alleviation of pain, we studied the effectiveness and feasibility of massage therapy delivered in the postoperative thoracic surgery setting. Methods: Patients who received massage in the postoperative setting had pain scores evaluated pre and post massage on a rating scale of 0 to 10 (0 = no pain, 10 = worst possible pain). Results: In total, 160 patients completed the pilot study and received massage therapy that was individualized. Patients receiving massage therapy had significantly decreased pain scores after massage (p ? .001), and patients’ comments were very favorable. Patients and staff were highly satisfied with having massage therapy available, and no major barriers to implementing massage therapy were identified. Conclusions: Massage therapy may be an important additional pain management component of the healing experience for patients after thoracic surgery. PMID:21847428

  19. Immediate reduction in temporal sensory summation after thoracic spinal manipulation

    PubMed Central

    Bishop, Mark D; Beneciuk, Jason M; George, Steven Z

    2011-01-01

    Background Context Spinal manipulative therapy (SMT) has shown clinical effectiveness in some patients with musculoskeletal pain. Purpose We performed the current experiment to test whether regional pain modulation is to be expected from thoracic SMT. Study Design/Setting Randomized experimental design performed in a university pain laboratory. Outcome Measures The primary outcome was experimental pain sensitivity in cervical and lumbar innervated area. Methods Ninety healthy volunteers were randomly assigned to receive one of three interventions (SMT, exercise or rest) to the upper thoracic spine. Participants completed questionnaires about pain-related affect and expectations regarding each of the interventions. We collected experimental pain sensitivity measures of cervical and lumbar innervated areas before and immediately after randomly assigned intervention. Mixed-model analysis of co-variance was used to test changes in measures of experimental pain sensitivity. Results No interactions or intervention (group) effects were noted for pressure or A-delta mediated thermal pain responses. Participants receiving SMT had greater reductions in temporal sensory summation (TSS). Conclusions This current study indicates thoracic SMT reduces TSS in healthy subjects. These findings extend our previous work in healthy and clinical subjects by indicating change in the nocioceptive afferent system occurred caudal to the region of SMT application. However, the duration of reduction in TSS is an unknown, and more work needs to be completed in clinical populations for confirm the relevance of these findings. PMID:21463970

  20. Surgical treatment for intra-thoracic migration of acupuncture needles.

    PubMed

    Kim, Dae Hyun; Kim, Soo-Cheol; Youn, Hyo Chul

    2012-03-01

    The aim of this study was to introduce the experience of diagnosis and treatment for patients with migrated acupuncture needle to pleural cavity and or lung parenchyma. We had treated 5 patients who had acupuncture needles in their thoracic cavity from January 2000 to September 2009. The mean age was 55.8 yr old. All patients suffered from the sequelae of the cerebrovascular accident and had been treated with acupuncture. They had drowsiness and hemiplegic or quadriplegic motor activity. Fever and dyspnea were main symptoms when referred to us. Diagnosis was made by the chest radiography and chest computed tomography which revealed straight metallic materials in their thoracic cavity. The needles were removed via thoracotomy or thoracoscopic procedures. Pleural decortications were also needed in four patients. Thoracoscopic surgery was successfully performed in two patients. After the removal all patients became symptomless. Although we experienced only five patients who have migrated acupuncture needles in thoracic cavity, we suggest that thoracoscopic removal of the needle with or without pleural decortication is the most optimal modality of treatment in those patients. PMID:22379339

  1. Anterior thoracic wall giant tumor--special surgical procedure.

    PubMed

    Grozavu, C; Fera, A; Ilia?, M; Marin, D; Pantile, D; Dabelea, C

    2012-01-01

    We describe the case of a 39 years old male known with an anterior thoracic traumatism in 1993 who observed ananterior thoracic wall tumor since 2000. After one and half year of empiric treatment the tumor starts growing very fast, reaching 30/40/35 cm by the date of his hospital admission (march 2003). Due to this accelerate growth and the size of the tumor the patient is proposed for a particular surgical procedure removing the tumor along with the anterior thoracic wall and the reconstruction using "spider web" technique, Thoratex reinforced mesh and muscle flaps. Thisprocedure had agood result, the patient returned to his anterior lifestyle few months after. The patient did not come for follow-up, although he was recommended to come every tree months. Four years after surgery (2007) the patient came back with local recurrence of the tumor. In 2007 the patient underwent another surgical intervention, removing the tumor recurrence. Chest wall tumors are complex surgical conditions requiring complex treatment. The empiric treatment and the fact that the patient did not come as planned for follow-up, prolonged his sufferance, leading to a second surgical intervention. PMID:22712358

  2. The transdural approach for thoracic disc herniations: a technical note

    PubMed Central

    Moon, Sung-Jun; Jang, Jae-Won; Hur, Hyuk; Lee, Jae-Hyun; Kim, Soo-Han

    2010-01-01

    Surgery for thoracic disc herniations is still challenging, and the disc excision via a posterior laminectomy is considered risky. A variety of dorsolateral and ventral approaches have been developed. However, the lateral extracavitary and transthoracic approach require extensive surgical exposure. Therefore, we adopted a posterior transdural approach for direct visualization without entry into the thoracic cavity. Three cases that illustrate this procedure are reported here with the preoperative findings, radiological findings and surgical techniques used. After the laminectomy, at the involved level, the dorsal dura was opened with a longitudinal paramedian incision. The cerebrospinal fluid was drained to gain more operating space. After sectioning of the dentate ligaments, gentle retraction was applied to the spinal cord. Between the rootlets above and below, the ventral dural bulging was clearly observed. A small paramedian dural incision was made over the disc space and the protruded disc fragment was removed. Neurological symptoms were improved, and no surgery-related complication was encountered. The posterior transdural approach may offer an alternative surgical option for selected patients with thoracic paracentral soft discs, while limiting the morbidity associated with the exposure. PMID:20143105

  3. [Prosthetic rehabilitation of unilateral anakusis. Study with stereoaudiometry].

    PubMed

    Vaneecloo, F M; Hanson, J N; Laroche, C; Vincent, C; Dehaussy, J

    2000-12-01

    We studied the clinical and stereoaudiometric results in two patients with unilateral anakusis who were rehabilitated with a bone-transmission prosthesis (B.A.H.A.) on the deaf side. Clinically, both patients improved considerably, recovering their capacity to communicate, particularly in a noisy environment. Sound localization tests demonstrated that the sound source was not precisely localized in space. Inversely, the spatial discrimination tests and the multidirectional tests showed an important improvement in comprehension of speech, particularly in the dead space of the defective hemifield. This recovery was certainly related to improved perception of high frequencies via intracranial transmission enabled by the prosthesis. PMID:11148346

  4. Subdural empyema and unilateral pansinusitis due to a tooth infection.

    PubMed

    Derin, Serhan; Sahan, Murat; Hazer, Derya Burcu; Sahan, Leyla

    2015-01-01

    Paranasal sinus infections are very common. Dental infections, tumours and anatomical malformations can cause unilateral sinusitis. Most cases can be treated without complications. However, rare life-threatening intracranial complications can occur. Generally, an intracranial complication progresses rapidly and can cause meningismus, focal neurological disorders, loss of consciousness and seizures. In such cases, an emergency craniotomy and concurrent sinus surgery are required. This article presents a 16-year-old patient with pansinusitis and subdural empyema that developed after a dental abscess. PMID:26123452

  5. Brooke-Spiegler syndrome complicated by unilateral hearing loss.

    PubMed

    Parren, Lizelotte J M T; Bauer, Boris; Hamm, Henning; Frank, Jorge

    2008-11-01

    Brooke-Spiegler syndrome is an autosomal dominant tumor predisposition disorder. The disease is characterized by the occurrence of multiple skin appendage tumors, including cylindroma, trichoepithelioma, and spiradenoma. In some patients, tumors cover the entire head circumference, thereby causing disfigurement and other complications. Here, we report on a man with multiple cylindroma that were distributed in a turban tumor-like fashion. One of these neoplasms arose in the meatus externus of the right ear leading to unilateral hearing loss, a complication that has been documented only on few occasions in this disease. PMID:18986490

  6. Parinaud's syndrome due to an unilateral vascular ischemic lesion.

    PubMed

    Serino, Josefina; Martins, João; Páris, Liliana; Duarte, Ana; Ribeiro, Isabel

    2015-04-01

    A 59-year-old man who complained of binocular vertical diplopia after an exploratory laparotomy, complicated by cardiorespiratory arrest during anesthetic induction, was found to have Collier's sign, anisocoria, complete paralysis of upward vertical gaze associated with convergence-retraction nystagmus on attempted upgaze and skew deviation with hypertropia in the left eye without ptosis, and an absent Bielschowsky sign. Magnetic resonance imaging of the brain showed a small lesion in the left paramedian midbrain compatible with microvascular ischemic sequelae. This patient was diagnosed with Parinaud's syndrome (dorsal midbrain syndrome) associated with a vertical strabismus from an unilateral vascular ischemic paramedian midbrain lesion. PMID:25649259

  7. Unilateral rubral tremors in Wilson's disease treated with dimercaprol.

    PubMed

    Chakor, Rahul T; Bharote, Haresh; Eklare, Nishikant; Tamboli, Khansabegum

    2015-01-01

    Tremors are reported as the most frequent neurological manifestation of Wilson's disease (WD) in some series. Postural tremors, rest tremors, action tremors and wing-beating (rubral) tremors are the different types of tremors seen in WD. We report a patient of WD with unilateral rubral tremors refractory to 1-year therapy with Penicillamine and anti-tremor medications. The tremors decreased considerably after adding chelation therapy with dimercaprol. Combination of Penicillamine and dimercaprol is an effective decoppering measure in rubral tremors of WD. PMID:25745328

  8. Unilateral coronal craniosynostosis in Abraham Lincoln and his family.

    PubMed

    Fishman, Ronald S

    2010-09-01

    Premature closure of one coronal skull suture produces a characteristic arching or relative elevation of the superior orbital rim on the involved side. This sign is associated with facial asymmetry, and both signs are usually the most conspicuous features in patients with mild unilateral coronal craniosynostosis. Photographs suggest that at least 9 individuals over 5 generations of the Abraham Lincoln family had premature closure of 1 coronal suture. In 8 males, there was involvement of the left side; in 1 female, there was involvement of the right side. PMID:20856045

  9. Primary sinonasal tuberculosis confined to the unilateral maxillary sinus

    PubMed Central

    Kim, Kyung Yeon; Bae, Jung Ho; Park, Jee Soo; Lee, Seung-Sin

    2014-01-01

    Extrapulmonary tuberculosis is not rare and occurs mainly in the head and neck region. Cervical tuberculous lymphadenopathy is the most common form of extrapulmonary tuberculosis. Sinonasal tuberculosis is known to occur very rarely due to the protective functions of sinonasal mucosa. Although some signs of sinonasal tuberculosis may be present, such as associated facial abscesses, the symptoms and signs are usually nonspecific. Clinical suspicion is important for timely diagnosis and proper management of sinonasal tuberculosis due to its rarity and nonspecific clinical presentation. We report a case of tuberculosis confined to the unilateral maxillary sinus that was first misdiagnosed as recurrent rhinosinusitis after endoscopic sinus surgery. PMID:24551309

  10. Surgical correction of unilateral and bilateral facial palsy

    PubMed Central

    Harrison, D

    2005-01-01

    Unilateral and bilateral facial palsies are debilitating and depressing conditions for the patient. For the past 30 years attempts have been made to improve the reanimation of these patients. The ability to transfer axons over significant distances with nerve grafts and the transfer of muscle that can be revascularised by microvascular surgery greatly improves results of this surgery. The revascularisation of muscle has been the important step forward but the re-focusing of interest in this condition has brought about a number of peripheral advances. PMID:16143684

  11. Transplanting Kidneys from Deceased Donors With Severe Acute Kidney Injury.

    PubMed

    Heilman, R L; Smith, M L; Kurian, S M; Huskey, J; Batra, R K; Chakkera, H A; Katariya, N N; Khamash, H; Moss, A; Salomon, D R; Reddy, K S

    2015-08-01

    Our aim was to determine outcomes with transplanting kidneys from deceased donors with acute kidney injury, defined as a donor with terminal serum creatinine ?2.0?mg/dL, or a donor requiring acute renal replacement therapy. We included all patients who received deceased donor kidney transplant from June 2004 to October 2013. There were 162 AKI donor transplant recipients (21% of deceased donor transplants): 139 in the standard criteria donor (SCD) and 23 in the expanded criteria donor (ECD) cohort. 71% of the AKI donors had stage 3 (severe AKI), based on acute kidney injury network (AKIN) staging. Protocol biopsies were done at 1, 4, and 12 months posttransplant. One and four month formalin-fixed paraffin embedded (FFPE) biopsies from 48 patients (24 AKI donors, 24 non-AKI) underwent global gene expression profiling using DNA microarrays (96 arrays). DGF was more common in the AKI group but eGFR, graft survival at 1 year and proportion with IF/TA>2 at 1 year were similar for the two groups. At 1 month, there were 898 differentially expressed genes in the AKI group (p-value <0.005; FDR <10%), but by 4 months there were no differences. Transplanting selected kidneys from deceased donors with AKI is safe and has excellent outcomes. PMID:25808278

  12. Adult stem-like cells in kidney

    PubMed Central

    Hishikawa, Keiichi; Takase, Osamu; Yoshikawa, Masahiro; Tsujimura, Taro; Nangaku, Masaomi; Takato, Tsuyoshi

    2015-01-01

    Human pluripotent cells are promising for treatment for kidney diseases, but the protocols for derivation of kidney cell types are still controversial. Kidney tissue regeneration is well confirmed in several lower vertebrates such as fish, and the repair of nephrons after tubular damages is commonly observed after renal injury. Even in adult mammal kidney, renal progenitor cell or system is reportedly presents suggesting that adult stem-like cells in kidney can be practical clinical targets for kidney diseases. However, it is still unclear if kidney stem cells or stem-like cells exist or not. In general, stemness is defined by several factors such as self-renewal capacity, multi-lineage potency and characteristic gene expression profiles. The definite use of stemness may be obstacle to understand kidney regeneration, and here we describe the recent broad findings of kidney regeneration and the cells that contribute regeneration. PMID:25815133

  13. Current Bioengineering Methods for Whole Kidney Regeneration

    PubMed Central

    Yamanaka, Shuichiro; Yokoo, Takashi

    2015-01-01

    Kidney regeneration is likely to provide an inexhaustible source of tissues and organs for immunosuppression-free transplantation. It is currently garnering considerable attention and might replace kidney dialysis as the ultimate therapeutic strategy for renal failure. However, anatomical complications make kidney regeneration difficult. Here, we review recent advances in the field of kidney regeneration, including (i) the directed differentiation of induced pluripotent stem cells/embryonic stem cells into kidney cells; (ii) blastocyst decomplementation; (iii) use of a decellularized cadaveric scaffold; (iv) embryonic organ transplantation; and (v) use of a nephrogenic niche for growing xenoembryos for de novo kidney regeneration from stem cells. All these approaches represent potentially promising therapeutic strategies for the treatment of patients with chronic kidney disease. Although many obstacles to kidney regeneration remain, we hope that innovative strategies and reliable research will ultimately allow the restoration of renal function in patients with end-stage kidney disease.

  14. Adult stem-like cells in kidney.

    PubMed

    Hishikawa, Keiichi; Takase, Osamu; Yoshikawa, Masahiro; Tsujimura, Taro; Nangaku, Masaomi; Takato, Tsuyoshi

    2015-03-26

    Human pluripotent cells are promising for treatment for kidney diseases, but the protocols for derivation of kidney cell types are still controversial. Kidney tissue regeneration is well confirmed in several lower vertebrates such as fish, and the repair of nephrons after tubular damages is commonly observed after renal injury. Even in adult mammal kidney, renal progenitor cell or system is reportedly presents suggesting that adult stem-like cells in kidney can be practical clinical targets for kidney diseases. However, it is still unclear if kidney stem cells or stem-like cells exist or not. In general, stemness is defined by several factors such as self-renewal capacity, multi-lineage potency and characteristic gene expression profiles. The definite use of stemness may be obstacle to understand kidney regeneration, and here we describe the recent broad findings of kidney regeneration and the cells that contribute regeneration. PMID:25815133

  15. Hereditary Causes of Kidney Stones and Chronic Kidney Disease

    PubMed Central

    Edvardsson, Vidar O.; Goldfarb, David S.; Lieske, John C.; Beara-Lasic, Lada; Anglani, Franca; Milliner, Dawn S.; Palsson, Runolfur

    2013-01-01

    Adenine phosphoribosyltransferase (APRT) deficiency, cystinuria, Dent disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) and primary hyperoxaluria (PH) are rare but important causes of severe kidney stone disease and/or chronic kidney disease in children. Recurrent kidney stone disease and nephrocalcinosis, particularly in pre-pubertal children, should alert the physician to the possibility of an inborn error of metabolism as the underlying cause. Unfortunately, the lack of recognition and knowledge of the five disorders has frequently resulted in an unacceptable delay in diagnosis and treatment, sometimes with grave consequences. A high index of suspicion coupled with early diagnosis may reduce or even prevent the serious long-term complications of these diseases. In this paper, we review the epidemiology, clinical features, diagnosis, treatment and outcome of patients with APRT deficiency, cystinuria, Dent disease, FHHNC and PH with emphasis on childhood manifestations. PMID:23334384

  16. Late Kidney Dysfunction in a Kidney Transplant Recipient

    PubMed Central

    2014-01-01

    Late kidney transplant dysfunction may be a harbinger of graft failure. For many years, calcineurin inhibitor toxicity was felt to be the main cause for graft dysfunction with fibrosis and transplant loss. Recently this idea has come into question. With the observation that peritubular capillary C4d staining in kidney allografts may indicate antibody-mediated injury in conjunction with biopsy study findings, an appreciation for antibody-mediated rejection as a major cause of late graft dysfunction and loss has emerged. Twenty percent to 30% of patients develop de novo donor-specific antibodies after kidney transplantation. There are no US Food and Drug Administration–approved treatments for antibody-mediated rejection, nor have any randomized controlled trials assessed efficacy. Off-label treatment strategies include some combination of plasma exchange, intravenous immunoglobulin, and rituximab. Other approaches, including splenectomy, bortezomib, and eculizumab, have also been tried. PMID:24370771

  17. Molecular Imaging of the Kidneys

    PubMed Central

    Szabo, Zsolt; Alachkar, Nada; Xia, Jinsong; Mathews, William B.; Rabb, Hamid

    2010-01-01

    Radionuclide imaging of the kidneys with gamma cameras involves the use of labeled molecules seeking functionally critical molecular mechanisms in order to detect the pathophysiology of the diseased kidneys and achieve an early, sensitive and accurate diagnosis. The most recent imaging technology, PET, permits quantitative imaging of the kidney at a spatial resolution appropriate for the organ. H215O, 82RbCl, and [64Cu] ETS are the most important radiopharmaceuticals for measuring renal blood flow. The renin angiotensin system is the most important regulator of renal blood flow; this role is being interrogated by detecting angiotensin receptor subtype AT1R using in vivo PET imaging. Membrane organic anion transporters are important for the function of the tubular epithelium; therefore, Tc-99m MAG3 as well as some novel radiopharmaceuticals such as copper-64 labeled mono oxo-tetraazamacrocyclic ligands have been utilized for molecular renal imaging. Additionally, other radioligands that interact with the organic cation transporters or peptide transporters have developed. Focusing on early detection of kidney injury at the molecular level is an evolving field of great significance. Potential imaging targets are the kidney injury molecule- 1 (KIM-1) that is highly expressed in kidney injury and renal cancer but not in normal kidneys. While pelvic clearance, in addition to parenchymal transport, is an important measure in obstructive nephropathy, techniques that focus on upregulated molecules in response to tissue stress resulted from obstruction will be of great implication. Monocyte chemoattractant protein -1 (MCP-1) is a well-suited molecule in this case. The greatest advances in molecular imaging of the kidneys have been recently achieved in detecting renal cancer. In addition to the ubiquitous [18F]FDG, other radioligands such as [11C]acetate and anti-[18F]FACBC have emerged. Radioimmuno-imaging with [124I]G250 could lead to radioimmunotherapy for renal cancer. Considering the increasing age of general population, the incidence of kidney diseases such as atherosclerosis, diabetic nephropathy, and cancer is expected to increase. Successful management of these diseases offers an opportunity and a challenge for development of novel molecular imaging technologies. PMID:21111857

  18. Thoracic temperature, shivering, and flight in the monarch butterfly, Danaus plexippus (L.)

    Microsoft Academic Search

    Ann E. Kammer

    1970-01-01

    Monarch butterflies, Danaus plexippus (L.), display a warm-up behavior characterized by wingstrokes of small amplitude. Thoracic temperature during this shivering and during fixed flight was measured by means of a smallbead thermistor inserted into the thorax. At ambient temperatures of 15–16°C, once shivering is initiated the thoracic temperature rises at a maximum rate of 1.3°C\\/min, and a thoracic temperature 4.0°C

  19. Thoracic wall reconstruction with Collamend® in trauma: report of a case and review of the literature

    PubMed Central

    2012-01-01

    Introduction Despite progress in reconstructive techniques, rebuilding portions of the thorax remains challenging, in particular when large resections, contamination or infection are involved. No other cases of thoracic reconstruction in trauma patients with biological prosthesis have been described since now. Methods We report a case of thoracic reconstruction in highly infected field in a trauma patient. We also performed a literature review about the topic. Conclusion Collamend® demonstrated its usefulness in thoracic wall reconstruction even in trauma patients and infected fields. PMID:23259462

  20. Living Kidney Donors and ESRD.

    PubMed

    Ross, Lainie Friedman

    2015-07-01

    There are more than 325 living kidney donors who have developed end-stage renal disease and have been listed on the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) deceased donor kidney wait list. The OPTN/UNOS database records where these kidney donors are listed and, if they donated after April 1994, where that donation occurred. These 2 locations are often not the same. In this commentary, I examine whether a national living donor registry should be created and whether transplantation centers should be notified when one of their living kidney donors develops end-stage renal disease. I consider and refute 5 potential objections to center notification. I explain that transplantation centers should look back at these cases and input data into a registry to attempt to identify patterns that could improve donor evaluation protocols. Creating a registry and mining the information it contains is, in my view, our moral and professional responsibility to future patients and the transplantation endeavor. As individuals and as a community, we need to acknowledge the many unknown risks of living kidney donation and take responsibility for identifying these risks. We then must share information about these risks, educate prospective donors about them, and attempt to minimize them. PMID:25936672

  1. Unilateral nerve injury produces bilateral loss of distal innervation.

    PubMed

    Oaklander, Anne Louise; Brown, Jennifer M

    2004-05-01

    There are no known anatomical connections between neurons that innervate homologous right and left body parts. Nevertheless, some patients develop bilateral abnormalities after unilateral injury, a phenomenon often unrecognized and not yet characterized. Therefore, we examined in rats the effects of ligating and cutting one tibial nerve on sensory function and on density of innervation in hind paws contralaterally as well as ipsilaterally to the injury, at times between 1 day and 5 months after surgery. Punches removed from tibial- or sural-innervated planter paw skin were immunolabeled to quantitate epidermal nerve endings. Naive and sham-operated rats provided controls. Axotomized rats had near-total loss of PGP9.5(+) innervation within ipsilateral tibial-innervated skin at all time-points. Adjacent ipsilateral sural-innervated skin had persistent hyperalgesia without denervation, and robust axonal sprouting at 5 months after surgery. Contralesional hind paws lost 54% of innervation in tibial-innervated epidermis starting 1 week after surgery and persisting throughout. Contralesional sural-innervated skin had neither neurite loss nor sprouting. These results imply that unilateral nerve injury can cause profound, long lasting, nerve-branch-specific loss of distal innervation contralaterally as well as ipsilaterally. They discredit the practice of using tissues contralateral to an injury to provide normative controls and suggest the possibility of rapid, transmedian postinjury signals between homologous mirror-image neurons. PMID:15122703

  2. Unilateral Altruism in Network Routing Games with Atomic Players

    E-print Network

    Azad, Amar Prakash

    2011-01-01

    We study a routing game in which one of the players unilaterally acts altruistically by taking into consideration the latency cost of other players as well as his own. By not playing selfishly, a player can not only improve the other players' equilibrium utility but also improve his own equilibrium utility. To quantify the effect, we define a metric called the Value of Unilateral Altruism (VoU) to be the ratio of the equilibrium utility of the altruistic user to the equilibrium utility he would have received in Nash equilibrium if he were selfish. We show by example that the VoU, in a game with nonlinear latency functions and atomic players, can be arbitrarily large. Since the Nash equilibrium social welfare of this example is arbitrarily far from social optimum, this example also has a Price of Anarchy (PoA) that is unbounded. The example is driven by there being a small number of players since the same example with non-atomic players yields a Nash equilibrium that is fully efficient.

  3. Unilateral peripheral neuropathic pain: The role of neurodiagnostic skin biopsy

    PubMed Central

    Buonocore, Michelangelo

    2014-01-01

    According to the current definition of neuropathic pain (“pain arising as a direct consequence of a lesion or disease affecting the somatosensory system”), the demonstration of a lesion or disease involving the somatosensory system is mandatory for the diagnosis of definite neuropathic pain. Although several methods are currently available for this aim, none is suitable for every type of disease (or lesion). Neurodiagnostic skin biopsy (NSB) is a relatively new technique for the diagnosis of peripheral nerve lesions. It is an objective method, completely independent from the patient’s complaining, based on immunohistochemical staining techniques that allow measurement of the density of the epidermal nerve fibers, currently considered the free nerve endings of small diameter (A-delta and C) afferent fibers. NSB has the important property of being used to investigate the skin, allowing obtaining a diagnosis of small fiber axonal neuropathy of peripheral nerves supplying every body part covered by skin. This feature appears to be very important, particularly in cases of unilateral nerve lesions, because it allows going beyond the possibilities of neurophysiological tests which are available only for a limited number of peripheral nerves. All these characteristics make NSB a precious instrument for the diagnosis of peripheral unilateral neuropathic pain. PMID:24579067

  4. JAG Tearing Technique with Radiofrequency Guide Wire for Aortic Fenestration in Thoracic Endovascular Aneurysm Repair

    SciTech Connect

    Ricci, Carmelo [Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte, Radiologia Interventistica (Italy); Ceccherini, Claudio, E-mail: claudiocec@hotmail.it; Leonini, Sara [Radiologia Universitaria, Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte (Italy); Cini, Marco; Vigni, Francesco [Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte, Radiologia Interventistica (Italy); Neri, Eugenio; Tucci, Enrico; Benvenuti, Antonio; Tommasino, Giulio; Sassi, Carlo [Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte, Chirurgia dell'Aorta Toracica (Italy)

    2012-02-15

    An innovative approach, the JAG tearing technique, was performed during thoracic endovascular aneurysm repair in a patient with previous surgical replacement of the ascending aorta with a residual uncomplicated type B aortic dissection who developed an aneurysm of the descending thoracic aorta with its lumen divided in two parts by an intimal flap. The proximal landing zone was suitable to place a thoracic stent graft. The distal landing zone was created by cutting the intimal flap in the distal third of the descending thoracic aorta with a radiofrequency guide wire and intravascular ultrasound catheter.

  5. Determinants of Autobiographical Memory in Patients with Unilateral Temporal Lobe Epilepsy or Excisions

    ERIC Educational Resources Information Center

    St-Laurent, Marie; Moscovitch, Morris; Levine, Brian; McAndrews, Mary Pat

    2009-01-01

    Patients with unilateral temporal lobe epilepsy from hippocampal origin and patients with unilateral surgical excision of an epileptic focus located in the medial temporal lobe were compared to healthy controls on a version of the Autobiographical Interview (AI) adapted to assess memory for event-specific and generic personal episodes. For both…

  6. Effects of eccentrically and concentrically induced unilateral fatigue on the involved and uninvolved limbs

    Microsoft Academic Search

    Mark D Grabiner; Tammy M Owings

    1999-01-01

    This study extended findings of others related to the fatigue resistance of maximum voluntary knee extension contractions performed eccentrically on an isokinetic dynamometer. Twelve subjects performed either 75 unilateral isokinetic concentric MVCs or 75 unilateral isokinetic eccentric MVCs at 30°s?1. A uniquely-configured dynamometer provided the opportunity to describe the effect of the concentric or eccentric fatigue protocol on the concentric

  7. Smad3 deficiency attenuates renal fibrosis, inflammation,and apoptosis after unilateral ureteral obstruction

    Microsoft Academic Search

    KUMI INAZAKI; YUTAKA KANAMARU; YUKO KOJIMA; NORIYOSHI SUEYOSHI; KO OKUMURA; KAZUNARI KANEKO; YUICHIRO YAMASHIRO; HIDEOKI OGAWA; ATSUHITO NAKAO

    2004-01-01

    Smad3 deficiency attenuates renal fibrosis, inflammation, and apoptosis after unilateral ureteral obstruction.BackgroundTransforming growth factor-? (TGF-?) has been implicated in the development of renal fibrosis induced by unilateral ureteral obstruction (UUO). However, there is little information on signaling pathways mediating TGF-? activity involved in molecular and cellular events leading to renal fibrosis induced by UUO. In this study, we sought to

  8. Identifying Live Nematodes in Diffuse Unilateral Subacute Neuroretinitis by Using the Scanning Laser Ophthalmoscope

    Microsoft Academic Search

    Lucio R. Moraes; Arnaldo P. Cialdini; Marcos P. Avila; Ann E. Elsner

    2002-01-01

    Objective: To describe use of the scanning laser oph- thalmoscope (SLO) to identify live nematodes in patients with diffuse unilateral subacute neuroretinitis. Methods: Infrared, red, and blue illumination (780, 633, and 488 nm, respectively) in an SLO were used to image and evaluate functional retinal status in patients with late- stage diffuse unilateral subacute neuroretinitis. An ex- amination to identify

  9. Unilateral mydriasis secondary to ipratropium bromide in a critically ill patient

    PubMed Central

    Santana-Cabrera, Luciano; Fernández-Tagarro, Ernesto José; del Amo-Nolasco, Beatriz; Jaén-Sánchez, Nieves; Cáceres-Agra, Juan José

    2012-01-01

    Unilateral dilated pupil in a critical patient under sedation is an important clinical sign that requires prompt evaluation. An exhaustive assessment must be performed, including neurological examination and imaging tests, and pharmacological causes must be ruled out. We describe a case of unilateral fixed dilated pupil secondary to the administration of a nebulized cholinergic antagonist, ipratropium bromide, in an unconscious patient. PMID:22787356

  10. Motor Learning of a Bimanual Task in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Hung, Ya-Ching; Gordon, Andrew M.

    2013-01-01

    Children with unilateral cerebral palsy (CP) have been shown to improve their motor performance with sufficient practice. However, little is known about how they learn goal-oriented tasks. In the current study, 21 children with unilateral CP (age 4-10 years old) and 21 age-matched typically developed children (TDC) practiced a simple bimanual…

  11. Proteomics and kidney stone disease.

    PubMed

    Thongboonkerd, Visith

    2008-01-01

    Kidney stone disease (nephrolithiasis) is an ancient and common affliction. It has been recognized for a long time with evidence of stone found in approximately 7,000-year-old mummies and remains a common problem worldwide, indicating ineffective prevention in the past. Precise pathogenic and molecular mechanisms of kidney stone formation are still poorly understood and should be further elucidated. Also, identification of novel therapeutic targets for better therapeutic outcome and successful prevention of the occurrence and recurrence of the stone are crucially required. One of the most promising tools for current and future biomedical research is proteomics, which has been extensively and widely applied to the nephrology field during the past 5 years. Its high-throughput capability holds a great promise also to kidney stone research. This chapter provides a brief overview of proteomic methodologies recently used for the investigation of nephrolithiasis and recent proteomic studies of nephrolithiasis are summarized. PMID:18401167

  12. Pelvic kidney: associated diseases and treatment.

    PubMed

    Cinman, Nadya M; Okeke, Zeph; Smith, Arthur D

    2007-08-01

    The incidence of pelvic kidney has been approximated at between 1 in 2200 and 1 in 3000. The ectopic kidney is thought to be no more susceptible to disease than the normally positioned kidney, except for the development of calculi and hydronephrosis. Because of the greater risk of injuring aberrant vessels or overlying abdominal viscera and nerves, the pelvic kidney presents special treatment challenges. Alternative approaches to treating nephrolithiasis may yield better outcomes. The tortuous ureter often associated with a pelvic kidney hinders deflection of the flexible ureteroscope, potentially limiting access. Laparoscopy-guided intervention permits visual exposure of the kidney, enhancing safe puncture and tract placement integral to percutaneous nephrolithotomy. Laparoscopy-assisted anterior retrograde percutaneous nephroscopy involves percutaneous access using a Hunter-Hawkins retrograde nephrostomy needle with adjunctive laparoscopy to permit viewing and manipulation of overlying bowel. Ureteropelvic junction (UPJ) obstruction has been reported to occur in 22% to 37% of ectopic kidneys. Endoscopic incision presents difficulties beyond those of anatomically normal kidneys. The laparoscopic approach provides good surgical exposure, and operative times are comparable to those of laparoscopic pyeloplasty in anatomically normal kidneys. To date, only a handful of cases of malignancy in a pelvic kidney have been described. Like a nonfunctioning anatomically normal kidney, a nonfunctional pelvic kidney may require primary removal. There are a few reports of laparoscopic pelvic nephrectomy. Additional studies are needed to compare the various treatments for disease of the pelvic kidney in order to decide which options have the most beneficial outcomes. PMID:17867938

  13. [TRPP subfamily and kidney diseases].

    PubMed

    Zhao, Jie; Yang, Wei; Luo, Jian-hong

    2010-11-01

    TRPP subfamily is an important member of transient receptor potential family. It has six transmembrane (TM) domains, a large extracellular loop between the first and second TM and 2-4 ankyrin repeats in the N terminal. TRPP subfamily includes TRPP2, TRPP3, TRPP5 etc. There are several differences in their structure, activation mode and function. TRPP subfamily is involved in many physiological mechanisms and its abnormal structure can lead to the formation of polycystic kidney. This subfamily is also closely related to gustation. In this review, we summarize recent research findings of TRPP subfamily and its association with polycystic kidney diseases. PMID:21166062

  14. Unilateral cross bite treated by corticotomy-assisted expansion: two case reports

    PubMed Central

    2010-01-01

    Background True unilateral posterior crossbite in adults is a challenging malocclusion to treat. Conventional expansion methods are expected to have some shortcomings. The aim of this paper is to introduce a new technique for treating unilateral posterior crossbite in adults, namely, corticotomy-assisted expansion (CAE) applied on two adult patients: one with a true unilateral crossbite and the other with an asymmetrical bilateral crossbite, both treated via modified corticotomy techniques and fixed orthodontic appliances. Methods Two cases with asymmetric maxillary constriction were treated using CAE. Results In both cases, effective asymmetrical expansion was achieved using CAE, and functional occlusion was established as well. Conclusions Unilateral CAE presents an effective and reliable technique to treat true unilateral crossbite. PMID:20482859

  15. A computational study of the role of the aortic arch in idiopathic unilateral vocal-fold paralysis.

    PubMed

    Williams, Megan J; Ayylasomayajula, Avinash; Behkam, Reza; Bierhals, Andrew J; Jacobs, M Eileen; Edgar, Julia D; Paniello, Randal C; Barkmeier-Kraemer, Julie M; Vande Geest, Jonathan P

    2015-02-15

    Unilateral vocal-fold paralysis (UVP) occurs when one of the vocal folds becomes paralyzed due to damage to the recurrent laryngeal nerve (RLN). Individuals with UVP experience problems with speaking, swallowing, and breathing. Nearly two-thirds of all cases of UVP is associated with impaired function of the left RLN, which branches from the vagus nerve within the thoracic cavity and loops around the aorta before ascending to the larynx within the neck. We hypothesize that this path predisposes the left RLN to a supraphysiological, biomechanical environment, contributing to onset of UVP. Specifically, this research focuses on the identification of the contribution of the aorta to onset of left-sided UVP. Important to this goal is determining the relative influence of the material properties of the RLN and the aorta in controlling the biomechanical environment of the RLN. Finite element analysis was used to estimate the stress and strain imposed on the left RLN as a function of the material properties and loading conditions. The peak stress and strain in the RLN were quantified as a function of RLN and aortic material properties and aortic blood pressure using Spearman rank correlation coefficients. The material properties of the aortic arch showed the strongest correlation with peak stress [? = -0.63, 95% confidence interval (CI), -1.00 to -0.25] and strain (? = -0.62, 95% CI, -0.99 to -0.24) in the RLN. Our results suggest an important role for the aorta in controlling the biomechanical environment of the RLN and potentially in the onset of left-sided UVP that is idiopathic. PMID:25477351

  16. Why kidneys fail in autosomal dominant polycystic kidney disease.

    PubMed

    Grantham, Jared J; Mulamalla, Sumanth; Swenson-Fields, Katherine I

    2011-10-01

    The weight of evidence gathered from studies in humans with hereditary polycystic kidney disease (PKD)1 and PKD2 disorders, as well as from experimental animal models, indicates that cysts are primarily responsible for the decline in glomerular filtration rate that occurs fairly late in the course of the disease. The processes underlying this decline include anatomic disruption of glomerular filtration and urinary concentration mechanisms on a massive scale, coupled with compression and obstruction by cysts of adjacent nephrons in the cortex, medulla and papilla. Cysts prevent the drainage of urine from upstream tributaries, which leads to tubule atrophy and loss of functioning kidney parenchyma by mechanisms similar to those found in ureteral obstruction. Cyst-derived chemokines, cytokines and growth factors result in a progression to fibrosis that is comparable with the development of other progressive end-stage renal diseases. Treatment of renal cystic disorders early enough to prevent or reduce cyst formation or slow cyst growth, before the secondary changes become widespread, is a reasonable strategy to prolong the useful function of kidneys in patients with autosomal dominant polycystic kidney disease. PMID:21862990

  17. Drinking Water Helps Prevent Kidney Stones

    MedlinePLUS

    ... nih.gov/medlineplus/news/fullstory_151715.html Drinking Water Helps Prevent Kidney Stones Researchers find eight or ... March 27, 2015 (HealthDay News) -- Drinking plenty of water will lower your risk of kidney stones, researchers ...

  18. Drugs Approved for Kidney (Renal Cell) Cancer

    MedlinePLUS

    ... Your Doctor about Treatment Research Drugs Approved for Kidney (Renal Cell) Cancer This page lists cancer drugs approved by the ... Temsirolimus Torisel (Temsirolimus) Votrient (Pazopanib Hydrochloride) Related Resources Kidney Cancer Chemotherapy and You: Support for People With Cancer ...

  19. Kidney Cancer - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... Are Here: Home ? Multiple Languages ? All Health Topics ? Kidney Cancer URL of this page: http://www.nlm.nih. ... V W XYZ List of All Topics All Kidney Cancer - Multiple Languages To use the sharing features on ...

  20. Prevent Diabetes Problems: Keep Your Kidneys Healthy

    MedlinePLUS

    ... Statistics Research Resources Order About Us Español National Diabetes Information Clearinghouse Publications Tools and Resources E-News ... Prevent diabetes problems: Keep your kidneys healthy Prevent diabetes problems: Keep your kidneys healthy On this page: ...

  1. Albuminuria prediction of kidney function outcome in kidney transplant recipients.

    PubMed

    El Minshawy, Osama; El-Bassuoni, Eman

    2015-03-01

    To investigate the association of albuminuria and kidney function outcome in kidney transplant recipients, we studied 161 kidney transplant recipients; 95 (59%) of them were males and the mean age of the patients was 46 ± 13 years (range 18-70 years). All the patients received allografts from living related kidney donors. The mean body mass index of the patients was 25 ± 4 kg/m 2 . Forty (25%) patients were diabetic and 72 (45%) patients were hypertensive. All the patients had glomerular filtration rate (iGFR) determination by ( 99m Tc-DTPA) clearance and albumiuria was assessed using the first voided morning urine samples. According to the results of albuminuria, the patients were subdivided into three groups: One group of 90 (56%) patients with normoalbuminuria (<30 mg albumin/g. creatinine), a second group of 52 (32%) patients with microalbuminuria (30-300 mg albumin/g. creatinine) and a third group of 19 (12%) patients with macroalbuminuria (>300 mg/g. creatinine). There was a significant increase in the time post transplantation in the patients with macroalbumiuria in comparison with microalbuminuria and normoalbuminuria (90 ± 28, 60 ± 22 and 18 ± 6 months, respectively), P <0.05. There was a significant decrease of iGFR in the macroalbumiuria group as compared with the microalbumiuria and normoalbuminuria groups (57 ± 24, 74 ± 20 and 74 ± 28 mL/min/1.73 m 2 , respectively), P <0.05. We conclude that there was an association between albuminuria and the status of the renal function in our transplant population, which may reflect renal injury due to proteinuria. Prospective studies are warranted to evaluate the effect of albuminuria on the prognosis of the kidney allografts. PMID:25758867

  2. Clinical features of thoracic endometriosis: A single center analysis

    PubMed Central

    Hwang, Sun Mi; Lee, Chung Won; Lee, Byung Seok

    2015-01-01

    Objective To analyze the diagnostic profiles and treatment outcomes of patients with thoracic endometriosis at a university hospital. Methods A retrospective review of medical records was performed for patients diagnosed with thoracic endometriosis at Gangnam Severance Hospital, Yonsei University College of Medicine, between January 2007 and January 2014. Results Fifteen patients (median age, 35 years; range, 23-48 years) were evaluated. Patients presented with catamenial hemoptysis (n=8), or catamenial pneumothorax (n=7). Patients with catamenial pneumothorax were significantly older than those presenting with hemoptysis (P=0.0002). Only 3 patients (20%) had coexisting pelvic endometriosis. All patients underwent chest computed tomography; lesions were shown to predominantly affect the right lung (right lung, n=13, 86.7%; left lung, n=2, 13.3%), and were mainly distributed on the right upper lobe (n=9, 60%). Ten patients underwent video-assisted thoracoscopic surgery, and 1 patient underwent a thoracotomy. Intraoperatively, endometriosis-specific findings were observed in 8/11 patients (72.7%); a further 5/11 patients (45.4%) had histologically detectable endometriosis. Over the follow-up period (mean, 18.4 months; range, 2-65 months) 5/15 patients (33%) had clinical signs of recurrence. Recurrence was not detected in any of the 5 catamenial pneumothorax patients that received adjuvant hormonal therapy after surgery. Conclusion The diagnosis and management of thoracic endometriosis requires a multidisciplinary approach, based upon skillful differential diagnosis, and involving careful gynecologic evaluation and assessment of the cyclicity of pulmonary symptoms. Imaging findings are non-specific, though there may be laterality towards the right lung. Since symptom recurrence is more common in those with presenting with pneumothorax, post-operative adjuvant medical therapy is recommended. PMID:26023672

  3. Physiological Interaction of Heart and Lung in Thoracic Irradiation

    SciTech Connect

    Ghobadi, Ghazaleh; Veen, Sonja van der [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands) [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Bartelds, Beatrijs [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)] [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Boer, Rudolf A. de [Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)] [Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Dickinson, Michael G. [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)] [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Jong, Johan R. de [Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)] [Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Faber, Hette; Niemantsverdriet, Maarten [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands) [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Brandenburg, Sytze [Kernfysisch Versneller Instituut, University of Groningen, Groningen (Netherlands)] [Kernfysisch Versneller Instituut, University of Groningen, Groningen (Netherlands); Berger, Rolf M.F. [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)] [Center for Congenital Heart Disease, Beatrix Children Hospital, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Langendijk, Johannes A. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)] [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Coppes, Robert P. [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands) [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands); Luijk, Peter van, E-mail: p.van.luijk@umcg.nl [Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen (Netherlands)

    2012-12-01

    Introduction: The risk of early radiation-induced lung toxicity (RILT) limits the dose and efficacy of radiation therapy of thoracic tumors. In addition to lung dose, coirradiation of the heart is a known risk factor in the development RILT. The aim of this study was to identify the underlying physiology of the interaction between lung and heart in thoracic irradiation. Methods and Materials: Rat hearts, lungs, or both were irradiated to 20 Gy using high-precision proton beams. Cardiopulmonary performance was assessed using breathing rate measurements and F{sup 18}-fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG-PET) scans biweekly and left- and right-sided cardiac hemodynamic measurements and histopathology analysis at 8 weeks postirradiation. Results: Two to 12 weeks after heart irradiation, a pronounced defect in the uptake of {sup 18}F-FDG in the left ventricle (LV) was observed. At 8 weeks postirradiation, this coincided with LV perivascular fibrosis, an increase in LV end-diastolic pressure, and pulmonary edema in the shielded lungs. Lung irradiation alone not only increased pulmonary artery pressure and perivascular edema but also induced an increased LV relaxation time. Combined irradiation of lung and heart induced pronounced increases in LV end-diastolic pressure and relaxation time, in addition to an increase in right ventricle end-diastolic pressure, indicative of biventricular diastolic dysfunction. Moreover, enhanced pulmonary edema, inflammation and fibrosis were also observed. Conclusions: Both lung and heart irradiation cause cardiac and pulmonary toxicity via different mechanisms. Thus, when combined, the loss of cardiopulmonary performance is intensified further, explaining the deleterious effects of heart and lung coirradiation. Our findings show for the first time the physiological mechanism underlying the development of a multiorgan complication, RILT. Reduction of dose to either of these organs offers new opportunities to improve radiation therapy treatment of thoracic tumors, potentially facilitating increased treatment doses and tumor control.

  4. 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

  5. Adverse events of pulmonary vascular stapling in thoracic surgery

    PubMed Central

    Yano, Motoki; Takao, Motoshi; Fujinaga, Takuji; Arimura, Takaaki; Fukai, Ichiro; Ota, Shinichiro; Saito, Yushi; Okuda, Katsuhiro

    2013-01-01

    OBJECTIVES The use of staplers for thoracic surgery has been widely accepted and regarded as a safe procedure. However, adverse events (AEs) of stapling are occasionally experienced. The aim of this retrospective study was to analyse the AEs of stapling in pulmonary vascular surgery. METHODS A retrospective multi-institutional review was conducted by the 29 institutions of the Central Japan Lung Cancer Surgery Study Group. All staplings of the pulmonary artery (PA) and vein in thoracic surgery were reviewed during the research period. RESULTS Stapling of the PA and vein was performed 3393 times. The total number of AEs related to stapling was nine (0.27%). Eight events occurred intraoperatively and one occurred immediately after the operation. Intraoperative AE occurred more frequently than postoperative AE. AE in the PA occurred more frequently than in the pulmonary vein. The intraoperative AEs were oozing (n = 3), stapling failure (n = 2), laceration of the peripheral vasculature at compression (n = 2) and technical injury of the vasculature at insertion (n = 1). The causes of AEs were reported to be tissue fragility (n = 3), stapler rocking during stapling (n = 2), stapler-tissue thickness mismatch (n = 2) and technical failure (n = 1). The only postoperative AE was staple line rupture of the PV stump. No relationship was seen between the incidence of AE and cartridge colours, compression types of staplers or numbers of staple lines. CONCLUSIONS Generally, stapling of the pulmonary vasculatures in recent thoracic surgery has been safe. Furthermore, the knowledge of the possible risks of pulmonary vascular stapling may help to decrease the AEs of stapling. PMID:23633560

  6. Fight-or-flight: murine unilateral ureteral obstruction causes extensive proximal tubular degeneration, collecting duct dilatation, and minimal fibrosis.

    PubMed

    Forbes, Michael S; Thornhill, Barbara A; Minor, Jordan J; Gordon, Katherine A; Galarreta, Carolina I; Chevalier, Robert L

    2012-07-01

    Unilateral ureteral obstruction (UUO) is the most widely used animal model of progressive renal disease. Although renal interstitial fibrosis is commonly used as an end point, recent studies reveal that obstructive injury to the glomerulotubular junction leads to the formation of atubular glomeruli. To quantitate the effects of UUO on the remainder of the nephron, renal tubular and interstitial responses were characterized in mice 7 and 14 days after UUO or sham operation under anesthesia. Fractional proximal tubular mass, cell proliferation, and cell death were measured by morphometry. Superoxide formation was identified by nitro blue tetrazolium, and oxidant injury was localized by 4-hydroxynonenol and 8-hydroxydeoxyguanosine. Fractional areas of renal vasculature, interstitial collagen, ?-smooth muscle actin, and fibronectin were also measured. After 14 days of UUO, the obstructed kidney loses 19% of parenchymal mass, with a 65% reduction in proximal tubular mass. Superoxide formation is localized to proximal tubules, which undergo oxidant injury, apoptosis, necrosis, and autophagy, with widespread mitochondrial loss, resulting in tubular collapse. In contrast, mitosis and apoptosis increase in dilated collecting ducts, which remain patent through epithelial cell remodeling. Relative vascular volume fraction does not change, and interstitial matrix components do not exceed 15% of total volume fraction of the obstructed kidney. These unique proximal and distal nephron cellular responses reflect differential "fight-or-flight" responses to obstructive injury and provide earlier indexes of renal injury than do interstitial compartment responses. Therapies to prevent or retard progression of renal disease should include targeting proximal tubule injury as well as interstitial fibrosis. PMID:22535799

  7. Cadaveric nerve allotransplantation in the treatment of persistent thoracic neuralgia.

    PubMed

    Barbour, John R; Yee, Andrew; Moore, Amy M; Trulock, Elbert P; Buchowski, Jacob M; Mackinnon, Susan E

    2015-04-01

    When relief from neuralgia cannot be achieved with traditional methods, neurectomy may be considered to abate the stimulus, and primary opposition of the terminal nerve ending is recommended to prevent neuroma. Nerve repair with autograft is limited by autologous nerves available for large nerve defects. Cadaveric allografts provide an unlimited graft source without donor-site morbidities, but are rapidly rejected unless appropriate immunosuppression is achieved. An optimal treatment method for nerve allograft transplantation would minimize rejection while simultaneously permitting nerve regeneration. This report details a novel experience of nerve allograft transplantation using cadaveric nerve grafts to desensitize persistent postoperative thoracic neuralgia. PMID:25841822

  8. 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

  9. Retained intra- thoracic surgical pack mimicking as recurrent aspergilloma.

    PubMed

    Mir, Ruquaya; Singh, Vikram P

    2012-12-01

    An intrathoracic gossypiboma is a rare condition. We are reporting a case of intrathoracicgossypiboma which was misdiagnosed as a recurrent aspergilloma. In our patient, the gossypiboma manifested as a pleural- based extra pulmonary mass which had a large contact area with the pleura and it displayed an extra pulmonary location. A retained surgical swab (gossypiboma) is a rare but an important complication of an intra- thoracic surgery. The diagnosis is usually overlooked, as in our case, resulting in delay of treatment, complications and a prolonged hospitalization. PMID:23373051

  10. Retained Intra- Thoracic Surgical Pack Mimicking as Recurrent Aspergilloma

    PubMed Central

    Mir, Ruquaya; Singh, Vikram P.

    2012-01-01

    An intrathoracic gossypiboma is a rare condition. We are reporting a case of intrathoracicgossypiboma which was misdiagnosed as a recurrent aspergilloma. In our patient, the gossypiboma manifested as a pleural- based extra pulmonary mass which had a large contact area with the pleura and it displayed an extra pulmonary location. A retained surgical swab (gossypiboma) is a rare but an important complication of an intra- thoracic surgery. The diagnosis is usually overlooked, as in our case, resulting in delay of treatment, complications and a prolonged hospitalization. PMID:23373051

  11. Anesthetic consideration for descending thoracic aortic aneurysm repair.

    PubMed

    Kahn, Ronald A; Stone, Marc E; Moskowitz, David M

    2007-09-01

    Anesthesia for surgery of the aorta poses some of the most difficult challenges for anesthesiologists. Major hemodynamic and physiologic stresses and sophisticated techniques of extracorporeal support are superimposed on patients with complex medical disease states. In this review, etiologies, natural history, and surgical techniques of thoracic aortic aneurysm are presented. Anesthetic considerations are discussed in detail, including the management of distal perfusion using partial cardiopulmonary bypass. Considerations of spinal cord protection, including management of proximal hypertension, cerebral spinal fluid drainage, and pharmacological therapies, are presented. PMID:17711972

  12. Thoracic outlet syndrome: a neurological and vascular disorder.

    PubMed

    Klaassen, Zachary; Sorenson, Edward; Tubbs, R Shane; Arya, Rahul; Meloy, Patrick; Shah, Rajnil; Shirk, Samuel; Loukas, Marios

    2014-07-01

    Thoracic outlet syndrome (TOS) is a condition arising from compression of the subclavian vessels and/or brachial plexus as the structures travel from the thoracic outlet to the axilla. Despite the significant pathology associated with TOS, there remains some general disagreement among experts on the specific anatomy, etiology, and pathophysiology of the condition, presumably because of the wide variation in symptoms that manifest in presenting patients, and because of lack of a definitive gold standard for diagnosis. Symptoms associated with TOS have traditionally been divided into vascular and neurogenic categories, a distinction based on the underlying structure(s) implicated. Of the two, neurogenic TOS (nTOS) is more common, and typically presents as compression of the brachial plexus; primarily, but not exclusively, involving its lower trunk. Vascular TOS (vTOS) usually involves compression of the vessel, most commonly the subclavian artery or vein, or is secondary to thrombus formation in the venous vasculature. Any anatomical anomaly in the thoracic outlet has the potential to predispose a patient to TOS. Common anomalies include variations in the insertion of the anterior scalene muscle (ASM) or scalenus minimus muscle, the presence of a cervical rib or of fibrous and muscular bands, variations in insertion of pectoralis minor, and the presence of neurovascular structures, which follow an atypical course. A common diagnostic technique for vTOS is duplex imaging, which has generally replaced more invasive angiographic techniques. In cases of suspected nTOS, electrophysiological nerve studies and ASM blocks provide guidance when screening for patients likely to benefit from surgical decompression of TOS. Surgeons generally agree that the transaxillary approach allows the greatest field of view for first rib excision to relieve compressed vessels. Alternatively, a supraclavicular approach is favored for scalenotomies when the ASM impinges on surrounding structures. A combined supraclavicular and infraclavicular approach is preferred when a larger field of view is required. The future of TOS management must emphasize the improvement of available diagnostic and treatment techniques, and the development of a consensus gold standard for diagnosis. Helical computed tomography offers a three-dimensional view of the thoracic outlet, and may be valuable in the detection of anatomical variations, which may predispose patients to TOS. This review summarizes the history of TOS, the pertinent clinical and anatomical presentations of TOS, and the commonly used diagnostic and treatment techniques for the condition. PMID:23716186

  13. Pediatric thoracic paravertebral block: roentgenologic evidence for extensive dermatomal coverage.

    PubMed

    Yanovski, Boris; Gat, Marina; Gaitini, Luis; Ben-David, Bruce

    2013-05-01

    A case of a 10 year old boy who underwent a T10 continuous thoracic paravertebral block (TPVB) using a standard technique for postoperative pain management is reported. In the postoperative recovery area, 10 mL of Omnipaque contrast dye was injected through the catheter and an anteroposterior chest radiograph was performed. The radiograph showed longitudinal spread of contrast parallel to the spine from the T(4)-T(5) intervertebral disc to the T(10)-T(11) intervertebral disc with clear lateral extension of contrast along the fifth through the tenth intercostal nerves. PMID:23688957

  14. Chronic Kidney Disease: Common, Harmful and Treatable – World Kidney Day 2007

    Microsoft Academic Search

    Andrew S. Levey; Sharon P. Andreoli; Thomas DuBose; Robert Provenzano; Allan J. Collins

    2007-01-01

    Thursday, March 8, 2007, is World Kidney Day! World Kidney Day was proposed by the International Society of Nephrology and International Federation of Kidney Foundations in 2006 to broadcast a message about kidney diseases to the public, government health officials, general physicians, allied health professionals, individuals, and families. It was launched on March 9, 2006, and will be fully inaugurated

  15. Bacterial kidney disease (Renibacterium salmoninarum)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Bacterial kidney disease (BKD), caused by Renibacterium salmoninarum, is a prevalent disease of salmonid fish that impacts sustainable production for consumption and species conservation efforts. The disease is chronic in nature and mortality most often occurs in juvenile salmonids and prespawning a...

  16. Nutrition and chronic kidney disease

    Microsoft Academic Search

    Denis Fouque; Solenne Pelletier; Denise Mafra; Philippe Chauveau

    2011-01-01

    The incidence of malnutrition disorders in chronic kidney disease (CKD) appears unchanged over time, whereas patient-care and dialysis techniques continue to progress. Despite some evidence for cost-effective treatments, there are numerous caveats to applying these research findings on a daily care basis. There is a sustained generation of data confirming metabolic improvement when patients control their protein intake, even at

  17. Functional MRI of the kidney

    Microsoft Academic Search

    N. Grenier; F. Basseau; M. Ries; B. Tyndal; R. Jones; C. Moonen

    2003-01-01

    Functional MR imaging of the kidney has a great potential of development because the functional parameters, which can be approached noninvasively, are multiple: glomerular filtration, tubular concentration and transit, blood volume and perfusion, diffusion, and oxygenation. Until now, its limitations in clinical applications are due to the difficulties in obtaining reproducible and reliable information in this mobile organ and, sometimes,

  18. Amyloidosis-Associated Kidney Disease

    Microsoft Academic Search

    Laura M. Dember

    2006-01-01

    The amyloidoses are a group of disorders in which soluble proteins aggregate and deposit extracellularly in tissues as insoluble fibrils, causing progressive organ dysfunction. The kidney is one of the most frequent sites of amyloid deposition in AL, AA, and several of the hereditary amyloidoses. Amyloid fibril formation begins with the misfolding of an amyloido- genic precursor protein. The misfolded

  19. Mechanical Ventilation and the Kidney

    Microsoft Academic Search

    Jay L. Koyner; Patrick T. Murray

    2010-01-01

    Acute lung injury (ALI) and acute kidney injury (AKI) are complications often encountered in the setting of critical illness. Both forms of end-organ injury commonly occur in similar settings of systemic inflammatory response syndrome, shock, and evolving multiple organ dysfunction. Recent elucidation of the pathobiology of critical illness has led to a more basic mechanistic understanding of the complex interplay

  20. Statins, inflammation and kidney disease

    Microsoft Academic Search

    Vera Krane; Christoph Wanner

    2011-01-01

    Inflammation is highly prevalent in patients with chronic kidney disease (CKD) and is consistently associated with cardiovascular morbidity and mortality. Clinical event rates increase with declining renal function and activation of the acute-phase response. Statins are potent anti-inflammatory drugs that reduce the incidence of cardiovascular events. Owing to the increased prevalence of inflammation in patients with CKD and the potent

  1. Apparatus for unilateral generation of a homogeneous magnetic field

    DOEpatents

    Fukushima, E.; Rath, A.R.; Roeder, S.B.W.

    1984-05-01

    An apparatus for unilaterally producing a substantially homogeneous magnetic field. The apparatus includes two circular electromagnet coils, a small coil and a large coil, which are coaxial with one another and which are separated by a distance equal to one-half the difference in the radius of the two coils. By appropriate selection of electrical currents, which are passed through the coils in opposite directions, a region of homogeneous magnetic field is formed. This region is centered on the common axis of the two coils, at a point on the axis which is at a distance from the small coil equal to one-half the radius of the small coil, and which is on the opposite side of the small coil from the large coil. The apparatus has particular application in the field of diagnostic medical NMR and other NMR applications.

  2. Apparatus for unilateral generation of a homogeneous magnetic field

    DOEpatents

    Fukushima, Eiichi (Los Alamos, NM); Rath, Alan R. (San Diego, CA); Roeder, Stephen B. W. (La Mesa, CA)

    1988-01-01

    An apparatus for unilaterally producing a substantially homogeneous magnetic field. The apparatus includes two circular electromagnet coils, a small coil and a large coil, which are coaxial with one another and which are separated by a distance equal to one-half the difference in the radius of the two coils. By appropriate selection of electrical currents, which are passed through the coil in opposite directions, a region of homogeneous magnetic field is formed. This region is centered on the common axis of the two coils, at a point on the axis which is at a distance from the small coil equal to one-half the radius of the small coil, and which is on the opposite side of the small coil from the large coil. The apparatus has particular application in the field of diagnostic medical NMR and other NMR applications.

  3. Early cavernous sinus thrombosis following unilateral pansinusitis in a child.

    PubMed

    Mallick, Ajay; Pathak, Som Dutt; Shankar, Sandeep; Sati, Alok

    2015-01-01

    Cavernous sinus thrombosis (CST) is a life-threatening entity with a high rate of mortality and lifelong morbidity. A strong clinical suspicion of the complication, early radiological detection and institution of timely, aggressive treatment are required to prevent permanent neurological disability. We present a 12-year-old girl with bilateral CST following unilateral pansinusitis. Clinical symptoms of headache and retro-orbital pain out of proportion to clinical signs on presentation prompted a suspicion of something beyond sinusitis and raised the clinical suspicion of cavernous sinus involvement. In spite of institution of an early medical treatment, she progressed to develop bilateral cranial nerve paresis. However, with the persistence of antibiotics and anticoagulation therapy, she was successfully managed with no residual neurological sequelae. The aim of this presentation is to highlight the grave consequences of cavernous sinus involvement following infections of paranasal sinus and the rare complete recovery from disability in this case. PMID:25917067

  4. Horizontal sound localization skills of unilaterally hearing-impaired children.

    PubMed

    Humes, L E; Allen, S K; Bess, F H

    1980-01-01

    The present study assessed the horizontal sound localization skills of three groups of subjects; normal-hearing adults, normal-hearing children, and unilaterally hearing-impaired children. The ability of these subjects to localize pure tones to 500 and 3000 Hz in quiet and in a background of cafeteria noise was evaluated using an array of thirteen loudspeakers mounted in a large anechoic chamber. Results indicated a significant effect of signal frequency in all three groups of listeners. In addition, the hearing-impaired children performed significantly poorer than their normal-hearing counterparts in all conditions. Individual differences in sound localization ability among the hearing-impaired listeners could be explained largely through effects of age and degree of hearing impairment. PMID:7425955

  5. Unilateral spiny hyperkeratosis: case report and review of the literature.

    PubMed

    Mevorah, Baruch; Gat, Andrea; Golan, Haim; Brenner, Sarah

    2008-01-01

    We describe the first case of unilateral spiny hyperkeratosis (SH) of the left hand, review the literature and discuss possible patho- mechanisms. SH can be sporadic or familial, often appearing in healthy individuals. However, there is an association with various malignancies in a significant number of the sporadic cases. Although there is no satisfactory explanation of this association, we agree with previous authors that a patient with SH appearing in adult life should be evaluated and followed for the presence of malignancy. Other patients with SH may suffer from a variety of nonmalignant diseases, which may be coincidental or causally related. SH is not a premalignant lesion of the skin and should not be confused with porokeratosis which has a malignant potential. Except for excision of individual lesions, there is no permanent cure. PMID:18577857

  6. Anterior decompression in the management of unilateral cervical spondylotic amyotrophy.

    PubMed

    Zhang, Jing Tao; Yang, Da Long; Shen, Yong; Zhang, Ying Ze; Wang, Lin Feng; Ding, Wen Yuan

    2012-12-01

    Cervical spondylotic amyotrophy is a rare clinical condition. The purpose of this study was to investigate the effects of anterior decompression in patients with unilateral upper-extremity amyotrophy caused by cervical spondylosis. The authors retrospectively analyzed the records of 31 patients (23 men and 8 women) who underwent anterior decompressive surgery for cervical spondylotic amyotrophy at the authors' institution between 2000 and 2011. Demographic characteristics, pre- and postoperative results of imaging studies, and postoperative muscle power improvement were reviewed at a mean follow-up of 22.2 months (range, 14-36 months). Patients were divided into proximal (n=21) and distal (n=10) types according to the most severely atrophic muscle, and the 2 groups were compared statistically. The most commonly affected intervertebral level in proximal-type patients was C4-C5, whereas that in distal-type patients was C5-C6. Impingements against the ventral nerve root and anterior horn were observed in 22 and 25 cases, respectively, with 16 cases having both impingements. Eighty-one percent of proximal-type patients gained 1 or more grades of muscle power improvement on manual muscle testing, whereas 40% of distal-type patients improved. Within 15 postoperative days, 57% of proximal-type patients attained subjective or objective improvement of muscle power, whereas all distal-type patients failed to improve. Anterior decompression was effective for most patients with unilateral cervical spondylotic amyotrophy, although postoperative muscle power improvement in distal-type patients was inferior to that in proximal-type patients. Furthermore, compared with the proximal type, the distal type showed a slower postoperative recovery. PMID:23218638

  7. Radioimmunoassay of inhibin: serum responses to unilateral and bilateral orchidectomy

    SciTech Connect

    Schanbacher, B.

    1988-11-01

    An overnight double antibody RIA using a rabbit antiserum to porcine inhibin alpha-chain (Tyr30) (1-30) NH2 (pI alpha(1-30)), radioiodinated pI alpha(1-30), and a preprecipitated second antibody complex has been developed to measure inhibin concentrations in sera and other biological fluids. The assay is accurate, precise (intraassay coefficient of variation, 4.8%), sensitive (25 pM; 2.5 fmol/tube), and specific for inhibin. The synthetic reference standard pI alpha(1-30) produced a displacement curve that paralleled intact male ovine and bovine sera, crude bovine follicular fluid, and a partially purified porcine follicular fluid reference preparation (WHO/NIH 86/690). Bilateral castration of prepubertal and postpubertal ram lambs resulted in a rapid decrease in serum inhibin concentrations and a subsequent increase in serum FSH. Inhibin levels were high in prepubertal lambs (approximately 375 pM), but these levels were not sustained near the time of puberty (approximately 180 pM). Intensive sampling by jugular venipuncture after castration indicated a 50% drop in circulating inhibin levels within 2 h of testes removal with chronic castrate levels (approximately 75 pM) achieved by 6 h postcastration. A rapid fall in circulating levels of inhibin was also observed after unilateral castration, but these values stabilized within hours to levels intermediate (i.e. approximately 200 pM) to those of intact and bilateral castrate rams. Hemicastrates exhibited a more subtle rise in serum FSH after testis removal, with FSH and inhibin levels of prepubertal hemicastrates returning to mature intact ram values by 15 weeks of age. Serum inhibin levels remained low and FSH levels high at 14 days in unilateral castrate postpubertal rams. Inhibin immunoreactivity increased abruptly in castrate ewes and rams injected iv with 5 ml bovine follicular fluid.

  8. Can internal thoracic arteries be used for both coronary artery bypass and breast reconstruction?

    PubMed Central

    Currie, Maria E.; Fox, Stephanie A.; Greer-Bayramoglu, Rebecca J.; Fortin, Amanda J.; Chu, Michael W. A.

    2012-01-01

    OBJECTIVES Recently, the internal thoracic arteries have been preferentially used in autologous breast reconstruction at the levels of the third or fourth intercostal spaces. This may compromise future treatment of occult coronary disease. We hypothesized that internal thoracic artery length at the fourth intercostal space would allow both breast reconstruction and future coronary artery bypass grafting (CABG). METHODS Anatomic analysis of 20 female patients undergoing CABG was performed examining internal thoracic artery length from its origin to the third, fourth, fifth intercostal spaces and the left anterior descending (LAD) artery target. RESULTS The left internal thoracic artery was anastamosed to the LAD target at a mean length of 11.4 ± 1.4 cm. The mean lengths of the pedicled left internal thoracic artery from its origin to the third, fourth and fifth intercostal space were 8.5 ± 1.0, 10.9 ± 1.2 and 13.0 ± 1.4 cm, respectively. Therefore, the left internal thoracic artery length was adequate at the fourth intercostal space in 6 of 20 (30%) patients. CONCLUSIONS Dissection of the left internal thoracic artery to the fourth intercostal space would allow for concomitant use in CABG and breast reconstruction in one-third of cases. However, skeletonization of the internal thoracic artery at the level of the fourth intercostal space would be sufficient for CABG in all cases following autologous breast reconstruction. PMID:22899665

  9. Pathologic comparison of video-assisted thoracic surgical lung biopsy with traditional open lung biopsy

    Microsoft Academic Search

    Mitsutaka Kadokura; Thomas V. Colby; Jeffrey L. Myers; Mark S. Allen; Claude Deschamps; Victor F. Trastek; Peter C. Pairolero

    1995-01-01

    Video-assisted thoracic surgical lung biopsy is an alternative to traditional open lung biopsy for diagnosis in patients with pleuropulmonary diseases. Between January 7, 1991, and August 3, 1993, 71 consecutive patients had video-assisted thoracic surgical lung biopsy and 42 patients had traditional open lung biopsy. A specific histologic diagnosis that correlated with the clinical findings was sought in each case

  10. A Thoracic Mechanism of Mild Traumatic Brain Injury Due to Blast Pressure Waves

    Microsoft Academic Search

    Amy Courtney; Michael Courtney

    2008-01-01

    The mechanisms by which blast pressure waves cause mild to moderate traumatic brain injury (mTBI) are an open question. Possibilities include acceleration of the head, direct passage of the blast wave via the cranium, and propagation of the blast wave to the brain via a thoracic mechanism. The hypothesis that the blast pressure wave reaches the brain via a thoracic

  11. Comparison of the effect of monopolar and bipolar cauterization on skeletonized, dissected internal thoracic arteries

    Microsoft Academic Search

    Hiroki Yoshida; Moses Hong-De Wu; Yasuhiro Kouchi; Yoko Onuki; Qun Shi; Lester R. Sauvage

    1995-01-01

    The internal thoracic artery is preferable to the saphenous vein for use as a conduit for coronary artery bypass. More extensive use is possible if this artery is mobilized in a skeletonized form to provide greater length. Internal thoracic arteries are usually mobilized with cauterization. This study compared the effectiveness and effects on neighboring areas of division of the branches

  12. 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

  13. Propranolol for the prevention of postoperative arrhythmias in general thoracic surgery

    Microsoft Academic Search

    Charles D Bayliff; David R Massel; Richard I Inculet; Richard A Malthaner; Susan D Quinton; Frank S Powell; Renee S Kennedy

    1999-01-01

    Background. Prevention of postoperative arrhythmias in patients undergoing general thoracic surgery is desirable to prevent morbidity.Methods. A randomized, double-blind, placebo controlled trial of propranolol (10 mg every 6 hours) for 5 days was undertaken in patients undergoing major thoracic operations to determine whether arrhythmias requiring treatment could be reduced. Secondary outcomes included overall arrhythmia rate, adverse events, and length of

  14. A Preliminary Experimental Study of Boron Neutron Capture Therapy for Malignant Tumors Spreading in Thoracic Cavity

    Microsoft Academic Search

    Minoru Suzuki; Yoshinori Sakurai; Shinichiro Masunaga; Yuko Kinashi; Kenji Nagata; Akira Maruhashi; Koji Ono

    Background: The purpose of the present study is to verify the treatment effects of boron neutron capture therapy (BNCT) in ectopic tumors implanted in the thoracic cavity mimicking malignant pleural mesothelioma (MPM). Methods: The tumor model was created by implanting murine squamous cell carcinoma cells into the thoracic cavity. Mice were sorted into four groups: group I for non-treatment; group

  15. Upper thoracic-spine disc degeneration in patients with cervical pain

    Microsoft Academic Search

    Estanislao Arana; Luis Martí-Bonmatí; Enrique Mollá; Salvador Costa

    2004-01-01

    Objective To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established. Design and patients One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean

  16. Superior diagnostic value of captopril(CAP)-enhanced noninvasive studies in unilateral renal artery stenosis(uRAS)

    SciTech Connect

    Nally, J.V.; Clarke, H.S.; Grecos, G.P.; Saunders, M.; Gross, M.L.; Windham, J.P.

    1985-05-01

    To assess the effect of CAP on individual kidney function in ..mu..RAS, the authors compared computer assisted 90 second and 15 minute /sup 99m/Tc-DTPA renal flow studies vs /sup 131/I-Hippuran renography with and without CAP. In Group 1 (n=10), angiograms, split function C/sub PAH/, DTPA and Hippuran studies were performed in dogs pre and post ..mu..RAS. Group II animals (n=8) with milder stenosis underwent the same protocol, plus DTPA and Hippuran studies, C/sub PAH/, and C/sub IN/ were performed during CAP (Captopril 1.5 mg/kg bolus and 1.5 mg/min x 60 min.) Recovery DTPA and Hippuran studies (Rec) were performed and were also obtained using nitroprusside (NP) to lower MP to a similar degree as CAP. The authors conclude /sup 99m/Tc-DTPA studies proved superior to Hipurran renography in both Groups I and II. With mild ..mu..RAS, CAP induced a decrease in ipsilateral GFR resulting in striking changes in the /sup 99m/Tc-DTPA curves such that all were now diagnostic of uRAS. These changes appeared specific for CAP and independent of MAP reduction with NP, and /sup 99m/Tc-DTPA renal flow studies with CAP unmask unilateral angiotension II dependent renal hemodynamic changes.

  17. Unilateral renal phaeohyphomycosis due to Bipolaris spicifera in an immunocompetent child - rare case presentation and review of literature.

    PubMed

    Kaur, Ravinder; Bala, Kiran

    2015-07-01

    Phaeohyphomycosis refers to infections caused by phaeoid fungi that can have an aggressive course in normal hosts. We report a case of left-sided renal phaeohyphomycosis due to Bipolaris spicifera in a 7-year-old immunocompetent male child. He presented with fever, dysuria, nausea, vomiting and flank pain. Examination revealed tenderness at the left costovertebral angle. Histological examination and culture of biopsy from left kidney and blood yielded the fungal pathogen Bipolaris spicifera. His past history revealed that he was diagnosed perinatally with bilateral hydronephrosis due to bilateral pelvic ureteric junction obstruction. He underwent an open dismembered pyeloplasty on the left side followed by the right side pyeloplasty at the age of 6 months and 1.5 years respectively. He was on a regular follow-up for 5 years and had been doing well. Now he was diagnosed as a case of unilateral renal phaeohyphomycosis. The patient was managed successfully with antifungal drugs amphotericin B and itraconazole. A review of previously reported bipolaris cases with their clinical manifestations, treatment and outcome is presented. Renal phaeohyphomycosis remains an unusual disease. Aggressive diagnostic approaches and careful management helped in survival of the patient. PMID:26058420

  18. Unmasked renal impairment and prolonged hyperkalemia after unilateral adrenalectomy for primary aldosteronism coexisting with primary hyperparathyroidism: report of a case.

    PubMed

    Hibi, Yatsuka; Hayakawa, Nobuki; Hasegawa, Midori; Ogawa, Kimio; Shimizu, Yoshimi; Shibata, Masahiro; Kagawa, Chikara; Mizuno, Yutaka; Yuzawa, Yukio; Itoh, Mitsuyasu; Iwase, Katsumi

    2015-02-01

    We herein report the case of a patient with critical hyperkalemia after unilateral adrenalectomy (ADX) for aldosterone-producing adenomas, which were coexisting with primary hyperparathyroidism. A right adrenal tumor oversecreting mineral corticoid was identified in a 62-year-old female whose kidney function had been impaired due to primary hyperaldosteronism and hyperparathyroidism. The ADX improved her hypertension with normalization of the plasma aldosterone concentration, but without adequately increasing her plasma renin activity. Her eGFR further decreased postoperatively, hyperkalemia appeared and the serum potassium level rose to 6.3 mEq/L at 3 months after ADX. Then, treatment with calcium polystyrene sulfonate jelly was started. Eight months after ADX, a left lower parathyroidectomy was performed, and the serum calcium and intact parathyroid hormone levels decreased to the normal range. The hyperkalemia was difficult to control within 20 months postoperatively without treatment with calcium polystyrene sulfonate jelly or hydrocortisone. This suggests that unmasking the renal impairment and relative hypoaldosteronism after ADX might induce critical hyperkalemia. PMID:24343173

  19. [Perioperative anticoagulant and antiplatelet treatment in general thoracic surgery].

    PubMed

    Schnell, J; Koryllos, A; Stoelben, E; Schlößer, B

    2014-09-01

    The perioperative use of anticoagulants in general thoracic surgery can be considered to be a "two-edged sword": the goal to minimise the risk of a thromboembolic episode is contrary to the ongoing effort of the surgeon to minimise the risk of intra- and postoperative blood loss. Dispositional factors such as excessive tobacco use are common for thoracic surgery patients and often lead to cardiovascular comorbidity which necessitates the use of anticoagulants or antiplatelet drugs. For deep venous thrombosis prophylaxis and for the indication and use of vitamin K antagonists or antiplatelet drugs it is proven in the literature that the risk profile of the patient and his/her classification in the appropriate risk group are of major importance. Through the individual risk profile of the patient it is possible to plan the appropriate perioperative anticoagulant therapy which will safely assist the surgeon and his/her patient during the peri- and postoperative phase on the knife-edge between blood loss and eminent thromboembolism. Unfortunately there are not enough existing data and published literature for evidence-based guidelines referring to the correct perioperative management for the new oral anticoagulants. Management algorithms are being recommended according to the multiple aspects of anticoagulant-treatment. PMID:25264718

  20. Breast Surgery Using Thoracic Paravertebral Blockade and Sedation Alone

    PubMed Central

    Ariyarathenam, Arun; Dunn, Julie; Ford, Pete

    2014-01-01

    Introduction. Thoracic paravertebral block (TPVB) provides superior analgesia for breast surgery when used in conjunction with general anesthesia (GA). Although TPVB and GA are often combined, for some patients GA is either contraindicated or undesirable. We present a series of 28 patients who received a TPVB with sedation alone for breast cancer surgery. Methods. A target controlled infusion of propofol or remifentanil was used for conscious sedation. Ultrasound guided TPVB was performed at one, two, or three thoracic levels, using up to 30?mL of local anesthetic. If required, top-up local infiltration analgesia with prilocaine 0.5% was performed by the surgeon. Results. Most patients were elderly with significant comorbidities and had TPVB injections at just one level (54%). Patient choice and anxiety about GA were indications for TVPB in 9 patients (32%). Prilocaine top-up was required in four (14%) cases and rescue opiate analgesia in six (21%). Conclusions. Based on our technique and the outcome of the 28 patients studied, TPVB with sedation and ultrasound guidance appears to be an effective and reliable form of anesthesia for breast surgery. TPVB with sedation is a useful anesthetic technique for patients in which GA is undesirable or poses an unacceptable risk. PMID:25214832

  1. Anatomic Variations of Cervical and High Thoracic Ligamentum Flavum

    PubMed Central

    Yoon, Sang Pil; Kim, Hyun Jung

    2014-01-01

    Background Epidural blocks are widely used for the management of acute and chronic pain. The technique of loss of resistance is frequently adopted to determine the epidural space. A discontinuity of the ligamentum flavum may increase the risk of failure to identify the epidural space. The purpose of this study was to investigate the anatomic variations of the cervical and high thoracic ligamentum flavum in embalmed cadavers. Methods Vertebral column specimens of 15 human cadavers were obtained. After vertebral arches were detached from pedicles, the dural sac and epidural connective tissue were removed. The ligamentum flavum from C3 to T6 was directly examined anteriorly. Results The incidence of midline gaps in the ligamentum flavum was 87%-100% between C3 and T2. The incidence decreased below this level and was the lowest at T4-T5 (8%). Among the levels with a gap, the location of a gap in the caudal third of the ligamentum flavum was more frequent than in the middle or cephalic portion of the ligamentum flavum. Conclusions The cervical and high thoracic ligamentum flavum frequently has midline intervals with various features, especially in the caudal portion of the intervertebral space. Therefore, the ligamentum flavum is not always reliable as a perceptible barrier to identify the epidural space at these vertebral levels. Additionally, it may be more useful to insert the needle into the cephalic portion of the intervertebral space than in the caudal portion. PMID:25317280

  2. Early structural changes in sheep lung following thoracic irradiation

    SciTech Connect

    Guerry-Force, M.L.; Perkett, E.A.; Brigham, K.L.; Meyrick, B.

    1988-04-01

    Using a large animal model of radiation lung injury--the sheep exposed to bilateral thoracic irradiation--we have recently shown the development of sustained pulmonary hypertension during the first 4 weeks following radiation. This is the period prior to the onset of pneumonitis and pulmonary fibrosis. In the present study, we have examined biopsy and autopsy lung tissue from these same sheep and assessed the sequential changes in lung morphology. Six unanesthetized sheep received bilateral thoracic irradiation (a total of 15 Gy); control sheep were sham irradiated. Lung biopsy tissue was taken prior to and at weekly or biweekly intervals during the 4 weeks immediately following radiation. The lungs were also removed at autopsy for light and electron microscopic examination. Our results show early (Week 1) interstitial and progressive intraalveolar edema accompanied by endothelial and epithelial injury. A gradual increase in number of interstitial mononuclear cells was evident from Week 1, both in the lung tissue and in perivascular cuffs. The number of peripheral lung interstitial mononuclear cells was twice baseline from Week 3 and included accumulation of lymphocytes, fibroblasts, and intravascular macrophages. The increased numbers of mononuclear cells paralleled the development of chronic pulmonary hypertension, perhaps suggesting their involvement in the pathogenesis of this disease. Alternatively, it may be that increased mononuclear cell number represents a stage of lung repair.

  3. Thoracic sympathetic nerve reconstruction for compensatory hyperhidrosis: the Melbourne technique

    PubMed Central

    Hensman, Chris; Leong, James

    2014-01-01

    Background Compensatory hyperhidrosis (CH) is a potential complication following endoscopic thoracic sympathectomy (ETS) in the management of primary hyperhidrosis. CH is considered a permanent condition with significant psychosocial impacts but with few treatment options. Various reversal surgical techniques, aimed at reconstituting sympathetic pathways, have been developed but results have been inconsistent. Objective We present two case reports of a novel technique of reversal surgery, the Melbourne technique, which was employed to treat severe CH that developed within 3-5 months following ETS. Both patients were followed-up to 8 years. Methods The Melbourne technique employs an endoscopic approach to expose previously sympathectomized or sympathotomized thoracic sympathetic chains. In these two cases it was performed on the right side only. Instead of an interpositional nerve graft, an autogenous vein graft was simultaneously harvested and used as a nerve conduit to bridge the secondary nerve defect after neuroma excision. Long-term outcomes were assessed using the dermatology life quality index (DLQI) and the quality of life (QoL) questionnaires, which are validated for hyperhidrosis. Results In both cases, patients reported postoperative improvements in QoL scores. However, the improvement was more marked in one case compared with the other. There were no significant immediate and long-term postoperative complications. Conclusions The Melbourne technique shows promise as an alternative to interpositional nerve grafts or nerve transfers employed in other endoscopic reversal surgeries for CH. PMID:25333020

  4. Interactive annotation of textures in thoracic CT scans

    NASA Astrophysics Data System (ADS)

    Kockelkorn, Thessa T. J. P.; de Jong, Pim A.; Gietema, Hester A.; Grutters, Jan C.; Prokop, Mathias; van Ginneken, Bram

    2010-03-01

    This study describes a system for interactive annotation of thoracic CT scans. Lung volumes in these scans are segmented and subdivided into roughly spherical volumes of interest (VOIs) with homogeneous texture using a clustering procedure. For each 3D VOI, 72 features are calculated. The observer inspects the scan to determine which textures are present and annotates, with mouse clicks, several VOIs of each texture. Based on these annotations, a k-nearest-neighbor classifier is trained, which classifies all remaining VOIs in the scan. The algorithm then presents a slice with suggested annotations to the user, in which the user can correct mistakes. The classifier is retrained, taking into account these new annotations, and the user is presented another slice for correction. This process continues until at least 50% of all lung voxels in the scan have been classified. The remaining VOIs are classified automatically. In this way, the entire lung volume is annotated. The system has been applied to scans of patients with usual and non-specific interstitial pneumonia. The results of interactive annotation are compared to a setup in which the user annotates all predefined VOIs manually. The interactive system is 3.7 times as fast as complete manual annotation of VOIs and differences between the methods are similar to interobserver variability. This is a first step towards precise volumetric quantitation of texture patterns in thoracic CT in clinical research and in clinical practice.

  5. Entrainment of circadian rhythms: retinofugal pathways and unilateral suprachiasmatic nucleus lesions.

    PubMed

    Donaldson, J A; Stephan, F K

    1982-12-01

    The role of retinohypothalamic input to the suprachiasmatic nuclei (SCN) as well as SCN afferents from the ventrolateral geniculate nuclei (LGNV) in the entrainment of circadian drinking rhythms was investigated in the rat. Bilateral lesions of the LGNV and the primary optic tracts had no affect on the entrainment of drinking rhythms to a light-dark cycle, the response to a 12 hr phase shift of the light-dark cycle, or on the period of the free-running circadian rhythm in constant light or constant darkness. Unilateral blinding in rats with or without LGNV lesions retarded the rate of phase shifting by 2 days and decreased the period of the free-running rhythm in constant light. For rats with unilateral SCN lesions, or such lesions combined with either ipsi- or contra-lateral blinding, the rate of re-entrainment was intermediate between intact and unilaterally blinded rats indicating that unilateral SCN lesions partially reversed the effects of unilateral blinding. Unilateral SCN lesions had no effect on the period of the free-running rhythm in constant light or darkness. These results are consistent with the interpretation that the asymmetrical innervation of the two SCN by the RHT in unilaterally blinded rats delays re-entrainment by changing the phase response curve of the circadian system. This change may be mediated by neural connections between the two SCN. PMID:7163396

  6. Comparison of weight changes following unilateral and staged bilateral STN DBS for advanced PD

    PubMed Central

    Lee, Eric M; Kurundkar, Ashish; Cutter, Gary R; Huang, He; Guthrie, Barton L; Watts, Ray L; Walker, Harrison C

    2011-01-01

    Unilateral and bilateral subthalamic nucleus deep brain stimulation (STN DBS) in Parkinson's disease (PD) result in weight gain in the initial postoperative months, but little is known about the changes in weight following unilateral and staged bilateral STN DBS over longer time intervals. A case–control comparison evaluated weight changes over 2 years in 43 consecutive unilateral STN DBS patients, among whom 25 elected to undergo staged bilateral STN DBS, and 21 age-matched and disease severity matched PD controls without DBS. Regression analyses incorporating age, gender, and baseline weight in case or control were conducted to assess weight changes 2 years after the initial unilateral surgery. Unilateral STN DBS and staged bilateral STN DBS patients gained 3.9 ± 2.0 kg and 5.6 ± 2.1 kg versus their preoperative baseline weight (P < 0.001, respectively) while PD controls without DBS lost 0.8 ± 1.1 kg. Although bilateral STN DBS patients gained 1.7 kg more than unilateral STN DBS patients at 2 years, this difference was not statistically significant (P = 0.885). Although there was a trend toward greater weight gain in staged bilateral STN DBS patients versus unilateral patients, we found no evidence for an equivalent or synergistic increase in body weight following placement of the second DBS electrode. PMID:22398977

  7. Parasites in the thoracic ganglion of Pachygrapsus marmoratus (Brachyura: Grapsidae) from the coast of Portugal.

    PubMed

    Kuris, A M; Torchin, M E; Lafferty, K D

    2004-12-01

    We examined 149 marbled shore crabs, Pachygrapsus marmoratus, from the coast of Portugal for parasites. In particular, we focused our effort on the crab thoracic ganglion. The thoracic ganglion is the largest concentration of nervous tissue in a crab and thus, parasites associated with this organ are well situated to influence host behavior. We found metacercariae of two microphallid trematode species in the thoracic ganglion. We also found a microsporan and an apicomplexan associated with the thoracic ganglion. Other parasites not associated with the thoracic ganglion included gregarine trophozoites which were present in the digestive diverticulae in some of the crabs and the entoniscid isopod, Grapsion cavolini. Metacercariae of one of the trematodes (probably Microphallus pachygrapsi (Deblock and Prevot)), may influence the mortality of its host. PMID:15638146

  8. Kidney disease associated with plasma cell dyscrasias.

    PubMed

    Heher, Eliot C; Goes, Nelson B; Spitzer, Thomas R; Raje, Noopur S; Humphreys, Benjamin D; Anderson, Kenneth C; Richardson, Paul G

    2010-09-01

    Plasma cell dyscrasias are frequently encountered malignancies often associated with kidney disease through the production of monoclonal immunoglobulin (Ig). Paraproteins can cause a remarkably diverse set of pathologic patterns in the kidney and recent progress has been made in explaining the molecular mechanisms of paraprotein-mediated kidney injury. Other recent advances in the field include the introduction of an assay for free light chains and the use of novel antiplasma cell agents that can reverse renal failure in some cases. The role of stem cell transplantation, plasma exchange, and kidney transplantation in the management of patients with paraprotein-related kidney disease continues to evolve. PMID:20462963

  9. Kidney disease associated with plasma cell dyscrasias

    PubMed Central

    Goes, Nelson B.; Spitzer, Thomas R.; Raje, Noopur S.; Humphreys, Benjamin D.; Anderson, Kenneth C.; Richardson, Paul G.

    2010-01-01

    Plasma cell dyscrasias are frequently encountered malignancies often associated with kidney disease through the production of monoclonal immunoglobulin (Ig). Paraproteins can cause a remarkably diverse set of pathologic patterns in the kidney and recent progress has been made in explaining the molecular mechanisms of paraprotein-mediated kidney injury. Other recent advances in the field include the introduction of an assay for free light chains and the use of novel antiplasma cell agents that can reverse renal failure in some cases. The role of stem cell transplantation, plasma exchange, and kidney transplantation in the management of patients with paraprotein-related kidney disease continues to evolve. PMID:20462963

  10. The Bergamo Kidney Transplant Program.

    PubMed

    Perico, Norberto; Cravedi, Paolo; Ruggenenti, Piero; Gotti, Eliana; Rota, Giovanni; Locatelli, Giuseppe; Gambara, Vincenzo; Perna, Annalisa; Rota, Stefano; Remuzzi, Giuseppe

    2005-01-01

    Since the beginning of transplant activities in 1989, the Kidney Transplant Center at the Ospedali Riuniti Bergamo has based its clinical program on the most recent achievements of transplant medicine, in order to optimize the outcome of kidney grafts and improve the quality of life of kidney transplant recipients. Although the transplantation community attempts to keep up with increasing demand for transplantable organs, the supply continues to fall far short of the need. This observation prompted us to focus on the expansion of the available pool of deceased donor organs. In 1997, we established a dual kidney transplant program for donors older than 60 years based on a pretransplant histology protocol with a scoring system ranging from low-dose RATG and delayed CsA administration has been successfully adopted in this population of kidney transplant recipients in our routine clinic practice. In kidney transplantation, chronic deterioration of renal function and death with a functioning graft, mainly due to side effects of the medications, represents a major limitation for long-term success of many transplant programs. We recently documented that per-protocol biopsy more than one year after kidney transplantation is a safe procedure to guide change of conventional immunosuppressive regimens and to lower the risk of major drug-related side effects. In particular, substantial reduction of the CsA dose, leading to extremely low CsA trough level, has no major detrimental effect on renal function and histology during 3 years follow-up, while patients remain free of rejection episodes with concomitant steroid and azathioprine therapy. Novel induction therapies with Campath-1H or Simulect and low-RATG have also helped to minimize maintenance immunosuppression in most patients largely avoiding the use of corticosteroids, Monitoring a patient's exposure to immunosuppressive agents is a critical issue in a minimum of 0 (no renal lesions) to a maximum of 12 (marked changes in renal parenchyma). The assumptions of the proposed algorithm to guide acceptance of single suboptimal or dual marginal kidneys for transplantation were validated in a prospective pilot study involving centers in Europe and North America. Whether the encouraging short-term data translate into improved graft survival is currently a matter of investigation in a prospective, multicenter, matched-cohort trial. As kidneys from marginal donors have an increased risk of delayed graft function, we also studied strategies to manage and prevent this complication. A dual immunosuppressive regimen of basiliximab and transplantation. By pharmacokinetics studies, we documented that a fixed dose regimen of MMF--adopted in the majority of transplant units worldwide--might no longer be the best approach for the management of transplant patients, and MPA pharmacokinetic monitoring is advised. Similarly, we reported pharmacokinetic interaction of concomitant immunosuppression on blood levels of the new immunosuppressant sirolimus. We have a special multiorgan transplant program at our center for patients affected by rare diseases, such as the recurrent hemolytic uremic syndrome (HUS). Based on genotyping for complement factor H-1, membrane co-factor protein or factor I gene mutations, we are exploring the possibility of combining liver and renal transplant or performing renal transplant alone in patients with recurrent HUS who have end-stage renal disease. The achievements of our clinical center are the result of the continuous support by an intense clinical and basic research program. This has allowed us to create a unique model to address the major challenges of transplant medicine. PMID:17424727

  11. A case report of thoracic compartment syndrome in the setting of penetrating chest trauma and review of the literature

    Microsoft Academic Search

    Michael W Wandling; Gary C An

    2010-01-01

    Trauma-related thoracic compartment syndrome (TCS) is a rare, life threatening condition that develops secondary to elevated intra-thoracic pressure and manifests itself clinically as significantly elevated airway pressures, inability to provide adequate ventilation and hemodynamic instability temporally related to closure of a thoracic surgical incision. TCS is exceedingly rare in the trauma population. We present a case of TCS following surgical

  12. A neural correlate of visceral emotional responses: evidence from fMRI of the thoracic spinal cord

    E-print Network

    Smith, Stephen D.

    A neural correlate of visceral emotional responses: evidence from fMRI of the thoracic spinal cord Functional magnetic resonance imaging (fMRI) of thoracic spinal cord neurons was used to examine the neural; functional MRI; spinal cord; thoracic spinal cord; emotion A core feature of emotional experience

  13. Hand-Held Thoracic Sonography for Detecting Post-Traumatic Pneumothoraces: The Extended Focused Assessment With Sonography For Trauma (EFAST)

    Microsoft Academic Search

    A. W. Kirkpatrick; M. Sirois; K. B. Laupland; D. Liu; K. Rowan; C. G. Ball; S. M. Hameed; R. Brown; R. Simons; S. A. Dulchavsky; D R. Hamiilton; S Nicolaou

    2004-01-01

    Background: Thoracic ultrasound (EFAST) has shown promise in inferring the presence of post-traumatic pneumo- thoraces (PTXs) and may have a particu- lar value in identifying occult pneumotho- races (OPTXs) missed by the AP supine chest radiograph (CXR). However, the di- agnostic utility of hand-held US has not been previously evaluated in this role. Methods: Thoracic US examinations were performed during

  14. Gauze packing as damage control for uncontrollable haemorrhage in severe thoracic trauma

    PubMed Central

    Toyoda, H; Harunari, N; Iwashita, M; Kosuge, T; Arata, S; Suzuki, N

    2013-01-01

    Introduction The usefulness of thoracic damage control (DC) for trauma requiring a thoracotomy is not established. The aim of this study was to clarify the usefulness of thoracic packing as DC surgery. Methods This was a retrospective case series study of 12 patients with thoracic trauma suffering uncontrollable intrathoracic haemorrhage and shock who underwent intrathoracic packing. Our thoracic DC technique consisted of ligation and packing over the bleeding point or filling gauze in the bleeding spaces as well as packing for the thoracotomy wound. The success rates of intrathoracic haemostasis, changes in the circulation and the volume of discharge from the thoracic tubes were evaluated. Results Packing was undertaken for the thoracic wall in five patients, for the lung in four patients, for the vertebrae in two patients and for the descending thoracic aorta in one patient. Haemostasis was achieved successfully in seven cases. Of these, the volume of discharge from the thoracic tube exceeded 400ml/hr within three hours after packing in three patients, decreased to less than 200ml/hr within seven hours in six patients and decreased to 100ml/hr within eight hours in six patients. Systolic pressure could be maintained over 70mmHg by seven hours after packing. Conclusions Intrathoracic packing is useful for some patients, particularly in the space around the vertebrae, at the lung apex, and between the diaphragm and the thoracic wall. After packing, it is advisable to wait for three hours to see whether vital signs can be maintained and then to wait further to see if the discharge from the thoracic tube decreases to less than 200ml/hr within five hours. PMID:23317720

  15. New loci associated with kidney function and chronic kidney disease

    Microsoft Academic Search

    Anna Köttgen; Cristian Pattaro; Carsten A Böger; Christian Fuchsberger; Matthias Olden; Nicole L Glazer; Afshin Parsa; Xiaoyi Gao; Qiong Yang; Albert V Smith; Jeffrey R O'Connell; Man Li; Helena Schmidt; Toshiko Tanaka; Aaron Isaacs; Shamika Ketkar; Shih-Jen Hwang; Andrew D Johnson; Abbas Dehghan; Alexander Teumer; Guillaume Paré; Elizabeth J Atkinson; Tanja Zeller; Kurt Lohman; Marilyn C Cornelis; Nicole M Probst-Hensch; Florian Kronenberg; Anke Tönjes; Caroline Hayward; Thor Aspelund; Gudny Eiriksdottir; Lenore J Launer; Tamara B Harris; Evadnie Rampersaud; Braxton D Mitchell; Dan E Arking; Eric Boerwinkle; Maksim Struchalin; Margherita Cavalieri; Andrew Singleton; Francesco Giallauria; Jeffrey Metter; Ian H de Boer; Talin Haritunians; Thomas Lumley; David Siscovick; Bruce M Psaty; M Carola Zillikens; Ben A Oostra; Mary Feitosa; Michael Province; Mariza de Andrade; Stephen T Turner; Arne Schillert; Andreas Ziegler; Philipp S Wild; Renate B Schnabel; Sandra Wilde; Thomas F Munzel; Tennille S Leak; Thomas Illig; Norman Klopp; Christa Meisinger; H-Erich Wichmann; Wolfgang Koenig; Lina Zgaga; Tatijana Zemunik; Ivana Kolcic; Cosetta Minelli; Frank B Hu; Åsa Johansson; Wilmar Igl; Ghazal Zaboli; Sarah H Wild; Alan F Wright; Harry Campbell; David Ellinghaus; Stefan Schreiber; Yurii S Aulchenko; Janine F Felix; Fernando Rivadeneira; Andre G Uitterlinden; Albert Hofman; Medea Imboden; Dorothea Nitsch; Anita Brandstätter; Barbara Kollerits; Lyudmyla Kedenko; Reedik Mägi; Michael Stumvoll; Peter Kovacs; Mladen Boban; Susan Campbell; Karlhans Endlich; Henry Völzke; Heyo K Kroemer; Matthias Nauck; Uwe Völker; Ozren Polasek; Veronique Vitart; Sunita Badola; Alexander N Parker; Paul M Ridker; Sharon L R Kardia; Stefan Blankenberg; Yongmei Liu; Gary C Curhan; Andre Franke; Thierry Rochat; Bernhard Paulweber; Inga Prokopenko; Wei Wang; Vilmundur Gudnason; Alan R Shuldiner; Josef Coresh; Reinhold Schmidt; Luigi Ferrucci; Michael G Shlipak; Cornelia M van Duijn; Ingrid Borecki; Bernhard K Krämer; Igor Rudan; Ulf Gyllensten; James F Wilson; Jacqueline C Witteman; Peter P Pramstaller; Rainer Rettig; Nick Hastie; Daniel I Chasman; W H Kao; Iris M Heid; Caroline S Fox

    2010-01-01

    Chronic kidney disease (CKD) is a significant public health problem, and recent genetic studies have identified common CKD susceptibility variants. The CKDGen consortium performed a meta-analysis of genome-wide association data in 67,093 individuals of European ancestry from 20 predominantly population-based studies in order to identify new susceptibility loci for reduced renal function as estimated by serum creatinine (eGFRcrea), serum cystatin

  16. Chronic kidney disease (CKD) in disadvantaged populations

    PubMed Central

    Garcia-Garcia, Guillermo; Jha, Vivekanand

    2015-01-01

    Twelve March 2015 will mark the 10th anniversary of World Kidney Day (WKD), an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has become the most successful effort ever mounted to raise awareness among decision-makers and the general public about the importance of kidney disease. Each year WKD reminds us that kidney disease is common, harmful and treatable. The focus of WKD 2015 is on chronic kidney disease (CKD) in disadvantaged populations. This article reviews the key links between poverty and CKD and the consequent implications for the prevention of kidney disease and the care of kidney patients in these populations. PMID:25713703

  17. Combined effect of hyperfiltration and renin angiotensin system activation on development of chronic kidney disease in diabetic db/db mice

    PubMed Central

    2014-01-01

    Background Hypertension is a major risk factor for renal disease progression. However, the mechanisms by which hypertension aggravates the effects of diabetes on the kidney are incompletely understood. We tested the hypothesis that renovascular hypertension accelerates angiotensin-II-dependent kidney damage and inflammation in the db/db mouse, a model of type II diabetes. Methods Renovascular hypertension was established in db/db and wild-type control mice through unilateral renal artery stenosis (RAS); the non-stenotic contralateral kidneys evaluated 2, 4 and 6 weeks later. Angiotensin-II infusion (1000 ng/kg/min), unilateral nephrectomy, or both were also performed in db/db mice to discern the contributions of hypertension versus hyperfiltration to development of chronic renal injury in db/db mice with RAS. The effect of blood pressure reduction in db/db mice with RAS was assessed using angiotensin-receptor-blocker (ARB) or hydralazine treatment. Results Db/db mice with renovascular hypertension developed greater and more prolonged elevation of renin activity than all other groups studied. Stenotic kidneys of db/db mice developed progressive interstitial fibrosis, tubular atrophy, and interstitial inflammation. Contralateral kidneys of wild type mice with RAS showed minimal histopathologic abnormalities, whereas db/db mice with RAS developed severe diffuse mesangial sclerosis, interstitial fibrosis, tubular atrophy, and interstitial inflammation. Db/db mice with Angiotensin II-induced hypertension developed interstitial lesions and albuminuria but not mesangial matrix expansion, while nephrectomized db/db mice exhibited modest mesangial expansion and interstitial fibrosis, but not significant albuminuria. The combination of unilateral nephrectomy and angiotensin II infusion reproduced all the features of the injury albeit in a less severe manner. ARB and hydralazine were equally effective in attenuating the development of mesangial expansion in the contralateral kidneys of db/db mice with RAS. However, only ARB prevented elevation of urinary albumin/creatinine in db/db mice with RAS. Conclusion Renovascular hypertension superimposed on diabetes exacerbates development of chronic renal disease in db/db mice at least in part through interaction with the renin-angiotensin system. Both ARB and hydralazine were equally effective in reducing systolic blood pressure and in preventing renal injury in the contralateral kidney of db/db mice with renal artery stenosis. ARB but not hydralazine prevented elevation of urinary albumin/creatinine in the db/db RAS model. PMID:24708836

  18. Thoracic hyperextension injury with complete “bony disruption” of the thoracic cage: Case report of a potentially life-threatening injury

    PubMed Central

    2012-01-01

    Background Severe chest wall injuries are potentially life-threatening injuries which require a standardized multidisciplinary management strategy for prevention of posttraumatic complications and adverse outcome. Case presentation We report the successful management of a 55-year old man who sustained a complete “bony disruption” of the thoracic cage secondary to an “all-terrain vehicle” roll-over accident. The injury pattern consisted of a bilateral “flail chest” with serial segmental rib fractures, bilateral hemo-pneumothoraces and pulmonary contusions, bilateral midshaft clavicle fractures, a displaced transverse sternum fracture with significant diastasis, and an unstable T9 hyperextension injury. After initial life-saving procedures, the chest wall injuries were sequentially stabilized by surgical fixation of bilateral clavicle fractures, locked plating of the displaced sternal fracture, and a two-level anterior spine fixation of the T9 hyperextension injury. The patient had an excellent radiological and physiological outcome at 6?months post injury. Conclusion Severe chest wall trauma with a complete “bony disruption” of the thoracic cage represents a rare, but detrimental injury pattern. Multidisciplinary management with a staged timing for addressing each of the critical injuries, represents the ideal approach for an excellent long-term outcome. PMID:22587588

  19. Toward the wearable artificial kidney.

    PubMed

    Ronco, Claudio; Davenport, Andrew; Gura, Victor

    2008-07-01

    The evolution of technology in hemodialysis has gone through several steps including the feasibility phase, the search for reliability, the implementation of automation to improve efficiency and the quest towards increased tolerance and treatment adequacy. Today, a new challenge is appearing on the scene and it concerns miniaturization, transportability, wearability and the possibility of developing implantable devices for renal replacement therapies. Although we are not there yet, a new series of papers have recently been published disclosing interesting and promising results on the application of wearable ultrafiltration systems (WUF) and wearable artificial kidneys (WAK). Some of these use extracorporeal blood cleansing as a method of blood purification while others use peritoneal dialysis as a treatment modality. This manuscript presents the initial results with these new devices and proposes an effort to make a quantum leap in technology making the wearable artificial kidney a reality rather than a dream. PMID:18638240

  20. Percutaneous Ablation in the Kidney

    PubMed Central

    Wood, Bradford J.; Gervais, Debra A.

    2011-01-01

    Percutaneous ablation in the kidney is now performed as a standard therapeutic nephron-sparing option in patients who are poor candidates for resection. Its increasing use has been largely prompted by the rising incidental detection of renal cell carcinomas with cross-sectional imaging and the need to preserve renal function in patients with comorbid conditions, multiple renal cell carcinomas, and/or heritable renal cancer syndromes. Clinical studies to date indicate that radiofrequency ablation and cryoablation are effective therapies with acceptable short- to intermediate-term outcomes and with a low risk in the appropriate setting, with attention to pre-, peri-, and postprocedural detail. The results following percutaneous radiofrequency ablation and cryoablation in the treatment of renal cell carcinoma are reviewed in this article, including those of several larger scale studies of ablation of T1a tumors. Clinical and technical considerations unique to ablation in the kidney are presented, and potential complications are discussed. © RSNA, 2011 PMID:22012904

  1. Ulinastatin attenuates renal interstitial inflammation and inhibits fibrosis progression in rats under unilateral ureteral obstruction.

    PubMed

    Jiang, Guo-Tao; Chen, Xiao; Li, Dong; An, Hui-Xia; Jiao, Jun-Dong

    2014-09-01

    The aim of the present study was to examine the protective effects of the urinary trypsin inhibitor ulinastatin (UTI) on renal interstitial inflammation and fibrosis in rats subjected to unilateral ureteral obstruction (UUO). A total of 24 male Wistar rats were randomly divided into the three groups; the sham operation (SOR) group (n=8), the UUO group (n=8) and the UUO+UTI group (post?UUO UTI treatment, n=8). UUO was performed with complete ligation of the left ureter. As a medical intervention, saline (4 ml kg?1 d?1) and UTI (40000 units kg?1 d?1) were injected, respectively, into the animals of the corresponding groups on day one following surgery. The rats in all three groups were euthanized on day seven post surgery. Blood samples were harvested for blood urea nitrogen (BUN) and serum creatinine (Scr) content measurements. The degree of interstitial pathological changes in the tissues from the obstructed kidneys were observed through hematoxylin and eosin (H&E) and Masson staining. The CD68+ macrophage amount, tumor necrosis factor?? (TNF??), interleukin 1? (IL?1?), nuclear factor??B (NF??B), transforming growth factor??1 (TGF??1) and type I collagen (Col?I) levels were examined immunohistochemically. The protein expression levels of NF??B were examined using western blot analysis. Total superoxide dismutase (SOD) activity and malondialdehyde (MDA) content of homogenates were measured spectrophotometrically. The results revealed that ulinastatin had no statistically significant effect on the BUN and Scr levels (P>0.05). However, in comparison with the SOR group, the UUO group exhibited significantly more severe renal interstitial pathological injury in terms of tubular dilation, epithelial atrophy, renal interstitial inflammatory cell infiltration and proliferation of fibrous tissues, as well as significantly elevated levels of interstitial CD68+ macrophages, IL?1?, TNF??, NF??B, TGF??1 and Col?I (P<0.01). UTI treatment significantly reduced UUO?induced renal interstitial damage with reduced levels of interstitial CD68+ macrophages, IL?1?, TNF??, NF??B, TGF??1 and Col?I and MDA (P<0.05), and increased SOD levels (P<0.05). In conclusion, the present study indicated that UTI is able to effectively inhibit UUO?side renal interstitial inflammatory reaction and fibrosis in UUO?inflicted rats. PMID:24926571

  2. VASOACTIVE NATRIURETIC PEPTIDES AND KIDNEY

    Microsoft Academic Search

    Ljiljana Suri?-Lambi?; S. Plješa; V. Stojanov; D. Avramovi?

    1998-01-01

    Summary. The natriuretic peptide family (ANP, BNP, CNP) is responsible for the body fluid homeostasis and blood pressure control. ANP and BNP act on guanylate cyclase-A and CNP on guanylate cyclase-B receptors.The main renal actions of ANP are: 1. direct and indirect effects on the kidney to alter renal hemodynamics, and to increase fluid and electrolyte excretion; 2. functional antagonism

  3. Autosomal Recessive Polycystic Kidney Disease

    Microsoft Academic Search

    Jodi M. Smith; Ruth A. McDonald

    \\u000a Autosomal recessive polycystic kidney disease (ARPKD) is an inherited disorder involving cystic dilatation of the renal collecting\\u000a ducts as well as varying degrees of hepatic abnormalities consisting of cysts, fibrosis, and portal hypertension. The ARPKD\\u000a locus has been mapped to chromosome 6p21 and encodes a novel protein product named fibrocystin or polyductin. There are several\\u000a modes of presentation depending on

  4. Long-Term Results after Proximal Thoracic Aortic Redo Surgery

    PubMed Central

    Czerny, Martin; Barchichat, Ilan; Meszaros, Katharina; Sodeck, Gottfried H.; Weber, Alberto; Reineke, David; Englberger, Lars; Schönhoff, Florian; Kadner, Alexander; Jenni, Hansjörg; Schmidli, Jürg; Carrel, Thierry P.

    2013-01-01

    Objective To evaluate early and mid-term results in patients undergoing proximal thoracic aortic redo surgery. Methods We analyzed 60 patients (median age 60 years, median logistic EuroSCORE 40) who underwent proximal thoracic aortic redo surgery between January 2005 and April 2012. Outcome and risk factors were analyzed. Results In hospital mortality was 13%, perioperative neurologic injury was 7%. Fifty percent of patients underwent redo surgery in an urgent or emergency setting. In 65%, partial or total arch replacement with or without conventional or frozen elephant trunk extension was performed. The preoperative logistic EuroSCORE I confirmed to be a reliable predictor of adverse outcome- (ROC 0.786, 95%CI 0.64–0.93) as did the new EuroSCORE II model: ROC 0.882 95%CI 0.78–0.98. Extensive individual logistic EuroSCORE I levels more than 67 showed an OR of 7.01, 95%CI 1.43–34.27. A EuroSCORE II larger than 28 showed an OR of 4.44 (95%CI 1.4–14.06). Multivariate logistic regression analysis identified a critical preoperative state (OR 7.96, 95%CI 1.51–38.79) but not advanced age (OR 2.46, 95%CI 0.48–12.66) as the strongest independent predictor of in-hospital mortality. Median follow-up was 23 months (1–52 months). One year and five year actuarial survival rates were 83% and 69% respectively. Freedom from reoperation during follow-up was 100%. Conclusions Despite a substantial early attrition rate in patients presenting with a critical preoperative state, proximal thoracic aortic redo surgery provides excellent early and mid-term results. Higher EuroSCORE I and II levels and a critical preoperative state but not advanced age are independent predictors of in-hospital mortality. As a consequence, age alone should no longer be regarded as a contraindication for surgical treatment in this particular group of patients. PMID:23469220

  5. [Neuroendocrine tumors of the kidneys].

    PubMed

    Moch, H

    2015-05-01

    The 2004 World Health Organization (WHO) classification of renal cancer includes renal carcinoid and neuroendocrine cancer of the kidneys in the group of primary renal neuroendocrine tumors. The histological features of primary renal carcinoids are similar to those of neuroendocrine tumors found in other anatomical locations. Primary carcinoid tumors of the kidneys are frequently misdiagnosed as other kidney cancers, such as papillary renal cell carcinoma, mesonephric tumors, Wilms tumor (WT) and undifferentiated carcinoma. Immunohistochemical staining results are consistent with the diagnosis of a neuroendocrine tumor with immunoreactivity for synaptophysin, chromogranin, CD56, and neuron-specific enolase (NSE). Positive expression of CD99 can also be seen. There is mainly absence of WT1, cytokeratin 7, cytokeratin 20, thyroid transcription factor (TTF1) and LCA, ruling out most other differential diagnoses. Renal carcinoid tumors are regarded as low-grade neuroendocrine tumors; however, many studies have demonstrated metastatic disease in patients with renal carcinoid tumors. The prognostic value of histological parameters is uncertain. Some studies have correlated poor patient prognosis with increased mitotic activity, presence of necrosis and cytological atypia. Cases with higher mitotic rates of >?2 mitoses/10 high power fields (HPF) developed metastases more frequently; therefore, the WHO classification of neuroendocrine tumors used in other organs is recommended for primary renal carcinoid tumors. PMID:25898936

  6. Acting alone: U.S. unilateral uses of force, military revolutions, and hegemonic stability theory 

    E-print Network

    Podliska, Bradley Florian

    2009-06-02

    The premise of this dissertation is straight-forward – the U.S., as hegemon, acts unilaterally given the power disparity between it and the rest of the world. In solving the puzzle of why presidents make the “wrong” ...

  7. Robotic Unilateral and Bilateral Upper-Limb Movement Training for Stroke Survivors Afflicted by

    E-print Network

    Rosen, Jacob

    for the upper limbs with a dual arm exoskeleton system (EXO-UL7) using three different modalities: bilateral exoskeleton was used to provide bilateral and unilateral treatments. Standard care was provided by a licensed

  8. Spatial Memory and Hippocampal Volume in Humans With Unilateral Vestibular Deafferentation

    E-print Network

    Hamilton, Derek

    2007 Wiley-Liss, Inc. KEY WORDS: hippocampus; navigation; unilateral vestibular deaf- ferentation to accurately navigate in space is thought to also depend on vestibular input (Etienne, 1980; Matthews et al

  9. Partial unilateral lesions of the mushroom bodies affect olfactory learning in honeybees Apis mellifera L.

    E-print Network

    Menzel, Randolf - Institut für Biologie

    Partial unilateral lesions of the mushroom bodies affect olfactory learning in honeybees Apis Toulouse cedex 04, France Keywords: brain lesion, cognition, honeybee, hydroxyurea, mushroom bodies been associated with olfactory learning and memory. Here we used hydroxyurea (HU) to treat honeybee

  10. Effect of unilateral lesion of amygdala on unmanifested response to Matatabi (Actinidia polygama) in cats.

    PubMed

    Katahira, K; Iwai, E

    1975-02-01

    The experiment was designed to elucidate the question whether the unilateral ablation of the amygdala significantly affects sexual behavior or not. For this purpose, the effect of the unilateral amygdalectomy upon Matatabi-response was investigated in the cat (R-cat), particularly in cats which showed unmanifested Matatabi-response in the innate status (NR-cat). Following the unilateral damage to the amygdala, NR-cats showed a significant manifestation in their Matatabi-response behavior, while R-cats indicated no change in it, their performance level being the same as preoperatively. It is concluded from the present results that even the unilateral ablation of the amygdala affects sexual behavior significantly, this being in contrast to many previous reprots. The present finding implies that individual differences in sexual behavior appear to depend on the neural basis of the amygdala, supporting an assumption that the amygdala is a controlling center of sexual and emotional behaviors. PMID:1129764

  11. Metallothionein in rabbit kidneys preserved for transplantation

    SciTech Connect

    Elinder, C.G.; Lundgren, G.; Nordberg, M.; Palm, B.; Piscator, M.

    1984-03-01

    Thirteen rabbits were given cadmium injections to achieve cadmium concentrations in kidney cortex ranging from 0.05 to 1 mmole Cd/kg wet weight. Another four animals served as controls. One kidney from each animal was frozen directly to -70/sup 0/C whereas the other kidney was kept for 24 hr at +4/sup 0/C in a preservative (Sachs' solution) to simulate conditions for preservation of human donor kidneys before transplantation. Protein binding of cadmium, zinc and copper in kidney homogenates and the concentration of metallothionein (MT) were measured in the kidney that was frozen directly and in the kidney that had been preserved. No gross differences in either the protein binding of cadmium, zinc and copper or in the MT content were seen between the directly frozen and preserved kidney from the same animal. This indicates that MT is not rapidly broken down in rabbit kidneys which have been preserved similarly to human donor kidneys for 24 hr in a standard preservative solution prior to a transplantation. 27 references, 3 figures, 1 table.

  12. Associations of Anisometropia with Unilateral Amblyopia, Interocular Acuity Difference and Stereoacuity in Preschoolers

    PubMed Central

    Ying, Gui-shuang; Huang, Jiayan; Maguire, Maureen; Quinn, Graham; Kulp, Marjean Taylor; Ciner, Elise; Cyert, Lynn; Orel-Bixler, Deborah

    2012-01-01

    Purpose To evaluate the relation of anisometropia with unilateral amblyopia, interocular acuity difference (IAD) and stereoacuity, among Head Start preschoolers, using both clinical notation and vector notation analyses. Design Multicenter, cross-sectional study. Participants 3- to 5-year-old participants in the Vision In Preschoolers (VIP) Study (N=4040). Methods Secondary analysis of VIP data from participants who had comprehensive eye examinations including monocular visual acuity (VA) testing, stereoacuity testing, and cycloplegic refraction. VA was retested with full cycloplegic correction when retest criteria were met. Unilateral amblyopia was defined as IAD ?2 lines in logarithm of the Minimum Angle of Resolution (logMAR). Anisometropia was defined as ?0.25 D (diopter) difference in spherical equivalent (SE) or in cylinder power, and also two approaches using power vector notation. The percentage with unilateral amblyopia, mean IAD, and mean stereoacuity were compared between anisometropic and isometropic children. Main Outcomes Measures The percentage with unilateral amblyopia, mean IAD, and mean stereoacuity. Results Compared with isometropic children, anisometropic children had a higher percentage of unilateral amblyopia (8% vs. 2%), larger mean IAD (0.07 vs. 0.05 logMAR) and worse mean stereoacuity (145 vs.117 arc sec) (all p<0.0001). Larger amounts of anisometropia were associated with higher percentages of unilateral amblyopia, larger IAD, and worse stereoacuity (trend p<0.001). Percentage of unilateral amblyopia was significantly increased with spherical equivalent (SE) anisometropia >0.5 D, cylindrical anisometropia >0.25 D, the vertical/horizontal meridian (J0) or oblique meridian (J45) >0.125 D, or vector dioptric distance (VDD) >0.35 D (all p<0.001). VDD had higher ability in detecting unilateral amblyopia than cylinder, SE, J0 and J45 (p<0.001). Conclusions The presence of and amount of anisometropia were associated with the presence of unilateral amblyopia, larger IAD and worse stereoacuity. The threshold level of anisometropia at which unilateral amblyopia becomes significant was lower than current guidelines. VDD is more accurate than spherical equivalent anisometropia or cylindrical anisometropia in identifying preschoolers with unilateral amblyopia. PMID:23174398

  13. Aortic Angiosarcoma: A Rare Cause for Leaking Thoracic Aneurysm

    SciTech Connect

    Hales, S. L., E-mail: sarah.hales@imperial.nhs.uk; Locke, R.; Sandison, A.; Jenkins, M.; Hamady, M. [St. Mary's Hospital, Imperial College Healthcare NHS Trust (United Kingdom)

    2011-02-15

    Primary malignant tumours of the aorta are rare. They present with aneurysm formation, arterial occlusion, and embolic phenomenon. We report the case of a 56-year-old man whose initial presentation and investigations lead to emergency endovascular stenting of a descending thoracic aneurysm with a contained leak. Initial response was favourable, yet the patient presented again with worsening symptoms. The circum-aortic haematoma expanded by 50% on subsequent imaging, but no endoleak was identified. When altered bone marrow signal was identified on magnetic resonance imaging, the possibility of malignancy was considered. A metastatic skin lesion was then biopsied, which demonstrated morphological and immunohistochemical features consistent with metastases from a pleomorphic sarcoma of the aorta.

  14. Unusual thoracic radiographic findings in children treated for Hodgkin's disease

    SciTech Connect

    Jochelson, M.S.; Tarbell, N.J.; Weinstein, H.J.

    1986-06-01

    Mantle irradiation is often part of the treatment for Hodgkin's disease. Localized pneumonitis and fibrosis are well-known sequelae of this treatment. We report nine patients with unusual thoracic radiographic findings following treatment for Hodgkin's disease. All nine had mediastinal widening. Seven of these patients received combined modality therapy in which prednisone was given with their MOPP. In these seven patients, an increase in mediastinal width developed at the same time as the radiographic changes of radiation pneumonitis. Two patients developed bilateral infiltrates extending beyond the field of radiation to the lung periphery. In one of these patients, a spontaneous pneumomediastinum developed. One patient underwent mediastinal biopsy that revealed inflammatory changes similar to those seen in radiation pneumonitis. All patients either responded to steroids or had spontaneous regression of radiographic abnormalities supporting the presumed diagnosis of treatment related changes. Recognition of these unusual sequelae of mantle irradiation will aid in differentiating them from infection or tumor and lead to prompt, appropriate treatment.

  15. Giant-cell reparative granuloma of the thoracic vertebra.

    PubMed

    Inoue, H; Tsuneyoshi, M; Enjoji, M; Shinohara, N; Yokoyama, K

    1986-05-01

    Giant-cell reparative granuloma occurring in the thoracic vertebra of a 16-year-old girl is presented, and the literature concerning the subject is reviewed. This report is of the second documented case with this essentially rare lesion arising in the vertebra. Microscopically, the lesion was characterized by a reactive granulation tissue with formation of reactive osteoid, collagenization and vascularization, and focal accumulations of giant cells, particularly around hemorrhagic portions. The patient is doing well without further recurrence 38 months after the second therapeutic curettage. The authors describe the clinicopathologic features of this particular case because of its rarity in location, and briefly discuss the difference from other giant-cell lesions of bone mainly in view of differential diagnosis. PMID:3739707

  16. Intramedullary thoracic spinal metastasis from small-cell lung cancer.

    PubMed

    Katsenos, S; Nikolopoulou, M

    2013-01-01

    Lung cancer with intramedullary spinal cord metastasis (ISCM) is a rare event exhibiting dismal prognosis. In the present paper, we describe a 74-year-old male who developed bilateral leg weakness with associated backache and non-productive cough. Chest imaging evaluation demonstrated pronounced bilateral mediastinal lymphadenopathy and a nodular opacity in the right lower lobe. The patient was diagnosed with small cell lung cancer through bronchoscopic procedures. Magnetic resonance imaging of the spinal cord with contrast-enhancement revealed an intramedullary lesion consistent with metastasis at the T5-T6 level. Despite chemotherapy and thoracic spine radiotherapy, he eventually succumbed to the disease 3 months after diagnosis. A brief overview of the current literature is also provided laying emphasis on the therapeutic strategies of this unusual extrathoracic metastatic disease. PMID:24761534

  17. Thoracic outlet syndrome secondary to a mid-clavicle malunion.

    PubMed

    Beliaev, Andrei M; Fougere, Christopher

    2015-01-01

    A 22-year-old man presented with a painful 'clunking' sensation in the right mid-clavicle, and pain and dysaesthesia along the medial aspect of his right arm and hand. Three months earlier, he had been involved in a vehicle accident and sustained a right clavicle fracture. He had a large step off of the right clavicle with a medialisation of the right shoulder. At 90° abduction in external rotation of both shoulders he developed pain, paraesthesia and disappearance of the right radial artery pulsation. CT of the right shoulder in the neutral position demonstrated the clavicle-to-first rib distance of 5.5?mm, MRI showed the clavicular bone callus had a mass effect with effacement of anterior fat adjacent to the brachial plexus cords. He was diagnosed with thoracic outlet syndrome and underwent a corrective right clavicle osteotomy with the use of an AcuMed superior clavicle plate. PMID:26045517

  18. Myoelectric activity during unilateral chewing in healthy subjects: Cycle duration and order of muscle activation

    Microsoft Academic Search

    Benito Rilo; José Luis da Silva; Francisco Gude; Urbano Santana

    1998-01-01

    Statement of problem. Craniomandibular disorders, unilateral mastication, and asymmetry of masticatory muscles appear to be related to each other. Thus, it is of interest to investigate masticatory muscle activity during unilateral mastication in healthy subjects.Purpose. This study monitored contractile activity of the right and left masticatory muscles during right- and left-side gum chewing.Material and methods. Electromyographic techniques were used to

  19. Survival after unilateral versus bilateral lung volume reduction surgery for emphysema

    Microsoft Academic Search

    D. L. Serna; M. Brenner; K. E. Osann; R MCKENNAJR; J. C. Chen; R. J. Fischel; B. U. Jones; A. F. Gelb; A. F. Wilson

    1999-01-01

    Objective: Bilateral staple lung volume reduction surgery (LVRS) immediately improves pulmonary function and dyspnea symptoms in patients with advanced heterogeneous emphysema to a greater degree than do unilateral procedures. However, the long-term outcome after these surgical procedures needs to be critically evaluated. We compare 2-year survival of patients who underwent unilateral versus bilateral video-assisted LVRS in a large cohort treated

  20. Genetic analysis of novel intra-species unilateral incompatibility in Brassica rapa (syn. campestris ) L

    Microsoft Academic Search

    Yoshinobu Takada; Takayuki Nakanowatari; Jun Sato; Katsunori Hatakeyama; Tomohiro Kakizaki; Akiko Ito; Go Suzuki; Hiroshi Shiba; Seiji Takayama; Akira Isogai; Masao Watanabe

    2005-01-01

    Plants have evolved many systems to prevent inappropriate fertilization. Among them, incompatibility is a well-organized system in which pollen germination or pollen-tube growth is inhibited in pistils. Self-incompatibility (SI), rejecting self-pollen, promotes outbreeding in flowering plants. On the other hand, inter-species incompatibility, preventing gene flow among species to restrict outbreeding, usually occurs unilaterally, and is known as unilateral incompatibility (UI).