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1

Unilateral duplex horseshoe kidney with ectopic ureterocele  

SciTech Connect

Horseshoe kidney results from mesial fusion of the two nephrogenic blastemas during the fourth to seventh weeks of gestation. Associated genitourinary anomalies occur in approximately 25% of patients with horseshoe kidney. The authors report a case of a horseshoe kidney with unilateral pelvis and ureteral duplication with an ectopic ureterocele obstructing its upper moiety diagnosed by intravenous urography and real-time sonography. 13 references, 2 figures.

Sumner, T.E.; Volberg, F.M.; Munitz, A.; Harrison, L.H.; Mashburn, A.M.

1985-02-01

2

Unilateral triplication of the collecting system in a horseshoe kidney.  

PubMed

We report on complete unilateral triplication of the collecting system and ureters in a patient with a horseshoe kidney. One of the ureteral segments was obstructed and the patient presented with urosepsis. To our knowledge, such a malformation has not been described previously. PMID:6887369

Pode, D; Shapiro, A; Lebensart, P

1983-09-01

3

Ectopic thoracic kidney: evaluation using 99mTc dimercaptosuccinic acid SPECT-CT.  

PubMed

Ectopic thoracic kidney is a very rare congenital defect and is usually diagnosed incidentally. 99mTc-dimercaptosuccinic acid SPECT-CT images of a 7-year-old boy with left ectopic thoracic kidney are presented here. PMID:22691527

Singh, Harmandeep; Sharma, Punit; Nazar, Aftab Hasan; Das, Kalpajyoti; Naswa, Niraj; Singla, Suhas; Kumar, Rakesh

2012-07-01

4

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

SciTech Connect

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.

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

1994-09-01

5

Kidney fibrosis is independent of the amount of ascorbic acid in mice with unilateral ureteral obstruction.  

PubMed

In response to sustained damage to a kidney, fibrosis that can be characterized as the deposition of a collagenous matrix occurs and consequently causes chronic kidney failure. Because most animals used in experiments synthesize ascorbic acid (AsA) from glucose, the roles of AsA in fibrotic kidney diseases are largely unknown. Unilateral ureteric obstruction (UUO) mimics the complex pathophysiology of chronic obstructive nephropathy and is an ideal model for the investigation of the roles of AsA in kidney failure. We examined the impact of a deficiency of Akr1a, a gene that encodes aldehyde reductase and is responsible for the production of AsA, on fibrotic damage caused by UUO in mice. Oxidatively modified DNA was elevated in wild-type and Akr1a-deficient kidneys as a result of UUO to a similar extent, and was only slightly suppressed by the administration of AsA. Even though Akrla-deficient mice could produce only about 10% of the AsA produced by wild-type mice, no difference was observed in collagen I synthesis under pathological conditions. The data implied either a low demand for AsA or the presence of another electron donor for collagen I production in the mouse kidney. Next, we attempted to elucidate the potential causes for oxidative damage in kidney cells during the fibrotic change. We found decreases in mitochondrial proteins, particularly in electron transport complexes, at the initial stage of the kidney fibrosis. The data imply that a dysfunction of the mitochondria leads to an elevation of ROS, which results in kidney fibrosis by stimulating cellular transformation to myofibroblasts. PMID:24735064

Nishida, H; Kurahashi, T; Saito, Y; Otsuki, N; Kwon, M; Ohtake, H; Yamakawa, M; Yamada, K-I; Miyata, S; Tomita, Y; Fujii, J

2014-09-01

6

Interleukin-10 deficiency aggravates kidney inflammation and fibrosis in the unilateral ureteral obstruction mouse model.  

PubMed

Interleukin-10 functions as a general immunosuppressive cytokine, which also negatively regulates inflammatory responses through complex mechanisms. Recent studies suggested that IL-10 may also inhibit fibrosis in various diseased models. However, the role of IL-10 in renal fibrosis has not been demonstrated. Here, we investigated the effects of IL-10 in the development of renal tubulointerstitial fibrosis by creating the unilateral ureteral obstruction (UUO) model in IL-10 knockout (-/-) mice. We performed sham or unilateral ureteral obstruction surgery in 8-week-old IL-10-/- male mice and age and sex-matched wild type littermates. Mice were killed at 7 days or 14 days post surgery and renal tissues were obtained for RNA, protein, and immunohistochemical analysis. Our results found IL-10 deficiency resulted in enhanced renal fibrosis demonstrated by more severe tubular injury and collagen deposition and higher expression of pro-fibrotic genes (including ?-SMA, MMP-2, fibronectin, FSP-1 and vimentin). Our results also found IL-10-/- UUO mice developed more severe renal inflammation with a significant increase in inflammatory cells infiltration, and upregulation of inflammatory chemokines (MCP-1 and RANTES), and cytokines (TNF-?, IL-6, IL-8, and M-CSF). Further study revealed that enhanced renal inflammation and fibrosis was associated with significantly increased activation of both TGF-?/Smad3 and NF-?B signaling pathways. In summary, our study provides the direct evidence that IL-10 is an endogenous cytokine that has a key role in protecting against development of renal inflammation and fibrosis. Enhancement of IL-10 expression could be a potential anti-fibrosis therapy for patients with chronic kidney diseases. PMID:23628901

Jin, Yuanmeng; Liu, Ruijie; Xie, Jingyuan; Xiong, Huabao; He, John Cijiang; Chen, Nan

2013-07-01

7

Increased Phosphorylation of PI3K/Akt/mTOR in the Obstructed Kidney of Rats with Unilateral Ureteral Obstruction  

PubMed Central

The present study aimed to investigate changes in the mammalian target of rapamycin (mTOR) signaling pathway in the obstructed kidney of rats with unilateral ureteral obstruction (UUO). Male Sprague-Dawley rats were unilaterally obstructed by ligation of the left proximal ureter for 7 days. Control rats were treated in the same way except that no ligature was made. The expression levels of phosphorylated phosphatidylinositol 3-kinase (PI3K), Akt, and mTOR were determined in the kidney by semiquantitative immunoblotting. The protein expression levels of transforming growth factor (TGF)-?1, Bax, and Bcl-2 were also determined in the kidney. The phosphorylation of PI3K, Akt, and mTOR was increased in the kidney of ureteral obstruction rats compared with the control. In the obstructed kidney, the protein expression of TGF-?1 and Bax was also increased, whereas Bcl-2 expression was decreased. In conclusion, the phosphorylation of PI3K/Akt/mTOR was increased in the obstructed kidney of rats with UUO. PMID:24400212

Ma, Seong Kwon; Joo, Soo Yeon; Kim, Chang Seong; Choi, Joon Seok; Bae, Eun Hui; Lee, JongUn

2013-01-01

8

Thoracic spine CT scan  

MedlinePLUS

CAT scan - thoracic spine; Computed axial tomography scan - thoracic spine; Computed tomography scan - thoracic spine; CT scan - ... remove iodine out of the body. Those with kidney disease or diabetes may need to receive extra fluids ...

9

Alleviation of Kidney Damage Induced by Unilateral Ureter Obstruction in Rats by Rhodiola rosea  

PubMed Central

Abstract Purpose To evaluate the efficacy of Rhodiola rosea extract in terms of alleviating the renal damage induced by unilateral ureter obstruction (UUO) in rats. Material and Methods Thirty Wistar albino male rats were divided into five groups: (I) Control, (II) UUO 7 days, (III) UUO 7 days+extract,(IV) UUO 14 days, and (V) UUO 14 days+extract. Seven or 14 days after the initiation of the experimental procedure, the left kidneys of rats in all five groups were removed for histological examination, and their blood was drawn for biochemical measurements. Result Median malondialdehyde (MDA) and glutathione peroxidase (GPx) levels were, respectively, 39.4 (5.04) nmol/mL and 25.8 (8.01) nmol/minute/mL in group I, 77.9 (12.38) nmol/mL and 5.8 (1.95) nmol/minute/mL in group II, 48.7 (12.1) nmol/mL and 9.1 (2.3) nmol/minute/mL in group III, 58.5 (23.83) nmol/mL and 8.4 (2.1) nmol/minute/mL in group IV, and 44.8 (4.97) nmol/mL and 13.8 (3.73) nmol/minute/mL in group V. There was a statistically significant difference among the groups in terms of MDA and GPx levels (p<0.05 for both). The median numbers of apoptotic cells were 1 (1), 8 (2.25), 3 (1.25), 23.5 (9), and 7 (I) in groups I, II, III, IV, and V, respectively. There was a statistically siginificant difference among the groups in terms of apoptotic cell number (p<0.05). Conclusion R. rosea extract was shown to alleviate the renal damage induced by UUO through its antioxidant effects. The mechanism by which R. rosea extract causes these effects merits further investigation. PMID:23806024

Terzi, E. Hakan; Kemahli, Eray; Gucuk, Adnan; Tosun, Mehmet; Cetinkaya, Ayhan

2013-01-01

10

Medullary sponge kidneys and unilateral Wilms tumour in a child with Beckwith-Wiedemann syndrome  

Microsoft Academic Search

The occurrence of a Wilms tumour in a 4-year-old girl with bilateral medullary sponge kidney, Beckwith-Wiedemann syndrome and congenital hemihypertrophy demonstrates the close relationship between these disorders. Another six cases from the literature with congenital hemihypertrophy and with medullary sponge kidney are discussed, two of them also developed intra-abdominal neoplasm.

R. Beetz; O. Schofer; H. Riedmiller; R. Schumacher; P. Gutjahr

1991-01-01

11

Hypertension in Unilaterally Nephrectomized Rats Induced by Single–Kidney Transfection with Angiotensinogen cDNA  

Microsoft Academic Search

Plasmid expression vectors containing angiotensinogen (ATG) cDNA were complexed to cationic liposomes and injected into the renal artery of unilaterally nephrectomized rats to evaluate the effect of intrarenal ATG cDNA on arterial blood pressure and the renin–angiotensin system. Systolic blood pressures measured by tail cuff on days 12, 16, and 18 after transfection were significantly higher in rats that received

Wanda Sue Marley; Richard Bowen; Robert W. Gotshall; Lee Wilke

2000-01-01

12

Activating Nrf-2 Signaling Depresses Unilateral Ureteral Obstruction-Evoked Mitochondrial Stress-Related Autophagy, Apoptosis and Pyroptosis in Kidney  

PubMed Central

Exacerbated oxidative stress and inflammation may induce three types of programmed cell death, autophagy, apoptosis and pyroptosis in unilateral ureteral obstruction (UUO) kidney. Sulforaphane activating NF-E2-related nuclear factor erythroid-2 (Nrf-2) signaling may ameliorate UUO-induced renal damage. UUO was induced in the left kidney of female Wistar rats. The level of renal blood flow, cortical and medullary oxygen tension and reactive oxygen species (ROS) was evaluated. Fibrosis, ED-1 (macrophage/monocyte) infiltration, oxidative stress, autophagy, apoptosis and pyroptosis were evaluated by immunohistochemistry and Western blot in UUO kidneys. Effects of sulforaphane, an Nrf-2 activator, on Nrf-2- and mitochondrial stress-related proteins and renal injury were examined. UUO decreased renal blood flow and oxygen tension and increased renal ROS, 3-nitrotyrosine stain, ED-1 infiltration and fibrosis. Enhanced renal tubular Beclin-1 expression started at 4 h UUO and further enhanced at 3d UUO, whereas increased Atg-5-Atg12 and LC3-II expression were found at 3d UUO. Increased renal Bax/Bcl-2 ratio, caspase 3 and PARP fragments, apoptosis formation associated with increased caspase 1 and IL-1? expression for pyroptosis formation were started from 3d UUO. UUO reduced nuclear Nrf-2 translocation, increased cytosolic and inhibitory Nrf-2 expression, increased cytosolic Bax translocation to mitochondrial and enhanced mitochondrial Cytochrome c release into cytosol of the UUO kidneys. Sulforaphane significantly increased nuclear Nrf-2 translocation and decreased mitochondrial Bax translocation and Cytochrome c release into cytosol resulting in decreased renal injury. In conclusion, sulforaphane via activating Nrf-2 signaling preserved mitochondrial function and suppressed UUO-induced renal oxidative stress, inflammation, fibrosis, autophagy, apoptosis and pyroptosis. PMID:23071780

Chung, Shue Dong; Lai, Ting Yu; Chien, Chiang Ting; Yu, Hong Jen

2012-01-01

13

Semicarbazide-sensitive amine oxidase (SSAO) inhibition ameliorates kidney fibrosis in a unilateral ureteral obstruction murine model.  

PubMed

Semicarbazide-sensitive amine oxidase (SSAO) is an enzyme known for its dual function in mediating inflammation and reactive oxygen species production. However, the role of SSAO inhibitors in limiting kidney fibrosis is unclear. We aimed to determine the effectiveness of a SSAO inhibitor (SSAOi; PXS4728A) as an antifibrotic agent using a 7-day unilateral ureteric obstruction (UUO) model of acute kidney fibrosis in 6- to 8-wk-old mice. The experimental groups were 1) Sham operated; 2) UUO; 3) UUO+SSAOi (2 mg/kg); 4) UUO+telmisartan, an angiotensin receptor blocker (3 mg/kg); and 5) UUO+SSAOi+telmisartan. Kidney tissue was analyzed for histological evidence of tubulointerstitial fibrosis, nitrotyrosine staining, and mRNA expression of markers associated with fibrosis and inflammation. Kidney SSAO activity was determined by radiometric [(14)C]benzylamine methodology. Our results show that SSAOi effectively suppresses UUO-mediated SSAO activity. Extracellular matrix markers, namely, fibronectin, collagen IV protein, and nitrotyrosine staining, were lower in UUO+SSAOi mice compared with untreated UUO mice. This was consistent with the attenuated mRNA expression of collagen IV and fibronectin. SSAOi effectively inhibited transforming growth factor-?1 (TGF-?1) and monocyte chemoattractant protein-1 (MCP-1) expression to a similar extent to that observed with telmisartan. Individually, SSAOi and telmisartan induced a reduction in interstitial leukocyte and macrophage accumulation. However, the combination of SSAOi and telmisartan was more effective at reducing inflammatory cell infiltration. These results demonstrate that SSAO inhibition significantly suppresses profibrotic and proinflammatory cytokine secretion, reduces oxidative stress, and limits inflammatory cell accumulation and extracellular matrix expression in an acute model of renal fibrosis. PMID:25143459

Wong, May; Saad, Sonia; Zhang, Jie; Gross, Simon; Jarolimek, Wolfgang; Schilter, Heidi; Chen, Jason A; Gill, Anthony J; Pollock, Carol A; Wong, Muh Geot

2014-10-15

14

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

PubMed

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

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

2013-01-01

15

Electrical properties of the rabbit cortical collecting duct from obstructed kidneys after unilateral ureteral obstruction. Effects of renal decapsulation.  

PubMed Central

Ureteral obstruction causes impaired salt wastage and K+ secretion in the distal nephron segments, including the cortical collecting duct (CCD). Recently, we demonstrated that conductances of Na+ and K+ in the apical membrane, as well as the electrogenic Na(+)-K+ pump activity and the relative K+ conductance in the basolateral membrane of the collecting duct cell, were inhibited in the obstructed kidney after unilateral ureteral obstruction (UUO). To examine whether the increased intrarenal pressure might be causally related to these abnormalities in the CCD, the effects of unilateral renal decapsulation, a maneuver that partially blocks the increase in renal pressure, were evaluated with microelectrode techniques in isolated CCDs from UUO and sham-operated (control) rabbits 24 h after operation. Renal decapsulation had no effects on barrier voltages and conductances in the CCD from control animals. The lumen-negative transepithelial (VT) and basolateral membrane (VB) voltages as well as the transepithelial (GT) and the apical membrane (GA) conductances were decreased in the CCD from UUO animals compared with control animals. Pretreatment of renal decapsulation partially corrected the decreases in VT, VB, GT, and GA seen in the CCD from UUO animals. The changes in apical membrane voltage and GT upon addition of luminal amiloride and Ba2+, and the changes in VB upon addition of bath ouabain, were also decreased in the CCD from UUO animals compared with control animals. Pretreatment of renal decapsulation also partially corrected the above abnormalities seen in UUO animals, whereas it had no effect in control animals. The transference numbers for Cl- (tCl) and K+ (tK) in the basolateral membrane were, respectively, increased and decreased in the CCD from UUO animals compared with control animals. Pretreatment of renal decapsulation also partially corrected the changes in tCl and tK seen in UUO animals, whereas it had no effect in control animals. We conclude that, in UUO animals, renal decapsulation partially corrects the inhibition of apical Na+ and K+ conductances as well as basolateral Na(+)-K+ pump activity and relative K+ conductance seen after UUO, whereas in control animals it has no effect. The increased renal pressure may partly contribute to the defects in Na+ and K+ transport in the CCD from obstructed kidneys. Renal decapsulation has protective effects on impaired Na+ and K+ transports in the CCD after ureteral obstruction. PMID:7962530

Muto, S; Asano, Y

1994-01-01

16

Electrical properties of the rabbit cortical collecting duct from obstructed and contralateral kidneys after unilateral ureteral obstruction.  

PubMed Central

Electrophysiological techniques were used to determine the electrical properties of the collecting duct (CD) cell in the isolated cortical collecting duct from obstructed (UUOOK) and contralateral (UUOCK) kidneys in rabbits 24 h after unilateral ureteral obstruction (UUO); results were compared with those from sham-operated kidneys. The lumen-negative transepithelial voltage and the basolateral membrane voltage (VB) were decreased in the UUOOK, and increased in the UUOCK. The transepithelial conductance (GT) was decreased in parallel with an increase in the fractional apical membrane resistance (fRA) and a decrease in apical membrane conductance in the UUOOK. By contrast, the GT was increased in parallel with increases in apical and basolateral membrane conductances in the UUOCK. The amiloride-sensitive changes in apical membrane voltage (VA), GT and fRA were lower in the UUOOK, but greater in the UUOCK. The changes in VA and GT upon raising the perfusate K+ concentration and upon addition of luminal Ba2+ were decreased in the UUOOK, and increased in the UUOCK. Addition of ouabain to the bath resulted in a smaller depolarization of VB in the UUOOK, but in a greater depolarization in the UUOCK. Upon lowering bath Cl-, the change in basolateral membrane electromotive force (delta EMF) was increased in the UUOOK, and decreased in the UUOCK. Reversely, upon raising bath K+, the delta EMF was decreased in the UUOOK, and increased in the UUOCK. We conclude: (a) the conductances of Na+ and K+ in the apical membrane, and active Na(+)-K+ pump activity and relative K+ conductance in the basolateral membrane are decreased in the UUOOK, and increased in the UUOCK; (b) the relative basolateral membrane Cl- conductance was increased in the UUOOK, and decreased in the UUOCK. PMID:8349797

Muto, S; Miyata, Y; Asano, Y

1993-01-01

17

Ectopic Thoracic Kidney and End-Stage Renal Disease in a 38-Year-Old Nigerian  

PubMed Central

This patient is a 38-year-old housewife who presented with a one-month history of difficulty, in breathing, chest pain and bilateral leg swelling and had a blood pressure of 260/150?mmHg, features of malignant hypertension and hypertensive heart disease. Chest CT scan revealed a chest location of the left kidney. She also had elevated serum urea and creatinine and proteinuria (++). The right kidney was normally located with loss of corticomedullary differentiation. She is on maintenance haemodialysis and is being worked up for possible left nephrectomy. PMID:24527243

Ekrikpo, U. E.; Effa, E. E.; Akpan, E. E.

2013-01-01

18

Suppression of AGE precursor formation following unilateral ureteral obstruction in mouse kidneys by transgenic expression of alpha-dicarbonyl/L-xylulose reductase.  

PubMed

Unilateral ureteral obstruction (UUO) of kidneys causes acute generation of carbonyl stress. By electrospray ionization/liquid chromatography/mass spectrometry (ESI/LC/MS) we measured the content of methyl glyoxal, glyoxal, and 3-deoxyglucosone in mouse kidney extracts following UUO. UUO resulted in elevation of these dicarbonyls in the obstructed kidneys. Furthermore, the accumulation of 3-deoxyglucosone was significantly reduced in the kidneys of mice transgenic for alpha-dicarbonyl/L-xylulose reductase (DCXR) as compared to their wild-type littermates, demonstrating 4.91+/-2.04 vs. 6.45+/-1.85 ng/mg protein (P=0.044) for the obstructed kidneys, and 3.68+/-1.95 vs. 5.20+/-1.39 ng/mg protein (P=0.026) for the contralateral kidneys. On the other hand, collagen III content in kidneys showed no difference as monitored by in situ hybridization. Collectively, DCXR may function in the removal of renal alpha-dicarbonyl compounds under oxidative circumstances, but it was not sufficient to suppress acute renal fibrosis during 7 d of UUO by itself. PMID:17151462

Asami, Jun; Odani, Hiroko; Ishii, Aiko; Oide, Kayoko; Sudo, Takako; Nakamura, Atsushi; Miyata, Noriyuki; Otsuka, Noboru; Maeda, Kenji; Nakagawa, Junichi

2006-12-01

19

Chronic unilateral ureteral obstruction in the neonatal mouse delays maturation of both kidneys and leads to late formation of atubular glomeruli.  

PubMed

Unilateral ureteral obstruction (UUO) in the adult mouse is the most widely used model of progressive renal disease: the proximal tubule is the nephron segment most severely affected and atubular glomeruli are formed after only 7 days of UUO. To determine the proximal nephron response to UUO in the maturing kidney, neonatal mice were examined 7 to 28 days following complete UUO under general anesthesia. Proximal tubular mass and maturation were determined by staining with Lotus tetragolonobus lectin. Superoxide was localized by nitroblue tetrazolium and collagen by Sirius red. Cell proliferation, cell death, PAX-2, megalin, ?-smooth muscle actin (?-SMA), renin, and fibronectin were identified by immunohistochemistry. During the first 14 days of ipsilateral UUO, despite oxidative stress (4-hydroxynonenal staining), glomerulotubular continuity was maintained and mitochondrial superoxide production persisted. However, from 14 to 28 days, papillary growth was impaired and proximal tubules collapsed with increased apoptosis, autophagy, mitochondrial loss, and formation of atubular glomeruli. Fibronectin, ?-SMA, and collagen increased in the obstructed kidney. Oxidative stress was present also in the contralateral kidney: renin was decreased, glomerulotubular maturation and papillary growth were delayed, followed by increased cortical and medullary growth. We conclude that neonatal UUO initially delays renal maturation and results in oxidative stress in both kidneys. In contrast to the adult, proximal tubular injury in the neonatal obstructed kidney is delayed at 14 days, followed only later by the formation of atubular glomeruli. Antioxidant therapies directed at proximal tubular mitochondria during early renal maturation may slow progression of congenital obstructive nephropathy. PMID:24107422

Forbes, Michael S; Thornhill, Barbara A; Galarreta, Carolina I; Minor, Jordan J; Gordon, Katherine A; Chevalier, Robert L

2013-12-15

20

Neutrophil gelatinase-associated lipocalin (NGAL) levels in response to unilateral renal ischaemia in a novel pilot two-kidney porcine model  

PubMed Central

OBJECTIVES To test a novel porcine two-kidney model for evaluating the effect of controlled acute kidney injury (AKI) related to induced unilateral ischaemia on both renal units (RUs) To use neutrophil gelatinase-associated lipocalin (NGAL) and physiological serum and urinary markers to assess AKI and renal function. METHODS Twelve female Yorkshire pigs had bilateral cutaneous ureterostomies placed laparoscopically with identical duration of pneumoperitoneum for all cases. An experimental group (n =9) underwent induced unilateral renal ischaemia with left hilar clamping of timed duration (15, 30, 60 min) and a control group (n =3) had no induced renal ischaemia. Urine was collected and analysed from each RU to assess creatinine and NGAL concentration preoperatively and at multiple postoperative time points. Serum was collected and analysed daily for creatinine and NGAL levels. Statistical comparisons were made using the rank-sum and sign-rank tests. RESULTS Three pigs were excluded because of intra-operative and postoperative complications. In the RUs that experienced renal ischaemia (n=7),the median urine volume was lower (P=0.04) at 6, 12, 24 and 48 h and the median NGAL concentration was higher (P=0.04) at 12 and 48 h compared with the RUs of control pigs that experienced no renal ischaemia (n=2). When comparing the ischaemic (left) RU of the pigs in the experimental group with their contralateral non-ischaemic (right) RU, ischaemic RUs had a lower median cumulative urine volume at 6, 12, 24 and 48 h (P = 0.05) and a higher median NGAL concentration at 12, 24 and 48 h (P<0.05). At 48 h, no significant increase was found in serum NGAL in pigs in the experimental group compared with controls (P=0.2). Creatinine clearance (CC) was lower in ischaemic RUs compared with non-ischaemic RUs 1 day after surgery (P=0.04) with decreasing CC as the duration of ischaemia increased. CONCLUSIONS We have developed a promising novel small-scale pilot surgical model that allowed the evaluation of bilateral RU function separately during and after unilateral renal ischaemia. The induction of unilateral renal ischaemia corresponds with physiological changes in both the ischaemic and contralateral RU. AKI as measured by increases in NGAL and decreased renal function as measured by decreases in CC, are specific to the RU exposed to ischaemia. PMID:23510358

Silberstein, Jonathan L.; Sprenkle, Preston C.; Su, Daniel; Power, Nicholas E.; Tarin, Tatum V.; Ezell, Paula; Sjoberg, Daniel D.; Feifer, Andrew; Fleisher, Martin; Russo, Paul; Touijer, Karim A.

2013-01-01

21

Macrophage Infiltration and Cellular Proliferation in the NonIschemic Kidney and Heart following Prolonged Unilateral Renal Ischemia  

Microsoft Academic Search

Background\\/Aims: Although ischemic renal failure remains a major cause of morbidity and mortality, whether ischemic changes within a kidney might also have adverse effects on other organs has not been examined. Furthermore, given the protective effects of angiotensin II receptor (AT1) antagonism in renal ischemia, we considered whether a similar strategy might also modulate the response to acute renal insult.

Hirobumi Tokuyama; Darren J. Kelly; Yuan Zhang; Renae M. Gow; Richard E. Gilbert

2007-01-01

22

4:03 The growth of the thoracic spine in congenital scoliosis after expansion thoracoplasty  

Microsoft Academic Search

Purpose of study: Children with congenital thoracic scoliosis associated with fused ribs with unilateral unsegmented bars adjacent to convex hemivertebra will invariably have curve progression without treatment. The growth inhibition effects on the thoracic spine by surgery is said to be neglectable, because it is assumed that the concave side of such curves and the unilateral unsegmented bars do not

Robert Campbell; A. K. Hell-Vocke

2002-01-01

23

Unilateral blepharochalasis  

Microsoft Academic Search

Unilateral blepharochalasis is an extremely rare disorder with an unknown etiology and pathogenesis. The authors present a 22-year old patient in whom a right-sided skin overhang of the upper eyelid caused visual field impairment. The condition was corrected by a standard blepharoplasty. The histological examination suggested a localised anomaly of the lymphatic system and an almost complete absence of elastic

Georg M. Huemer; Thomas Schoeller; Gottfried Wechselberger; Bernhard Zelger; Karin M. Dunst; Hildegunde Piza-Katzer

2003-01-01

24

Unilateral hyperhydrosis in Pourfour du Petit syndrome.  

PubMed

Upper limp hyperhydrosis is an idiopathic disease with bilateral involvement. However, Pourfour du Petit syndrome, the opposite of Horner syndrome, may result in unilateral upper limb hyperhydrosis. It occurs following hyperactivity of the sympathetic cervical chain as a consequence of irritation secondary to trauma. We report herein two cases with Pourfour du Petit syndrome showing unilateral upper limb hyperhydrosis. The patients presented with right-sided mydriasis and ipsilateral hemifacial hyperhydrosis. The onset of disease was followed by a trauma in both patients. They underwent upper thoracic sympathectomy with favorable outcome. A history of an antecedent trauma in patients with unilateral upper limb hyperhydrosis and anisocoria may imply a possible diagnosis of Pourfour du Petit syndrome. PMID:15296919

Kara, Murat; Dikmen, Erkan; Akarsu, Cengiz; Birol, Ahu

2004-08-01

25

Thoracic aortic aneurysm  

MedlinePLUS

Aortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aortic ... The most common cause of a thoracic aortic aneurysm is hardening of the ... with high cholesterol, long-term high blood pressure, or who ...

26

Arterial thoracic outlet syndrome  

Microsoft Academic Search

Thoracic outlet syndrome (TOS) is a well described upper extremity disorder comprising neurovascular complications caused by thoracic outlet compression. By far neurogenic thoracic outlet syndrome is the most common manifesta- tion of this disorder. Arterial complications of thoracic outlet compression are much rarer, accounting for less than 5% of all operations performed for TOS. Major arterial degenerative and thromboembolic complications

Gerald M. Patton

27

Society of Thoracic Surgeons  

MedlinePLUS

... Choosing Wisely® What is 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 ...

28

[Unilateral borderline ovarian tumor and unilateral adenexectomy?].  

PubMed

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

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

2014-09-01

29

Harlequin syndrome: the sudden onset of unilateral flushing and sweating.  

PubMed Central

Facial flushing and sweating were investigated in five patients who complained of the sudden onset of unilateral facial flushing in hot weather or when exercising vigorously. One patient probably suffered a brainstem infarct at the time that the unilateral flush was first noticed, and was left with a subtle Horner's syndrome on the side opposite to the flush. The other four had no other neurological symptoms and no ocular signs of Horner's syndrome. Thermal and emotional flushing and sweating were found to be impaired on the non-flushing side of the forehead in all five patients whereas gustatory sweating and flushing were increased on that side in four of the five patients, a combination of signs indicating a deficit of the second sympathetic neuron at the level of the third thoracic segment. CT and MRI of this area failed to disclose a structural lesion but latency from stimulation of the motor cortex and thoracic spinal cord to the third intercostal muscle was delayed on the non-flushing side in one patient. The complaint of unilateral flushing and sweating was abolished in one patient by ipsilateral stellate ganglionectomy. The unilateral facial flushing and sweating induced by heat in all five patients was thus a normal or excessive response by an intact sympathetic pathway, the other side failing to respond because of a sympathetic deficit. The onset in the four cases of peripheral origin followed strenuous exertion, which suggested that an anterior radicular artery may have become occluded at the third thoracic segment during torsion of the thoracic spine. Images PMID:3155385

Lance, J W; Drummond, P D; Gandevia, S C; Morris, J G

1988-01-01

30

Kidney Dysplasia  

MedlinePLUS

... List of Topics and Titles : Kidney Dysplasia Kidney Dysplasia On this page: What is kidney dysplasia? How ... through Research For More Information What is kidney dysplasia? The kidneys are a pair of bean-shaped ...

31

Aneurysmal disease: thoracic aorta.  

PubMed

Thoracic aortic aneurysms are clinically significant for their high mortality risk in the face of rupture. This article reviews the natural history and pathophysiology of thoracic and thoracoabdominal aortic aneurysms, discusses the evaluation of these patients, and details the treatment options. Specifically discussed are treatment advances arising from the development of endovascular technology. PMID:23885936

Hoel, Andrew W

2013-08-01

32

Recurrent neurogenic thoracic outlet syndrome  

Microsoft Academic Search

BackgroundAlthough 90% of patients with neurogenic thoracic outlet syndrome (NTOS) experience “excellent” or “good” results after thoracic outlet decompression, recurrent symptoms may develop in certain patients.

Esteban Ambrad-Chalela; George I Thomas; Kaj H Johansen

2004-01-01

33

Burned unilateral half-cheek resurfacing techniques.  

PubMed

Postburn cheek deformities are a tragedy for patients and pose a great challenge to surgeons due to a limited number of well-matching donor sites. In cases of unilateral half-cheek deformity, the flap's skin should match the contralateral cheek and the residual skin of the deformed cheek. The skin of a distant flap does not match the facial skin and resembles a patch. The most suitable skin type is the neck's skin and residual cheek's skin transposed on the defect with special techniques. Seventy-six patients with unilateral cheek scars covering nearly half of cheek's surface (total cheek deformities are not included in this series) were personally operated. The deformities were divided into four types or forms: lower cheek, lateral, medial, and upper. The flaps and techniques were designed for each type. The cervical skin, residual cheek skin, and periauricular skin (most matching the cheek's skin) was used in form of different flaps, depending on the scar location on the cheek. The basic flap used was the cervical split flap which could include A) a thoracic adipose-cutaneous layer (cervico-thoracic flap); B) periauricular fasciocutaneous layer (cervico-periauricular and cervico-thoraco-periauricular flaps); C) residual healthy facial adipocutaneous layer (cervico-facial, cervico-facio-periauricular, and cervico-thoraco-facioperiauricular flaps). Cervical flap has axial circulation and is elevated without platysma; it is transposed on the cheek with some tension. The lower and lateral cheek deformities were eliminated most successfully with the cervico-thoraco-periauricular flap by one-stage procedure. Medial and upper cheek deformities were eliminated with the cervico-facio-thoraco-periauricular flap. The facial segment can be expanded (usually in cases of upper cheek reconstruction); in such cases, the thoracic region is not included in the flap (cervico-facio-periauricular flap). The cheeks were reconstructed in all patients without serious complications. The flap's skin matched the contralateral cheek and surrounding healthy skin; the donor site's damage was minimal; operation scars' line was maximally shortened. The use of cervical split flap in combination with thoracic, facial, and periauricular adipose-cutaneous layer opens, in author's opinion, a reliable and most successful way for postburn half-cheek resurfacing. PMID:22210070

Grishkevich, Viktor M

2012-01-01

34

Percutaneous radiofrequency upper thoracic sympathectomy: a new technique.  

PubMed

The author describes a new technique for performing unilateral or bilateral upper thoracic sympathectomy safely, effectively, and more easily than by any of the surgical methods now in use. The technique described is one of percutaneous radiofrequency sympathectomy, which is usually done on a day surgery or outpatient surgery basis. The technique has been effective and well tolerated in a small group of patients. PMID:6514152

Wilkinson, H A

1984-12-01

35

Complications of unilateral weight bearing.  

PubMed

The most common and significant complication of excessive unilateral weight bearing in adult horses is support limb laminitis. Young horses with unilateral lameness problems develop support limb laminitis infrequently compared with adult horses. PMID:19203705

Baxter, Gary M; Morrison, Scott

2008-12-01

36

Arterial thoracic outlet syndrome.  

PubMed

Arterial thoracic outlet syndrome is a rare cause of shoulder pain due to compression of the subclavian or axillary artery within the thoracic outlet. It is the least common form of thoracic outlet syndrome but is potentially dangerous as it can result in significant morbidity. An athlete initially may present with exertional pain, early fatigability, a dull ache, or discomfort in the affected arm. History and physical examination are paramount in diagnosis, and imaging confirms the anatomy. Surgical repair or resection alleviates the compression of the affected structure and allows for a safe return to participation. Familiarity with this condition aids in the prompt diagnosis and treatment of this disorder. PMID:24614419

Daniels, Brian; Michaud, Leslie; Sease, Franklin; Cassas, Kyle J; Gray, Bruce H

2014-01-01

37

Thoracic Malignancy Steering Committee  

Cancer.gov

The TMSC functions to harmonize an efficient, cost-effective, science-driven, and transparent process that will identify and promote the "Best Science" in clinical research of lung and other thoracic malignancies by addressing the design and prioritization of phase III trials and large phase II studies in chest malignancies. In addition to focusing on lung cancer, the TMSC addresses oncology trials in other thoracic sites, such as mesothelioma. Esophageal cancer trials are reviewed by the Gastrointestinal Cancer Steering Committee.

38

Kidney Biopsy  

MedlinePLUS

... List of Topics and Titles : Kidney Biopsy Kidney Biopsy On this page: What is a kidney biopsy? ... Research For More Information What is a kidney biopsy? A biopsy is a diagnostic test that involves ...

39

Kidney Transplantation  

MedlinePLUS

A kidney transplant is an operation that places a healthy kidney in your body. The transplanted kidney takes over the work ... so you no longer need dialysis. During a transplant, the surgeon places the new kidney in your ...

40

Sudden death due to thoracic lymphoma in a standardbred racing horse  

PubMed Central

Abstract During training, a 6-year-old standardbred gelding collapsed, exhibiting severe epistaxis and agonal breathing and was euthanized. The horse had a recent history of poor performance, lethargy, and unilateral eyelid swelling with serous ocular discharge. Postmortem and histopathologic examination findings revealed thoracic lymphosarcoma and concurrent exercise-induced pulmonary hemorrhage. PMID:16048014

2005-01-01

41

Unilateral radiation pneumonitis in sheep: Physiological changes and bronchoalveolar lavage  

SciTech Connect

Radiation pneumonitis is a life-threatening result of therapeutic thoracic irradiation, yet its mechanisms are poorly understood. We studied the effects of unilateral lung irradiation (3,000 rad) in sheep from the immediate response to the later development of radiation pneumonitis. We defined radiation pneumonitis by its diagnostic clinical feature, radiographic infiltration of the irradiated zone with a straight margin corresponding to the radiation port. The immediate response in the few hours after irradiation was characterized by cough, labored respiration, hypoxemia (arterial PO{sub 2} decreased 19 Torr), mild pulmonary hypertension (pulmonary arterial pressure increased 20%), and lymphopenia. Hemodynamics and gas exchange returned to normal by day 2 but became abnormal again before or during radiation pneumonitis at 32 +/- 2 days. Respiratory distress, hypoxemia, and pulmonary hypertension recurred during radiation pneumonitis. Bronchoalveolar lavage during radiation pneumonitis contained increased neutrophils (19 +/- 4%, control = 7%), increased protein (0.27 +/- 0.1 g/dl, control = 0.12 +/- 0.03), and severely impaired ability to lower surface tension. Alveolar macrophages from both lungs during unilateral radiation pneumonitis exhibited impaired generation of superoxide after phorbol myristate (only a 30% increase). Normal control alveolar macrophages increased superoxide production after stimulation greater than 400%. We conclude that unilateral lung irradiation in sheep causes a mild immediate response followed by radiation pneumonitis at 1 mo. Unilateral radiation pneumonitis in this model is associated with ipsilateral neutrophilic alveolitis, increased bronchoalveolar lavage protein, and impaired surfactant function, as well as bilateral functional abnormalities of alveolar macrophages.

Tillman, B.F.; Loyd, J.E.; Malcolm, A.W.; Holm, B.A.; Brigham, K.L. (Vanderbilt Univ. School of Medicine, Nashville, TN (USA))

1989-03-01

42

Spontaneous thoracic duct cyst.  

PubMed

Spontaneous and asymptomatic supraclavicular thoracic duct cysts (lymphoceles ) are rare. Only five cases have been reported so far. They are more common after surgery or trauma and have been reported in the abdomen, mediastinum, pelvis and neck. They must be differentiated from other neck cysts as failure to recognise their attachment may result in the disastrous consequence of chylothorax. A high index of suspicion is necessary, and diagnosis usually can be established by fine-needle aspiration and suitable imaging. This case is reported along with a review of the literature and management options, including that of inadvertent damage to the thoracic duct. PMID:12750920

Ray, J; Braithwaite, D; Patel, P J

2003-05-01

43

Understanding Thoracic Outlet Syndrome  

PubMed Central

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

Freischlag, Julie

2014-01-01

44

Solitary thoracic intradural extramedullary ependymoma  

Microsoft Academic Search

Intradural extramedullary ependymomas of the cervical or thoracic spine are extremely rare. We present a 62-year-old woman with progressive thoracic back pain over 9 months. Magnetic resonance imaging rerevealed a thoracic intradural extamedullary tumour which was surgically removed in total. Histologic examination identified the tumour as ependymoma, WHO Grade II. Our radiological and surgical findings are consistent with the hypothesis

Michael Payer; Yasuhiro Yonekawa; Hans-Georg Imhof

1999-01-01

45

ThoracicScoliosis Scoliosis u  

E-print Network

Thoracic­Scoliosis : = Scoliosis u 9LOCATION. (Thoracic­Spine u 9¯. Spine) then we can derive that: Femur­Condyle­Fracture v Femur­Fracture but not: Thoracic­Scoliosis v Spine­Scoliosis The decidability

Franconi, Enrico

46

European perspectives in thoracic surgery.  

PubMed

Europe, the old Continent, has been the cradle of thoracic surgery from the beginning of the last century. The structure and the activities of the European Society of Thoracic Surgeons (ESTS) activities are directed to enlighten the path, provide the tools and set the standards for a quality inspired practice in thoracic surgery. PMID:24868436

Venuta, Federico

2014-05-01

47

Thoracic outlet syndrome  

MedlinePLUS

... hands. Problems with the nerves cause almost all cases of thoracic outlet syndrome. Pressure may happen if you have: An extra rib, above the first one An abnormal tight band connecting the spine to the ribs. People with this syndrome often ...

48

Thoracic Outlet Syndrome  

Microsoft Academic Search

\\u000a Thoracic outlet syndrome (TOS) is a neurovascular entrapment syndrome of the upper extremity. It is most broadly separated\\u000a into vasculogenic (V-TOS) and neurogenic (N-TOS) subtypes. TOS occurs relatively rarely in sports but can be devastating when\\u000a it does.

Scott Laker; William J. Sullivan; Thomas A. Whitehill

49

Thoracic epidural analgesia in lung transplantation.  

PubMed

Achieving optimal pain relief after lung transplantation (LT) is often difficult, because both systemic analgesics and regional techniques have specific advantages and disadvantages. Uncontrolled pain impedes repeated powerful coughs and hinders valid respiratory excursions and graft expansion; these consequences markedly increase the risk of pulmonary complications. Thoracic epidural analgesia (TEA) is a universally accepted method of pain management after unilateral or bilateral thoracotomy, and in clinical experience it has proven to be the best option after LT. The combination of epidural local anesthetic plus opioid is associated with significant reduction in pain scores and/or supplementary analgesic requirement compared with parenteral opioid analgesia. Even though the benefits of epidural techniques in reduction of respiratory morbidity and protection from stress response to surgery have to be weighted against the risk of spinal bleeding, a well functioning thoracic sensory blockade provides satisfactory pain control and avoids the excessive sedation associated with systemic opiates. Multiple factors determine the quality of postoperative assistance, and a clear relationship between "adequate" or "high-quality" postoperative analgesia and improved outcome is difficult to establish. However, an individualized perimedullary analgesic regimen may certainly contribute to greater cooperation with physical maneuvers, avoid noxious limitations to graft expansion, and possibly decrease overall morbidity. PMID:20534277

Feltracco, P; Barbieri, S; Milevoj, M; Serra, E; Michieletto, E; Carollo, C; Rea, F; Marulli, G; Ori, C

2010-05-01

50

Kidney Failure  

MedlinePLUS Videos and Cool Tools

... The kidneys also help to keep necessary chemical substances in the blood, such as sodium, proteins, and ... Kidneys are extremely important organs that filter harmful substances out of the body. The kidneys are susceptible ...

51

Impedance cardiography: noninvasive measurement of hemodynamics and thoracic fluid content during endoscopic thoracic sympathectomy.  

PubMed

Endoscopic thoracic sympathectomy (ETS) is a minimally invasive procedure for treating palmar hyperhidrosis (PH). Hemodynamic changes are associated with CO(2) insufflation during ETS. In the present study, we examined hemodynamic changes during general anesthesia using impedance cardiography (ICG) monitor. Seventeen adult patients (15 males) scheduled to undergo elective unilateral ETS for treatment of PH were enrolled in the study. Patients with cardiorespiratory diseases were excluded from the study. Their age and weight mean values were 26.5 +/- 5 years, 71.9 +/- 11.5 kg, respectively. Besides routine monitoring, impedance cardiography monitor was used to measure cardiac output (CO), cardiac index (CI), stroke volume (SV), thoracic fluid content (TFC), and systemic vascular resistance (SVR). Three phases were defined for data collection: A, prior to CO(2) insufflation; B during gas insufflation (at 10, 5, and 2 mm Hg intrathoracic pressures); and C, after gas deflation. Repeated-measures analysis of variance (ANOVA) was used for statistical analysis and post hoc Bonferroni test for multiple comparisons of the data obtained. For all comparisons, P < 0.05 was considered significant. Systemic vascular resistance significantly increased at stages B10 and 5 compared with stage A mean value (P < 0.05). CO, CI, and SV mean values decreased significantly at stage B compared with stage A mean values. The mean values of thoracic fluid content at stages A, B10, 5, 2, and C were 33 +/- 5, 30.6 +/- 3.5, 31 +/- 3.4, 31.6 +/- 3.3, and 32.5 +/- 6.8/kOmega, respectively with significant differences (P < 0.05). Significant reductions of cardiac parameters were reported in the present study, but they were of minimal clinical significance. Of interest was the significant reduction of thoracic fluid content during CO(2) insufflation, whether it correlates to the magnitude of compression, caused by CO(2) insufflation accompanied by high systemic vascular resistance or sympathectomy procedure, yet to be further studied. PMID:16340563

El-Dawlatly, Abdelazeem Ali

2005-12-01

52

Vascular Thoracic Outlet Syndrome  

Microsoft Academic Search

  Abstract\\u000a \\u000a The surgical treatment of 30 cases of vascular thoracic outlet syndrome (TOS) in 25 patients is presented. Patients included\\u000a 17 women and 8 men with average age of 26.1 years. The causes of compression were cervical rib (n = 16), soft tissue anomalies (n = 12), and scar tissue after clavicle fracture (n = 2). Ten subclavian artery aneurysms

Lazar B. Davidovic; Dusan M. Kostic; Nenad S. Jakovljevic; Ilija L. Kuzmanovic; Tijana M. Simic

2003-01-01

53

Traumatic unilateral vasomotor rhinitis.  

PubMed

Vasomotor rhinitis (VMR) is a commonly encountered entity that may be difficult to diagnose. The classic symptoms are clear rhinorrhea and nasal congestion, commonly brought on by exercise, stress, heat, cold, and environmental irritants. The diagnosis is one of exclusion, and management usually involves avoidance of inciting agents and treatment with an anticholinergic nasal spray. We describe a case of VMR in a 22-year-old woman who presented with symptoms of clear, left-sided rhinorrhea and epiphora that had begun shortly after a motor vehicle accident approximately 1.5 years earlier, but which she had not reported at that time. The patient's left carotid canal had been fractured and the surrounding sympathetic plexus injured in the accident, resulting in an overactive parasympathetic system. Both exercise and heat exacerbated her symptoms. Allergy was excluded by negative allergy testing, and the patient did not respond to fluticasone nasal spray. Given the mechanism of injury, the unilaterality of symptoms, and the patient's lack of response to nasal steroids, it was thought that the VMR was due to the earlier traumatic injury, which had resulted in imbalance of the autonomic neural input. A trial of ipratropium was given to directly treat the parasympathetic overactivity. This treatment resulted in immediate improvement in both the nasal and lacrimal secretions. PMID:23288805

Harlor, Evan J; Greene, J Scott; Considine, Catherine

2012-11-01

54

Renal dysplasia with unilateral renal agenesis in a dog.  

PubMed

This report describes a renal dysplastic lesion associated with renal agenesis in a 3-year-old dog with chronic renal failure. Haematological examination revealed non-regenerative anaemia, azotaemia, increased creatinine and hyperphosphataemia. At necropsy, the right kidney and right ureter could not be identified. The left kidney was slightly enlarged, with a reduced cortico-medullary ratio. Histologically, the medulla of the left kidney had persistent mesenchyme and primitive tubules (tall pseudostratified columnar epithelium), dilated collecting ducts lined by flattened epithelium, and adenomatoid proliferation of cuboidal epithelium; fetal or immature glomeruli could not be identified. To our knowledge, this is the first report of a renal dysplastic lesion with unilateral agenesis in animals. PMID:15899491

Morita, T; Michimae, Y; Sawada, M; Uemura, T; Araki, Y; Haruna, A; Shimada, A

2005-07-01

55

Thoracic Outlet Syndromes.  

PubMed

The clinical presentation of thoracic outlet syndrome depends on which anatomic structure is compressed in the area of the thoracic outlet (eg, the axillary-subclavian artery, vein, brachial plexus, or the sympathetic nerves). The clinical syndrome may be isolated to one or a mixture of these compressed anatomic structures. Although there are multiple compressive forces, the first rib is the common denominator, and extirpation of this structure is the "gold" standard for therapy. The various syndromes are discussed in their clinical order of frequency. For severe nerve compression, whether upper or lower brachial plexus, the best surgical procedure is the transaxillary first rib resection, anterior scalenectomy, and neurovascular decompression. Axillary-subclavian vein occlusion (ie, Paget-Schroetter syndrome) is best treated with early diagnosis, intravenous thrombolysis of the clot, transaxillary first rib resection anterior scalenectomy, and resection of the costoclavicular ligament. Arterial compression, occlusion, or aneurysm may occur with or without peripheral emboli and require a supraclavicular approach with arterial ligation, endarterectomy, or bypass grafts from the supraclavicular subclavian to the infraclavicular brachial artery. Compression of the sympathetic nerves produces vasospasm, Raynaud's phenomenon, or Raynaud's disease, requiring dorsal sympathectomy as well as first rib extirpation occasionally. This may be performed through the transaxillary, supraclavicular posterior, or thoracoscopic approach. Recurrent thoracic outlet syndrome may involve any or all of the above anatomic syndromes. The surgical approach is best from the posterior, high thoracoplasty, muscle-splitting incision, performing neurolysis of the C7, C8, and T1 nerve roots and the brachial plexus as well as release of any vascular constriction. PMID:12686013

Urschel, Harold C.; Patel, Amit

2003-04-01

56

[Acute thoracic pain].  

PubMed

We report the case of a 56 year-old female patient without previous medical history presenting in the emergency room with acute left-sided thoracic pain and dyspnea. Initial lab exams, ECG and chest X-ray in supine position were normal and excluded most common pathologies, e.g. a large pneumothorax or myocardial infarction. A subsequent computed tomography to exclude an aortic dissection or pulmonary embolism showed left-sided sero-pneumothorax and mediastinal air. A spontaneous esophageal rupture (Boerhaave Syndrome) was diagnosed. An additional fluoroscopic study was performed to evaluate the exact site of rupture. PMID:17639965

Matt, D; Kubik-Huch, R A; Teufelberger, G; Knüsel, P R

2007-06-20

57

Thoracic spine x-ray  

MedlinePLUS

Vertebral radiography; X-ray - spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films ... The test is done in a hospital radiology department or in the health care provider's office. You will lie on the x-ray table in different positions. If the x-ray ...

58

Palmar hyperhidrosis. Long-term results following high thoracic sympathectomy.  

PubMed

Fourteen men and 22 wemon, with an average of 23 years (range 14-36 years) were operated on for hyperhidrosis of the upper extremity during the period from 1955 to 1970. Twenty-eight had had symptoms for more than 10 years. Resection of the 2nd and 3rd thoracic ganglia and the connecting sympathetic chain was carried out using a posterior approach; in 33 cases the operation was bilateral, and in three unilateral. Thirty-five patients were followed up after an average of 7.8 years (range 2-17 years). In one patient unilateral reoperation was carried out four months after the first operation. Since the first operation 34 patients had suffered from neither palmar nor axillary sweating. However 20 had permanent compensatory hyperhidrosis, and 15 suffered from gustatory facial sweating, which had usually started within six months of operation. Four, in whom two spinal thoracic nerves had also been resected, reported marked dysaesthesia over the front of the chest and in the axilla, lasting for several years. PMID:1114879

Gjerris, F; Olesen, H P

1975-02-01

59

The thoracic paravertebral block performed for open cholecystectomy operation in order to anesthesia: Two cases  

PubMed Central

It is known that, unilateral thoracic paravertebral block (TPVB) applications performed with general anesthesia provide satisfactory conditions for open cholecystectomy increase the quality of post-operative analgesia and patient comfort and decrease the frequency of post-operative nausea and vomiting. In this case report, the TPVB was presented which was performed for two patients with high risk of anesthesia who have been planned to undergo open cholecystectomy.

Beyaz, Serbulent Gokhan; Ozocak, Hande; Ergonenc, Tolga; Erdem, Ali Fuat

2014-01-01

60

Cardiac output measurement: Lack of agreement between thermodilution and thoracic electric bioimpedance in two clinical settings  

Microsoft Academic Search

Study objective: To determine the agreement between thermodilution (TD) and thoracic electric bioimpedance (TEB) techniques in cardiac output (CO) measurements in hyperdynamic kidney recipients and normodynamic patients subjected to radical cystectomy. The main objective was to determine the reliability of TEB in CO measurement.Design: Open two-group study.Setting: Unïversity hospital.Patients: 19 kidney recipients and 5 radical cystectomy patients.Interventions: Radial artery cannula

Mohamed M. Atallah; Atef D. Demain

1995-01-01

61

Bilateral Rectus Sheath Hematoma in Kidney Transplant Patient: Case Study and Literature Review  

PubMed Central

Rectus sheath hematoma usually occurs unilateral but rare cases of bilateral hematoma have been reported. Herein we report the first case of spontaneous bilateral Rectus Sheath Hematoma in the kidney transplanted patient. PMID:24350093

Feizzadeh Kerigh, Behzad; Maddah, Ghodratolah

2013-01-01

62

Primary unilateral tuberculous inguinal lymphadenitis  

Microsoft Academic Search

We report the case of a young Greek woman who presented with erythema nodosum and isolated unilateral inguinal lymphadenopathy. Excision and biopsy of the lymph node showed infection due to M. tuberculosis. An extensive workup did not reveal any other foci of tuberculosis. Isolated tuberculous inguinal lymphadenitis is a rare entity in developed countries and is almost always bilateral. Our

Dionisios Loukeris; Alexandra Zormpala; Konstantinos Chatzikonstantinou; Athena Androulaki; Nikolaos V. Sipsas

2005-01-01

63

What Is a Thoracic Surgeon?  

MedlinePLUS

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

64

Neuroblastoma of the thoracic inlet.  

PubMed

The case of a 5-month-old girl with a large neuroblastoma of the thoracic inlet, an unusual location for this tumor, is presented. The patient had marked airway compromise due to tumor compression, with extension of the mass through the thoracic inlet into the base of the neck, also incorporating the right subclavian artery. The highly unusual location of this tumor is presented, and challenging technical aspects of its management are discussed. PMID:2352091

Pelton, J J; Ratner, I A

1990-05-01

65

KIDNEY CANCER 15. KIDNEY CANCER  

E-print Network

in Ireland, accounting for 1.8% of all malignant neoplasms, excluding non-melanoma skin cancer, in women cancer cases 1.3% 2.0% 1.3% 2.0% 1.4% 2.1% % of all new cancer cases excluding non-melanoma skin cancer 1KIDNEY CANCER 135 15. KIDNEY CANCER 15.1. SUMMARY Kidney cancer was the twelfth most common cancer

Paxton, Anthony T.

66

Kidney transplant  

MedlinePLUS

... end-stage kidney disease in the U.S. is diabetes. However, there are many other causes. A kidney transplant may NOT be done if you have: Certain infections, such as TB or bone infections Problems taking medications several times each day for ...

67

Renoprotective effects of telmisartan after unilateral renal ablation in rats  

PubMed Central

Purpose The renoprotective function of the angiotensin II type 1 receptor blocker (ARB) is well-known in various studies, including the animal model of renal failure. However, detailed temporal changes of pathological and molecular findings after unilateral nephrectomy are not fully understood. The main purpose of this study was to clarify the renoprotective effects and pathological changes induced by the ARB in rat-remnant kidney (RK) tissues after unilateral nephrectomy, but not after a 5/6 nephrectomy. Methods Telmisartan, which is structurally and functionally unique among ARB, was used in this study. Three rat groups were examined: A) no ARB administrated (RK, n=21); B) continuous subcutaneous infusion of an ARB administrated (RK-ARB, n=21); and C) a sham-operated group (Sham). Renal function was evaluated by blood urea nitrogen (BUN) levels and creatinine clearance (Ccr). Fibrosis was evaluated by hydroxyproline levels and Masson’s trichrome staining. Expressions of angiotensin II type 1 receptor (AT1R) and transforming growth factor beta (TGF-?) were investigated by real-time polymerase chain reaction and Western blotting. Results There was no significant difference regarding body and kidney weight or pathological features evaluated by hematoxylin and eosin staining between the RK and RK-ARB groups. The Ccr in the RK group was significantly lower than that in the Sham group (P<0.01), but no significant difference was found between the RK-ARB and Sham groups. The fibrotic area increased significantly with time after nephrectomy in the RK group. Although a similar trend was found in the RK-ARB group, the percentage of fibrous area in the RK-ARB group was significantly lower than that in the RK group at each time point (P<0.01). AT1R mRNA levels in the RK group were regulated immediately compared with those in the RK-ARB group. Although expressions of the AT1R and TGF-? were significantly higher in the RK-ARB group than in the Sham group, no significant differences were found between the RK-ARB and Sham group. Conclusion The ARB had renoprotective effects after unilateral nephrectomy. The ARB effectively maintained Ccr. Our results also showed the possibility that fibrotic changes mediated by AT1R and TGF-? play an important role in renal protection. Moreover, this is the first report on changes of AT1R expression after using the ARB telmisartan in kidney tissues after unilateral nephrectomy. Finally, our results suggest that ARB may be useful to prevent renal failure in patients treated with nephrectomy. PMID:24143119

Matsuo, Tomohiro; Miyata, Yasuyoshi; Sagara, Yuji; Higami, Yoshikazu; Tobu, Shohei; Matsuo, Manabu; Noguchi, Mitsuru; Shimokawa, Isao; Kanetake, Hiroshi; Sakai, Hideki

2013-01-01

68

Secondary procedures in thoracic aorta.  

PubMed

Secondary procedures for thoracic aorta are very demanding to the patient, with significantly high perioperative mortality and morbidity. The aim of this paper was to review the most remarkable secondary procedures following open and endorepairs of thoracic aorta. The PubMed database was searched without any year limits. Search terms used %were "thoracic", "aorta" and "reintervention". Two authors independently reviewed abstracts identified by the search and subsequently the reference lists of eligible series were scrutinized in order to detect any additional relevant articles. Different early and late complications following open an endovascular repair of thoracic aorta were described adding their incidence and their potential solutions with secondary interventions. Secondary interventions after open repair (OR) are more related to bleeding and progression of the aortic disease issues and open surgery is again the most common solution. However, in more fragile patients with favorable anatomy, endovascular repair can be offered as a secondary procedure. Reinterventions after endovascular treatment of thoracic aorta diseases (TEVAR) are mostly related to endoleaks and also to the aortic disease progression. Hopefully, the oncoming technological improvements together with the optimized operator expertise can reduce the incidence of secondary procedures following TEVAR for all the aortic pathologies. PMID:25216218

Mestres, G; Capoccia, L; Riambau, V

2014-12-01

69

Segmental thoracic spinal has advantages over general anesthesia for breast cancer surgery  

PubMed Central

Background: Thoracic spinal anesthesia has been used for laparoscopic cholecystectomy and abdominal surgeries, but not in breast surgery. The present study compared this technique with general anesthesia in breast cancer surgeries. Materials and Methods: Forty patients were enrolled in this comparative study with inclusion criteria of ASA physical status I-III, primary breast cancer without known extension beyond the breast and axillary nodes, scheduled for unilateral mastectomy with axillary dissection. They were randomly divided into two groups. The thoracic spinal group (S) (n = 20) underwent segmental thoracic spinal anesthesia with bupivacaine and fentanyl at T5-T6 interspace, while the other group (n = 20) underwent general anesthesia (G). Intraoperative hemodynamic parameters, intraoperative complications, postoperative discharge time from post-anesthesia care unit (PACU), postoperative pain and analgesic consumption, postoperative adverse effects, and patient satisfaction with the anesthetic techniques were recorded. Results: Intraoperative hypertension (20%) was more frequent in group (G), while hypotension and bradycardia (15%) were more frequent in the segmental thoracic spinal (S) group. Postoperative nausea (30%) and vomiting (40%) during PACU stay were more frequent in the (G) group. Postoperative discharge time from PACU was shorter in the (S) group (124 ± 38 min) than in the (G) group (212 ± 46 min). The quality of postoperative analgesia and analgesic consumption was better in the (S) group. Patient satisfaction was similar in both groups. Conclusions: Segmental thoracic spinal anesthesia has some advantages when compared with general anesthesia and can be considered as a sole anesthetic in breast cancer surgery with axillary lymph node clearance.

Elakany, Mohamed Hamdy; Abdelhamid, Sherif Ahmed

2013-01-01

70

Kidney Stones in Children  

MedlinePLUS

... Titles : Kidney Stones in Children Kidney Stones in Children On this page: What is a kidney stone? ... the ureters. [ Top ] Are kidney stones common in children? No exact information about the incidence of kidney ...

71

Kidney stones  

MedlinePLUS

... in the urine can crystallize, forming a kidney stone (renal calculus). Usually the calculus is the size ... are very sensitive to being stretched, and when stones form and distend it, the stretching can be ...

72

Ectopic Kidney  

MedlinePLUS

... find more effective treatments. Through its Pediatric Urology Program, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) funds research into bladder and urinary tract development. Additionally, the Eunice Kennedy Shriver National Institute of ...

73

Video-Assisted Thoracic Surgery (VATS)  

MedlinePLUS

... advice from the experts at Harvard Medical School. Video-Assisted Thoracic Surgery What is the test? How ... known? View other tests What is the test? Video-assisted thoracic surgery (VATS) is a recently developed ...

74

Radiologic features of “adult type” polycystic kidney disease in the neonate  

Microsoft Academic Search

Two cases are reported of adult type polycystic renal disease (autosomal dominant) presenting in the newborn as a unilateral abdominal mass. The radiographic findings in the involved kidney simulated the ectatic tubules of infantile polycystic disease, yet histologic examination was consistent with the adult variety and both infants had other family members with adult type polycystic kidneys. These cases emphasize

R. A. Fellows; J. C. Leonidas; E. C. Beatty

1976-01-01

75

Congenital unilateral hydrocephalus--CT findings.  

PubMed

Congenital unilateral hydrocephalus is extremely uncommon with 18 cases previously reported in the English literature. Two additional newborns with unilateral hydrocephalus are presented. The second baby also presented a mega cisterna magna. This unusual association between Dandy-Walker variant and unilateral hydrocephalus has not been previously reported. Following ventriculo-peritoneal shunt, the babies had a normal cognitive neurodevelopment. The role of cranial computed tomography (CT) in diagnosis and follow-up is emphasized. PMID:11091018

Schulman, H; Landau, D; Schulman, P; Hertzanu, Y

2000-12-01

76

[A case of thoracic actinomycosis].  

PubMed

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

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

77

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

PubMed Central

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

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

2012-01-01

78

Activation of Toll-like receptor 9 attenuates unilateral ureteral obstruction-induced renal fibrosis  

Microsoft Academic Search

Aim:To study whether activation of TLR9 by CpG-ODN would protect against and\\/or reverse renal fibrosis.Methods:Animals were treated with CpG-ODN before or after undergoing a unilateral ureteral obstruction (UUO) procedure. The interstitial fibrotic lesions of obstructed kidneys were evaluated using histology and immunohistostaining. The Th2-type cytokine profile and the expression and activity of sma and mad related protein (Smad)3, signal transducers

Bing-mu Xin; Xiao-xing Wang; Wen Jin; Hui-min Yan; Bing Cui; Xiao-wei Zhang; Fang Hua; Hong-zhen Yang; Zhuo-wei Hu

2010-01-01

79

Glomerular sclerosis in Wistar rats: analysis of its variable occurrence after unilateral nephrectomy.  

PubMed Central

Individual differences in susceptibility to the development of focal and segmental glomerular hyalinosis and sclerosis (FSGHS) were studied in rats after unilateral nephrectomy. A total of 20 male Wistar rats underwent unilateral nephrectomy at 3 months of age. Glomerular number in the removed kidney ranged from 17,000 to 32,700 with a mean value of 25,997 (n = 19). At death 30 weeks later, the incidence of glomeruli with FSGHS in the remaining kidney varied from 0 to 20% with a mean of 4.4%. However, the percentage of glomeruli with FSGHS and the degree of proteinuria did not correlate either with glomerular number per kidney (left and right kidneys were shown to be equivalent for glomerular number) or with glomerular volume on killing. The occurrence of FSGHS correlated significantly with mean protein excretion (P less than 0.01) and serum cholesterol levels (P less than 0.01). In conclusion, in the rat a relatively low number of nephrons in the kidneys does not increase susceptibility to the development of FSGHS. Images Fig. 3 PMID:3741773

Grond, J.; van Goor, H.; Erkelens, D. W.; Elema, J. D.

1986-01-01

80

Endovascular Repair of Thoracic Aortic Aneurysms  

PubMed Central

Degenerative aneurysms of the thoracic aorta are increasing in prevalence; open repair of descending thoracic aortic aneurysms is associated with high rates of morbidity and mortality. Repair of isolated descending thoracic aortic aneurysms using stent grafts was introduced in 1995, and in an anatomically suitable subgroup of patients with thoracic aortic aneurysm, repair with endovascular stent graft provides favorable outcomes, with decreased perioperative morbidity and mortality relative to open repair. The cornerstones of successful thoracic endovascular aneurysm repair are appropriate patient selection, thorough preprocedural planning, and cautious procedural execution, the elements of which are discussed here. PMID:22379281

Findeiss, Laura K.; Cody, Michael E.

2011-01-01

81

Living Kidney Donation: The Outcomes for Donors  

PubMed Central

During the past decade, the number of transplantation from living kidney donors has substantially increased worldwide. The rate of increase varies from one country to another. The risk of unilateral nephrectomy to the donor includes perioperative mortality and morbidity plus the long-term risk of living with a single kidney. The rate of perioperative mortality and morbidity is about 0.03% and 10%, respectively. More attention is required to prevent serious complications of laparoscopic donor nephrectomy. A grading system in recording perioperative complications is necessary for making it available to each potential donor. The number of studies on long-term outcome of living donors is very limited. The overall evidence suggests that the risk of end-stage kidney disease is not increased in donors, however, mild renal failure, hypertension and proteinuria are not uncommon in living donors. There is also concern that the incidence of cardiovascular disease may be higher in kidney donors. Establishing living donor registry and follow-up is extremely important. Only through these registries the long-term risk of kidney donation will become more apparent. Because of severe shortage of transplantable kidneys, some transplant centers are now using donors with comorbidities and few centers are involved in transplant tourism with inadequate donor screening and follow-up. Prevention of these unacceptable practices in living kidney donors was emphasized in Amsterdam Forum in 2004 and Istanbul Summit in 2008. PMID:25013567

Ghods, A. J.

2010-01-01

82

Unilateral hyperhydrosis in Pourfour du Petit syndrome  

Microsoft Academic Search

Upper limp hyperhydrosis is an idiopathic disease with bilateral involvement. However, Pourfour du Petit syndrome, the opposite of Horner syndrome, may result in unilateral upper limb hyperhydrosis. It occurs following hyperactivity of the sympathetic cervical chain as a consequence of irritation secondary to trauma. We report herein two cases with Pourfour du Petit syndrome showing unilateral upper limb hyperhydrosis. The

Murat Kara; Erkan Dikmen; Cengiz Akarsu; Ahu Birol

2004-01-01

83

Extraosseous thoracic foraminal osteoblastoma: diagnostic dilemma and management with 3 year follow-up.  

PubMed

Osteoblastomas are bone forming lesions arising mainly from posterior elements of the vertebra. They are commonly encountered in the cervical and lumbar regions. We present a case of a thoracic osteoblastoma which is extra osseous and is not communicating with any part of the vertebra present intraforaminally. This is a rare presentation of an osteoblastoma. Imaging studies do not accurately diagnose the osteiod lesion. The size of the lesion and cortical erosion seen on the computed tomography scan help in differentiating the osteoid osteoma and osteoblastoma, but they are less sensitive and specific. Thus a histopathology is the investigation of choice to diagnose the osteoblastoma. Early and adequate removal of mass prevents malignant transformation, metastasis, and recurrence. In our case we excised the pars interarticularis unilaterally, removed the osteoid mass intact, and performed unilateral instrumented fusion. There was no recurrence and solid fusion was seen at 3 years follow up. PMID:25346825

Hadgaonkar, Shailesh Ramakant; Shyam, Ashok Kumar; Shah, Kunal Chandrakant; Khurjekar, Ketan Shripad; Sancheti, Parag Kantilal

2014-10-01

84

Extraosseous Thoracic Foraminal Osteoblastoma: Diagnostic Dilemma and Management with 3 Year Follow-Up  

PubMed Central

Osteoblastomas are bone forming lesions arising mainly from posterior elements of the vertebra. They are commonly encountered in the cervical and lumbar regions. We present a case of a thoracic osteoblastoma which is extra osseous and is not communicating with any part of the vertebra present intraforaminally. This is a rare presentation of an osteoblastoma. Imaging studies do not accurately diagnose the osteiod lesion. The size of the lesion and cortical erosion seen on the computed tomography scan help in differentiating the osteoid osteoma and osteoblastoma, but they are less sensitive and specific. Thus a histopathology is the investigation of choice to diagnose the osteoblastoma. Early and adequate removal of mass prevents malignant transformation, metastasis, and recurrence. In our case we excised the pars interarticularis unilaterally, removed the osteoid mass intact, and performed unilateral instrumented fusion. There was no recurrence and solid fusion was seen at 3 years follow up.

Hadgaonkar, Shailesh Ramakant; Shah, Kunal Chandrakant; Khurjekar, Ketan Shripad; Sancheti, Parag Kantilal

2014-01-01

85

Kidney Disease of Diabetes  

E-print Network

Kidney Disease of Diabetes National Kidney and Urologic Diseases Information Clearinghouse The Burden of Kidney Failure Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes.1 Kidney failure

Baker, Chris I.

86

Thoracic endovascular aortic repair: the basics.  

PubMed

Endografting for the treatment of thoracic aortic pathology continues to gain popularity; in some countries, numbers of endovascular aortic repairs now exceed those of open surgical cases. The skills and understanding of open surgical teams are not always translated into endovascular intervention teams, which may be led by cardiologists or vascular surgeons with little knowledge of thoracic pathology. Our experience with more than 400 thoracic interventional cases leads us to believe that that the cardiovascular surgeon is crucial to the success of any thoracic endovascular aortic repair program. Experienced surgeons should be involved in preoperative planning of cases, assessment of access vessels, creation of landing zones with revascularization procedures, passage of stents through the thoracic aorta, and protection of the spinal cord. In addition, surgeons should be familiar with the most common complications of thoracic endovascular aortic repair and be able to use both open surgical and endovascular strategies for complication management. PMID:23410772

Cheshire, Nick; Bicknell, Colin

2013-03-01

87

Thoracic extruded disc mimicking spinal cord tumor  

Microsoft Academic Search

Background context: Thoracic disc herniation is a rare condition. Distinguishing between a herniated disc and tumor for a lesion found at the thoracic level can be a diagnostic challenge.Purpose: To describe a case of thoracic disc herniation that mimicked a spinal cord tumor.Study design\\/setting: Case report and review of the literature.Patient sample: Case report.Outcome measures: Report of postoperative symptoms.Methods\\/description: A

Bikash Bose

2003-01-01

88

Hemispatial sunglasses: Effect on unilateral spatial neglect  

Microsoft Academic Search

Objective: To investigate whether using glasses shaded on the non-neglected side would lead to less unilateral neglect during pencil-and-paper activities.Design: Descriptive study of ten patients. One remarkable case is described in detail.Setting: Rehabilitation medicine department in an urban general hospital.Patients: Ten hemiplegic patients showing left unilateral neglect during pencil-and-paper activities.Intervention: Use of glasses in which the right half of each

Takashi Arai; Hiroshi Ohi; Hisato Sasaki; Hiroo Nobuto; Koh Tanaka

1997-01-01

89

Postural disturbances resulting from unilateral and bilateral diaphragm contractions: a phrenic nerve stimulation study.  

PubMed

Thoracoabdominal breathing movements are a complex source of postural disturbance, but there are contradictory reports in the literature with inspiration described as having either a backward or a forward disturbing effect. To elucidate the mechanisms underlying this phenomenon, the present study studied the postural disturbance caused by isolated contractions of the diaphragm. Eight male and four female healthy subjects followed an original paradigm of phrenic nerve stimulation (bilateral and unilateral) and "diaphragmatic" voluntary sniff maneuvers in the seated and standing postures. Center of gravity (CG) acceleration was calculated from force plate recordings, and respiratory kinematics were assessed with thoracic and abdominal sensor belts. CG and respiratory signals revealed that, while seated, bilateral phrenic stimulation and sniff maneuvers consistently produced expansion of the abdomen associated with a forward peak of CG acceleration. In the standing posture, the direction of the CG peak was reversed and always directed backward. Unilateral phrenic stimulation induced an additional medial-lateral acceleration of the CG, directed toward the nonactive side while seated, but in the opposite direction while standing. These results suggest that isolated diaphragmatic contractions produce a constant disturbing pattern for a given posture, but with opposite effects between standing and seated postures. This could be related to the different biomechanical configuration of the body in each posture, corresponding to distinct kinematic patterns of the osteoarticular chain. In addition, the lateral component of the CG acceleration induced by unilateral diaphragm contractions could be clinically relevant in patients with hemidiaphragm paralysis. PMID:25150226

Hamaoui, Alain; Hudson, Anna L; Laviolette, Louis; Nierat, Marie-Cécile; Do, Manh-Cuong; Similowski, Thomas

2014-10-15

90

Calvarial hyperostosis presenting as unilateral exophthalmos in a female English Springer Spaniel.  

PubMed

A 4-month-old intact female English Springer Spaniel presented to the University of Georgia Veterinary Teaching Hospital for evaluation of unilateral, progressive exophthalmos oculus sinister (OS) of 2 weeks' duration. Complete ophthalmic examination revealed moderate OS exophthalmos and lateral globe deviation. No other abnormalities were noted on physical or ophthalmic examination, ocular ultrasound, complete bloodwork, or thoracic radiography. Skull computed tomography (CT) revealed a large, focal, smoothly irregular, cavitated, expansile bony lesion involving the left caudal maxillary and left frontal bones. Biopsies, obtained through a frontal sinusotomy approach to preserve the left globe integrity, demonstrated normal reactive trabecular bone with locally extensive fibrosis. Calvarial hyperostosis was diagnosed based upon appearance on imaging, lesion unilaterality, absence of mandibular involvement, and histopathology. Six months after initial presentation, skull CT was repeated and marked reduction in the degree of frontal bone thickening was demonstrated with complete resolution of cavitations. There was marked clinical improvement with mild, nonpainful exophthalmos, and lateral globe deviation OS on ophthalmic examination. Eleven months after initial presentation, there was complete resolution of the frontal bone lesion with mild thickening of the left calvarial bones on repeat skull CT. There was no exophthalmos or globe deviation present on clinical ophthalmic examination. The proliferative osteopathic lesion was self-resolving with resolution of the exophthalmos and has not recurred to date. To the authors' knowledge, this is the first report of calvarial hyperostosis in a previously unreported breed presenting as unilateral exophthalmos. PMID:22192474

Mathes, Rachel L; Holmes, Shannon P; Coleman, Kevin D; Radlinsky, Mary A G; Moore, Phillip A

2012-07-01

91

Captopril induced renographic alteration in unilateral renal artery stenosis  

SciTech Connect

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.

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

1984-01-01

92

Bilateral internal thoracic artery grafting  

PubMed Central

The effectiveness of the left internal mammary artery graft to the anterior descending coronary artery as a surgical strategy has been shown to improve the survival rate and decrease the risk of adverse cardiac events in patients undergoing coronary bypass surgery. These clinical benefits appear to be related to the superior short and long-term patency rates of the internal thoracic artery graft. Although the advantages of using of both internal thoracic arteries (ITA) for bypass grafting have taken longer to prove, recent results from multiple data sets now support these findings. The major advantage of bilateral ITA grafting appears to be improved survival rate, while the disadvantages of complex ITA grafting include the increased complexity of operation, and an increased risk of wound complications. While these short-term disadvantages have been mitigated in contemporary surgical practice, they have not eliminated. Bilateral ITA grafting should be considered the procedure of choice for patients undergoing coronary bypass surgery that have a predicted survival rate of longer than ten years. PMID:23977627

2013-01-01

93

Surgical Sciences Cardiovascular Surgery, Thoracic Surgery ------------------------------------------------------  

E-print Network

38 Surgical Sciences Cardiovascular Surgery, Thoracic Surgery ------------------------------------------------------ http://ctstokyo.umin.ne.jp/ We are leading in Japan by annual surgery case volume of 700. New knowledge. ·Clinical research · Brain and spinal cord protection in thoracic aortic surgery · Minimally invasive

Miyashita, Yasushi

94

Retropancreatic Teratoma with Intra-thoracic Extension  

PubMed Central

Primary retroperitoneal teratoma is a rare entity in adults. We present a case of 23-yearsold female who presented with complaint of abdominal pain in left upper quadrant. Computed tomography scan revealed a retroperitoneal retropancreatic teratoma near celiac axis with intra thoracic extension. Laparotomy with tumor resection was done. The case report is interesting for intra thoracic extension of retropancreatic teratoma. PMID:24765493

Bakhshi, Girish D.; Wankhede, Kishor R.; Bhadarwar, Ajay H.; Tayade, Mukund B.; Shenoy, Sachin S.; Gore, Sandeep T.

2013-01-01

95

Medicolegal Corner: When minimally invasive thoracic surgery leads to paraplegia  

PubMed Central

A patient with mild cervical myelopathy due to multilevel ossification of the posterior longitudinal ligament (OPLL) initially underwent a cervical C3-T1 laminectomy with C2-T2 fusion utilizing lateral mass screws. The patient's new postoperative right upper extremity paresis largely resolved within several postoperative months. However, approximately 6 months later, the patient developed increased paraparesis attributed to thoracic OPLL and Ossification of the yellow ligament (OYL) at the T2-T5 and T10-T11 levels. The patient underwent simultaneous minimally invasive (MIS) unilateral MetRx approaches to both regions. Postoperatively, the patient was paraplegic and never recovered function. Multiple mistakes led to permanent paraplegia due to MIS MetRx decompressions for T2-T5 and T10-11 OPLL/OYL in this patient. First, both thoracic procedures should have been performed “open” utilizing a full laminectomy rather than MIS; adequate visualization would have likely averted inadvertent cord injury, and the resultant CSF leak. Second, the surgeon should have used an operating microscope. Third, the operation should have been monitored with somatosensory evoked potentials (SEP), motor evoked potentials (MEP), and EMG (electromyography). Fourth, preoperatively the patient should have received a 1-gram dose of Solumedrol for cord “protection”. Fifth, applying Gelfoam as part of the CSF leak repair is contraindicated (e.g. due to swelling in confined spaces- see insert). Sixth, if the patient had not stopped Excedrin prior to the surgery, the surgery should have been delayed to avoid the increased perioperative risk of bleeding/hematoma. PMID:24843811

Epstein, Nancy E.

2014-01-01

96

Minimally invasive endoscopic-assisted posterior thoracic sympathectomy.  

PubMed

Palmar hyperhidrosis is a disorder of the autonomic nervous system characterized by excessive perspiration of the palms, but may involve other body parts as well. Traditional posterior approaches have been performed less often in favor of less invasive thoracoscopic sympathectomies, which have a high success rate with low associated morbidity. However, some patients are not candidates for a transthoracic surgery and may need an alternative treatment strategy. In situations in which a posterior approach may be necessary, the authors have developed a minimal access endoscopic-assisted dorsal sympathectomy procedure, applying minimally invasive spine muscle splitting techniques. The authors believe that the development of this technique may help to minimize surgical morbidity associated with the traditional posterior approach by reducing pain, tissue damage, and length of postoperative recovery. This paper is a report on the successful treatment of palmar hyperhidrosis using a minimally invasive posterior technique and describes the surgical approach and outcomes in 2 patients who have been treated in this manner. Two patients underwent minimally invasive endoscopic-assisted posterior thoracic sympathectomy for hyperhidrosis. Both patients experienced relief of their symptoms after surgery with follow-up durations of 32 and 9 months and length of stays of 0.9 and 2.8 days, respectively. One patient suffered a unilateral Horner syndrome and underwent an eyelid lift. The other patient was readmitted to the hospital 2 days after discharge with atelectasis. She was obese and suffered from chronic obstructive pulmonary disease at baseline, which were reasons she opted for a posterior approach. Neither patient suffered a pneumo- or hemothorax. Minimally invasive endoscopic-assisted posterior thoracic sympathectomy can be safely performed for relief of hyperhidrosis. The procedure has risks for the usual complications of sympathectomy. This technique may provide an alternative to thoracoscopic approaches, especially in those patients with pulmonary disease or obesity. PMID:18673054

Gardner, Paul A; Ochalski, Pawel G; Moossy, John J

2008-01-01

97

Kidney cell electrophoresis  

NASA Technical Reports Server (NTRS)

The following aspects of kidney cell electrophoresis are discussed: (1) the development and testing of electrophoresis solutions; (2) optimization of freezing and thawing; (3) procedures for evaluation of separated kidney cells; and (4) electrophoretic mobility characterization of kidney cells.

Todd, P.

1980-01-01

98

Kidney cell electrophoresis  

NASA Technical Reports Server (NTRS)

A kidney cell electrophoresis technique is described in four parts: (1) the development and testing of electrophoresis solutions; (2) optimization of freezing and thawing; (3) procedures for evaluation of separated kidney cells; and (4) electrophoretic mobility characteristics of kidney cells.

Todd, P.

1979-01-01

99

Diabetes and kidney disease  

MedlinePLUS

Kidney disease or kidney damage that occurs in people with diabetes is called diabetic nephropathy. This condition is ... who have more severe and long-term (chronic) kidney disease may have symptoms such as: Fatigue most of ...

100

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

PubMed Central

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

2012-01-01

101

KIDNEY XENOTRANSPLANTATION  

PubMed Central

Xenotransplantation using pigs as donors offers the possibility of eliminating the chronic shortage of donor kidneys, but there are several obstacles to be overcome before this goal can be achieved. Preclinical studies have shown that while porcine renal xenografts are broadly compatible physiologically, they provoke a complex rejection process involving preformed and elicited antibodies, heightened innate immune cell reactivity, dysregulated coagulation, and a strong T cell-mediated adaptive response. Furthermore, the susceptibility of the xenograft to pro-inflammatory and pro-coagulant stimuli is probably increased by cross-species molecular defects in regulatory pathways. To balance these disadvantages, xenotransplantation has at its disposal a unique tool to address particular rejection mechanisms and incompatibilities: genetic modification of the donor. This review focuses on the pathophysiology of porcine renal xenograft rejection, and on the significant genetic, pharmacological and technical progress that has been made to prolong xenograft survival. PMID:24088952

Cowan, Peter J.; Cooper, David K.C.; d'Apice, Anthony J.F.

2013-01-01

102

[The thoracic aorta aneurism stenting].  

PubMed

27 patients with thoracic aortic aneurism with dissection type III were operated on and stented. The mean age was 56±11,17 years. Men were 24, women 3. 1 patient developed intraoperative stent-graft leakage type IV, and 1 - type II. Both cases needed no additional manipulations. Minimal invasiveness of the procedure and pain absence allowed early activisation of patients. 2 patients had postoperative paraplegia, which was successfully treated by spinal drainage. There were no lethal cases. The long-term follow-up showed no leakage on CT scans; 11 patients demonstrated complete closure of false canal of the stented segment. The overall survival rate was 92.6% after 60 months of follow-up. Unfavorable results were registered in 29.6%. PMID:23503388

Abugov, S A; Belov, Iu V; Puretski?, M V; Strutsenko, M V; Saakian, Iu M; Poliakov, R S; Khovrin, V V; Charchian, E R

2013-01-01

103

Ossification of thoracic ligamenta flava  

SciTech Connect

Although ligamentum flavum ossification (LFO) often occurs in normal persons, there are no reports of its detection on lateral chest radiographs made during screening examinations. Review of 1,744 consecutive lateral chest radiographs identified LFO in 6.2% of males and 4.8% of females. LFO occurred mainly at the intervertebral segments from T9-T10 through T12-L1. Most prevalent was the hook-shaped LFO, protruding inferoirly from the inferior facets into the projections of the intervertabral foramina. Though LFO can cause severe neurologic symptoms, none of the affected persons in this study reported such symptoms. LFO was first visualized radiographically when the subjects were 20-40 years old, and it may be a physiologic condition. The LFO in these cases existed independent of thoracic posterior longitudinal ligament ossification, diffuse idiopathic skeletal hyperostosis, and degenerative osteoarthritis.

Kudo, S.; Minoru, O.; Russell, W.J.

1983-07-01

104

Long-term effects of 24-hr unilateral ureteral obstruction on renal function in the rat.  

PubMed

To characterize the pattern of recovery following release of unilateral ureteral obstruction of 24-hr duration, rats were studied with whole kidney clearance techniques, 3 hrs, 8, 14, and 60 days after release. The single nephron glomerular filtration rate (SNGFR) of superficial and juxtamedullary nephrons was estimated with a modification of Hanssen's technique in rats studied 8 and 60 days after ureteral release. The whole kidney glomerular filtration rates (GFR) were decreased markedly 3 hrs after relief of obstruction, but gradually increased and by 14 days, the GFR of the postobstructed kidney (POK) and the contralateral kidney (CK) were comparable. This recovery of GFR was not a consequence of a homogeneous improvement in SNGFR. At 8 days, more than 15% of superficial and juxtamedullary nephrons were not filtering in the POK. This decrease in the percent of filtering nephrons persisted to 60 days post release, indicating a permanent loss of nephron units. The SNGFR of the residual nephrons of the POK was significantly greater than that of the CK at 8 and 60 days following ureteral release. Thus, acute unilateral ureteral obstruction results in a permanent loss of filtering nephrons, which is offset by hyperfiltration of those remaining. Abnormalities in renal tubule function persisted beyond the time (14 days) when whole kidney GFR had returned to normal. These abnormalities were in distal tubule function. Urine osmolality was consistently lower at all time intervals post release, as was net acid excretion. The results of the present study suggest that these abnormalities are a consequence of the reduction in the number of filtering juxtamedullary nephrons and/or to abnormalities in collecting duct function. PMID:4087683

Bander, S J; Buerkert, J E; Martin, D; Klahr, S

1985-10-01

105

Detecting Unilateral Phrenic Paralysis by Acoustic Respiratory Analysis  

PubMed Central

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

Fiz, Jose Antonio; Jane, Raimon; Lozano, Manuel; Gomez, Rosa; Ruiz, Juan

2014-01-01

106

Detecting unilateral phrenic paralysis by acoustic respiratory analysis.  

PubMed

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

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

2014-01-01

107

Unilateral Isolated Proximal Femoral Focal Deficiency  

PubMed Central

Objective. To discuss a patient with a prenatal diagnosis of unilateral isolated femoral focal deficiency. Case. Antenatal diagnosis of unilateral isolated femoral focal deficiency was made at 20 weeks of gestation. The length of left femur was shorter than the right, and fetal femur length was below the fifth percentile. Proximal femoral focal deficiency was diagnosed. After delivery, the diagnosis was confirmed with skeletal radiographs and magnetic resonance imaging. In prenatal ultrasonographic examination, the early recognition and exclusion of skeletal dysplasias is important; moreover, treatment plans should be initiated, and valuable information should be provided to the family. PMID:23984135

Do?er, Emek; Köpük, ?ule Y.; Çak?ro?lu, Yi?it; Çak?r, Özgür; Yücesoy, Gülseren

2013-01-01

108

Thoracic Wall Reconstruction in Advanced Breast Tumours  

PubMed Central

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

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

2014-01-01

109

Unilateral renal cystic disease--report of one case and review of literature.  

PubMed

Clinical presentation of unilateral renal cystic disease (URCD) is characterized by multiple simple cysts in only 1 kidney. Involvement of other intra-abdominal organs is not found. Renal function is usually preserved despite the existence of multiple cysts. No genetic background can be delineated up to the present. We present 1 patient with URCD, who was evaluated for his right flank pain. Urinalysis and biochemical tests showed normal renal function (BUN 5.03 mmol/l, creatinine 110.5 micromol/l). Ultrasonographic examination was done and it revealed 2 right renal stones. Furthermore, multiple renal cysts over the juxta-medullary area were noted. His left kidney was intact. Computed tomography (CT) of both kidneys confirmed this finding. 99mTc-DTPA renal scan showed that the glomerular filtration rate of both kidneys was not significantly different. There was no family history of renal diseases. His parents, grandparents and siblings were examined for possible kidney lesions, but none of them had any renal cystic lesion. This patient was followed for only a relatively short period of time (3 years) and his renal function did not deteriorate. Follow-up image studies with sonography and CT were not different from the previous ones. PMID:12005250

Lin, S P; Chang, J M; Chen, H C; Lai, Y H

2002-04-01

110

Transgenic Expression of Nonclassically Secreted FGF Suppresses Kidney Repair  

PubMed Central

FGF1 is a signal peptide-less nonclassically released growth factor that is involved in angiogenesis, tissue repair, inflammation, and carcinogenesis. The effects of nonclassical FGF export in vivo are not sufficiently studied. We produced transgenic mice expressing FGF1 in endothelial cells (EC), which allowed the detection of FGF1 export to the vasculature, and studied the efficiency of postischemic kidney repair in these animals. Although FGF1 transgenic mice had a normal phenotype with unperturbed kidney structure, they showed a severely inhibited kidney repair after unilateral ischemia/reperfusion. This was manifested by a strong decrease of postischemic kidney size and weight, whereas the undamaged contralateral kidney exhibited an enhanced compensatory size increase. In addition, the postischemic kidneys of transgenic mice were characterized by hyperplasia of interstitial cells, paucity of epithelial tubular structures, increase of the areas occupied by connective tissue, and neutrophil and macrophage infiltration. The continuous treatment of transgenic mice with the cell membrane stabilizer, taurine, inhibited nonclassical FGF1 export and significantly rescued postischemic kidney repair. It was also found that similar to EC, the transgenic expression of FGF1 in monocytes and macrophages suppresses kidney repair. We suggest that nonclassical export may be used as a target for the treatment of pathologies involving signal peptide-less FGFs. PMID:22606265

Kirov, Aleksandr; Duarte, Maria; Guay, Justin; Karolak, Michele; Yan, Cong; Oxburgh, Leif; Prudovsky, Igor

2012-01-01

111

Kidney Stones  

PubMed Central

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

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

1980-01-01

112

Robotic assisted kidney transplantation  

PubMed Central

Kidney transplantation is the standard of care for patients with end stage renal disease. While open surgery remains the gold standard, minimally invasive surgery has recently been introduced for the recipient undergoing kidney transplantation. We review the evolution of techniques of minimally invasive surgery for kidney transplantation with specific emphasis on technical aspects of robotic assisted kidney transplantation. PMID:25097315

Modi, Pranjal; Pal, Bipinchandra; Modi, Jayesh; Kumar, Suresh; Sood, Akshay; Menon, Mani

2014-01-01

113

Modern impact of video assisted thoracic surgery  

PubMed Central

With advancement in technology, experience and training over the last two decades, video assisted thoracic surgery (VATS) has become widely accepted and utilized all over the world. VATS started as a diagnostic tool in the early 1990s, technique of VATS lobectomy evolved and became safer over the next 10-15 years and now it is being used for more advanced and hybrid operations. VATS has contributed to the development of minimally invasive surgical interventions for other thoracic disorders like mediastinal tumors and esophageal cancer as well. This article looks at the advantages of VATS, technique advancements and its applications in other thoracic operations and its influence on the present and future of thoracic surgery. PMID:25379201

D'Amico, Thomas A.

2014-01-01

114

Characteristics and outcome of thoracic neuroblastoma.  

PubMed

It has been reported by several groups that thoracic neuroblastoma (NB) are associated with a better outcome than NB of other localisation. Concerning the reason for this phenomenon, however, the findings have diverged and therefore therapeutic recommendations are not uniform. We performed a retrospective analysis of the prognostic factors and surgical results of 113 thoracic NB and compared these to 556 NB of other sites, all treated according to the protocol of the German Cooperative Study NB90. Compared to non-thoracic NB, thoracic NB showed a female preponderance (P = 0.018), more often with localised disease stages 1 - 3 (P < 0.001), lower LDH serum levels (P = 0.027), and less often with MYCN amplification (P = 0.04), while there was no statistically significant difference in the patients' ages and histological grades. In a separate analysis of localised (stages 1 - 3), stage 4 and stage 4 S NB, there were no differences between thoracic and non-thoracic NB in LDH secretion. MYCN amplification was different only in localised NB (P = 0.037). In a multivariate analysis, tumour stage (P < 0.0001), MYCN-status (P < 0.001) and serum-LDH (P = 0.008), but not thoracic localisation, were independent prognostic factors. A complete resection was achieved in 73/104 (70 %) operated thoracic NB, while 25 (24 %) were partially resected and 6 (6 %) only biopsied. Patients with thoracic NB had a better outcome only in stage 4, but not in stages 1 - 3 and 4 S (EFS; P = 0.028). There was no difference for all stages in the event-free survival between completely and incompletely resected tumours. Surgical complications occurred in 34 (20 %) of all operations, some of them severe, although there were no surgical deaths. Our results suggest that although thoracic NB has a relatively favourable prognosis, it should be treated in the same way as NB with non-thoracic localisation, with stratification according to tumour stage and biological properties, such as MYCN status. Radical surgery is only indicated if mutilation and life-threatening complications can be avoided. PMID:12101494

Häberle, B; Hero, B; Berthold, F; von Schweinitz, D

2002-06-01

115

Objective voice analysis after autologous fat injection for unilateral vocal fold paralysis.  

PubMed

This study was designed to objectively compare a patient's voice after onset of unilateral vocal fold paralysis (UVFP) to his or her own normal voice, and to compare the results after treatment by intrafold injection of autologous fat. Acoustic recordings were obtained for 2 male patients before thoracic surgery and after the onset of iatrogenic left UVFP. Vocal fold augmentation was performed 10 days after UVFP. The acoustic recordings were repeated within 3 days and at 1 month. The phonation quotient, pitch perturbation quotient, amplitude perturbation quotient, harmonics-to-noise ratio, cepstral peak prominence, and long-term average spectrum were analyzed. All parameters improved after treatment, with a return to preparalytic values for most. During the first month, some deterioration was noted. This is the first study comparing a subject's own normal voice to his or her voice after vocal fold augmentation. We recommend overinjection of fat if vocal fold atrophy is expected. PMID:11269766

Hartl, D M; Hans, S; Vaissière, J; Riquet, M; Laccourreye, O; Brasnu, D F

2001-03-01

116

Unilateral Vestibular Loss Impairs External Space Representation  

PubMed Central

The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal) and far (extrapersonal) spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation), and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss. PMID:24523916

Borel, Liliane; Redon-Zouiteni, Christine; Cauvin, Pierre; Dumitrescu, Michel; Deveze, Arnaud; Magnan, Jacques; Peruch, Patrick

2014-01-01

117

A rare cause of thoracic outlet syndrome  

Microsoft Academic Search

First rib pathology can narrow the thoracic outlet thus producing compression of the brachial plexus and subclavian vessels.\\u000a There have been only three case reports of neurogenic thoracic outlet syndrome (TOS) caused by a nonunion of the first rib\\u000a and there have been no reports of a first rib malunion causing TOS. A rare case of TOS caused by a

Ethan R. Wiesler; George D. Chloros; N. Michael Xu; Zhongyu Li

2008-01-01

118

Current management of thoracic outlet syndrome  

Microsoft Academic Search

Opinion statement  Thoracic outlet syndrome (TOS) is a condition caused by compression of the neurovascular structures leading to the arm passing\\u000a through the thoracic outlet. There are three distinct types of TOS: neurogenic (95%), venous (4%–5%), and arterial (1%). Treatment\\u000a algorithms depend on the type of TOS. Although statistically the most common type, neurogenic TOS can often be the most difficult

Mark W. Fugate; Lisa Rotellini-Coltvet; Julie A. Freischlag

2009-01-01

119

Shear wave velocity measurements using acoustic radiation force impulse in young children with normal kidneys versus hydronephrotic kidneys  

PubMed Central

Purpose: To measure shear wave velocities (SWVs) by acoustic radiation force impulse (ARFI) ultrasound elastography in normal kidneys and in hydronephrotic kidneys in young children and to compare SWVs between the hydronephrosis grades. Methods: This study was approved by an institutional review board, and informed consent was obtained from the parents of all the children included. Children under the age of 24 months were prospectively enrolled. Hydronephrosis grade was evaluated on ultrasonography, and three valid ARFI measurements were attempted using a high-frequency transducer for both kidneys. Hydronephrosis was graded from 0 to 4, and high-grade hydronephrosis was defined as grades 3 and 4. Results: Fifty-one children underwent ARFI measurements, and three valid measurements for both kidneys were obtained in 96% (49/51) of the patients. Nineteen children (38.8%) had no hydronephrosis. Twenty-three children (46.9%) had unilateral hydronephrosis, and seven children (14.3%) had bilateral hydronephrosis. Seven children had ureteropelvic junction obstruction (UPJO). Median SWVs in kidneys with high-grade hydronephrosis (2.02 m/sec) were higher than those in normal kidneys (1.75 m/sec; P=0.027). However, the presence of UPJO did not influence the median SWVs in hydronephrotic kidneys (P=0.362). Conclusion: Obtaining ARFI measurements of the kidney is feasible in young children with median SWVs of 1.75 m/sec in normal kidneys. Median SWVs increased in high-grade hydronephrotic kidneys but were not different between hydronephrotic kidneys with and without UPJO. PMID:24936504

2014-01-01

120

The Society of Thoracic Surgeons\\/American Association for Thoracic Surgery Off-Pump Training Program  

Microsoft Academic Search

Background. Opportunities to acquire knowledge and skills in new technology are limited for cardiothoracic surgeons after completion of residency. In 2000 The Society of Thoracic Surgeons\\/American Association for Thoracic Surgery Joint Committee for New Technology Assessment accepted an educational grant from the Foundation for Advanced Medical Education to imple- ment and test an instructional program for practicing cardiothoracic surgeons in

Richard P. Anderson; Meghan Carey; Evelyn Baram-Clothier; Michael J. Mack; Bruce W. Lytle

2006-01-01

121

Influence of Thoracic Flexion Syndrome on Proprioception in the Thoracic Spine  

PubMed Central

[Purpose] This study was performed to determine the difference in thoracic repositioning sense in young people with and without thoracic flexion syndrome (TFS) in target positions of half extension. [Subjects] People with TFS (n = 15; 7 men and 8 women) and people without TFS (n = 15; 7 men and 8 women) were recruited from three universities. Subjects were guided into a sitting extension target posture and were asked to move from a neutral position (2?s) to an extension target position (2?s); 10 trials were performed. [Results] People with TFS showed a significantly higher thoracic repositioning error in the extension target position than people without TFS. [Conclusion] People with TFS show a higher thoracic spine repositioning error in extension than people without TFS. A rehabilitation program to treat TFS should be implemented for individuals with decreased position sense of the thoracic spine. PMID:25364109

Park, Kyue-Nam; Oh, Jae-Seop

2014-01-01

122

Percutaneous radiofrequency upper thoracic sympathectomy.  

PubMed

Between June 1979 and May 1994, I performed 148 unilateral or bilateral sympathectomies on 247 limbs in 110 patients using a percutaneous radiofrequency technique, usually on an outpatient surgery basis. Patient ages ranged from 10 to 81 years, with 45 male and 65 female patients. Four patients had unsuccessfully undergone prior open surgical sympathectomy. Patients suffered from hyperhidrosis, vascular occlusion, Raynaud's disease or other chronic vasculopathies, painful causalgia or reflex sympathetic dystrophy, or Prinzmetal's angina. The sympathectomy technique has evolved over this 15-year period and is currently in its third phase. Changes in the procedure were based on anatomic and clinical/radiographic correlations and careful patient follow-up. Current modifications have reduced the frequency of both early and late failures. The present technique (Phase III) relies on neuroleptanalgesia with superficial local anesthesia only and does not require general anesthesia, intubation, or lung collapse. Two 18-gauge radiofrequency TIC needle electrodes (Radionics, Burlington, MA) are used. A series of three lesions is rostrocaudally made at each of the ganglion sites selected in an attempt to destroy the entire fusiform ganglion. Lesion sites are targeted by C-arm fluoroscopy and electrical stimulation, which produces a threshold of sensory awareness of > 1.0 V. Lesion effectiveness is monitored by bilateral finger plethysmography and hand skin temperature measurement. With the Phase III technique, the sympathetic activity in 96% of operated limbs after 2 years and in 91% of operated limbs after 3 years continues to be completely or largely interrupted. By comparison, I achieved similar success in 83 and 72% operated limbs with the Phase I technique and in 77 and 71% with the Phase II technique. Symptomatic pneumothorax, in six patients, has been the only serious complication. When necessary, a subsequent operation can easily be performed and is effective. PMID:8692390

Wilkinson, H A

1996-04-01

123

Unilateral paralysis associated with profound hypokalemia.  

PubMed

Unilateral paralysis is rarely reported to be primary presentation of severe hypokalemia. We describe a 24-year-old woman who presented to the emergency department with sudden onset of right-sided weakness. Neurologic examination revealed diminished muscle strength and tendon reflexes over the right limbs. Computed tomography of the brain showed no organic brain lesion. However, laboratory data showed hypokalemia (K+ 2.0 mmol/L) with metabolic acidosis (HCO3 ? 19 mmol/L). She needed a total of 260 mmol K+ to achieve complete recovery of muscle strength at a serum K+ level of 3.2 mmol/L and was proved to have distal renal tubular acidosis. Severe hypokalemia must be kept in mind as a cause of acute unilateral paralysis without organic lesions to avoid unnecessary examination and potentially life-threatening complications. PMID:22463964

Chiang, Wen-Fang; Yeh, Fu-Chiang; Lin, Shih-Hua

2012-11-01

124

?2AP mediated myofibroblast formation and the development of renal fibrosis in unilateral ureteral obstruction.  

PubMed

Renal fibrosis is the final common pathway of a wide variety of chronic kidney diseases. Myofibroblast formation via the differentiation of from tissue-resident fibroblasts and bone marrow-derived mesenchymal stem cells (MSCs), and epithelial-to-mesenchymal transition (EMT) is known to play a pivotal role in the development of renal fibrosis. However, the detailed mechanisms underlying this disorder remain unclear. We herein investigated the role of alpha 2-antiplasmin (?2AP) in myofibroblast formation and the development of renal fibrosis. We observed the development of renal fibrosis using unilateral ureteral obstruction (UUO). ?2AP had accumulated in the UUO-induced obstructed kidneys and ?2AP deficiency attenuated UUO-induced renal fibrosis in mice. The degree of myofibroblast formation in the obstructed kidneys of ?2AP(-/-) mice was less than that in ?2AP(+/+) mice. In vitro, ?2AP induced myofibroblast formation in renal tubular epithelial cells (RTECs), renal fibrosblasts, and bone marrow-derived mesenchymal stem cells (MSCs). ?2AP also induced the production of TGF-?, which is known to be a key regulator of myofibroblast formation and fibrosis. ?2AP-induced the TGF-? production was significantly reduced by SP600125, c-Jun N-terminal kinase (JNK) specific inhibitor. Our findings suggest that ?2AP induces myofibroblast formation in the obstructed kidneys, and mediates the development of renal fibrosis. PMID:25095732

Kanno, Yosuke; Kawashita, Eri; Kokado, Akiko; Kuretake, Hiromi; Ikeda, Kanako; Okada, Kiyotaka; Seishima, Mariko; Ueshima, Shigeru; Matsuo, Osamu; Matsuno, Hiroyuki

2014-01-01

125

Unilateral coronal craniosynostosis and Down syndrome.  

PubMed

There is no known correlation between Down syndrome and craniosynostosis. The authors report 2 infants with trisomy 21 and right unilateral coronal craniosynostosis. Both patients were clinically asymptomatic but displayed characteristic craniofacial features associated with each disorder. One patient underwent a bilateral fronto-orbital advancement and the other underwent an endoscopically assisted strip craniectomy with postoperative helmet therapy. Both patients demonstrated good cosmesis at follow-up. PMID:24635134

Siu, Alan; Rogers, Gary F; Myseros, John S; Khalsa, Siri S; Keating, Robert F; Magge, Suresh N

2014-05-01

126

Local recurrence of a unilateral cystic nephroma.  

PubMed

Cystic nephroma is an uncommon, benign renal lesion. We report the first case of local recurrence of a unilateral cystic nephroma in an adult. Only three cases of recurrence in bilateral cystic nephroma have been described in the literature before. Other renal lesions may not be differentiated preoperatively from cystic nephroma and thus require surgical exploration. Long-term follow-up is recommended to rule out local recurrence. PMID:15147551

Bastian, Patrick J; Kuhlmann, Richard; Vogel, Jürgen; Bastian, Hans-Peter

2004-05-01

127

Functioning unilateral adrenocortical carcinoma in a dog.  

PubMed

An 11-year-old, 24-kg, intact female Siberian husky dog in anestrus had a 2-month history of polyuria and polydipsia. The dog had signs of mineralocorticoid excess such as hypertension and hypokalemia refractory to potassium supplementation. Abdominal ultrasound revealed an irregular mass in the left adrenal gland. The ACTH stimulation test for aldosterone concentration did not reveal hyperaldosteronism. Unilateral adrenalectomy was performed and histopathology identified adrenal cortical carcinoma. All clinical signs of mineralocorticoid excess ceased after surgery. PMID:23204580

Gójska-Zygner, Olga; Lechowski, Roman; Zygner, Wojciech

2012-06-01

128

Unilateral headache with bilateral internal ophthalmoplegia.  

PubMed

We describe the case of a young woman suffering from migraine. After some years, the headache started to be accompanied by internal ophthalmoplegia. Mydriasis was unilateral and after a few months became bilateral. The ophthalmoplegic migraine is a rare type of headache and it is characterized by paresis of one or more of the third, fourth or sixth cranial nerves. Migraine attacks associated with mydriasis (internal ophthalmoplegia) are extremely rare. Triptan therapy resolved mydriasis, but not the headache. PMID:22183266

Simonetto, Marco; Zanet, Luca; Capozzoli, Francesca; Gelli, Andrea; Masè, Giovanni

2012-10-01

129

Coexisting papillary and clear renal cell carcinoma in the same kidney.  

PubMed

Renal cell carcinoma (RCC) is the most common solid lesion of the kidney. Bilateral synchronous benign and malignant renal tumors have been defined in some reports. However, unilateral concordance of malignant renal tumors is very rare and there are only a few cases that had synchronous different subtypes of malignant renal tumors arising within the same kidney. Herein, we describe a 67-year-old male patient who had clear cell RCC and papillary RCC in his right kidney that were successfully treated with radical nephrectomy. We also reviewed the pertinent literature. PMID:25180117

Ustuner, Murat; Yaprak, Busra; Teke, Kerem; Ciftci, Seyfettin; Kart, Mucahit; Yildiz, Kursat; Culha, Melih

2014-01-01

130

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

PubMed Central

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

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

2014-01-01

131

Kidney function tests  

MedlinePLUS

Kidney function tests are common lab tests used to evaluate how well the kidneys are working. Such tests include: ... 2011:chap 8. Oh MS. Evaluation of renal function, water, electrolytes and acid-base balance. In: McPherson ...

132

Proximal tubule PPAR? attenuates renal fibrosis and inflammation caused by unilateral ureteral obstruction.  

PubMed

We examined the effects of increased expression of proximal tubule peroxisome proliferator-activated receptor (PPAR)? in a mouse model of renal fibrosis. After 5 days of unilateral ureteral obstruction (UUO), PPAR? expression was significantly reduced in kidney tissue of wild-type mice but this downregulation was attenuated in proximal tubules of PPAR? transgenic (Tg) mice. When compared with wild-type mice subjected to UUO, PPAR? Tg mice had reduced mRNA and protein expression of proximal tubule transforming growth factor (TGF)-?1, with reduced production of extracellular matrix proteins including collagen 1, fibronectin, ?-smooth muscle actin, and reduced tubulointerstitial fibrosis. UUO-mediated increased expression of microRNA 21 in kidney tissue was also reduced in PPAR? Tg mice. Overexpression of PPAR? in cultured proximal tubular cells by adenoviral transduction reduced aristolochic acid-mediated increased production of TGF-?, demonstrating PPAR? signaling reduces epithelial TGF-? production. Flow cytometry studies of dissociated whole kidneys demonstrated reduced macrophage infiltration to kidney tissue in PPAR? Tg mice after UUO. Increased expression of proinflammatory cytokines including IL-1?, IL-6, and TNF-? in wild-type mice was also significantly reduced in kidney tissue of PPAR? Tg mice. In contrast, the expression of anti-inflammatory cytokines IL-10 and arginase-1 was significantly increased in kidney tissue of PPAR? Tg mice when compared with wild-type mice subjected to UUO. Our studies demonstrate several mechanisms by which preserved expression of proximal tubule PPAR? reduces tubulointerstitial fibrosis and inflammation associated with obstructive uropathy. PMID:23804447

Li, Shenyang; Mariappan, Nithya; Megyesi, Judit; Shank, Brian; Kannan, Krishnaswamy; Theus, Sue; Price, Peter M; Duffield, Jeremy S; Portilla, Didier

2013-09-01

133

Effect of unilateral ureteral obstruction and anti-angiotensin II treatment on renal tubule cell apoptosis and interstitial fibrosis in rats.  

PubMed

Unilateral ureteral obstruction (UUO) results in a number of pathophysiological and morphological changes in the renal parenchyma, including interstitial inflammation and fibrosis, apoptotic changes of tubular and interstitial cells. Recent studies have indicated an association between renin-angiotensin system and apoptotic alterations in the kidney after unilateral obstructive nephropathy. In this study, the effect of ACE inhibitors and AT1 receptor antagonists on tubular cell apoptosis and interstitial fibrosis in obstructive nephropathy after UUO in rats was investigated. The study was conducted on Wistar rats with unilaterally ligated ureter and sham operated animals (control group). The rats with UUO were treated with ACE inhibitor (cilazapril) or AT1 receptor antagonists (losartan) and control group was treated with H2O. Sham-operated animals were treated in the same way. Tubular and interstitial cell apoptosis was detected morphologically by hematoxylin and eosin (HE) staining and terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL). The area of intersitial fibrosis was determined using computer-assisted image processing after Gomory silver impregnation of paraffin sections. All experimental animal groups with unilateral ureter ligation showed a significantly increased number of apoptotic tubular and interstitial cells in the obstructed kidney compared with the contralateral, unobstructed kidney. Histomorphometric analysis of renal interstitial fibrotic changes in the groups of rats treated with losartan or water showed a statistically significant difference (p < 0.05) between the operated and sham--operated animals. In conclusion, following UUO there is a significantly increased number of apoptotic tubular cells and interstitial fibrosis in the ipsilateral kidney compared with the contralateral kidney. ACE inhibitors and AT1 receptor antagonists could not decrease the extent of renal cells apoptosis and interstitial fibrosis after UUO. PMID:25144992

Radovi?, Nikola; Aralica, Gorana; Ljubanovi?, Danica Galesi?; Jelec, Vjekoslav; Kontek, Mladen

2014-06-01

134

Kidney Dysplasia National Kidney and Urologic Diseases Information Clearinghouse  

E-print Network

Kidney Dysplasia National Kidney and Urologic Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is kidney dysplasia? The kidneys are a pair the kidneys to the bladder through tubes called ureters. Kidney dysplasia is a condition that can occur

Baker, Chris I.

135

Acute Shingles after Resection of Thoracic Schwannoma  

PubMed Central

Herpes zoster is relatively uncommon after surgery in immunocompetent patients. To our knowledge, there have been no reports of herpes zoster after the resection of a thoracic schwannoma. We report the case of a 48-year-old woman in whom acute shingles developed after the video-assisted thoracic surgical resection of a posterior mediastinal schwannoma adjacent to the 4th thoracic vertebral body. The patient recovered after receiving timely antiviral therapy. Rash and pain are common in patients who have wound infections and contact dermatitis after surgery, so the possible reactivation of varicella virus might not be prominent in the surgeon's mind. This case serves as a reminder that viral infections such as shingles should be considered in the differential diagnosis of postoperative erythema and pain. PMID:22740749

Muesse, Jason L.; Blackmon, Shanda H.; Harris, Richard L.; Kim, Min P.

2012-01-01

136

Pleural abnormalities: thoracic ultrasound to the rescue!  

PubMed

Diaphragmatic hernias that are diagnosed in adulthood may be traumatic or congenital in nature. Therefore, respiratory specialists need to be aware of the presentation of patients with these conditions. In this report, we describe a case series of patients with congenital and traumatic diaphragmatic hernias and highlight a varied range of their presentations. Abnormalities were noted in the thorax on the chest radiographs, but it was unclear as to the nature of the anomaly. The findings on thoracic ultrasound conducted by a pulmonologist helped to direct appropriate investigations avoiding unnecessary interventions. Instead of pleural effusions, consolidation or collapse, thoracic computed tomography demonstrated diaphragmatic hernias which were managed either conservatively or by surgery. There is increasing evidence that pulmonary specialists should be trained in thoracic ultrasonography to identify pleural pathology as well as safely conducting pleural-based interventions. PMID:23819018

Aslam, Imran; Pathmanathan, Sega; Lakshminarayana, Umesh B; Avery, Gerard R; Kastelik, Jack A; Morjaria, Jaymin B

2013-07-01

137

New stereotactic technique for percutaneous thermocoagulation upper thoracic ganglionectomy in cases of palmar hyperhidrosis.  

PubMed

To perform unilateral or bilateral upper thoracic ganglionectomy, we established a three-dimensional system of coordinates for T2 and T3 ganglia. For this purpose, the spatial relations were represented by drawings obtained from 50 Chinese cadavers. A simple stereotactic frame was constructed as an aid in performing the procedure. Then, according to the established three-dimensional system of coordinates, percutaneous thermocoagulation of both T2 and T3 ganglia was performed on 10 patients (20 sides) with palmar hyperhidrosis, under local anesthesia and fluoroscopic guidance at the posteroanterior projection. Excellent relief of abnormal sweating in 19 of the 20 hands was achieved. Partial relief was obtained in the remaining hand. No complication was observed in our patients. The technique has been proved to be safe, effective, and simpler than other methods now in use. PMID:3283596

Chuang, K S; Liou, N H; Liu, J C

1988-03-01

138

update: acute KIDNEY INJURY  

E-print Network

Guidelines update: acute KIDNEY INJURY August 2012, Issue 8 Tlaleletso is a monthly publication that have acute kidney injury. We review the common presentations and causes, especially in patients living it to cover, please send us your feedback­ either on content or format. Respectfully, Mike Reid Acute kidney

Bushman, Frederic

139

Polycystic Kidney Disease (PKD)  

MedlinePLUS

... have PKD have kidney failure by age 60. Dialysis (blood filtering) and kidney transplants are both effective treatments for kidney failure. Symptoms What are the symptoms of PKD? The most common symptom of PKD is high blood pressure. Other symptoms are: Pain in the back and side Blood in the ...

140

Advances in thoracic aortic surgery: Arch replacement with axillary cannulation and thoracic stent grafts  

PubMed Central

During the past decade, significant advances in thoracic surgery have contributed to a decrease in the morbidity and mortality linked to surgery of the thoracic aorta. Drawing from the experiences at the Quebec Heart Institute, the present article focuses on the improvements in surgery of the aortic arch, mainly the use of the ‘arch-first technique’ and arterial cannulation through the right axillary artery. Furthermore, advances in the treatment of diseases of the descending aorta using thoracic stent grafts are delineated. The importance of establishing dedicated multi-disciplinary teams and follow-up clinics to ensure good outcomes in the treatment of these complex diseases is stressed. PMID:17932592

Dagenais, Francois; Dumont, Eric; Mathieu, Patrick; Voisine, Pierre

2007-01-01

141

Advances in thoracic aortic surgery: arch replacement with axillary cannulation and thoracic stent grafts.  

PubMed

During the past decade, significant advances in thoracic surgery have contributed to a decrease in the morbidity and mortality linked to surgery of the thoracic aorta. Drawing from the experiences at the Quebec Heart Institute, the present article focuses on the improvements in surgery of the aortic arch, mainly the use of the 'arch-first technique' and arterial cannulation through the right axillary artery. Furthermore, advances in the treatment of diseases of the descending aorta using thoracic stent grafts are delineated. The importance of establishing dedicated multidisciplinary teams and follow-up clinics to ensure good outcomes in the treatment of these complex diseases is stressed. PMID:17932592

Dagenais, François; Dumont, Eric; Mathieu, Patrick; Voisine, Pierre

2007-10-01

142

Compensatory Growth of Congenital Solitary Kidneys in Pigs Reflects Increased Nephron Numbers Rather Than Hypertrophy  

PubMed Central

Background Patients with unilateral MultiCystic Kidney Dysplasia (MCKD) or unilateral renal agenesis (URA) have a congenital solitary functioning kidney (CSFK) that is compensatory enlarged. The question whether this enlargement is due to increased nephron numbers and/or to nephron hypertrophy is unresolved. This question is of utmost clinical importance, since hypertrophy is associated with a risk of developing hypertension and proteinuria later in life with consequent development of CKD and cardiovascular disease. Methodology/Principal Findings In a cohort of 32,000 slaughter pigs, 7 congenital solitary functioning kidneys and 7 control kidneys were identified and harvested. Cortex volume was measured and with a 3-dimensional stereologic technique the number and volume of glomeruli was determined and compared. The mean total cortex volume was increased by more than 80% and the mean number of glomeruli per kidney was 50% higher in CSFKs than in a single control kidney, equaling 75% of the total nephron number in both kidneys of control subjects. The mean total glomerular volume in the CSFKs was not increased relative to the controls. Conclusions/Significance Thus, in pigs, compensatory enlargement of a CSFK is based on increased nephron numbers. Extrapolation of these findings to the human situation suggests that patients with a CSFK might not be at increased risk for developing hyperfiltration-associated renal and cardiovascular disease in later life due to a lower nephron number. PMID:23185419

van Vuuren, Stefan H.; Sol, Chalana M.; Broekhuizen, Roel; Lilien, Marc R.; Oosterveld, Michiel J. S.; Nguyen, Tri Q.

2012-01-01

143

Normal black kidney.  

PubMed

A black kidney has 3 major differential diagnoses: hemosiderosis, lipofuscin pigment and melanotic renal cell carcinoma. Excluding lipofuscin, the other 2 are accompanied by an abnormal renal function. We report on a 25-year-old man who intended to donate a kidney to his cousin. On the operating room table when we incised the left flank region and exposed the kidney, we found a firm and black kidney so the operation was cancelled due to potential vascular injuries. Days after the incomplete procedure, we reviewed the donor's biochemistry and imaging to reassess his renal function, but the results showed quite normal renal function again. The result of Ham test was also negative. Two weeks later, we began the operation, removed the same left kidney and found that it was in the same conditions as it was before. We took the opportunity to send needle biopsies of the kidney for histopathologic analysis. The analysis showed a melanotic kidney without pathological changes in glomeruli and interstitium and vessels. A black kidney may result in hemosiderin, lipofuscin or melanin deposits in the kidney, which can confirm the diagnosis; however, special tests for underlying disease and renal function should be considered. Some causes of black kidney lead to abnormal function, but our patients's kidney returned to normal. PMID:24839502

Yarmohamadi, Aliasghar; Rezayat, Ali Reza Akhavan; Memar, Bahram; Rahimi, Hamid Reza; Cand, PhD

2014-03-01

144

AMERICAN THORACIC SOCIETY PATIENT HEALTH SERIES Lung Cancer Prevention  

E-print Network

AMERICAN THORACIC SOCIETY PATIENT HEALTH SERIES Lung Cancer Prevention What are the chances that I. 182, Number 10, P3. www.thoracic.org ATS Patient Health Series ©2011 American Thoracic Society What can I do to decrease my risk of developing lung cancer? The best way to lower your risk is to avoid

Kaski, Samuel

145

THORACIC RADIOGRAPHIC IMAGING THE COUGHING AND DYSPNEIC DOG AND CAT  

Microsoft Academic Search

CLINICAL OVERVIEW- THORACIC RADIOGRAPHY The thoracic radiograph provides information about thoracic musculoskeletal conformation and disease, cardiac size and shape, pulmonary parenchymal and vascular disorders, and conditions involving the pleura, mediastinum, esophagus, and diaphragm. Radiographs help confirm or exclude clinical impressions, support or reject specific diagnoses, and provide important information not otherwise suspected. They help to screen for cardiopulmonary, systemic, and

Philip R Fox

146

Convergence of Unilateral Laplace Transforms on Time Scales  

Microsoft Academic Search

A time scale is any closed subset of the real line. Continuous time and discrete time are special cases. The unilateral Laplace\\u000a transform of a signal on a time scale subsumes the continuous-time unilateral Laplace transform, and the discrete-time unilateral\\u000a z-transform as special cases. The regions of convergence (ROCs) time scale Laplace transforms are determined by the time scale’s\\u000a graininess.

John M. Davis; Ian A. Gravagne; Robert J. Marks

2010-01-01

147

Self-perceived video-assisted thoracic surgery lobectomy proficiency by recent graduates of North American thoracic residencies  

PubMed Central

Minimally invasive surgical techniques offer several advantages over traditional open procedures, yet the pathway to minimally invasive proficiency can be difficult to navigate. As a part of an effort of the Joint Council of Thoracic Surgical Education to increase access to this skill set in the general thoracic community, recent graduates of thoracic residencies were surveyed to determine the self-reported achievement of video-assisted thoracic surgery (VATS) lobectomy proficiency and the merits of various educational opportunities. The objective of this study was to estimate the comfort level of recent graduates with the minimally invasive approach, as this demographic not only reflects the current status of training, but represents the future of the specialty. Surgeons graduating North American thoracic residencies between 2006 and 2008 identifying themselves as practitioners of general thoracic surgery were surveyed. A total of 271 surgeons completed training between 2006 and 2008 and indicated general thoracic to be a part of their practice (84 dedicated thoracic and 187 mixed). One hundred and forty-six surgeons completed the survey (54%) including 74 of 84 (88%) dedicated thoracic surgeons. Overall, 58% of recent graduates who perform general thoracic procedures consider themselves proficient in VATS lobectomies (86% of dedicated thoracic surgeons and 28% of surgeons with a mixed practice, P < 0.0001). Of surgeons considering themselves to be proficient at VATS lobectomies, 66% felt thoracic residency was critical or very important to achieving proficiency. Fellowships after completing board residency, animal labs, and follow-up VATS courses put on by experts were much less consistently beneficial. The vast majority of the 25 dedicated general thoracic surgeons who graduate each year consider themselves proficient in VATS lobectomies, largely due to training in their thoracic residencies. On the other hand, the minority of surgeons performing general thoracic procedures as a part of a mixed practice consider themselves proficient in VATS lobectomies. Further study is warranted to enhance the VATS lobectomy experience of mixed practice surgeons particularly during their thoracic residencies. PMID:22381653

Boffa, Daniel J.; Gangadharan, Sidharta; Kent, Michael; Kerendi, Faraz; Onaitis, Mark; Verrier, Edward; Roselli, Eric

2012-01-01

148

Modern Anesthetic Techniques for Thoracic Operations  

Microsoft Academic Search

Continuing advances in anesthesiology enable surgeons to perform more and more complex operations. Nowhere is this relation more important than for the patient undergoing thoracic surgery. Specialized anesthetic techniques including safe lung separation, the maintenance of oxygenation during selective one-lung ventilation, and effective postoperative analgesia allow procedures such as lung volume reduction surgery and lung transplantation to be performed routinely.

2001-01-01

149

Thoracic BB injuries in pediatric patients.  

PubMed

Penetrating thoracic injury from BB shot remains an innocuous event in most patients, but factors including location, proximity, gun type, and patient weight may identify groups at risk. The following cases demonstrate morbidity and mortality in two patients, and this experience may suggest the need for reassessment of this injury. PMID:7897723

Fernandez, L G; Radhakrishnan, J; Gordon, R T; Shah, M R; Lain, K Y; Messersmith, R N; Roettger, R H; Norwood, S H

1995-03-01

150

Thoracic vertebral osteomyelitis following catfish spine impalement.  

PubMed

Although rare, thoracic osteomyelitis can occur when toxins from a catfish spine impalement to the hand spread via the blood. This article describes diagnosis and management of this condition in a man who required hospitalization for debilitating back pain that developed 3 weeks after the initial injury. PMID:25343428

Sateren-Zoller, Elizabeth; Sharma, Manish S; Tin, Thiha; Cannella, Dominic M; Chyatte, Douglas

2014-11-01

151

Tricuspid valve regurgitation following blunt thoracic trauma.  

PubMed

Valvular lesions following blunt thoracic trauma are uncommon. Tricuspid valve regurgitation occurs very rarely. We report a successful tricuspid valve reconstruction for rupture of the chordae tendineae in a young man nine years after a motor vehicle accident. The value of echocardiography and transesophageal echocardiography for the diagnosis and quantification of this valve lesion is stressed. PMID:1395792

Kleikamp, G; Schnepper, U; Körtke, H; Breymann, T; Körfer, R

1992-10-01

152

Combining Targeted Therapies for Thoracic Cancers  

Cancer.gov

In this trial, patients with advanced thoracic cancers (cancers of the chest) or other cancers that have spread to the chest will be treated with the drugs romidepsin and flavopiridol. Researchers will study the safety of this combination and how these agents affect gene and protein expression in these patients.

153

Thoracic Outlet Decompression for Subclavian Vein Thrombosis  

Microsoft Academic Search

Hypothesis:Thereisadifferenceinoutcomeswhenpa- tients have neurogenic thoracic outlet syndrome in ad- dition to subclavian vein thrombosis. Methods: Analysis of a prospectively developed data- base, medical record review, and a patient question- naire were used to summarize clinical experience from December 1990 to December 2001 on the basis of the patient's original evaluation. Patients were stratified on the presence (group 1) or absence

Vasu Divi; Mary C. Proctor; David A. Axelrod; Lazar J. Greenfield

2005-01-01

154

Thoracic endoscopic T2-T3 sympathectomy in palmar hyperhidrosis: experience of 112 cases.  

PubMed

Palmar hyperhidrosis is a troublesome and embarrassing disorder that causes professional, psychological, and social handicaps. Its etiology is unknown, although surgical treatment by thoracic sympathectomy is presently believed to be the best method of cure. Up to now, numerous methods of sympathectomy, including open thoracotomy, as well as posterior and supraclavicular approaches have been described. We favor endoscopy at this time due to both its simplicity and its resultant short hospital stay. During the period between March 1988 and October 1990, 112 patients (55 males, 57 females) suffering from palmar hyperhidrosis underwent 222 thoracoscopic T2-T3 sympathectomies under general anesthesia in our department. The remaining 2 hands had a second operation of unilateral open thoracotomy due to pleural adhesion. The patients' ages ranged from 15 to 45 years. A total of 220 hands became dry while the others showed improvements. There were 5 patients who required unilateral chest tube insertion, 2 for post-thoracotomy drainage and 3 for intrathoracic hemorrhage after thoracoscopic pneumonolysis. The average operative time (bilateral) was 30.8 min and hospital stay was 2.87 days. Compensatory hyperhidrosis was the major complication. There was no mortality. We therefore consider thoracoscopic sympathectomy to be a simple, safe, and effective method for treating palmar hyperhidrosis. PMID:8467154

Chou, S H; Lee, S H; Kao, E L

1993-01-01

155

Unilateral straight hair and congenital horner syndrome.  

PubMed

Congenital Horner syndrome is a rare disorder that accounts for less than 5% of all cases of Horner syndrome. Like Horner syndrome in general, it consists primarily of ptosis, miosis, and anhidrosis. Congenital Horner syndrome may manifest some special features such as iris heterochromia since the sympathetic nervous system is an essential component for the development and maintenance of eye color. We present 3 cases of unilateral straight hair in association with congenital Horner syndrome in which the patients had straight hair ipsilateral to the Horner syndrome, whereas on the contralateral side, it was curly, and we discuss possible mechanisms for this phenomenon. PMID:22622362

Wang, Frederick M; Wertenbaker, Christian; Cho, Hyung; Marmor, Maury A; Ahn-Lee, Sandra S; Bernard, Bruno A

2012-06-01

156

Unilateral nevoid telangiectasia associated with ipsilateral melorheostosis.  

PubMed

Melorheostosis is a rare disorder characterized by irregular, flowing hyperostosis in long bones, commonly described on radiographs as wax flowing down a candle. In addition to bony sclerosis, cutaneous manifestations overlying the involved bones have been reported including linear scleroderma, neurofibromatosis, and vascular and lymphatic malformations. Unilateral nevoid telangiectasia (UNT) is a rare primarily cutaneous condition characterized by linearly arranged small dilated blood vessels in dermatomal or Blaschkoid patterns on the skin. Here, we present the case of a nine-year-old Korean male with UNT associated with ipsilateral melorheostosis. PMID:22577274

Kim, Jihyun; Cho, Sung Bin; Cho, Suhyun; Bang, Dongsik

2012-05-01

157

Unilateral Molar Distalization: A Nonextraction Therapy  

PubMed Central

In the recent years, nonextraction treatment approaches and noncompliance therapies have become more popular in the correction of space discrepancies. One of the conventional approaches for space gaining in the arches without patient compliance is done by using certain extra oral appliances or intraoral appliance. The greatest advantage of certain appliances like fixed functional and molar distalization appliances is that they minimize the dependence on patient cooperation. Molar distalization appliances like pendulum appliance which distalizes the molar rapidly without the need of head gear can be used in patients as a unilateral space gaining procedure due to buccal segment crowding. PMID:23320203

Prasad, M. Bhanu; Sreevalli, S.

2012-01-01

158

Adult-onset unilateral disabling pansclerotic morphea.  

PubMed

Disabling pansclerotic morphea (DPM) is a rare, severe, and mutilating form of morphea, involving the dermis, subcutaneous tissue, fat, muscle, and even bone. It is usually seen before the age of 14 years, with the patient complaining of arthralgia and stiffness at the time of onset. We report a case of unilateral adult-onset DPM with sparing of the face. Within a few months of onset, painful contracture deformities of the hand, elbow, and shoulder joints developed, impairing the patient's normal daily activities. We are reporting this case because of the unusual presentation: DPM in an adult, with history of trauma in childhood and rapid onset of complications, is rare. PMID:24891683

Singh, Adarshlata; Singhal, Kritika; Choudhary, Sanjiv; Bisati, Shazia; Arora, Mallika

2014-05-01

159

Simultaneous thoracic and abdominal transplantation: can we justify two organs for one recipient?  

PubMed

Simultaneous thoracic and abdominal (STA) transplantation is controversial because two organs are allocated to a single individual. We studied wait-list urgency, and whether transplantation led to successful outcomes. Candidates and recipients for heart-kidney (SHK), heart-liver (SHLi), lung-liver (SLuLi) and lung-kidney (SLuK) were identified through the United Network for Organ Sharing (UNOS) and outcomes were compared to single-organ transplantation. Since 1987, there were 1801 STA candidates and 836 recipients. Wait-list survival at 1- and 3 years for SHK (67.4%, 40.8%; N = 1420), SHLi (65.7%, 43.6%; N = 218) and SLuLi (65.7%, 41.0%; N = 122), was lower than controls (p < 0.001), whereas for SLuK (65.0%, 51.6%; N = 41) it was comparable (p = 0.34). All STA groups demonstrated similar 1- and 5 years posttransplant survival to thoracic controls. Compared to abdominal controls, 1- and 5 years posttransplant survival in SHK (85.3%, 74.0%; N = 684), SLuLi (75.5%, 59.0%; N= 42) and SLuK (66.7%, 55.6%; N = 18) was decreased (p < 0.01), but SHLi (85.9%, 74.3%; N = 92) was comparable (p = 0.81). In summary, STA candidates had greater risk of wait-list mortality compared to single-organ candidates. STA outcomes were similar to thoracic transplantation; however, outcomes were similar to abdominal transplantation for SHLi only. Although select patients benefit from STA, risk-exposure variables for decreased survival should be identified, aiming to eliminate futile transplantation. PMID:23718142

Wolf, J H; Sulewski, M E; Cassuto, J R; Levine, M H; Naji, A; Olthoff, K M; Shaked, A; Abt, P L

2013-07-01

160

Thoracic radiculopathy caused by ossification of the ligamentum flavum  

PubMed Central

Thoracic ossification of the ligamentum flavum (OLF) has been widely recognized as a main cause of thoracic myelopathy in Asia, particularly in Japan. However, thoracic OLF rarely causes radiculopathy. We report a rare case of thoracic radiculopathy caused by OLF. A 67-year-old male presented with a chief complaint of back pain radiating to the right of the abdomen. Neurological examination revealed mild sensory deficit at the right side of the abdomen at the T9–10 level. Magnetic resonance imaging and computed tomography demonstrated OLF at the right T9–10 level. Thoracic radiculopathy caused by OLF was suspected. Because conservative treatment was not effective to this lesion, surgical intervention was performed, and the pain disappeared immediately after the operation. Thoracic OLF rarely causes radiculopathy, but it should be considered as a differential diagnosis of thoracic radicular pain. When conservative treatment is not effective in this lesion, surgical treatment should be considered. PMID:23163624

Yabe, Yutaka; Honda, Masahito; Tohjo, Yuuichi; Nakajima, Souichi; Ando, Akira; Sonofuchi, Kazuaki; Itoi, Eiji

2013-01-01

161

Renal Cell (Kidney) Cancer  

Cancer.gov

The most common type of kidney cancer is renal cell carcinoma (RCC), which arises in the renal parenchyma (the part of the kidney that makes urine). RCC accounts for more than 90 percent of kidney cancers. Nearly three-quarters of RCCs are classified as clear cell carcinomas because of their pale appearance when examined under a microscope. The other major type of RCC is called papillary carcinoma.

162

The European educational platform on thoracic surgery  

PubMed Central

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

Rocco, Gaetano; Venuta, Federico

2014-01-01

163

Radiation response of the monkey kidney following contralateral nephrectomy  

SciTech Connect

The long-term functional and morphologic responses of the hypertrophied monkey kidney after unilateral nephrectomy to fractionated irradiation were assessed. The right kidney of 13 adult female rhesus monkeys was removed. Twelve weeks after unilateral nephrectomy (UN) the remaining kidney received fractionated doses of {gamma}-rays ranging from 35.2 Gy/16 fractions (F) up to 44 Gy/20 F. Glomerular filtration rate, effective renal plasma flow, blood urea nitrogen, serum creatinine, and hematocrit values were measured up to 107 weeks postirradiation (PI). The monkeys were killed and the remaining kidneys were removed 107 weeks PI or earlier when end-stage renal failure was exhibited. Glomeruli were scored for the presence/absence of several pathologic features including increased intercapillary eosinophilic material (ICE), ecstatic capillaries, and thrombi. The relative proportion of renal cortex occupied by glomeruli, interstitium, normal tubules or abnormal tubules was determined using a Chalkley point grid. These quantal dose response data were analyzed using a logistic regression model. Irradiation of the remaining kidney in UN monkeys resulted in a dose-dependent reduction in renal function and anemia. Glomerular dysfunction preceded tubular dysfunction. Animals receiving 44 Gy all manifested progressive clinical renal failure. Conversely, those receiving {le} 39.6 Gy showed stable, albeit impaired, renal function for the duration of the observation period of 107 weeks. Morphologically, the incidence of ICE, ecstatic glomerular capillaries, thrombi, and periglomerular fibrosis was significantly dose-related (p < 0.005). A significant (p < 0.001) dose-related increase in the relative proportion of renal cortex occupied by abnormal tubules was indicative of tubular injury. A highly significant (p < 0.001) dose-dependent increase in the proportion of abnormal to normal tubules was also seen. 27 refs., 4 figs., 2 tabs.

Robbins, M.E.C. [Research Institute, Oxford (United Kingdom); Stephens, L.C.; Gray, K.N. [Univ. of Texas M.D. Anderson Cancer Center, Houston, TX (United States)] [and others

1994-09-30

164

"Kidney Health" Deaf Health Talks  

E-print Network

"Kidney Health" Deaf Health Talks September 22, 2010 #12;Supporters Deaf Health Community Committee Recreation Club for the Deaf ("REAP") #12;Overview What do kidneys do for us? What are common causes for kidney failure? What are common causes for kidney stones? How can we protect our kidneys? #12;Quiz How

Goldman, Steven A.

165

Sustained attention training for unilateral neglect: Theoretical and rehabilitation implications  

Microsoft Academic Search

Many studies have shown a co-variation of unilateral neglect with nonlateralised attentional functions. Recently, Posner has argued that there are two separate neural systems that influence the posterior attentional system which is presumed to be impaired in unilateral neglect, namely, the posterior system itself (located partly in the inferior parietal lobules) as well as a secondary modulatory sustained attention or

Ian H. Robertson; Richard Tegnér; Kerstin Tham; Ada Lo; Ian Nimmo-smith

1995-01-01

166

Reproducibility of Tactile Assessments for Children with Unilateral Cerebral Palsy  

ERIC Educational Resources Information Center

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…

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

2012-01-01

167

Sliding performance of unilateral external fixators for tibia  

Microsoft Academic Search

Some unilateral external fixators have a sliding mechanism to achieve dynamic axial fixation. However, it has been reported that binding of this mechanism occurs during routine ambulation. The Hifixator, a unilateral external fixator, has been developed which has a new type of sliding mechanism. The mechanism of the Hifixator was tested by connecting it to a fractured bone model with

Takashi Matsushita; Kozo Nakamura; Isao Ohnishi; Takahide Kurokawa

1998-01-01

168

Did Unilateral Divorce Raise Divorce Rates? Evidence from Panel Data  

Microsoft Academic Search

This paper revisits the evidence on the impact of unilateral divorce laws on divorce rates in the United States. Most states switched from requiring mutual consent to allowing unilateral or no-fault divorce between 1970 and 1985, while the national divorce rate more than doubled after 1965. According to the Coase theorem, however, the legal shift should have had no effect

Leora Friedberg

1998-01-01

169

Unilateral retinitis pigmentosa: a proposal of genetic pathogenic mechanisms  

PubMed Central

Purpose To investigate and integrate anatomic and physiologic findings from a group of patients who present retinitis pigmentosa affecting just one eye and use this information to propose mechanisms of disease pathogenesis. Methods This prospective cross-sectional study examined 5 patients, all female, from 8 to 60 years old. The study was conducted in 4 university hospitals. The patients were selected according to the characteristics of ocular involvement, notably unilateral presentation of similar anatomic and functional abnormalities. Full-field electroretinogram, fundus photography, fundus autofluorescence, infrared imaging, optical coherence tomography, and genetic testing were performed. Results Full-field electroretinogram showed unilateral decrease in amplitude and increase in implicit time; autofluorescence showed unilateral areas of decreased intensity. The USH2AW4149R mutation was confirmed in one patient. Conclusions Imaging and functional testing are important in elucidating the unilateral pattern of the disease and in monitoring these individuals. Mosaicism or somatic mutation may cause unilateral genetic disease presentation. PMID:22139616

Marsiglia, Marcela; Duncker, Tobias; Peiretti, Enrico; Brodie, Scott E.; Tsang, Stephen H.

2013-01-01

170

Acute Aortic Syndromes and Thoracic Aortic Aneurysm  

PubMed Central

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

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

2009-01-01

171

Kidney disease among the Zuni Indians: The Zuni Kidney Project  

Microsoft Academic Search

Kidney disease among the Zuni Indians: The Zuni Kidney Project.BackgroundThere is an epidemic of kidney disease among the Zuni Indians. In collaboration with health care providers and research institutions, the Zuni Pueblo established the Zuni Kidney Project to reduce the burden of kidney disease.MethodsThe Zuni Kidney Project conducted a population-based, cross-sectional survey to estimate the prevalence of albuminuria, hematuria, and

MARINA SCAVINI; Vallabh O. Shah; Christine A. Stidley; FRANCESCA TENTORI; Susan S. Paine; Antonia M. Harford; Andrew S. Narva; David S. Kessler; ARLENE BOBELU; Carleton P. Albert; JEANETTE BOBELU; EUNICE JAMON; KATHY NATACHU; DONICA NEHA; Thomas K. Welty; Jean W. MacCluer; Philip G. Zager

2005-01-01

172

Thoracic epidural anaesthesia in infants and children  

Microsoft Academic Search

When compared with conventional analgesic techniques, epidural anaesthesia not only provides improved analgesia, but also\\u000a has several beneficial effects on the postoperative respiratory, cardiovascular, and metabolic status of the patient. Although\\u000a the efficacy and safety of caudal and lumbar epidural anaesthesia in children has been demonstrated, there is little information\\u000a concerning the use of thoracic epidural anaesthesia. The purpose of

Joseph D. Tobias; Sandra Lowe; Nancy O’Dell; George W. Holcomb III

1993-01-01

173

Updated Perspectives on Neurogenic Thoracic Outlet Syndrome  

Microsoft Academic Search

Pain represents a foremost feature of neurogenic thoracic outlet syndrome (NTOS). Similar to other persistent pain conditions,\\u000a the physical discomfort associated with NTOS can cause severe and often debilitating symptoms. In fact, those suffering from\\u000a the syndrome report a quality of life impacted as significantly as those with chronic heart failure. This evidence-based literature\\u000a review focuses on the classification, etiology,

Paul J. Christo; Kai McGreevy

2011-01-01

174

Managing Dissections of the Thoracic Aorta  

PubMed Central

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

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

2010-01-01

175

Outcomes after surgery for thoracic outlet syndrome  

Microsoft Academic Search

Purpose: This study determined whether there is an association between psychological and socioeconomic characteristics and the long-term outcome of operative treatment for patients with sensory neurogenic thoracic outlet syndrome (N-TOS). Methods: Clinical records, preoperative psychological testing results, and long-term follow-up questionnaire data were reviewed for consecutive patients who underwent surgery for N-TOS from 1990 to 1999. Multivariate logistic regression models

David A. Axelrod; Mary C. Proctor; Michael E. Geisser; Randy S. Roth; Lazar J. Greenfield

2001-01-01

176

Supraclavicular Approach for Thoracic Outlet Syndrome  

Microsoft Academic Search

The authors' experience with the supraclavicular approach for the treatment of patients with primary thoracic outlet syndrome\\u000a (TOS) and for patients with recurrent TOS or iatrogenic brachial plexus injury after prior transaxillary first rib resection\\u000a is presented. The records of 33 patients (34 plexuses) with TOS who presented for evaluation and treatment were analyzed.\\u000a Of these, 12 (35%) plexuses underwent

Julia K. Terzis; Zinon T. Kokkalis

2010-01-01

177

Endoscopic Transforaminal Thoracic Foraminotomy and Discectomy for the Treatment of Thoracic Disc Herniation  

PubMed Central

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

Nie, Hong-Fei; Liu, Kai-Xuan

2013-01-01

178

EFFECTS OF UNILATERAL CASTRATION AND UNILATERAL CRYPTORCHIDISM OF THE HOLSTEIN BULL ON IN VITRO LEYDIG CELL RESPONSE 1'2  

Microsoft Academic Search

Summary The effects of unilateral castration (UC) and induced unilateral cryptorchidism (CR) on in vitro Leydig cell function were determined utilizing 36 Holstein bulls altered at either 3, 6 or 9 mo of age. Testes were removed 11 mo after gonadal manipulation and Leydig cells were dispersed in media containing 0 or 75 ng luteinizing hormone (LH). After incubation for

F. R. Boockfor; M. A. Barnes; J. F. Dickey

2010-01-01

179

The European general thoracic surgery database project  

PubMed Central

The European Society of Thoracic Surgeons (ESTS) Database is a free registry created by ESTS in 2001. The current online version was launched in 2007. It runs currently on a Dendrite platform with extensive data security and frequent backups. The main features are a specialty-specific, procedure-specific, prospectively maintained, periodically audited and web-based electronic database, designed for quality control and performance monitoring, which allows for the collection of all general thoracic procedures. Data collection is the “backbone” of the ESTS database. It includes many risk factors, processes of care and outcomes, which are specially designed for quality control and performance audit. The user can download and export their own data and use them for internal analyses and quality control audits. The ESTS database represents the gold standard of clinical data collection for European General Thoracic Surgery. Over the past years, the ESTS database has achieved many accomplishments. In particular, the database hit two major milestones: it now includes more than 235 participating centers and 70,000 surgical procedures. The ESTS database is a snapshot of surgical practice that aims at improving patient care. In other words, data capture should become integral to routine patient care, with the final objective of improving quality of care within Europe. PMID:24868445

Brunelli, Alessandro

2014-01-01

180

[Thoracic and cardiovascular surgery in Jehovah's Witness].  

PubMed

A Jehovah's Witness who requires thoracic and cardiovascular surgery represents a challenge to both the surgeon and the patient because of the patient's refusal to accept blood transfusion. We reported 15 cases of Jehovah's Witness patients from 43 to 80 years of age who underwent cardiac operations or thoracic vascular operations. There was 1 emergency operation case and 2 re-do operation cases. Erythropoietin and serum albumin injections were allowed to be used in some cases. The mean pre-operative haemoglobin level in these patients was 12.3 g/dl. The mean postoperative lowest haemoglobin level was 9.2 g/dl. The mean haemoglobin level at the point of leaving hospital was 11.4 g/dl. There were no postoperative complications and no operative deaths. We successfully performed the thoracic and cardiovascular operations on Jehovah's Witnesses, including emergency cases, safely without blood transfusion. The most important thing is a careful and safe operative technique which reduces perioperative bleeding as much as possible. PMID:23202705

Furuya, Onichi; Higashiue, Shinichi; Matsubayashi, Keiji; Tonda, Hisashi; Kawahira, Toshihiro; Azuma, Shuhei; Komooka, Masatoshi; Hiramatsu, Norihiko

2012-12-01

181

Anterior exposure of the thoracic spine.  

PubMed

Spinal operation via an anterior thoracic approach is becoming increasingly common, and the thoracic surgeon is now being called upon to provide exposure for orthopedic and neurosurgical colleagues. We report experience with 126 such patients from 1982 through 1993. There were 61 male and 65 female patients (mean age, 39.0 years; range, 14 to 77 years). Indications were trauma in 45 patients (36%), spinal deformity in 42 (33%), cancer in 15 (12%), disc disease in 12 (10%), and infection in 12 (10%). Operative incisions included 22 (17%) right and 14 (11%) left thoracotomies, 33 (26%) right and 56 (44%) left thoracolumbar approaches, and one (1%) sternotomy. A prior spinal operation had been performed on 31 patients (25%), and 56 (44%) had a subsequent posterior spinal operation. Instrumentation was used in 38 (30%) and bone grafts in all but 6 patients. A neurologic deficit was present in 69 patients (55%) preoperatively and was improved in 67 patients postoperatively. Operative mortality was 3.2% (4 patients) due to myocardial infarction, stroke with pneumonia, adult respiratory distress syndrome, and malignant biliary obstruction. Univariate and multivariate risk analysis were performed. Only the diagnosis of osteomyelitis proved to be a significant (p = 0.0002) indicator of operative mortality, with 3 of 12 such patients dying (25%). These results suggest that anterior spinal exposure via thoracic approach is a major operation with considerable perioperative risk. Patients with osteomyelitis appear to be at increased risk for operative mortality. PMID:8010785

Naunheim, K S; Barnett, M G; Crandall, D G; Vaca, K J; Burkus, J K

1994-06-01

182

Vascular complications of thoracic outlet syndrome.  

PubMed

Vascular complications of thoracic outlet syndrome are uncommon but may result in significant long-term disability. This report documents a retrospective review of 17 such patients. Ten patients presented with acute onset of upper extremity swelling and axillosubclavian vein thrombosis. One patient presented with chronic, intermittent arm swelling and subclavian vein stenosis. Three patients presented with acute symptoms of upper extremity emboli, and three presented with chronic arm claudication. Cervical ribs were discovered in four patients with arterial symptoms and in no patients with venous symptoms. All ten patients with acute venous thrombosis underwent successful thrombolysis, with venous stenosis uncovered in 8. Thrombolysis was also performed for two patients with arterial emboli. All 17 patients underwent surgical decompression of the thoracic outlet, 16 via a supraclavicular approach and one via a transaxillary approach. One subclavian arteriotomy with endarterectomy and one resection of a subclavian artery aneurysm were performed at the time of decompression. Repeat venography after decompression demonstrated persistent venous stenosis in one patient that was treated with balloon angioplasty and stenting. After a mean of 22 months' follow-up, 12 patients had no residual symptoms, and 5 had experienced significant improvement of symptoms. In conclusion, a combined approach of thrombolysis and surgical decompression of the thoracic outlet provides a salutary outcome in a majority of patients. PMID:9322672

Hood, D B; Kuehne, J; Yellin, A E; Weaver, F A

1997-10-01

183

Fabrication of a unilateral oral commissure retractor.  

PubMed

The fabrication of a unilateral device to treat microstomia after trauma is presented. Maximum opening was recorded before treatment. A dual arch impression that captured the dentition and commissure on the affected side was made with vinyl polysiloxane (VPS) impression material. A 1 mm vacuum formed template (VFT) was fabricated over the maxillary dentition, and a 2 mm VFT was fabricated around the commissure. A 0.9 mm (0.036") stainless steel wire was attached with acrylic resin to both templates in order to apply a constant force to the commissure. The use of a helix in the wire allowed for flexibility and adjustment of the retractor. The patient was instructed to wear the retractor for 6 hours per day, and, during a 10-week period, the maximum opening increased from 30 mm to 45 mm. PMID:23217473

Alfano, Stephen G; Lemus, Frank E

2012-12-01

184

Unilateral muscle contractions enhance creative thinking.  

PubMed

Following the notion of relative importance of the right hemisphere (RH) in creative thinking, we explored the possibility of enhancing creative problem solving by artificially activating the RH ahead of time using unilateral hand contractions. Participants attempted to complete the Remote Associates Test after squeezing a ball with either their left or right hand. As predicted, participants who contracted their left hand (thus activating the RH) achieved higher scores than those who used their right hand and those who did not contract either hand. Our findings indicate that tilting the hemispheric balance toward the processing mode of one hemisphere by motor activation can greatly influence the outcome of thought processes. Regardless of the specific mechanism involved, this technique has the potential for acting as a therapeutic or remedial manipulation and could have wide applications in aiding individuals with language impairments or other disorders that are believed to be related to hemispheric imbalances. PMID:21169586

Goldstein, Abraham; Revivo, Ketty; Kreitler, Michal; Metuki, Nili

2010-12-01

185

Unilateral Idiopathic Macular Telangiectasia with Choroidal Neovascularization.  

PubMed

A 40-year-old man with decreasing visual acuity in his left eye over 1 year, diagnosed elsewhere as vein occlusion and treated unsuccessfully by systemic steroids was reported. Retrospective analysis of available previous imaging studies was undertaken, and a retrospective diagnosis of idiopathic macular telangiectasia (IMT) was made. Examination revealed subfoveal neovascularization and retinochoroidal anastomosis (RCA) in his left eye with macular edema and exudates surrounding it. The right eye was normal. Current fluorescein angiography (FA) confirmed the presence of choroidal neovascularization and RCA, and optical coherence tomography (OCT) demonstrated cystoid macular edema and subfoveal neovascularization.The patient was diagnosed with unilateral idiopathic macular telangiectasia complicated by subretinal neovascularization. The presences of a choroidal neovascularization process and an RCA have not, to our knowledge, been reported in this type of IMT. PMID:20337307

Mezad-Koursh, Daphna; Zayit-Soudry, Shiri; Barak, Adiel; Loewenstein, Anat

2010-03-01

186

Unilateral temporomandibular joint ankylosis with contralateral aplasia  

PubMed Central

The temporomandibular joint (TMJ) is considered as one of the complex joints of the human body. Mandibular condylysis is distinguished from condylar aplasia by its non-association with aural/facial anomalies, and also as normal development appears to proceed until the lytic event occurs. It is further distinguished from primary and secondary condylar hypoplasia by the following: Absence of condyle rather than it being small, the normal development appears to proceed until the lytic event occurs, and its non-association with aural/facial anomalies or temporomandibular ankylosis. In the present report, a patient with a unilateral missing mandibular condyle with contralateral TMJ ankylosis is presented and the treatment is outlined and discussed. PMID:24665190

Singh, Nimisha; Pal, U. S.; Mohammad, S.; Singh, R. K.; Mehta, Gagan; Makadia, Hardik S.

2013-01-01

187

Vestibular perception following acute unilateral vestibular lesions.  

PubMed

Little is known about the vestibulo-perceptual (VP) system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO) and VP function in 25 patients with vestibular neuritis (VN) acutely (2 days after onset) and after compensation (recovery phase, 10 weeks). Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2) and velocity steps of 90°/s (acceleration 180°/s(2)). We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of perceptual processes (ultimately cortical) participating in vestibular compensation, suppressing asymmetry acutely in unilateral vestibular lesions. PMID:23671577

Cousins, Sian; Kaski, Diego; Cutfield, Nicholas; Seemungal, Barry; Golding, John F; Gresty, Michael; Glasauer, Stefan; Bronstein, Adolfo M

2013-01-01

188

Kidney Disease (and Oral Health)  

MedlinePLUS

Kidney Disease Oral Effects At the Dentist Oral Effects People with kidney disease often have other health issues. They often have ... body cannot absorb calcium properly. Therefore, people with kidney disease are at risk for losing bone from their ...

189

Kidney Surgery Codes  

Cancer.gov

Kidney, Renal Pelvis, and Ureter Kidney C649, Renal Pelvis C659, Ureter C669 (Except for M9727, 9733, 9741-9742, 9764-9809, 9832, 9840-9931, 9945-9946, 9950-9967, 9975-9992) Codes 00 None; no surgery of primary site; autopsy ONLY 10 Local tumor

190

Kidney Cancer Association  

MedlinePLUS

... fully accredited kidney cancer charity Previous Next icon-iphone Download the KidneyCancer.org iPhone & iPad App icon-book See Survivorship Book icon- ... Cancer Doctor icon-donate Donate Now Video Download iPhone RCC Prognositc Risk Calculator feature-learn-experts feature- ...

191

Unilateral squamous cell carcinoma of the renal pelvis with hydronephrosis in a cat.  

PubMed

A 4-year-old female neutered domestic shorthair cat was presented for evaluation of gradual onset of lethargy and anorexia. Physical examination revealed moderate abdominal distension. Investigations performed included complete blood count, serum biochemistry, urinalysis, pyelocentesis, abdominal fluid analysis, abdominal ultrasonography and exploratory celiotomy. Nephrectomy was performed on the hydronephrotic kidney and a sample of the omentum was also taken, as it was grossly abnormal. No other abnormalities were found in the remainder of the abdominal organs. Findings were consistent with unilateral hydronephrosis and squamous cell carcinoma of the renal pelvis with abdominal carcinomatosis. The patient was given supportive treatment while the results of the biopsies from the renal tissue and the omentum were pending. The patient deteriorated a short time after surgical intervention and was euthanased. This is the first report of a squamous cell carcinoma arising from the renal pelvis in a cat. A comparison with the disease presentation in humans is also discussed. PMID:23817013

Gómez Selgas, Aida; Scase, Timothy J; Foale, Robert D

2014-02-01

192

Renal functional decline and glomerulotubular injury are arrested but not restored by release of unilateral ureteral obstruction (UUO).  

PubMed

Murine unilateral ureteral obstruction (UUO), a major model of progressive kidney disease, causes loss of proximal tubular mass and formation of atubular glomeruli. Adult C57BL/6 mice underwent a sham operation or reversible UUO under anesthesia. In group 1, kidneys were harvested after 7 days. In group 2, the obstruction was released after 7 days, and a physiological study of both kidneys was performed 30 days later. Renal blood flow (RBF), glomerular filtration rate (GFR), urine protein, and albumin excretion were measured after ligation of either the left or right ureter. Glomerular volume (periodic acid-Schiff), glomerulotubular integrity and proximal tubular mass (Lotus tetragonolobus lectin), and interstitial collagen (Sirius red) were measured by histomorphometry. Obstructed kidney weight was reduced by 15% at 7 days but was not different from sham after a 30-day recovery. Glomerular volume and proximal tubular area of the obstructed kidney were reduced by 55% at 7 days, but normalized after 30 days. Interstitial collagen deposition increased 2.4-fold after 7 days of UUO and normalized after release. However, GFR and RBF were reduced by 40% and urine albumin/protein ratio was increased 2.8-fold 30 days after release of UUO. This was associated with a 50% reduction in glomerulotubular integrity despite a 30-day recovery (P < 0.05 for all data). We conclude that release of 7-day UUO can arrest progression but does not restore normal function of the postobstructed kidney. Although the remaining intact nephrons have hypertrophied, glomerular injury is revealed by albuminuria. These results suggest that glomerulotubular injury should become the primary target of slowing progressive kidney disease. PMID:23220725

Chaabane, Wassim; Praddaude, Françoise; Buleon, Marie; Jaafar, Acil; Vallet, Marion; Rischmann, Pascal; Galarreta, Carolina I; Chevalier, Robert L; Tack, Ivan

2013-02-15

193

Thoracic surgery associations, societies, and clubs: which organizations are right for you?  

PubMed

Determining which organizations to join can be challenging given the wide selection of associations, societies, and clubs available to practicing thoracic surgeons. This article briefly reviews 7 important North American thoracic surgery organizations (the American Association for Thoracic Surgery, the Canadian Association of Thoracic Surgeons, the General Thoracic Surgical Club, the Society of Thoracic Surgeons, the Southern Thoracic Surgical Association, the Western Thoracic Surgical Association, and Women in Thoracic Surgery). The authors also review the criteria that may assist in deciding which organizations best meet a surgeon's career goals and personal expectations. PMID:21762862

Schieman, Colin; Grondin, Sean C; Gelfand, Gary A J

2011-08-01

194

L-Endoglin Overexpression Increases Renal Fibrosis after Unilateral Ureteral Obstruction  

PubMed Central

Transforming growth factor-? (TGF-?) plays a pivotal role in renal fibrosis. Endoglin, a 180 KDa membrane glycoprotein, is a TGF-? co-receptor overexpressed in several models of chronic kidney disease, but its function in renal fibrosis remains uncertain. Two membrane isoforms generated by alternative splicing have been described, L-Endoglin (long) and S-Endoglin (short) that differ from each other in their cytoplasmic tails, being L-Endoglin the most abundant isoform. The aim of this study was to assess the effect of L-Endoglin overexpression in renal tubulo-interstitial fibrosis. For this purpose, a transgenic mouse which ubiquitously overexpresses human L-Endoglin (L-ENG+) was generated and unilateral ureteral obstruction (UUO) was performed in L-ENG+ mice and their wild type (WT) littermates. Obstructed kidneys from L-ENG+ mice showed higher amounts of type I collagen and fibronectin but similar levels of ?-smooth muscle actin (?-SMA) than obstructed kidneys from WT mice. Smad1 and Smad3 phosphorylation were significantly higher in obstructed kidneys from L-ENG+ than in WT mice. Our results suggest that the higher increase of renal fibrosis observed in L-ENG+ mice is not due to a major abundance of myofibroblasts, as similar levels of ?-SMA were observed in both L-ENG+ and WT mice, but to the higher collagen and fibronectin synthesis by these fibroblasts. Furthermore, in vivo L-Endoglin overexpression potentiates Smad1 and Smad3 pathways and this effect is associated with higher renal fibrosis development. PMID:25313562

Arevalo, Miguel; Nunez-Gomez, Elena; Perez-Roque, Lucia; Pericacho, Miguel; Gonzalez-Nunez, Maria; Langa, Carmen; Martinez-Salgado, Carlos; Perez-Barriocanal, Fernando; Bernabeu, Carmelo; Lopez-Novoa, Jose M.

2014-01-01

195

L-endoglin overexpression increases renal fibrosis after unilateral ureteral obstruction.  

PubMed

Transforming growth factor-? (TGF-?) plays a pivotal role in renal fibrosis. Endoglin, a 180 KDa membrane glycoprotein, is a TGF-? co-receptor overexpressed in several models of chronic kidney disease, but its function in renal fibrosis remains uncertain. Two membrane isoforms generated by alternative splicing have been described, L-Endoglin (long) and S-Endoglin (short) that differ from each other in their cytoplasmic tails, being L-Endoglin the most abundant isoform. The aim of this study was to assess the effect of L-Endoglin overexpression in renal tubulo-interstitial fibrosis. For this purpose, a transgenic mouse which ubiquitously overexpresses human L-Endoglin (L-ENG+) was generated and unilateral ureteral obstruction (UUO) was performed in L-ENG+ mice and their wild type (WT) littermates. Obstructed kidneys from L-ENG+ mice showed higher amounts of type I collagen and fibronectin but similar levels of ?-smooth muscle actin (?-SMA) than obstructed kidneys from WT mice. Smad1 and Smad3 phosphorylation were significantly higher in obstructed kidneys from L-ENG+ than in WT mice. Our results suggest that the higher increase of renal fibrosis observed in L-ENG+ mice is not due to a major abundance of myofibroblasts, as similar levels of ?-SMA were observed in both L-ENG+ and WT mice, but to the higher collagen and fibronectin synthesis by these fibroblasts. Furthermore, in vivo L-Endoglin overexpression potentiates Smad1 and Smad3 pathways and this effect is associated with higher renal fibrosis development. PMID:25313562

Oujo, Bárbara; Muñoz-Félix, José M; Arévalo, Miguel; Núñez-Gómez, Elena; Pérez-Roque, Lucía; Pericacho, Miguel; González-Núñez, María; Langa, Carmen; Martínez-Salgado, Carlos; Perez-Barriocanal, Fernando; Bernabeu, Carmelo; Lopez-Novoa, José M

2014-01-01

196

CT and MRI in the Evaluation of Thoracic Aortic Diseases  

PubMed Central

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

2013-01-01

197

The right sided syndrome, congenital absence of kidney and testis.  

PubMed

Unilateral renal agenesis (URA) is a developmental defect associated with ano-malies of the genitourinary system. The associations vary from absence of testis alone to high anorectal anomalies in other patients. We present two interesting patients with URA, encountered recently. Our first case was diagnosed with URA at the age of 11 years, which was detected on sonography, when he presented with pain abdomen. The presence of an epididymal cyst masked the absence of ipsilateral testes leading to delay in the diagnosis. Our second case was diagnosed with URA during the neonatal period when he presented with anorectal agenesis. He underwent abdomino-anal pull-through operation and later clinical course was complicated by recurrent cystitis, secondary vesicoureteral reflux and hydroureteronephrosis of solitary kidney, progressing to chronic kidney disease. PMID:21422633

Kumar, K V S Hari; Rao, B Srinivas; Shiradhonkar, Shekhar; Jha, Ratan; Narayan, Girish; Modi, K D

2011-03-01

198

Obstruction of the Superior Mesenteric Artery Due to Emboli from the Thoracic Aorta in a Patient with Thromboangiitis Obliterans  

PubMed Central

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.

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

2014-01-01

199

The reported thoracic injuries in Homer's Iliad.  

PubMed

Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%), the stones (7.4%), the arrow (5.5%) and the sword (5.5%). We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim), medium (those which cause the victim to abandon the battlefield), and severe (those which cause death of the victim). According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95%) and the remaining 8 an Achaean (21.05%). The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield. PMID:21087529

Apostolakis, Efstratios; Apostolaki, Georgia; Apostolaki, Mary; Chorti, Maria

2010-01-01

200

The reported thoracic injuries in Homer's Iliad  

PubMed Central

Homer's Iliad is considered to be a prominent and representative work of the tradition of the ancient Greek epic poetry. In this poem Homer presents the battles which took place during the last year of the 10-year lasting Trojan War between Achaeans and Trojans. We wanted to examine the chest wounds, especially those which are described in detail, according to their localization, severity and mortality. Finally, there are reported 54 consecutive thoracic injuries in the Iliad. The mostly used weapons were the spear (63%), the stones (7.4%), the arrow (5.5%) and the sword (5.5%). We divided the injuries according to their severity in mild (those which did not cause serious injury to the victim), medium (those which cause the victim to abandon the battlefield), and severe (those which cause death of the victim). According to this classification, the reported injuries were mild in 11.11%, medium in 18.52%, and severe in the last 70.37% of the reported cases. In other words, 89% of the injuries belong to the medium or severe category of thoracic injury. As far as the mortality of the injuries is concerned, 38 out of 54 thoracic injuries include death, which makes the mortality percentage reach 70.37%. Concerning the "allocation of the roles", the Achaean were in 68% perpetrators and the Trojans in only 32%. In terms of gravity, out of 38 mortal injuries 30 involve a Trojan (78.95%) and the remaining 8 an Achaean (21.05%). The excellent and detailed description of the injuries by Homer, as well as of the symptoms, may reveal a man with knowledge of anatomy and medicine who cared for the injured warriors in the battlefield. PMID:21087529

2010-01-01

201

Primary Thoracic Epidural Melanoma : A Case Report  

PubMed Central

A 68-year-old woman with progressive paraparesis and altered sensation lasting approximately five days was admitted to our clinic. Magnetic resonance imaging (MRI) revealed an advanced stage T7-8 epidural mass ventral to the spinal cord, which was believed to be a metastatic tumor considering the patient's age. A highly enhanced epidural mass and pedicle appeared during the MR scan. However, the pathologic findings were compatible with the diagnosis of a primary meningeal melanocytic tumor. Primary epidural melanomas are extremely rare lesions. This case was finally diagnosed as a primary thoracic spinal epidural melanoma. PMID:20622955

Jo, Kwang-Wook; Kim, Sang-Don; Park, Ik-Seong

2010-01-01

202

Medullary cystic kidney disease  

MedlinePLUS

... include: 24-hour urine volume and electrolytes Blood urea nitrogen (BUN) Complete blood count (CBC) Creatinine - blood ... weakening and fractures Cardiac tamponade Changes in glucose metabolism Congestive heart failure End-stage kidney disease Gastrointestinal ...

203

[Kidney and HIV infection].  

PubMed

Screening of chronic kidney disease (CKD) that includes estimation of the glomerular filtration rate (GFR) and evaluation proteinuria should be performed in all HIV-infected patients and these parameters have to be monitored annually in patients at higher risk for CKD. Black patients have a genetic predisposition to develop HIV-associated nephropathy. Suppression of HIV viral replication with antiretroviral therapy prevents the development of HIV-associated nephropathy or halts its progression. Kidney biopsy remains the most informative diagnosis test to differentiate various forms of kidney diseases in HIV-infected patients. Dosing antiretroviral agents with kidney metabolism should be adjusted when eGFR is bellow 50 mL/min/1.73 m(2). eGFR and serum phosphorus at baseline and during treatment should be carefully assessed in patients receiving tenofovir. Proximal renal tubular toxicity must be further evaluated in the presence of eGFR decrease and/or hypophosphatemia under tenofovir therapy. PMID:22245017

Plaisier, Emmanuelle; Lescure, François-Xavier; Ronco, Pierre

2012-03-01

204

Your Kidney Test Results  

MedlinePLUS

... Program Name: Date: Chronic Kidney Disease (CKD) Tests Results Why It Is Important Serum Creatinine and Estimated ... an eGFR less than 60 Your Serum Creatinine Result: Your eGFR Result: eGFR estimates how well your ...

205

American Kidney Fund  

MedlinePLUS

... on BisNow American Kidney Fund to Honor Meshia Adams, of Woodbridge more news » Learn How toManage Diabetes ... our Oct. 22 event: Hero of Hope Artemeshia Adams, Caregiver of the Year Keith McDonald and 2015 ...

206

Acquired Cystic Kidney Disease  

MedlinePLUS

... Fax: 813–636–8122 Email: info@aakp.org Internet: www.aakp.org American Kidney Fund 6110 Executive ... Fax: 301–881–0898 Email: helpline@kidneyfund.org Internet: www.kidneyfund.org Life Options Rehabilitation Resource Center ...

207

10 Symptoms of Kidney Disease  

MedlinePLUS

... kidney disease don't know it because the early signs can be very subtle. It can take many years to go from chronic kidney disease ( CKD ) to kidney failure. Most people with CKD live out their lives without ever reaching kidney failure . People ...

208

A transaction cost approach to unilateral presidential action  

E-print Network

when presidents will act unilaterally through executive orders and when they will instead seek legislative avenues to policy change. This project develops a parsimonious theory grounded in the transaction costs framework that explains how a president...

Marchbanks, Miner Peek, III

2006-04-12

209

The medieval kidney.  

PubMed

This article surveys the various perceptions of the kidney and its pathologies by encyclopedists, preachers, natural philosophers, surgeons and academic physicians around 1300. It focuses on the medical works of Arnau de Vilanova (d. 1311) and shows the medical discourse about the kidney in all its complexity. It draws attention to the incorporation of the medical nephrological debate into the scholastic frame, and to the close links between nephrology and astrology as well as alchemy. PMID:12097733

Ziegler, Joseph

2002-07-01

210

Kidney cell electrophoresis  

NASA Technical Reports Server (NTRS)

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.

Todd, P. W.

1985-01-01

211

Symptomatic unilateral renal angiomyolipoma in a child with tuberous sclerosis.  

PubMed

We report a case of unilateral renal angiomyolipoma in a 10-year-old boy with tuberous sclerosis. The case is worthy of attention because the symptoms occurred at an early age and because the lesion was unilateral, the latter confirmed at 11-year follow-up. The presentation and treatment are discussed, and the pertinent literature is reviewed. The case demonstrates that it is of clinical importance to monitor renal involvement in children with tuberous sclerosis. PMID:11598456

Avolio, L; Savasta, S; Matteotti, C; Fusillo, M; Bragheri, R

2001-01-01

212

The effects of plyometric exercise on unilateral balance performance  

Microsoft Academic Search

The purpose of this study was to determine the effects of plyometric exercise on unilateral balance performance. Nine healthy adults performed baseline measurements on the dominant limb that consisted of: a 20-s unilateral stability test on a tilt balance board, where a higher stability index represented deterioration in balance performance; isokinetic plantar flexion torque at 0.52 and 3.14 rad · s; muscle

Craig Twist; Nigel Gleeson; Roger Eston

2008-01-01

213

Unilateral condylar hyperplasia: A case report and review of literature  

PubMed Central

Condylar hyperplasia is (CH) an uncommon malformation of the mandible involving change in size and morphology of the condylar neck and head. CH is an anomaly that usually occurs unilaterally and equally affects in both men and women. Hyperplasia of the condyle ‘differentiated into hemimandibular hyperplasia, hemimandibular elongation and CH. Here, we are presenting a case of 17-year-old male patient with unilateral CH and its review of the literature. PMID:24818099

Bharathi, Saravana C.; Senthilnathan, S.; Kumar, Lokesh D.; Mohan, Anand C. S.; Taranath, M.

2014-01-01

214

Grip Force Coordination during Bimanual Tasks in Unilateral Cerebral Palsy  

ERIC Educational Resources Information Center

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…

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

2011-01-01

215

Iron chelation by deferoxamine prevents renal interstitial fibrosis in mice with unilateral ureteral obstruction.  

PubMed

Renal fibrosis plays an important role in the onset and progression of chronic kidney diseases (CKD). Although several mechanisms underlying renal fibrosis and candidate drugs for its treatment have been identified, the effect of iron chelator on renal fibrosis remains unclear. In the present study, we examined the effect of an iron chelator, deferoxamine (DFO), on renal fibrosis in mice with surgically induced unilateral ureter obstruction (UUO). Mice were divided into 4 groups: UUO with vehicle, UUO with DFO, sham with vehicle, and sham with DFO. One week after surgery, augmented renal tubulointerstitial fibrosis and the expression of collagen I, III, and IV increased in mice with UUO; these changes were suppressed by DFO treatment. Similarly, UUO-induced macrophage infiltration of renal interstitial tubules was reduced in UUO mice treated with DFO. UUO-induced expression of inflammatory cytokines and extracellular matrix proteins was abrogated by DFO treatment. DFO inhibited the activation of the transforming growth factor-?1 (TGF-?1)-Smad3 pathway in UUO mice. UUO-induced NADPH oxidase activity and p22(phox) expression were attenuated by DFO. In the kidneys of UUO mice, divalent metal transporter 1, ferroportin, and ferritin expression was higher and transferrin receptor expression was lower than in sham-operated mice. Increased renal iron content was observed in UUO mice, which was reduced by DFO treatment. These results suggest that iron reduction by DFO prevents renal tubulointerstitial fibrosis by regulating TGF-?-Smad signaling, oxidative stress, and inflammatory responses. PMID:24586712

Ikeda, Yasumasa; Ozono, Iori; Tajima, Soichiro; Imao, Mizuki; Horinouchi, Yuya; Izawa-Ishizawa, Yuki; Kihira, Yoshitaka; Miyamoto, Licht; Ishizawa, Keisuke; Tsuchiya, Koichiro; Tamaki, Toshiaki

2014-01-01

216

Laterality of nephrocalcinosis in kidney stone formers with severe hypocitraturia  

PubMed Central

OBJECTIVE To examine the hypothesis that the distribution of nephrocalcinosis in patients with severe hypocitraturia should be symmetric. PATIENTS AND METHODS Patients with profound hypocitraturia defined as a 24-h urine citrate <50 mg at the time of initial presentation were identified from the metabolic stone clinic database at our academic medical center. Two independent blinded reviewers evaluated all of the abdominal radiographs for the segmental distribution of macroscopic nephrocalcinosis. RESULTS A total of 44 patients met study criteria, with an equal distribution of males and females and a mean age of 55.4 ± 13.7 years. Mean urinary citrate was 28 ± 11 mg/day. Nephrocalcinosis was present in at least one renal segment in 22 patients (50%). Of the 22 patients with nephrocalcinosis, 9 patients (41%) had unilateral nephrocalcinosis and 13 patients (59%) had bilateral nephrocalcinosis. Of the 35 kidneys with nephrocalcinosis, 14 kidneys (40%) had nephrocalcinosis in only one renal segment, 13 kidneys (37%) had nephrocalcinosis in two segments and eight kidneys (23%) had nephrocalcinosis involving all three segments. CONCLUSIONS Despite the systemic nature of severe hypocitraturia, nephrocalcinosis is frequently asymmetric and focal in nature. This suggests that local factors intrinsic to the renal medullary interstitium, such as vascular injury, must play a role in the formation of nephrocalcinosis. Further study to elucidate these intrinsic local factors may further improve the treatment and prevention of urinary stone disease. PMID:20590541

Le, Jesse D.; Eisner, Brian H.; Tseng, Timothy Y.; Chi, Thomas; Stoller, Marshall L.

2014-01-01

217

Lithium transport in the chicken and marine teleost kidney.  

PubMed

The clearance ratio-C(Li)/C(ln) (Excretion Fraction of Lithium-EFLi) in the cod (Gadus morrhua L.) kidney amounts to 15.1 +/- 4.7, in the black sculpin (Myoxocephalus scorpius L.) kidney, to 6.88 +/- 1.22, which indicates secretion of lithium by the marine teleost kidney. A direct correlation has been found between EFLi and EFMg. Injection of furosemide (15 mg/kg B.W.) increase while injection of the 20% para-amino-hippurate solution (1.6 ml/kg B.W.) does not change EFLi in the cod kidney. Infusion of 10 mM LiNO3 in the 0.9% NaCl solution (3.5 ml/kg B.W.) into the chicken (Gallus domesticus L.) left v. saphena produces, owing to the lithium inflow into the renoportal system, a marked unilateral increase of the renal lithium excretion. Infusion of 10% NaCl solution (3.5 ml/kg B.W.) together with 10 mM LiNO3 into the chicken left v. saphena is accompanied by a more pronounced ipsilateral increase of the lithium excretion and EFLi. The data obtained indicate diversity of mechanisms (glomerular filtration, reabsorption and secretion) participating in the renal lithium excretion in the animals studied. PMID:8858841

Natochin YuV; Shakhmatova, E I

1996-09-01

218

Thoracic neuroblastoma: a Pediatric Oncology Group study.  

PubMed

Ninety-six patients with thoracic neuroblastoma were studied in a prospective fashion. Median age at presentation was 0.9 years. Forty-eight percent of the patients presented with stage A disease, 20% stage B, 13% stage C, 17% stage D, and 2% stage DS. Seventy-five patients have been followed for greater than 4 years. A posterior mediastinal mass was diagnosed on incidental chest roentgenograms performed for nontumor-related symptoms in 49% of the cases. Sixteen percent of the cases presented with neurological symptoms and 14% of the patients presented with acute respiratory distress. Urinary catecholamines were elevated in 76% of the cases. Complete surgical resection was carried out in 47% of the cases, while incomplete resection or biopsy was performed in 45%. No operation was performed in 3 patients. Minor surgical complications occurred in 20% of the patients, and 3% of the patients had significant perioperative complications. One patient died as a complication of therapy. Overall actuarial survival was 88% at 4 years. This study confirms the favorable outcome in children with mediastinal neuroblastoma. The basic biology of thoracic neuroblastomas seems to differ from that of other sites in that the majority of patients present at a younger age with localized disease or regional lymph node metastases, and have an improved survival even after correcting for age and stage. While complete excision is recommended, if possible, radical surgical procedures are not indicated since an excellent prognosis is associated with combined modality therapy. PMID:8468649

Adams, G A; Shochat, S J; Smith, E I; Shuster, J J; Joshi, V V; Altshuler, G; Hayes, F A; Nitschke, R; McWilliams, N; Castleberry, R P

1993-03-01

219

Cancers by Body Location/System: Respiratory/Thoracic  

Cancer.gov

Cancers by Body Location/System: Respiratory/Thoracic To find a cancer: select a body location or system — AIDS-RelatedBreastDigestive/GastrointestinalEndocrine and NeuroendocrineEye GenitourinaryGerm CellGynecologicHead and NeckHematologic/Blood MusculoskeletalNeurologicRespiratory/ThoracicSkinUnknown

220

Complications after endovascular stent-grafting of thoracic aortic diseases  

Microsoft Academic Search

BACKGROUND: To update our experience with thoracic aortic stent-graft treatment over a 5-year period, with special consideration for the occurrence and management of complications. METHODS: From December 2000 to June 2006, 52 patients with thoracic aortic pathologies underwent endovascular repair; there were 43 males (83%) and 9 females, mean age 63 ± 19 years (range 17–87). Fourteen patients (27%) were

Gabriele Piffaretti; Matteo Tozzi; Chiara Lomazzi; Nicola Rivolta; Roberto Caronno; Patrizio Castelli

2006-01-01

221

Depth of the thoracic epidural space in children  

Microsoft Academic Search

Thoracic epidural anaesthesia in anaesthetized children requires a meticulous technique and may have an increased success rate when the distance between skin and epidural space is known. The objective of this observational study was to measure the skin to epidural distance (SED) during thoracic epidural puncture in 61 children. The epidural puncture was performed using the loss of resistance technique

F. Masir; J. J. Driessen; K. C. Thies; M. H. W. A. Wijnen; J. van Egmond

2006-01-01

222

Fleischner Society: Glossary of TermsforThoracicImaging1  

Microsoft Academic Search

Members of the Fleischner Society compiled a glossary of terms for thoracic imaging that replaces previous glossa- ries published in 1984 and 1996 for thoracic radiography and computed tomography (CT), respectively. The need to update the previous versions came from the recognition that new words have emerged, others have become obso- lete, and the meaning of some terms has changed.

David M. Hansell; Alexander A. Bankier; Heber MacMahon; Theresa C. McLoud; Nestor L. Muller; Jacques Remy

2008-01-01

223

Computed Tomography Angiography to Evaluate Thoracic Outlet Neurovascular Compression  

Microsoft Academic Search

The objective was to evaluate the efficacy of computed tomography angiography with upper extremity hyperab- duction to diagnose thoracic outlet syndrome. Over 5 years, 21 patients were treated surgically for neurogenic symptoms of thoracic outlet syndrome. For patients whose diagnosis was unclear after history and physical examination, adjunctive tests (duplex, magnetic reso- nance angiography, or computed tomography angiogra- phy) were

Ravishankar Hasanadka; Jonathan B. Towne; Gary R. Seabrook; Kellie R. Brown; Brian D. Lewis; W. Dennis Foley

224

Limited Upper Thoracic Epidural Block and Splanchnic Perfusion in Dogs  

Microsoft Academic Search

Epidural blockade leads to a sympathetic block in af- fected segments and an increase of sympathetic out- flow from various unblocked segments. A limited up- per thoracic epidural block (LUTEB) is used during coronary artery surgery affecting the cardiac sympa- thetic fibers cephalad to the fifth thoracic segment. This block does not extend to the sympathetic fibers inner- vating the

A. Meissner; T. P. Weber; H. Van Aken; N. Rolf

1999-01-01

225

The impacts of Unilateral Stratospheric Geoengineering  

NASA Astrophysics Data System (ADS)

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.

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

2013-12-01

226

Perception of colour in unilateral tritanopia.  

PubMed Central

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

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

1983-01-01

227

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

PubMed Central

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

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

2014-01-01

228

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

PubMed

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

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

2014-06-01

229

Multifocal thoracic chordoma mimicking a paraganglioma.  

PubMed

Chordoma of thoracic vertebras is a very rare locally invasive neoplasm with low grade malignancy arising from embryonic notochordal remnants. Radical surgery remains the cornerstone of the treatment. We describe a case of multifocal T1-T2 chordoma, without bone and disc involvement, incidentally misdiagnosed as a paraganglioma, occurring in a 47-year-old male asymptomatic patient. Neoplasm was radically removed by an endocrine surgeon through a right extended cervicotomy. A preoperative reliable diagnosis of chordoma, as in the reported case, is often difficult. Radical surgery can provide a favorable outcome but, given the high rates of local recurrence of this neoplasm, a strict and careful follow-up is recommended. Although very rare, chordoma should be suggested in the differential diagnosis of the paravertebral cervical masses of unknown origin. Spine surgeon consultation and a FNB should be routinely included in the multidisciplinary preoperative work-up of these neoplasms. PMID:24125991

Conzo, Giovanni; Gambardella, Claudio; Pasquali, Daniela; Ciancia, Giuseppe; Avenia, Nicola; Pietra, Cristina Della; Napolitano, Salvatore; Palazzo, Antonietta; Mauriello, Claudio; Parmeggiani, Domenico; Pettinato, Guido; Napolitano, Vincenzo; Santini, Luigi

2013-01-01

230

Thoracic spine compression fracture after TASER activation.  

PubMed

The TASER is a less lethal weapon seeing increased use by police jurisdictions across the country. As a result, subjects of TASER use are being seen with increasing frequency in emergency departments across the country. The potential injury patterns of the device are important for emergency physicians to understand. This report describes the case of an officer who complained of back pain after a single 5-s TASER discharge during a routine training exercise. Subsequent evaluation led to the diagnosis of an acute thoracic vertebral compression fracture. We discuss the potential mechanisms of injury in this case. Because we were unable to find any cases like this in our review of TASER-related injuries, we liken it to compression fractures that have been documented after seizures. We recommend that physicians consider obtaining back radiographs to rule out a vertebral compression fracture in any individual who has sustained a TASER discharge and has ongoing or persistent back pain. PMID:18191526

Sloane, Christian M; Chan, Theodore C; Vilke, Gary M

2008-04-01

231

Current management of traumatic thoracic aortic injury.  

PubMed

Traumatic aortic rupture is a devastating injury that is difficult to manage because of the need to approach aortic repair, often in concert with management of complex associated injuries to nonvascular organ systems. Traditional open repair, while effective in the long-term, is associated with a periprocedural mortality between 10% and 20%, along with a 5% risk of stroke and up to a 5% risk of spinal chord ischemia. The advent of endovascular stent graft repair has allowed single centers to cut periprocedural mortality in half and decrease the risk of major neurologic events to <2%. It is unlikely that a multicenter prospective randomized trial will ever be performed to evaluate these two procedures. However, several large meta-analyses have been published recently, along with a clinical practice guideline from the Society for Vascular Surgery. The purpose of this article is to review the trends and current concepts in the management of traumatic rupture of the thoracic aorta. PMID:21194638

Kwolek, Christopher J; Blazick, Elizabeth

2010-12-01

232

Haematopoietic stem cell migration to the ischemic damaged kidney is not altered by manipulating the SDF-1/CXCR4-axis  

PubMed Central

Background. Haematopoietic stem cells (HSC) have been shown to migrate to the ischemic kidney. The factors that regulate the trafficking of HSC to the ischemic damaged kidney are not fully understood. The stromal cell-derived factor-1 (SDF-1)/CXCR4-axis has been identified as the central signalling axis regulating trafficking of HSC to the bone marrow. Therefore, we hypothesized that SDF-1/CXCR4 interactions are implicated in the migration of HSC to the injured kidney. Methods. HSC were isolated from mouse bone marrow and labelled with a cell tracker. Acceptor mice were subjected to unilateral ischemia and received HSC intravenously directly after reperfusion. In addition, in separate groups of acceptor mice, endogenous SDF-1 or HSC-associated CXCR4 was blocked or kidneys were injected with SDF-1. Results. Exogenous HSC could be detected in the tubules and interstitium of the kidney 24 h after ischemic injury. Importantly, the amount of HSC in the ischemic kidney was markedly higher compared to the contralateral kidney. Neutralizing endogenous SDF-1 or HSC-associated CXCR4 did not prevent the migration of HSC. No increase in the number of labelled HSC could be observed after local administration of SDF-1, as was also determined in bilateral kidney ischemia. Conclusion. In conclusion, systemically administered HSC preferentially migrate to the ischemic injured kidney. This migration could not be prevented by blocking the SDF-1/CXCR4-axis or increased after local administration of SDF-1. PMID:19223274

Stroo, Ingrid; Stokman, Geurt; Teske, Gwendoline J. D.; Florquin, Sandrine; Leemans, Jaklien C.

2009-01-01

233

Faster imaging with a portable unilateral NMR device.  

PubMed

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

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

2013-06-01

234

Breast size, thoracic kyphosis & thoracic spine pain - association & relevance of bra fitting in post-menopausal women: a correlational study  

PubMed Central

Background Menopause would seem to exist as a period of accelerated changes for women and their upper torso mechanics. Whether these anthropometric changes reflect changes in pain states remains unclear. Plausible mechanisms of pain exist for the independent and combined effect of increasing breast size and thoracic kyphosis. Bra fit has the potential to change when the anthropometric measures (chest circumference and bust circumference) used to determine bra size change, such as postmenopausally. Identifying an association between breast size, thoracic kyphosis and thoracic spine pain in postmenopausal women and identifying the relevance of bra fit to this association may be of importance to the future management and education of post-menopausal women presenting clinically with thoracic spine pain. Methods A cross-sectional study design. Fifty-one postmenopausal bra-wearing women were recruited. Measures included breast size (Triumph International), thoracic kyphosis (flexible curve), bra fitted (Y/N) and pain (Short Form McGill Pain Questionnaire) and tenderness on palpation (posteroanterior pressure testing). These measures were collected in one session at a physiotherapy clinic. Results The majority of the women in this study were overweight or obese and wearing an incorrect sized bra. Pain was significantly related to breast size, body weight and BMI at mid thoracic levels (T7-8). In contrast self-reported thoracic pain was not correlated with age or index of kyphosis (thoracic kyphosis). Women with thoracic pain were no more likely to have their bra professionally fitted whereas women with a higher BMI and larger breasts were more likely to have their bra professionally fitted. Conclusion The findings of this study show that larger breasts and increased BMI are associated with thoracic pain in postmenopausal women. This is unrelated to thoracic kyphosis. Increasing breast size and how a bra is worn may have biomechanical implications for the loaded thoracic spine and surrounding musculature. Post-menopause women present with a spectrum of anthropometrical changes that have the potential to contribute to altered biomechanics and affect pain states in the thoracic spine. PMID:23816160

2013-01-01

235

Thoracic Endometriosis Syndrome: Case Report and Review of the Literature  

PubMed Central

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

Azizad-Pinto, Parisa; Clarke, David

2014-01-01

236

Thoracoscopic transclavicular approach for a large thoracic inlet tumor.  

PubMed

Large lesions of the thoracic inlet represent a significant challenge to surgeons due to their close relationship with important adjacent neurovascular structures. We report a case of neurofibromatosis type 1 presented with a large neurofibroma located in the right thoracic inlet, and a malignant peripheral nerve sheath tumor in the right clavicle and treated with a hybrid thoracoscopic anterior transclavicular approach to remove the tumors. Combination of thoracoscopic and minimal chest wall resection may serve as a feasible option for resection of the large and benign thoracic inlet tumor in a way of minimal invasiveness and safety. PMID:25282248

Yan, Shi; Sun, Yu; Sun, Yingshi; Fan, Zhengfu; Phan, Kevin; Yang, Yue; Wu, Nan

2014-10-01

237

Anemia in Chronic Kidney Disease  

MedlinePLUS

... Fax: 813–636–8122 Email: info@aakp.org Internet: www.aakp.org American Kidney Fund 11921 Rockville ... Rockville, MD 20852 Phone: 1–800–638–8299 Internet: www.kidneyfund.org National Kidney Foundation 30 East ...

238

FastStats: Kidney Disease  

MedlinePLUS

... State and Territorial Data NCHS Home FastStats Home Kidney Disease Data are for the U.S. Morbidity Number of noninstitutionalized adults with diagnosed kidney disease: 3.9 million Percent of noninstitutionalized adults with ...

239

Unilateral opercular infarction presenting with Foix-Chavany-Marie Syndrome.  

PubMed

A 76-year-old man with a history of pontine, cerebellar infaction suddenly became speechless during the procedure of percutaneous coronary intervention. On examination, he was unable to close his mouth voluntarily, but spontaneous closing was preserved when smiling. He had anarthria and hypophonia, although his comprehension was preserved. He also had a severe dysphagia. Radiological studies revealed an acute stroke in the left anterior operculum, indicating Foix-Chavany-Marie Syndrome (FCMS) caused by a unilateral opercular lesion. Pathophysiology of the previous cases reported as unilateral FCMS remains controversial, but in our case, it could be delineated by the combination of the new lesion in the unilateral operculum and the old one in the contralateral pons. Since FCMS is not only related to biopercular lesions, we should consider thorough radiologic examination to clarify its anatomic basis. PMID:23040957

Ohtomo, Ryo; Iwata, Atsushi; Tsuji, Shoji

2014-01-01

240

Clock-drawing test and unilateral spatial neglect.  

PubMed

We investigated the ability of 25 patients with left unilateral spatial neglect to make a clock face by putting numbers inside a printed circle. Impairment seen in this clock-drawing test did not parallel neglect severity as judged by results of the line-cancellation and line-bisection tests, as well as the copying of a daisy. The score for clock drawing correlated highly with the verbal WAIS score. Most neglect patients with a verbal IQ of 87 or more could draw a clock face fairly well and used planning in placing the numbers 12, 3, 6, and 9 before the others. In clock drawing, verbal intelligence may compensate for left unilateral spatial neglect. We therefore recommend use of the line-cancellation and line-bisection tests, as well as the copying test, but do not recommend use of the clock-drawing test in the diagnosis of left unilateral spatial neglect. PMID:8423871

Ishiai, S; Sugishita, M; Ichikawa, T; Gono, S; Watabiki, S

1993-01-01

241

Prepubertal unilateral gynecomastia in the absence of endocrine abnormalities  

PubMed Central

Gynecomastia is defined as the excessive development of breast tissue in males, which can occur as unilateral or bilateral. Although the overall prevalence of gynecomastia is 40%-65%, the prepubertal unilateral gynecomastia in the absence of endocrine abnormalities is unusual, with only a few case reports in literature. Idiopathic gynecomastia in prepuberty is benign but a diagnosis of exclusion. We here report two cases of healthy prepubertal boys aged 8.8 and 9.6 years old, respectively, presented with painful palpable mass in their unilateral breast. Breast tissue with glandular proliferation was confirmed on ultrasonography. Serum levels of estradiol, testosterone, and other laboratory findings were within normal range. They seem to have the prepubertal idiopathic gynecomastia but further follow-up to see their progression is needed.

Kang, Min; Lee, Chan Jae; Hwang, Il Tae; Lee, Kwanseop

2014-01-01

242

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 ...

243

Kidney angiomyolipoma in pregnancy  

PubMed Central

Neoplasms are rare in pregnant women, however they are always a challenging diagnostic and curative problem. We present a case of a benign kidney tumor (angiomyolipoma) imitating nephroblastoma on magnetic resonance diagnosed in pregnancy. Cesarean section was performed in 29. gestotic week followed immediately by right radical nephrectomy. PMID:24757536

Bialy, Aleksander; Dembowski, Janusz; Zlotkiewicz, Monika; Guzinski, Maciej; Kolodziej, Anna Karina; Zdrojowy, Romuald

2013-01-01

244

Spontaneous Kidney Allograft Rupture  

Microsoft Academic Search

Spontaneous renal allograft rupture is one of the most dangerous complications of kidney transplantation, which can result in graft loss.This condition needs immediate surgical intervention. Conservative management has dismal results. Its prevalence varies from 0.3% to 3%. Rupture occurs in first few weeks after transplantation. Predisposing factors for graft rupture are acute rejection, acute tubular necrosis, and renal vein thrombosis.

H. Shahrokh; H. Rasouli; M. A. Zargar; K. Karimi; K. Zargar

2005-01-01

245

Monitoring Your Kidney Health  

MedlinePLUS

... results compare to the last results. The key tests to track kidney health include: Blood pressure The most important thing you can do to ... your A1C can help you to stay healthy. Test Result/Date Result/Date Result/Date Result/Date Blood pressure Goal: Less than ___/___ GFR Goal: Keep from going ...

246

Chronic Kidney Disease  

MedlinePLUS

... suspects you might have chronic kidney disease: Blood pressure test Urine albumin (a test to see how much protein is in the urine) Serum creatinine (a test to see how much creatinine, a ... or high blood pressure, talk to your doctor about whether you should ...

247

Black kidney in Albinism  

PubMed Central

Implication for health policy/practice/research/medical education: Oculocutaneous albinism may be similar to two related syndromes (Hermansky-Pudlak and Chediak-Higashi) and could lead to more widespread lysosome excretory defects. These defects could lead to accumulation of some intracellular material, leading to the gross discoloration of the kidney. PMID:24772396

Ardalan, Mohammad-Reza

2014-01-01

248

Bite force in pre-orthodontic children with unilateral crossbite.  

PubMed

In the present study bite force was examined in pre-orthodontic children with unilateral posterior crossbite and compared with an age- and sex-matched control group. The sample comprised 52 children aged 7-13 years, 26 pre-orthodontic children with unilateral posterior crossbite (crossbite group), and 26 children with neutral occlusion (control group). Unilateral bite force was measured at the first molar by means of a pressure transducer. Furthermore, symptoms and signs of temporomandibular disorders (TMD) and number of teeth in contact in the intercuspal position (ICP) were recorded. In both groups, the maximum bite force increased significantly with age and with increasing stages of dental eruption, but the bite force in both sexes did not differ significantly. There were no significant differences in bite force between sides, but this was significantly smaller in the crossbite group than in the controls (P < 0.001). Regression analysis showed that stage of dental eruption (P < 0.001), number of teeth in occlusal contact (P < 0.01), and unilateral crossbite (P < 0.001) were the only variables significantly correlated with bite force. The number of teeth in contact was significantly smaller in the crossbite group than in the controls (P < 0.05) and the frequency of muscle tenderness was significantly higher in the crossbite group than in the controls (P < 0.05). These results suggest that differences in the muscle function associated with unilateral crossbite lead to a significantly smaller bite force in the crossbite group compared with controls and this difference did not diminish with age and development. These findings indicate that early treatment of unilateral posterior crossbite is advisable to optimize conditions for function. PMID:11890069

Sonnesen, L; Bakke, M; Solow, B

2001-12-01

249

ORIGINAL ARTICLE Kidney Cancer Mortality  

E-print Network

ORIGINAL ARTICLE Kidney Cancer Mortality Fifty-year Latency Patterns Related to Arsenic Exposure,e and Allan H. Smitha Background: Arsenic in drinking water is associated with kidney cancer. Beginning obtained computerized mortality data for all of Chile for 1971­2000. Results: Kidney cancer risks

California at Berkeley, University of

250

JAMA Patient Page: Kidney Transplantation  

MedlinePLUS

... C I P I E N T Kidney Transplantation Procedure The donor kidney is attached to a blood supply (an artery and a vein), and the ureter (to drain urine from the kidney) is attached to the ... a major operation usually requiring general anesthesia. ...

251

Kidney function of single comb white Leghorn pullets following acute renal portal infusion of the mycotoxin citrinin.  

PubMed

Poultry consuming diets contaminated with citrinin excrete copious quantities of urine and exhibit increased water consumption. The present study was conducted to determine if citrinin acts directly on the kidneys and, if so, to provide a detailed physiological evaluation of the nephrotoxic effects of citrinin. Single Comb White Leghorn pullets were anesthetized and prepared for renal function studies. Ureteral urine was collected during a pre-infusion period (30 min), during unilateral renal portal infusion of 200 ppm citrinin (30 min), and during a recovery period following citrinin infusion (90 min). Pilot studies had shown that 200 ppm citrinin is the lowest dose capable of causing consistent unilateral responses when infused at a rate of .2 ml/kg body weight (BW) X min. The responses of the portal-infused kidneys were compared with the responses of the contralateral (uninfused) kidneys to determine the direct effects of citrinin. Citrinin had no acute direct (unilateral) effect on glomerular filtration rate, renal plasma flow rate, urine pH, or fractional calcium or magnesium excretion. Citrinin caused rapid unilateral increases in urine flow rates, free water clearance, and in fractional sodium, potassium, and inorganic phosphate excretion. Increased solute excretion did not compensate for increased free water clearance, as reflected by a significant decrease in urine osmolality. Recovery from the effects of citrinin occurred within 30 min after cessation of unilateral renal portal infusion. No histopathological damage was seen when citrinin was infused at 200 and 800 ppm, although dose-related increases in urine flow and decreases in urine osmolality were observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4048052

Hnatow, L L; Wideman, R F

1985-08-01

252

Cold shivering activity after unilateral destruction of the vestibular apparatus  

NASA Technical Reports Server (NTRS)

The bioelectric activity of muscles (flexors and extensors of the forelimbs and hindlimbs) during cold shivering after unilateral destruction of the vestibular apparatus. It was found, that unilateral delabyrinthing produces bilateral facilitation of cold shivering in the flexor extremities more pronounced on the ipsilateral side. In the extensor muscles there was an absence of bioelectric activity both before and after delabyrinthing. Enhancement of cold shivering in the flexor extremities following intervention was evidently conditioned by removal of the inhibiting effect of the vestibulary apparatus on the function of special centers.

Kuzmina, G. I.

1980-01-01

253

Advances of unilateral mobile NMR in nondestructive materials testing.  

PubMed

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

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

2005-02-01

254

Thoracic trident pigmentation in Drosophila melanogaster : Differentiation of geographical populations  

E-print Network

Thoracic trident pigmentation in Drosophila melanogaster : Differentiation of geographical : Drosophila melanogaster, pigmentation, teuzperature response, maternal effect, latitudinal cline. Résumé La pigmentation thoracique en forme de trident chez Drosophila melanogaster : différenciation de populations de

Paris-Sud XI, Université de

255

Segmental thoracic lipomatosis of nerve with nerve territory overgrowth.  

PubMed

Lipomatosis of nerve (LN), or fibrolipomatous hamartoma, is a rare condition of fibrofatty enlargement of the peripheral nerves. It is associated with bony and soft tissue overgrowth in approximately one-third to two-thirds of cases. It most commonly affects the median nerve at the carpal tunnel or digital nerves in the hands and feet. The authors describe a patient with previously diagnosed hemihypertrophy of the trunk who had a history of large thoracic lipomas resected during infancy, a thoracic hump due to adipose proliferation within the thoracic paraspinal musculature, and scoliotic deformity. She had fatty infiltration in the thoracic spinal nerves on MRI, identical to findings pathognomonic of LN at better-known sites. Enlargement of the transverse processes at those levels and thickened ribs were also found. This case appears to be directly analogous to other instances of LN with overgrowth, except that this case involved axial nerves rather than the typical appendicular nerves. PMID:24506247

Mahan, Mark A; Amrami, Kimberly K; Howe, B Matthew; Spinner, Robert J

2014-05-01

256

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

PubMed

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

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

2002-11-01

257

Twelve contiguous spinous process fracture of cervico-thoracic spine.  

PubMed

The clay-shoveler's fracture is an isolated avulsion fracture of the lower cervical or upper thoracic spinous process. Among them, multiple spinous process fractures are very rare. We present 34-year-old male patient who have multiple spinous process fractures with twelve contiguous levels of cervico-thoracic spine (from C4 to T8) after motorcycle accident. This case is multiple isolated spinous process fractures with good clinical outcome. PMID:25346773

Han, Seong Rok; Sohn, Moon Jun

2014-09-01

258

Treatment of Thoracic Outlet Syndromes and Cervical Sympathectomy  

Microsoft Academic Search

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

Robert W. Thompson

259

Optimal Approach to Thoracic Outlet Syndrome: Transaxillary, Supraclavicular, or Infraclavicular  

Microsoft Academic Search

Thoracic outlet syndrome (TOS) is not a single entity. By definition, TOS is compression of the neurovascular bundle in the\\u000a thoracic outlet area eliciting symptoms in the upper extremity. The neurovascular bundle, comprising nerve, artery, and vein,\\u000a gives rise to three types of TOS: neurogenic, arterial, and venous. When using the term TOS, most people are referring to\\u000a the neurogenic

Richard J. Sanders

260

Twelve Contiguous Spinous Process Fracture of Cervico-Thoracic Spine  

PubMed Central

The clay-shoveler's fracture is an isolated avulsion fracture of the lower cervical or upper thoracic spinous process. Among them, multiple spinous process fractures are very rare. We present 34-year-old male patient who have multiple spinous process fractures with twelve contiguous levels of cervico-thoracic spine (from C4 to T8) after motorcycle accident. This case is multiple isolated spinous process fractures with good clinical outcome. PMID:25346773

Sohn, Moon Jun

2014-01-01

261

Myeloma-related kidney disease.  

PubMed

Multiple myeloma is a malignant plasma cell disorder characterized by the overproduction of monoclonal proteins. The kidney is 1 of the major target organs of multiple myeloma. Most often, this is the result of the monoclonal proteins, which can injure the kidney via several mechanisms. In some cases, direct invasion by myeloma cells and/or bone marrow cells can also result in kidney injury. A kidney biopsy can help distinguish the various myeloma-related kidney diseases and aid in the treatment plan. PMID:24359985

Leung, Nelson; Nasr, Samih H

2014-01-01

262

Evaluation of intrarenal mesenchymal stem cell injection for treatment of chronic kidney disease in cats: a pilot study  

Microsoft Academic Search

The feasibility of autologous intrarenal mesenchymal stem cell (MSC) therapy in cats with chronic kidney disease (CKD) was investigated. Six cats (two healthy, four with CKD) received a single unilateral intrarenal injection of autologous bone marrow-derived or adipose tissue-derived MSC (bmMSC or aMSC) via ultrasound guidance. Minimum database and glomerular filtration rate (GFR) via nuclear scintigraphy were determined pre-injection, at

Jessica M. Quimby; Tracy L. Webb; Debra S. Gibbons; Steven W. Dow

2011-01-01

263

Preclinical evaluation of erythropoietin administration in a model of radiation-induced kidney dysfunction  

SciTech Connect

Purpose: To test whether the clinically available growth factor erythropoietin (EPO) influences radiation-induced normal-tissue damage in a model of kidney dysfunction. Methods: Animal experiments were conducted to test the role of EPO administration in a C3H mouse model of unilateral kidney irradiation with 6, 8, and 10 Gy and to assess the effects of 2 different dose levels of EPO. The kidney function was assessed before radiotherapy, as well as 19, 25, 31, and 37 weeks thereafter by means of {sup 99m}Tc-dimercaptosuccinat scans (static scintigraphy). Results: Concomitant EPO administration significantly increased the degree of radiation-induced kidney dysfunction. A dose of 2,000 IU/kg body weight per injection tended to cause more damage than the lower dose of 500 IU/kg. Conclusion: Administration of growth factors concomitant to radiotherapy might modify the development of kidney dysfunction. Although insulin-like growth factor-1 has previously been shown to protect the kidney, such an effect could not be demonstrated for EPO. The latter agent even increased the development of nephropathy.

Andratschke, Nicolaus [Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich (Germany); Schnaitera, Andrea [Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich (Germany); Weber, Wolfgang A. [Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center, The University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA (United States); Caia, Lu [Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich (Germany); Schill, Sabine [Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich (Germany); Wiedenmann, Nicole [Department of Experimental Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Schwaiger, Markus [Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich (Germany); Molls, Michael [Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich (Germany); Nieder, Carsten [Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Munich (Germany)]. E-mail: cnied@hotmail.com

2006-04-01

264

Endovascular Management of Thoracic Aortic Aneurysms  

SciTech Connect

The overall survival of patients with thoracic aortic aneurysm (TAA) has improved significantly in the past few years. Endovascular treatment, proposed as an alternative to surgery, has been considered a therapeutic innovation because of its low degree of invasiveness, which allows the treatment of even high-surgical risk patients with limited complications and mortality. A major limitation is the lack of adequate evidence regarding long-term benefit and durability because follow-up has been limited to just a few years even in the largest series. The combination of endovascular exclusion with visceral branch revascularization for the treatment of thoraco-abdominal aortic aneurysms involving the visceral aorta has also been attempted. As an alternative, endografts with branches represent a technological evolution that allows treatment of complex anatomy. Even if only small numbers of patients and short follow-up are available, this technical approach, which has with limited mortality (<10%) and paraplegia rates, to expand endovascular treatment to TAA seems feasible. With improved capability to recognize proper anatomy and select clinical candidates, the choice of endovascular stent-graft placement may offer a strategy to optimize management and improve prognosis.

Fattori, Rossella, E-mail: rossella.fattori@unibo.it; Russo, Vincenzo; Lovato, Luigi; Buttazzi, Katia; Rinaldi, Giovanni [University Hospital S. Orsola, Cardiovascular Radiology Unit, Cardio-Thoracic-Vascular Department (Italy)

2011-12-15

265

Primary osseous hemangiopericytoma in the thoracic spine.  

PubMed

Hemangiopericytoma (HPC) is a rare tumor of the central nervous system, most commonly found in the cranial cavity. HPCs in the spine are rare, and very few of them are primary osseous HPC. The aims of this study were to describe a rare case of primary osseous HPC in the thoracic spine and review the literature. A 54-year-old man presented with a 3-month history of back pain. Aneuro logical examination revealed no motor or sensory deficits. Magnetic resonance imaging (MRI) and computed tomography (CT) scan showed a tumor originating from the bone structure of the T10 vertebra with paravertebral extension, and chest CT revealed pulmonary metastases. A laminectomy, face-totomy,and subtotal resection of the tumor was performed with posterior pedicle screw system fixation followed by radiotherapy. The post-operative course was uneventful. His back pain was resolved completely after surgery. The patient survived with tumor during the 18-month follow-up period. Histopathology and immunohistologic findings were consistent with HPC. On immunohistochemistry, the tumor was positive for vimentin and CD34, partially positive for S-100, but negative for EMA, desmin, CD117, and CD1a. A literature review identified eight such cases reported between 1942 and 2013. As a conclusion, clinical manifestations of primary osseous spinal HPCs are different from intraspinal meningeal HPCs. Although showing certain variability, histopathology and immunohistochemical examinations are essential to establish the diagnosis. Surgical resection and radiotherapy are the treatment of choice. *These authors contributed equally to this work. PMID:24887400

Ren, Ke; Zhou, Xing; Wu, SuJia; Sun, Xiaoliang

2014-01-01

266

Thoracic sarcoidosis: radiologic-pathologic correlation.  

PubMed

Sarcoidosis is a systemic disease of unknown etiology with variable presentation, prognosis, and progression. At diagnosis, about 50% of patients are asymptomatic, 25% complain of cough or dyspnea, and 25% have skin lesions (erythema nodosum, lupus pernio, or plaques or scars) or eye symptoms (or develop them during the course of the disease). Bilateral hilar adenopathy is the most common radiographic finding. Other characteristic findings include interstitial lung disease, occasional calcification of affected lymph nodes, and pleural effusions and thickening. Computed tomography is more sensitive than radiography in the detection of adenopathy and subtle parenchymal disease; gallium-67 scintigraphy is useful in identifying extrathoracic sites of involvement, detecting active disease, and assessing response to treatment. The diagnosis is established most securely when clinicoradiologic findings are supported by histologic evidence of widespread noncaseating granulomas. The disease ranges from a self-limited subclinical process to chronic debilitation and death, with the major complications being fibrosis, mycetoma formation, and cor pulmonale. Because the disease so often involves thoracic structures, chest radiography plays a crucial role in the diagnosis, staging, and follow-up of sarcoidosis. PMID:7761646

Miller, B H; Rosado-de-Christenson, M L; McAdams, H P; Fishback, N F

1995-03-01

267

Molecular Mechanisms of Thoracic Aortic Dissection  

PubMed Central

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

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

2013-01-01

268

Kidney stone disease  

PubMed Central

About 5% of American women and 12% of men will develop a kidney stone at some time in their life, and prevalence has been rising in both sexes. Approximately 80% of stones are composed of calcium oxalate (CaOx) and calcium phosphate (CaP); 10% of struvite (magnesium ammonium phosphate produced during infection with bacteria that possess the enzyme urease), 9% of uric acid (UA); and the remaining 1% are composed of cystine or ammonium acid urate or are diagnosed as drug-related stones. Stones ultimately arise because of an unwanted phase change of these substances from liquid to solid state. Here we focus on the mechanisms of pathogenesis involved in CaOx, CaP, UA, and cystine stone formation, including recent developments in our understanding of related changes in human kidney tissue and of underlying genetic causes, in addition to current therapeutics. PMID:16200192

Coe, Fredric L.; Evan, Andrew; Worcester, Elaine

2005-01-01

269

Cerebellar dysplasia and unilateral cataract in Marinesco-Sjörgen syndrome  

Microsoft Academic Search

The classic features of Marinesco-Sjögren syndrome include bilateral cataracts, cerebellar ataxia, and mental deficiency with an autosomal recessive inheritance pattern. Weakness and a variety of other characteristics are present inconsistently. A limited number of neuroimaging studies have indicated that cerebellar hypoplasia is the most common finding. We report a patient with near normal intelligence, unilateral cataract, and the previously unreported

Tracy E. Williams; Jeffrey R. Buchhalter; Michael D. Sussman

1996-01-01

270

Prism adaptation and unilateral neglect: Review and analysis  

Microsoft Academic Search

Theory and data from normal prism adaptation are applied toward understanding the ameliorating effects of prism adaptation for left unilateral neglect patients. Neglect is proposed to be, at least in part, a dysfunction in selection of the region of space appropriate for the task at hand. Normally, a task-work space is strategically sized and positioned (calibrated) around the task-relevant objects.

Gordon M. Redding; Benjamin Wallace

2006-01-01

271

Vestibulo-ocular and optokinetic impairments in left unilateral neglect  

Microsoft Academic Search

Right brain damaged patients affected by left unilateral neglect (N+) typically fail to explore the contralesional space. For the first time, this study investigates the dynamic and spatial features of the horizontal vestibular–ocular response (VOR), the optokinetic response (OKR) and the VOR–OKR interaction in six N+ and in five right brain damaged patients without neglect (N?). No lateral asymmetry of

Fabrizio Doricchi; Isabelle Siegler; Giuseppe Iaria; Alain Berthoz

2002-01-01

272

Bilateral Effects of Unilateral Cochlear Implantation in Congenitally Deaf Cats  

E-print Network

Bilateral Effects of Unilateral Cochlear Implantation in Congenitally Deaf Cats Jahn N. O'Neil,1 deafness results in synaptic abnormalities in auditory nerve endings. These abnormalities are most at this synaptic junction. We sought to determine whether electrical stimulation of the congenitally deaf auditory

Ryugo, David K.

273

On unilateral divorce and the “selection of marriages” hypothesis  

Microsoft Academic Search

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

Eric Langlais

2010-01-01

274

Unilateral lumbar facet joint hypertrophy causing nerve root irritation.  

PubMed

We present four cases of massive unilateral lumbar facet joint hypertrophy in an otherwise morphologically normal spine. All presented with a combination of low back pain and symptoms of entrapment of a single lumbar nerve root. The abnormality is best visualised by CT scanning and the results of surgical decompression by partial undercutting facetectomy are favourable. PMID:3190129

Wilde, G P; Szypryt, E P; Mulholland, R C

1988-09-01

275

EQUILIBRIUM PATHS OF MECHANICAL SYSTEMS WITH UNILATERAL CONSTRAINTS  

E-print Network

in structural mechanics is the determination of the static equilibrium path of a structure for varying valuesEQUILIBRIUM PATHS OF MECHANICAL SYSTEMS WITH UNILATERAL CONSTRAINTS PART I: THEORY M. Schulz and S theoretical formulation is required for simulating their behaviour. After showing that the equilibrium

Pellegrino, Sergio

276

Human ocular torsional position before and after unilateral vestibular neurectomy  

Microsoft Academic Search

The static ocular torsional position of both eyes of 23 patients was measured by means of fundus photographs one day before and one week after unilateral vestibular neurectomy for the treatment of acoustic neuroma, Ménière's disease or paroxysmal vertigo. The results showed that in all patients the vestibular neurectomy caused both eyes to tort (i.e. to roll around the visual

I. S. Curthoys; M. J. Dai; G. M. Halmagyi

1991-01-01

277

Traumatic glaucoma with features of unilateral pigment dispersion  

PubMed Central

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

Bowler, Gordon; Ellul, Antony; Gouws, Pieter

2014-01-01

278

Bimanual Force Coordination in Children with Spastic Unilateral Cerebral Palsy  

ERIC Educational Resources Information Center

In this study bimanual grip-force coordination was quantified using a novel "Gripper" system that records grip forces produced while holding a lower and upper unit, in combination with the lift force necessary to separate these units. Children with unilateral cerebral palsy (CP) (aged 5-14 years, n = 12) were compared to age matched typically…

Smits-Engelsman, B. C. M.; Klingels, K.; Feys, H.

2011-01-01

279

Unilateral Spatial Neglect in The Late Stage of Alzheimer's Disease  

Microsoft Academic Search

We report two patients with presumptive diagnosis of dementia of the Alzheimer's type (AD) who manifested a clear unilateral neglect syndrome in the late stage of the disease. At onset, their cognitive profiles were broadly similar to the usual cases of degenerative dementia, but, as the disease progressed, neglect appeared, becoming gradually more severe. MRI showed more pronounced cerebral atrophy

Annalena Venneri; Roberta Pentore; Biagio Cotticelli; Sergio Della Sala

1998-01-01

280

Bill Goodwine California Institute of Technology Controllability with Unilateral  

E-print Network

Bill Goodwine California Institute of Technology Controllability with Unilateral Control Inputs Bill Goodwine and Joel Burdick December 13, 1996 Slide 0 In this talk we present a controllability test;Bill Goodwine California Institute of Technology Motivating Examples Many control systems have inputs

Goodwine, Bill

281

Perceptual awareness and its loss in unilateral neglect and extinction  

Microsoft Academic Search

We review recent evidence from studies of patients with unilateral neglect and\\/or extinction, who suffer from a loss of awareness for stimuli towards the affected side of space. We contrast their deficit with the effects of damage to primary sensory areas, noting that such areas can remain structurally intact in neglect, with lesions typically centred on the right inferior parietal

Jon Driver; Patrik Vuilleumier

2001-01-01

282

On the treatment of nonlinear unilateral contact problems  

Microsoft Academic Search

This paper is concerned with finite deformations of elastic bodies in the presence of unilateral constraints. The penalty formulation is applied to introduce the contact constraints. We develop special isoparametric contact elements. Starting from their Gaussian points the distance between the body and the obstacle is determined, where the obstacle is given as aC2 continuous function. Variation and subsequent consistent

P. Wriggers; M. Imhof

1993-01-01

283

Unilateral Galactorrhea Associated with Low-dose Escitalopram.  

PubMed

Galactorrhea is a rare adverse effect of selective serotonin reuptake inhibitor treatment. We report a 27-year-old woman who developed unilateral breast engorgement with galactorrhea 18 days after initiation of escitalopram (10 mg/day). The symptom remitted 7 days after withdrawal of escitalopram and did not subsequently recur during maintenance therapy with agomelatine (25 mg/day). PMID:25035569

Ravi, P Bangalore; Guruprasad, K G; Andrade, Chittaranjan

2014-07-01

284

Unilateral Galactorrhea Associated with Low-dose Escitalopram  

PubMed Central

Galactorrhea is a rare adverse effect of selective serotonin reuptake inhibitor treatment. We report a 27-year-old woman who developed unilateral breast engorgement with galactorrhea 18 days after initiation of escitalopram (10 mg/day). The symptom remitted 7 days after withdrawal of escitalopram and did not subsequently recur during maintenance therapy with agomelatine (25 mg/day). PMID:25035569

Ravi, P. Bangalore; Guruprasad, K. G.; Andrade, Chittaranjan

2014-01-01

285

Unilateral sacroiliitis as an unusual complication of acupuncture  

Microsoft Academic Search

Septic sacroiliitis in an uncommon disease and is rarely reported as a complication of acupuncture. We present a case of unilateral septic sarcoiliitis, which developed as a complication of acupuncture because of failure to sterilise the skin properly before treatment. Bone scan and computed tomography were positive for sacroiliitis. After a course of antibiotics with oxacillin for 6 weeks, the

Sheung-Mei Lau; Chung-Tei Chou; Chung-Ming Huang

1998-01-01

286

Weights of carotid endarterectomy specimens in patients undergoing unilateral procedures.  

PubMed

Analysis of 273 unilateral carotid endarterectomy specimens showed those in the men to be larger than those in the women (1.4 vs 0.96 g). A large weight variation was found. The smallest specimen weighed 0.38 g, and the largest weighed 4.2 g, a 10-fold difference; the mean weight was 1.25 g. PMID:12972132

Roberts, William Clifford; Laborde, Nolan Joseph; Pearl, Gregory John

2003-09-15

287

Psychosocial outcome of TBI in children with unilateral frontal lesions.  

PubMed

To evaluate effects of unilateral frontal lesions on psychosocial and global outcome of traumatic brain injury (TBI) in children, Study 1 compared matched groups of 22 school aged children who had sustained TBI either with or without unilateral frontal lesions. Study 2 evaluated effects of unilateral extrafrontal lesions in 18 TBI patients as compared with 18 nonlesional TBI patients. Communication, Daily Living, and Socialization domains and the Maladaptive Behavior Scale of the Vineland Adaptive Behavior Scales (VABS) were used to assess psychosocial outcome, and the Glasgow Outcome Scale (GOS) measured global outcome. All patients underwent magnetic resonance imaging at least 3 months post injury. Children with frontal lesions had worse scores on the Daily Living and Socialization domains and a higher frequency of maladaptive behavior than those without frontal lesions, but there was no difference in cognitive function. Disability was twice as common in the frontal lesion group relative to children without frontal lesions. Volume of frontal lesion was related to the Socialization domain. Side of lesion had no effect, nor did presence of an extrafrontal lesion (Study 2). Unilateral frontal lesions adversely affect late psychosocial outcome of TBI in children. PMID:15147589

Levin, Harvey S; Zhang, Lifang; Dennis, Maureen; Ewing-Cobbs, Linda; Schachar, Russell; Max, Jeffrey; Landis, Julie A; Roberson, Garland; Scheibel, Randall S; Miller, Daisy L; Hunter, Jill V

2004-05-01

288

A case of unilateral keloid after bilateral breast reduction  

Microsoft Academic Search

Keloid scar is a manifestation of abnormal wound healing in predisposed individuals. Many treatment modalities have been tried with varying degrees of success. Radiotherapy is one such modality that is widely recognised. We present a case report and literature review based on a patient who developed unilateral keloid scarring following bilateral breast reduction surgery. Some 4 years previously, she had

Haresh Devalia; Lucy Mansfield; Neda Minakaran; Dibyesh Banerjee

2008-01-01

289

Total versus hemithyroidectomy for small unilateral papillary thyroid carcinoma  

PubMed Central

The correct approach to treat low-risk intrathyroidal papillary thyroid carcinoma (PTC) is controversial. Specific authors advocate unilateral thyroidectomy to minimize perioperative morbidity. The purpose of the present study was to determine an effective treatment strategy for patients with small unilateral papillary thyroid. This was a retrospective comparative analysis of 161 patients with PTC treated between 2001–2010; 60 consecutive patients following hemithyroidectomy and 101 patients following total thyroidectomy. Only patients with preoperatively-predicted localized unilateral disease were included. No between-group difference was identified in the rate of permanent surgical complications. In total, 36 hemithyroidectomy patients (60%) exhibited benign thyroid nodules in the contralateral lobe on preoperative ultrasound; this factor was found to positively correlate with the performance of ?1 fine needle aspirations (FNAs) during follow-up. In addition, 47 hemithyroidectomy patients (78.3%) were prescribed thyroxine postoperatively. The hemithyroidectomy patients visited the endocrine clinic significantly less frequently than the total thyroidectomy patients (P=0.01), but were referred more often for neck ultrasound (P=0.03) and FNA (P<0.001). In addition, an increased number of patients in the hemithyroidectomy group were reoperated for suspected recurrent/persistent disease (P=0.06). Results of this retrospective study indicate that hemithyroidectomy for small unilateral PTC is associated with a significant follow-up burden and provides no clear patient benefit. PMID:24520302

HIRSCH, DANIA; LEVY, SIGAL; TSVETOV, GLORIA; SHIMON, ILAN; BENBASSAT, CARLOS

2014-01-01

290

Shipping and climate change: Scope for unilateral action  

E-print Network

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

Matthews, Adrian

291

Unilateral Forced Nostril Breathing Affects Dichotic Listening for Emotional Tones  

ERIC Educational Resources Information Center

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…

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

2004-01-01

292

Kidney Cell Electrophoresis  

NASA Technical Reports Server (NTRS)

Materials and procedures for microgravity electrophoresis of living human embryonic kidney cells were evaluated, ground support in the form of analytical cell electrophoresis and flow cytometry was provided and cells returned from space flight were analyzed. Preflight culture media, electrophoresis buffer, fraction collection media, temperature profiles, and urokinase assay procedures were tested prior to flight. Electrophoretic mobility distributions of aliquots of the cell population to be fractionated in flight were obtained. The protocol established and utilized is given.

Todd, P.

1985-01-01

293

Unilateral Incompatibility in Capsicum (Solanaceae): Occurrence and Taxonomic Distribution  

PubMed Central

• Background and aims Unilateral incompatibility (UI) occurs when pollinations between species are successful in one direction but not in the other. Self-incompatible (SI) species frequently show UI with genetically related, self-compatible (SC) species, as pollen of SI species is compatible on the SC pistil, but not vice versa. Many examples of unilateral incompatibility, and all those which have been studied most intensively, are found in the Solanaceae, particularly Lycopersicon, Solanum, Nicotiana and Petunia. The genus Capsicum is evolutionarily somewhat distant from Lycopersicon and Solanum and even further removed from Nicotiana and Petunia. Unilateral incompatibility has also been reported in Capsicum; however, this is the first comprehensive study of crosses between all readily available species in the genus. • Methods All readily available (wild and domesticated) species in the genus are used as plant material, including the three genera from the Capsicum pubescens complex plus eight other species. Pollinations were made on pot-grown plants in a glasshouse. The number of pistils pollinated per cross varied (from five to 40 pistils per plant), depending on the numbers of flowers available. Pistils were collected 24 h after pollination and fixed for 3–24 h. After staining, pistils were mounted in a drop of stain, squashed gently under a cover slip and examined microscopically under ultra-violet light for pollen tube growth. • Key results Unilateral incompatibility is confirmed in the C. pubescens complex. Its direction conforms to that predominant in the Solanaceae and other families, i.e. pistils of self-incompatible species, or self-compatible taxa closely related to self-incompatible species, inhibit pollen tubes of self-compatible species. • Conclusions Unilateral incompatibility in Capsicum does not seem to have arisen to prevent introgression of self-compatibility into self-incompatible taxa, but as a by-product of divergence of the C. pubescens complex from the remainder of the genus. PMID:15229125

ONUS, A. NACI; PICKERSGILL, BARBARA

2004-01-01

294

Outcomes After Unilateral Uterine Artery Embolization: A Retrospective Review  

SciTech Connect

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.

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

295

Unilateral electronegative ERG of non-vascular aetiology  

PubMed Central

Background: Full field and pattern electroretinograms (ERG, PERG) are performed to assess generalised retinal function and macular function, respectively. An (electro) negative full field ERG usually describes an ISCEV standard maximal response in which the b-wave is smaller than a normal or minimally reduced a-wave and indicates dysfunction that is post-phototransduction. The most common cause of a unilateral negative ERG is central retinal artery occlusion (CRAO) or birdshot chorioretinopathy (BCR). This study examines the clinical and electrophysiological features of patients with unilateral negative ERG who do not have CRAO or BCR. Methods: 12 patients were ascertained with a unilateral negative ERG in whom a vascular aetiology and BCR were excluded. Most presented with symptoms of central retinal dysfunction. In 11 of the 12 patients additional long duration photopic stimuli were used to test cone system ON and OFF responses. Results: All 12 patients had unilateral electronegative bright flash full field ERGs indicating total or relative preservation of rod photoreceptor function, but dysfunction post-phototransduction. Seven of these patients had non-specific inflammatory changes in the eye with the negative ERG. Six patients, including five with inflammatory signs, had involvement of the cone ON response with complete preservation of cone OFF responses. A further three patients showed evidence of cone ON response abnormality with less severe OFF response involvement. Conclusion: The ERGs in this heterogeneous group of patients predominantly showed post-phototransduction involvement of the ON pathways. Sparing of the cone OFF response was often observed. The majority of patients had signs of previous inflammation and it is speculated that these highly unusual unilateral changes may be mediated via an autoimmune mechanism. PMID:16299143

Robson, A G; Richardson, E C; Koh, A H C; Pavesio, C E; Hykin, P G; Calcagni, A; Graham, E M; Holder, G E

2005-01-01

296

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

PubMed Central

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

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

297

Analgesia in post-thoracotomy patients: Comparison between thoracic epidural and thoracic paravertebral blocks  

PubMed Central

Background: Acute postoperative pain can cause detrimental effects on multiple organ systems, leading to chronic pain syndromes. Objective: To compare thoracic epidural block (TEB) and paravertebral block (PVB) for relief of postoperative pain in adult patients undergoing thoracotomy. Materials and Methods: In this randomized, single-blinded, prospective study, 60 adult patients of both sexes, belonging to ASA physical status I and II, were scheduled for elective thoracotomy under general anesthesia. They were randomly divided into two groups, A and B of 30 each, who were comparable in terms of demographic parameters and body weight. Group A received TEB and Group B received PVB. All the patients underwent thoracotomy under general anesthesia using a uniform standard anesthetic technique. Thirty minutes before the anticipated end of skin suture, blocks were activated in both the groups with 7.5 ml for TEB and 15 ml for thoracic PVB of 0.25% bupivacaine, along with 1 ml of fentanyl for postoperative analgesia. Results: Patients receiving PVB for postoperative analgesia experienced better analgesia than those receiving TEB from the immediate postoperative period that lasted longer. Intragroup comparison showed that in the cases receiving TEB, there was a significant statistical difference in preoperative and postoperative values with regard to the mean systolic blood pressure (SBP), mean arterial pressure and mean pulse rate. However, in patients receiving PVB, significant difference in preoperative and postoperative values was seen in mean SBP only. Conclusions: We observed longer duration of analgesia with PVB compared to TEB.

Mukherjee, Maitreyee; Goswami, Anupam; Gupta, Sampa Dutta; Sarbapalli, Debabrata; Pal, Ranabir; Kar, Sumit

2010-01-01

298

[Ultrasound-guided thoracic paravertebral block for acute thoracic trauma: continuous analgesia after high speed injury].  

PubMed

Paravertebral blocks have experienced a renaissance because ultrasound-guidance is becoming common practice. The method is often presented as an alternative to thoracic epidural anaesthesia, mainly in the field of elective thoracic surgery. It is also propagated as an opioid-saving analgesic procedure in breast tumor surgery. In this case report it was successfully used as a continuous intervention for acute pain therapy of a severe injury of the left thorax. A transverse probe position in the fifth intercostal space was combined with an in-plane needle technique from lateral to medial. An ultrasound-enhanced needle positioning was used due to the steep angle of puncture. The absolute limit for medial needle advancement is the acoustic shadow of the transverse process. A catheter was placed 2 cm beyond the needle tip and its correct position was verified by hydrolocation. The excellent and continuous analgesia enabled non-invasive patient ventilation to be achieved directly after extubation and was continued for 6 days. PMID:23732525

Reisig, F; Büttner, J

2013-06-01

299

Thoracic pedicle subtraction osteotomy for fixed sagittal spinal deformity.  

PubMed

STUDY DESIGN.: A retrospective clinical study. OBJECTIVE.: To find the corrective capacity of a thoracic pedicle subtraction osteotomy (PSO), determine if segmental correction is dependent on level, and to compute the impact of thoracic PSO on regional and global spinal balance. SUMMARY OF BACKGROUND DATA.: PSO is a technique popularized in the lumbar spine primarily for the correction of fixed sagittal imbalance. Despite several studies describing the clinical and radiographic outcome of lumbar PSO, there is no study in literature reporting its application in the thoracic spine. METHODS.: We retrospectively analyzed patients with fixed thoracic kyphosis who underwent thoracic PSOs for sagittal realignment. Segmental pedicle screw instrumentation and intraoperative neurophysiologic monitoring was used in all patients. Data acquisition was performed by reviewing medical charts and radiographs to determine sagittal correction (segmental/regional/global) and complications. Clinical outcome using the Scoliosis Research Society-22 (SRS-22) instrument was determined by interview. RESULTS.: A total of 25 thoracic PSOs were performed (mean: 1.7 PSOs/patient, range: 1-3) in 15 patients (9 M/6 F). The study population had an average age of 56 years (range, 36-81 years) and was followed up after surgery for a mean of 3.5 years (range, 24-75 months). The osteotomies were carried out in the proximal thoracic spine (T2-T4, n = 6), midthoracic spine (T5-T8, n = 12), and distal thoracic spine (T9-T12, n = 7). Mean correction at the PSO for all 25 levels was 16.3 degrees +/- 9.6 degrees . Stratified by region of the spine, thoracic PSO correction was as follows: T2-T4 = 10.7 degrees +/- 15.8 degrees , T5-T8 = 14.7 degrees +/- 4.6 degrees , and T9-T12 = 23.9 degrees +/- 4.1 degrees . Mean thoracic kyphosis (T2-T12 Cobb angle) was improved from 75.7 degrees +/- 30.9 degrees to 54.3 degrees +/- 21.4 degrees resulting in a significant regional sagittal correction of 21.4 degrees +/- 13.7 degrees (P < 0.005). Global sagittal balance was improved from 106.1 +/- 56.6 to 38.8 +/- 37.0 mm yielding a mean correction of 67.3 +/- 54.7 mm (P < 0.005). One patient, in whom there was segmental translation during osteotomy closure, had a decline in intraoperative somatosensory-evoked potentials. No patient sustained a temporary or permanent neurologic deficit after surgery. The mean SRS-22 Questionnaire score at final follow-up was 82.4 +/- 10.2. CONCLUSION.: Thoracic PSO can be performed safely. Segmental sagittal correction appears to vary based on the region of the thoracic spine the PSO is performed. The distal thoracic segments, which more closely resemble lumbar segments in morphology, rendered the greatest sagittal correction after PSO, approximately 24 degrees . There was no case of neurologic injury associated with thoracic PSO, and clinical outcomes according to the SRS-22 instrument were generally favorable. PMID:20010396

O'shaughnessy, Brian A; Kuklo, Timothy R; Hsieh, Patrick C; Yang, Benson P; Koski, Tyler R; Ondra, Stephen L

2009-12-15

300

Investigation of pulsatile flowfield in healthy thoracic aorta models.  

PubMed

Cardiovascular disease is the primary cause of morbidity and mortality in the western world. Complex hemodynamics plays a critical role in the development of aortic dissection and atherosclerosis, as well as many other diseases. Since fundamental fluid mechanics are important for the understanding of the blood flow in the cardiovascular circulatory system of the human body aspects, a joint experimental and numerical study was conducted in this study to determine the distributions of wall shear stress and pressure and oscillatory WSS index, and to examine their correlation with the aortic disorders, especially dissection. Experimentally, the Phase-Contrast Magnetic Resonance Imaging (PC-MRI) method was used to acquire the true geometry of a normal human thoracic aorta, which was readily converted into a transparent thoracic aorta model by the rapid prototyping (RP) technique. The thoracic aorta model was then used in the in vitro experiments and computations. Simulations were performed using the computational fluid dynamic (CFD) code ACE+((R)) to determine flow characteristics of the three-dimensional, pulsatile, incompressible, and Newtonian fluid in the thoracic aorta model. The unsteady boundary conditions at the inlet and the outlet of the aortic flow were specified from the measured flowrate and pressure results during in vitro experiments. For the code validation, the predicted axial velocity reasonably agrees with the PC-MRI experimental data in the oblique sagittal plane of the thoracic aorta model. The thorough analyses of the thoracic aorta flow, WSSs, WSS index (OSI), and wall pressures are presented. The predicted locations of the maxima of WSS and the wall pressure can be then correlated with that of the thoracic aorta dissection, and thereby may lead to a useful biological significance. The numerical results also suggest that the effects of low WSS and high OSI tend to cause wall thickening occurred along the inferior wall of the aortic arch and the anterior wall of the brachiocephalic artery, similar implication reported in a number of previous studies. PMID:19890715

Wen, Chih-Yung; Yang, An-Shik; Tseng, Li-Yu; Chai, Jyh-Wen

2010-02-01

301

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

PubMed Central

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

2014-01-01

302

Investigating mechanisms of chronic kidney disease in mouse models.  

PubMed

Animal models of chronic kidney disease (CKD) are important experimental tools that are used to investigate novel mechanistic pathways and to validate potential new therapeutic interventions prior to pre-clinical testing in humans. Over the past several years, mouse CKD models have been extensively used for these purposes. Despite significant limitations, the model of unilateral ureteral obstruction (UUO) has essentially become the high-throughput in vivo model, as it recapitulates the fundamental pathogenetic mechanisms that typify all forms of CKD in a relatively short time span. In addition, several alternative mouse models are available that can be used to validate new mechanistic paradigms and/or novel therapies. Here, we review several models-both genetic and experimentally induced-that provide investigators with an opportunity to include renal functional study end-points together with quantitative measures of fibrosis severity, something that is not possible with the UUO model. PMID:21695449

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

2012-08-01

303

Prevention of reflex natriuresis after acute unilateral nephrectomy by neonatal administration of MSG  

SciTech Connect

Acute unilateral nephrectomy (AUN) results in natriuresis from the remaining kidney through reflex pathways involving the central nervous system and requiring an intact pituitary gland. The natriuresis is accompanied by an increase in the plasma concentration of a peptide or peptides derived from the N-terminal fragment (NTF) of proopiomelanocortin. The authors measured plasma immunoreactive NTF-like material (IR-NTF) by radioimmunoassay, before and after AUN in control rats and rats treated neonatally with monosodium glutamate (MSG), a procedure that produces neuroendocrine dysfunction by destroying cell bodies in the hypothalamic arcuate nucleus, median eminence, and other brain regions. In control rats, IR-NTF increased from 85.8 +/- 54.9 (SD) to 207 +/- 98.1 fmol/ml after AUN as sodium excretion (U/sub Na/V) doubled. In MSG-treated rats, AUN produced no change in plasma IR-NTF concentration, nor did U/sub Na/V increase. Tissue content of IR-NTF was reduced in the arcuate nucleus and anterior lobe of pituitaries from MSG-treated rats compared with controls, but was no different in the neurointermediate lobe. These results indicate that the hypothalamic lesion produced by neonatal administration of MSG prevents both the increase in plasma IR-NTF concentration and the natruiuresis after AUN, and therefore lend further support to the concept of a casual relationship between these two consequences of AUN.

Lin, S.Y.; Wiedemann, E.; Deschepper, C.F.; Alper, R.H.; Humphreys, M.H.

1987-02-01

304

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

PubMed Central

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

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

2014-01-01

305

Reflux nephropathy in children submitted to unilateral nephrectomy: a clinicopathological study.  

PubMed

The clinical findings and renal histopathology have been reviewed in children with gross primary vesicoureteric reflux (VUR) submitted to unilateral nephrectomy. Of the 42 children reviewed, sections of the nephrectomy specimens were available in 36. In this series, 34 patients were male and eight were female. The boys included seven in which hydronephrosis was identified by fetal ultrasound. The male patients tended to present earlier and had nephrectomies younger than the females. Segmental scarring was frequent in both males and females, but evidence of dysplastic renal development was confined to the male patients and occurred in the majority (63%). Acquired mechanisms for the induction of segmental renal scarring, involving VUR, intrarenal reflux (IRR) and urinary infection, shown to be important in older children, clearly operate in infancy. However, this study emphasizes that congenital malformation of the kidney is a crucial factor in the development of reflux nephropathy (RN) in this younger age group, particularly in males. Speculation on the significance of the association between renal dysplasia and RN is discussed in relation to observations on the embryological development of the male lower urinary tract. PMID:8299237

Risdon, R A; Yeung, C K; Ransley, P G

1993-12-01

306

Paeoniflorin of Paeonia lactiflora prevents renal interstitial fibrosis induced by unilateral ureteral obstruction in mice.  

PubMed

Paeoniflorin (PF), the major active constituent of Paeonia lactiflora Pallas, has previously been reported to alleviate hepatic fibrosis. Whether and how it affects renal fibrosis was evaluated in the present study. The experimental renal fibrosis was induced by unilateral ureteral obstruction (UUO) operation in mice, and PF was orally administered for consecutive 7 days. Renal interstitial destruction and fibrosis degree were evaluated by histopathological examination and hydroxyproline assay. It was shown that PF treatment markedly ameliorated renal interstitial fibrotic lesions, attenuated synthesis of collagen and plasminogen activator inhibitor-1 (PAI-1), an important inhibitor of extracellular matrix degrading enzymes, in UUO mice. PF also suppressed epithelial-mesenchymal transition (EMT) by down-regulating TGF-?1 expression and maintaining BMP-7 mRNA expression, and inhibited Smad2/3 activation in fibrotic kidneys induced by UUO. These observations suggest that PF can effectively prevent renal interstitial fibrosis, and the underlying mechanisms are, at least in part, through blocking EMT via BMP-7 recovery and TGF-?/Smad signaling inhibition. PMID:23535189

Zeng, Junnan; Dou, Yannong; Guo, Jiaomei; Wu, Xin; Dai, Yue

2013-06-15

307

Multiatlas segmentation of thoracic and abdominal anatomy with level set-based local search.  

PubMed

Segmentation of organs at risk (OARs) remains one of the most time-consuming tasks in radiotherapy treatment planning. Atlas-based segmentation methods using single templates have emerged as a practical approach to automate the process for brain or head and neck anatomy, but pose significant challenges in regions where large interpatient variations are present. We show that significant changes are needed to autosegment thoracic and abdominal datasets by combining multi-atlas deformable registration with a level set-based local search. Segmentation is hierarchical, with a first stage detecting bulk organ location, and a second step adapting the segmentation to fine details present in the patient scan. The first stage is based on warping multiple presegmented templates to the new patient anatomy using a multimodality deformable registration algorithm able to cope with changes in scanning conditions and artifacts. These segmentations are compacted in a probabilistic map of organ shape using the STAPLE algorithm. Final segmentation is obtained by adjusting the probability map for each organ type, using customized combinations of delineation filters exploiting prior knowledge of organ characteristics. Validation is performed by comparing automated and manual segmentation using the Dice coefficient, measured at an average of 0.971 for the aorta, 0.869 for the trachea, 0.958 for the lungs, 0.788 for the heart, 0.912 for the liver, 0.884 for the kidneys, 0.888 for the vertebrae, 0.863 for the spleen, and 0.740 for the spinal cord. Accurate atlas segmentation for abdominal and thoracic regions can be achieved with the usage of a multi-atlas and perstructure refinement strategy. To improve clinical workflow and efficiency, the algorithm was embedded in a software service, applying the algorithm automatically on acquired scans without any user interaction. PMID:25207393

Schreibmann, Eduard; Marcus, David M; Fox, Tim

2014-01-01

308

Hand-Assisted Laparoscopic Nephrectomy for Polycystic Kidney Disease  

PubMed Central

Background and Objectives: Historically, nephrectomy for autosomal dominant polycystic kidney disease was performed by an open technique. We performed this study to compare outcomes in hand-assisted laparoscopic nephrectomy with open nephrectomy in this population. Methods: Charts of patients with autosomal dominant polycystic kidney disease who underwent nephrectomy by a transplant surgeon from January 1, 2000, to December 31, 2011, were reviewed. The hand-assisted laparoscopic nephrectomy group was compared with the open group. Data collected included unilateral versus bilateral nephrectomy, operative time, complications, transfusion requirement, and length of stay. Results: Of the 78 patients identified, 18 underwent open transabdominal nephrectomy, 56 underwent hand-assisted laparoscopic nephrectomy, and 2 underwent hand-assisted laparoscopic nephrectomy that was converted to an open procedure. Two patients were excluded because another major procedure was performed at the same time as the nephrectomy. Operative times were similar. Patients undergoing open bilateral nephrectomy were more likely to receive transfusion (odds ratio, 3.57 [95% confidence interval, 0.74–17.19]; P = .016), and the length of stay was longer in the open groups (5.9 days vs 4.0 days for unilateral [P = .013] and 7.8 days vs 4.6 days for bilateral [P = .001]). Overall complication rates were similar. The most frequent complications associated with hand-assisted laparoscopic nephrectomy were the development of an incisional hernia at the hand-port site and arteriovenous fistula thrombosis. Conclusion: Hand-assisted laparoscopic nephrectomy can be safely performed without increased operative times or complications. The hand-assisted laparoscopic nephrectomy group enjoyed a shorter length of stay, and fewer patients in this group received transfusion. For patients considering renal transplantation, avoidance of transfusion is important to prevent sensitization and limiting access to compatible organs. PMID:23925022

Jones, Christopher M.; Cannon, Robert M.; Marvin, Michael R.

2013-01-01

309

Endovascular aortic injury repair after thoracic pedicle screw placement.  

PubMed

Our objective was to describe the management and prevention of thoracic aortic injuries caused by a malposition of pedicle screws in corrective surgery of major spine deformities. Positioning pedicle screws in thoracic vertebras by posterior approach exposes to the risk of injury of the elements placed ahead of the thoracic spine, as the descending thoracic aorta. This complication can result in a cataclysmic bleeding, needing urgent vascular care, but it can also be totally asymptomatic, resulting in the long run in a pseudoaneurysm, justifying the systematic removal of the hardware. We report the case of a 76-year-old woman who underwent spinal correction surgery for thoraco-lumbar degenerative kypho-scoliosis. Immediately after the surgery, a thoracic aortic injury caused by the left T7 pedicle screw was diagnosed. The patient underwent a two-step surgery. The first step was realized by vascular surgeons and aimed to secure the aortic wall by short endovascular aortic grafting. During the second step, spine surgeons removed the responsible screw by posterior approach. The patient was discharged in a rehabilitation center 7 days after the second surgery. When such a complication occurs, a co-management by vascular and spine surgeons is necessary to avoid major complications. Endovascular management of this kind of vascular injuries permits to avoid an open surgery that have a great rate of morbi-mortality in frail patients. Nowadays, technologies exist to prevent this kind of event and may improve the security when positioning pedicle screws. PMID:25023930

Pesenti, S; Bartoli, M A; Blondel, B; Peltier, E; Adetchessi, T; Fuentes, S

2014-09-01

310

Impotence after kidney transplantation.  

PubMed

Sexual performance was evaluated in 28 men, thirty to sixty years of age, with functioning renal allografts: 13 were potent (controls), 10 had moderate sexual dysfunction, 5 had marked sexual dysfunction. Penile blood pressures, serum hormone levels, plasma zinc levels, and penile venous angiography were evaluated in search of causes of impotence. Thirteen of 15 impotent transplant patients (87 per cent) had marked abnormalities in at least one of the four areas studied. Systematic search for etiologic factors may permit specific therapy for impotence, which occurred in 54 per cent of the 28 kidney transplant patients analyzed. PMID:6986706

Brannen, G E; Peters, T G; Hambidge, K M; Kumpe, D A; Kempczinski, R F; Schröter, G P; Weil, R

1980-02-01

311

Epidemiology of kidney cancer.  

PubMed

Renal-cell carcinoma usually affects those over 40 years old, and, in any age group, the disease occurs about twice as frequently among men as it does among women. The incidence of the disease has been steadily increasing over the years. In the United States, the probability of surviving after diagnosis of renal cancer has been improving since 1940 regardless of race, sex, and age at diagnosis. The relationship between SES and the chance of developing the disease is sporadic with an indication of a slightly higher risk in the upper socioeconomic classes. Urbanrural comparisons consistently suggest that a higher risk is associated with urban residence. Tobacco use is probably the only environmental factor that could be considered to be etiologically related to cancer of the kidney. A variety of studies point to a moderate but consistent association with tobacco use in the form of cigarette, cigar, or pipe smoking. The excess of the disease in males compared to females and the lower incidence in Mormons may partly be due to the confounding effect of smoking. Dietary vitamin A or vitamin A supplements may have an antipromoting effect in the development of kidney cancer. Hypotheses implicating fat and/or cholesterol intake in the etiology of cancer of the kidney appear to be too tenuous. The evidence of a relationship between concentrations of certain trace metals in drinking water and incidence of renal cancer is weak. Similarly, there is no strong indication of an increased risk among individuals exposed to radiation. In general, with the exception of the observation of an unusually high risk among coke-oven workers, occupational studies have not identified any high-risk groups. Familial aggregation, though rare, occurs with peculiar disease characteristics that may predict similar cancers in the proband's relatives with a high degree of accuracy. In conclusion, the etiology of cancer of the kidney is poorly understood. The descriptive epidemiology of the disease provides some interesting insights into the correlates of the distribution of the disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:6320449

Dayal, H; Kinman, J

1983-12-01

312

Laparoscopic en bloc kidney transplantation  

PubMed Central

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

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

2012-01-01

313

The Bioartificial Kidney and Bioengineered Membranes in Acute Kidney Injury  

Microsoft Academic Search

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

Feng Ding; H. David Humes

2008-01-01

314

Matrix metalloproteinases contribute to kidney fibrosis in chronic kidney diseases  

PubMed Central

Matrix metalloproteinases (MMPs) are members of the neutral proteinase family. They were previously thought to be anti-fibrotic because of their ability to degrade and remodel of extracellular matrix. However, recent studies have shown that MMPs are implicated in initiation and progression of kidney fibrosis through tubular cell epithelial–mesenchymal transition (EMT) as well as activation of resident fibroblasts, endothelial-mesenchymal transition (EndoMT) and pericyte-myofibroblast transdifferentiation. Interstitial macrophage infiltration has also been shown to correlate with the severity of kidney fibrosis in various chronic kidney diseases. MMPs secreted by macrophages, especially MMP-9, has been shown by us to be profibrotic by induction of tubular cells EMT. EMT is mainly induced by transforming growth factor-? (TGF-?). However, MMP-9 was found by us and others to be up-regulated by TGF-?1 in kidney tubular epithelial cells and secreted by activated macrophages, resulting in EMT and ultimately kidney fibrosis. Therefore, MMP-9 may serve as a potential therapeutic target to prevent kidney fibrosis in chronic kidney disease. This review, by a particular focus on EMT, seeks to provide a comprehensive understanding of MMPs, especially MMP-9, in kidney fibrosis. PMID:24255890

Zhao, Hong; Dong, Yanting; Tian, Xinrui; Tan, Thian Kui; Liu, Zhuola; Zhao, Ye; Zhang, Yun; Harris, David CH; Zheng, Guoping

2013-01-01

315

Offspring of patients treated for unilateral Wilms' tumor in childhood  

SciTech Connect

Twenty-seven women and the wives of nine men who survived unilateral Wilms' tumor in childhood had a total of 59 live born offspring. Among the 33 infants born to women who had received orthovoltage abdominal irradiation, ten weighed less than 2500 g at birth and three died during the perinatal period. In addition, one term infant of normal weight died of complications of a breech delivery. Only one of 26 infants born to the wives of Wilms' tumor patients and unirradiated female patients weighed less than 2500 g at birth and none died. The frequency of congenital malformations and spontaneous abortions in this series was not increased, and no offspring has developed cancer. The findings suggest that the risk of Wilms' tumor is low among progeny of survivors of nonfamilial, unilateral lesions. Damage from abdominal irradiation given to girls with Wilms' tumor may predispose them to the subsequent delivery of low birthweight children.

Green, D.M.; Fine, W.E.; Li, F.P.

1982-01-01

316

Global suppression of electrocortical activity in unilateral perinatal thalamic stroke  

PubMed Central

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

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

2014-01-01

317

An isolated long thoracic nerve injury in a Navy Airman.  

PubMed

A palsy of the long thoracic nerve of Bell is a cause of scapular winging that has been reported after trauma, surgery, infection, electrocution, chiropractic manipulation, exposure to toxins, and various sports-related injuries that include tennis, hockey, bowling, soccer, gymnastics, and weight lifting. Scapular winging can result from repetitive or sudden external biomechanical forces that may either exert compression or place extraordinary traction in the distribution of the long thoracic nerve. We describe an active duty Navy Airman who developed scapular winging secondary to traction to the long thoracic nerve injury while working on the flight line. A thorough history and physical is essential in determining the mechanism of injury. Treatment should initially include refraining from strenuous use of the involved extremity, avoidance of the precipitating activity, and physical therapy to focus on maintaining range of motion and strengthening associated muscles, with most cases resolving within 9 months. PMID:15495726

Oakes, Michael J; Sherwood, Daniel L

2004-09-01

318

Neurogenic thoracic outlet and pectoralis minor syndromes in children.  

PubMed

Brachial plexus compression (BPC) occurs above the clavicle as neurogenic thoracic outlet syndrome (NTOS) and below as neurogenic pectoralis minor syndrome (NPMS). It was recently noted that 75% of the adults seen for NTOS also had NPMS and in some this was the only diagnosis. This is also true in children but has not yet been reported. Because surgical treatment of NPMS is a minimum risk operation for pectoralis minor tenotomy (PMT), recognition of NPMS and distinguishing it from NTOS becomes important. In this study, 40 operations, 20 PMT and 20 NTOS procedures, were performed. Success rate for PMT was 85% and for thoracic outlet decompression was 70%. It was concluded that in children, as in adults, BPC is more often due to combined NTOS and NPMS. Surgical PMT should be considered first as the treatment of choice for children with NPMS. Thoracic outlet decompression is available if PMT is unsuccessful. PMID:23503361

Sanders, Richard J; Annest, Stephen J; Goldson, Edward

2013-07-01

319

Current Evidence and Insights about Genetics in Thoracic Aorta Disease  

PubMed Central

Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also sporadic forms have been found to be potentially associated with genetic disorders, as highlighted by the analysis of rare variants and expression of specific microRNAs. We therefore sought to perform a comprehensive review of the role of genetic causes in the development of thoracic aortic aneurysms, by analyzing in detail the current evidence of genetic alterations in syndromes such as Marfan, Loeys-Dietz, and Ehler-Danlos, familial or sporadic forms, or forms associated with bicuspid aortic valve. PMID:24453931

Muneretto, Claudio

2013-01-01

320

Klotho and kidney disease  

PubMed Central

Klotho is a single-pass transmembrane protein that exerts its biological functions through multiple modes. Membrane-bound Klotho acts as coreceptor for the major phosphatonin fibroblast growth factor-23 (FGF23), while soluble Klotho functions as an endocrine substance. In addition to in the distal nephron where it is abundantly expressed, Klotho is present in the proximal tubule lumen where it inhibits renal Pi excretion by modulating Na-coupled Pi transporters via enzymatic glycan modification of the transporter proteins – an effect completely independent of its role as the FGF23 coreceptor. Acute kidney injury (AKI) and chronic kidney disease (CKD) are states of systemic Klotho deficiency, making Klotho a very sensitive biomarker of impaired renal function. In addition to its role as a marker, Klotho also plays pathogenic roles in renal disease. Klotho deficiency exacerbates decreases in, while Klotho repletion or excess preserves, glomerular filtration rate in both AKI and CKD. Soft tissue calcification, and especially vascular calcification, is a dire complication in CKD, associated with high mortality. Klotho protects against soft tissue calcification via at least 3 mechanisms: phosphaturia, preservation of renal function and a direct effect on vascular smooth muscle cells by inhibiting phosphate uptake and dedifferentiation. In summary, Klotho is a critical molecule in a wide variety of renal diseases and bears great potential as a diagnostic and prognostic biomarker as well as for therapeutic replacement therapy. PMID:21170871

Hu, Ming-Chang; Kuro-o, Makoto; Moe, Orson W.

2011-01-01

321

Genetic kidney diseases  

PubMed Central

Knowledge of the primary cause of a disease is essential for understanding its mechanisms and for adequate classification, prognosis, and treatment. Recently, the etiologies of many kidney diseases have been revealed as single-gene defects. This is exemplified by steroid-resistant nephrotic syndrome, which is caused by podocin mutations in ~25% of childhood and ~15% of adult cases. Knowledge of a disease-causing mutation in a single-gene disorder represents one of the most robust diagnostic examples of “personalized medicine”, because the mutation conveys an almost 100% risk of developing the disease by a certain age. Whereas single-gene diseases are rare disorders, polygenic “risk alleles” are found in common adult-onset diseases. This review will discuss prominent renal single-gene kidney disorders and polygenic risk alleles of common disorders. We delineate how emerging techniques of total exome capture and large-scale sequencing will facilitate molecular genetic diagnosis, prognosis and specific therapy and lead to a better understanding of disease mechanisms, thus enabling development of new targeted drugs. PMID:20382325

Hildebrandt, Friedhelm

2010-01-01

322

Unilateral Closed Lip Schizencephaly with Septo-Optic Dysplasia  

PubMed Central

Schizencephaly is a rare malformation of the central nervous system. Both genetic and non-genetic etiologies like prenatal infections or ischemia have been postulated. Clinical manifestations most often include varying degrees of developmental delay, motor impairment and seizures. It can be associated with septo-optic dysplasia (SOD), optic nerve hypoplasia and absence of septum pellucidum, pachygyria, polymicrogyria, heterotopia and arachnoid cysts. We report a case of unilateral closed lip schizencephaly with SOD. PMID:24761255

Bhatnagar, S; Kuber, R; Shah, D; Kulkarni, VM

2014-01-01

323

[Diagnostic problems of unilateral exophthalmos--case report].  

PubMed

This paper presents a case of a 54-year-old patient with unilateral exophthalmos. During the hospitalization basic laboratory investigations, USG, skull X-ray film, NMR of orbits were carried out. The patient was treated with systemic corticosteroids with good response. Inflammatory infiltration and venous stasis are considered to be the cause of exophthalmos. Granulomatous orbital inflammation was detected. The etiology of nonspecific orbital inflammation remains still unknown. PMID:15515323

Delong, Gabriela; Stankiewicz, Andrzej; Warczy?ska, Agnieszka

2004-01-01

324

Unilateral lumbar facet joint hypertrophy causing nerve root irritation.  

PubMed Central

We present four cases of massive unilateral lumbar facet joint hypertrophy in an otherwise morphologically normal spine. All presented with a combination of low back pain and symptoms of entrapment of a single lumbar nerve root. The abnormality is best visualised by CT scanning and the results of surgical decompression by partial undercutting facetectomy are favourable. Images fig. 1 fig. 2 fig. 3 fig. 4 PMID:3190129

Wilde, G. P.; Szypryt, E. P.; Mulholland, R. C.

1988-01-01

325

Therapeutic Effect of Retinoic Acid on Unilateral Ureteral Obstruction Model  

Microsoft Academic Search

Background: Retinoic acids, a group of natural and synthetic vitamin A derivatives, have potent anti-proliferative, anti-inflammatory and anti-fibrotic properties. We investigated the therapeutic effect of all-trans-retinoic acid (ATRA) on unilateral ureteral obstruction (UUO) model mice. Methods: First, to evaluate the prophylactic effect, we administered 0.5 mg of ATRA for 3 days before UUO (UUO ATRA). Then, to evaluate the therapeutic

Kazuya Kishimoto; Koji Kinoshita; Shoichi Hino; Tomohiro Yano; Yasuaki Nagare; Hideki Shimazu; Yuji Nozaki; Masafumi Sugiyama; Shinya Ikoma; Masanori Funauchi

2011-01-01

326

Comparison of maximal unilateral versus bilateral voluntary contraction force  

Microsoft Academic Search

The aim of the present study was to determine whether the difference in maximal voluntary contraction (MVC) forces between\\u000a unilateral (UL) and bilateral (BL) contractions could be due to a difference in the timing of MVC peak force production between\\u000a legs during BL MVC, or due to the maximal voluntary activation level (VAL) in each leg between UL and BL

Boris Matkowski; Alain Martin; Romuald Lepers

327

Unilateral hearing during development: hemispheric specificity in plastic reorganizations  

PubMed Central

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

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

2013-01-01

328

Stability with unilateral external fixation in the tibia  

Microsoft Academic Search

\\u000a Abstract\\u000a   Unilateral external fixation can be used in the provisional or definitive treatment of tibial fractures. A properly applied\\u000a fixator allows bony and soft tissue stability, whereas an improperly applied fixator achieves neither and can be a hindrance.\\u000a The principles for the successful application of monolateral external fixation, including the rationale for choosing this\\u000a type of device, the assembly of

N. Giotakis; B. Narayan

2007-01-01

329

Severe Personality Changes after Unilateral Left Paramedian Thalamic Infarct  

Microsoft Academic Search

Personality changes are not uncommon after paramedian thalamic infarction, but usually bilateral or relatively large lesions, often complicated by other neurological or neuropsychological deficits, are present. ‘Pure’ cases of unilateral lesions are extremely rare. We report that a right-handed, 48-year-old man, who was hypertensive and diabetic but had no prior psychiatric history, developed severe personality changes and a frontal-like syndrome

Toshio Fukutake; Koichi Akada; Shoichi Ito; Tomoko Okuda; Yoshihiro Ueki

2002-01-01

330

Prospective Evaluation of Thoracic Ultrasound in the Detection of Pneumothorax  

NASA Technical Reports Server (NTRS)

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.

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

331

Shock wave lithotripsy (SWL) induces significant structural and functional changes in the kidney  

NASA Astrophysics Data System (ADS)

The foundation for understanding SWL-injury has been well-controlled renal structural and functional studies in pigs, a model that closely mimics the human kidney. A clinical dose (2000 shocks at 24 kV) of SWL administered by the Dornier HM3 induces a predictable, unique vascular injury at F2 that is associated with transient renal vasoconstriction, seen as a reduction in renal plasma flow, in both treated and untreated kidneys. Unilateral renal denervation studies links the fall in blood flow in untreated kidneys to autonomic nerve activity in the treated kidney. SWL-induced trauma is associated with an acute inflammatory process, termed Lithotripsy Nephritis and tubular damage at the site of damage that leads to a focal region of scar. Lesion size increases with shock number and kV level. In addition, risk factors like kidney size and pre-existing renal disease (e.g., pyelonephritis), can exaggerate the predicted level of renal impairment. Our new protection data show that lesion size can be greatly reduced by a pretreatment session with low kV and shock number. The mechanisms of soft tissue injury probably involves shear stress followed by acoustic cavitation. Because of the perceived enhanced level of bioeffects from 3rd generation lithotripters, these observations are more relevant than ever.

Evan, Andrew P.; Willis, Lynn R.; Lingeman, James E.

2003-10-01

332

An unusual cause of dysphagia: thoracic aorta aneurysm.  

PubMed

The vascular structure related compression of esophagus is rather rare. Aberrant right subclavicular artery accounts for the majority of the rare entity, while the thoracic aorta aneurysm is a more dangerous type, called as dysphagia aortica. Delay in diagnosis and treatment of the dysphagia aortica predisposes to rupture and death. Herein, we reported a female patient with thoracic aorta aneurysm. A quick diagnosis by using chest contrast computed tomography (CT) scan and angiography of heart was made, and followed by emergent surgery. In the process, there was no delay on the diagnosis and treatment. The patient is going on well in the follow up. PMID:24416520

Wang, Wu-Ping; Yan, Xiao-Long; Ni, Yun-Feng; Zhang, Tao; Han, Yong; Li, Xiao-Fei; Lu, Qiang

2013-12-01

333

An unusual cause of dysphagia: thoracic aorta aneurysm  

PubMed Central

The vascular structure related compression of esophagus is rather rare. Aberrant right subclavicular artery accounts for the majority of the rare entity, while the thoracic aorta aneurysm is a more dangerous type, called as dysphagia aortica. Delay in diagnosis and treatment of the dysphagia aortica predisposes to rupture and death. Herein, we reported a female patient with thoracic aorta aneurysm. A quick diagnosis by using chest contrast computed tomography (CT) scan and angiography of heart was made, and followed by emergent surgery. In the process, there was no delay on the diagnosis and treatment. The patient is going on well in the follow up. PMID:24416520

Wang, Wu-Ping; Yan, Xiao-Long; Ni, Yun-Feng; Zhang, Tao; Han, Yong; Li, Xiao-Fei

2013-01-01

334

Late recurrent ovarian carcinoma metastatic to the thoracic wall.  

PubMed

Ovarian cancer is the second most common gynaecologic malignancy. Ovarian carcinomas typically metastasize to multiple sites via exfoliation, lymphatic spread or direct invasion. We present a rare case of a very late recurrence of ovarian carcinoma into the thoracic wall, heralded by thoracic pain in a patient otherwise disease-free for 23 years. This unusual and late presentation of an ovarian cancer metastasis underscores the need for continued awareness and attention to new symptoms in patients with ovarian cancer who show prolonged disease-free intervals. PMID:21128565

Testelmans, D; Van Raemdonck, D; Amant, F; De Wever, W; Verbeken, E; Nackaerts, K

2010-01-01

335

Epidural neural fibrolipoma of the thoracic vertebral canal.  

PubMed

Neural fibrolipoma is a benign tumor that most frequently infiltrates the median nerve. The authors describe a patient with spinal cord compression syndrome caused by a neural fibrolipoma. The tumor originated in the thoracic nerve at the T6-7 extradural level in the left conjugate foramen and extended into the thoracic cavity. Total removal was achieved by a combined posterior and costotransversectomy approach. Postoperatively, the patient's spinal cord compression syndrome resolved. No tumor recurrence has been observed in medium-term follow-up. This is the second case of an extradural spinal neural fibrolipoma to be reported in the literature. PMID:22958074

Missori, Paolo; Pandolfi, Sergio; Antonelli, Manila; Domenicucci, Maurizio

2012-11-01

336

Diagnosis and treatment of thoracic intervertebral disc protrusions  

PubMed Central

A series of 14 patients with a protruded thoracic intervertebral disc is reported. We believe that the true incidence may be as high as one patient per million population per annum. Trauma, sometimes mild, seems to have played a significant role in this series. This fact coupled with pronounced numbness and disagreeable paraesthesiae should suggest the diagnosis with thoracic spinal lesions. Armed with clinical suspicion, radiological verification of the lesion can be expected using a thorough myelographic technique supported if necessary by tomography. A posterolateral approach which combines laminectomy, complete excision of the ligamentum flavum, and the extradural removal of protruded disc is described. The technique is safe and effective. Images PMID:5551695

Carson, James; Gumpert, John; Jefferson, Antony

1971-01-01

337

Managing congestive heart failure with thoracic electrical bioimpedance.  

PubMed

Because of clinical utility, immediate feedback, absence of risk to the patient, portability, and use in virtually any practice setting, facilities using thoracic electrical bioimpedance monitoring are increasing throughout the world. Specialized centers treating patients with heart failure have shown remarkable benefits, both in health care costs and patient morbidity, attributable to the careful monitoring and management of patients with heart failure. The ability of thoracic bioimpedance monitoring to provide objective data in the management of congestive heart failure provides practitioners with the clinical reassurance to optimize pharmacologic therapy safely. PMID:10745709

Gilbert, J; Lazio, L

1999-08-01

338

[Aneurysms and dissections of the thoracal and abdominal aorta].  

PubMed

One to four per cent of all deaths in patients over 65 are caused by aneurysmatic diseases of the abdominal or thoracic aorta. For elective surgery in abdominal aneurysms, open surgery and endovascular treatment both demonstrate brilliant overall results. In the thoracic aorta, new endovascular procedures have led to considerable reductions of postoperative morbidity and mortality. Nevertheless, in view of the endovascular procedure's high cost and the still unclear long-term behaviour of the stent device, a second opinion from a specialised centre is an absolute necessity. PMID:17594068

Heider, P; Wolf, O; Reeps, C; Hanke, M; Zimmermann, A; Berger, H; Eckstein, H H

2007-07-01

339

Coronary Revascularization Using Bilateral Internal Thoracic Arteries: Safe with Skeletonization?  

PubMed Central

Substantial evidence exists to support a long-term survival benefit with bilateral internal thoracic artery (BITA) revascularization in coronary artery bypass grafting. However, this technique remains grossly underutilized worldwide and especially in the United States. In this review, we discuss evidence for the advantages of BITA grafting as well as the associated the risk of sternal wound complications. We then review a growing body of literature that suggests ‘skeletonization’ of the internal thoracic artery during harvest confers a protective benefit against sternal wound infection in patients receiving BITA. PMID:24761259

Wehman, Brody; Taylor, Bradley

2014-01-01

340

Kidney scintigraphy after ACE inhibition in the diagnosis of renovascular hypertension  

SciTech Connect

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.

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

1986-01-01

341

Genetics of Chronic Kidney Disease  

Microsoft Academic Search

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

Conall M. O’Seaghdha; Caroline S. Fox

2011-01-01

342

Autosomal recessive polycystic kidney disease  

Microsoft Academic Search

Autosomal recessive polycystic kidney disease is a rare inherited disorder which usually becomes clinically manifest in early childhood, whereas autosomal dominant polycystic kidney disease usually is a disorder of adult onset. With increasing knowledge and improving diagnostic techniques, it becomes evident that the spectrum of both entities is much more variable than generally known. The presentation of autosomal recessive polycystic

K. Zerres

1992-01-01

343

Thoracic neuroblastoma: what is the best imaging modality for evaluating extent of disease?  

Microsoft Academic Search

Background. Thoracic neuroblastoma accounts for 15 % of all cases of neuroblastoma. A minority of children with thoracic neuroblastoma\\u000a will have dumbbell tumors, i. e., intraspinal extension, but only half these patients will have neurologic signs or symptoms.\\u000a Hypothesis. MR imaging is the single best test to evaluate the extent of thoracic and spinal disease in thoracic neuroblastoma after\\u000a the

Thomas L. Slovis; Manuel P. Meza; Barbara Cushing; Sheryl S. Elkowitz; John C. Leonidas; Robert Festa; Marvin S. Kogutt; Barry D. Fletcher

1997-01-01

344

Neurology and the kidney  

PubMed Central

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 failure there are both acquired and genetically determined diseases which may affect the kidney and the brain. Those acquired diseases include the vasculitides, the paraproteinaemias, and various granulomatous conditions (considered in other chapters of Neurology and Medicine). In two of the most commonly encountered genetically determined diseases, Von Hippel-Lindau disease and polycystic kidney disease, location of pathogenic mutations will provide improved screening programmes and, possibly, allow therapeutic intervention. Uraemia may affect both the central and peripheral nervous systems. Whereas the clinical features of uraemia are well documented, the pathophysiology is less well understood and probably multifactorial. Uraemic encephalopathy, which classically fluctuates, is associated with problems in cognition and memory and may progress to delirium, convulsions, and coma. The encephalopathy may initially worsen with periods of dialysis and almost certainly relates to altered metabolic states in association with ionic changes and possibly impaired synaptic function. Renal failure may affect the peripheral nervous system, resulting in a neuropathy which shows a predilection for large diameter axons. This may be reversed by dialysis and transplantation. The myopathy seen in renal failure, often associated with bone pain and tenderness, is similar to that encountered in primary hyperparathyroidism and osteomalacia.? Dialysis itself is associated with neurological syndromes including the dysequilibrium syndrome, subdural haematoma, and Wernicke's encephalopathy. Dialysis dementia, which was prevalent during the 1970s, has reduced in frequency with the use of aluminium free dialysate. With the introduction of transplantation and the concomitant use of powerful immunosuppressive drugs, the pattern of neurological problems encountered in renal replacement therapy has shifted. Five per cent of patients develop nerve injuries during renal transplantation, and up to 40% of patients experience neurological side effects from cyclosporine. Furthermore, CNS infections, often fungal in type, have been reported in up to 45% of transplant patients coming to postmortem. The nature of the involvement of neurologists with their nephrology colleagues is therefore evolving.?? PMID:9854955

Burn, D; Bates, D

1998-01-01

345

Hyperphosphatemia of Chronic Kidney Disease  

PubMed Central

Observational studies have determined hyperphosphatemia to be a cardiovascular risk factor in chronic kidney disease. Mechanistic studies have elucidated that hyperphosphatemia is a direct stimulus to vascular calcification, which is one cause of morbid cardiovascular events contributing to the excess mortality of chronic kidney disease. This review describes the pathobiology of hyperphosphatemia that develops as a consequence of positive phosphate balance in chronic kidney disease and the mechanisms by which hyperphosphatemia acts on neointimal vascular cells that are stimulated to mineralize in chronic kidney disease. The characterization of hyperphosphatemia of chronic kidney disease as a distinct syndrome in clinical medicine with unique disordered skeletal remodeling, heterotopic mineralization and cardiovascular morbidity is presented. PMID:18449174

Hruska, Keith A; Mathew, Suresh; Lund, Richard; Qiu, Ping; Pratt, Raymond

2009-01-01

346

Cervical Rib Fracture: An Unusual Etiology of Thoracic Outlet Syndrome in a Child  

Microsoft Academic Search

Thoracic outlet syndrome in children is an extremely rare disorder. Only 5 previous reports were presented in the literature with a description of thoracic outlet syndrome in 8 children. In these cases, the diagnosis of a cervical rib was common. We describe a case of neurogenic thoracic outlet syndrome in a 9-year-old patient where the initial symptoms occurred 2 months

Roberto S. Martins; Mario G. Siqueira

2007-01-01

347

Case report Large thoracic duct cyst - a case report and review of the literature  

Microsoft Academic Search

Large thoracic duct cysts are rare and standard lateral thoracotomy is usually used for resection. In the reported case the combination of an antero-lateral thoracotomy with a partial longitudinal median sternotomy (hemiclamshell approach) allowed an excellent visualization and dissection of a large thoracic duct cyst expanding in the anterior cervico-thoracic junction, and was associated with an uncomplicated recovery. q 2000

Alexandros Karajiannis; Thorsten Krueger; Eduard Stauffer; Hans-Beat Ris

348

Thoracic CT-PET Registration Using a 3D Breathing Model  

E-print Network

Thoracic CT-PET Registration Using a 3D Breathing Model Antonio Moreno1 , Sylvie Chambon1 , Anand P Orlando, USA Abstract. In the context of thoracic CT-PET volume registration, we present a novel method applications. We consider Computed Tomography (CT) and Positron Emission Tomography (PET) in thoracic regions

Paris-Sud XI, Université de

349

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

Microsoft Academic Search

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

Hongkai Wang; Jing Bai; Yonghong Zhang

2008-01-01

350

Role of kidney biomarkers of chronic kidney disease: An update  

PubMed Central

Chronic kidney disease (CKD) is a progressive pathological condition marked by deteriorating renal function over time. Diagnostic of kidney disease depend on serum creatinine level and glomerular filtration rate which is detectable when kidney function become half. The detection of kidney damage in an early stage needs robust biomarkers. Biomarkers allow monitoring the disease progression at initial stages of disease. On the onset of impairment in cellular organization there is perturbation in signaling molecules which are either up-regulated or down-regulated and act as an indicator or biomarker of diseased stage. This review compiled the cell signaling of different kidney biomarkers associated with the onset of chronic kidney diseases. Delay in diagnosis of CKD will cause deterioration of nephron function which leads to End stage renal disease and at that point patients require dialysis or kidney transplant. Detailed information on the complex network in signaling pathway leading to a coordinated pattern of gene expression and regulation in CKD will undoubtedly provide important clues to develop novel prognostic and therapeutic strategies for CKD. PMID:25183938

Khan, Zeba; Pandey, Manoj

2014-01-01

351

Role of kidney biomarkers of chronic kidney disease: An update.  

PubMed

Chronic kidney disease (CKD) is a progressive pathological condition marked by deteriorating renal function over time. Diagnostic of kidney disease depend on serum creatinine level and glomerular filtration rate which is detectable when kidney function become half. The detection of kidney damage in an early stage needs robust biomarkers. Biomarkers allow monitoring the disease progression at initial stages of disease. On the onset of impairment in cellular organization there is perturbation in signaling molecules which are either up-regulated or down-regulated and act as an indicator or biomarker of diseased stage. This review compiled the cell signaling of different kidney biomarkers associated with the onset of chronic kidney diseases. Delay in diagnosis of CKD will cause deterioration of nephron function which leads to End stage renal disease and at that point patients require dialysis or kidney transplant. Detailed information on the complex network in signaling pathway leading to a coordinated pattern of gene expression and regulation in CKD will undoubtedly provide important clues to develop novel prognostic and therapeutic strategies for CKD. PMID:25183938

Khan, Zeba; Pandey, Manoj

2014-09-01

352

Wars, disasters and kidneys.  

PubMed

This paper summarizes the impact that wars had on the history of nephrology, both worldwide and in the Ghent Medical Faculty notably on the definition, research and clinical aspects of acute kidney injury. The paper briefly describes the role of 'trench nephritis'? as observed both during World War I and II, supporting the hypothesis that many of the clinical cases could have been due to Hantavirus nephropathy. The lessons learned from the experience with crush syndrome first observed in World War II and subsequently investigated over many decades form the basis for the creation of the Renal Disaster Relief Task Force of the International Society of Nephrology. Over the last 15 years, this Task Force has successfully intervened both in the prevention and management of crush syndrome in numerous disaster situations like major earthquakes. PMID:25409904

Lameire, N

2014-12-01

353

Growth Failure in Children with Kidney Disease  

MedlinePLUS

... for more information. [ Top ] National Kidney Disease Education Program 3 Kidney Information Way Bethesda, MD 20892 Phone: ... Accessibility | PDF versions require the free Acrobat Reader software for viewing.

354

Reduced Klotho expression level in kidney aggravates renal interstitial fibrosis.  

PubMed

Renal expression of the klotho gene is markedly suppressed in chronic kidney disease (CKD). Since renal fibrosis is the final common pathology of CKD, we tested whether decreased Klotho expression is a cause and/or a result of renal fibrosis in mice and cultured renal cell lines. We induced renal fibrosis by unilateral ureteral obstruction (UUO) in mice with reduced Klotho expression (kl/+ mice) and compared them with wild-type mice. The UUO kidneys from kl/+ mice expressed significantly higher levels of fibrosis markers such as ?-smooth muscle actin (?-SMA), fibronectin, and transforming growth factor-?(1) (TGF-?(1)) than those from wild-type mice. In addition, in cultured renal fibroblast cells (NRK49F), the levels of ?-SMA and PAI1 expression were significantly suppressed by addition of recombinant Klotho protein to the medium. The similar effects were observed by a TGF-?(1) receptor inhibitor (ALK5 inhibitor). These observations suggest that low renal Klotho expression enhances TGF-?(1) activity and is a cause of renal fibrosis. On the other hand, TGF-?(1) reduced Klotho expression in renal cultured epithelial cells (inner medullary collecting duct and human renal proximal tubular epithelium), suggesting that low renal Klotho expression is a result of renal fibrosis. Taken together, renal fibrosis can trigger a deterioration spiral of Klotho expression, which may be involved in the pathophysiology of CKD progression. PMID:22338084

Sugiura, Hidekazu; Yoshida, Takumi; Shiohira, Shunji; Kohei, Junko; Mitobe, Michihiro; Kurosu, Hiroshi; Kuro-o, Makoto; Nitta, Kosaku; Tsuchiya, Ken

2012-05-15

355

New applications of magnetic resonance imaging for thoracic oncology.  

PubMed

Since the clinical introduction of magnetic resonance imaging (MRI), the chest has been one of its most challenging applications, and since the 1980s many physicists and radiologists have been trying to evaluate images for various lung diseases as well as mediastinal and pleural diseases. However, thoracic MRI could not yield image quality sufficient for a convincing diagnosis within an acceptable examination time, so MRI did not find acceptance as a substitute for computed tomography (CT) and other modalities. Until the 2000, thoracic MRI was generally used only for select, minor clinical indications. Within the past decade, however, technical advances in sequencing, scanners and coils, adaptation of parallel imaging techniques, utilization of contrast media, and development of postprocessing tools have been developed. In addition, pulmonary functional MRI has been extensively researched, and MR is being assessed as a new research and diagnostic tool for pulmonary diseases. State-of-the art thoracic MRI now has the potential as a substitute for traditional imaging techniques and/or to play a complimentary role in patient management. In this review, we focus on these advances in MRI for thoracic oncologic imaging, especially for pulmonary nodule assessment, lung cancer staging, mediastinal tumor diagnosis and malignant mesothelioma evaluation, prediction of postoperative lung function, and prediction or evaluation of therapeutic effectiveness. We also discuss the potential and limitations of these advances for routine clinical practice in comparison with other modalities such as CT, positron emission tomography (PET), PET/CT, or nuclear medicine studies. PMID:24481757

Ohno, Yoshiharu

2014-02-01

356

Specific complications and mortality of endoscopic thoracic sympathectomy  

Microsoft Academic Search

Endoscopic Thoracic Sympathectomy (ETS) has gained an increasing popularity due to its minimal invasive character. Despite the simplicity of the procedure, non-surgical options should always be considered as the first line of treatment. The complication risk of ETS is low but side effects, primarily compensatory sweating (CS) of mainly the trunk may be severe enough to cause regret of the

Alan E. P. Cameron

2003-01-01

357

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

PubMed

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

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

358

Use of thoracic epidural anaesthesia for coronary artery bypass grafting  

Microsoft Academic Search

Cardiac sympathetic blockade in experimental settings show beneficial effects on blood flow redistribution after myocardial infarction and functional recovery following myocardial ischaemia. This aim can be achieved by TEA without jeopardizing systemic haemodynamics.In patients, thoracic epidural anaesthesia (TEA) demonstrates potential benefit for the perioperative management for coronary artery bypass grafting (CABG). Perioperative sympathetic blockade of the cardiac nerves and an

Heinz Michael Loick; Thomas Möllhoff; Norbert Rolf; Hugo Van Aken

1999-01-01

359

Postoperative Complications after Thoracic Surgery in the Morbidly Obese Patient  

PubMed Central

Little has been recently published about specific postoperative complications following thoracic surgery in the morbidly obese patient. Greater numbers of patients who are obese, morbidly obese, or supermorbidly obese are undergoing surgical procedures. Postoperative complications after thoracic surgery in these patients that can lead to increased morbidity and mortality, prolonged hospital stay, and increased cost of care are considered. Complications include difficulties with mask ventilation and securing the airway, obstructive sleep apnea with risk of oversedation, pulmonary complications related to reduced total lung capacity, reduced functional residual capacity, and reduced vital capacity, risks of aspiration pneumonitis and ventilator-associated pneumonia, cardiomyopathies, and atrial fibrillation, inadequate diabetes management, positioning injuries, increased risk of venous thrombosis, and pulmonary embolism. The type of thoracic surgical procedure may also pose other problems to consider during the postoperative period. Obese patients undergoing thoracic surgery pose a challenge to those caring for them. Those working with these patients must understand how to recognize, prevent, and manage these postoperative complications. PMID:22242020

Cooper, Lebron

2011-01-01

360

Video-assisted thoracoscopic surgery for acute thoracic trauma  

PubMed Central

Background: Operative intervention for thoracic trauma typically requires thoracotomy. We hypothesized that thoracoscopy may be safely and effectively utilized for the acute management of thoracic injuries. Materials and Methods: The Trauma Registry of a Level I trauma center was queried from 1999 through 2010 for all video-assisted thoracic procedures within 24 h of admission. Data collected included initial vital signs, operative indication, intraoperative course, and postoperative outcome. Results: Twenty-three patients met inclusion criteria: 3 (13%) following blunt injury and 20 (87%) after penetrating trauma. Indications for urgent thoracoscopy included diaphragmatic/esophageal injury, retained hemothorax, ongoing hemorrhage, and open/persistent pneumothorax. No conversions to thoracotomy were required and no patient required re-operation. Mean postoperative chest tube duration was 2.9 days and mean length of stay was 5.6 days. Conclusion: Video-assisted thoracoscopic surgery is safe and effective for managing thoracic trauma in hemodynamically stable patients within the first 24 h post-injury. PMID:23723618

Goodman, Michael; Lewis, Jaime; Guitron, Julian; Reed, Michael; Pritts, Timothy; Starnes, Sandra

2013-01-01

361

Reevaluation of postoperative radiotherapy for thoracic esophageal carcinoma  

Microsoft Academic Search

Purpose: To reevaluate postoperative radiotherapy for thoracic esophageal carcinoma.Methods and Materials: Reviewed were the outcome of 89 patients who underwent esophagectomy with systematic dissection of regional lymph nodes between 1988 and 1993. Of the 89 patients, 19 underwent no adjuvant treatment, 22 underwent adjuvant chemotherapy alone, and 48 underwent postoperative radiotherapy. Twelve of the 48 also underwent adjuvant chemotherapy.Results: All

Michinori Yamamoto; Takashi Yamashita; Toshiki Matsubara; Tadashi Kitahara; Kenji Sekiguchi; Masahiko Furukawa; Akiyoshi Uki; Masao Kobayashi; Emiko Tanaka; Mamoru Ueda; Toshifusa Nakajima

1997-01-01

362

Two internal thoracic artery grafts are better than one  

Microsoft Academic Search

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

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

363

The diagnosis and treatment of non-cardiac thoracic trauma.  

PubMed

Penetrating and blunt force mechanisms frequently result in thoracic trauma. Thoracic injuries cover the spectrum from trivial to lethal, and more than half are associated with head, abdomen or extremity trauma. Fortunately over eighty percent of injuries can be managed non-operatively utilizing tube thoracostomy, appropriate analgesia and aggressive respiratory therapy. Patients requiring emergency thoracotomy are either in shock or have life threatening injuries and, as expected, have significant mortality and morbidity. Injury to the thorax directly accounts for approximately 25% of trauma related mortality and is a contributing factor in another 25%. Early mortality results from haemorrhage, catastrophic injury or associated head or abdominal trauma. Not unexpectedly, late deaths are related to sepsis and organ failure. Blunt injury to the thorax most commonly results from motor vehicle collisions, with motorcycle accidents, pedestrians struck and falls next in frequency. Stab wound and gunshot wounds comprise the vast majority of penetrating injuries. In general the mortality from penetrating injury is higher and related to vascular injury and shock. Mortality from blunt trauma often results from abdominal and, especially, head injury. Rapid assessment and interventions, such as tube thoracostomy and airway control, can be life saving. The patient's haemodynamic status drives early treatment, often necessitating emergency surgery. Detailed imaging studies are reserved for haemodynamically stable patients. The evaluation and treatment of specific thoracic injuries will be discussed, as well as some general principles in treating thoracic trauma. PMID:20433098

O'Connor, J V; Adamski, J

2010-03-01

364

Cellular and molecular mechanisms of thoracic aortic aneurysms  

Microsoft Academic Search

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

Ismail El-Hamamsy; Magdi H. Yacoub

2009-01-01

365

Branches of the thoracic sympathetic trunk in the human fetus  

Microsoft Academic Search

The segmental organization of the thoracic sympathetic trunk and all its ramifications was studied in 6 human fetuses (16–22 weeks) by means of the acetylcholinesterase in toto staining method. Each trunk was divided into 12 sympathetic segments. A segment is defined as that part of the sympathetic trunk which is connected via its rami communicates with one spinal nerve, without

G. J. Groen; B. Baljet; A. B. Boekelaar; J. Drukker

1987-01-01

366

Ciclosporin population pharmacokinetics and Bayesian estimation in thoracic transplant recipients  

E-print Network

1 Ciclosporin population pharmacokinetics and Bayesian estimation in thoracic transplant recipients Thoracique et Cardio-Vasculaire, CHU Limoges, Limoges, France 7 Département de Néphrologie et Transplantation1043, IFR­BMT, CHU Purpan, Toulouse France 10 Pôle médico-chirurgical de transplantation cardiaque

Paris-Sud XI, Université de

367

Neurogenic thoracic outlet decompression: rationale for sparing the first rib  

Microsoft Academic Search

A total of 168 primary supraclavicular decompressions were performed on 146 patients with neurogenic thoracic outlet syndrome. This report compares the results of rib resection (supraclavicular anterior and middle scalenectomy and first rib resection) with rib-sparing (supraclavicular anterior and middle scalenectomy alone) operations. All patients with cervical ribs were excluded. In total, 125 rib resections and 43 rib-sparing procedures were

S. W. K. Cheng; L. M. Reilly; N. A. Nelken; W. V. Ellis; R. J. Stoney

1995-01-01

368

A novel finding in thoracic outlet syndrome: tachycardia  

Microsoft Academic Search

In this case report, we rendered a 22 year old woman with the diagnosis of neurogenic thoracic outlet syndrome. We have evaluated her symptoms of palpitation with Holter monitorization during Roos test before and after surgery where transaxillary first rib resection and scalenectomy were performed. Postoperatively she improved and the tachycardia resolved. We propose that stellate ganglion or postganglionic efferent sympathetic

Bayram Kaymak; Levent Özçakar; Ali Kemal O?uz; Murat Arsava; Ça?da? Özdöl

2004-01-01

369

Combined posterior and transaxillary approach for neurogenic thoracic outlet syndrome  

Microsoft Academic Search

Background: Incomplete removal of the first rib in operations intended to decompress the thoracic outlet is often seen after the single transaxillary approach (often leaving a posterior stump) or supraclavicular techniques (leaving an anterior stump). The former may also cause neurogenic and vascular injuries because the exposure is often poor in attempting complete removal of the first rib posteriorly and

J. Ernesto Molina

1998-01-01

370

The Efficacy of Scalene Injection in Thoracic Outlet Syndrome  

PubMed Central

Objective To evaluate the efficacy of scalene injection in patients with thoracic outlet syndrome. Methods We selected 142 patients diagnosed with thoracic outlet syndrome between January 2005 and October 2009. We performed a series of scalene injection with conservative treatment in all cases. Patients rated their pain degrees using a visual analogue scale. We also evaluated the time to return to everyday life and work, and patients' functional capacity. Results There were no complications or instances of inadvertent somatic or sympathetic ganglionic blockade after scalene injection. Overall, 111 patients (76.5%) experienced improved symptoms after the first set of scalene injection and 128 patients (88.2%) improved after scalene injection followed by conservative treatment. Of the 68 patients who returned to work during the study period, 54 returned within 1 week, and 62 within 2 weeks. Of those who returned to work, 61 reported nearly full functional capacity. We found that scalene injection was more effective in cases of thoracic outlet syndrome related to trauma than in those related to work-related repetitive stress. Conclusion In patients with thoracic outlet syndrome, scalene injection effectively reduces pain. We recommend scalene injection as an adjunct to conservative treatment. PMID:21892402

Lee, Gun Woo; Kwon, Young Ho; Jeong, Ju Ho

2011-01-01

371

Blood kidney injury molecule-1 is a biomarker of acute and chronic kidney injury and predicts progression to ESRD in type I diabetes.  

PubMed

Currently, no blood biomarker that specifically indicates injury to the proximal tubule of the kidney has been identified. Kidney injury molecule-1 (KIM-1) is highly upregulated in proximal tubular cells following kidney injury. The ectodomain of KIM-1 is shed into the lumen, and serves as a urinary biomarker of kidney injury. We report that shed KIM-1 also serves as a blood biomarker of kidney injury. Sensitive assays to measure plasma and serum KIM-1 in mice, rats, and humans were developed and validated in the current study. Plasma KIM-1 levels increased with increasing periods of ischemia (10, 20, or 30 minutes) in mice, as early as 3 hours after reperfusion; after unilateral ureteral obstruction (day 7) in mice; and after gentamicin treatment (50 or 200 mg/kg for 10 days) in rats. In humans, plasma KIM-1 levels were higher in patients with AKI than in healthy controls or post-cardiac surgery patients without AKI (area under the curve, 0.96). In patients undergoing cardiopulmonary bypass, plasma KIM-1 levels increased within 2 days after surgery only in patients who developed AKI (P<0.01). Blood KIM-1 levels were also elevated in patients with CKD of varous etiologies. In a cohort of patients with type 1 diabetes and proteinuria, serum KIM-1 level at baseline strongly predicted rate of eGFR loss and risk of ESRD during 5-15 years of follow-up, after adjustment for baseline urinary albumin-to-creatinine ratio, eGFR, and Hb1Ac. These results identify KIM-1 as a blood biomarker that specifically reflects acute and chronic kidney injury. PMID:24904085

Sabbisetti, Venkata S; Waikar, Sushrut S; Antoine, Daniel J; Smiles, Adam; Wang, Chang; Ravisankar, Abinaya; Ito, Kazumi; Sharma, Sahil; Ramadesikan, Swetha; Lee, Michelle; Briskin, Rebeccah; De Jager, Philip L; Ngo, Thanh Thu; Radlinski, Mark; Dear, James W; Park, Kevin B; Betensky, Rebecca; Krolewski, Andrzej S; Bonventre, Joseph V

2014-10-01

372

Application of video-assisted thoracic surgery in the standard operation for thoracic tumors  

PubMed Central

Objective To evaluate the short-term outcomes of video-assisted thoracic surgery (VATS) for thoracic tumors. Methods The data of 1,790 consecutive patients were retrospectively reviewed. These patients underwent VATS pulmonary resections, VATS esophagectomies, and VATS resections of mediastinal tumors or biopsies at the Cancer Institute & Hospital, Chinese Academy of Medical Sciences between January 2009 and January 2012. Results There were 33 patients converted to open thoracotomy (OT, 1.84%). The overall morbidity and mortality rate was 2.79% (50/1790) and 0.28% (5/1790), respectively. The overall hospitalization and chest tube duration were shorter in the VATS lobectomy group (n=949) than in the open thoracotomy (OT) lobectomy group (n=753). There were no significant differences in morbidity rate, mortality rate and operation time between the two groups. In the esophageal cancer patients, no significant difference was found in the number of nodal dissection, chest tube duration, morbidity rate, mortality rate, and hospital length of stay between the VATS esophagectomy group (n=81) and open esophagectomy group (n=81). However, the operation time was longer in the VATS esophagectomy group. In the thymoma patients, there was no significant difference in the chest tube duration, morbidity rate, mortality rate, and hospital length of stay between the VATS thymectomy group (n=41) and open thymectomy group (n=41). However, the operation time was longer in the VATS group. The median tumor size in the VATS thymectomy group was comparable with that in the OT group. Conclusions In early-stage (I/II) non-small cell lung cancer patients who underwent lobectomies, VATS is comparable with the OT approach with similar short-term outcomes. In patients with resectable esophageal cancer, VATS esophagectomy is comparable with OT esophagectomy with similar morbidity and mortality. VATS thymectomy for Masaoka stage I and II thymoma is feasible and safe, and tumor size is not contraindicated. Longer follow-ups are needed to determine the oncologic equivalency of VATS lobectomy, esophagectomy, and thymectomy for thymoma vs. OT. PMID:23691442

Mu, Ju-Wei; Chen, Gui-Yu; Sun, Ke-Lin; Wang, Da-Wei; Zhang, Bai-Hua; Li, Ning; Lv, Fang; Mao, You-Sheng; Xue, Qi; Gao, Shu-Geng; Zhao, Jun; Wang, Da-Li; Li, Zhi-Shan; Lei, Wen-Dong; Gao, Yu-Shun; Zhang, Liangze; Huang, Jin-Feng; Shao, Kang; Su, Kai; Yang, Kun; Zhao, Liang; Feng, Fei-Yue; Wang, Yong-Gang; Li, Jian; He, Jie

2013-01-01

373

Cysteine-rich protein 61 plays a proinflammatory role in obstructive kidney fibrosis.  

PubMed

Cysteine-rich protein 61 (Cyr61) is a secreted matrix-associated protein that regulates a broad spectrum of biological and cellular activities. This study aimed to investigate the role of Cyr61 in progressive kidney fibrosis induced by unilateral ureteral obstruction (UUO) surgery in mice. The expression of Cyr61 transcripts and proteins in the obstructed kidneys were increased from day 1 and remained high until day 10 after surgery. Immunohistochemistry indicated that Cyr61 was expressed mainly in renal tubular epithelial cells. The upregulated Cyr61 in UUO kidneys was reduced in mice treated with pan-transforming growth factor-? (TGF-?) antibody. The role of TGF-? in tubular Cyr61 upregulation after obstructive kidney injury was further supported by experiments showing that TGF-?1 stimulated Cyr61 expression in cultured tubular epithelial cells. Notably, the upregulation of Cyr61 in UUO kidneys was followed by a marked increase in monocyte chemoattractant protein 1 (MCP-1) transcripts and macrophage infiltration, which were attenuated in mice treated with anti-Cyr61 antibodies. This proinflammatory property of Cyr61 in inducing MCP-1 expression was further confirmed in tubular epithelial cells cultured with Cyr61 protein. The anti-Cyr61 antibody in UUO mice also reduced the levels of collagen type 1-?1 transcripts, collagen fibril accumulation evaluated by picrosirius red staining, and the levels of ?-smooth muscle actin (?-SMA) transcripts and proteins on day 4 after surgery; however, the antifibrotic effect was not sustained. In conclusion, the TGF-?-mediated increase in tubular Cyr61 expression involved renal inflammatory cell infiltration through MCP-1 induction during obstructive kidney injury. The Cyr61 blockade attenuated kidney fibrosis in the early phase, but the antifibrotic effect could not be sustained. PMID:23457573

Lai, Chun-Fu; Chen, Yung-Ming; Chiang, Wen-Chih; Lin, Shuei-Liong; Kuo, Min-Liang; Tsai, Tun-Jun

2013-01-01

374

[Unilateral laryngeal nerve paralysis in the adult: Epidemiology, symptoms, physiopathology and treatment].  

PubMed

In France, the main causes for unilateral laryngeal nerve paralysis in the adult patient are surgery and malignant tumors. Most of unilateral laryngeal nerve paralysis following thyroid surgery will recover within the first six postoperative months. At the time of unilateral laryngeal nerve paralysis, swallowing impairment and dyspnea occur in around 30% and 5% of cases, respectively. In the face of a unilateral laryngeal nerve paralysis occurring without a history of trauma of surgery, the main paraclinical examination to perform is a computed laryngeal nerve examination analyzing the whole length of the nerve involved. Speech therapy efficiency is related to the degree of severity of the symptoms related to unilateral laryngeal nerve paralysis. In the vast majority of cases, laryngeal medialization approaches improve dysphonia and swallowing impairment related to unilateral laryngeal paralysis, but not dyspnea. PMID:24525308

Laccourreye, Ollivier; Malinvaud, David; Ménard, Madeleine; Bonfils, Pierre

2014-04-01

375

Feasibility of endoscopic transumbilical thoracic sympathectomy in a porcine model  

PubMed Central

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

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

2013-01-01

376

Normal Thoracic Radiographic Appearance of the Cynomolgus Monkey (Macaca fascicularis)  

PubMed Central

Background The cynomolgus monkey (Macaca fascicularis) has been increasingly used as a non-human primate model in biomedical research. As establishing baseline thoracic radiography for the cynomolgus monkey is essential, we tested the hypothesis that age and sex may affect the thoracic radiography parameters of this species. Methods Here, 697 healthy cynomolgus monkeys were segregated by sex and age (three age groups: 25–36 months, 37–48 months, 49–60 months). The lung length (LL), maximal interior thoracic depth (TD), maximal interior thoracic breadth (TBr), cardiac silhouette breadth (CBr), cardiothoracic ratio (CR), right and left costophrenic angles (RCA and LCA), and right hilar height ratio (R-HHR) were assessed by chest film. Statistical analysis was applied to examine the effect of age, sex, and age × sex interactions. Results Significant effects by age were shown for LL, TD, TBr, CBr, and CR. Significant effects by sex were found for TD, TBr, CBr, CR, and R-HHR. Significant effects by age × sex were observed for TD, TBr, CBr, and CR. Both TD and TBr increased with age in both sexes, and both were significantly higher in males than in females in the group aged 49–60 months. CBr increased with age and was significantly higher in males than in females across all age groups. CR declined with age and was significantly higher in males than females across all age groups, and CR was similar or slightly higher relative to those previously found in other non-human primate species. As to the other parameters with no significant sex nor age-related differences, the R-HHR was greater than 1.00, and the angulation of bilateral costophrenic angles were sharp. Conclusions The thoracic radiographic parameters for the healthy cynomolgus monkey presented here should prove useful in veterinary practice, research involving non-human primate models of respiratory or cardiovascular disorders, and morphological studies on cynomolgus monkeys. PMID:24416248

Wu, Qingyuan; Ji, Yongjia; Zhang, Lujun; Xu, Fan; Gong, Wei; Melgiri, Narayan D.; Xie, Peng

2014-01-01

377

Kidney donation after cardiac death  

PubMed Central

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

Akoh, Jacob A

2012-01-01

378

Kidney donation after cardiac death.  

PubMed

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

Akoh, Jacob A

2012-06-01

379

Medicare Coverage of Kidney Dialysis and Kidney Transplant Services  

MedlinePLUS

... 16 Section 2: Kidney dialysis . . . . . . . . . . . . . . . . . . 17 What’s dialysis?. . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Dialysis treatment options. . . . . . . . . . . . . . . . . . . . . 17 Dialysis services & supplies covered by Medicare . . . . . . . . 18 Dialysis ... when you have Medicare. Section 1—Medicare basics 17 Words in red are defined on pages 51– ...

380

Lateral specificity in resistance training: the effect of bilateral and unilateral training  

Microsoft Academic Search

Maximal voluntary strength of simultaneous bilateral exertion has been shown to be small compared to the sum of the unilateral\\u000a exertions. Three experiments were conducted to determine the effects of bilateral and unilateral resistance training on this\\u000a bilateral deficit and to compare these in hands, arms, and legs. In each experiment, the subjects were divided into three\\u000a groups: unilateral training

Yuko Taniguchi

1997-01-01

381

An official American Thoracic Society workshop report: tobacco control initiatives within the American Thoracic Society.  

PubMed

Cigarette smoking represents the single most preventable cause of premature morbidity and mortality in the United States and the burden of tobacco use is apparent world-wide. Cigarette smoking is a major risk factor for chronic obstructive pulmonary disease, the third leading cause of death in the United States in 2004. The American Thoracic Society (ATS) and its members have contributed significantly to an understanding of the biological and pathophysiologic mechanisms responsible for the development and management of tobacco-attributable disease and disability. The society's active involvement in tobacco control advocacy and policy-related initiatives are central to its mission. Within the ATS, there is also increased interest in accelerating the society's efforts to understand the mechanisms responsible for the uptake, persistence, and cessation of tobacco use. Scientific, clinical, and educational activities that include an examination of these underlying mechanisms are warranted. This paper describes findings from an ATS initiative that developed a preliminary strategy for enhancing scientific, clinical, educational, and policy-related tobacco control efforts that are consistent with the vision of the ATS. The specific aims of this project included the identification of existing mechanisms, as well as the current governance in place within the ATS infrastructure, to address tobacco control issues related to scientific inquiry, policy initiatives, and advocacy for tobacco control. This assessment generated recommendations to inform the ATS leadership with regard to the future development of relevant tobacco control initiatives. PMID:20160142

Wewers, Mary Ellen; Bailey, William C; Carlsen, Kai-Häkon; Eisner, Mark D; Folan, Patricia; Heath, Janie; Klinnert, Mary D; Kovesi, Tom; Pien, Grace W; Reichart, Virginia C; Talwar, Arunabh; Thompson, Katherine

2010-02-01

382

Thoracic Aortic Distensibility and Thoracic Aortic Calcium (From the Multi-ethnic Study of Atherosclerosis [MESA])  

PubMed Central

Decreased arterial distensibility is an early manifestation of adverse structural and functional changes within the vessel wall. Its correlation with thoracic aortic calcium (TAC), a marker of atherosclerosis, has not been well demonstrated. We tested the hypothesis that decreasing aortic compliance and increasing arterial stiffness is independently associated with increased TAC. We included 3,540 (61±10 years, 46% males) subjects from the Multi-ethnic Study of Atherosclerosis (MESA) study who underwent aortic distensibility (AD) assessment on MRI. TAC was calculated using modified Agatston algorithm on non-contrast cardiac CT. Multivariate regression models were calculated for the presence of TAC. Overall, 861 (24%) individuals had detectable TAC. A lower AD was observed among those with vs. without TAC (2.02±1.34 vs. 1.28±0.74, p<0.0001). The prevalence of TAC increased significantly across decreasing quartiles of AD (7%, 17%, 31%, and 42%, p<0.0001). Using multivariate analysis, TAC was independently associated with AD after adjusting for age, gender, ethnicity and other covariates. In conclusion, our analysis demonstrates that increased arterial stiffness is associated with increased TAC independent of ethnicity and other atherosclerotic risk factors. PMID:20691319

Al-Mallah, Mouaz H.; Nasir, Khurram; Katz, Ronit; Takasu, Junichiro; Lima, Joao A.; Bluemke, David A.; Hundley, Gregory; Blumenthal, Roger S.; Budoff, Matthew J

2014-01-01

383

Role of Nox4 in murine models of kidney disease.  

PubMed

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

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

384

Unilateral Radiotherapy for the Treatment of Tonsil Cancer  

SciTech Connect

Purpose: To assess, through a retrospective review, clinical outcomes of patients with squamous cell carcinoma of the tonsil treated at the M. D. Anderson Cancer Center with unilateral radiotherapy techniques that irradiate the involved tonsil region and ipsilateral neck only. Methods and Materials: Of 901 patients with newly diagnosed squamous cell carcinoma of the tonsil treated with radiotherapy at our institution, we identified 102 that were treated using unilateral radiotherapy techniques. All patients had their primary site of disease restricted to the tonsillar fossa or anterior pillar, with <1 cm involvement of the soft palate. Patients had TX (n = 17 patients), T1 (n = 52), or T2 (n = 33) disease, with Nx (n = 3), N0 (n = 33), N1 (n = 23), N2a (n = 21), or N2b (n = 22) neck disease. Results: Sixty-one patients (60%) underwent diagnostic tonsillectomy before radiotherapy. Twenty-seven patients (26%) underwent excision of a cervical lymph node or neck dissection before radiotherapy. Median follow-up for surviving patients was 38 months. Locoregional control at the primary site and ipsilateral neck was 100%. Two patients experienced contralateral nodal recurrence (2%). The 5-year overall survival and disease-free survival rates were 95% and 96%, respectively. The 5-year freedom from contralateral nodal recurrence rate was 96%. Nine patients required feeding tubes during therapy. Of the 2 patients with contralateral recurrence, 1 experienced an isolated neck recurrence and was salvaged with contralateral neck dissection only and remains alive and free of disease. The other patient presented with a contralateral base of tongue tumor and involved cervical lymph node, which may have represented a second primary tumor, and died of disease. Conclusions: Unilateral radiotherapy for patients with TX-T2, N0-N2b primary tonsil carcinoma results in high rates of disease control, with low rates of contralateral nodal failure and a low incidence of acute toxicity requiring gastrostomy.

Chronowski, Gregory M., E-mail: gchronowski@mdanderson.org [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Garden, Adam S.; Morrison, William H.; Frank, Steven J. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Schwartz, David L. [Department of Radiation Medicine, Long Island Jewish Hospital (United States); Shah, Shalin J.; Beadle, Beth M.; Gunn, G. Brandon [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Kupferman, Michael E. [Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Ang, Kian K.; Rosenthal, David I. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

2012-05-01

385

Autologous bone plugs in unilateral total knee arthroplasty  

PubMed Central

Background: The purpose of this study was to compare blood loss, declines in hemoglobin (HgB) and hematocrit (HcT) levels, and required homologous transfusions for patients who either had the femoral intramedullary defect left open or filled with an autologous bone plug during total knee arthroplasty (TKA). We hereby present our results of autologous bone plugs in unilateral TKA. Materials and Methods: A retrospective chart review was performed on 55 patients diagnosed with osteoarthritis (OA) who had undergone unilateral TKA. Twenty six patients had the femoral defect filled with an autologous bone plug and 29 did not. Lateral releases and patella replacements were not performed. Drained blood was reinfused when appropriate. Results: Mean blood loss and mean blood reinfused were similar for the plugged (loss: 960.8 ± 417.3 ml; reinfused: 466.7 ± 435.9 mL) and unplugged groups (loss: 1065.9 ± 633.5 ml, P = 0.38; reinfused: 528.4 ± 464.8 ml, P = 0.61). Preoperative HgB (14.3 ± 1.4 g/dL, P = 0.93) and HcT levels (42.2 ± 4.6%, P = 0.85) were similar across plug conditions. HgB and HcT levels declined similarly for the plugged (2.7 ± 1.2 g/dl and 7.9 ± 4.0%) and unplugged groups (3.0 ± 0.9 g/dl, P = 0.16 and 9.0 ± 2.6%, P = 0.16), respectively. Of patients, one in the plugged group and none in the unplugged group required homologous transfusions (P = 0.5). Conclusion: The autologous bone plug does not appear to reduce the need for homologous blood transfusions following unilateral TKA. PMID:23682181

Protzman, Nicole M; Buck, Nicholas J; Weiss, Carl B

2013-01-01

386

Cerebellar dysplasia and unilateral cataract in Marinesco-Sjögren syndrome.  

PubMed

The classic features of Marinesco-Sjögren syndrome include bilateral cataracts, cerebellar ataxia, and mental deficiency with an autosomal recessive inheritance pattern. Weakness and a variety of other characteristics are present inconsistently. A limited number of neuroimaging studies have indicated that cerebellar hypoplasia is the most common finding. We report a patient with near normal intelligence, unilateral cataract, and the previously unreported magnetic resonance imaging findings of cerebellar dysplasia, arachnoid cyst, and absent septum pellucidum. A review of the literature suggests significant heterogeneity in the Marinesco-Sjögren syndrome. PMID:8703231

Williams, T E; Buchhalter, J R; Sussman, M D

1996-02-01

387

Isolated Unilateral Hypoglossal Nerve Palsy Due to Vertebral Artery Dissection  

PubMed Central

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

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

2012-01-01

388

Unilateral conjunctival ulcer due to Stenotrophomonas maltophilia infection  

PubMed Central

We report a case of unilateral conjunctival ulcer due to Stenotrophomonas maltophilia infection in an immunocompetent individual. A 44-year-old male presented with complaints of pain and yellowish discharge in the right eye for one week. Patient underwent complete ophthalmic evaluation and relevant laboratory investigations. Anterior segment examination revealed localized conjunctival and episcleral congestion with conjunctival ulceration on the bulbar conjunctiva in the right eye. Gram's stain revealed gram-negative bacilli. Culture and sensitivity revealed S. maltophilia and responded well to topical moxifloxacin with systemic co-trimoxazole therapy. PMID:22446910

Mahendradas, Padmamalini; Avadhani, Kavitha; Anandula, Venkatramana; Shetty, Rohit

2012-01-01

389

Significance of unilateral radiation nephropathy. [/sup 60/Co; Linear accelerator  

SciTech Connect

Thirteen patients with non-Hodgkin's lymphoma with residual disease in the abdomen were treated by irradiation to the whole abdomen and left upper quadrant. The entire or half of the left kidney received between 2550 rad in 6 weeks and 4900 rad in 5 weeks. Seven of 12 patients evaluated showed functional and/or morphological changes in the left kidney on renal function studies and renal scan at various intervals. None of these patients clinically demonstrated overt acute radiation nephropathy. Three patients developed elevated blood pressure; the plasma renin level was markedly elevated in one of these patients. With the possible exception of one patient, no patient was discovered to have any functional morphological changes in the right kidney. The lymphoma in the abdomen was under control in 12 out of 13 patients treated at this writing.

Kim, T.H.; Freeman, C.R.; Webster, J.H.

1980-11-01

390

Endovascular management of traumatic ruptures of the thoracic aorta: A retrospective multicenter analysis of 28 cases in The Netherlands  

Microsoft Academic Search

Background. Minimally invasive endovascular treatment of a traumatic rupture of the thoracic aorta is a new strategy in the care of multitrauma patients. We report the experience in The Netherlands with endovascular management of patients with acute traumatic ruptures of the thoracic aorta. Methods. We reviewed 28 patients with a traumatic thoracic aortic rupture treated with a thoracic aortic endograft

Liselot L. Hoornweg; Maarten K. Dinkelman; J. Carel Goslings; Jim A. Reekers; Hence J. M. Verhagen; Eric L. Verhoeven; Geert Willem H. Schurink; Ron Balm

2006-01-01

391

The kidney tight junction (Review)  

PubMed Central

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

HOU, JIANGHUI

2014-01-01

392

Development of the kidney medulla  

PubMed Central

The mature renal medulla, the inner part of the kidney, consists of the medullary collecting ducts, loops of Henle, vasa recta and the interstitium. The unique spatial arrangement of these components is essential for the regulation of urine concentration and other specialized kidney functions. Thus, the proper and timely assembly of medulla constituents is a crucial morphogenetic event leading to the formation of a functioning metanephric kidney. Mechanisms that direct renal medulla formation are poorly understood. This review describes the current understanding of the key molecular and cellular mechanisms underlying morphological aspects of medulla formation. Given that hypoplasia of the renal medulla is a common manifestation of congenital obstructive nephropathy and other types of congenital anomalies of the kidney and urinary tract (CAKUT), better understanding of how disruptions in medulla formation are linked to CAKUT will enable improved diagnosis, treatment and prevention of CAKUT and their associated morbidity. PMID:22343825

Song, Renfang; Yosypiv, Ihor V.

2012-01-01

393

Kidney Failure and Vascular Disease  

MedlinePLUS

... Atherosclerosis Carotid Artery Disease Chronic Venous Insufficiency Critical Limb Ischemia (CLI) Deep Vein Thrombosis (DVT) Peripheral Artery ... be removed artificially through dialysis, or a kidney transplant can be ... access procedure to create a connection, usually an artificial graft ...

394

Adiponectin effects on the kidney.  

PubMed

Adiponectin is a 30-kDa polypeptide secreted primarily by adipose tissue and plays a key role in kidney disease. In obesity, reduced adiponectin levels are associated with insulin resistance, cardiovascular disease and obesity related kidney disease. The latter includes microalbuminuria, glomerulomegaly, overt proteinuria and focal segmental glomerulosclerosis. Adiponectin levels in type 2 diabetics also negatively correlate with early features of nephropathy. However, in patients with established chronic kidney disease, adiponectin levels are elevated and positively predict progression of disease. The mechanism of action of adiponectin in the kidney appears to be related to AMPK activation and NADPH oxidase. Further studies are needed to elucidate this pathway and investigate the role of potential targets of adiponectin-AMPK-Nox pathway for CKD as obesity-related CKD is increasing worldwide. PMID:24417947

Sweiss, Natalie; Sharma, Kumar

2014-01-01

395

Kidney Disease Risks among Hispanics  

MedlinePLUS

... tell you your GFR , the best test for kidney disease. 2. Eat right. Eat foods low in fat and cholesterol . Eat foods that are high in fiber. Limit how much alcohol you drink. 3. Live healthy. Exercise, keep a ...

396

The kidney tight junction (Review).  

PubMed

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

Hou, Jianghui

2014-12-01

397

Polycystic kidney and liver disease in cats  

Microsoft Academic Search

This paper reviews 27 cases of polycystic disease of the kidneys and\\/or liver in cats. The multiple cysts in the kidneys were rounded in all but one case, as described in adult polycystic kidney disease in humans. In 68% of the cats presented with polycystic kidneys, there were also cystic changes of the liver (uni? or multilocular cysts and\\/or congenital

J. T. Bosje; T. S. G. A. M. van den Ingh

1998-01-01

398

VEGF ameliorates tubulointerstitial fibrosis in unilateral ureteral obstruction mice via inhibition of epithelial-mesenchymal transition  

PubMed Central

Aim: Vascular endothelial growth factor (VEGF) has been shown to be a survival factor for renal tubular epithelial cells. In the present study, we investigated whether administration of VEGF ameliorates tubulointerstitial fibrosis in a mouse model of unilateral ureteral obstruction (UUO). Methods: Thirty-six male CD-1 mice were randomly divided into three groups: sham-operation, UUO and UUO+VEGF group. VEGF (50 ?g/kg) was subcutaneously injected twice daily from d 1 to d 14. Mice in each group were killed at d 3, 7, or 14 after the operation, and the tubulointerstitial fibrosis was histopathologically evaluated. Human proximal tubular epithelial cells (HK-2) were used for in vitro study. The expression levels of ?-SMA, E-cadherin, TGF-?1, CTGF, and BMP-7 in the kidney were determined using Western blot and RT-PCR. Results: In the UUO mice, the degree of interstitial fibrosis was dramatically increased in a time-dependent manner. At d 3, 7, and 14, both the mRNA and protein expression levels for ?-SMA, TGF-?1, and CTGF were significantly upregulated, whereas those for E-cadherin and BMP-7 were significantly downregulated. At d 3 and 7, VEGF treatment significantly reduced interstitial fibrosis and the expression levels for ?-SMA, TGF-?1, and CTGF, while significantly increased the expression of E-cadherin and BMP-7, as compared with the UUO mice. At d 14 after operation, no significant differences were observed in the expression of the examined markers between VEGF-treated mice and UUO mice, with the exception of CTGF. In HK-2 cells, VEGF blocked TGF-?1-induced ?-SMA and vimentin expression and restored E-cadherin expression in a dose-dependent manner. Conclusion: VEGF may ameliorate renal tubulointerstitial fibrosis at the early stage in UUO mice. This effect may be related to inhibition of VEGF on renal tubular epithelial-mesenchymal transition (EMT). PMID:21986574

Lian, Yao-guo; Zhou, Qiu-gen; Zhang, Ying-juan; Zheng, Fa-lei

2011-01-01

399

Renin in the human kidney  

Microsoft Academic Search

We have localized the enzyme renin (EC 3.4.99.19) in the normal adult human kidney by immunohistology. Serial paraffin sections of kidneys were incubated with renin antisera and then processed by the peroxidase-antiperoxidase method. Renin immunoreactivity was observed in the juxta-glomerular “epithelioid granular cells” (JEG-cells) in the wall of the afferent and rarely of the efferent vessel of the glomerulus. JEG-cells

M. R. Celio; T. Inagami

1981-01-01

400

Models of chronic kidney disease  

PubMed Central

Chronic kidney diseases result from recurrent or progressive injuries in glomeruli, tubules, interstitium and/or vasculature. In order to study pathogenesis, mechanisms and effects of interventions, many animal models have been developed, including spontaneous, genetic and induced models. However, these models do not exactly simulate human diseases, and most of them are strain, gender or age dependent. We review key information on various rodent models of chronic kidney diseases. PMID:21286234

Yang, Hai-Chun; Zuo, Yiqin; Fogo, Agnes B.

2010-01-01

401

Apoptosis in Acute Kidney Injury  

Microsoft Academic Search

Acute kidney injury (AKI), also called acute renal failure, is a major kidney disease associated with high mortality. Under\\u000a the disease condition, renal tubular cells are reversibly or irreversibly injured, undergoing cell death in both forms of\\u000a necrosis and apoptosis. Research during the last few years has established an important role for tubular cell apoptosis in\\u000a ischemic as well as

Navjotsingh Pabla; Qingqing Wei; Zheng Dong

402

Efficacy of Progesterone following a Moderate Unilateral Cortical Contusion Injury  

PubMed Central

Abstract Traumatic brain injury (TBI) results in an accumulation of edema and loss of brain tissue. Progesterone (PROG) has been reported to reduce edema and cortical tissue loss in a bilateral prefrontal cortex injury. This study tests the hypothesis that PROG is neuroprotective following a unilateral parietal cortical contusion injury (CCI). Adult male Sprague-Dawley rats were subjected to a moderate unilateral TBI using the CCI model. Rats were given 8?mg/kg PROG 15?min post-injury with four subsequent injections (6?h, and days 1, 2, and 3). Edema was determined 3 days post-injury, while cortical tissue sparing was also evaluated at 7 days post-injury. Animals were injured and given one of four treatments: (I) vehicle; (II) low dose: 8?mg/kg PROG; (III) high dose: 16?mg/kg PROG; (IV) tapered: 8?mg/kg PROG. Animals were given an initial injection within 15?min, followed by five injections (6?h, and days 1, 2, 3, and 4). Group IV received two additional injections (4?mg/kg on day 5; 2?mg/kg on day 6). PROG failed to alter both cortical edema and tissue sparing at any dose. Failure to modify two major sequelae associated with TBI brings into question the clinical usefulness of PROG as an effective treatment for all types of brain injury. PMID:18476780

Gilmer, Lesley K.; Roberts, Kelly N.

2008-01-01

403

Unilateral exposure of Shaker B potassium channels to hyperosmolar solutions.  

PubMed Central

This study tests the hypothesis that ion channels will be affected differently by external (extracellular) versus internal (cytoplasmic) exposure to hyperosmolar media. We looked first for effects on inactivation kinetics in wild-type Shaker B potassium channels. Although external hyperosmolar exposure did not alter the inactivation rate, internal exposure slowed both onset and recovery from fast inactivation. Differential effects on activation kinetics were then characterized by using a noninactivating Shaker B mutant. External hyperosmolar exposure slowed the late rising phase of macroscopic current without affecting the initial delay or early rising phase kinetics. By contrast, internal exposure slowed the initial steps in channel activation with only minimal changes in the later part of the rising phase. Neither external nor internal hyperosmolar exposure affected tail current rates in these noninactivating channels. Additionally, suppression of peak macroscopic current was approximately twofold smaller during external, as compared with internal, hyperosmolar exposure. Single-channel currents, observed under identical experimental conditions, showed a differential suppression equivalent to that seen in macroscopic currents. Apparently, during unilateral hyperosmolar exposure, changes in macroscopic peak current arise primarily from changes in single-channel conductance rather than from changes in equilibrium channel gating. We conclude that unilateral hyperosmolar exposure can provide information concerning the potential structural localization of functional components within ion-channel molecules. Images FIGURE 10 PMID:8519986

Starkus, J G; Schlief, T; Rayner, M D; Heinemann, S H

1995-01-01

404

Gamma knife stereotactic radiosurgery for unilateral acoustic neuromas  

PubMed Central

Objective:To evaluate the clinical results achievable using current techniques of gamma knife stereotactic radiosurgery to treat sporadic unilateral acoustic neuromas. Methods:A retrospective review of 234 consecutive patients treated for unilateral acoustic neuromas between 1996 and 1999, with a mean (SD) follow up of 35 (16) months. Tumour control was assessed with serial radiological imaging and by the need for surgical intervention. Hearing preservation was assessed using Gardner-Robertson grades. Details of complications including cranial neuropathies and non-specific vestibulo-cochlear symptoms are included. Results:A tumour control rate in excess of 92% was achieved, with only 3% of patients undergoing surgery after radiosurgery. Results were less good for larger tumours, but control rates of 75% were achieved for 35–45 mm diameter lesions. Of patients with discernible hearing, Gardner-Robertson grades were unchanged in 75%. Facial nerve function was adversely affected in 4.5%, but fewer than 1% of patients had persistent weakness. Trigeminal symptoms improved in 3%, but developed in 5% of patients, being persistent in less than 1.5%. Transient non-specific vestibulo-cochlear symptoms were reported by 13% of patients. Conclusions:Tumour control rates, while difficult to define, are comparable after radiosurgery with those experienced after surgery. The complications and morbidity after radiosurgery are far less frequent than those encountered after surgery. This, combined with its minimally invasive nature, may make radiosurgery increasingly the treatment of choice for small and medium sized acoustic neuromas. PMID:14617712

Rowe, J; Radatz, M; Walton, L; Hampshire, A; Seaman, S; Kemeny, A

2003-01-01

405

Postural pattern recognition in children with unilateral cerebral palsy  

PubMed Central

Background Several different strategies for maintaining upright standing posture in children with cerebral palsy (CP) were observed. Purpose The purpose of the present study was to define two different postural patterns in children with unilateral CP, using moiré topography (MT) parameters. Additionally, another focus of this article was to outline some implications for managing physiotherapy in children with hemiplegia. Patients and methods The study included 45 outpatients with unilateral CP. MT examinations were performed using a CQ Elektronik System device. In addition, a weight distribution analysis on the base of support between unaffected and affected body sides was performed simultaneously. A force plate pressure distribution measurement system (PDM-S) with Foot Print software was used for these measurements. Results The cluster analysis revealed four groups: cluster 1 (n=19; 42.22%); cluster 2 (n=7; 15.56%); cluster 3 (n=9; 20.00%); and cluster 4 (n=10; 22.22%). Conclusion Based on the MT parameters (extracted using a data reduction technique), two postural patterns were described: 1) the pro-gravitational postural pattern; and 2) the anti-gravitational pattern. PMID:24600228

Domagalska-Szopa, Malgorzata; Szopa, Andrzej

2014-01-01

406

Increased Circulating miR-21 Levels Are Associated with Kidney Fibrosis  

PubMed Central

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

Gnemmi, Viviane; Buob, David; Van der Hauwaert, Cynthia; Lo-Guidice, Jean-Marc; Bouye, Sebastien; Hazzan, Marc; Pottier, Nicolas; Perrais, Michael

2013-01-01

407

Thoracic metastasis in advanced ovarian cancer: comparison between computed tomography and video-assisted thoracic surgery  

PubMed Central

Objective To determine which computed tomography (CT) imaging features predict pleural malignancy in patients with advanced epithelial ovarian carcinoma (EOC) using video-assisted thoracic surgery (VATS), pathology, and cytology findings as the reference standard. Methods This retrospective study included 44 patients with International Federation of Obstetrics and Gynecology (FIGO) stage III or IV primary or recurrent EOC who had chest CT ?30 days before VATS. Two radiologists independently reviewed the CT studies and recorded the presence and size of pleural effusions and of ascites; pleural nodules, thickening, enhancement, subdiaphragmatic tumour deposits and supradiaphragmatic, mediastinal, hilar, and retroperitoneal adenopathy; and peritoneal seeding. VATS, pathology, and cytology findings constituted the reference standard. Results In 26/44 (59%) patients, pleural biopsies were malignant. Only the size of left-sided pleural effusion (reader 1: rho=-0.39, p=0.01; reader 2: rho=-0.37, p=0.01) and presence of ascites (reader 1: rho=-0.33, p=0.03; reader 2: rho=-0.35, p=0.03) were significantly associated with solid pleural metastasis. Pleural fluid cytology was malignant in 26/35 (74%) patients. Only the presence (p=0.03 for both readers) and size (reader 1: rho=0.34, p=0.04; reader 2: rho=0.33, p=0.06) of right-sided pleural effusion were associated with malignant pleural effusion. Interobserver agreement was substantial (kappa=0.78) for effusion size and moderate (kappa=0.46) for presence of solid pleural disease. No other CT features were associated with malignancy at biopsy or cytology. Conclusion In patients with advanced EOC, ascites and left-sided pleural effusion size were associated with solid pleural metastasis, while the presence and size of right-sided effusion were associated with malignant pleural effusion. No other CT features evaluated were associated with pleural malignancy. PMID:22247803

Mironov, Oleg; Sala, Evis; Mironov, Svetlana; Pannu, Harpreet; Chi, Dennis S.

2011-01-01

408

A Right Ectopic Kidney with Bilateral Multiple Anomalies of the Renal Vasculature - A Case Report  

PubMed Central

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

C, Krishnaveni; Kulkarni, Roopa

2013-01-01

409

miR-34c attenuates epithelial-mesenchymal transition and kidney fibrosis with ureteral obstruction  

PubMed Central

micro RNAs (miRNAs) are small non-coding RNAs that act as posttranscriptional repressors by binding to the 3?-UTR of target mRNAs. On the other hand, mesenchymal-epithelial transition (EMT) and kidney fibrosis is a pathological process of chronic kidney disease (CKD), and its relationship to miRNAs is becoming recognized as a potential target for CKD therapies. To find new miRNAs involved in EMT, we examined miRNA expression in experimental models of EMT and renal epithelialization using microarray, and found that miR-34c attenuates EMT induced by TGF-? in a mouse tubular cell line. To confirm the effects of miR-34c in vivo, we administered the precursor of miR-34c to mice with unilateral ureteral obstruction, and miR-34c decreased kidney fibrosis area and the expression of connective tissue growth factor, ?-SMA, collagen type 1, collagen type 3 and fibronectin. In conclusion, our study showed miR-34c attenuates EMT and kidney fibrosis of mice with ureteral obstruction. PMID:24694752

Morizane, Ryuji; Fujii, Shizuka; Monkawa, Toshiaki; Hiratsuka, Ken; Yamaguchi, Shintaro; Homma, Koichiro; Itoh, Hiroshi

2014-01-01

410

Tempol attenuates renal fibrosis in mice with unilateral ureteral obstruction: the role of PI3K-Akt-FoxO3a signaling.  

PubMed

This study investigated whether tempol, an anti-oxidant, protects against renal injury by modulating phosphatidylinositol 3-kinase (PI3K)-Akt-Forkhead homeobox O (FoxO) signaling. Mice received unilateral ureteral obstruction (UUO) surgery with or without administration of tempol. We evaluated renal damage, oxidative stress and the expression of PI3K, Akt, FoxO3a and their target molecules including manganese superoxide dismutase (MnSOD), catalase, Bax, and Bcl-2 on day 3 and day 7 after UUO. Tubulointerstitial fibrosis, collagen deposition, ?-smooth muscle actin-positive area, and F4/80-positive macrophage infiltration were significantly lower in tempol-treated mice compared with control mice. The expression of PI3K, phosphorylated Akt, and phosphorylated FoxO3a markedly decreased in tempol-treated mice compared with control mice. Tempol prominently increased the expressions of MnSOD and catalase, and decreased the production of hydrogen peroxide and lipid peroxidation in the obstructed kidneys. Significantly less apoptosis, a lower ratio of Bax to Bcl-2 expression and fewer apoptotic cells in TUNEL staining, and decreased expression of transforming growth factor-?1 were observed in the obstructed kidneys from tempol-treated mice compared with those from control mice. Tempol attenuates oxidative stress, inflammation, and fibrosis in the obstructed kidneys of UUO mice, and the modulation of PI3K-Akt-FoxO3a signaling may be involved in this pathogenesis. PMID:24550650

Yoon, Hye Eun; Kim, Soo Jeong; Kim, Sung Jun; Chung, Sungjin; Shin, Seok Joon

2014-02-01

411

Cystic Cholangioma in the Thoracic Cavity of a Rat  

PubMed Central

A female congenic rat produced by repeated backcrossing of Nihon rats, a model for hereditary renal cell carcinoma, to Brown Norway rats was necropsied at 24 months of age. At necropsy, a white mass about 1 centimeter in size was observed in the thoracic cavity, and the mass partly adhered to the esophagus and the diaphragm. Histologically, the mass was clearly circumscribed by connective tissue, and consisted of neoplastic cuboidal epithelial cells that showed cystic tubular proliferation. Some islands of well-differentiated hepatocytes and some vessels were observed in the mass. Immunohistochemically, the tumor cells were strongly positive for cytokeratin and partly positive for vimentin but were negative for mesothelin and Von Willebrand Factor. The positive rate for Ki-67 was 2.4%. Based on these histological and immunohistochemical evidences, we diagnosed this tumor as a cystic cholangioma that might have arisen from the ectopic hepatic tissue in the thoracic cavity. PMID:22481863

Michimae, Yoshiko; Okimoto, Kazuo; Toyosawa, Kaoru; Matsumoto, Izumi; Kouchi, Mami; Tochitani, Tomoaki; Koujitani, Takatoshi; Funabashi, Hitoshi; Seki, Takaki

2012-01-01

412

[Thoracic ultrasound in penetrating chest trauma: the tactics management].  

PubMed

The thoracic ultrasound for the detection of hemothorax and hemopericardium was performed in 655 patients with penetrating thoracic trauma. Ultrasound findings were compared with the results of surgical exploration. Sensitivity and specificity of ultrasound in detection of hemothorax was 72.1 and 90.1%; in detection of hemopericardium - 70.6 and 73.7%, respectively. The results of the US diagnostics depended on patients' position (supine or when seated) and on time interval between the examination and surgery. The isolated US investigation in supine position leads to the increase of false negative results. We consider that in hemodynamically stable patients the doutbtfull US data in detection of hemopericardium is the indication to videothoracoscopy. The lower-chest injuries with the US signs of hemothorax are considered to be the indication for VATS except for the obvious left-side thoracoabdominal injuries. PMID:22433517

Voskresenski?, O V; Trofimova, E Iu; Radchenko, Iu A; Abakumov, M M

2011-01-01

413

The genetics and genomics of thoracic aortic disease  

PubMed Central

Genetic studies over the past several decades have helped to better elucidate the genomics and inheritance of thoracic aortic diseases. Seminal work from various researchers have identified several genetic factors and mutations that predispose to aortic aneurysms, which will aid in better screening and early intervention, resulting in better clinical outcomes. Syndromic aneurysms have been associated with Marfan syndrome, Loeys-Dietz syndrome, aneurysm osteoarthritis syndrome, arterial tortuosity syndrome, Ehlers-Danlos Syndrome, and TGF? mutation. Mutations in MYH11, TGF?R1, TGF?R2, MYLK, and ACTA2 genes have been linked to familial non-syndromic cases, although linkage analysis is limited by incomplete penetrance and/or locus heterogeneity. This overview presents a summary of key genetic and genomic factors that are associated with thoracic aortic diseases. PMID:23977594

Pomianowski, Pawel

2013-01-01

414

Evolutionary Reduction of the First Thoracic Limb in Butterflies  

PubMed Central

Members of the diverse butterfly families Nymphalidae (brush-footed butterflies) and Riodinidae (metalmarks) have reduced first thoracic limbs and only use two pairs of legs for walking. In order to address questions about the detailed morphology and evolutionary origins of these reduced limbs, the three thoracic limbs of 13 species of butterflies representing all six butterfly families were examined and measured, and ancestral limb sizes were reconstructed for males and females separately. Differences in limb size across butterflies involve changes in limb segment size rather than number of limb segments. Reduction of the first limb in both nymphalids and riodinids appears particularly extensive in the femur, but the evolution of these reduced limbs is suggested to be a convergent evolutionary event. Possible developmental differences as well as ecological factors driving the evolution of reduced limbs are discussed. PMID:21867433

Wolfe, Joanna M.; Oliver, Jeffrey C.; Monteiro, Antonia

2011-01-01

415

Thoracic Disc Herniation Presenting with Transient Anterior Spinal Artery Syndrome  

PubMed Central

Summary This report is a clinical and radiologic correlation of anterior spinal arterial distribution ischemia with a thoracic disc herniation affecting the artery of Adamkiewicz. We could only find one other similar reported case. A 38-year-old woman developed sudden onset of severe back pain and radiculopathy, followed by rapidly evolving paraparesis. The neurological examination was consistent with a deficit caused by anterior spinal artery ischemia. MRI revealed T2 signal change in the thoracolumbar spinal cord and a laterally placed, non-calcified disc herniation. Selective spinal angiography performed 30 hours after onset revealed displacement of the left T9 radicular feeding artery by the disc herniation; at this time the artery was patent. The patient experienced some resolution of symptoms within the first 24 hours and was managed conservatively and made a significant recovery within two weeks. Appropriately located thoracic disc herniations can disturb the blood supply to the thoracolumbar spinal cord. PMID:20667212

Guest, J.D.; Griesdale, D.E.; Marotta, T.

2000-01-01

416

Bilateral Thoracic Ganglion Cyst : A Rare Case Report  

PubMed Central

Ganglion cysts usually arise from the tissues around the facet joints. It is usually associated with degenerative cahanges in facet joints. Bilateral thoracic ganglion cysts are very rare and there is no previous case that located in bilateral intervertebral foramen compressing the L1 nerve root associated with severe radiculopathy. We report a 53 years old woman who presented with bilateral groin pain and severe numbness. Magnetic resonance imaging revealed bilateral cystic mass in the intervertebral foramen between 12th thoracal and 1st lumbar vertebrae. The cystic lesions were removed after bilateral exposure of Th12-L1 foramens. The result of hystopathology confirmed the diagnosis as ganglion cyst. The ganglion cyst may compromise lumbar dorsal ganglion when it located in the intervertebral foramen. The surgeon should keep this rare entity in their mind for differential diagnosis. PMID:23908708

Kazanci, Burak; Tehli, Ozkan; Guclu, Bulent

2013-01-01

417

Bilateral thoracic ganglion cyst : a rare case report.  

PubMed

Ganglion cysts usually arise from the tissues around the facet joints. It is usually associated with degenerative cahanges in facet joints. Bilateral thoracic ganglion cysts are very rare and there is no previous case that located in bilateral intervertebral foramen compressing the L1 nerve root associated with severe radiculopathy. We report a 53 years old woman who presented with bilateral groin pain and severe numbness. Magnetic resonance imaging revealed bilateral cystic mass in the intervertebral foramen between 12th thoracal and 1st lumbar vertebrae. The cystic lesions were removed after bilateral exposure of Th12-L1 foramens. The result of hystopathology confirmed the diagnosis as ganglion cyst. The ganglion cyst may compromise lumbar dorsal ganglion when it located in the intervertebral foramen. The surgeon should keep this rare entity in their mind for differential diagnosis. PMID:23908708

Kazanci, Burak; Tehli, Ozkan; Türkoglu, Erhan; Guclu, Bulent

2013-05-01

418

Disruptive technology in the treatment of thoracic trauma.  

PubMed

The care of patients with thoracic injuries has undergone monumental change over the past 25 years. Advances in technology have driven improvements in care, with obvious benefits to patients. In many instances, new or "disruptive" technologies have unexpectedly displaced previously established standards for the diagnosis and treatment of these potentially devastating injuries. Examples of disruptive technology include the use of ultrasound technology for the diagnosis of cardiac tamponade and pneumothorax; thoracoscopic techniques instead of thoracotomy, pulmonary tractotomy, and stapled lung resection; endovascular repair of thoracic aortic injury; operative fixation of flail chest; and the enhanced availability of extracorporeal lung support for severe respiratory failure. Surgeons must be prepared to recognize the benefits, and limits, of novel technologies and incorporate these methods into day-to-day treatment protocols. PMID:24296093

Smith, R Stephen

2013-12-01

419

Venous thoracic outlet syndrome caused by a congenital rib malformation  

PubMed Central

Summary Venous thoracic outlet syndrome (VTOS) represents a rare disorder. Hypertrophy of the anterior scalene musculature is the cause of the compression syndrome in most cases. To our knowledge, we describe the first reported case worldwide of a venous compression syndrome caused by a congenital malformation of the 1st and 2nd ribs. Treatment by transaxillary partial rib resection was necessary and a very good postoperative result was achieved. PMID:22544354

Kirschbaum, Andreas; Palade, Emanuel; Csatari, Zoltan; Passlick, Bernward

2012-01-01

420

Neurological Complications Following Endoluminal Repair of Thoracic Aortic Disease  

SciTech Connect

Open surgery for thoracic aortic disease is associated with significant morbidity and the reported rates for paraplegia and stroke are 3%-19% and 6%-11%, respectively. Spinal cord ischemia and stroke have also been reported following endoluminal repair. This study reviews the incidence of paraplegia and stroke in a series of 186 patients treated with thoracic stent grafts. From July 1997 to September 2006, 186 patients (125 men) underwent endoluminal repair of thoracic aortic pathology. Mean age was 71 years (range, 17-90 years). One hundred twenty-eight patients were treated electively and 58 patients had urgent procedures. Anesthesia was epidural in 131, general in 50, and local in 5 patients. Seven patients developed paraplegia (3.8%; two urgent and five elective). All occurred in-hospital apart from one associated with severe hypotension after a myocardial infarction at 3 weeks. Four of these recovered with cerebrospinal fluid (CSF) drainage. One patient with paraplegia died and two had permanent neurological deficit. The rate of permanent paraplegia and death was 1.6%. There were seven strokes (3.8%; four urgent and three elective). Three patients made a complete recovery, one had permanent expressive dysphasia, and three died. The rate of permanent stroke and death was 2.1%. Endoluminal treatment of thoracic aortic disease is an attractive alternative to open surgery; however, there is still a risk of paraplegia and stroke. Permanent neurological deficits and death occurred in 3.7% of the patients in this series. We conclude that prompt recognition of paraplegia and immediate insertion of a CSF drain can be an effective way of recovering spinal cord function and improving the prognosis.

Morales, J. P.; Taylor, P. R.; Bell, R. E.; Chan, Y. C. [Guy's and St. Thomas' Foundation Hospital NHS Trust, Department of Vascular Surgery (United Kingdom); Sabharwal, T. [Guy's and St. Thomas' Foundation Hospital NHS Trust, Department of Interventional Radiology (United Kingdom); Carrell, T. W. G. [Guy's and St. Thomas' Foundation Hospital NHS Trust, Department of Vascular Surgery (United Kingdom); Reidy, J. F. [Guy's and St. Thomas' Foundation Hospital NHS Trust, Department of Interventional Radiology (United Kingdom)], E-mail: John.Reidy@gstt.nhs.uk

2007-09-15

421

Segmental thoracic spinal anesthesia in patient with Byssinosis undergoing nephrectomy  

PubMed Central

Byssinosis is an occupational disease occurring commonly in cotton mill workers; it usually presents with features of chronic obstructive pulmonary disease (COPD). The management of patients with COPD presents a significant challenges to the anesthetist. Regional anesthesia is preferred in most of these patients to avoid perioperative and postoperative complications related to general anesthesia. We report a known case of Byssinosis who underwent nephrectomy under segmental spinal anesthesia at the low thoracic level.

Patel, Kiran; Salgaonkar, Sweta

2012-01-01

422

The role of diagnostic VATS in penetrating thoracic injuries  

PubMed Central

Background Penetrating chest injuries account for 1–13% of thoracic trauma hospital admissions and most of these are managed with a conservative approach. Nevertheless, 18–30% of cases managed only with tube thoracostomy have residual clotted blood, considered the major risk factor for the development of fibrothorax and empyema. In addition, 4–23% of chest injury patients present persistent pneumothorax and 15–59% present an injury to the diaphragm, which is missed in 30% of cases. In order to make a correct diagnosis, reduce the number of missed injuries, chronic sequelae and late mortality we propose performing surgical exploration of all patients with a penetrating injury of the pleural cavity. Methods 1270 patients who sustained thoracic trauma were admitted to our hospital between 1994 and 2004. Of these, 16 patients had penetrating injuries: thirteen were surgically explored by means of Video Assisted Thoracic Surgery (VATS), and 3 with thoracotomy due to hemodynamic instability or suspected lesion of the heart or great vessels. Results In the 13 patients who underwent VATS, 5 injuries to the diaphragm, 3 lesions to an intercostal artery, and 1 lesion to the diaphragmatic artery were detected. In 12 of these patients a laceration of the pulmonary parenchyma was also present. A conversion to thoracotomy was necessary due to a broad laceration of the diaphragm and due to hemostasis of an intercostal artery. In all but one case, which was later converted, diagnostic imaging missed the diagnosis of laceration of the diaphragm. There was no intra- or postoperative mortality, and average hospital stay was five days. Conclusion VATS is a safe and effective way to diagnose and manage penetrating thoracic injuries, and its extensive use leads to a reduction in the number of missed, potentially fatal lesions as well as in chronic sequelae. PMID:17022807

Paci, Massimiliano; Ferrari, Guglielmo; Annessi, Valerio; de Franco, Salvatore; Guasti, Guido; Sgarbi, Giorgio

2006-01-01

423

Surgical repair of a thoracic meningocele in a foal.  

PubMed

A 6 week old American Paint filly was admitted for evaluation of a dorsal thoracic mass suspected to be a meningocele. The diagnosis was confirmed by plain and contrast enhanced computed tomography. Surgical repair was performed by dissection of the base of the meningocele followed by ligation. No postoperative complications occurred. Contrast enhanced computed tomography was useful to confirm the diagnosis of meningocele and rule out a meningomyelocele. PMID:10582748

van Hoogmoed, L; Yarbrough, T B; Lecouteur, R A; Hornof, W J

1999-01-01

424

Clinical Experience and Management of Cervico-Thoracic Epidural Hematoma  

PubMed Central

Spinal epidural hematoma (SEH) causing acute myelopathy is rare. The usual clinical presentation of a SEH is sudden severe neck or back pain that progresses toward paraparesis or quadriparesis, depending on the level of the lesion. Recent studies have shown that early decompressive surgery is very important for patient's recovery. We experienced five patients of cervico-thoracic epidural hematomas associated with neurologic deficits that were treated successfully with surgical intervention. PMID:20539799

Ahn, Sang-Soak

2010-01-01

425

Lymphoscintigraphic evaluation of the thoracic duct in the canine  

E-print Network

intervention, conservative management of patients with chylothorax due to TD rupture for at least 2 weeks is recommended to allow the TD to heal. " A non-invasive diagnostic technique that distinguishes thoracic lymphangiectasia from TD rupture would..., LSG appears to be a non-invasive, safe, and reproduc- ible technique for evaluating lymph nodes and lymphatic channels. ~"" " Lymphoscintigraphy was introduced as an experimental procedure shortly after World War II, with several investigators...

Hodges, Carlos Cintron

2012-06-07

426

Thoracic EndoVascular Stent Graft Repair for Aortic Aneurysm  

PubMed Central

Background The number of cases employing thoracic endovascular aortic repair (TEVAR) has been increasing due to lower morbidity and mortality compared to open repair technique. The aim of this study is to evaluate the outcome of TEVAR for thoracic aortic diseases. Materials and Methods Sixteen patients underwent TEVAR from October 2003 to April 2010. Mean age at operation was 59 years (20~78 years), and 11 were male. Indications for TEVAR were large aortic diameter (>5.5 cm) upon presentation in 6 patients, increasing aortic diameter during the follow-up period in 4, traumatic aortic rupture in 3, persistent chest pain in 2, and ruptured aortic aneurysm in one. The mean diameter, length and the number of the stents were 33 mm (26~40 mm), 12 cm (9.5~16.0 cm), and 1.25 (1~2), respectively. Aortography employing Multi-detector computerized tomography (MDCT) technique was performed at one week, and patients were followed up in the out-patient department at one month, 6 months, and one year postoperatively. Results Primary technical success showing complete exclusion of the aneurysm was achieved in 15 patients. One patient showed a small endo-leak (type 1). Four patients developed perioperative stroke: Three recovered without sequelae, and one showed mild right-side weakness. There was no operative mortality. Diameter of the thoracic aorta covered by stent graft changed within 10% range in 12 patients, decreased by more than 10% in 3, and increased by more than 10% in one during mean follow-up duration of 18 months (1~73 months). There was no recurrence-related death during this period. Conclusion Intermediate-term outcome after TEVAR was encouraging. Indications for TEVAR could be extended for other thoracic aortic diseases. PMID:22263142

Yoon, Yong Han; Lim, Hyun Kyung; Yang, Ki Hwan; Baek, Wan Ki; Kim, Kwang Ho

2011-01-01

427

Screening for Cardiovascular Disease in Survivors of Thoracic Radiation  

Microsoft Academic Search

\\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.

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

428

Current costs of video-assisted thoracic surgery (VATS) lobectomy  

PubMed Central

Video-assisted thoracoscopic lobectomy has many benefits over open surgery such as smaller incisions, less pain, less blood loss, faster postoperative recovery, shortened hospital stay, similar or superior survival rates. In contrast video-assisted thoracic surgery (VATS) has higher equipment costs, increased operating room times, at least initially, and a learning curve for the team. However when an experienced surgeon performs the surgery, significant hospital savings combined with better outcomes are achieved by video-assisted thoracoscopic lobectomy. PMID:24040522

Swanson, Scott

2013-01-01

429

Notch-3 receptor activation drives inflammation and fibrosis following tubulointerstitial kidney injury.  

PubMed

Kidney diseases impart a vast burden on affected individuals and the overall health care system. Progressive loss of renal parenchymal cells and functional decline following injury are often observed. Notch-1 and -2 receptors are crucially involved in nephron development and contribute to inflammatory kidney diseases. We specifically determined the participation of receptor Notch-3 following tubulointerstitial injury and in inflammatory responses. Here we show by heat map analyses that Notch-3 transcripts are up-regulated in human kidney diseases. A similar response was corroborated with kidney cells following TGF-? exposure in vitro. The murine unilateral ureteral obstruction (UUO) model mirrors hallmarks of tubulointerstitial injury and damage. A subset of tubular and interstitial cells demonstrated up-regulated Notch-3 receptor expression in diseased animals. We hypothesized a relevance of Notch-3 receptors for the chemotactic response. To address this question, animals with genetic ablation of receptor Notch-3 were analysed following UUO. As a result, we found that Notch-3-deficient animals are protected from tubular injury and cell loss with significantly reduced interstitial collagen deposition. Monocytic cell infiltration was significantly reduced and retarded, likely due to abrogated chemokine synthesis. A cell model was set up that mimics enhanced receptor Notch-3 expression and activation. Here a pro-mitogenic response was seen with activated signalling in tubular cells and fibroblasts. In conclusion, Notch-3 receptor fulfils non-redundant roles in the inflamed kidney that may not be replaced by other Notch receptor family members. Thus, specific blockade of this receptor may be suitable as therapeutic option to delay progression of kidney disease. PMID:22806125

Djudjaj, Sonja; Chatziantoniou, Christos; Raffetseder, Ute; Guerrot, Dominique; Dussaule, Jean-Claude; Boor, Peter; Kerroch, Monique; Hanssen, Lydia; Brandt, Sabine; Dittrich, Annemarie; Ostendorf, Tammo; Floege, Jürgen; Zhu, Cheng; Lindenmeyer, Maja; Cohen, Clemens D; Mertens, Peter R

2012-11-01

430

Epidemiology of concomitant injuries in traumatic thoracic aortic rupture: A meta-analysis.  

PubMed

Traumatic thoracic aortic rupture is a highly lethal injury. For those who arrive alive at the hospital, it is of utmost importance to quickly evaluate concomitant injuries and prioritize therapeutic interventions. We aimed to review the frequency of concomitant injuries in patients with thoracic aortic rupture, according to anatomic location and type of injury. A systematic literature search of six medical databases led to the identification of 90 publications; 27 categories of thoracic aortic rupture concomitant injuries were thereafter created. The respective pooled proportions and 95% confidence intervals were calculated and ranked in order of frequency. Among the 7258 patients studied, orthopedic fractures were the most frequent thoracic aortic rupture concomitant injury, amounting to a high pooled proportion of almost 70%, followed by thoracic injury in ?50% and abdominal injury in over 40%. Pooled proportion for any type of head injury was also high (37%) pointing to the multiple-injury type of lesions among thoracic aortic rupture victims. Thoracic aortic rupture is a devastating injury, but rarely occurs as a sole traumatic entity. The recognition of concomitant thoracic, abdominal, head injuries and fractures after thoracic aortic rupture is of paramount importance. Future studies should focus on the impact of these injuries upon survival, morbidity and disability of multiple-injured thoracic aortic rupture patients. PMID:24459130

Antonopoulos, Constantine N; Sfyroeras, George S; Kallinis, Aristides; Kakisis, John D; Liapis, Christos D; Petridou, Eleni Th

2014-12-01

431

Impact of lumbar spine posture on thoracic spine motion and muscle activation patterns.  

PubMed

Complex motion during standing is typical in daily living and requires movement of both the thoracic and lumbar spine; however, the effects of lumbar spine posture on thoracic spine motion patterns remain unclear. Thirteen males moved to six positions involving different lumbar (neutral and flexed) and thoracic (flexed and twisted) posture combinations. The thoracic spine was partitioned into three segments and the range of motion from each posture was calculated. Electromyographical data were collected from eight muscles bilaterally. Results showed that with a flexed lumbar spine, the lower-thoracic region had 14.83° and 15.61° more flexion than the upper- and mid-thoracic regions, respectively. A flexed lumbar spine significantly reduced the mid-thoracic axial twist angle by 5.21° compared to maximum twist in the mid-thoracic region. Functional differences emerged across muscles, as low back musculature was greatest in maintaining flexed lumbar postures, while thoracic erector spinae and abdominals showed bilateral differences with greater activations to the ipsilateral side. Combined postures have been previously identified as potential injury modulators and bilateral muscle patterns can have an effect on loading pathways. Overall, changes in thoracic motion were modified by lumbar spine posture, highlighting the importance of considering a multi-segmented approach when analyzing trunk motion. PMID:25026559

Nairn, Brian C; Drake, Janessa D M

2014-10-01

432

Thoracic epidural steroid injection for rib fracture pain.  

PubMed

Treatment for rib fracture pain can be broadly divided into pharmacologic approaches with oral and/or parenteral medication and interventional approaches utilizing neuraxial analgesia or peripheral nerve blocks to provide pain relief. Both approaches attempt to control nociceptive and neuropathic pain secondary to osseous injury and nerve insult, respectively. Success of treatment is ultimately measured by the ability of the selected modality to decrease pain, chest splinting, and to prevent sequelae of injury, such as pneumonia. Typically, opioids and NSAIDs are the drugs of first choice for acute pain because of ease of administration, immediate onset of action, and rapid titration to effect. In contrast, neuropathic pain medications have a slower onset of action and are more difficult to titrate to therapeutic effect. Interventional approaches include interpleural catheters, intercostal nerve blocks, paravertebral nerve blocks, and thoracic and lumbar epidural catheters. Each intervention has its own inherent advantages, disadvantages, and success rates. Rib fracture pain management practice is founded on the thoracic surgical and anesthesiology literature. Articles addressing rib fracture pain are relatively scarce in the pain medicine literature. As life expectancy increases, and as healthcare system modifications are implemented, pain medicine physicians may be consulted to treat increasing number of patients suffering rib fracture pain and may need to resort to novel therapeutic measures because of financial constraints imposed by those changes. Here we present the first published case series of thoracic epidural steroid injections used for management of rib fracture pain. PMID:23009717

Rauchwerger, Jacob J; Candido, Kenneth D; Deer, Timothy R; Frogel, Jonathan K; Iadevaio, Robert; Kirschen, Neil B

2013-06-01

433

Endovascular Repair of Contained Rupture of the Thoracic Aorta  

SciTech Connect

Purpose: To assess the efficacy of stent-grafts for the treatment of acute rupture of the thoracic aorta. Methods: Four patients with acute contained ruptures of the thoracic aorta were treated by insertion of stent-grafts. The underlying aortic lesions were aneurysm, acute aortic ulcer, acute type B dissection and giant cell aortitis. The procedures were performed under general anesthesia in three patients and local anesthesia in one patient. Results: All stent-grafts were successfully deployed. All patients survived the procedure and are now alive and well at follow-up (mean 6.3 months, range 44 days-16 months). One patient underwent a second stent procedure 10 days after the first procedure because of a proximal endoleak. All hemothoraces have resolved. There were no complications. Conclusion:Treatment of acute contained ruptures of the thoracic aorta by the insertion of stent-grafts is feasible. The technical success rates,complication rates and patient survival compare favorably with emergency surgery.

Morgan, Robert [Department of Radiology, St. George's Hospital, Blackshaw Road, London SW17 0QT (United Kingdom); Loosemore, Tom [Department of Vascular Surgery, St. George's Hospital, Blackshaw Road, London SW17 0QT (United Kingdom); Belli, Anna-Maria [Department of Radiology, St. George's Hospital, Blackshaw Road, London SW17 0QT (United Kingdom)

2002-08-15

434

First thoracic vertebral body as reference for endotracheal tube placement.  

PubMed

After intubation in newborn infants, the placement of the endotracheal tube in the trachea must be checked by a chest radiograph. The most commonly used reference point for placement is the medial ends of the clavicles. The position of the clavicles may be variable. The present study was carried out to determine whether the body of the first thoracic vertebra should be used instead of the clavicles because its position on chest radiographs is more constant. Seventy eight radiographs obtained from 35 neonates were examined prospectively. The carina was situated between T3 and T5, most commonly at T3-4 or T4 (85%). The position of the clavicles varied markedly from patient to patient and within the same patient on different days, and this variation was significantly higher than that of the carina. On 65 (83%) examinations the clavicles lay above the first thoracic vertebra. It is recommended that, for accurate placement within the trachea, the tip of the endotracheal tube should be placed at the level of the body of the first thoracic vertebra; this could be used as the sole reference point on chest radiographs obtained in the neonatal period. PMID:8092867

Blayney, M P; Logan, D R

1994-07-01

435

Identification and surgical treatment of primary thoracic spinal stenosis.  

PubMed

We report the surgical treatment results for 7 patients (4 men, 3 women; mean age, 49 years) who presented with myelopathy caused exclusively by primary thoracic spinal stenosis, predominantly in the lower thoracic spine. (Patients with concurrent ascending lumbosacral degenerative disease were excluded.) All patients received extensive nonoperative treatment before referral to our center. Surgical treatment consisted of wide posterior decompression and instrumented fusion (5 cases), anterior vertebrectomy and fusion (1), and anterior vertebrectomy with autograft strut followed by wide posterior decompression and instrumented fusion (1). Mean operative time was 313 minutes, mean blood loss was 944 mL, and there were no major postoperative complications. Minimum follow-up was 2 years. Five patients had significant improvement in myelopathy and were ambulating normally, 1 had modest improvement in ambulation, and 1 remained wheelchair-bound. All patients achieved solid radiographic fusions. After presenting these case studies, we review the current literature on treatment effectiveness. Primary thoracic spinal stenosis should be considered in patients who present with isolated lower extremity myelopathy, particularly when no significant pathologic findings are identified in the cervical or lumbosacral spine. Expedient wide decompression with concurrent instrumented fusion is recommended to prevent late development of spinal instability and recurrent spinal stenosis. PMID:19104683

Dimar, John R; Bratcher, Kelly R; Glassman, Steven D; Howard, Jennifer M; Carreon, Leah Y

2008-11-01

436

The Effect of Chlorpyrifos on Isolated Thoracic Aorta in Rats  

PubMed Central

This study investigated the effect of chlorpyrifos on thoracic aorta and on the level of NO in plasma and aorta. The effect of chlorpyrifos on thoracic aorta in organ bath was determined in 10 rats. Another 45 rats were assigned to 3 groups with 15 rats each: control group 1 received distilled water, control group 2 was given corn oil, and the last group was given 13.5?mg/kg chlorpyrifos dissolved in corn oil every other day for 8 weeks orally. Chlorpyrifos (10?10?M–10?5?M) showed no effect on isolated thoracic aorta. Plasma AChE activity was decreased, while LDH, ALT, GGT, and AST activities were increased in chlorpyrifos group compared to control groups. Plasma NO level was increased in chlorpyrifos group compared to control groups. iNOS expression was present in all groups in the cytoplasm of the endothelia and in the smooth muscle cells of aorta. According to semiquantitative histomorphological analysis, iNOS immunopositive reactions were seen in the decreasing order in chlorpyrifos, control 2, and control 1 groups. eNOS immunopositive reactions were observed in the endothelial cell cytoplasm, rarely in the subintimal layer, and the smooth muscle cells of aorta. There were no differences among the groups in terms of eNOS immunostaining. In conclusion, chlorpyrifos induced NO production in aorta following an increase in NOS expression. PMID:23878805

Y?ld?r?m, Ebru; Baydan, Emine; Kanbur, Murat; Kul, Oguz; C?nar, Miyase; Ekici, Husamettin; Atmaca, Nurgul

2013-01-01

437

3D geometric reconstruction of thoracic aortic aneurysms  

PubMed Central

Background The thoracic aortic aneurysm (TAA) is a pathology that involves an expansion of the aortic diameter in the thoracic aorta, leading to risk of rupture. Recent studies have suggested that internal wall stress, which is affected by TAA geometry and the presence or absence of thrombus, is a more reliable predictor of rupture than the maximum diameter, the current clinical criterion. Accurate reconstruction of TAA geometry is a crucial step in patient-specific stress calculations. Methods In this work, a novel methodology was developed, which combines data from several sets of magnetic resonance (MR) images with different levels of detail and different resolutions. Two sets of images were employed to create the final model, which has the highest level of detail for each component of the aneurysm (lumen, thrombus, and wall). A reference model was built by using a single set of images for comparison. This approach was applied to two patient-specific TAAs in the descending thoracic aorta. Results The results of finite element simulations showed differences in stress pattern between the coarse and fine models: higher stress values were found with the coarse model and the differences in predicted maximum wall stress were 30% for patient A and 11% for patient B. Conclusion This paper presents a new approach to the reconstruction of an aneurysm model based on the use of several sets of MR images. This enables more accurate representation of not only the lumen but also the wall surface of a TAA taking account of intraluminal thrombus. PMID:17081301

Borghi, Alessandro; Wood, Nigel B; Mohiaddin, Raad H; Xu, X Yun

2006-01-01

438

Posteriorly migrated thoracic disc herniation: a case report  

PubMed Central

Introduction Posterior epidural migration of thoracic disc herniation is extremely rare but may occur in the same manner as in the lumbar spine. Case presentation A 53-year-old Japanese man experienced sudden onset of incomplete paraplegia after lifting a heavy object. Magnetic resonance imaging revealed a posterior epidural mass compressing the spinal cord at the T9-T10 level. The patient underwent emergency surgery consisting of laminectomy at T9-T10 with right medial facetectomy, removal of the mass lesion, and posterior instrumented fusion. Histological examination of the mass lesion yielded findings consistent with sequestered disc material. His symptoms resolved, and he was able to resume walking without a cane 4 weeks after surgery. Conclusions Pre-operative diagnosis of posterior epidural migration of herniated thoracic disc based on magnetic resonance imaging alone may be overlooked, given the rarity of this pathology. However, this entity should be considered among the differential diagnoses for an enhancing posterior thoracic extradural mass. PMID:23402642

2013-01-01

439

ERP effects of spatial attention and display search with unilateral and bilateral stimulus displays  

Microsoft Academic Search

Two experiments were performed in which the effects of selective spatial attention on the ERPs elicited by unilateral and bilateral stimulus arrays were compared. In Experiment 1, subjects received a series of grating patterns. In the unilateral condition these gratings were presented one at a time, randomly to the right or left of fixation. In the bilateral condition, gratings were

Jan J Lange; Albertus A Wijers; Lambertus J. M Mulder; Gijsbertus Mulder

1999-01-01

440

Outcome in patients undergoing unilateral uterine artery embolization for symptomatic fibroids  

Microsoft Academic Search

AIMS: To evaluate patients undergoing uterine artery embolization for symptomatic fibroids who, for technical reasons, underwent unilateral rather than bilateral embolization.PATIENTS: Prospective data were collected on 109 patients undergoing uterine artery embolization for symptomatic fibroids. Of these, six underwent unilateral embolization. They were followed with ultrasound or magnetic resonance imaging (MRI) at 3, 6 and 12 months. Patients' histories were

T Nicholson

2004-01-01

441

Effect of unilateral electro-acupuncture on function of ipsilateral and contralateral tibialis anterior muscle  

Microsoft Academic Search

AIMS: It is known that unilateral resistance exercise or electromyostimulation training can increase muscular strength not only in the trained limb, but also in the homologous muscle of the contralateral limb. The principle of using unilateral therapy to treat conditions of the contralateral limb has been previously applied in traditional Chinese medicine. The primary aim of this study was to

Liping Huang; Shi Zhou; Zhen Lu; Lyndon O Brooks; Qiang Tian; Xia Li; Longjun Cao; Junhai Yu; Hui Wang

2006-01-01

442

Effects of eccentrically and concentrically induced unilateral fatigue on the involved and uninvolved limbs  

Microsoft Academic Search

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

Mark D Grabiner; Tammy M Owings

1999-01-01

443

Unilateral mydriasis secondary to ipratropium bromide in a critically ill patient.  

PubMed

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

Santana-Cabrera, Luciano; Fernández-Tagarro, Ernesto José; Del Amo-Nolasco, Beatriz; Jaén-Sánchez, Nieves; Cáceres-Agra, Juan José

2012-04-01

444

Unilateral relationship enhancement in the treatment of spouses of uncooperative alcohol abusers  

Microsoft Academic Search

This article presents the conceptualization of unilateral relationship enhancement (URE) and a URE treatment program developed for use with the spouses of alcohol abusers unmotivated to enter treatment. Enhancing the marital relationship through a unilateral program is described as an important step in the preparation of the spouse to function as a positive rehabilitative influence with his or her alcohol-abusing

Edwin J. Thomas; Kathryn Betts Adams; Marianne R. Yoshioka; Richard D. Ager

1990-01-01