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1

Unilateral and segmental localised polycystic kidney disease.  

PubMed Central

Unilateral and segmental localised polycystic disease is a rare type of cystic disease of the kidney. It takes the form of a segmental cystic abnormality in one kidney morphologically identical to the autosomal dominant adult form of polycystic kidney disease. The clinical, radiological, and pathological appearances of a case are described. The differential diagnosis and a possible pathogenic mechanism are discussed. Images

Gouldesbrough, D R; Fleming, S

1998-01-01

2

Unilateral shunt formation with thoracic aortic dissection in a whippet.  

PubMed

A three-year-old neutered male whippet was presented with intermittent, exercise-induced paraparesis. Femoral pulses were bilaterally absent. Neurologic examination was suggestive of a thoracolumbar myelopathy. Blood pressure measurements revealed hypotension in both pelvic limbs, hypertension in the right thoracic limb and it was immeasurable in the left thoracic limb. Echocardiography was within reference limits. A clear vascular pulsation was palpable on the right ventral abdominal wall. Computed tomographic angiography revealed a dissection of the aortic wall between the left subclavian artery and the brachiocephalic trunk with subsequent thrombus formation. A shunt between the right internal thoracic, cranial and caudal epigastric arteries to preserve blood flow to the pelvic limbs was visualized. Necropsy was declined by the owner. This is the first case report describing the formation of a unilateral vascular shunt following a thoracic aortic occlusion, which presented as exercise-induced paraparesis. PMID:24602076

Cornelis, I; Bosmans, T; Doom, M; Binst, D; Van der Vekens, E; Kromhout, K; Cornillie, P; Van Ham, L

2014-06-01

3

Unilateral Hemiparesis with Thoracic Epidural in an Adolescent  

PubMed Central

Objective. Unilateral sensory and motor blockade is known to occur with epidural anesthesia but is rarely reported in children. The differential diagnosis should include the presence of a midline epidural septum. Case Report. We describe a case of a 16-year-old adolescent who developed repeated complete unilateral extensive epidural sensory and motor blockade with Horner's syndrome after thoracic epidural catheter placement. This unusual presentation of complete hemibody neural blockade has not been reported in the pediatric population. Maneuvers to improve contralateral uniform neural blockade were unsuccessful. An epidurogram was performed to ascertain the correct location of the catheter within the epidural space and presence of sagittal compartmentalization. Conclusion. This case report highlights a less frequently reported reason for unilateral sensory and motor blockade with epidural anesthesia in children. The presence of a midline epidural septum should be considered in the differential diagnosis of unilateral epidural blockade.

Tassone, Rosalie F.; Seefelder, Christian; Sethna, Navil F.

2012-01-01

4

Compensatory hypertrophy of the contralateral kidney after unilateral ureteral ligation  

PubMed Central

1. The ligation of one ureter is accompanied by compensatory hypertrophy of the contralateral kidney. 2. The rate of growth of the contralateral kidney after ligation of the opposite ureter is similar to that observed after unilateral nephrectomy. 3. Ligation of one ureter produced ipsilateral hydronephrosis. 4. The development of hydronephrosis was accompanied by a marked increase of DNA, suggesting hyperplasia, and of the rate of anaerobic glycolysis, while the rate of oxygen uptake decreased, especially in the cortex. 5. During compensatory hypertrophy of the contralateral kidney, after ligation of the opposite ureter, there were increases of RNA/DNA ratios and of oxygen uptake, especially marked in the cortex, and in every respect similar to those observed after unilateral nephrectomy. 6. Ligation of one ureter resulted in an increase of glomerular filtration rate of the contralateral kidney similar to that observed after unilateral nephrectomy. 7. The mechanisms of contralateral renal hypertrophy after ligation of one ureter and after unilateral nephrectomy are discussed. It is suggested that in both cases the prime mover to compensatory hypertrophy is the increase of glomerular filtration rate.

Dicker, S. E.; Shirley, D. G.

1972-01-01

5

Thoracic outlet syndrome: another cause for unilateral palmar hyperhidrosis  

Microsoft Academic Search

One of the most important therapeutic goal in hyperhidrosis treatment is to seek for the underlying cause and to tailor the\\u000a treatment accordingly. A detailed history and prompt physical examination are needed to clarify the etiological factor. In\\u000a this study, we report a 34-year-old woman with a diagnosis of thoracic outlet syndrome presenting with complaints of pain,\\u000a numbness, and fatigue

Oya Özdemir; Levent Özçakar

2007-01-01

6

Autosomal dominant polycystic kidney disease with ectopic unilateral multicystic dysplastic kidney  

PubMed Central

Background Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder. In most cases, ADPKD similarly affects bilateral kidneys. Case presentation Among the 605 ADPKD patients that were followed up by our center, we identified two male patients with unilateral ADPKD. The cases were remarkable because the patients also had ectopia and multicystic dysplasia in the contralateral kidney, which are generally sporadic disease conditions. Both patients tested positive for polycystic kidney disease 1 mutation, but negative for hepatocyte nuclear factor 1 beta mutation. Moreover, the deterioration of their kidney function seemed to be quicker than their age- and sex-matched controls and siblings. Both patients had started a long-term hemodialysis in their 40s. Conclusion Anatomical and genetic abnormality in patients with ADPKD may be more frequent and complex than previously believed. The compensatory capacity in patients with ADPKD is fragile, and missing one kidney could accelerate the deterioration of renal function.

2013-01-01

7

Kidney growth and renal function in unilateral multicystic dysplastic kidney disease.  

PubMed

The natural history of multicystic dysplastic kidney (MCDK) is not well established. We analyzed kidney growth and renal function in 33 children with prenatally diagnosed unilateral MCDK in a long-term study. The mean observation period was 4.9 years with a range of 1-11.6 years. Abnormalities of the contralateral kidney were found in 10 of 33 patients (30%): ureteropelvic junction obstruction (5), ureterovesical junction obstruction (2), and vesicoureteral reflux (3). In 6 children the dysplastic kidney had been removed. Complete involution was observed in 48% and a decrease of size in 33% of 27 dysplastic kidneys. At the time of last examination, 27 of 29 children showed a volume of the contralateral kidney above the normal range (>145%). Hypertrophy of the contralateral kidney, defined as kidney length above 2 standard deviation scores (SDS), was seen in 24% of 33 children at birth, thus showing that hypertrophy of the contralateral kidney starts in utero and continues throughout childhood. The extent of contralateral hypertrophy was independent of associated abnormalities in this study. Mean creatinine was increased in the whole group (mean +1.13 SDS). Calculated creatinine clearance in 21 patients over 2 years was within normal limits, with a median of 102 ml/min per 1.73 m2 (range 84-143). Based on the results of this and previous studies, nephrectomy cannot be recommended in typical cases, but a regular follow-up of these patients seems necessary. PMID:9761356

John, U; Rudnik-Schöneborn, S; Zerres, K; Misselwitz, J

1998-09-01

8

Long-term risk of chronic kidney disease in unilateral multicystic dysplastic kidney.  

PubMed

The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/creatinine ratio, estimated GFR (eGFR), blood pressure, surgical intervention, renal length and abnormalities of the contralateral kidney, and the involution rate. There was a predominance of left-sided MCDK. Diagnosis was made prenatally in 86.7%. Contralateral abnormalities included vesicoureteral reflux (16.8%), UPJ obstruction (4.1%), and megaureter (2.4%). Complete involution of MCDK occurred within 5 years in 60%. Compensatory hypertrophy of the contralateral kidney to >97% occurred in 74.1%. Nephrectomy was performed in 19.8%. There was an increased risk of chronic kidney disease (CKD) stage ? 2, and hypertension in those with contralateral abnormalities (p<0.0001; p<0.001 respectively). In those without contralateral abnormalities, hyperfiltration with mean eGFR of 149 ± 13 ml/min/1.73 m(2) was seen in 32% and proteinuria in 9.8%. There was a significantly inverse relationship between proteinuria and eGFR (p<0.0001). In conclusion, children with contralateral abnormalities are at risk for developing decreased kidney function, whereas a substantial number of patients with no obvious contralateral abnormalities have markers of renal injury. Therefore, systematic follow-up of all patients is recommended. PMID:21240528

Mansoor, Omer; Chandar, Jayanthi; Rodriguez, Maria M; Abitbol, Carolyn L; Seeherunvong, Wacharee; Freundlich, Michael; Zilleruelo, Gaston

2011-04-01

9

Effect of Preoperative Thoracic Duct Drainage on Canine Kidney Transplantation  

PubMed Central

Chronic drainage of the thoracic duct to the esophagus was developed in dogs, and its efficacy in immunomodulation was tested using kidney transplantation. Compared to 9.7 days in the control, the mean animal survival was prolonged to 9.9 days, 17.8 days, and 18.5 days when TDD was applied preoperatively for 3 weeks, 6 weeks, and 9 weeks, respectively. Prolongation was significant after 6 weeks. Patency of the fistula was 93.5, 80.4, and 76.1% at respective weeks. Number of peripheral T-lymphocytes determined by a new monoclonal antibody diminished after 3 weeks. All animals were in normal health, requiring no special care for fluid, electrolyte, or protein replacement.

FUNAKOSHI, YOICHI; CARRIERI, GIUSEPPE; YAGIHASHI, ATSUHITO; IWAKI, YUICHI; TODO, SATORU; STARZL, THOMAS E.

2010-01-01

10

[Hydrometrocolpos causing progressive unilateral hydronephrosis in agenesis of the contralateral kidney].  

PubMed

The number of detected fetal abnormalities in our prenatal diagnostic division illustrate the high frequency of fetal urogenitaly malformations. Moreover, we report on a case of hydrometrocolpos caused by sinus urogenitalis which effects a progressive unilateral hydronephrosis by agenesia of the contralateral kidney. The progressive hydronephrosis in conclusion leads to a preterm induction of labor in fetoprotective intension. PMID:11127774

Müller, R; Döhmann, S

2000-01-01

11

Management and etiology of the unilateral multicystic dysplastic kidney: a review  

Microsoft Academic Search

In children, unilateral multicystic dysplastic kidney (MCDK) is one of the most frequently identified urinary tract abnormalities.\\u000a A variety of proposed etiologies has been associated with the underlying pathogenesis of MCDK. These include genetic disturbances,\\u000a teratogens, in utero infections, and urinary outflow tract obstruction. From 5–43% of the time, MCDK has associated genito-urinary\\u000a anomalies, both structural and functional in nature.

David S. Hains; Carlton M. Bates; Susan Ingraham; Andrew L. Schwaderer

2009-01-01

12

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

PubMed

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

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

2010-09-01

13

Dyserythropoiesis in a child with pyruvate kinase deficiency and coexistent unilateral multicystic dysplastic kidney.  

PubMed

Pyruvate kinase (PK) deficiency is the commonest enzyme deficiency in the glycolytic pathway leading to hemolytic anemia secondary to decreased Adenosine Triphosphate (ATP) synthesis in the red cells. synthesis. PK deficiency due to mutations in the PKLR (1q21) gene leads to highly variable clinical presentation ranging from severe fetal anemia to well compensated anemia in adults. We describe dyserythropoiesis in the bone marrow of a child with transfusion dependent anemia and unilateral multicystic dysplastic kidney (MCDK) mimicking Congenital Dyserythropoietic Anemia type I (CDA type I). Persistently low erythrocyte PK levels and double heterozygous mutations present in the PKLR gene confirmed the diagnosis of PK deficiency. Pediatr Blood Cancer 2014; 61:1463-1465. © 2014 Wiley Periodicals, Inc. PMID:24481986

Haija, Marwa Abu El; Qian, You-Wen; Muthukumar, Akila

2014-08-01

14

Unilateral hypoplastic kidney - a novel highly penetrant feature of familial juvenile hyperuricaemic nephropathy  

PubMed Central

Background Familial juvenile hyperuricaemic nephropathy is a rare inherited nephropathy with genetic heterogeneity. Categorised by genetic defect, mutations in uromodulin (UMOD), renin (REN) and hepatocyte nuclear factor-1? (HNF-1?) genes as well as linkage to chromosome 2p22.1-21 have previously been identified. Knowledge of the genetics of this phenotype has provided important clues to developmental pathways in the kidney. Case presentation We report a novel phenotype, with the typical features of hyperuricemia and renal deterioration, but with the additional unexpected feature of unilateral renal hypoplasia. Mutation analyses of the existing known genes and genetic loci were negative indicating a new monogenic cause. Interestingly two cousins of the index case did not share the latter feature, suggesting a modifier gene effect. Conclusion Unilateral renal hypo/aplasia is usually sporadic and relatively common, with no genetic cause to date identified. This reported pedigree reveals the possibility that a new, unknown renal developmental gene may be implicated in the FJHN phenotype.

2014-01-01

15

Time Course of Cytokine mRNA Expression in Kidneys of Rats with Unilateral Ureteral Obstruction  

Microsoft Academic Search

The development of renal interstitial fibrosis (RIF) is related to the expression and excretion of cytokines and growth factors. Thus, we investigated the time course of mRNA expression of cytokines known as causative factors in a model of RIF in rats before and on day 10 after unilateral ureteral obstruction (UUO), when first signs of fibrosis were visible, as well

Manfred Sommer; Ulrike Eismann; Winnie Deuther-Conrad; Thoralf Wendt; Thomas Mohorn; Reinhard Fünfstück; Günter Stein

2000-01-01

16

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.

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

2012-01-01

17

Management of an unusual case of atypical Mayer–Rokitansky–Kuster–Hauser syndrome, with unilateral gonadal agenesis, solitary ectopic pelvic kidney, and pelviureteric junction obstruction  

Microsoft Academic Search

Congenital absence of uterus and vagina, Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome, is mullerian agenesis and is the\\u000a second most frequent cause of primary amenorrhea. Only atypical form of MRKH (type B) is associated with renal skeletal and\\u000a ovarian abnormalities. We report the management of an unusual case of atypical MRKH, unilateral gonadal agenesis, and solitary\\u000a ectopic pelvic kidney with pelviureteric junction obstruction

Anup Kumar; Saurabh Mishra; P. N. Dogra

2007-01-01

18

Bone marrow derived cells and reactive oxygen species in hypertrophy of contralateral kidney of transient unilateral renal ischemia-induced mouse.  

PubMed

Renal mass reduction, such as unilateral nephrectomy induces a compensatory hypertrophy of remaining renal mass in response to overload induced by reduction of functional renal parenchyma. In our recent study, we observed that the recovery of ischemic injured kidney following transient unilateral renal ischemia took longer time than that following transient bilateral renal ischemia, indicating that non-damaged kidney may affect the damaged kidney and vice versa. Here, we investigated whether transient and partial renal parenchymal injury by transient unilateral renal ischemia (UI) results in the hypertrophy of its contralateral kidney (CLK) and reactive oxygen species is associated with the hypertrophy. Thirty minutes of UI resulted in gradual increase in CLK weight over time. UI increased superoxide formation, but not lipid peroxidation in the CLK. After UI, a significant increase in the number of NADPH oxidase 2 (Nox2)-expressing cells and the level of Nox2 expression in the CLK was observed. In parallel with the increases in Nox2-expressing cells in CLKs, infiltration of bone marrow-derived cells (BMDC) increased in CLK. Treatments with Mn(III) Tetrakis(1-methyl-4-pyridyl) porphyrin (MnTMPyP, a superoxide dismutase (SOD) mimetic) and apocynin (a putative NADPH oxidase inhibitor) inhibited UI-induced hypertrophy of CLK along with reduction in Nox2-positive cell, BMDC, amount of Nox2 expression and superoxide formation. In conclusion, transient and partial renal mass reduction by UI resulted in the hypertrophy of CLK through increased ROS formation by infiltrated cells into the interstitium of CLK. PMID:22512329

Jang, Hee-Seong; Kim, Jee In; Kim, Jinu; Na, Yeon Kyung; Park, Jeen-Woo; Park, Kwon Moo

2012-07-01

19

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

20

Unilateral demodicidosis.  

PubMed

A 45-year-old man presented with a unilateral, papulopustular, rosacealike, chronic dermatitis which involved the left portion of the forehead and the eyelids unilaterally. Many Demodex mites were found in the follicles of the affected area. Topical crotamiton cleared the lesions after an unsuccessful trial with oral metronidazole. This observation provides further evidence that demodicidosis is a condition distinct from common rosacea. PMID:9649702

Pallotta, S; Cianchini, G; Martelloni, E; Ferranti, G; Girardelli, C R; Di Lella, G; Puddu, P

1998-01-01

21

Associations of atherosclerosis in the descending thoracic aorta on CTA with arterial stiffness and chronic kidney disease in asymptomatic patients with diabetes mellitus.  

PubMed

The relation between atherosclerosis in the descending thoracic aortic (DTA), arterial stiffness and chronic kidney disease (CKD) in patients with diabetes mellitus (DM) remains unclear. The current aim was to evaluate associations of DTA atherosclerosis with arterial stiffness and parameters of CKD in asymptomatic patients with DM. A total of 213 asymptomatic patients with diabetes (mean age 52 years, 56 % men) underwent cardiovascular risk assessment including multi-slice computed tomography (for non-invasive coronary angiography, from which DTA atherosclerosis can be derived), non-invasive assessment of arterial stiffness with applanation tonometry and assessment of renal function. Measurements of DTA atherosclerosis included assessment of DTA thickening and calcium score. Arterial stiffness was determined by the carotid-femoral pulse wave velocity (PWV), parameters of CKD included estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR). DTA atherosclerosis was present in 180 (84 %) patients. Patients with DTA atherosclerosis had increased arterial stiffness, lower eGFR and higher UACR values. After multivariate correction, DTA calcium score was independently associated with PWV (? = 0.18, p = 0.04). Furthermore, both DTA maximal wall thickness and DTA calcium score were independently associated with eGFR (? = -7.37, p < 0.001 and ? = -1.99, p < 0.003, respectively), but not with UACR. The increase in arterial stiffness by atherosclerosis seemed to be mediated by arterial calcification, while the DTA calcium score was independently associated with arterial stiffness, but not DTA maximal wall thickness. Furthermore, parameters of CKD in patients with DM had a distinct relationship with DTA atherosclerosis: DTA atherosclerosis was associated with eGFR but not with UACR. PMID:24816844

Roos, Cornelis J; Delgado, V; de Koning, Eelco J; Rabelink, Ton J; Jukema, J Wouter; Bax, Jeroen J; Scholte, Arthur J

2014-08-01

22

Thoracic trauma.  

PubMed

The physiologic equilibrium of chest injury patients is frequently precarious, and mild stress during examination and treatment may precipitate acute decompensation and death. This is particularly true with the respiratory system, where the normally large respiratory reserve capacity may be rapidly lost. Accurate assessment of the nature of the thoracic injury and the severity of that injury must be determined in order to formulate a therapeutic plan. Many thoracic injuries, such as pneumothorax, pulmonary contusions, or rib fractures, will be self-limiting. Other conditions must be recognized for their potentially lethal nature and dealt with aggressively, and these include cardiac tamponade, tension pneumothorax, and esophageal perforation. By performing a systematic evaluation of the patient and confirming or denying the presence of all possible types of thoracic injury, the veterinarian may avoid overtreatment of self-limiting lesions and recognize and aggressively treat those with potentially fatal outcomes. PMID:6970443

Kagan, K G

1980-08-01

23

Unilateral true hypertrophy of the calf muscle  

Microsoft Academic Search

Sirs: A 47-year-old man had unilateral hypertrophy of the left calf muscle, which was first noted 4 years ago. His parents were cousins. The left calf muscle was larger than the right by 6 cm in maximum circumference. Neurological e xaminations showed absence of right ankle jerk and atrophy of the right gastrocnemius. X-rays of cervical, thoracic and lumbosacral spines

S. Ono; Y. Kuroiwa; H. Miyajima; Y. Nishimura; N. Honda

1985-01-01

24

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 ...

25

Increased incidence of thoracic wall deformities in related Bengal kittens.  

PubMed

Clinical records made during routine vaccinations were compared between populations of domestic shorthair cats and Bengal kittens. An increased incidence (12/244) of thoracic wall deformity was detected amongst the Bengal kittens. Deformities detected were: pectus excavatum (five), unilateral thoracic wall concavity (six) and scoliosis (one). Five-generation pedigrees were analysed for the affected kittens that showed a high degree of common ancestry indicating the likelihood of a familial cause. PMID:22311892

Charlesworth, Timothy M; Sturgess, Christopher P

2012-06-01

26

Unilateral pedal lymphangiography with non-contrast computerized tomography is valuable in the location and treatment decision of idiopathic chylothorax  

PubMed Central

Purpose To identify the value of unilateral pedal lymphangiography (LAG) with non-contrast CT in the location and treatment decision of idiopathic chylothorax after failure of thoracic duct ligation. Materials and Methods Twenty four patients aged 9–84 year old (median 44 yr) who had idiopathic chylothorax were involved, and unilateral pedal LAG with non-contrast CT was performed in every patient. All patients failed to previous right supra-diaphragmatic thoracic duct ligation. Results The amount of iodized oil used was 6–14 ml with no related complications. LAG demonstrated 8 patients with thoracic duct leaks and 10 patients with leaks elsewhere, but no visible chylous leak in 6 patients. Ligation of thoracic duct was performed as the primary treatment in all 8 cases as having thoracic duct leakage and cured 7(87.5%) patients. For 8 patients not having thoracic duct lesion under LAG, the successful rate of thoracic duct ligation was 25% (2 out of 8 patients), which was significantly lower than patients due to thoracic duct lesions (P?=?0.02). Meanwhile, non-operative therapy had significantly higher successful rate (87.5% vs 25%, P?=?0.02). Conclusions Unilateral pedal LAG with non-contrast CT could identify the causes and locate the leaks of idiopathic chylothorax in 75% of patients after failure of thoracic duct ligation. Two thirds of patients were found not to have thoracic duct leakage and would be better managed by non-operative treatment.

2014-01-01

27

Thoracic outlet anatomy (image)  

MedlinePLUS

Thoracic outlet syndrome is a rare condition that occurs when there is compression of vessels and nerves in the ... in the last 3 fingers and inner forearm. Thoracic outlet syndrome is usually treated with physical therapy which helps ...

28

Thoracic outlet syndrome  

MedlinePLUS

Thoracic outlet syndrome is a rare condition that involves pain in the neck and shoulder, numbness and tingling of ... with the nerves cause almost all cases of thoracic outlet syndrome. Pressure may happen if you have: An extra ...

29

Society of Thoracic Surgeons  

MedlinePLUS

... Adult Cardiac Surgery Valve Repair/Replacement Surgery Lung/Thoracic Surgery Esophageal Surgery Aneurysm Surgery Arrhythmia Surgery Other Types ... Adjustment? Valve Repair/Replacement Surgery Esophageal Surgery Lung/Thoracic Surgery Aneurysm Surgery Arrhythmia Surgery Other Types of Surgery ...

30

Unilateral pudendal neuropathy  

Microsoft Academic Search

PURPOSE: Obstetric trauma and excessive defecatory straining with perineal descent may lead to pudendal neuropathy with bilateral increase in pudendal nerve terminal motor latencies (PNTML). We have frequently observed unilateral prolongation of PNTML. Diagnostic and therapeutic implications of unilateral pudendal neuropathy are discussed. METHODS: Records of 174 patients referred to pelvic floor laboratory for anorectal manometry and PNTML testing were

Yash P. Sangwan; John A. Coller; Richard C. Barrett; John J. Murray; Patricia L. Roberts; David J. Schoetz

1996-01-01

31

Thoracic paravertebral block performance for modified radical mastectomy with axillary dissection in a patient with severe chronic obstructive pulmonary disease.  

PubMed

We present the case of an 86-year-old patient with severe chronic obstructive pulmonary disease undergoing modified radical mastectomy with axillary dissection by thoracic paravertebral block (PVB). Use of thoracic PVB provided hemodynamic and respiratory stability, excellent unilateral anesthesia and high patient satisfaction. PMID:21341151

Akçaboy, Erkan Yavuz; Akçaboy, Zeynep Nur; Sönmez, Bilgehan; Gö?ü?, Nermin

2011-01-01

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

Kidney removal  

MedlinePLUS

... Simple nephrectomy; Radical nephrectomy; Open nephrectomy; Laparoscopic nephrectomy; Partial nephrectomy ... be recommended for: Someone donating a kidney Birth defects Kidney cancer A kidney damaged by infection, kidney ...

34

Abnormal Growth and Clonal Proliferation of Fibroblasts in an Animal Model of Unilateral Ureteral Obstruction  

Microsoft Academic Search

The time course for the development of renal interstitial fibrosis (RIF) in rats between days 5 and 25 after unilateral ureteral obstruction (UUO) was studied. In kidneys with UUO under histological examination, an interstitial fibrosis was observed after more than 10 days with progression up to day 25. On day 5, collagen peptidase activity in homogenates of UUO kidneys was

Manfred Sommer; Robby Schaller; Reinhard Fünfstück; Adalbert Bohle; Frank D. Böhmer; Gerhard A. Müller; Günter Stein

1999-01-01

35

The influnce of volume expanison on renal function after relief of chronic unilateral ureteral obstruction  

Microsoft Academic Search

The influence of volume expansion on renal function after relief of unilateral chronic ureteral obstruction. Postobstructive diuresis was not observed after the relief of chronic partial ureteral obstruction in hydropenic rats with an intact contralateral kidney. However, when such animals were volume-expanded with hypotonic saline solution after relief of obstruction, urine flow from the hydronephrotic kidney was double that of

Douglas R Wilson

1974-01-01

36

Thoracic Outlet Syndrome  

MedlinePLUS

Thoracic outlet syndrome (TOS) causes pain in the arm, shoulder, and neck. It happens when the nerves or blood vessels just below your ... vein is compressed, your hand might be sensitive to cold, or turn pale or bluish. Your arm ...

37

Nephron sparing surgery for unilateral non-syndromic wilms tumor.  

PubMed

The initial therapy for most children with Wilms tumor is radical nephrectomy. Several centers, have explored the role of Nephron-sparing procedures in children with unilateral non-syndromic Wilms tumors. The primary motivation for this approach is concern about late occurrence of renal dysfunction after unilateral nephrectomy. We report our experience with NSS for unilateral non-syndromic Wilms tumor. We reviewed the records of nine children who underwent nephron sparing surgery for unilateral, nonsyndromic Wilms tumors at our Hospital between Jan 2000 through Jan 2012. All patients received preoperative chemotherapy with two drugs (vincristine, and dactinomycin) following which patients underwent tumor resection. Subsequent renal function was assessed by estimating the glomerular filtration rate using creatinine clearance and other measures of long-term renal function assessment included blood pressure evaluation and the need for antihypertensive medications. During the study period nine children with a mean age 19.66?±?14.37 months at diagnosis and presenting with unilateral non-syndromic Wilms tumor underwent nephron sparing surgery. In all the nine children, the renal plane of resection showed a tumor-free margin. Post-operative serum creatinine repeated at the end of 3 months revealed maintenance of good renal function in all children. Nephron sparing surgery is a safe and effective option in the management of early stage unilateral non-syndromic Wilms tumor. It is oncologically safe and does not lead to decreased local tumor control. The function of the kidney remnant remains rather well. PMID:24669161

Nerli, R B; Pujar, V C; Hiremath, M B; Jali, S M; Joshi, S S; Hiremath, S C; Guntaka, A K

2014-03-01

38

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.

39

Thoracic outlet syndromes  

Microsoft Academic Search

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

Harold C. Urschel; Amit Patel

2003-01-01

40

Unilateral demodectic rosacea.  

PubMed

A unilateral rosacea-like chronic dermatitis of the right side of the face was shown to harbor innumerable Demodex folliculorum and D. brevis. Treatment with oral metronidazole suppressed the dermatitis but did not significantly reduce the Demodex population. Treatment with topical crotamiton eliminated the Demodex and was curative. These observations support the view that D. folliculorum and D. brevis may be pathogenic when they are present in extremely large numbers. PMID:2523912

Shelley, W B; Shelley, E D; Burmeister, V

1989-05-01

41

Thoracic spine CT scan  

MedlinePLUS

... type of contrast given into a vein contains iodine. If a person with an iodine allergy is given this type of contrast, nausea ... steroids before the test. The kidneys help remove iodine out of the body. Those with kidney disease ...

42

An experimental model for unilateral ischaemic acute renal failure in dog  

Microsoft Academic Search

We determined the recovery of unilateral ischaemic acute renal failure in both ischaemic and non-ischaemic canine kidneys.\\u000a Split renal clearance studies were repeated for seven weeks after 90 minutes of left renal artery clamping. Clearance of inulin\\u000a and para-aminohippuric acid in the ischaemic kidneys dropped significantly for 3 weeks. Significant increase of the fractional\\u000a excretion of sodium in those kidneys

Y. Tsuji; A. Ariyoshi; K. Sakamoto

1993-01-01

43

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

44

Profiles of Spinal Cord Tumors Removed through a Unilateral Hemilaminectomy  

PubMed Central

Objective To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. Methods From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. Results The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. Conclusion Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.

Yeo, Dong Kyu; Park, Kwan Woong; Shin, Dong Seong; Kim, Bum Tae; Shin, Won Han

2011-01-01

45

Bilateral thoracic paravertebral block: potential and practice.  

PubMed

Paravertebral nerve blocks (PVBs) can provide excellent intraoperative anaesthetic and postoperative analgesic conditions with less adverse effects and fewer contraindications than central neural blocks. Most published data are related to unilateral PVB, but its potential as a bilateral technique has been demonstrated. Bilateral PVB has been used successfully in the thoracic, abdominal, and pelvic regions, sometimes obviating the need for general anaesthesia. We have reviewed the use of bilateral PVB in association with surgery and chronic pain therapy. This covers 12 published studies with a total of 538 patients, and with varied methods and outcome measures. Despite the need for relatively large doses of local anaesthetics, there are no reports of systemic toxicity. The incidence of complications such as pneumothorax and hypotension is low. More studies on the use of bilateral PVB are required. PMID:21233114

Richardson, J; Lönnqvist, P A; Naja, Z

2011-02-01

46

Kidney Facts  

MedlinePLUS

... Lung Kidney Pancreas Kidney/Pancreas Liver Intestine Kidney Facts The kidneys are a pair of reddish-brown ... Camps for kids Contacting my donor family Data Facts about living donation Financing a transplant Matching organs ...

47

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

48

European perspectives in thoracic surgery  

PubMed Central

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.

2014-01-01

49

A case of unilateral dysmenorrhea  

PubMed Central

Unilateral dysmenorrhea in an adolescent may be associated with uterine malformation. Relevant investigations in suspected cases and timely intervention can prevent future complications in such cases. Here, we present a case of unicornuate uterus with rudimentary horn in an adolescent complaining of unilateral dysmenorrhea.

Borah, Tulon; Das, Ananya; Panda, Subrat; Singh, Santa

2010-01-01

50

[Chronic thoracic pain].  

PubMed

The etiological diagnosis of chronic thoracic pain is wide, from benign mechanical disorders to tumors. Reaching the exact diagnosis in often time consuming. Despite the availability of new techniques of imagery, a meticulous clinical history and physical examination remain mandatory. They will lead the exploration. Idiopathic intercostal neuralgia does not exist. PMID:12143167

Malaise, M G; Kaye, O; Radermecker, M; Duysinx, B; Hustinx, R; Hermans, G; de Leval, L

2002-05-01

51

Thoracic Outlet Syndrome  

MedlinePLUS

... doesn't relieve pain, a doctor may recommend thoracic outlet decompression surgery to release or remove the structures causing compression ... Vascular TOS, and true neurogenic TOS often require surgery to relieve pressure on the ... Outlet Syndrome Clinical Trials At NIH Clinical Center ...

52

American Thoracic Society  

MedlinePLUS

... the ATS has grown to tackle asthma, COPD, lung cancer, sepsis, acute respiratory distress, and sleep apnea, among other diseases. The Society’s 15,000 members and its patient arm, the ATS Public Advisory Roundtable, believe that disease is vanquished faster when ... Copyright © 2014 American Thoracic Society · Privacy Statement

53

Posterior thoracic osteotomies.  

PubMed

Spinal osteotomies are used to treat partially flexible and fixed deformities. Fixed thoracic spinal deformities have been traditionally treated with anterior release and posterior correction with fusion. In recent decades, it has been shown that posterior-only osteotomies might be sufficient to achieve proper deformity correction with lower complication rates than with combined anterior and posterior procedures. Different types of osteotomies have been described to treat spinal deformities through a single posterior approach. These include posterior column osteotomies such as the Smith-Petersen osteotomy and the Ponte osteotomy, and three-column osteotomies such as the pedicle subtraction osteotomy, the posterior vertebral column resection and the posterior vertebral column decancellation. In general, three-column osteotomies are most commonly performed in the lumbar spine, where the vast majority of reports have focused on. They can also be performed in the thoracic spine in the setting of rigid thoracic deformity. A progressive increase in complications has been reported with more aggressive osteotomies. The aim of this article was to describe the most common posterior spinal osteotomies used to treat adult thoracic spinal deformities, with special emphasis on the technical aspects, complications and outcomes, based on current publications and European Spine Study Group (ESSG) data. PMID:24781506

Pellisé, Ferran; Vila-Casademunt, Alba

2014-07-01

54

The Valiant thoracic endograft.  

PubMed

Thoracic aortic pathology is common, but conventional surgery carries with it a significant risk of mortality and morbidity due to thoracotomy, extensive surgical dissection, partial left lung collapse, proximal aortic cross-clamping and blood loss necessary for open thoracic aortic replacement. Endovascular techniques have the potential to remove much of this harm. However, endograft delivery to the thoracic aorta brings its own challenges; the graft and delivery system must be conformable to follow the aortic arch, flexible to track through tortuous calcified vessels, of low profile for access through the iliac arteries, and deploy accurately and with minimal force to avoid accidental side branch occlusion. The endoprosthesis must also prove to be durable. This paper reviews current indications for thoracic aortic stent grafts and the properties of an ideal endograft for deployment in the arch and descending aorta. The Medtronic Valiant TM endoprosthesis with Xcelerant TM Delivery System is a third-generation system designed specifically for the treatment of a range of thoracic aortic pathologies, including but not exclusively, aneurysms and dissections. The design of the Valiant endoprosthesis and delivery system are described in detail, and compared to the second-generation Talent system. Our early experience of using Valiant in 28 patients with a range of pathologies is described. The graft achieved an initial technical success in 93% and was easy to position and deploy. Long-term data is now required; the Virtue Registry is a prospective multicenter European registry collecting clinical and health economics data on Valiant in the management of aortic dissections. PMID:16760863

Brooks, M; Loftus, I; Morgan, R; Thompson, M

2006-06-01

55

Minimally Invasive Thoracic Surgery  

PubMed Central

To reduce the risk, trauma, and expense of intrathoracic surgical treatments, minimally invasive procedures performed with the assistance of fiberoptic video technology have been developed for thoracic and bronchial surgeries. The surgical treatment of nearly every intrathoracic condition can benefit from a video-assisted approach performed through a few small incisions. Video-assisted thoracoscopic and rigid-bronchoscopic surgery have improved the results of thoracic procedures by decreasing postoperative pain and speeding the return to normal activity. From January 1992 to February 2000, 185 patients underwent 189 video-assisted thoracoscopic procedures in Ochsner Foundation Hospital for various conditions with good results; only 18 procedures (9.5%) required conversion to open thoracotomy. Video-assisted rigid bronchoscopic surgery has been helpful in managing tracheobronchial conditions and complications following lung transplantation. Ninety-nine patients with bronchial complications following lung transplantation and 20 patients with tracheobronchial conditions not related to transplantation have undergone therapeutic techniques involving video-assisted rigid bronchoscopy.

McFadden, P. Michael

2000-01-01

56

[Cervicomediastinal and thoracic goiters].  

PubMed

Between 1950 and 1979 approximately 2400 patients with thyropathies have been operated in the I-st Surgical Clinic of Jassy. Of these 100 had cervico-mediastinal goiters, of which 79 were of the plunging cervico-mediastinal type, 18 were of the mediastino-cervical type and 3 were mediastinal goiters. The surgical treatment was applied in 98 patients, cervicotomy being sufficient to relieve the symptoms in 92 of the cases. The mixed approach (cervicosternotomy, or cervico-thoracic approach) were necessary in 5 cases, and the thoracic approach was selected in one case with an independent posterior mediastinal goiter. The immediate postoperative evolution, as well as the late evolution was good in most of the cases. Postoperative mortality was of 2 percent. PMID:6454906

Laz?r, C; Chifan, M; Strat, V; Diaconescu, M R; Niculescu, D; Tîrcoveanu, E; Luchian, S; Veisa, E; Boingeanu, A; Cotea, E; Georgescu, S; Rusu, O; Pencea, V; Baran, T; Dobrescu, G

1981-01-01

57

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

58

Analgesic efficacy and safety of thoracic paravertebral and epidural analgesia for thoracic surgery: a systematic review and meta-analysis.  

PubMed

Though once considered the gold standard, epidural anaesthesia has complications that may be significant and include hypotension, urinary retention, partial or patchy block and, in rare cases, devastating neurological injuries also. Paravertebral block (PVB) is an alternative technique for unilateral surgical procedures like thoracotomy, which may offer similar analgesic effectiveness and a more favourable side-effect profile than epidural analgesia. This systematic review and meta-analysis of published randomized clinical trials aims to compare thoracic paravertebral with thoracic epidural analgesia (TEA) in thoracotomy for lung surgery. Five hundred and forty-one patients from 12 clinical trials have been included in this systematic review and meta-analysis. We found that visual analogue scale (VAS) scores at rest and during activity/coughing at 4-8, 24 and 48 h postoperatively were similar in both the PVB and TEA groups. Considering studies not included in the previous meta-analysis, a VAS score on activity at 48 h is significantly better in the PVB group (mean difference 0.40 cm; 95% confidence interval [95% CI] 0.77, 0.02; Mantel-Haenszel (M-H) fixed). Hypotension (odds ratio 0.13; 95% CI 0.06, 0.31; M-H fixed) and urinary retention are more common in the epidural analgesia group. So, we conclude that thoracic PVB may be as effective as thoracic epidural analgesia for post-thoracotomy pain relief and is also associated with fewer complications. PMID:24488821

Baidya, Dalim Kumar; Khanna, Puneet; Maitra, Souvik

2014-05-01

59

Multilevel somatosensory evoked potentials (SEPs) for spinal cord monitoring in descending thoracic and thoraco-abdominal aortic surgery  

Microsoft Academic Search

The usefulness of somatosensory evoked potential (SEP) monitoring as a means of preventing paraplegia in descending aorta surgery was evaluated in 47 consecutive cases operated on for isthmic (14 cases), thoracic (22 cases), or thoraco-abdominal (11 cases) repair. An aortic dissection was found in 11 cases (acute in 6). Somatosensory evoked potentials were obtained by unilateral left and right posterior

A. Matta; R VERHELST; J RUBAY; G KHOURY; R DION

1996-01-01

60

Unilateral adrenal hemorrhage after total knee arthroplasty.  

PubMed

Adrenal hemorrhage (AH) is a rare but serious condition that is often diagnosed at autopsy. Unilateral adrenal hemorrhage (UAH) in adults is extremely rare and is often due to trauma or anticoagulation or is associated with systemic illness. The case of a 73-year-old man who was diagnosed with UAH several days after an elective total knee replacement is presented. The patient had an uncomplicated procedure and he was treated postoperatively with a prophylactic dose of subcutaneous low-molecular- weight heparin and compression sleeves. On postoperative day 8, he reported sustained epigastric and midback pain at the lower thoracic level. He had a temperature of 38.5°C. On clinical examination, the patient expressed only mild tenderness at the lumbar area. Abdominal ultrasound and computed tomography (CT) scan were inconclusive. On postoperative day 13, the patient experienced no pain but remained febrile. An abdominal CT scan revealed a high-density mass on the left adrenal gland suggestive of hemorrhage. The subcutaneous heparin as well as the antimicrobial therapy was discontinued and a serum cortisol examination was done. Serum levels were within normal values in the evening and the morning. On postoperative day 16, all laboratory values returned to normal and the patient was discharged in excellent condition. Patients who have abdominal pain, hypotension, or both soon after initiation of anticoagulation or patients who experience abdominal pain, fever, nausea, or confusion postoperatively should be screened for AH. PMID:24810831

Chronopoulos, Efstathios; Nikolaou, Vassilios S; Masgala, Aikaterini; Kaspiris, Angelos; Babis, Georgios C

2014-05-01

61

Computed tomography of unilateral hematometrocolpos.  

PubMed

A 14-year-old girl presented with urinary retention and a pelvic mass. Computed tomography revealed a uterus didelphys with a unilateral right moderate hematometra and a large hematocolpos. PMID:3366982

Fields, S I; Katz, S; Beyth, Y

1988-01-01

62

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

63

The Congenital and Acquired Solitary Kidney  

PubMed Central

The embryonic insult that results in unilateral renal agenesis may involve not only the ureteral bud but also other mesonephric duct derivatives, including the seminal vesicles, vas deferens, and epididymis; in the female with a solitary kidney, müllerian duct anomalies frequently occur. Normal renal development depends upon a normal ureteral bud, which undergoes orderly branching and penetrates the metanephric blastema at about the fifth week of gestation. Ureteral and kidney development are thought to be interdependent, and when there is failure of the ureteral bud to form or absence of the nephrogenic ridge, the kidney does not develop normally. Unilateral renal agenesis is compatible with normal longevity and does not predispose the contralateral kidney to greater-than-normal risk; nevertheless, patients should have annual surveillance, including a blood pressure measurement, serum creatinine if not initially normal, and urinalysis to detect proteinuria. Removal of one kidney leads to structural and functional changes by the remaining kidney, including increased filtration of the remaining glomeruli. These functional changes have generally been considered beneficial because they mitigate the reduction in the total glomerular filtration rate that would otherwise occur, but experimental evidence suggests that these changes may have an adverse effect on the remaining kidney. Clinical evidence shows that these changes do not lead to renal deterioration in kidney donors because the renal function of kidney donors is well preserved in over 20 years of follow-up after donor nephrectomy.

Shapiro, Ellen; Goldfarb, David A; Ritchey, Michael L

2003-01-01

64

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 ...

65

Serum Interleukin6, Interleukin8, Hepatocyte Growth Factor, and Nitric Oxide Changes during Thoracic Surgery  

Microsoft Academic Search

. Thoracic surgery creates a different environment from abdominal surgery in respect to the surgical procedure with\\u000a pulmonary collapse under unilateral ventilation. Definitive evidence whether surgical trauma during thoracotomy is involved\\u000a in postoperative pulmonary infections has not been clearly demonstrated. The objectives of this study were to evaluate the\\u000a influence of surgical trauma during thoracotomy on postoperative infections and to

Takatsugu Yamada; Michiyoshi Hisanaga; Yoshiyuki Nakajima; Hiromichi Kanehiro; Akihiko Watanabe; Takao Ohyama; Kazushi Nishio; Masayuki Sho; Mitsuo Nagao; Kouji Matsushima; Hiroshige Nakano

1998-01-01

66

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.

Feizzadeh Kerigh, Behzad; Maddah, Ghodratolah

2013-01-01

67

Kidney Problems  

MedlinePLUS

... a machine to wash out your blood). How Common are Kidney Diseases? Electrolyte imbalances, such as sodium concentrations that are ... of adults with high blood pressure. Chronic kidney disease is very common in older people. Slowing or preventing its progress ...

68

Kidney biopsy  

MedlinePLUS

... order a kidney biopsy if you have: An unexplained drop in kidney function Blood in the urine that does not go away Protein in the urine found during a urine test A transplanted kidney, which needs to be monitored using a biopsy

69

Thoracic Anesthesia in the Elderly  

Microsoft Academic Search

\\u000a Projections are that the elderly population is increasing by as much as 50% by 2025. Increasing age and noncardiac thoracic\\u000a surgery are both risk factors for increased morbidity and mortality. Thoracic anesthesia for the elderly patient requires\\u000a optimization of medical status when possible. Coexisting diseases and subtle changes in physiology can affect the stability\\u000a of an anesthetic. Drug metabolism may

Anne C. Kolker

70

Interhemispheric Control of Unilateral Movement  

PubMed Central

To perform strictly unilateral movements, the brain relies on a large cortical and subcortical network. This network enables healthy adults to perform complex unimanual motor tasks without the activation of contralateral muscles. However, mirror movements (involuntary movements in ipsilateral muscles that can accompany intended movement) can be seen in healthy individuals if a task is complex or fatiguing, in childhood, and with increasing age. Lateralization of movement depends on complex interhemispheric communication between cortical (i.e., dorsal premotor cortex, supplementary motor area) and subcortical (i.e., basal ganglia) areas, probably coursing through the corpus callosum (CC). Here, we will focus on transcallosal interhemispheric inhibition (IHI), which facilitates complex unilateral movements and appears to play an important role in handedness, pathological conditions such as Parkinson's disease, and stroke recovery.

Beaule, Vincent; Tremblay, Sara; Theoret, Hugo

2012-01-01

71

Managing advanced unilateral pseudoexfoliative glaucoma.  

PubMed

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

Marques, André

2014-01-01

72

Audiological assessment of unilateral deafness.  

PubMed

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

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

2001-01-01

73

Acute minor thoracic injuries  

PubMed Central

ABSTRACT OBJECTIVE To review the management and follow-up of patients with minor thoracic injuries (MTI) treated by emergency or primary care physicians. DESIGN A multicentre, retrospective study. SETTING Three university-affiliated emergency departments of the metropolitan region of Quebec city, Que. PARTICIPANTS Patients older than 16 years of age with suspected or proven rib fractures following traumatic events. MAIN OUTCOME MEASURES Differences in admission and discharge proportions and disposition management following MTI. RESULTS Four hundred and forty-seven charts were analyzed. Only 23 patients (5.2%) were admitted during the study period. Admission and discharge proportions were significantly different among the 3 surveyed hospitals, ranging from 1.3% to 15.2% (P ? .001). There were no recommendations of follow-up noted in most (53.5%) of the charts and there were no differences after hospital stratification. Planned follow-up visits were scheduled for 5.7% of discharged patients. Being older than 65 years of age or having multiple rib fractures had no influence on management and follow-up recommendations. Eighty-two patients (18.6%) had unplanned follow-up visits in the emergency department, with inadequate pain relief as the principal reason for consultation (56.1%). There was no significant difference after stratification for age and type of analgesia. Other clinically significant delayed complications were recorded in 8.3% of all MTI patients. CONCLUSION The proportion of patients admitted for rib fractures was lower than the expected 25%, based on previous publications, and varied across surveyed hospitals. A very low proportion of patients was offered planned follow-up visits or even any follow-up recommendations in view of possible delayed complications and disabilities. Further studies are needed to identify predictors of delayed MTI complications and enhance appropriate use of follow-up resources.

Shields, Jean-Francois; Emond, Marcel; Guimont, Chantal; Pigeon, Dany

2010-01-01

74

Isolated Unilateral Absence of the Left Pulmonary Artery: A Case Report  

PubMed Central

We report the case of a 37-year-old man with isolated unilateral absence of the pulmonary artery (UAPA), which was diagnosed upon the occurrence of hemoptysis. Plain chest radiography demonstrated decreased left pulmonary volume. Computed tomography of the chest revealed the complete absence of the left pulmonary artery. Angiography revealed marked dilation of the left bronchial artery, inferior phrenic artery, internal thoracic artery, and the arterial branches of the thyrocervical trunk. These arteries were considered as collateral circulation to the left lung. In cases with UAPA, collateral circulation should be evaluated by angiography to obtain useful information for treatment.

2014-01-01

75

Genetics Home Reference: Asphyxiating thoracic dystrophy  

MedlinePLUS

... people with asphyxiating thoracic dystrophy live only into infancy or early childhood. Some people with asphyxiating thoracic ... individuals may live into adolescence or adulthood. After infancy, people with this condition often develop life-threatening ...

76

Genetics of thoracic aortic aneurysms.  

PubMed

Understanding of the genetics of thoracic aortic aneurysm is increasing rapidly, due to discovery of novel genes, better definition of the phenotypes associated with mutations in a given gene and better understanding of the pathophysiology. Beyond Marfan syndrome, usually related to mutation in FBN1, mutations have been reported in TGFBR1, TGFBR2, ACTA2, MYH11, and SMAD3. All are transmitted as dominant autosomal traits. The importance of genetics in patients with bicuspid aortic valve and non-syndromic thoracic aortic aneurysm is also increasingly recognized. The following is a review of the phenotypes associated with the different mutations and the clinical consequences of this recent information. PMID:22415348

Jondeau, Guillaume; Boileau, Catherine

2012-06-01

77

Opposing changes in thoracic and abdominal aortic biomechanical properties in rodent models of vascular calcification and hypertension.  

PubMed

This study investigated the effects of hypertension on regional aortic biomechanical and structural properties in three rat models of vascular calcification: the hypertensive Lewis polycystic kidney (LPK; n = 13) model of chronic kidney disease, spontaneously hypertensive rats (SHRs; n = 12), and calcification in normotensive Lewis rats induced by vitamin D3 and nicotine (VDN; n = 8). Lewis and Wistar-Kyoto rats were controls. Thoracic and abdominal aortic stiffness parameters were assessed by tensile testing. In models where aortic stiffness differences compared with controls existed in both thoracic and abdominal segments, an additional cohort was quantified by histology for thoracic and abdominal aortic elastin, collagen, and calcification. LPK and VDN animals had higher thoracic breaking strain than control animals (P < 0.01 and P < 0.05, respectively) and lower energy absorption within the tensile curve of the abdominal aorta (P < 0.05). SHRs had a lower abdominal breaking stress than Wistar-Kyoto rats. LPK and VDN rats had more elastic lamellae fractures than control rats (P < 0.001), which were associated with calcium deposition (thoracic R = 0.37, P = 0.048; abdominal: R = 0.40, P = 0.046). LPK rats had higher nuclear density than control rats (P < 0.01), which was also evident in the thoracic but not abdominal aorta of VDN rats (P < 0.01). In LPK and VDN rats, but not in control rats, media thickness and cross-sectional area were at least 1.5-fold greater in thoracic than abdominal regions. The calcification models chronic kidney disease and induced calcification in normotension caused differences in regional aortic stiffness not seen in a genetic form of hypertension. Detrimental abdominal aortic remodeling but lower stiffness in the thoracic aorta with disease indicates possible compensatory mechanisms in the proximal aorta. PMID:24838503

Ameer, Omar Z; Salman, Ibrahim M; Avolio, Alberto P; Phillips, Jacqueline K; Butlin, Mark

2014-07-15

78

Thoracic venous congestion caused by thoracic disc herniation  

PubMed Central

We present what is to our knowledge the first reported case of thoracic disc herniation leading to venous congestive myelopathy (VCM), which was clinically and radiographically suggestive of Foix–Alajouanine syndrome (angiodysgenetic necrotizing myelopathy). In addition, we review current concepts in evaluating the etiology of VCM and discuss indications for surgery.

Roger, Eric P; Chamczuk, Andrea J; Hagan, Marygrace C

2013-01-01

79

Thoracoscopic ligation of the thoracic duct.  

PubMed

Traditional operative management for chylous drainage refractory to conservative therapy is thoracic duct ligation via right open thoracotomy. This case report details successful thoracoscopic ligation of the thoracic duct for a chylous leak following a left neck dissection. Since the thoracoscopic approach is less morbid than open thoracotomy, early operative management is recommended for thoracic duct injuries. PMID:8424235

Kent, R B; Pinson, T W

1993-01-01

80

Thoracoscopic ligation of the thoracic duct  

Microsoft Academic Search

Traditional operative management for chylous drainage refractory to conservative therapy is thoracic duct ligation via right open thoracotomy. This case report details successful thoracoscopic ligation of the thoracic duct for a chylous leak following a left neck dissection. Since the thoracoscopic approach is less morbid than open thoracotomy, early operative management is recommended for thoracic duct injuries.

Raleigh B. Kent; Terry W. Pinson

1993-01-01

81

Trauma-Related Thoracic Outlet Syndrome  

Microsoft Academic Search

181 patients treated for thoracic outlet syndrome by first rib resection were reviewed. 88 (49%) indicated a single traumatic event which precipitated the thoracic outlet syndrome. 79% of patients with a history of a single traumatic episode had good to excellent results after first rib resection. A separate group of 18 patients developed work-related thoracic outlet syndrome due to repetitive

D. W. ELLISON; V. E. WOOD

1994-01-01

82

Thoracic aortic emergencies: impact of endovascular surgery  

Microsoft Academic Search

BackgroundConventional surgery for thoracic aortic emergencies, such as contained or free rupture of thoracic aortic aneurysms, acute type B dissections, and traumatic rupture of the thoracic aorta, is frequently associated with a high rate of mortality and morbidity. To obviate this risk, endovascular surgery is considered to be a valid alternative procedure.

Gabriele Iannelli; Federico Piscione; Luigi Di Tommaso; Mario Monaco; Massimo Chiariello; Nicola Spampinato

2004-01-01

83

Thoracic myelopathy caused by calcified ligamentum flavum  

Microsoft Academic Search

Calcification of the ligamentum flavum is a rare manifestation of the calcium pyrophosphate dihydrate deposition disease (CPPD).In CPPD deposition disease, spinal involvement is rare. Until now, thoracic spine CPPD causing thoracic cord compression has been reported in only sporadic cases. We report a new case of thoracic calcification of the ligamentum flavum. In our case, similar to the other reported

Marco Giulioni; Mino Zucchelli; Stefania Damiani

2007-01-01

84

Your Kidneys  

MedlinePLUS

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

85

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.

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

2012-01-01

86

Distinct Role of Intrarenal Cyclooxygenase1\\/2 in Chronic Unilateral Renal Ischemia  

Microsoft Academic Search

Aims: The role of cyclooxygenase (COX)-1\\/2-induced prostaglandins (PG) in unilateral chronic renal ischemia of anesthetized dogs was examined. Methods: Ischemic kidneys were established by reducing renal blood flow of left renal artery to 10% of baseline with an adjustable clip. After 4 weeks, changes in intrarenal contents of PGE2\\/PGI2 and angiotensin (Ang) II were evaluated with renal microdialysis and biopsy.

Hirobumi Tokuyama; Koichi Hayashi; Hiroto Matsuda; Eiji Kubota; Masanori Honda; Ken Okubo; Yuri Ozawa; Takao Saruta

2002-01-01

87

Thoracic Malignancy Steering Committee Roster  

Cancer.gov

Thoracic Malignancy Steering Committee Roster Co-chairs A. William Blackstock, M.D.Wake Forest School of MedicineWinston-Salem, NC David H. Harpole Jr., M.D.Duke UniversityDurham, NC Members Mark A. Socinski, M.D. [Chair Emeritus]University of PittsburghPittsburgh,

88

Management of thoracic outlet syndrome  

Microsoft Academic Search

The experience with transaxillary first-rib resection and scalenotomy reported herein shows these to be safe and effective treatments for patients with thoracic outlet syndrome (TOS). The former operation usually offers the best possibility for complete resection of the first rib and all anomalous congenital bands, and is curative in most cases, regardless of the mechanism of the compression. Scalenotomy, or

K. Takagi; M. Yamaga; K. Morisawa; T. Kitagawa

1987-01-01

89

Immunological aspects of acute ureteral obstruction: Immune cell infiltrate in the kidney  

Microsoft Academic Search

Immunological aspects of acute ureteral obstruction: Immune cell infiltrate in the kidney. Kidneys from rats subjected to bilateral ureteral obstruction (BUO), unilateral ureteral obstruction (UUO) and UUO with subsequent release were analyzed for leukocyte infiltration. A time-dependent influx of leukocytes, predominantly macrophages and suppressor T lymphocytes, occurred in both the cortex and medulla following obstruction, and disappeared with release of

George F Schreiner; Kevin P G Harris; Mabel L Purkerson; Saulo Klahr

1988-01-01

90

Navigating the thoracic inlet in children.  

PubMed

Though various approaches to the thoracic inlet have been described in adults, currently no guidelines exist in children. Reports in the literature of resection of thoracic inlet tumours in children are only anecdotal. Literature was reviewed to assess the various described approaches with reference to suitability in children. Experience with a 3.5-year-old boy having a thoracic inlet ganglioneuroma, using the anterior cervico-thoracic trap door incision demonstrated excellent access and minimal morbidity. We recommend the trap door incision as the preferable route for exploring thoracic inlet tumours in children. PMID:17973113

Jones, Vinci S; Pitkin, John

2008-04-01

91

Unilateral Eyelid Ptosis and a Red Eye  

Microsoft Academic Search

A 56-year-old woman presented with a unilateral ptosis induced by a nonembedded soft contact lens of approximately 2 years’ duration. The unilateral ptosis most likely resulted form localized inflammation and the physical presence of the soft contact lens. The patient’s symptoms resolved completely after double lid eversion and lens removal

Niraj P Patel; Peter J Savino

1998-01-01

92

Unilateral eyelid ptosis and a red eye.  

PubMed

A 56-year-old woman presented with a unilateral ptosis induced by a nonembedded soft contact lens of approximately 2 years' duration. The unilateral ptosis most likely resulted form localized inflammation and the physical presence of the soft contact lens. The patient's symptoms resolved completely after double lid eversion and lens removal. PMID:9763140

Patel, N P; Savino, P J; Weinberg, D A

1998-01-01

93

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

94

An unusual cause of unilateral facial pain.  

PubMed

Cardiac pain that is referred to the face is a common symptom in patients with angina pectoris, but unilateral facial pain referred from a non-ischaemic cardiac source is rare. We report a case of unilateral facial pain that occurred in relation to a large pericardial effusion and which resolved on drainage of the effusion. PMID:10563079

Chukwuemeka, A O; John, L C

1999-06-01

95

Kidney disease - resources  

MedlinePLUS

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

96

Aneurysm of common and internal iliac arteries 14 years after kidney transplantation--a case report.  

PubMed

The aim of the report is to present successful surgical treatment of aneurysm of common iliac artery (CIA) and internal iliac artery (IIA) in a kidney transplant patient. The aneurysm of CIA and IIA, causing arterial hypertension, was diagnosed and treated surgically in a 47-year-old male patient, who had received a cadaveric kidney transplant 14 years before. During the operation, consisting of aorto-femoral unilateral grafting with transplanted kidney artery implantation to the side of the graft and aneurysm exclusion, cold Ringer's lactate perfusion was used to protect the transplanted kidney. There were no postoperative complications; the transplant function is satisfactory in a follow-up of 44 months. Exclusion of CIA and IIA aneurysm using aorto-femoral unilateral graft is an effective way of treatment in kidney transplant patients. The cold perfusion during aortic cross-clamping is an effective and simple method of transplanted kidney protection. PMID:12221900

Ga?azka, Zbigniew; Swiercz, Pawe?; Rongies, Witold; Szmidt, Jacek

2002-01-01

97

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 ...

98

Regional Anaesthesia for Thoracic Surgery  

Microsoft Academic Search

Thoracic operations include a wide variety of different operative approaches. Most procedures are performed under general\\u000a anaesthesia since controlled one-lung ventilation (OLV) is usually required. Analgesia strategies involving regional anaesthetic\\u000a techniques are usually instituted prior to or during surgery in anticipation of postoperative pain. Different incisions are\\u000a associated with varying degrees of postoperative pain. In general, the lateral thoracotomy incision

J. B. Brodsky

99

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.

Ghods, A. J.

2010-01-01

100

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

PubMed Central

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

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

2014-01-01

101

Differences in quantitative urine composition in stone-forming versus unaffected mate kidneys  

PubMed Central

Objectives Many patients present with bilateral stones. There is a unique group of patients, however, that presents with stones exclusively on one side. We hypothesize that in such situations, 24-hour urine collections may not reveal specific defects on the affected stone-bearing kidney. We therefore evaluated selective 12-hour urine collections after percutaneous nephrolithotomy (PNL) to help determine if there is differential renal excretion. Methods We collected urine specimens from patients with nephrolithiasis who underwent unilateral PNL. Urine samples were collected and analyzed from nephrostomy tubes, representing the affected kidneys, and from Foley bladder catheters, representing the contralateral mate kidney. Results Thirty-one patients were studied (14 with unilateral nephrolithiasis and 17 with bilateral). Treated kidneys from patients with unilateral nephrolithiasis displayed lowered urine excretion of uric acid, sodium, chloride, calcium, and total osmoles when compared to patients with bilateral nephrolithiasis. Stone size and length of procedure were not predictive of urine composition after PNL. Conclusions Treated kidneys from patients with a history of unilateral stone disease revealed marked differences in urine excretion compared to those with bilateral nephrolithiasis after unilateral PNL. These findings could be secondary to the surgical insult, urinary stone disease, or could be a responsible factor for stone pathogenesis.

Eisenberg, Michael L; Lee, Keith L; Breyer, Benjamin N; Walsh, Thomas J; Konety, Badrinath R; Stoller, Marshall L

2009-01-01

102

Kidney cancer.  

PubMed

Over 65,000 Americans are diagnosed with kidney cancer each year and nearly 13,000 die of this disease. Kidney cancer is not a single disease, it is made up of a number of different types of cancer, each with a different histology, a different clinical course, responding differently to therapy and caused by a different gene. Study of the 13 genes that are known to cause kidney cancer has led to the understanding that kidney cancer is a metabolic disease. Recent discoveries of chromatin remodeling/histone modifying genes, such as PBRM1 and SETD2, have opened up new areas of intense interest in the study of the fundamental genetic basis of kidney cancer. New approaches to immunotherapy with agents such as the CTLA4 inhibitor, ipilumumab, have opened up promising new directions for clinical trials. A number of new agents targeting of VEGF receptor signaling and the mTOR pathways as well as novel approaches targeting HIF2 will hopefully provide the foundation for the development of effective forms of therapy for this disease. PMID:23218074

Linehan, W Marston; Rathmell, W Kimryn

2012-01-01

103

[Unilateral choanal atresia: a missed diagnosis].  

PubMed

Bilateral choanal atresia is a congenital anomaly usually diagnosed at birth. In contrast, unilateral atresia causes variable degrees of nasal stuffiness and discharge that might mask the diagnosis and delay the proper treatment. We present five cases of unilateral atresia in which the correct diagnosis was delayed and erroneous treatments were instituted--two adults who had undergone unnecessary septal and turbinate surgery, two older children who were treated medically and one patient who was treated for epiphora. Insufficient awareness of this entity occurring in adults and older children and other possible causes of diagnostic error are discussed. A unilateral mucoid or watery rhinorrhea and obstruction, that lasts from early childhood without evidence of sinusitis and not responding to any medical treatment, should alert the physician to consider unilateral atresia and to perform endoscopic and computed tomography examinations at an early age. Careful interpretation of the computed tomography scan including the axial planes is required. PMID:23367729

Joshua, Ben-Zion; Gluck, Ofer; Puterman, Mark

2012-11-01

104

36 CFR 223.236 - Unilateral termination.  

Code of Federal Regulations, 2013 CFR

36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01...Unilateral termination. 223.236 Section 223.236 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL...

2013-07-01

105

[Thoracic nocardiosis with thoracic manifestations in two immunocompetent patients].  

PubMed

Nocardiosis is a rare infectious disease caused by bacteria of the genus nocardia, which causes considerable morbidity and mortality. We report two unusual cases of nocardiosis in young, immunocompetent patients; the first case involved a nocardia farcinica pulmonary and chest-wall infection, while the second was an anterior mediastinal nocardia asiaticum infection mimicking a mediastinal tumor. These cases reflect the need for a broad differential diagnosis during exploration of thoracic findings, white the potentially ambiguous presentation of nocardiosis must be considered. PMID:24482994

Faber, Dan Levy; Lapidot, Moshe; Neuberger, Ami; Orlovsky, Michael; Best, Lael Anson; Kremer, Ran

2013-12-01

106

A Case of Unilateral Auditory Neuropathy  

Microsoft Academic Search

We report a case of unilateral auditory neuropathy (AN) showing improvement in both pure tone hearing (PTA) and speech discrimination\\u000a scores (SDS) with time. Some reports have documented the findings of auditory examination in patients with unilateral AN,\\u000a and a few reports have documented the time-related changes in these findings for the same patients. A 3-year-old Japanese\\u000a boy was referred

Yuki Saito; Mitsuya Suzuki; Tunemasa Sato

107

Management of unilateral vocal fold paralysis.  

PubMed

Management of unilateral vocal fold paralysis continues to generate controversy. Polytetrafluoroethylene (Teflon) injection remains the most popular procedure for medialization; however, there are problems involved with its use. Endoscopic assessment of patients treated with medialization laryngoplasty revealed a normal mucosal wave form in contrast to the stiff vocal fold observed with Teflon injection. Medialization laryngoplasty is also considered a reversible procedure. Based on these findings, medialization laryngoplasty should be considered the procedure of choice for unilateral vocal fold paralysis. PMID:7733552

Odland, R M; Wigley, T; Rice, R

1995-05-01

108

Multiple-injection thoracic paravertebral block as an alternative to general anaesthesia for elective breast surgeries: A randomised controlled trial  

PubMed Central

Background: General anaesthesia is currently the conventional technique used for surgical treatment of breast lump. Paravertebral block (PVB) has been used for unilateral procedures such as thoracotomy, breast surgery, chest wall trauma, hernia repair or renal surgery. Methods: We compared unilateral thoracic PVB with general anaesthesia (GA) in 60 consenting ASA physical status I and II female patients of 18–65 years age, scheduled for unilateral breast surgery. Patients were randomly assigned into two groups, P (n=30) or G (n=30), to receive either PVB or GA, respectively. Results: The average time to first post-operative analgesic requirement at visual analogue scale score?4 (primary endpoint) was significantly longer in group P (303.97±76.08 min) than in group G (131.33±21.36 min), P<0.001. Total rescue analgesic (Inj. Tramadol) requirements in the first 24 h were 105.17±20.46 mg in group P as compared with 176.67±52.08 mg in group G (P<0.001). Significant post-operative nausea and vomiting requiring treatment occurred in three (10.34%) patients of the PVB group and eight (26.67%) patients in the GA group. Conclusion: The present study concludes that unilateral PVB is more efficacious in terms of prolonging post-operative analgesia and reducing morbidities in patients undergoing elective unilateral breast surgery.

Das, Sabyasachi; Bhattacharya, Pradipta; Mandal, Mohan Chandra; Mukhopadhyay, Soma; Basu, Sekhar Ranjan; Mandol, Bikas Kusum

2012-01-01

109

Diagnosis, treatment, and complications of thoracic outlet syndrome  

Microsoft Academic Search

:   New concepts regarding the diagnosis and treatment of thoracic outlet syndrome, double crush syndrome related to thoracic\\u000a outlet syndrome, and minor traumatic dystrophy related to thoracic outlet syndrome are explained.

Masataka Abe; Katsuaki Ichinohe; Jun Nishida

1999-01-01

110

Organ Facts: Kidney / Pancreas  

MedlinePLUS

... Kidney Pancreas Kidney/Pancreas Liver Intestine Kidney/Pancreas Facts The kidneys are a pair of reddish-brown ... Camps for kids Contacting my donor family Data Facts about living donation Financing a transplant Matching organs ...

111

Age Thresholds for Increased Mortality of Predominant Crash Induced Thoracic Injuries  

PubMed Central

The growing elderly population in the United States presents medical, engineering, and legislative challenges in trauma management and prevention. Thoracic injury incidence, morbidity, and mortality increase with age. This study utilized receiver-operator characteristic analysis to identify the quantitative age thresholds associated with increased mortality in common isolated types of thoracic injuries from motor vehicle crashes (MVCs). The subject pool consisted of patients with a single AIS 3+ thorax injury and no injury greater than AIS 2 in any other body region. A logistic regression algorithm was performed for each injury to estimate an age threshold that maximally discriminates between survivors and fatalities. The c-index describing discrimination of the model and odds ratio describing the increased mortality risk associated with being older than the age threshold were computed. Twelve leading thoracic injuries were included in the study: unilateral and bilateral pulmonary contusion (AIS 3/4), hemo/pneumothorax, rib fractures with and without hemo/pneumothorax (AIS 3/4), bilateral flail chest, and thoracic penetrating injury with hemo/pneumothorax. Results are consistent with the traditional age threshold of 55, but were injury-specific. Pulmonary contusions had lower age thresholds compared to rib fractures. Higher severity pulmonary contusions and rib fractures had lower age thresholds compared to lower severity injuries. This study presents the first quantitatively estimated mortality age thresholds for common isolated thoracic injuries. This data provides information on the ideal ‘threshold’ beyond which age becomes an important factor to patient survival. Results of the current study and future work could lead to improvements in automotive safety design and regulation, automated crash notification, and hospital treatment for the elderly.

Stitzel, Joel D.; Kilgo, Patrick D.; Weaver, Ashley A.; Martin, R. Shayn; Loftis, Kathryn L.; Meredith, J. Wayne

2010-01-01

112

[Anesthetic management of a 1.7-kg premature infant undergoing thoracoscopic thoracic duct ligation].  

PubMed

We report successful anesthetic management of a 1.7-kg premature infant who underwent thoracoscopic thoracic duct ligation under general anesthesia. She was born at 30 weeks gestation with birth weight of 1,546 g and was suffering from respiratory distress due to persistent right chylothorax for two months after birth. Chest tube drainage, fasting and intrapleural fibrin glue did not reduce her right chylothorax. Thoracoscopic thoracic duct ligation was scheduled on her day 64 under general anesthesia. The tracheal tube end was placed in the midtrachea and carbon dioxide was insufflated into the operative side of the thorax. During thoracoscopy her left lung was ventilated with the right lung pressed with spatulaes, but her respiratory status did not deteriorate so much despite of unilateral ventilation. We speculate that, due to massive right chylothorax, her pulmonary blood flow had already shifted to the left lung, therefore intraoperative substantial left unilateral lung ventilation exerted minimal effect on her respiratory status. The operation was successful and she was weaned from the ventilator on the following day. PMID:16231777

Watanabe, Kanako; Miyamoto, Yoshikazu; Kinouchi, Keiko; Kagawa, Kiyokazu; Kitamura, Seiji

2005-10-01

113

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.

Epstein, Nancy E.

2014-01-01

114

Medicolegal Corner: When minimally invasive thoracic surgery leads to paraplegia.  

PubMed

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

115

Thoracic duct tributaries from intrathoracic organs  

Microsoft Academic Search

Background. The thoracic duct (TD) is the main collecting vessel of the lymphatic system. Little is known about the intrathoracic tributaries of the TD, which are named intercostal, mediastinal, and bronchomediastinal trunks. The purpose of the study was to identify the lymphatic tributaries from intrathoracic organs to the thoracic duct.Methods. The study was performed on 530 adult cadavers. The lymphatics

Marc Riquet; Françoise Le Pimpec Barthes; Redha Souilamas; Geneviève Hidden

2002-01-01

116

Rehabilitation of patients with thoracic outlet syndrome  

Microsoft Academic Search

A series of physical therapy protocols is proposed for patients with thoracic outlet syndrome. The anatomic findings dictating certain physical therapeutic approaches are outlined. General principles of physical therapy that stem from these findings are suggested, and a specific protocol for the physical therapy regimen is given. An appropriate physical therapy program for thoracic outlet syndrome patients with symptoms of

Christian Aligne; Xavier Barral

1992-01-01

117

Thoracic disc herniation: a diagnostic challenge  

Microsoft Academic Search

An unusual case of lower thoracic disc herniation combined with shoulder pain is presented in this case report, A literature search showed that shoulder pain associated with a lower thoracic disc herniation has not yet been reported. An acromioplasty for chronic impingement syndrome was performed to relieve the patient's shoulder symptoms. An unsatisfactory outcome plus a progressive but incomplete paraplegia,

Axel Wilke; Udo Wolf; Peter Lageard; Peter Griss

2000-01-01

118

A patient with thoracic intradural disc herniation  

Microsoft Academic Search

Intradural disc herniation is a rare disease that occurs most commonly in the lumbar region, while fewer than 5% occur in the thoracic and cervical regions. We report a patient with thoracic intradural disc herniation at T12–L1 who presented with radiculopathy and motor weakness. The preoperative MRI did not demonstrate an intradural lesion, and it was identified intraoperatively by inspection

Robert G. Whitmore; Brian J. Williams; Bradley C. Lega; Matthew R. Sanborn; Paul Marcotte

119

Ultrasound imaging of the thoracic epidural space  

Microsoft Academic Search

Background and Objectives: In thoracic epidural anesthesia, the [ldquo ]loss of resistance[rdquo ] technique is the standard technique for the identification of the epidural space (EDS), the feedback to the operator is often solely tactile. Our aim was to establish ultrasonography for the prepuncture demonstration of the anatomic structures surrounding the thoracic EDS and to evaluate its precision and imaging

T. Grau; R. W. Leipold; S. Delorme; E. Martin; J. Motsch

2002-01-01

120

Minimally invasive treatment of thoracic disc herniations.  

PubMed

In the past, treatment of thoracic disc herniations has not been seen as a minimally invasive procedure. This article evaluates the progression of minimally invasive techniques for the treatment of thoracic disc herniations. Discussion of the advantages and disadvantages of the approaches is noted so that surgeons may consider them while incorporating these techniques in their practice. PMID:24703446

Snyder, Laura A; Smith, Zachary A; Dahdaleh, Nader S; Fessler, Richard G

2014-04-01

121

Thoracic Duct Tributaries From Intrathoracic Organs  

Microsoft Academic Search

Background. The thoracic duct (TD) is the main collect- ing vessel of the lymphatic system. Little is known about the intrathoracic tributaries of the TD, which are named intercostal, mediastinal, and bronchomediastinal trunks. The purpose of the study was to identify the lymphatic tributaries from intrathoracic organs to the thoracic duct. Methods. The study was performed on 530 adult cadav-

Marc Riquet; Redha Souilamas; Françoise Le Pimpec Barthes; Geneviève Hidden

2010-01-01

122

The Thoracic Shape of Hominoids  

PubMed Central

In hominoids, the broad thorax has been assumed to contribute to their dorsal scapular position. However, the dorsoventral diameter of their cranial thorax was found in one study to be longer in hominoids. There are insufficient data on thoracic shape to explain the relationship between broad thorax and dorsal scapular position. The current study presents data on multilevel cross-sectional shape and volume distribution in a range of primates. Biplanar radiographs of intact fluid-preserved cadavers were taken to measure the cross-sectional shape of ten equally spaced levels through the sternum (called decisternal levels) and the relative volume of the nine intervening thoracic segments. It was found that the cranial thorax of hominoids is larger and broader (except in the first two decisternal levels) than that of other primates. The cranial thorax of hominoids has a longer dorsoventral diameter because the increase in dorsoventral diameter caused by the increase in the volume of the cranial thorax overcompensates for the decrease caused by the broadening of the cranial thorax. The larger and broader cranial thorax in hominoids can be explained as a locomotor adaptation for scapular gliding and as a respiratory adaptation for reducing the effects of orthograde posture on ventilation-perfusion inequality.

Chan, Lap Ki

2014-01-01

123

Exposure latitude for thoracic radiography  

NASA Astrophysics Data System (ADS)

The chest PA examination is one of the single most performed studies in radiology today. It can provide a wealth of information in a single examination. As in many other areas of radiology there is a conflict between high contrast, which enables subtle structures to be visualized, and wide latitude, which allows all areas of interest in the chest to be displayed in a single image. In order to optimize the design of receptor systems it is useful to establish and understand the latitude required for thoracic imaging. We have measured the distributions of x-ray transmittance within the lungs, heart, and abdomen for a population of 868 out-patients. The measurements were made with a resolution element approximately 2 X 2 cm, at a single x-ray beam quality, and with a low-scatter slot-beam geometry. Under these conditions, the required receptor latitude for capturing each area of interest in the thorax is derived as a function of body habitus. To capture all three regions the required receptor latitude for the PA examination varies from 11:1 to 81:1 with increasing patient size. The implications of these results for thoracic image-receptor design is discussed.

van Metter, Richard L.; Lemmers, Henri E.; Schultze Kool, Leo J.

1992-06-01

124

[A case of mediastinal thoracic duct cyst].  

PubMed

This is a rare case of thoracic duct cyst in 34-year-old woman. She complained of a left supraclavicular mass and admitted our hospital. A clinical examinations were all within normal limit. The chest X-ray and the magnetic resonance imaging examinations revealed a round tumor 65 x 40 mm in diameter with clear margin located at the left upper mediastinum. The slightly dilated thoracic duct was connected to the tumor. The left supraclavicular vein was compressed by the tumor. The cystectomy was performed under diagnosis of thoracic duct cyst by Trap door method on September, 17, 1999. Macroscopically, thin-capsulated elastic soft tumor contained chyle, and it was connected to the thoracic duct and the left jugular vein. The histological diagnosis was thoracic duct cyst. The postoperative course was uneventful, and the patient was discharged 9 days after operation. The patient remains disease-free at 8 months after the operation. PMID:11712381

Suzuki, Y; Ogawa, N; Mukai, K; Ishiwa, N

2001-11-01

125

Effect of Unilateral Ureteral Obstruction and Anti-angiotensin II Treatment on Renal Tubule and Interstitial Cell Apoptosis in Rats  

PubMed Central

Aim To investigate the effects of angiotensin-converting enzyme inhibitor (cilazapril) and angiotensin II type I receptor antagonist (losartan) on tubular and interstitial cell apoptosis and caspase-3 activity in rats with obstructive nephropathy after unilateral ureteral obstruction. Methods Rats with unilateral obstructive nephropathy and sham-operated rats were treated with cilazapril, losartan, or the vehicle (water). Tubular and interstitial cell apoptosis was detected morphologically on hematoxylin and eosin-stained renal specimens and by the terminal deoxynucleotidyl transferase-mediated nick end-labeling. Caspase-3 activity in whole-kidney tissue homogenates was measured colorimetrically. Results After unilateral ureter ligation, there was a significant increase in the number of apoptotic tubular and interstitial cells in the obstructed kidney (13.17?±?8.73 vs 3.00?±?4.53 cells per high power field; P?=?0.049 and 6.33?±?3.27 vs 2.00?±?2.35 cells per high power field; P?=?0.036 vs sham-operated rats, 10 days after ligation). In rats with unilateral obstructive nephropathy, neither cilazapril nor losartan had an effect on tubular cell apoptosis. However, cilazapril caused a significant increase in the number of renal apoptotic interstitial cells (7.00?±?9.74 vs 0.8?±?1.41 cells per high power field, P?=?0.019). Caspase-3 activity was not significantly different in rats with unilateral obstructive nephropathy than in sham-operated rats. Conclusion Rats with unilateral obstructive nephropathy had increased apoptosis of tubular and interstitial cells in comparison with sham-operated rats. Neither cilazapril nor losartan had an effect on tubular cell apoptosis, and cilazapril even increased interstitial cell apoptosis.

Radovic, Nikola; Cuzic, Snjezana; Knotek, Mladen

2008-01-01

126

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.

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

2014-01-01

127

Migraine with benign episodic unilateral mydriasis  

PubMed Central

Pupil asymmetry or anisocoria can have benign or malignant causes, and be categorized as acute or chronic. It can also be a normal finding in about 20% of cases. Benign episodic unilateral mydriasis is an isolated benign cause of intermittent pupil asymmetry. The exact pathophysiology is not always understood. According to one hypothesis, it is due to discordance between the sympathetic and parasympathetic systems. It is occasionally seen in patients with migraine. Some authors consider it a limited form of ophthalmoplegic migraine. We report a case of benign episodic unilateral mydriasis diagnosed in a 30-year-old lady with a history of migraine who had extensive negative neurological evaluation.

Skeik, Nedaa; Jabr, Fadi I

2011-01-01

128

Migraine with benign episodic unilateral mydriasis.  

PubMed

Pupil asymmetry or anisocoria can have benign or malignant causes, and be categorized as acute or chronic. It can also be a normal finding in about 20% of cases. Benign episodic unilateral mydriasis is an isolated benign cause of intermittent pupil asymmetry. The exact pathophysiology is not always understood. According to one hypothesis, it is due to discordance between the sympathetic and parasympathetic systems. It is occasionally seen in patients with migraine. Some authors consider it a limited form of ophthalmoplegic migraine. We report a case of benign episodic unilateral mydriasis diagnosed in a 30-year-old lady with a history of migraine who had extensive negative neurological evaluation. PMID:21760752

Skeik, Nedaa; Jabr, Fadi I

2011-01-01

129

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.

Doger, Emek; Kopuk, Sule Y.; Cak?roglu, Yigit; Cak?r, Ozgur; Yucesoy, Gulseren

2013-01-01

130

Prenatal diagnosis of unilateral tibial hemimelia.  

PubMed

We describe a case of unilateral tibial agenesis which was initially observed at 21 weeks' gestation. Unlike bilateral tibial hemimelia syndrome, a rare autosomal dominant condition, unilateral tibial agenesis, which accounts for about three-quarters of all newborns with this condition, has not previously been described. This case could have been a sporadic abnormality but, in view of the association with other observations (distal bifurcation of the femur, club foot), could be considered as an autosomal recessive inherited condition with variable penetrance. Ultrasonographic features and the genetic prognosis are discussed. PMID:8705415

Dreyfus, M; Baldauf, J J; Rigaut, E; Clavert, J M; Gasser, B; Ritter, J

1996-03-01

131

Unilateral breast uptake on radionuclide ventriculography.  

PubMed

Gated equilibrium radionuclide ventriculography is frequently used to measure the left ventricular ejection fraction. We report a case of unilateral breast activity resulting in significant underestimation of the left ventricular ejection fraction, which mimicked a left ventricular aneurysm, pseudoaneurysm, or an intrathoracic vascular mass. Unilateral breast uptake, in the absence of gastric activity, was presumed because of increased blood pool in the lactating breast, a finding not previously reported in the literature. This case is also presented to emphasize the importance of localizing abnormalities based on a review of tomographic images or images taken in at least 2 orthogonal projections. PMID:24662654

Pelletier-Galarneau, Matthieu; Sogbein, Oyebola O; Pham, Xuan H; Zuckier, Lionel S

2014-07-01

132

Recurrent Unilateral Vulval Elephantiasis: A Case Report  

PubMed Central

Genital elephantiasis is caused by a variety of infective and non infective causes leading to blockage of lymphatic. We are presenting a rare case of recurrent unilateral vulval elephantiasis which has recurred after initial reconstructive surgery. A 38 year old female presented with vulval swelling and on examination there was gross unilateral vulval enlargement. FNAC (Fine needle aspiration cytology) and biopsy were contributory for diagnosis. Patient was started with antibiotics and daily dressing was done till the infection was subsided and the patient was planned for reconstructive surgery.

G., Sampath Kumar; Venkatesh, Shreedhar

2014-01-01

133

Preoperative Statin Use and Postoperative Acute Kidney Injury  

PubMed Central

BACKGROUND Acute kidney injury is a frequent postoperative complication that confers increased mortality, morbidity, and costs. The purpose of this study was to evaluate whether preoperative statin use is associated with a decreased risk of postoperative acute kidney injury. METHODS We assembled a retrospective cohort of 98,939 patients who underwent a major open abdominal, cardiac, thoracic, or vascular procedure between 2000 and 2010. Statin users were pair-matched to nonusers on the basis of surgery type, baseline kidney function, days from admission until surgery, and propensity score based on demographics, comorbid conditions, and concomitant medications. Acute kidney injury was defined based on changes in serum creatinine measurements applying Acute Kidney Injury Network and Risk-Injury-Failure staging systems, and on the need for renal replacement therapy. Associations between statin use and acute kidney injury were estimated by conditional logistic regression. RESULTS Across various acute kidney injury definitions, statin use was consistently associated with a decreased risk: adjusted odds ratios (95% confidence intervals) varied from 0.74 (0.58–0.95) to 0.80 (0.71–0.90). Associations were similar among diabetics and nondiabetics, and across strata of baseline kidney function. The protective association of statins was most pronounced among patients undergoing vascular surgery and least among patients undergoing cardiac surgery. CONCLUSIONS Preoperative statin use is associated with a decreased risk of postoperative acute kidney injury. Future randomized clinical trials are needed to determine causality.

Brunelli, Steven M.; Waikar, Sushrut S.; Bateman, Brian T.; Chang, Tara I.; Lii, Joyce; Garg, Amit X.; Winkelmayer, Wolfgang C.; Choudhry, Niteesh K.

2013-01-01

134

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.

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

2014-01-01

135

Thromboembolic stroke associated with thoracic outlet syndrome.  

PubMed

Thoracic outlet syndrome occurs due to compression of the neurovascular structures as they exit the thorax. Subclavian arterial compression is usually due to a cervical rib, and is rarely associated with thromboembolic stroke. The mechanism of cerebral embolisation associated with the thoracic outlet syndrome is poorly understood, but may be due to retrograde propagation of thrombus or transient retrograde flow within the subclavian artery exacerbated by arm abduction. We report an illustrative patient and review the clinical features, imaging findings and management of stroke associated with thoracic outlet syndrome. PMID:24321459

Meumann, Ella M; Chuen, Jason; Fitt, Greg; Perchyonok, Yuliya; Pond, Franklin; Dewey, Helen M

2014-05-01

136

Idiopathic Thoracic Epidural Lipomatosis with Chest Pain  

PubMed Central

Spinal epidural lipomatosis (SEL) is an overgrowth of the normally encapsulated adipose tissue in the epidural space around the spinal cord in the thoracic and lumbar spine causing compression of the neural components. Idiopathic SEL in non-obese patients is exceptional. Idiopathic SEL can result in thoracic myelopathy and lumbar radiculopathy. A thoracic radiculopathy due to idiopathic SEL has not been reported yet. We report a case of idiopathic SEL with intractable chest pain and paresthesia. We suggest that idiopathic SEL should be considered as a cause of chest pain.

Lee, Sang-Beom; Chang, Jae-Chil; Jin, So-Young

2011-01-01

137

Radiation-induced long thoracic nerve palsy  

SciTech Connect

The incidence of long thoracic nerve palsy after radical mastectomy has been documented to be approximately 10%. No cases have been reported after the more recent treatment for breast cancer, lumpectomy with axillary dissection. This more recent surgical procedure is customarily followed by aggressive radiation therapy to the remaining breast tissue. This is the first case report of a patient with radiation-induced long thoracic nerve palsy. The patient was a young woman who underwent left breast quadrantectomy and axillary dissection for breast cancer. After radiation therapy, she had isolated left long thoracic nerve palsy. The diagnosis was confirmed by electrodiagnostic studies. Almost full recovery occurred after 5 months.

Pugliese, G.N.; Green, R.F.; Antonacci, A.

1987-09-15

138

Thoracic aortic frontier: review of current applications and directions of thoracic endovascular aortic repair (TEVAR).  

PubMed

Thoracic endovascular aortic repair, a minimally invasive technique is replacing the maximally invasive gold standard of thoracotomy and replacement of the descending thoracic aorta. With experience, indications have expanded to encroach on the arch and even ascending aorta. This review highlights the current state of technology, discusses controversies, and takes the perspective of a forward-thinking review to describe novel, innovative techniques that might make the entire thoracic aorta amenable to minimally invasive repair. PMID:24365190

Appoo, Jehangir J; Tse, Leonard W; Pozeg, Zlatko I; Wong, Jason K; Hutchison, Stuart J; Gregory, Alex J; Herget, Eric J

2014-01-01

139

Needlescopic video-assisted thoracic surgery for reversal of thoracic sympathectomy  

PubMed Central

Thoracic sympathectomy is a commonly performed surgical procedure for the treatment of palmar hyperhidrosis. However, one major complication of such a procedure is compensatory truncal hyperhidrosis. We describe an extreme case of compensatory truncal hyperhidrosis and anhidrosis over the head and neck region which led to a heatstroke. Bilateral reoperative needlescopic video-assisted thoracic surgery was performed for the reversal of thoracic sympathectomy with an interposition intercostal nerve graft. The patient's truncal hyperhidrosis resolved gradually over 1 month following the reversal procedure.

Wong, Randolph H.L.; Ng, Calvin S.H.; Wong, Jasper K.W.; Tsang, Susanna

2012-01-01

140

Case report of cardiac arrest, abdominal compartment syndrome, and thoracic aortic injury with endovascular repair of thoracic aortic tear.  

PubMed

The introduction of thoracic endografts has revolutionized the management of thoracic aortic disease. Currently, endografts are not FDA-approved for treating thoracic aortic injury (TAI). We report a case of TAI who presented in hemorrhagic shock and preoperative cardiac arrest who was successfully treated with large volume resuscitation, closed chest cardiac massage, exploratory laparotomy, and thoracic endografting. PMID:17661787

Stevens, Randy M; Tehrani, Hassan; Shaw, Jason; Medina, Andres; Calcaterra, Dominico; Katariya, Kushagra; Williams, Donald; Panos, Anthony L; Salerno, Tomas A

2007-01-01

141

Unilateral vestibular loss impairs external space representation.  

PubMed

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; Devèze, Arnaud; Magnan, Jacques; Péruch, Patrick

2014-01-01

142

Unilateral retinal dysplasia clinically mimicking retinoblastoma.  

PubMed

Retinal dysplasia is a rare non-neoplastic congenital disorder characterized by aberrant differentiation of the retina with formation of abnormal tubular and rosette-like structure. Clinically, the lesion presents with leukocoria and mimics a retinoblastoma. One such case is described that occurred unilaterally in a 9-month-old boy. PMID:21158372

Biswas, Saumitra; Paul, Prabir Chandra; Chakraborty, Jayati; Chakrabarti, Sudipta

2010-01-01

143

Unilateral hyperlucent lung: the case for investigation  

Microsoft Academic Search

Seventeen children with unilateral hyperlucent lungs were referred for investigation. Of the 11 who had a referring diagnosis of possible Macleod's syndrome only two were shown to have post-viral bronchiolitis. Three of the 11 had conditions that required surgical treatment and a further two with brochiectasis were treated medically. To avoid confusion we suggest that Macleod's syndrome is reserved exclusively

S A McKenzie; D J Allison; M P Singh; S Godfrey

1980-01-01

144

Thoracic radiculopathy caused by a myodil cyst.  

PubMed

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

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

2000-08-01

145

Thoracic and abdominal blastomycosis in a horse.  

PubMed

A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy. PMID:10319179

Toribio, R E; Kohn, C W; Lawrence, A E; Hardy, J; Hutt, J A

1999-05-01

146

The Effectiveness of Preemptive Thoracic Epidural Analgesia in Thoracic Surgery  

PubMed Central

Background. The aim of this study is to investigate the effectiveness of preemptive thoracic epidural analgesia (TEA) comparing conventional postoperative epidural analgesia on thoracotomy. Material and Methods. Forty-four patients were randomized in to two groups (preemptive: Group P, control: Group C). Epidural catheter was inserted in all patients preoperatively. In Group P, epidural analgesic solution was administered as a bolus before the surgical incision and was continued until the end of the surgery. Postoperative patient controlled epidural analgesia infusion pumps were prepared for all patients. Respiratory rates (RR) were recorded. Patient's analgesia was evaluated with visual analog scale at rest (VASr) and coughing (VASc). Number of patient's demands from the pump, pump's delivery, and additional analgesic requirement were also recorded. Results. RR in Group C was higher than in Group P at postoperative 1st and 2nd hours. Both VASr and VASc scores in Group P were lower than in Group C at postoperative 1st, 2nd, and 4th hours. Patient's demand and pump's delivery count for bolus dose in Group P were lower than in Group C in all measurement times. Total analgesic requirements on postoperative 1st and 24th hours in Group P were lower than in Group C. Conclusion. We consider that preemptive TEA may offer better analgesia after thoracotomy.

Erturk, Engin; Aydogdu Kaya, Ferdane; Kutanis, Dilek; Besir, Ahmet; Akdogan, Ali; Geze, Sukran; Tugcugil, Ersagun

2014-01-01

147

Unilateral non-communicating cervical atresia in a patient with uterus didelphys and unilateral renal agenesis.  

PubMed

A 16-year-old adolescent girl presented with chronic pelvic pain. Pelvic ultrasound and MRI showing a uterus didelphys, normal left uterus and cervix, right pelvic fluid collection and right unilateral renal agenesis. After two unsuccessful vaginal surgeries for drainage of hematotrachelos and creation of an outflow tract, patient underwent unilateral total abdominal hysterectomy with final pathology confirming hematotrachelos and non-communicating cervical atresia on the right. Patient on postoperative follow-up doing well. PMID:20813328

Saleh, Marwan; Badawy, Shawky Z A

2010-10-01

148

Percutaneous treatment of thoracic duct injuries  

Microsoft Academic Search

Background  Major thoracic or neck surgery or penetrating trauma can cause injury to the thoracic duct and development of a chylothorax.\\u000a Chylothorax results in metabolic and immunologic disorders that can be life threatening, with a mortality rate reaching 50%.\\u000a The management of chyle leaks is dependent on the etiology and daily output. Interventions are used to treat only leaks unresponsive\\u000a to

Francesca Marcon; Katayun Irani; Theresa Aquino; John K. Saunders; Thomas H. Gouge; Marcovalerio Melis

149

Thoracoscopic Approaches to the Thoracic Spine  

Microsoft Academic Search

Summary  ?Microsurgical approaches for the treatment of pathology located in the ventral thoracic spine using video-assisted thoracic\\u000a surgery (VATS) allow neurosurgeons to access the disc spaces, vertebral bodies, paravertebral soft tissues, spinal cord, spinal\\u000a nerves, and sympathetic chain with minimally invasive surgery. This has been associated with substantial clinical benefits\\u000a including reduced postoperative pain, lower complication rates and shorter recovery times

M. Visocchi; R. Masferrer; V. K. H. Sonntag; C. A. Dickman

1998-01-01

150

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

151

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

152

Acute arterial occlusion - kidney  

MedlinePLUS

... occlusion of the kidney is a sudden, severe blockage of the artery that supplies blood to the ... impair kidney function. If it continues, a complete blockage of blood flow to the kidney often results ...

153

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

154

American Kidney Fund  

MedlinePLUS

... Failure Kidney Health Brochures Blood Test: eGFR AKF News Kidney Action Days Raise Awareness of CKD in ... in Nephrology Fellow more news » AKF in the News Upper Marlboro resident advocates for kidney disease research ...

155

E-Kidney Newsletter  

MedlinePLUS

... Northeast Ohio Kidney Walk June 8, 2014 Great Lakes Science Center - Cleveland, OH Colorado Kidney Walk June ... Richmond, VA NKF Golf Classic June 9, 2014 Lake Forest Country Club - Louisville, KY 2014 Kidney Golf ...

156

Quick Kidney Risk Check  

MedlinePLUS

... Northeast Ohio Kidney Walk June 8, 2014 Great Lakes Science Center - Cleveland, OH Colorado Kidney Walk June ... Richmond, VA NKF Golf Classic June 9, 2014 Lake Forest Country Club - Louisville, KY 2014 Kidney Golf ...

157

Cadmium and the kidney.  

PubMed Central

The paper is a review of certain aspects of importance of cadmium and the kidney regarding the assessment of risks and understanding of mechanisms of action. The review discusses the following topics: history and etiology of cadmium-induced kidney dysfunction and related disorders; cadmium metabolism, metallothionein and kidney dysfunction; cadmium in urine as indicator of body burden, exposure and kidney dysfunction; cadmium levels in kidney and liver as indicators of kidney dysfunction; characteristics of early kidney dysfunction; the critical concentration concept; critical concentrations of cadmium in kidney cortex; and prognosis.

Friberg, L

1984-01-01

158

Thoracic outlet syndrome--a functional disturbance of the thoracic upper aperture?  

PubMed

We describe a young woman with typical neurovascular symptoms of thoracic outlet syndrome (TOS). A three-dimensional computerized scan showed a "dislocation" of the first rib at the costotransverse joint. The patient responded to a conservative approach to treatment. The patient presented here demonstrates the functional compromise of the upper thoracic aperture that is frequently seen in young women. PMID:7739640

Lindgren, K A; Manninen, H; Rytkönen, H

1995-05-01

159

Percutaneous Thoracic Intervertebral Disc Nucleoplasty: Technical Notes from 3 Patients with Painful Thoracic Disc Herniations  

PubMed Central

Symptomatic thoracic disc herniation is an uncommon condition and early surgical approaches were associated with significant morbidity and even mortality. We are the first to describe the technique of percutaneous thoracic nucleoplasty in three patients with severe radicular pain due to thoracic disc herniation. Two of the patients experienced more than 75% pain relief and one patient experienced more than 50% pain relief. Post-procedural pain relief was maintained up to an average of 10 months after nucleoplasty. One patient with preoperative neurological signs improved postoperatively. There were no reported complications in all three patients. In view of the reduced morbidity and shorter operating time, thoracic intervertebral disc nucleoplasty can be considered in patients with pain due to thoracic disc herniation, with no calcification of the herniated disc, and in patients who may be otherwise be unfit for conventional surgery.

Gultuna, Ismail; Riezebos, Patricia; Beems, Tjemme; Vissers, Kris C.

2011-01-01

160

Smell sparing unilateral intracranial dermoid resection  

PubMed Central

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

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

2014-01-01

161

Differential outcomes of unilateral interferences at birth.  

PubMed

Behavioural modifications, including modifications of emotional reactivity, can occur following early experience such as handling (manual rubbing). Here, we investigated the effects of unilateral tactile stimulation at an early stage on emotional reactions later on. We handled newborn foals intensively on one side of their body. This early unilateral tactile experience had medium-term effects: the reactions of foals to a human approach, when they were 10 days old, differed according to the side stimulated at birth. Fewer right-handled foals accepted contact with humans, they delayed first contact longer and they evaded approaching humans sooner than did non-handled and left-handled foals. These results raise questions concerning the organization of neonatal care in animals and humans. PMID:21084335

de Boyer des Roches, Alice; Durier, Virginie; Richard-Yris, Marie-Annick; Blois-Heulin, Catherine; Ezzaouïa, Mohammed; Hausberger, Martine; Henry, Severine

2011-04-23

162

Differential outcomes of unilateral interferences at birth  

PubMed Central

Behavioural modifications, including modifications of emotional reactivity, can occur following early experience such as handling (manual rubbing). Here, we investigated the effects of unilateral tactile stimulation at an early stage on emotional reactions later on. We handled newborn foals intensively on one side of their body. This early unilateral tactile experience had medium-term effects: the reactions of foals to a human approach, when they were 10 days old, differed according to the side stimulated at birth. Fewer right-handled foals accepted contact with humans, they delayed first contact longer and they evaded approaching humans sooner than did non-handled and left-handled foals. These results raise questions concerning the organization of neonatal care in animals and humans.

de Boyer des Roches, Alice; Durier, Virginie; Richard-Yris, Marie-Annick; Blois-Heulin, Catherine; Ezzaouia, Mohammed; Hausberger, Martine; Henry, Severine

2011-01-01

163

Unilateral Punctate Keratitis Secondary to Wallenberg Syndrome  

PubMed Central

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

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

2014-01-01

164

[Changes in the kidney in a case of neurofibromatosis (author's transl)].  

PubMed

In a case of an 18-yr-old girl with generalized neurofibromatosis there was an unilateral hydronephrosis due to polypoid neurofibromas in the ureter and urinary bladder. In the kidney were interstitial neurofibromas, a great number of dysontogenetic adenomas and also neurofibromatosis of the vessels. PMID:810993

Fladerer, H; Vilits, P

1975-01-01

165

Ambulatory blood pressure monitoring and renal functions in children with a solitary kidney  

PubMed Central

The aim of this study is to investigate the blood pressure (BP) profile, microalbuminuria, renal functions, and relations with remaining normal kidney size in children with unilateral functioning solitary kidney (UFSK). Sixty-six children with UFSK were equally divided into three groups: unilateral renal agenesis (URA), unilateral atrophic kidney (UAK), and unilateral nephrectomy (UNP). Twenty-two age-, weight-, and height-matched healthy children were considered as a control group. The serum creatinine level and first-morning urine microalbumin and creatinine concentrations were determined by the standard methods. Also, the BP profile was determined by ambulatory blood pressure monitoring (ABPM). We found that the serum creatinine level was higher and creatinine clearance was lower in each patient groups compared to those of the control group (p??0.05). An inverse correlation was found between the renal size standard deviation scores (SDS) of normal kidneys and 24-h systolic and diastolic BP load SDS in all of the patients (p?

Bayazit, Aysun K.; Cengiz, Nurcan; Seydaoglu, Gulsah; Buyukcelik, Mithat; Soran, Mustafa; Noyan, Aytul; Anarat, Ali

2007-01-01

166

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.

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

2014-01-01

167

Motor learning after unilateral brain damage  

Microsoft Academic Search

Forty adults, post-stroke from anterior circulation unilateral cerebrovascular accident(?2 years post onset) and 40 age-matched controls (M = 57 years) practiced a rapid,spatially and temporally constrained programmed action under one of two augmented feedbackpractice conditions. Participants in the stroke group used the upper limb ipsilateral to the lesion.After an extended practice period (198 trials), acquisition, retention, and reacquisitionperformance was assessed

Carolee J. Winstein; Alma S. Merians; Katherine J. Sullivan

1999-01-01

168

Unilateral pulmonary hypoplasia with abdominal situs inversus.  

PubMed

A case of unilateral pulmonary hypoplasia in association with abdominal situs inversus (Situs Inversus Partialis) is described here in a 2-mo-old baby. The normally related heart (levocardia) is dextroposed due to the hypoplastic right lung and compensatory hyper-inflation of the opposite lung which clinically mimicked a mirror-image situs inversus totalis. Such a combination, to the best of authors' knowledge, has never been reported in the world literature. PMID:22237637

Sarkar, Sumantra; Mondal, Rakesh; Nandi, Madhumita; Das, Niloy Kumar

2012-10-01

169

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

170

Unilateral Angle II in functional lateralities  

Microsoft Academic Search

SUMMARY The aim of this study was to explore unilateral Angle II-type malocclusion prevalences in functionally true right-sided (TRS) and non-right-sided (NRS) children having one or more left-sided functions (eye, hand, foot). A half cusp sagittal relationship of the upper and lower M1 and Dm2 was determined on dental casts of 1423 young American black and white children in a

T. Heikkinen; T. Poikela; L. Alvesalo

2004-01-01

171

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

172

Functioning unilateral adrenocortical carcinoma in a dog  

PubMed Central

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.

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

2012-01-01

173

Unilateral molar distalization with a modified slider.  

PubMed

Although there are numerous publications on bilateral non-compliance molar distalization appliances, there is limited information on problems such as asymmetrical unilateral Class II malocclusions. The aim of the present investigation was to examine the distalization of molars unilaterally in patients with a unilateral Class II molar relationship utilizing a Keles Slider, designed without a bite plane. Ten girls (mean age 13.94 +/- 2.13 years) and seven boys (mean age 13.12 +/- 1.51 years) comprised the study material. Following insertion of the appliance, the patients were seen monthly and the screw was reactivated every 2 months. After a super-Class I molar relationship was achieved, the appliance was removed and the molars were stabilized with a Nance appliance for 2 months before the second-phase of orthodontic treatment. The Nance appliance was maintained in the palate until the end of canine distalization. Lateral cephalometric radiographs were obtained before and immediately after insertion of the molar distalizer. The results showed that the maxillary first molars were distalized bodily on average by 2.85 mm. The maxillary first premolars moved forward bodily 2 mm and were extruded 2.03 mm. In all, 1.32 mm of protrusion, 1.12 mm of extrusion, and 1.79 degrees of proclination of the upper incisors were observed. The mandibular incisors and mandibular molars erupted 0.83 and 0.95 mm, respectively. The unilateral Keles Slider distalized molars successfully to a Class I molar relationship. PMID:16648210

Sayinsu, Korkmaz; Isik, Fulya; Allaf, Ferdi; Arun, Tülin

2006-08-01

174

Unilateral lung hyperlucency after mediastinal irradiation  

SciTech Connect

A 39-yr-old woman developed progressive exertional dyspnea 13 yr after receiving mediastinal irradiation for Hodgkin's disease. Chest roentgenogram showed a hyperlucent right lung. Pulmonary blood flow was markedly reduced on the right by ventilation-perfusion scanning. Pulmonary angiography showed attenuation and diffuse atrophy of the right pulmonary artery and its branches. This case represents a late and uncommon complication of mediastinal irradiation manifesting as a unilateral hyperlucent lung.

Wencel, M.L.; Sitrin, R.G.

1988-04-01

175

Neuropsychological functioning in unilateral cerebellar damage.  

PubMed

A woman had a left superior cerebellar artery infarct associated with reduced hexamethylpropileneamine oxime uptake on SPECT scan of the basal ganglia and frontoparietal areas of the opposite hemisphere performed poorly in some neuropsychological tests indicating right hemisphere dysfunction. There was a lengthening of reaction and movement times with the hand ipsilateral to the lesion. These deficits were temporary. A unilateral cerebellar lesion can produce neuropsychological deficits, possibly because of hypoperfusion in contralateral frontoparietal regions, but spontaneous neuropsychological remissions may occur. PMID:7874621

Botez-Marquard, T; Léveillé, J; Botez, M I

1994-11-01

176

Unilateral hematometrocolpos associated with double uterus.  

PubMed

The case of twelve year old girl with double uterus, unilateral vaginal obstruction and ipsilateral renal agenesis is described. Excision of the imperforate vaginal septum resulted in drainage of the hematometrosalpingocolpos and complete disappearance of the large pelvic-abdominal mass. Such a mass in normally menstruating women may detract from the true diagnosis. Awareness of this relatively rare condition is the mainstay of prompt diagnosis which will prevent unnecessary and destructive surgery. PMID:8777781

Lang, N; Stark, H; Ohel, G

1995-01-01

177

Multiyear experience in endoscopic thoracic sympathectomy.  

PubMed

The results of endoscopic thoracic sympathectomy performed for 787 patients during a 30-year period are presented. Six hundred seventy three patients were operated on for upper limb arterial occlusion of distal and diffuse type, Raynaud's disease or syndrome, 7 patients - for causalgic pain in upper limbs and Sudeck's syndrome, 85 - for hyperhidrosis. Twelve patients underwent lower thoracic sympathectomy for painful chronic pancreatitis, 4 - total destruction of thoracic sympathetic trunk due to pernicious hypertension of unknown origin, and 6 - endoscopic thoracic sympathectomy for acute thrombosis of upper limb arteries with distal circulation impairment. Immediate positive effect of interventions was detected in all cases except for acute arterial thrombosis. One patient died postoperatively due to arrhythmia-related cardiac arrest. Postoperative complications - lung border damage and intercostal vascular hemorrhage - were detected in 0.2% of cases. Increased air effusion from pleural cavity and intercostal neuralgia were observed postoperatively in some cases but did not require any special management. Long-term outcomes were followed up for period of 5-10 years, 72.7% of monitored patients had stable positive outcomes. Our experience has demonstrated that endoscopic thoracic sympathectomy is a safe, minimally invasive and effective intervention for upper limb chronic arterial insufficiency of distal and diffuse type or for hyperhidrosis. PMID:15163977

Andrievskikh, I A; Fokin, A A

2004-01-01

178

High Thoracic Epidural Anesthesia in Cardiac Surgery  

PubMed Central

There is an interest in the use of high thoracic epidural anesthesia in cardiac surgery, because experimental and clinical studies have suggested that central neuroaxial blockade attenuates the response to surgical stress and improves myocardial metabolism and perioperative analgesia—thus enabling earlier extubation and a smoother postoperative course. Matters of major concern in the adoption of high thoracic epidural anesthesia in cardiac surgery are neurologic injury secondary to neuroaxial hematoma and hypotension secondary to sympatholysis. The risk associated with possible neuraxial hematoma caused by high thoracic epidural anesthesia has been thoroughly investigated and largely discounted, but scant attention has been devoted to the onset of hypotensive episodes in the same setting. We analyzed the hypotensive episodes that occurred in a series of 144 patients who underwent on-pump cardiac surgery procedures. Among the patient variables that we tested in a multivariate logistic-regression model, only female sex was found to be significantly correlated with hypotension. In order to decrease the incidence and severity of hypotensive episodes resulting from anesthetic blockade, anesthesiologists need to monitor, with special care, women patients who are under high thoracic epidural anesthesia. Further studies are needed in order to determine why women undergoing open heart surgery under high thoracic epidural anesthesia are at a relatively greater risk of hypotension.

Casalino, Stefano; Mangia, Fabio; Stelian, Edmond; Novelli, Eugenio; Diena, Marco; Tesler, Ugo F.

2006-01-01

179

Kidney stones  

PubMed Central

Introduction The age of peak incidence for stone disease is 20 to 40 years, although stones are seen in all age groups. There is a male to female ratio of 3:2. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions for stone removal in people with asymptomatic kidney stones? What are the effects of interventions for the removal of symptomatic renal stones? What are the effects of interventions to remove symptomatic ureteric stones? What are the effects of interventions for the management of acute renal colic? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: antispasmodic drugs, extracorporeal shockwave lithotripsy, intravenous fluids, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, oral fluids, percutaneous nephrolithotomy, and ureteroscopy.

2011-01-01

180

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.

2014-01-01

181

European institutional accreditation of general thoracic surgery  

PubMed Central

To improve standardization of general thoracic surgery (GTS) practice across Europe, the European Society of Thoracic Surgeons (ESTS) has implemented a program of Institutional Accreditation. We reviewed the methods and rules of engagement of this program. A composite performance score (CPS) including outcome and process indicators is used to measure institutional performance and assess eligibility for accreditation. Eligible units are invited to participate and accept a local audit performed by an external auditors team composed by data inspectors and thoracic surgeons. In addition to data quality, a series of structural, procedural and qualification characteristics are inspected. Once the visit is complete, the team will produce an audit report to be sent to the members of the database committee for deliberation on the institutional accreditation of that unit. The Database committee will send an executive report to the ESTS Executive Committee for their final decision on the accreditation.

Falcoz, Pierre Emmanuel

2014-01-01

182

Myocardial conducting system dysfunctions from thoracic impact.  

PubMed

An analysis of electrocardiograms (ECG lead II) obtained following blunt thoracic impacts conducted on 12 anesthetized pigs indicated that all animals developed some degree of trauma to the heart conducting system: sino-atrial nodal disturbances, atrio-ventricular junctional dysfunction, intraventricular conduction defects (e.g., bundle branch blocks), or ventricular fibrillation. The induced ventricular fibrillation proceeded rapidly to the demise of four animals in this study. A comparison of the occurrence of ventricular fibrillation with measured biomechanical response parameters indicated a significant correlation of ventricular dysfunction with high levels of sternal acceleration (930 g) and impact velocity (10.7 m/s). The initiation of ventricular fibrillation did not correlate with typical biomechanical thoracic injury "indicators" (i.i., level of normalized thoracic deflection, cumulative AIS, peak spinal acceleration, or applied force). An injury severity classification (MCD) was subsequently developed for the evaluation of myocardial conducting system dysfunctions. PMID:660701

Viano, D C; Artinian, C G

1978-06-01

183

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.

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

2012-01-01

184

Thoracic ultrasonography for the pulmonary specialist.  

PubMed

Thoracic ultrasonography is a noninvasive and readily available imaging modality that has important applications in pulmonary medicine outside of the ICU. It allows the clinician to diagnose a variety of thoracic disorders at the point of care. Ultrasonography is useful in imaging lung consolidation, pleural-based masses and effusions, pneumothorax, and diaphragmatic dysfunction. It can identify complex or loculated effusions and be useful in planning treatment. Identifying intrathoracic mass lesions can guide sampling by aspiration and biopsy. This article summarizes thoracic ultrasonography applications for the pulmonary specialist, related procedural codes, and reimbursement. The major concepts are illustrated with cases. These case summaries are enhanced with online supplemental videos and chest radiograph, chest CT scan, and ultrasound correlation. PMID:22045878

Koenig, Seth J; Narasimhan, Mangala; Mayo, Paul H

2011-11-01

185

Thoracic Duct Embolization for Chylous Leaks  

PubMed Central

Chylous leaks, such as chylothorax and chylopericardium, are uncommon effusions resulting from the leakage of intestinal lymphatic fluid from the thoracic duct (TD) and its tributaries, or intestinal lymphatic ducts. The cause can be either traumatic (thoracic surgery) or nontraumatic (idiopathic, malignancy). Treatment has traditionally consisted of dietary modification (nonfat diet) and/or surgery (TD ligation, pleurodesis). Thoracic duct embolization (TDE) has become a viable treatment alternative due to it high success rate and minimal complications. In this article, the authors describe the etiologies of chylothorax, patient population, outcomes, and long-term follow-up of TDE patients. Relevant lymphatic anatomy and physiology are reviewed, with special attention paid to the formation of the duct by tributaries at the cisterna chyli (CC). The technique of TDE is outlined, including bilateral pedal lymphangiography, TD cannulation, and embolic agents used for the procedure.

Chen, Eric; Itkin, Maxim

2011-01-01

186

Modelling non-linearities in the vestibulo-ocular reflex (VOR) after unilateral or bilateral loss of peripheral vestibular function.  

PubMed

We recorded the vestibulo-ocular reflex (VOR) in 18 normal subjects, 50 patients with unilateral loss of vestibular function and 18 patients with bilateral loss of vestibular function. The unilateral cases had either partial loss (i.e. vestibular neuronitis or Meniere's disease) or total loss (i.e. vestibular nerve section), whereas bilateral cases had only partial loss (i.e. due to ototoxicity or to suspected microangiopathy, secondary to severe kidney disease). Tests were performed at 1/6-Hz passive head rotation in the dark, with peak head velocities ranging from 125 to 190 degrees/s. We report on the distinct VOR non-linearities observed in unilateral versus bilateral patients: whereas unilateral patients all exhibit an asymmetric hypofunction with decreasing VOR gain at higher head velocities, bilateral patients have a more severe but symmetric hypofunction associated with increasing VOR gain at higher head velocities. We present a model study that can duplicate the nature of these characteristics, based mainly on peripheral non-linear semicircular canal characteristics and secondary central compensation. Theoretical analyses point to the importance of clinical test parameters (rotation speed and frequency) in the determination of a functional VOR and the detection of reflex non-linearities, so that test protocols can seriously bias the evaluation of adequate functional recovery. PMID:11355383

Galiana, H L; Smith, H L; Katsarkas, A

2001-04-01

187

Genetics Home Reference: Familial thoracic aortic aneurysm and dissection  

MedlinePLUS

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

188

THORACIC ROTATION MEASUREMENT TECHNIQUES: CLINICAL COMMENTARY  

PubMed Central

A number of sporting and daily activities involve rotation of the spine. The ability to quantify motion of the spine in a clinical setting usually relies on the use of a device to measure angles (goniometer or inclinometer) or visual assessment. Standardized measurement criteria exist for measuring rotation at the cervical and lumbar spine. Little has been written regarding established methods for measuring thoracic spine rotation. Thoracic rotation may be measured in a seated position, half-kneeling position, or quadruped position. Steps should be taken to minimize motion of surrounding segments such as the shoulder and hips, which may improve measurement accuracy. Key words: inclinometer, goniometer, range of motion

Johnson, Katherine D.

2010-01-01

189

Accuracy of Pedicle Screw Placement in Thoracic Spine Fractures  

Microsoft Academic Search

Background and Purpose: Transpedicular instrumentation in the thoracic spine is technically difficult because of small pedicle diameters. There are not many studies assessing in vivo accuracy, complications, and the revision rate of transpedicular screws in the thoracic spine. In this retrospective study 278 thoracic pedicle screws of 43 patients were assessed using a scoring system and postoperative computed tomography (CT)

Marty Zdichavsky; Michael Blauth; Christian Knop; Joachim Lotz; Christian Krettek; Leonard Bastian

2004-01-01

190

THE RELATIONSHIP BETWEEN THORACIC ORGAN INJURIES AND ASSOCIATED RIB FRACTURES  

Microsoft Academic Search

Thoracic trauma can involve serious injuries of both the rib cage and thoracic organs. The leading cause of thoracic trauma is motor vehicle crashes (MVCs). Rib fractures are often associated with injuries to the underlying organs. This paper investigates the situations in which lung, liver, and spleen injuries occur with associated rib fractures. Side impacts were found to have corresponding

Craig P. Thor; Hampton C. Gabler

191

Unilateral cerebellar hypoplasia with different clinical features.  

PubMed

Unilateral cerebellar hypoplasia (UCH) is a rare pathological condition characterized by the loss of volume in cerebellar hemispheres ranging from mild asymptomatic to severe symptomatic cases. As the designation of UCH remains problematic, the underlying etiopathogenesis also lacks explanation. We investigated the patients admitted to Departments of Child Neurology, Neurology, and Genetics between the years 1992 and 2010 and detected 12 patients with unilateral cerebellar volume loss, with the exclusion of all other cerebellar pathologies. The ages of patients ranged between 6 months to 55 years. Five patients had a delay in developmental milestones, and one of these was diagnosed with neurofibromatosis type 1. Two patients had epileptic seizures, one patient had peripheral facial paralysis as a component of Moebius syndrome, and four patients were incidentally diagnosed during etiological work-up for headache. The clinical outcomes of patients varied from healthy subjects to marked developmental impairment. Radiologically, five patients had severe disproportionate UCH, six had moderate disproportionate, and one had mild proportionate UCH. Cerebellar peduncles were affected in all, and vermis was partly hypoplastic in eight patients. Brainstem was involved in four patients, and seven patients showed involvement of white matter and/or corpus callosum. Imaging features supported that patients with severe disproportionate UCH also displayed additional cerebral and commissural changes, which were related to ischemic or vascular injuries, implying a prenatally acquired disruption. In the presence of such a wide spectrum of clinical and radiological features, a prenatally acquired lesion and, thus, a disruption seem to be more explanatory rather than a primary developmental process or malformation in the etiopathogenesis of unilateral cerebellar hypoplasia. PMID:20967575

Benbir, Gulcin; Kara, Simay; Yalcinkaya, Beyza Citci; Karhkaya, Geysu; Tuysuz, Beyhan; Kocer, Naci; Yalcinkaya, Cengiz

2011-03-01

192

Adult-Onset Unilateral Disabling Pansclerotic Morphea  

PubMed Central

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.

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

2014-01-01

193

Unilateral molar distalization: a nonextraction therapy.  

PubMed

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

194

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.

Prasad, M. Bhanu; Sreevalli, S.

2012-01-01

195

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

196

Some remarks on unilateral matrix equations  

SciTech Connect

We briefly review the results of our paper LBNL-46775: We study certain solutions of left-unilateral matrix equations. These are algebraic equations where the coefficients and the unknown are square matrices of the same order, or, more abstractly, elements of an associative, but possibly noncommutative algebra, and all coefficients are on the left. Recently such equations have appeared in a discussion of generalized Born-Infeld theories. In particular, two equations, their perturbative solutions and the relation between them are studied, applying a unified approach based on the generalized Bezout theorem for matrix polynomials.

Cerchiai, Bianca L.; Zumino, Bruno

2001-02-01

197

Unilateral sudden hearing loss due to otosyphilis  

PubMed Central

The differential diagnosis of sudden hearing loss is very extensive. However, in most patients, no underlying pathology will be found and the patient is consequently diagnosed with idiopathic sudden hearing loss. Nevertheless, it is important that one stays alert in everyday routine practice to less common but potentially treatable pathology. We report a case of a 53-year old patient with sudden unilateral hearing loss and tinnitus caused by otosyphilis. Diagnosis, therapy and the incidence of (oto)syphilis are discussed. Also, as ENT-surgeons, it is important to realise that syphilis is still with us, and that its prevalence might well increase in the near future.

de Goffau, Maaike J.; Doelman, Jan C.; van Rijswijk, Jeroen B.

2011-01-01

198

Thoracoscopic thoracic duct ligation for traumatic chylothorax  

Microsoft Academic Search

Traumatic chylothorax requires surgical intervention when conservative medical management fails to reduce chyle leakage. This usually entails thoracotomy or laparotomy. We report a case in which successful ligation of a torn thoracic duct was achieved using a video-assisted thoracoscopic technique.

Keith G Buchan; Amir-Reza Hosseinpour; Andrew J Ritchie

2001-01-01

199

Thoracoscopic thoracic duct ligation for traumatic chylothorax.  

PubMed

Traumatic chylothorax requires surgical intervention when conservative medical management fails to reduce chyle leakage. This usually entails thoracotomy or laparotomy. We report a case in which successful ligation of a torn thoracic duct was achieved using a video-assisted thoracoscopic technique. PMID:11603464

Buchan, K G; Hosseinpour, A R; Ritchie, A J

2001-10-01

200

Functional chiral asymmetry in descending thoracic aorta.  

PubMed

To determine whether rotational blood flow or chiral asymmetry exists in the human descending thoracic aorta, we established the ability of color Doppler ultrasound to detect rotational flow in a tornado tube model of a vortex descending fluid column. In a model of the human aortic arch with a pulse duplicator, color Doppler was then used to demonstrate that rotational flow occurs first in the transverse arch and then in the proximal descending thoracic aorta. With the use of color Doppler esophageal echocardiography, 53 patients (age range, 25-78 years; mean age, 56.4 years) were prospectively examined for rotational flow in the descending thoracic aorta. At 10 cm superior to retro-left ventricular position, 22 of 38 patients (58%) revealed rotational flow with obvious diastolic counterclockwise rotation but less obvious systolic clockwise rotation. At 5 cm superior to retro-left ventricular position, 29 of 46 patients (63%) revealed rotational flow with a tendency toward systolic clockwise and diastolic counterclockwise rotation. At the retro-left ventricular position, 47 of 53 patients (89%) revealed rotational flow, usually of a clockwise direction, occurring in systole. Our data suggest that aortic flow is not purely pulsatile and axial but has a rotational component. Rotational flow begins in the aortic arch and is carried through to the descending thoracic aorta, where flow is chirally asymmetric with systolic clockwise and diastolic counterclockwise components. These data demonstrate an aortic rotational flow component that may have physiological implications for organ perfusion. PMID:2242523

Frazin, L J; Lanza, G; Vonesh, M; Khasho, F; Spitzzeri, C; McGee, S; Mehlman, D; Chandran, K B; Talano, J; McPherson, D

1990-12-01

201

Upper Plexus Thoracic Outlet Syndrome: Optimal Therapy  

Microsoft Academic Search

Background. Previously, transaxillary first rib resection alone was not considered adequate therapy for “upper plexus” (median nerve) thoracic outlet syndrome. It was thought that the “combined” approach with upper plexus dissection through a supraclavicular incision in addition to the transaxillary approach was necessary. However, with better understanding of anatomy—that the median nerve receives fibers from C8 and T1 as well

1997-01-01

202

Post-Traumatic Thoracic Outlet Syndromes  

Microsoft Academic Search

This retrospective study aims to clarify the mechanisms, frequency, symptoms, treatment, and outcome of post-traumatic thoracic outlet syndromes. A total of 13 patients (7 men and 6 women) with a mean age of 41±16 years were studied. Underlying injuries resulted from sports, road, and household accidents. Bone lesions were pseudarthrosis, hypertrophic callus, and luxations. Congenital anomalies were observed in five

Laurent Casbas; Xavier Chauffour; Jérôme Cau; Jean-Pierre Bossavy; Dominique Midy; Jean-Claude Baste; André Barret

2005-01-01

203

Complexity of the thoracic spine pedicle anatomy  

Microsoft Academic Search

Transpedicular screw fixation provides rigid stabilization of the thoracolumbar spine. For accurate insertion of screws into the pedicles and to avoid pedicle cortex perforations, more precise knowledge of the anatomy of the pedicles is necessary. This study was designed to visualize graphically the surface anatomy and internal architecture of the pedicles of the thoracic spine. Fifteen vertebrae distributed equally among

M. M. Panjabi; J. D. O'Holleran; J. J. Crisco; R. Kothe

1997-01-01

204

Thoracoscopic repair of thoracic spine trauma  

Microsoft Academic Search

Modern concepts of treating thoracic and lumbar spinal trauma are based on posterior transpedicular fixation techniques which confer angular stability and instrument only a few levels of the spine. In addition, to prevent secondary losses in postoperative reduction of kyphotic deformities, transpedicular resection of torn dises, and inter-and intracorporeal bone grafting are included in the repair procedures for the entire

H. Hertlein; W. H. Hartl; H. Dienemann; M. Schiirmann; G. Lob

1995-01-01

205

Thoracic sympathetic block: A new approach  

Microsoft Academic Search

Although a number of approaches to the thoracic sympathetic ganglia are described, the risk of pneumothorax generally precludes this procedure for other than neurolytic ablation. The approach that is described uses the principle of inserting a needle in a direction away from a potential complication by taking advantage of very consistent anatomy. Making use of 2 radiologic landmarks, the tubercle

Michael Stanton-Hicks

2001-01-01

206

Thoracic pedicle: surgical anatomic evaluation and relations.  

PubMed

This anatomic study investigated the thoracic pedicle and its relations. The objective was to emphasize the importance of the thoracic pedicle for transpedicular screw fixation to avoid complications during surgery. Twenty cadavers were used to observe the cervical pedicle and its relations. The isthmus of the pedicle was exposed after removal of whole-posterior bony elements, including spinous processes, laminas, lateral masses, and the inferior and superior facets. The pedicle width and height, interpedicular distance, pedicle-inferior nerve root distance, pedicle-superior nerve root distance, pedicle-dural sac distance, root exit angle, and nerve root diameter were measured. There was no distance between the pedicle and dural sac in eight specimens. There was, however, a short distance in 12 remaining specimens in the upper and lower thoracic regions. The distances between the thoracic pedicle and the adjacent nerve roots ranged from 1.5 to 6.7 mm and 0.8 to 6.0 mm superiorly and inferiorly at all levels. The mean pedicle height and width at T1-T12 ranged from 2.9 to 11.4 mm and 6.2 to 21.3 mm, respectively. The interpedicular distance decreased gradually from T1 to T5 and then increased gradually to T12. The mean root exit angle decreased consistently from 104 degrees to 60 degrees. The nerve root diameter was between 2.3 and 2.5 mm at the T1-T5 level and then increased consistently from 2.5 to 3.7 mm. All significant differences were noted at p < 0.05 and p < 0.01. The following suggestions are made based on these results. 1) More care should be taken when a transpedicular screw is placed in the horizontal plane. 2) Improper medial placement of the pedicle screw, especially in the middle thoracic spine, should be avoided, and the anatomic variations between individuals should be considered. 3) Because of substantial variations in the size of thoracic pedicles, utmost attention should be given to the findings of a computed tomographic evaluation before thoracic transpedicular fixation is begun. PMID:11242273

Ugur, H C; Attar, A; Uz, A; Tekdemir, I; Egemen, N; Genç, Y

2001-02-01

207

Medullary cystic kidney disease  

MedlinePLUS

Most people with MCKD reach end-stage kidney disease between ages 30 and 50. Lifelong treatment may control the symptoms of chronic kidney disease. The cysts that occur with MCKD may be very small, but large numbers of them ...

208

Polycystic Kidney Disease  

MedlinePLUS

National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) A service of the National Institute of Diabetes and Digestive and ... Statistics Research Resources Order About Us Español National Kidney and Urologic Diseases Information Clearinghouse Publications Tools and ...

209

Horseshoe Kidney (Renal Fusion)  

MedlinePLUS

... sit amet, consectetur adipiscing elit. Horseshoe Kidney (Renal Fusion) Most people are born with two kidneys, which ... as is the case for people with renal fusion abnormalities. The following information will help you talk ...

210

Wine and Your Kidneys  

MedlinePLUS

... the lower right-hand corner of the player. Wine and Your Kidneys HealthDay April 23, 2014 Related ... Pages Alcohol Kidney Diseases Transcript Drinking a little wine now and then might actually be good for ...

211

Clinical verification of a unilateral otolith test  

NASA Astrophysics Data System (ADS)

In a previous study 13 we reported promising results for a new test to differentiate in vivo unilateral otolith functions. That study pointed to a need for further validation on known pathological cases. In this presentation we will detail the results gathered on a group of clinically verified vestibular defectives (verum) and a normal (control) group. The subjects in the verum group were former patients of the ENT clinic of the university hospital. These subjects had usually suffered from neurinoma of the VIIth cranial nerve or inner ear infections. All had required surgical intervention including removal of the vestibular system. The patients were contacted usually two or more years postoperatively. A group of students from the pre- and clinical phase of medical training served as control. Both groups were subjected to standardized clinical tests. These tests served to reconfirm the intra- or postoperative diagnosis of unilateral vestibular loss in the verum group. In the control group they had to establish the normalcy of the responses of the vestibular system. Both groups then underwent testing on our exccentric rotary chair in the manner described before 13. Preliminary results of the trials indicate that this test may indeed for the first time offer a chance to look at isolated otolith apparati in vivo.

Wetzig, J.; Hofstetter-Degen, K.; Maurer, J.; von Baumgarten, R. J.

212

Unilateral amblyopia: Optical coherence tomography findings  

PubMed Central

Purpose This study was performed to measure the macular and the retinal nerve fiber layer (RNFL) thicknesses using optical coherence tomography (OCT) in patients with unilateral amblyopia. Methods Measurement of the Retinal nerve fiber layer and Macular Retinal Layer thickness for both amblyopic and normal fellow eyes by (OCT) was carried out at king Abdulaziz University Hospital, Riyadh, Saudi Arabia. Results Ninety-three patients with unilateral amblyopia between the ages of 5 years and 12 years were included. The macular retinal thickness and the RNFL thickness were measured using OCT. The mean macular retinal thickness was 259.3 ?m and 255.6 ?m, and the mean RNFL thickness was 112.16 ?m and 106 ?m, in the amblyopic eye and the normal eye, respectively. OCT assessment of RNFL thickness revealed a significantly thicker RNFL in amblyopic eye (P < 0.0001), but no statistically significant difference was found in macular retinal thickness (P = 0.195). Conclusion The amblyopic process may involve the RNFL, but not the macula. However, further evaluation is needed.

Alotaibi, Abdullah G.; Al Enazi, Badriah

2011-01-01

213

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.

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

2013-01-01

214

Pancreas and kidney transplantation  

Microsoft Academic Search

Kidney transplantation is preferred over dialysis for management of end-stage renal disease complicating type 1 or type 2\\u000a diabetes, for those who are eligible. Simultaneous pancreas-kidney (SPK) or pancreas after kidney transplantation (PAK) is\\u000a an important alternative to kidney transplantation alone for type 1 diabetes patients if the patient is able to withstand\\u000a the additional risks of these procedures, because

Jennifer Larsen; Lynn Mack-Shipman

2002-01-01

215

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

216

Kidney and hypertension  

Microsoft Academic Search

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

Marcin Adamczak; Martin Zeier; Ralf Dikow; Eberhard Ritz

2002-01-01

217

HIV and Kidney Disease  

MedlinePLUS

... BUN levels can be due to a high-protein diet, dehydration, or kidney or heart failure. High BUN ... GFR falls. People need a kidney transplant or dialysis when the GFR falls to about 15 or less. The simple screening test of a urine exam for protein is the most sensitive way to diagnose kidney ...

218

Unilateral spatial neglect following right inferior parietal cortectomy  

Microsoft Academic Search

Research in brain-damaged patients has suggested that the right hemisphere plays a role in unilateral spatial neglect (USN), but provides only limited information for pinpointing the intraparietal localization of the lesions associated with this syndrome. We report a case of unilateral neglect in a patient who underwent a right inferior parietal cortectomy for refractory epilepsy without any macroscopic lesion. We

C. Hommet; F. Bardet; B. de Toffol; D. Perrier; A. Biraben; J. P. Vignal; J. M. Scarabin; M. Corbineau; P. Chauvel

2004-01-01

219

Quadratic finite element methods for unilateral contact problems  

Microsoft Academic Search

The present paper is concerned with the frictionless unilateral contact problem between two elastic bodies in a bidimensional context. We consider a mixed formulation in which the unknowns are the displacement field and the contact pressure. We introduce a finite element method using quadratic elements and continuous piecewise quadratic multipliers on the contact zone. The discrete unilateral non-interpenetration condition is

Patrick Hild; Patrick Laborde

2002-01-01

220

Stereopsis and binocular vision after surgery for unilateral infantile cataract  

Microsoft Academic Search

Purpose: To assess the prevalence and level of binocular function in children with unilateral congenital or very early infantile cataract. Methods: We retrospectively reviewed the charts of all patients with unilateral congenital or very early infantile cataract who underwent operation before 4 months of age, at the W. K. Kellogg Eye Center\\/University of Michigan Hospitals, from 1985 to 1995. Amblyopia

Sandra M. Brown; Steven Archer; Monte A. Del Monte

1999-01-01

221

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.

Rocco, Gaetano; Venuta, Federico

2014-01-01

222

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.

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

2013-01-01

223

Effects of unilateral ureteric occlusion on renal necrosis occurring in rats fed a methyl-deficient diet.  

PubMed Central

Wistar male rats were fed from weaning a methyl-deficient diet (groups I and II) or a standard commercial diet (groups III and IV). At the day 3 the left ureter was tied and divided in animals of groups I and III, while those in groups II and IV were sham operated. Rats of all groups were killed on days 8 and 10 to evaluate the incidence and extent of tubular necrosis (day 8) and tubular and cortical necrosis (day 10). The results of this study show that unilateral ureteric obstruction diminishes the incidence, severity and extent of necrosis in the same kidney. Images Fig. 3 Fig. 4

Roberti, M. F.; Perazzo, J. C.; Monserrat, A. J.

1988-01-01

224

Evaluation of unilateral cage-instrumented fixation for lumbar spine  

PubMed Central

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

2010-01-01

225

Normal black kidney  

PubMed Central

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.

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

2014-01-01

226

Endovascular repair of thoracic aortic pathology.  

PubMed

Endovascular repair of thoracic aortic pathology is an evolving and increasingly attractive alternative to open repair. Endograft technology and delivery systems have improved rapidly since their introduction in the 1990s, and early and mid-term results for currently available devices are promising. No individual device has proven to be superior as no comparative trials have been performed. However, each available device is unique in its characteristics to treat aortic disease: GORE(®) TAG(®) (WL Gore and Associates, AZ, USA), Zenith(®) (TX1(®) and TX2(®), Cook, IN, USA), and Talent™ (Medtronic Vascular, CA, USA). In addition to a prerequisite set of endovascular skills, a detailed knowledge of different graft designs and an understanding of aortic pathology significantly affect the efficacy of endovascular repair of thoracic aortic disease. This article focuses on the currently available devices, their characteristics and pivotal clinical trial results. PMID:21728735

Kiguchi, Misaki; Chaer, Rabih A

2011-07-01

227

Giant cell tumor of upper thoracic spine.  

PubMed

Giant cell tumor (GCT) of the spine is a rare benign tumor, but can be aggressive and can exhibit a high local recurrence rate. Furthermore, GCT of the upper thoracic spine may pose diagnostic and management difficulties. Here, we report a rare case of GCT of the upper thoracic spine with soft tissue extension to the spinal canal. The patient was managed by decompressive laminectomy and posterolateral fusion followed by an injection of polymethylmethacrylate into the vertebral lesion. The patient recovered clinically and showed radiological improvement after surgical treatment without tumor recurrence at his last follow-up of postoperative 7 years. We present this unusual case of GCT and include a review of the literature. PMID:24851155

Lee, Chul Gab; Kim, Sung Hoon; Kim, Dong Min; Kim, Seok Won

2014-03-01

228

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.

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

2009-01-01

229

Giant Cell Tumor of Upper Thoracic Spine  

PubMed Central

Giant cell tumor (GCT) of the spine is a rare benign tumor, but can be aggressive and can exhibit a high local recurrence rate. Furthermore, GCT of the upper thoracic spine may pose diagnostic and management difficulties. Here, we report a rare case of GCT of the upper thoracic spine with soft tissue extension to the spinal canal. The patient was managed by decompressive laminectomy and posterolateral fusion followed by an injection of polymethylmethacrylate into the vertebral lesion. The patient recovered clinically and showed radiological improvement after surgical treatment without tumor recurrence at his last follow-up of postoperative 7 years. We present this unusual case of GCT and include a review of the literature.

Lee, Chul Gab; Kim, Sung Hoon; Kim, Dong Min

2014-01-01

230

Thoracoscopy for minimally invasive thoracic spine surgery.  

PubMed

Thoracoscopy has been used worldwide for many years by thoracic surgeons. Despite a long learning curve and technical demands of the procedure, thoracoscopy has several advantages, including better cosmesis, adequate exposure to all levels of the thoracic spine from T2 to L 1, better illumination and magnification at the site of surgery, less damage to the tissue adjacent to the surgical field, less morbidity when compared with standard thoracotomy in terms of respiratory problems, pain, blood loss, muscle and chest wall damages, consequent shorter recovery time, less postoperative pulmonary function impairment, and shorter hospitalization. Good results at short- and medium-term follow-up need to be confirmed at long-term follow-up. PMID:19773050

Longo, Umile Giuseppe; Papapietro, Nicola; Maffulli, Nicola; Denaro, Vincenzo

2009-10-01

231

Thoracic endometriosis syndrome: CT and MRI features.  

PubMed

Thoracic endometriosis is considered to be rare, but is the most frequent form of extra-abdominopelvic endometriosis. Thoracic endometriosis syndrome affects women of reproductive age. Diagnosis is mainly based on clinical findings, which can include catamenial pneumothorax and haemothorax, non-catamenial endometriosis-related pneumothorax, catamenial haemoptysis, lung nodules, and isolated catamenial chest pain. Symptoms are typically cyclical and recurrent, with a right-sided predominance. Computed tomography (CT) is the first-line imaging method, but is poorly specific; therefore, its main role is to rule out other pulmonary diseases. However, in women with a typical clinical history, some key CT findings may help to confirm this often under-diagnosed syndrome. MRI can also assist with the diagnosis, by showing signal changes typical of haemorrhage within diaphragmatic or pleural lesions. PMID:24331768

Rousset, P; Rousset-Jablonski, C; Alifano, M; Mansuet-Lupo, A; Buy, J-N; Revel, M-P

2014-03-01

232

[Unilateral blindness following intranasal aethoxysklerol injection].  

PubMed

In spite of extensive experience based on animal experiments and human treatment, a unilateral, irreversible amaurosis occurred in one case of paravascular sclerotherapy of epistaxis with Aethoxysklerol. The strict submucosal application of Aethoxysklerol does not cause a mural thrombosis but leads to narrowing of the vessels (e.g., in the region of the Locus Kiesselbachii) due to gradual subepithelial sclerosis of the mesenchymal tissue. Temporary or permanent amaurosis has also been described in cases of injection of local anesthetics or glucocorticoid crystalline suspensions in the facial and neck region. From the pathophysiological point of view, allergic reactions, neuroreflex vascular spasm, or micro embolism of the central retinal artery have to be considered. The incident on which this paper is based led to a liability lawsuit. Judgement was given against the attending doctor because of severe bodily injury. PMID:6885527

Uffenorde, J; Georgi, W

1983-07-01

233

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

234

Isolated unilateral idiopathic transient hypoglossal nerve palsy.  

PubMed

A 52-year-old Caucasian man presented with sudden onset of difficulty in moving his tongue to the left with preceding left-sided headache with no neck pain. Earlier, he had self-limiting chest infection without rashes or tonsillar enlargement. His medical and surgical history was unremarkable with no recent trauma. Oral examination revealed difficulty in protruding his tongue to the left with muscle bulk loss and fasciculation on the same side, suggesting left hypoglossal nerve palsy. Examination of the rest of the cranial nerves and nervous system was normal. The patient's oropharyngeal and laryngeal examination was unremarkable with no cervical lymphadenopathy. He had normal laboratory investigations and cerebrospinal fluid examination. Extensive imaging of the head, neck and chest failed to reveal any pathology. Further review by an otorhinologist and rheumatologist ruled out any other underlying pathology. He made a good recovery without treatment. English literature search revealed very few cases of idiopathic, transient, unilateral hypoglossal nerve palsy. PMID:24969070

Ahmed, Syed Viqar; Akram, Muhammad Saqub

2014-01-01

235

Unilateral primary lung hypoplasia diagnosed in adulthood.  

PubMed

Unilateral primary pulmonary hypoplasia is rare in adulthood. It is usually present in the neonatal period or in early childhood, and is characterized by a decreased number of bronchial segments and decreased/absent alveolar air space. Most patients have recurrent episodes of wheezing or pneumonia and severe respiratory distress leading to chronic respiratory failure, whereas some patients may occasionally be asymptomatic. Herein, we present a case of left lung hypoplasia in an asymptomatic 28-year-old male, who was admitted to the hospital for further investigation of an abnormal result on a chest radiograph that was obtained as part of a health evaluation for military service. A thorough workup, including imaging modalities and bronchoscopy, disclosed a hypoplastic left lung, which had gone undiagnosed for 25 years. Embryological, clinical, and diagnostic aspects are briefly discussed. PMID:24026186

Katsenos, Stamatis; Antonogiannaki, Elvira-Markela; Tsintiris, Konstantinos

2014-04-01

236

Unilateral hydroureteronephrosis after a mesh procedure.  

PubMed

Synthetic mesh has become a popular treatment of pelvic floor relaxation and pelvic organ prolapse, with low complication rates. We describe the case of a woman with unilateral hydroureteronephrosis after a mesh procedure (Gynecare Prolift; Ethicon Women's Health & Urology, Ethicon, Inc., Somerville, New Jersey) successfully treated by neoureterocystostomy. A 39-year-old woman with pelvic organ prolapse underwent the mesh procedure. Two months later, she had left flank pain, and hydroureteronephrosis was diagnosed on the same side despite cystoscopic confirmation of ureteral passage at the first operation. The arm of the mesh was removed surgically, and neoureterocystostomy was performed successfully. Mesh surgery is not without serious complications, and surgeons should bear in mind the possible complications associated with this surgical procedure. PMID:20226414

Karateke, Ates; Cam, Cetin; Ayaz, Reyhan

2010-01-01

237

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.

Nie, Hong-Fei; Liu, Kai-Xuan

2013-01-01

238

Über das Thoracic-outlet-Syndrom  

Microsoft Academic Search

Zusammenfassung   In der Ätiologie des Thoracic-outlet-Syndroms (TOS) spielen angeborene knöcherne und fibromuskuläre Strukturen, Haltungsanomalien\\u000a und Traumata eine Rolle. Das Beschwerdebild ist sehr variabel und vielfältig, je nachdem ob die Kompression des Plexus, der\\u000a Arterie oder der Vene im Vordergund steht. Bei der Diagnostik ist die sorgfältige klinische Untersuchung unter Einschluß des\\u000a AER-Testes von ausschlaggebender Bedeutung. Unabdingbar sind die Darstellungen von

J. D. Gruss; C. Geissler

1997-01-01

239

Diagnosis and treatment of thoracic outlet syndrome  

Microsoft Academic Search

Patients who develop symptoms of thoracic outlet syndrome (TOS) have a predisposing anatomic abnormality. In most patients\\u000a with TOS, the symptoms are caused by entrapment of the brachial plexus and they do not arise from compression of the subclavian\\u000a artery, as was previously thought. The tests advocated for diagnosing this common syndrome (i.e., evaluating the positional\\u000a compression of the artery

Masataka Abe; Tadashi Shimamura; Jun Nishida; Katsuaki Ichinohe

1997-01-01

240

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

241

Outcome following Surgery for Thoracic Outlet Syndrome  

Microsoft Academic Search

Introduction: the diagnosis of thoracic outlet syndrome (TOS) relies heavily on subjective rather than objective assessment criteria. Subsequently, published results after surgical decompression vary considerably. This study aimed to use a symptom-based patient-directed questionnaire to assess the outcome after decompression for TOS.Methods: sixty patients who underwent decompression procedures were identified from a prospectively maintained vascular database. Patient records were analysed

V Bhattacharya; M Hansrani; M. G Wyatt; D Lambert; N. A. G Jones

2003-01-01

242

Thoracic dorsal ramus entrapment. Case report.  

PubMed

Entrapment of the dorsal ramus of a thoracic spinal nerve is described in a patient with chronic back pain and sensory disturbance in the cutaneous territory served by the T3-5 dorsal rami. The dorsal ramus of the T-4 nerve was found to be compressed by a bone spur involving the inferior T-4 apophyseal facet. The point of entrapment was a tunnel bounded by the transverse process, apophyseal joint, rib, and superior costotransverse ligament. PMID:2521245

González-Darder, J M

1989-01-01

243

Successful transplantation of marginally acceptable thoracic organs.  

PubMed Central

OBJECTIVE: This study evaluates the efficacy of personally inspecting marginal thoracic organ donors to expand the donor pool. SUMMARY BACKGROUND DATA: The present donor criteria for heart and lung transplantation are very strict and result in exclusion of many potential thoracic organ donors. Due to a limited donor pool, 20-30% of patients die waiting for transplantation. METHODS: The authors have performed a prospective study of personally inspecting marginal donor organs that previously would have been rejected by standard donor criteria. RESULTS: Fourteen marginal hearts and eleven marginal lungs were inspected. All 14 marginal hearts and 10 of the marginal lungs were transplanted. All cardiac transplant patients did well. The mean ejection fraction of the donor hearts preoperatively was 39 +/- 11% (range 15-50%). Postoperatively, the ejection fraction of the donor hearts improved significantly to 55 +/- 3% (p < 0.002). Nine of the ten lung transplant patients did well and were operative survivors. Our donor pool expanded by 36% over the study period. CONCLUSIONS: The present donor criteria for heart and lung transplantation are too strict. Personal inspection of marginal thoracic donor organs will help to maximize donor utilization. Images Figure 1.

Kron, I L; Tribble, C G; Kern, J A; Daniel, T M; Rose, C E; Truwit, J D; Blackbourne, L H; Bergin, J D

1993-01-01

244

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.

Brunelli, Alessandro

2014-01-01

245

Thoracic core needle biopsy using ultrasound guidance.  

PubMed

This article demonstrates the usefulness of ultrasound (US)-guided core needle biopsy in the diagnosis of thoracic lesions. Between January 1997 and June 2000, 45 US-guided core needle biopsies were performed in the department of radiology. This method was chosen in every case when the lesion abutted the chest wall. Conventional histologic examinations supplemented by immunohistochemical methods were performed. The location and size of the mass, the number of samplings, the needle size, the histologic results, and any complications were recorded. Twenty-two lesions reached the anterior, six reached the lateral, and 14 reached the posterior chest wall. Biopsies were performed on three masses from the supraclavicular region. The mean diameter was 4.5 cm and the number of passes was 1.8; 18-G, 16-G, and 14-G needles were used in 41, two, and two cases, respectively. In 43 of the 45 cases (95.68%), an exact histologic diagnosis could be provided. In two cases, only necrotic tissue was seen in the biopsy sample. No major complications occurred. Minor complications, including pain and collaptiform weakness, were documented in four patients. Ultrasound-guided core needle biopsy of thoracic lesions is a safe, quick, and accurate method. For diagnosing thoracic lesions, a single sample with an 18-G biopsy needle is sufficient to achieve a final diagnosis when using appropriate histologic methods. PMID:12973082

Morvay, Z; Szabó, E; Tiszlavicz, L; Furák, J; Troján, I; Palkó, A

2001-06-01

246

Evaluation of renal function after successful treatment for unilateral, non-syndromic Wilms tumor.  

PubMed

Impaired renal function may occur in experimental animals following surgical removal of most functioning renal tissue ("hyperfiltration injury"). Although end-stage renal disease is uncommon among long-term survivors of unilateral, non-syndromic Wilms tumor, concern has been expressed that there may be an increased risk of less serious, but progressive, renal function impairment among these individuals. The recent development of equations for estimating glomerular filtration rate (eGFR) has facilitated the study of renal function in Wilms tumor survivors. However, the estimating equations were developed to categorize individuals with chronic kidney disease and have significant limitations with regard to the accuracy of individual GFR estimates. These limitations must be considered when utilizing the estimating equations in cross-sectional or longitudinal evaluations of renal function in cohorts of patients who have been treated successfully for Wilms tumor or other childhood cancers. PMID:24039069

Green, Daniel M

2013-12-01

247

An extremely rare case of unilateral renal arterial and venous multiple deformity, combined with duplex pelvis and malrotation.  

PubMed

Renal vascular deformity (RVD) happens during the embryonic period when kidneys ascend into the lumber region. However, the exact etiology of this deformity remains unknown. RVD is not a rare congenital anomaly in urology as many cases with vascular deformity have been reported.However, no case has been reported with unilateral kidney almost in the normal position, but with several different branches of ectopic arteries-one even receiving the arterial supply from the contralateral iliac artery-and ectopic veins, one of which forms a collateral circulation with the portal vein. Moreover, it is quite interesting that this case of RVD is combined with another abnormality-duplex pelvis and renal malrotation. We will present this extremely rare case of multiple malformation of the right renal vascular deformity combined with duplex pelvis and malrotation. PMID:23371832

Gao, Liang; Bu, Siyuan; Wan, Fan; Zhao, Fei; Wei, Qiang; Han, Ping; Fan, Tianyong; Yang, Lu

2013-04-01

248

Generalization of visuomotor learning between bilateral and unilateral conditions.  

PubMed

A long history of behavioral and physiological research has suggested that bilateral coordination invokes unique neural processes that are not involved in unilateral movements. This hypothesis predicts that motor learning should show limited transfer between unilateral and bilateral conditions, which is consistent with a recent finding that indicated partial, but not complete, transfer of learning between the two conditions. However, during learning of new motor skills, transformations must also be made between visual and proprioceptive coordinate systems, a process that may occur upstream to the processes that differentiate bilateral from unilateral movements. We now investigate whether visuomotor adaptations are shared between unilateral and bilateral movement conditions. Our results indicate substantial transfer from bilateral to subsequent unilateral conditions for both arms. Interestingly, whereas the nondominant arm never showed complete adaptation to visual rotation under bilateral conditions, this interference, or lack of improvement, in bilateral performance did not disturb the visuomotor adaptation process or transfer, as reflected by superb unilateral performances immediately following the bilateral conditions. These findings unambiguously indicate that visuomotor adaptation can extensively generalize between bilateral and unilateral conditions, thus suggesting a substantial overlap in the neural processes underlying visuomotor transformations between the two movement conditions. Our findings provide support for a two-stage model of motor planning, in which the visuomotor transformation process precedes the processes that convert the visuomotor plan into effector-specific commands that incorporate bilateral synergies and that result in the forces that determine motion. PMID:19759325

Wang, Jinsung; Sainburg, Robert L

2009-11-01

249

Posterior Lumbar Interbody Fusion via a Unilateral Approach  

PubMed Central

This study sought to determine the outcomes of posterior lumbar interbody fusion (PLIF), via a unilateral approach, in selected patients who presented with unilateral leg pain and segmental instability of the lumbar spine. Patients with a single level of a herniated disc disease in the lumbar spine, unilateral leg pain, chronic disabling lower back pain (LBP), and a failed conservative treatment, were considered for the procedure. A total of 41 patients underwent a single-level PLIF using two PEEK™ (Poly-Ether-Ether-Ketone) cages filled with iliac bone, via a unilateral approach. The patients comprised 21 women and 20 men with a mean age of 41 years (range: 22 to 63 years). Two cages were inserted using a unilateral medial facetectomy and a partial hemilaminectomy. At follow-up, the outcomes were assessed using the Prolo Scale. The success of the fusion was determined by dynamic lumbar radiography and/or computerized tomography scanning. All the patients safely underwent surgery without severe complications. During a mean follow-up period of 26 months, 1 patient underwent percutaneous pedicle screw fixation due to persistent LBP. A posterior displacement of the cage was found in one patient. At the last follow up, 90% of the patients demonstrated satisfactory results. An osseous fusion was present in 85% of the patients. A PLIF, via a unilateral approach, enables a solid union with satisfactory clinical results. This preserves part of the posterior elements of the lumbar spine in selected patients with single level instability and unilateral leg pain.

Shin, Hyun Chul; Yi, Seong; Kim, Sang Hyun; Yoon, Do Heum

2006-01-01

250

Unilateral Auditory Neuropathy Caused by Cochlear Nerve Deficiency  

PubMed Central

Objective. To explore possible corelationship between the cochlear nerve deficiency (CND) and unilateral auditory neuropathy (AN). Methods. From a database of 85 patients with unilateral profound sensorineural hearing loss, eight who presented with evoked otoacoustic emissions (EOAEs) or cochlear microphonic (CM) in the affected ear were diagnosed with unilateral AN. Audiological and radiological records in eight patients with unilateral AN were retrospectively reviewed. Results. Eight cases were diagnosed as having unilateral AN caused by CND. Seven had type “A” tympanogram with normal EOAE in both ears. The other patient had unilateral type “B” tympanogram and absent OAE but CM recorded, consistent with middle ear effusion in the affected ear. For all the ears involved in the study, auditory brainstem responses (ABRs) were either absent or responded to the maximum output and the neural responses from the cochlea were not revealed when viewed by means of the oblique sagittal MRI on the internal auditory canal. Conclusion. Cochlear nerve deficiency can be seen by electrophysiological evidence and may be a significant cause of unilateral AN. Inclined sagittal MRI of the internal auditory canal is recommended for the diagnosis of this disorder.

Liu, Cheng; Bu, Xingkuan; Wu, Feiyun; Xing, Guangqian

2012-01-01

251

Thoracic Aortic Endografting Is the Treatment of Choice for Elderly Patients With Thoracic Aortic Disease  

PubMed Central

Objective: To assess the effect of age on outcomes following thoracic aortic endografting. Summary Background Data: Endograft therapy for thoracic aortic disease is rapidly evolving. This therapy is less invasive, and elderly patients with significant medical comorbidities are more frequently referred for endografting. We hypothesized that elderly patients over the age of 75 have worse outcomes after thoracic endografting than patients under the age of 75. Methods: We retrospectively reviewed the charts of the first 42 patients who underwent endografting for thoracic aortic pathology. Charts were reviewed for demographics, comorbid conditions, perioperative complications and death, endoleaks, and results at 3, 6, and 12 months. Preexisting medical conditions were also evaluated to determine if any patient characteristics were associated with adverse outcomes. Perioperative morbidity included cardiac, pulmonary, renal, hemorrhagic, and neurologic (stroke and spinal cord injury) complications. Results: Twenty-four patients were under the age of 75, and 18 patients were 75 or older. Baseline demographics and comorbidities were similar between the 2 groups. There were no differences in operative time, length of stay, perioperative mortality, or the incidence of significant complications between the 2 age groups. Gender, however, was associated with a statistically significant difference between the occurrence of complications, with more women experiencing complications than men (P = 0.026, relative risk = 2.36). One patient (age >75 years) in the entire cohort of 42 (2.4%) suffered a spinal cord injury. At 3 months, endoleaks were more common in the older age group (P = 0.059). Conclusion: Endograft therapy for thoracic aortic disease can be performed safely in elderly patients with no significant increase in perioperative morbidity or mortality compared with younger patients. Female gender is associated with a higher likelihood of perioperative complications, regardless of age. The overall incidence of spinal cord injury is very low. Endograft therapy, when anatomically possible, is the treatment of choice for thoracic aortic disease in elderly patients.

Kern, John A.; Matsumoto, Alan H.; Tribble, Curtis G.; Gazoni, Leo M.; Peeler, Benjamin B.; Harthun, Nancy L.; Chong, Tae; Cherry, Kenneth J.; Dake, Michael D.; Angle, John S.; Kron, Irving L.

2006-01-01

252

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

253

A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor  

PubMed Central

While the majority of human spinal cord injuries occur in the cervical spinal cord, the vast majority of laboratory research employs animal models of spinal cord injury (SCI) in which the thoracic spinal cord is injured. Additionally, because most human cord injuries occur as the result of blunt, non-penetrating trauma (e.g. motor vehicle accident, sporting injury) where the spinal cord is violently struck by displaced bone or soft tissues, the majority of SCI researchers are of the opinion that the most clinically relevant injury models are those in which the spinal cord is rapidly contused.1 Therefore, an important step in the preclinical evaluation of novel treatments on their way to human translation is an assessment of their efficacy in a model of contusion SCI within the cervical spinal cord. Here, we describe the technical aspects and resultant anatomical and behavioral outcomes of an unilateral contusive model of cervical SCI that employs the Infinite Horizon spinal cord injury impactor. Sprague Dawley rats underwent a left-sided unilateral laminectomy at C5. To optimize the reproducibility of the biomechanical, functional, and histological outcomes of the injury model, we contused the spinal cords using an impact force of 150 kdyn, an impact trajectory of 22.5° (animals rotated at 22.5°), and an impact location off of midline of 1.4 mm. Functional recovery was assessed using the cylinder rearing test, horizontal ladder test, grooming test and modified Montoya's staircase test for up to 6 weeks, after which the spinal cords were evaluated histologically for white and grey matter sparing. The injury model presented here imparts consistent and reproducible biomechanical forces to the spinal cord, an important feature of any experimental SCI model. This results in discrete histological damage to the lateral half of the spinal cord which is largely contained to the ipsilateral side of injury. The injury is well tolerated by the animals, but does result in functional deficits of the forelimb that are significant and sustained in the weeks following injury. The cervical unilateral injury model presented here may be a resource to researchers who wish to evaluate potentially promising therapies prior to human translation.

Lee, Jae H.T.; Streijger, Femke; Tigchelaar, Seth; Maloon, Michael; Liu, Jie; Tetzlaff, Wolfram; Kwon, Brian K.

2012-01-01

254

Estrogen preserves split renal function in a chronic complete unilateral ureteral obstruction animal model  

PubMed Central

Estrogen may help to preserve renal function in chronic kidney disease. This study examined whether estrogen administration or deprivation affected the split renal function in rats subjected to chronic unilateral ureteral obstruction (UUO). Fifteen adult female Sprague-Dawley rats were randomly divided into three groups. Low- and high-estrogen groups were modeled by female castration or estrogen intraperitoneal injection, respectively, and the rats in the normal-estrogen group were untreated. Intermittent split renal function [glomerular filtration rate (GFR)] examination was performed on rats on days 2, 6 and 16 after UUO surgery via single-photon emission computed tomography (SPECT/CT). Routine hematoxylin and eosin (H&E) staining, immunohistochemistry, pathology examination and electron microscopy were performed to compare the histological differences. Low-, normal- and high-estrogen groups were successfully established (P<0.001). In the acute stage, the GFR of the contralateral healthy kidney showed a greater compensatory rise in the normal- and high-estrogen groups than in the low-estrogen group (P<0.05). In the chronic stage, the GFR of the obstructed kidney continued to decrease with the GFR of the high-estrogen group being significantly better preserved than that of the low-estrogen group (P<0.05). The GFR of the contralateral kidney compensated to the greatest extent in the high-estrogen group (P=0.01), and the total GFR was significantly superior (P<0.05). Routine H&E examination showed significant histological changes following surgery. The low-estrogen group had significant renal interstitial fibrosis compared with the normal- and high-estrogen groups (P<0.05), as observed by immunohistochemical (IHC) examination of transforming growth factor-? (TGF-?) and ?-smooth muscle actin (?-SMA). Electron-microscopic (EM) examination also differentiated between groups. In conclusion, estrogen administration and deprivation significantly affected renal function. Estrogen may preserve the split renal function (GFR) in rats with chronic UUO.

MAO, SHANHUA; XU, HUA; ZOU, LUJIA; XU, GANG; WU, ZHONG; DING, QIANG; JIANG, HAOWEN

2014-01-01

255

Urinary PGE2 in rats with chronic partial unilateral ureteral obstruction.  

PubMed

Urinary prostaglandin E2 (PGE2) was measured in Munich-Wistar rats with surgically created chronic partial unilateral ureteral obstruction (UUO). Mean values of bladder urine PGE2 were higher in sham than in UUO (24.5 +/- 14.4 vs 12.9 +/- 8.2 ng/mg creatinine, respectively, P less than 0.05). Following diuresis, both ureters were cannulated and urine was collected. PGE2 excretion was increased in sham (66.5 +/- 34.4 and 70.1 +/- 44.5 ng/mg creatinine, left and right, respectively). But in UUO, the obstructed kidney excreted less PGE2 than the contralateral kidney (32.1 +/- 6.0 vs 62.3 +/- 40.4 ng/mg creatinine, obstructed vs contralateral, respectively, P = 0.08). PGE2 synthesis was then determined in separated renal medullary and cortical slices. Renal medullary slices from kidneys with severe obstruction synthesized less PGE2 than the contralateral unobstructed side (3.30 +/- 1.22 vs 10.52 +/- 3.23 ng/mg wet wt-30 min, respectively, P less than 0.05) and failed to respond to arachidonic acid stimulation with any significant increase in PGE2 synthesis (3.30 +/- 1.22 vs 4.47 +/- 1.04 ng/mg wet wt-30 min, baseline vs stimulated). In contrast, contralateral unobstructed kidney slices responded with a significant increase in PGE2 synthesis (10.52 +/- 3.23 vs 21.10 +/- 2.50 ng/mg wet wt-30 min, baseline vs stimulated, P less than 0.05). We conclude that chronic partial UUO in the Munich-Wistar rats resulted in significantly less PGE2 elaboration. PMID:1908925

Sankari, B R; Steinhardt, G F; Salinas-Madrigal, L; Spry, L A

1991-09-01

256

THORACIC REGION SELF-MOBILIZATION: A CLINICAL SUGGESTION  

PubMed Central

Limitations in thoracic spine motion may be due to restrictions in contractile or non-contractile tissues. Joint mobilizations are indicated when hypomobility of a joint (non-contractile tissue) is identified. The ability for a patient to perform self-mobilizations of the thoracic spine and ribs may help maximize intervention outcomes. The purpose of this article is to describe a low cost, portable device which can be used for thoracic spine self-mobilization techniques.

Grindstaff, Terry L.

2012-01-01

257

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.

2013-01-01

258

Acute phase responses following minimal access and conventional thoracic surgery  

Microsoft Academic Search

Objectives: Major thoracic surgery is associated with trauma-related immunological changes. These may impair anti-tumour immunity. We hypothesize that the reduced operative trauma associated with a video-assisted thoracic surgery (VATS) approach may decrease acute phase responses and, consequently, lead to better preservation of immune function. This prospective randomized study compared the effects of conventional open thoracic surgery and VATS on acute

S. R Craig; H. A Leaver; P. L Yap; G. C Pugh; W. S Walker

2001-01-01

259

[Kidney and hypertension].  

PubMed

In patients with chronic kidney disease elevated blood pressure is a common finding, but primary hypertension can also damage healthy kidneys. Renal outcome is strictly dependent on blood pressure, no matter whether the kidneys are cause or consequence of hypertension. Furthermore, hypertension and kidney disease are strong cardiovascular risk factors. In every patient diagnosed with hypertension glomerular filtration rate has to be checked. Proteinuria and structural abnormalities of the kidneys should be ruled out. Patients with a decreased glomerular filtration rate, proteinuria or pathologic ultrasound should be seen by a nephrologist. A strict antihypertensive therapy (blood pressure <130/80 mmHg) can substantially improve the prognosis of hypertensive renal patients. In patients with kidney damage, inhibitors of the renin-angiotensin-system are preferred. To avoid adverse events a close monitoring of antihypertensive therapy is warranted. PMID:19319498

Quack, I; Rump, L C

2009-04-01

260

The thoracic spine sign in bedside ultrasound. Three cases report.  

PubMed

The "thoracic spine sign" is visualized when anechoic or hypoechoic fluid is present in the pleural space. Fluid serves as a medium through which the thoracic vertebral bodies are visualized above the diaphragm. We present three cases of emergency department patients with a thoracic spine sign identified on bedside ultrasound. These patients were subsequently diagnosed with pleural fluid accumulations on chest radiograph. Our findings suggest that the identification of the sonographic spine sign may aid the physician in the evaluation and diagnosis of emergency department patients with thoracic complaints. PMID:24791852

Ahmed, Abdul-Aziz R; Martin, Jennifer A; Saul, Turandot; Lewiss, Resa E

2014-06-01

261

Robotic thoracic surgery: from the perspectives of European chest surgeons  

PubMed Central

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

2014-01-01

262

Thoracic empyema due to bacterial translocation in acute appendicitis.  

PubMed

Appendicitis and thoracic empyema are rarely presented together. Herein, we present a thoracic empyema due to bacterial translocation in a patient, after she underwent appendicectomy for nonperforated acute appendicitis. Postoperative third day, thoracic empyema was revealed clinically and radiologically. Tube thoracostomy and antibiotherapy were performed. Despite all these therapy, her symptoms went on, and abdominal ultrasonography revealed multilocular collections and formations of abscess in the abdomen. All abscesses were drained by nonvascular interventional radiologic methods. We believe that simultaneous occurence of thoracic empyema and formations of abscess were occured due to bacterial translocation. PMID:23581268

Tokat, Arif Osman; Karasu, Sezgin; Barlas, Aziz Mutlu; Akgün, Yusuf Akif

2013-01-01

263

Kidney's role in hypertension.  

PubMed

Hypertension is both the cause and effect of kidney disease. Together these two diseases have become epidemics in our society and are associated with an increased risk of cardiovascular events. Over the last several decades multiple clinical and transplant studies have shown the kidney to be an important determinant of essential hypertension. However, little is known about the direct mechanisms in which the kidney induces hypertension or why the blood pressure tends to rise in the failing kidney. This document provides a systematic analysis of peer-reviewed, published literature pertaining to the central role of the kidney in the development of essential hypertension in adults. We will describe the pathophysiology of essential hypertension and its relationship to chronic kidney disease and cardiovascular disease. Particular focus will be drawn to effects of sodium handling, the renin angiotensin aldosterone system, the sympathetic system and mediators of vascular tone in the development of kidney induced hypertension. In addition, the mediators which initiate and maintain the progression of chronic kidney disease, and how these factors are related in the development of hypertension will also be discussed. Finally, therapeutic strategies to treat individuals with chronic kidney disease in order to prevent the development of essential hypertension and lower their cardiovascular risk will be presented. PMID:19942846

Lubanski, M S; McCullough, P A

2009-12-01

264

Glycosphingolipids and kidney disease.  

PubMed

Glycosphingolipids, derived from the addition of sugar-moieties to the sphingolipid ceramide, are highly abundant in the kidney. Glycosphingolipids are known to play an important role in organ function at least in part from inherited lipid storage diseases such as Anderson-Fabry disease (Fabry's disease; FD) that results from a mutation in alpha-galactosidase a (?-GLA or ?-Gal A), the enzyme responsible for catalyzing the removal of terminal galactose residues from glycosphingolipids. The inactivation in ?-GLA in FD results in the accumulation of glycosphingolipids, including globosides and lactosylceramides, which manifests as several common pathologies including end-stage kidney disease. More recently, glycosphingolipids and other sphingolipids have become increasingly recognized for their roles in a variety of other kidney diseases including polycystic kidney disease, acute kidney injury, glomerulonephritis, diabetic nephropathy and kidney cancer. This chapter reviews evidence supporting a mechanistic role for glycosphingolipids in kidney disease and discusses data implicating a role for these lipids in kidney disease resulting from metabolic syndrome. Importantly, inhibitors of glycosphingolipid synthesis are well tolerated in animal models as well as in humans. Thus, an increased understanding of the mechanisms by which altered renal glycosphingolipid metabolism leads to kidney disease has great therapeutic potential. PMID:21910086

Mather, Andrew R; Siskind, Leah J

2011-01-01

265

The kidney allocation system.  

PubMed

The current kidney allocation system for transplants is outdated and has not evolved to reflect the changing demographics of patients on the waiting list. This article proposes a new system for kidney allocation, which more appropriately incorporates the biology of highly sensitized patients into the waiting-time scoring algorithm. This system will significantly reduce mismatches between possible donor kidney longevity and life expectancy of recipients, and makes incremental advances toward more geographic sharing. The proposed system makes significant progress toward eliminating deficiencies in the current system, and has the potential to increase the supply of available kidneys. PMID:24206858

Friedewald, John J; Samana, Ciara J; Kasiske, Bertram L; Israni, Ajay K; Stewart, Darren; Cherikh, Wida; Formica, Richard N

2013-12-01

266

Ophthalmoplegic migraine with alternating unilateral and bilateral internal ophthalmoplegia.  

PubMed

We describe a patient with ophthalmoplegic migraine and internal ophthalmoplegia with alternating unilateral involvement and bilateral involvement in whom brain MRI scan showed alternating gadolinium enhancement on the cisternal portion of the oculomotor nerve. PMID:17501857

Choi, Jeong-Yoon; Jang, Sang Hyun; Park, Moon Ho; Kim, Byung Jo; Lee, Dae Hie

2007-05-01

267

Respiratory Displacement of the Thoracic Aorta: Physiological Phenomenon With Potential Implications for Thoracic Endovascular Repair  

Microsoft Academic Search

The purpose of this study was to assess the magnitude and direction of respiratory displacement of the ascending and descending thoracic aorta during breathing maneuvers. In 11 healthy nonsmokers, dynamic magnetic resonance imaging was performed in transverse orientation at the tracheal bifurcation during maximum expiration and inspiration as well as tidal breathing. The magnitude and direction of aortic displacement was

Tim Frederik Weber; Ralf Tetzlaff; Fabian Rengier; Philipp Geisbuesch; Annette Kopp-Schneider; Dittmar Boeckler; Monika Eichinger; Hans-Ulrich Kauczor; Hendrik von Tengg-Kobligk

2009-01-01

268

Thoracic outlet syndrome: A functional dysfunction of the upper thoracic aperture?  

PubMed

Purpose of the study: To determine possible malfunction of the upper thoracic aperture (an upward displacement of the first rib at the costotransverse joint) as the cause of thoracic outlet syndrome (TOS) symptoms among consecutive TOS patients admitted for conservative treatment. Basic procedures: Fifteen consecutive TOS patients, with a positive TOS index, admitted for conservative treatment were investigated with a three-dimensional CT scan of the upper thoracic aperture. A rehabilitation program was administered at a rehabilitation ward. The CT scans were evaluated for a possible upward displacement of the first rib at the costotransverse joint. The outcome of conservative therapy was classified as good if the patient was symptom free and poor if loading of the upper limbs still produced symptoms. Outcome follow-up time was 1 year. Main findings: An asymmetry of the first rib was shown on the symptomatic side, indicating an upward displacement of the first rib at the costotransverse joint, in 12 of the patients. Only three patients did not respond to therapy. Eleven patients were engaged in sedentary work. Conclusion: Malfunction of the upper thoracic aperture, especially among patients doing sedentary work, seems to cause TOS symptoms. A carefully planned conservative therapy program based on the functional findings of the individual patient is recommended. PMID:24572819

Lindgren, K A; Rytkönen, H

1997-01-01

269

Emergent Repair of Acute Thoracic Aortic Catastrophes  

PubMed Central

Objective To provide a contemporary institutional comparative analysis of expedient correction of acute catastrophes of the descending thoracic aorta (ACDTA) by traditional direct thoracic aortic repair (DTAR) or thoracic endovascular aortic repair (TEVAR). Design Single-center retrospective review (April 2001-January 2010). Setting Academic medical center. Patients One hundred patients with ACDTA treated with either TEVAR (n=76) or DTAR (n=24). Indications for repair included ruptured degenerative aneurysm (n = 41), traumatic transection (n = 27), complicated acute type B dissection (n=20), penetrating ulcer (n=4), intramural hematoma (n=3), penetrating injury (n=3), and embolizing lesion (n=2). Main Outcome Measures Demographics and 30-day and late outcomes were analyzed using multivariate analysis over a mean follow-up of 33.8 months. Results Among the 100 patients, mean (SD) age was 58.5 (17.3) years (range, 18–87 years). Demographics and comorbid conditions were similar between the 2 groups, except more patients in the DTAR group had prior aortic surgery (P=.02) and were older (P=.01). Overall 30-day mortality was significantly better among the TEVAR group (8% vs 29%; P=.007). Incidence of postoperative myocardial infarction, acute renal failure, stroke, and paraplegia/paresis was similar between the 2 treatment groups (TEVAR, 5%, 12%, 8%, and 8% vs DTAR, 13%, 13%, 9%, and 13%, respectively). Major respiratory complications were lower in the TEVAR group (16% vs 48%; P<.05). Mean length of hospital stay was also shorter after TEVAR (13.5 vs 16.3 days; P=.30). Independent predictors of patient mortality included age (P=.004) and DTAR (P=.001). Conclusion Patients presenting with ACDTA are best treated with TEVAR whenever feasible.

Naughton, Peter A.; Park, Michael S.; Morasch, Mark D.; Rodriguez, Heron E.; Garcia-Toca, Manuel; Wang, C. Edward; Eskandari, Mark K.

2014-01-01

270

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.

2010-01-01

271

Unilateral Mydriasis After Mandibular Fracture Fixation Surgery  

PubMed Central

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

Nesioonpour, Sholeh; Khiabani, Kazem; Hassanijirdehi, Marzieh

2014-01-01

272

Congenital unilateral hypoplasia of depressor anguli oris.  

PubMed

Objectives. Asymmetric facial appearance may originate from abnormalities of facial musculature or facial innervation. We describe clinical features of congenital hypoplasia of depressor anguli oris muscle in a child. Material and Methods. Chart of a 10-month-old female referred to a tertiary care pediatric hospital for assessment of facial paralysis was reviewed. Data included relevant history and physical examination, diagnostic work up, and management. Results. The child presented with asymmetric movement of lower lip since birth. Asymmetry of lower lip was more pronounced when she smiled and cried. Rest of the face movement was symmetric. On examination, the face appeared symmetric at rest. The child had inward deviation of right lower lip when she smiled. Facial nerve function, as determined by frowning/forehead, wrinkling, eye closure, nasolabial fold depth, and tearing, was symmetric. Magnetic resonance imaging of the temporal bones and internal auditory canals were within normal limits. Echocardiogram did not show cardiac abnormality. Auditory brainstem response showed no abnormality. Conclusions. Congenital hypoplasia of depressor anguli oris is a rare anomaly that causes asymmetric crying face. Pediatricians and otolaryngologists need to be cognizant of cardiac, head and neck, and central nervous system anomalies associated with congenital unilateral hypoplasia of depressor anguli oris. PMID:23024875

Ulualp, Seckin O; Deskin, Ronald

2012-01-01

273

Unilateral cryptorchidism in mice mutant for Ptgds.  

PubMed

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

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

2013-02-01

274

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

275

Stabilization procedures for thoracic and lumbar fractures.  

PubMed

New concepts regarding the biomechanics of spinal instability, new technology for spinal and neurodiagnostic imaging, further evolution of the role of neurological decompression, and the development of improved systems and techniques for achieving anatomical reconstruction and fixation of the spine continue to improve the care of patients suffering injuries of the thoracic and lumbar spine. This field of medicine is in rapid evolution, and newer improved methods will be forthcoming in the near future. An understanding of all of these developments as well as their limitations and potential complications is requisite if we are to optimize the functional capability of patients suffering these catastrophic injuries. PMID:3288401

Sypert, G W

1988-01-01

276

Thoracic complications and emergencies in oncologic patients  

PubMed Central

Abstract Oncology patients often experience urgent or emergent medical complications that are a direct or indirect result of the underlying malignant condition and are first identified or clarified on radiologic imaging studies. The aim of this review is to identify, discuss, and illustrate some of the major thoracic complications in patients with primary intrathoracic or extrathoracic neoplasms; particular focus is placed on issues in which radiologic imaging may have a significant impact on patient management, including superior vena cava (SVC) syndrome, post-obstructive pneumonia, diaphragmatic paralysis, pleural effusions, pericardial disease, tracheo-esophageal fistula, deep venous thrombosis, and pulmonary embolism.

2009-01-01

277

[Tele-surgery of thoracic sympathectomy].  

PubMed

Experience of surgical treatment of Raynaud's disease with application of thoracoscopic sympathectomy (TSSE) method using telesurgical technique was analyzed. Operative intervention was performed in 17 patients. Stable positive result was observed in all the patients for the period of 2 years and more. Regarding the intervention traumaticity, efficacy of treatment in immediate and late postoperative period, the patients quality of life, the duration of stay in hospital and the value of treatment, the TSSE results, performed with telesurgical technique application, were significantly better than the results of thoracotomic sympathectomy. Peculiarities of anesthesiologic support and predominance of application of monopulmonary artificial ventilation of lungs during performance of thoracic sympathectomy were noted. PMID:12145857

Zemliankin, O O; Arbuzov, I V; Polinchuk, I S; Polinchuk, I M; Diachenko, A Iu

2002-04-01

278

How Is Kidney Cancer Staged?  

MedlinePLUS

... rates for kidney cancer by stage How is kidney cancer staged? The stage of a cancer describes ... the information is not available.” T categories for kidney cancer TX: The primary tumor cannot be assessed ( ...

279

Kidney Disease Risks among Hispanics  

MedlinePLUS

... Renal Home > Kidney Health > Are You At Risk? Kidney Disease Risks Among Hispanics Hispanics are more at ... year) Charity Navigator Stay Connected With the American Kidney Fund: nonprofit software About Us | Print This Page | ...

280

Targeted Therapies for Kidney Cancer  

MedlinePLUS

... is kidney cancer treated? Surgery for kidney cancer Ablation and other local therapy for kidney cancer Active ... nausea, diarrhea, headaches, low blood cell counts, and liver problems. It can cause lab test results of ...

281

Sexuality and Chronic Kidney Disease  

MedlinePLUS

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

282

Kidney (Renal) Failure  

MedlinePLUS

... scintigraphy (www.radiologyinfo.org/en/info.cfm?pg=renal) : During this nuclear medicine examination, the kidneys are evaluated using a radiotracer and a gamma camera . This test can provide information about both the function of the kidneys by allowing the radiologist or ...

283

Internal jugular vein stenosis is common in patients presenting with neurogenic thoracic outlet syndrome.  

PubMed

Previous magnetic resonance imaging studies have shown abnormalities of the internal jugular veins in patients with thoracic outlet syndrome (TOS), but this finding has largely been ignored. We, thus, prospectively performed diagnostic brachiocephalic venograms in all patients with diagnosed neurogenic TOS from April 2008 to December 2011 (mean age, 42.6; r, 16-68; 77.8% women and 22.2% men). Stenosis of the left internal jugular vein, left subclavian vein, right internal jugular vein, and right subclavian vein were assessed, and significant stenoses of these vessels were seen in 63.49%, 65.08%, 60.32%, and 68.25% of patients, respectively. Internal jugular vein stenosis was not present in 23.81%, present unilaterally in 28.57%, and present bilaterally in 47.62% of patients. Subclavian vein stenosis was not present in 17.46%, present unilaterally in 28.57%, and present bilaterally in 53.97% of patients. Phi coefficients of correlation were 0.067 between left internal jugular vein and left subclavian vein stenoses, 0.061 between right internal jugular vein and right subclavian vein stenoses, and 0 between any internal jugular vein and any subclavian vein stenoses, indicating there is no correlation between jugular vein stenosis and subclavian vein stenosis in these patients. We conclude that right and left internal jugular vein stenosis is common in patients with neurogenic TOS symptoms. Treatment of internal jugular vein stenosis could potentially benefit these patients, and the implications of these findings warrant further study. PMID:24462538

Ahn, Samuel S; Miller, Travis J; Chen, Sheena W; Chen, Julia F

2014-05-01

284

Video-assisted thoracic surgery. Current state of the art.  

PubMed Central

OBJECTIVE. The author reviews the current state of the art of video-assisted thoracic surgery in the context of modern thoracic surgical practice. SUMMARY BACKGROUND DATA. Thoracoscopy has been a part of thoracic surgical practice for many years, but was used mainly for diagnosis of pleural disease. The development of laparoscopic cholecystectomy awakened a new interest in this technique and led to the development of many new therapeutic and diagnostic applications of video-assisted thoracic surgery. METHODS. Current literature and the author's personal experience with more than 500 cases are reviewed. RESULTS. Video-assisted techniques have proven useful for the performance of a broad spectrum of thoracic surgical procedures. Patients may experience less pain and have a shorter hospital stay after a video-assisted procedure. Definitive proof of less morbidity when compared with the analagous open procedure remains to be determined. Patient acceptance has been high, and most thoracic surgeons use these techniques in their practice. CONCLUSIONS. Video-assisted thoracic surgical procedures have made a significant impact on the practice of thoracic surgery. Advantages and disadvantages of specific procedures remain to be definitively determined. Surgeons have learned these techniques and have kept morbidity to acceptance levels during the learning phase. Where these techniques ultimately fit into the overall practice remains to be determined as more experience is gained. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. Figure 8. Figure 9. Figure 10. Figure 11. Figure 12. Figure 13. Figure 14.

Kaiser, L R

1994-01-01

285

Thoracic epidural anesthesia improves outcome after breast surgery.  

PubMed Central

OBJECTIVE: The authors' objective was to compare the outcomes, including the incidence of nausea and vomiting and the time until discharge to home, of patients undergoing general anesthesia and thoracic epidural anesthesia for oncologic breast procedures. SUMMARY BACKGROUND DATA: General anesthesia is the traditional anesthetic technique used in oncologic breast procedures. In March 1993, the authors initiated the use of high thoracic epidural anesthesia for patients undergoing oncologic breast surgery and reconstructive procedures. METHODS: A retrospective analysis was undertaken of 136 operations performed by one surgeon (T.J.E.) at Brigham and Women's Hospital. A chi square analysis was used to compare the outcomes of patients undergoing general anesthesia and thoracic epidural anesthesia. RESULTS: Compared with general anesthesia, thoracic epidural anesthesia was associated with a statistically significant earlier hospital discharge (p = 0.01). For quadrantectomy/axillary node dissection procedures, 20 of 39 patients (51%) having thoracic epidural anesthesia were discharged on the operative day versus 7 of 32 patients (22%) in the general anesthesia group. Furthermore, 8 of 39 patients (20%) in the thoracic epidural group experienced nausea and/or vomiting during their hospital stay versus 18 of 32 patients (56%) in the general anesthesia group (p = 0.002). CONCLUSION: Thoracic epidural anesthesia is a safe technique not associated with neurologic or respiratory complications. The use of thoracic epidural anesthesia for breast surgery could improve patients recovery and reduce the cost of these procedures.

Lynch, E P; Welch, K J; Carabuena, J M; Eberlein, T J

1995-01-01

286

Thoracic duct and cisterna chyli: evaluation with multidetector row CT  

PubMed Central

Objectives The aim of this study was to evaluate the normal anatomy of the thoracic duct and cisterna chyli obtained by axial and multiplanar reformation (MPR) images of 1 mm slice thickness using multidetector row CT (MDCT). Methods We evaluated the ability of MDCT to examine the normal anatomy of the thoracic duct and cisterna chyli. The axial and coronal images of thoracoabdominal MDCT images obtained in 50 patients (20 females and 30 males; mean age, 63.5 years; range, 32–81 years) were reviewed between January and October 2005. We excluded patients with malignant neoplasms, inflammation or vascular diseases (e.g. aortic aneurysm, aortic dissection) and those with a history of thoracoabdominal surgery. The thoracic duct was divided into three anatomical sections: the upper, middle and lower. We evaluated the degree of visualisation and the maximum size of the thoracic duct. We also evaluated the degree of visualisation, maximum size, configuration and location of the cisterna chyli. Results Visualisation of the thoracic duct and cisterna chyli was almost 100% on axial and coronal images. The lower section of the thoracic duct was most clearly visualised among the three sections. There was little difference in the maximum size of the thoracic duct among the three sections. The cisterna chyli was most frequently located at the Th12 or L1 level, and the most common type was the “straight thin tube type”. Conclusion Axial and MPR images of 1 mm slice thickness using MDCT can clearly depict the thoracic duct and cisterna chyli.

Kiyonaga, M; Mori, H; Matsumoto, S; Yamada, Y; Sai, M; Okada, F

2012-01-01

287

Thoracic Outlet Syndromes— Application of Microcirculation Techniques and Clinical Review  

Microsoft Academic Search

The thoracic outlet syndromes of the upper extremities consist of many disorders. The most important two are the costoclavicular syndrome (compres sion of neurovascular structures between the clavicle and the first rib) and the scalenus anticus syndrome (compression of these structures within the scalene triangle). Congenital abnormalities of the clavicle, congenital small thoracic outlet, high first rib, cervical ribs of

Travis Winsor; David Winsor; Amani Mikail; A. E. Sibley

1989-01-01

288

Neurography of the brachial plexus in the thoracic outlet syndrome  

Microsoft Academic Search

Neurography of the brachial plexus was carried out in 180 patients with suspected thoracic outlet syndrome and in 30 normal subjects. In the thoracic outlet syndrome, abnormalities were found in 85% of suspected cases. Narrowing was seen in the scalenus triangle (30%), in the costoclavicular-space (75%) and at the subcoracoid level (6%). Translucent lines were present in 53%, and in

M. Takeshita; H. Minamikawa; H. Iwamoto; N. Takagishi

1991-01-01

289

Thoracic outlet syndrome caused by first rib hemangioma  

Microsoft Academic Search

We report a case of first rib hemangioma that caused thoracic outlet syndrome. A 50-year-ole woman who was admitted to our hospital with a clinical diagnosis of thoracic outlet syndrome presented with fullness and easy fatigue of her right arm. Her right arm discomfort was associated with intermittent engorgement of superficial veins over the shoulder girdle. A chest radiograph revealed

Kee-Min Yeow; Hung-Chang Hsieh

2001-01-01

290

A comprehensive classification of thoracic and lumbar injuries  

Microsoft Academic Search

In view of the current level of knowledge and the numerous treatment possibilities, none of the existing classification systems of thoracic and lumbar injuries is completely satisfactory. As a result of more than a decade of consideration of the subject matter and a review of 1445 consecutive thoracolumbar injuries, a comprehensive classification of thoracic and lumbar injuries is proposed. The

F. Magerl; M. Aebi; S. D. Gertzbein; J. Harms; S. Nazarian

1994-01-01

291

Disappointing results with a new commercially available thoracic endograft  

Microsoft Academic Search

IntroductionNew devices for endovascular treatment of thoracic aortic diseases were recently approved for clinical use by European authorities, obtaining the Conformité Européenne (CE) mark. In all patients who underwent endovascular treatment of a thoracic aortic disease in 2002, we used a new CE-marked device, the Endofit stent graft. The device is constituted of nitinol stents and polytetrafluoroethylene fabric, and has

Germano Melissano; Yamume Tshomba; Efrem Civilini; Roberto Chiesa

2004-01-01

292

Extraforaminal ligament attachments of the thoracic spinal nerves in humans  

PubMed Central

An anatomical study of the extraforaminal attachments of the thoracic spinal nerves was performed using human spinal columns. The objectives of the study are to identify and describe the existence of ligamentous structures at each thoracic level that attach spinal nerves to structures at the extraforaminal region. During the last 120 years, several mechanisms have been described to protect the spinal nerve against traction. All the described structures were located inside the spinal canal proximal to the intervertebral foramen. Ligaments with a comparable function just outside the intervertebral foramen are mentioned ephemerally. No studies are available about ligamentous attachments of thoracic spinal nerves to the spine. Five embalmed human thoracic spines (Th2–Th11) were dissected. Bilaterally, the extraforaminal region was dissected to describe and measure anatomical structures and their relationships with the thoracic spinal nerves. Histology was done at the sites of attachment of the ligaments to the nerves and along the ligaments. The thoracic spinal nerves are attached to the transverse process of the vertebrae cranial and caudal to the intervertebral foramen. The ligaments consist mainly of collagenous fibers. In conclusion, at the thoracic level, direct ligamentous connections exist between extraforaminal thoracic spinal nerves and nearby structures. They may serve as a protective mechanism against traction and compression of the nerves by positioning the nerve in the intervertebral foramen.

Hoogland, P. V. J. M.; Wuisman, P. I. J. M.

2009-01-01

293

Anatomic considerations of costotransverse screw placement in the thoracic spine  

Microsoft Academic Search

BACKGROUNDNumerous techniques have been reported to restore spinal stability and to correct spinal deformities, including rods with wires\\/hooks, and rods or plates with pedicular screws. It was thought that posterior fixation of the thoracic spine through the costotransverse joint may be another alternative.METHODSNine cadavers were obtained for study of screw fixation of the costotransverse joint for posterior thoracic instrumentation. The

Rongming Xu; Nabil A Ebraheim; Yiangjia Ou; Martin Skie; Richard A Yeasting

2000-01-01

294

Comparative Study of Posterior Lumbar Interbody Fusion via Unilateral and Bilateral Approaches in Patients with Unilateral Leg Symptoms  

PubMed Central

Objective We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. Methods We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. Results In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. Conclusion Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.

Lee, Jong-Won; Kwon, Ki-Young; Rhee, Jong-Joo; Hur, Jin-Woo; Lee, Hyun-Koo

2011-01-01

295

Loss of a kidney during fetal life: long-term consequences and lessons learned.  

PubMed

Epidemiological studies reveal that children born with a solitary functioning kidney (SFK) have a greater predisposition to develop renal insufficiency and hypertension in early adulthood. A congenital SFK is present in patients with unilateral renal agenesis or unilateral multicystic kidney dysplasia, leading to both structural and functional adaptations in the remaining kidney, which act to mitigate the reductions in glomerular filtration rate and sodium excretion that would otherwise ensue. To understand the mechanisms underlying the early development of renal insufficiency in children born with a SFK, we established a model of fetal uninephrectomy (uni-x) in sheep, a species that similar to humans complete nephrogenesis before birth. This model results in a 30% reduction in nephron number rather than 50%, due to compensatory nephrogenesis in the remaining kidney. Similar to children with a congenital SFK, uni-x sheep demonstrate a progressive increase in arterial pressure and a loss of renal function with aging. This review summarizes the compensatory changes in renal hemodynamics and tubular sodium handling that drive impairments in renal function and highlights the existence of sex differences in the functional adaptations following the loss of a kidney during fetal life. PMID:24500691

Lankadeva, Yugeesh R; Singh, Reetu R; Tare, Marianne; Moritz, Karen M; Denton, Kate M

2014-04-01

296

Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis  

PubMed Central

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

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

2014-01-01

297

Developing the academic thoracic surgeon: teaching surgery.  

PubMed

Teaching surgery can be a very gratifying experience for those of us involved in academic thoracic surgery. Fundamentals of a good residency program require that patients should always be placed in the highest priority. However, the residency program should also be committed to teaching as a priority. Creating the proper operating room environment is essential for optimal conduct of the operation. This environment is similar to that of the airline industry, which is known as crew or cockpit resource management. The design of a teaching program needs to have evaluation as one of its key elements. In addition to resident evaluation, it is also important to have faculty evaluation by the residents. The goal of any residency program should be to foster the development of the future leaders in our specialty. The information contained within this article represents the art and science of teaching thoracic surgery as applied by the faculty in the Division of Cardiac Surgery at The Johns Hopkins Hospital. PMID:10727957

Baumgartner, W A; Greene, P S

2000-04-01

298

Thoracic pedicle screw fixation for spinal deformity.  

PubMed

Techniques to improve segmental fixation have advanced the ability to correct complex spinal deformity. The purpose of instrumentation is to correct spinal deformity or to stabilize the spine to enhance the long-term biological fusion. The ultimate goal of spinal deformity surgery is the creation of a stable, balanced, pain-free spine centered over the pelvis in the coronal and sagittal planes. The minimum number of segments should be fused. These concepts remain challenging in the setting of deformity and instability. Successful results can be obtained if the surgeon understands the technology available, its capabilities, biological limitations, and the desired solution. The authors prefer to use thoracic pedicle screws when treating patients with spinal deformity because they provide greater corrective forces for realignment. This allows shorter-segment constructs and the possibility of true derotation in correction. In this article the authors focus on the use of thoracic transpedicular screw fixation in the management of complex spinal disorders and deformity. PMID:15766224

Rosner, Michael K; Polly, David W; Kuklo, Timothy R; Ondra, Stephen L

2003-01-15

299

Penetrating thoracic wounds caused by plastic bullets.  

PubMed

Thoracic penetrating injuries caused by a new plastic bullet were studied to determine the nature of the wounds and the appropriate management. Twenty-six casualties from the Israeli-Palestinian conflict (Intifada) were included. The organs most commonly involved were lung (n = 21), bony chest wall (n = 9), heart (n = 3), and diaphragm. Bleeding was at least moderate in 20 patients, amounting in all patients to an average of 975 ml. Thoracotomy was required in 11 patients (42%) mainly because of cardiac injury (n = 3) and aortic or other arterial bleeding (n = 3). Simple oversewing of severed organs (n = 8) or ligation of bleeding vessels (n = 3) was satisfactory. Two patients died (7.7% mortality); one after major liver resection; the other was dead on arrival. We conclude that plastic bullets have a linear course unless displaced by the bony chest wall, when they tend to fragment and cause simple fractures. Fired from a presumed range of at least 70 m, plastic bullets behave like low-velocity missiles, and tissue destruction is minimal. Management should be similar to that of civilian thoracic penetrating trauma. PMID:1736005

Yellin, A; Golan, M; Klein, E; Avigad, I; Rosenman, J; Lieberman, Y

1992-02-01

300

The thoracic anterior spinal cord adhesion syndrome  

PubMed Central

Objectives This study included a series of middle-aged male and female patients who presented with chronic anterior hemicord dysfunction progressing to paraplegia. Imaging of anterior thoracic cord displacement by either a dural adhesion or a dural defect with associated cord herniation is presented. Methods This is a retrospective review of cases referred to a tertiary neuroscience centre over a 19-year period. Imaging series were classified by two experienced neuroradiologists against several criteria and correlated with clinical examination and/or findings at surgery. Results 16 cases were available for full review. Nine were considered to represent adhesions (four confirmed surgically) and four to represent true herniation (three confirmed surgically). In the three remaining cases the diagnosis was radiologically uncertain. Conclusion The authors propose “thoracic anterior spinal cord adhesion syndrome” as a novel term to describe this patient cohort and suggest appropriate clinicoradiological features for diagnosis. Several possible aetiologies are also suggested, with disc rupture and inflammation followed by disc resorption and dural pocket formation being a possible mechanism predisposing to herniation at the extreme end of a clinicopathological spectrum.

Taylor, T R; Dineen, R; White, B; Jaspan, T

2012-01-01

301

Bilateral versus unilateral thyroid eye disease  

PubMed Central

Aims: The aim of this study was to compare demographics, clinical manifestations, associated systemic and ocular factors, severity and activity of patients with unilateral thyroid eye disease (U-TED) versus bilateral thyroid eye disease (B-TED). Materials and Methods: In a cross-sectional study, all patients with Graves’ hyperthyroidism and primary hypothyroidism seen in an endocrinology clinic were included from September 2003 to July 2006. Demographics, complete eye examination, severity score (NOSPECS, total eye score), and clinical activity score were recorded and compared in the B-TED and U-TED groups of patients. Results: From 851 patients with thyroid disorders, 303 (35.6%) had TED. Thirty-two patients (32/ 303, 10.56%) were found to have U-TED. Patients with U-TED (mean age 31.6 ± 11.6 years) were significantly younger than patients with B-TED (mean age 37.7 ± 14.7 years). Monovariate analysis (Chi-square and independent sample t-test) showed a significantly higher severity score in B-TED (U-TED 4.09±4.05, B-TED: 6.7±6.3; P= 0.002) and more activity score in B-TED (U-TED= 1.03±0.96, B-TED: 1.74±1.6, P= 0.001). However, multivariate analysis did not show any significant difference between the two groups in terms of age, gender, type of thyroid disease, duration of thyroid disease and TED, severity and activity of TED, smoking habit, and presentation of TED before or after the presentation of thyroid disease (0.1

Kashkouli, Mohsen Bahmani; Kaghazkanani, Reza; Heidari, Iraj; Ketabi, Nooshin; Jam, Sara; Azarnia, Shahrzad; Pakdel, Farzad

2011-01-01

302

Postural compensation for unilateral vestibular loss.  

PubMed

Postural control of upright stance was investigated in well-compensated, unilateral vestibular loss (UVL) subjects compared to age-matched control subjects. The goal was to determine how sensory weighting for postural control in UVL subjects differed from control subjects, and how sensory weighting related to UVL subjects' functional compensation, as assessed by standardized balance and dizziness questionnaires. Postural control mechanisms were identified using a model-based interpretation of medial-lateral center-of-mass body-sway evoked by support-surface rotational stimuli during eyes-closed stance. The surface-tilt stimuli consisted of continuous pseudorandom rotations presented at four different amplitudes. Parameters of a feedback control model were obtained that accounted for each subject's sway response to the surface-tilt stimuli. Sensory weighting factors quantified the relative contributions to stance control of vestibular sensory information, signaling body-sway relative to earth-vertical, and proprioceptive information, signaling body-sway relative to the surface. Results showed that UVL subjects made significantly greater use of proprioceptive, and therefore less use of vestibular, orientation information on all tests. There was relatively little overlap in the distributions of sensory weights measured in UVL and control subjects, although UVL subjects varied widely in the amount they could use their remaining vestibular function. Increased reliance on proprioceptive information by UVL subjects was associated with their balance being more disturbed by the surface-tilt perturbations than control subjects, thus indicating a deficiency of balance control even in well-compensated UVL subjects. Furthermore, there was some tendency for UVL subjects who were less able to utilize remaining vestibular information to also indicate worse functional compensation on questionnaires. PMID:21922014

Peterka, Robert J; Statler, Kennyn D; Wrisley, Diane M; Horak, Fay B

2011-01-01

303

Postural Compensation for Unilateral Vestibular Loss  

PubMed Central

Postural control of upright stance was investigated in well-compensated, unilateral vestibular loss (UVL) subjects compared to age-matched control subjects. The goal was to determine how sensory weighting for postural control in UVL subjects differed from control subjects, and how sensory weighting related to UVL subjects’ functional compensation, as assessed by standardized balance and dizziness questionnaires. Postural control mechanisms were identified using a model-based interpretation of medial–lateral center-of-mass body-sway evoked by support-surface rotational stimuli during eyes-closed stance. The surface-tilt stimuli consisted of continuous pseudorandom rotations presented at four different amplitudes. Parameters of a feedback control model were obtained that accounted for each subject’s sway response to the surface-tilt stimuli. Sensory weighting factors quantified the relative contributions to stance control of vestibular sensory information, signaling body-sway relative to earth-vertical, and proprioceptive information, signaling body-sway relative to the surface. Results showed that UVL subjects made significantly greater use of proprioceptive, and therefore less use of vestibular, orientation information on all tests. There was relatively little overlap in the distributions of sensory weights measured in UVL and control subjects, although UVL subjects varied widely in the amount they could use their remaining vestibular function. Increased reliance on proprioceptive information by UVL subjects was associated with their balance being more disturbed by the surface-tilt perturbations than control subjects, thus indicating a deficiency of balance control even in well-compensated UVL subjects. Furthermore, there was some tendency for UVL subjects who were less able to utilize remaining vestibular information to also indicate worse functional compensation on questionnaires.

Peterka, Robert J.; Statler, Kennyn D.; Wrisley, Diane M.; Horak, Fay B.

2011-01-01

304

[Unilateral choreic movements in idiopathic hypoparathyroidism].  

PubMed

We report a patient with idiopathic hypoparathyroidism associated with unilateral calcification of the basal ganglia and contralateral choreic movements. A 66-year-old woman was admitted to our hospital because of involuntary movements of the left limbs. Two years before the present admission, she had operations for bilateral cataracts. Eight months before admission, she had an onset of severe carpal spasms and pain in both arms and legs. These symptoms improved after one month's rest in a hospital. About a month before admission, she noted progressive difficulty in using her left hand, followed by difficulty in walking due to the abnormal involuntary movement of the left lower limb. Two weeks before admission her carpal spasms appeared again, bilaterally. On admission, she was alert. The general physical examination was normal. Neurological examination revealed choreic movements in the left hand, arm, leg and neck, and grimacing of the left face. She also complained of the spasms and pain in her hands, dysarthria and shortness of the breath. Chvostek and Trousseau signs were positive. Laboratory examination revealed marked decrease in serum calcium level (2.57 mEq/ml) and increase in inorganic phosphorus level (6.40 mEq/ml). Serum level of parathyroid hormone was less than 10 pg/ml. Ellthworth-Howard test was positive, in that the infusion of parathyroid hormone (100 u) elicited a marked increment of the urinary excretions of phosphorus and cAMP. X-ray examination of the spine revealed ossification of the posterior longitudinal ligament in the cervical region. CT-scans of the brain revealed calcification in the region of right globus pallidus and putamen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1520567

Kashihara, K; Yabuki, S

1992-05-01

305

History and current status of mini-invasive thoracic surgery  

PubMed Central

Mini-invasive thoracic technique mainly refers to a technique involving the significant reduction of the chest wall access-related trauma. Notably, thoracoscope is the chief representative. The development of thoracoscope technique is characterized by: developing from direct peep to artificial lighting, then combination with image and video technique in equipments; technically developing from diagnostic to therapeutic approaches; developing from simpleness to complexity in application scope; and usually developing together with other techniques. At present, the widely used mini-invasive thoracic surgery refers to the mini-open thoracic surgery performed mainly by using some instruments to control target tissues and organs based on the vision associated with multi-limb coordination, which may be hand-assisted if necessary. The mini-invasive thoracic surgery consists of three approaches including video-assisted thoracic surgery (VATS), video-assisted Hybrid and hand-assisted VATS. So far the mini-invasive thoracic technique has achieved great advances due to the development in instruments of mini-invasive thoracic surgery which has the following features: instruments of mini-invasive thoracic surgery appear to be safe and practical, and have successive improvement and diversification in function; the specific instruments of open surgeries has been successively developed into dedicated instruments of endoscopic surgery; the application of endoscopic mechanical suture device generates faster fragmentation and reconstruction of organ tissues; the specific delicated instruments of endoscopic surgery have rapid development and application; and the simple instruments structurally similar to the conventional instruments are designed according to the mini-incison. In addition, the mini-invasive thoracic technique is widely used in five aspects including diseases of pleura membrane and chest wall, lung diseases, esophageal diseases, mediastinal diseases and heart diseases. However, there remain many problems in specifications and trainings, economic cost, conservation and innovation. Therefore, particular attention should be paid to these problems. Nevertheless, the promotion of thoracic surgery appears promising in the future.

He, Jianxing

2011-01-01

306

Thoracic size-selective sampling of fibres: performance of four types of thoracic sampler in laboratory tests.  

PubMed

The counting of fibres on membrane filters could be facilitated by using size-selective samplers to exclude coarse particulate and fibres that impede fibre counting. Furthermore, the use of thoracic size selection would also remove the present requirement to discriminate fibres by diameter during counting. However, before thoracic samplers become acceptable for sampling fibres, their performance with fibres needs to be determined. This study examines the performance of four thoracic samplers: the GK2.69 cyclone, a Modified SIMPEDS cyclone, the CATHIA sampler (inertial separation) and the IOM thoracic sampler (porous foam pre-selector). The uniformity of sample deposit on the filter samples, which is important when counts are taken on random fields, was examined with two sizes of spherical particles (1 and 10 microm) and a glass fibre aerosol with fibres spanning the aerodynamic size range of the thoracic convention. Counts by optical microscopy examined fields on a set scanning pattern. Hotspots of deposition were detected for one of the thoracic samplers (Modified SIMPEDS with the 10 microm particles and the fibres). These hotspots were attributed to the inertial flow pattern near the port from the cyclone pre-separator. For the other three thoracic samplers, the distribution was similar to that on a cowled sampler, the current standard sampler for fibres. Aerodynamic selection was examined by comparing fibre concentration on thoracic samples with those measured on semi-isokinetic samples, using fibre size (and hence calculated aerodynamic diameter) and number data obtained by scanning electron microscope evaluation in four laboratories. The size-selection characteristics of three thoracic samplers (GK2.69, Modified SIMPEDS and CATHIA) appeared very similar to the thoracic convention; there was a slight oversampling (relative to the convention) for d(ae) < 7 microm, but that would not be disadvantageous for comparability with the cowled sampler. Only the IOM thoracic sampler tended to undersample the fibres relative to the thoracic convention. With the data divided into four classes based on fibre length, the size-selection characteristics appeared to be unaffected by fibre length for GK2.69, Modified SIMPEDS and CATHIA. Only the IOM thoracic sampler (with the foam selector) showed slightly lower selection for longer length classes of fibres. These results indicate that the tested samplers follow the thoracic sampling convention for fibres, and may be used to improve the quality and reliability of samples that are taken when there is likely to be significant background dust. PMID:15790615

Jones, A D; Aitken, R J; Fabriès, J F; Kauffer, E; Liden, G; Maynard, A; Riediger, G; Sahle, W

2005-08-01

307

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

308

Transperitoneal laparoscopic heminephrectomy in duplex kidneys: a one centre experience  

PubMed Central

Purpose: The standard treatment for a duplex kidney with poorly functioning upper pole moiety is ipsilateral upper pole heminephrectomy. This procedure is usually performed by open surgery, but with recent developments in techniques of uro-laparoscopy, it can be done with it, safely. In this study we evaluated the results and safety of laparoscopic heminephrectomy in our consecutive cases. Materials and Methods: From February 2001 to May 2007 fourteen unilateral laparoscopic heminephrectomy were performed in our center. Patients' characteristics, presenting symptoms, operative time, and blood loss, early and late complications were all collected retrospectively. Using pre-operative ultrasonography, intravenous pyelography (IVP) and CT scanning, unilateral upper pole hydronephrosis was detected in all cases. By DMSA isotope scan hypofunctioning of ipsilateral moieties was detected in all cases. Results: Mean operative time was 203±80 minutes. No major intra-operative or early complications were identified. Mean hospital stay was 4.1 days. On mean follow-up of 32 months no disturbing symptoms or episodes of urinary tract infections (UTIs) were detected. Atrophic kidney was detected in one case in post-operative IVP. Conclusion: Laparoscopic heminephrectomy is a valuable minimal invasive procedure that can be performed safely in experienced hands without any important complication. Perfect renal pedicles vascular system manipulation is important for the preservation of renal function post-operatively.

Abedinzadeh, Mehdi; Nouralizadeh, Akbar; Radfar, Mohammad Hadi; Moslemi, Mohammad Kazem

2012-01-01

309

Respiratory Displacement of the Thoracic Aorta: Physiological Phenomenon With Potential Implications for Thoracic Endovascular Repair  

Microsoft Academic Search

The purpose of this study was to assess the magnitude and direction of respiratory displacement of the ascending and descending\\u000a thoracic aorta during breathing maneuvers. In 11 healthy nonsmokers, dynamic magnetic resonance imaging was performed in transverse\\u000a orientation at the tracheal bifurcation during maximum expiration and inspiration as well as tidal breathing. The magnitude\\u000a and direction of aortic displacement was

Tim Frederik Weber; Ralf Tetzlaff; Fabian Rengier; Philipp Geisbüsch; Annette Kopp-Schneider; Dittmar Böckler; Monika Eichinger; Hans-Ulrich Kauczor; Hendrik von Tengg-Kobligk

2009-01-01

310

Outcome of prenatally diagnosed mild unilateral cerebral ventriculomegaly.  

PubMed

The objective of this study was to determine the frequency of prenatally diagnosed unilateral cerebral ventriculomegaly and also to assess neonatal outcome in infants with this prenatal diagnosis. A computerized ultrasonography database identified fetuses with isolated and nonisolated unilateral cerebral ventriculomegaly from October 1994 to June 1999. The Denver II Developmental Screening Test was used to assess developmental skills. Unilateral cerebral ventriculomegaly was diagnosed in 15 of 21,172 (1 per 1,411) pregnancies. The width of the enlarged lateral ventricle ranged from 1.0 to 1.9 cm. In 10 (67%) of 15 cases unilateral cerebral ventriculomegaly was an isolated finding. Eight of the 14 infants who were born at 36 weeks' gestation or later had postnatal cranial imaging, and ventricular asymmetry was confirmed in 5 (63%). One infant with an arachnoid cyst and cerebral palsy died at 2 years of age. The remaining 11 infants in whom developmental milestones were assessed had age-appropriate skills. Unilateral fetal ventriculomegaly is usually an isolated finding and when isolated has little measurable effect on developmental outcome. PMID:11270530

Kinzler, W L; Smulian, J C; McLean, D A; Guzman, E R; Vintzileos, A M

2001-03-01

311

Respiratory Displacement of the Thoracic Aorta: Physiological Phenomenon With Potential Implications for Thoracic Endovascular Repair  

SciTech Connect

The purpose of this study was to assess the magnitude and direction of respiratory displacement of the ascending and descending thoracic aorta during breathing maneuvers. In 11 healthy nonsmokers, dynamic magnetic resonance imaging was performed in transverse orientation at the tracheal bifurcation during maximum expiration and inspiration as well as tidal breathing. The magnitude and direction of aortic displacement was determined relatively to resting respiratory position for the ascending (AA) and descending (DA) aorta. To estimate a respiratory threshold for occurrence of distinct respiratory aortic motion, the latter was related to the underlying change in anterior-posterior thorax diameter. Compound displacement between maximum expiration and inspiration was 24.3 {+-} 6.0 mm for the AA in the left anterior direction and 18.2 {+-} 5.5 mm for the DA in the right anterior direction. The mean respiratory thorax excursion during tidal breathing was 8.9 {+-} 2.8 mm. The respiratory threshold, i.e., the increase in thorax diameter necessary to result in respiratory aortic displacement, was estimated to be 15.7 mm. The data suggest that after a threshold of respiratory thorax excursion is exceeded, respiration is accompanied by significant displacement of the thoracic aorta. Although this threshold may not be reached during tidal breathing in the majority of individuals, segmental differences during forced respiration impact on aortic geometry, may result in additional extrinsic forces on the aortic wall, and may be of significance for aortic prostheses designed for thoracic endovascular aortic repair.

Weber, Tim Frederik, E-mail: tim.weber@med.uni-heidelberg.d [University Medical Center Heidelberg, Department of Diagnostic and Interventional Radiology (Germany); Tetzlaff, Ralf [German Cancer Research Center, Department of Radiology (Germany); Rengier, Fabian [University Medical Center Heidelberg, Department of Diagnostic and Interventional Radiology (Germany); Geisbuesch, Philipp [University Medical Center Heidelberg, Department of Vascular and Endovascular Surgery (Germany); Kopp-Schneider, Annette [German Cancer Research Center, Department of Biostatistics (Germany); Boeckler, Dittmar [University Medical Center Heidelberg, Department of Vascular and Endovascular Surgery (Germany); Eichinger, Monika [German Cancer Research Center, Department of Radiology (Germany); Kauczor, Hans-Ulrich [University Medical Center Heidelberg, Department of Diagnostic and Interventional Radiology (Germany); Tengg-Kobligk, Hendrik von [German Cancer Research Center, Department of Radiology (Germany)

2009-07-15

312

Video assisted thoracic surgery in children  

PubMed Central

Thoracoscopic surgery, i.e., video assisted thoracic surgery (VATS) has been in use in children for last 98 years. Its use initially was restricted to the diagnostic purposes. However, with the improvement in the optics, better understanding of the physiology with CO2 insufflation, better capabilities in achieving the single lung ventilation and newer vessel sealing devices have rapidly expanded the spectrum of the indication of VATS. At present many complex lung resections, excision of mediastinal tumors are performed by VATS in the experienced centre. The VATS has become the standard of care in empyema, lung biopsy, Mediastinal Lymphnode biopsy, repair of diaphragmatic hernia, etc. The article discusses the indications of VATS, techniques to achieve the selective ventilation and surgical steps in the different surgical conditions in children.

Shah, Rasik; Reddy, A Suyodhan; Dhende, Nitin P

2007-01-01

313

Tophaceous pseudogout of the thoracic spine.  

PubMed

Calcium pyrophosphate dihydrate deposition disease (CPDD, tophaceous pseudogout) is a rare crystal arthropathy characterized by pyrophosphate crystal deposition in joints, synovitis and chondrocalcinosis on imaging. We present the case of a 72-year-old man with 6 months of left chest pain; magnetic resonance imaging revealed a T9/T10 herniated disc. Intraoperatively, the material was sent for pathological analysis revealing pseudogout. Axial calcium pyrophosphate crystal deposition is rare but reported in the literature and found at the craniocervical junction and skull. Spinal calcium pyrophosphate crystal deposition is rare in the thoracic spine. It is often asymptompatic and can involve the disc or ligaments. This case demonstrates a unique presentation of CPDD. PMID:22367409

Srinivasan, Vasisht; Kesler, Henry; Johnson, Mahlon; Dorfman, Howard; Walter, Kevin

2012-04-01

314

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

315

Endovascular treatment of thoracic aortic fistulas.  

PubMed

Aortoesophageal and aortobronchial fistulas constitute a problem in therapy because of the high rates of morbidity and mortality associated with operation. From May 1996 to March 2000, we treated by an endovascular procedure one aortoesophageal and three aortobronchial fistulas. There was no postoperative death. We noted one peripheral vascular complication that required a surgical procedure, one postoperative confusion, and one inflammatory syndrome. In one case, because of a persistent leakage after 21 months, we had to implant a second endovascular stent graft. A few weeks later the reopening of this patient's esophageal fistula led to his death by mediastinitis 25 months after the first procedure. The few cases published seem to bear out the interest, observed in our 4 patients, of an endovascular approach to treat complex lesions such as fistulas of the thoracic aorta especially in emergency or palliative cases. PMID:12118773

Léobon, Bertrand; Roux, Daniel; Mugniot, Antoine; Rousseau, Hervé; Cérene, Alain; Glock, Yves; Fournial, Gérard

2002-07-01

316

Thoracic aortic dissection associated with cocaine abuse.  

PubMed

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

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

2004-05-10

317

Kidney Cancer Association  

MedlinePLUS

... Overview Research Annual Report Website Sponsors Privacy Policy Employee Handbook Contact Us Privacy Policy Contact Us Members Only RSS Feeds Sitemap © 2014 KidneyCancer.org. All rights reserved worldwide.

318

[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

319

Artificial Kidneys: Biochemical Evaluations.  

National Technical Information Service (NTIS)

The dialysance of amino acids and conjugated amino acids was measured in patients being maintained by hemodialysis with the Model 4 Cordis Dow hollow fiber artificial kidney. Dialysance and molecular weights of the amino acids were inversely related. Conj...

J. H. Peters F. A. Gotch

1973-01-01

320

[Kidney resection in cancer].  

PubMed

The authors analyze 5 cases of conservative surgery in renal cancer and formulate their point of view on indications for such interventions in patients with contralateral kidney. Relevant techniques and policy are specified. PMID:1475886

Mazo, E B; Artemova, L G; Gerlivanov, B A; Tarasov, V N; Ivshin, V V

1992-01-01

321

Make the Kidney Connection  

MedlinePLUS

... the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), U.S. Department of Health & Human Services (HHS) NIH...Turning Discovery Into Health ®

322

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.

2013-01-01

323

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

324

Synchronous absolute EIT in three thoracic planes at different gravity levels  

NASA Astrophysics Data System (ADS)

The validity of absolute Electrical Impedance Tomography (a-EIT) for assessment of local lung volume has been investigated far less than the well evaluated ventilation monitoring by functional EIT (f-EIT). To achieve progress in a-EIT we investigated 10 healthy volunteers in an upright sitting position by using a-EIT at normal gravity (1 g), weightlessness (0 g) and approx. double gravity (1.8 g) during parabolic flight manoeuvres. Lung resistivity in three thoracic planes was determined by a-EIT using a multiple-plane synchronised Goe-MF II EIT system. Tomograms of resistivity at end-expiration in normal spontaneous breathing were reconstructed by a modified SIRT algorithm. Local lung resistivity was determined separately for both lungs. The respective resistivity values at 1 g and 1.8 g before and after weightlessness show an almost reversible behaviour along the sequence of gravity changes with a tendency to be lower after occurrence of weightlessness. The results reveal not only the expected varying resistivity of lung tissue in cranio-caudal direction but also a clear difference in these cranio-caudal stratifications of local lung volume between the left and right lung. The resolution and stability of absolute EIT seem to be valid and expressive for future investigations of unilateral lung volume under different physiological and pathological conditions.

Hahn, G.; Just, A.; Dittmar, J.; Fromm, K. H.; Quintel, M.

2013-04-01

325

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

PubMed Central

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

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

2011-01-01

326

Surgery for thoracic disc disease. Complication avoidance: overview and management.  

PubMed

The operative approach for discectomy in the treatment of thoracic disc disease has changed from standard laminectomy to a variety of dorsolateral and ventral approaches. The procedure-related complications have been reported in numerous clinical studies over the last seven decades: death, neurological deterioration, postoperative vertebral column instability, incomplete disc resection, cerebrospinal fluid leak and fistula, infection, misdiagnosis, pulmonary embolism, pneumonia, and intercostal neuralgia. The authors conducted a Medline search to identify series reporting clinical data related to thoracic discectomy. They analyzed the morbidity and mortality resulting from the various surgical approaches for thoracic disc disease, with special attention to the avoidance and management of surgery-related complications. PMID:16833243

McCormick, W E; Will, S F; Benzel, E C

2000-01-01

327

Thoracic endovascular aortic repair: update on indications and guidelines.  

PubMed

Thoracic endovascular aortic repair (TEVAR) has revolutionized thoracic aortic surgery and has increased the options available to the aortic specialist in treating thoracic aortic disease. TEVAR is less invasive, and is associated with a decrease in perioperative morbidity and mortality when compared with open surgical repair. The dramatic expansion of TEVAR activity has necessitated a better definition for the indications, contraindications, and limitations of this new technology. Ideally TEVAR should be performed in specialized aortic centers providing a full range of diagnostic and treatment options, using a multidisciplinary team approach. PMID:23711653

Nicolaou, Georghios; Ismail, Mohamed; Cheng, Davy

2013-06-01

328

Unilateral versus bilateral clubfoot: an analysis of severity and correlation.  

PubMed

This study compares the severity of unilateral and bilateral clubfoot, and the correlation between right and left feet of bilateral cases. Sixty-six unilateral and 75 bilateral clubfoot patients were assessed for severity using the Pirani score at an average age of 12.9 days (SD 9 days). In bilateral cases, the severity of right and left feet was highly correlated (r=0.68). The odds of being very severe were 2.6 (95% confidence interval 1.3-5.1) times higher in bilateral cases (P=0.007). Bilateral and unilateral clubfeet present with differing severity. Right and left feet from bilateral cases are highly correlated. Researchers need to address these issues during study design and analysis. PMID:24869905

Gray, Kelly; Barnes, Elizabeth; Gibbons, Paul; Little, David; Burns, Joshua

2014-09-01

329

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

330

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

331

Proposal of unilateral single-flux-quantum logic gate  

SciTech Connect

A new type of single flux quantum logic gate is proposed, which can perform unilateral propagation of signal without using three-phase clock. This gate is designed to be built with bridge-type Josephson junctions. A basic logic gate consists of two one-junction interferometers coupled by superconducting interconnecting lines, and the logical states are represented by zero or one quantized fluxoid in one of one-junction interferometers. The bias current of the unequal magnitude to each of the two one-junction interferometers results in unilateral signal flow. By adjusting design parameters such as the ratio of the critical current of Josephson junctions and the inductances, circuits with the noise immunity of greater than 50% with respect to the bias current have been designed. Three cascaded gates were modeled and simulated on a computer, and the unilateral signal flow was confirmed. The simulation also shows that a switching delay about 2 picoseconds is feasible.

Mikaye, H.; Fukaya, N.; Okabe, Y.; Sugamo, T.

1985-03-01

332

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

333

Unilateral interventions for women living with heavy drinkers.  

PubMed

Despite the fact that unilateral therapy is often the only treatment option for women living with heavy drinkers, very few structured programs have been developed for this client group. Moreover, the programs that do exist lack empirical support (as in the case of Al-Anon) or have as their highest priority promoting change in the drinker. This article looks at unilateral therapy for women partners of heavy drinkers and concludes that although a number of promising developments have occurred in recent years, more research is needed on the benefits to the women themselves. PMID:9009889

Barber, J G; Gilbertson, R

1997-01-01

334

Septal mucoperiosteal flap for the repair of unilateral choanal atresia.  

PubMed

The authors present a new modality of endoscopic repair for unilateral choanal atresia. A 14-year old girl complained of right-sided nasal obstruction. Endoscopy and CT scans showed unilateral bony choanal atresia. The patient underwent endoscopic endonasal surgery. A mucoperiosteal flap at the posterior part of the septum in the left, healthy nasal cavity was fashioned and the denuded part of the septum was removed. The atretic choanae was resected and a unified posterior nasal opening was formed. The flap was spread over the posterior septal edge and adjusted to the opposite septal side. One-year follow-up of the patient showed no stenosis of the choanae. PMID:19839259

Mladina, Ranko; Prstaci?, Ratko; Prstasi?, Ratko; Vukovi?, Katarina; Skitareli?, Neven

2009-09-01

335

Type 1 angiotensin receptors on macrophages ameliorate IL-1 receptor-mediated kidney fibrosis  

PubMed Central

In a wide array of kidney diseases, type 1 angiotensin (AT1) receptors are present on the immune cells that infiltrate the renal interstitium. Here, we examined the actions of AT1 receptors on macrophages in progressive renal fibrosis and found that macrophage-specific AT1 receptor deficiency exacerbates kidney fibrosis induced by unilateral ureteral obstruction (UUO). Macrophages isolated from obstructed kidneys of mice lacking AT1 receptors solely on macrophages had heightened expression of proinflammatory M1 cytokines, including IL-1. Evaluation of isolated AT1 receptor–deficient macrophages confirmed the propensity of these cells to produce exaggerated levels of M1 cytokines, which led to more severe renal epithelial cell damage via IL-1 receptor activation in coculture compared with WT macrophages. A murine kidney crosstransplantation concomitant with UUO model revealed that augmentation of renal fibrosis instigated by AT1 receptor–deficient macrophages is mediated by IL-1 receptor stimulation in the kidney. This study indicates that a key role of AT1 receptors on macrophages is to protect the kidney from fibrosis by limiting activation of IL-1 receptors in the kidney.

Zhang, Jian-dong; Patel, Mehul B.; Griffiths, Robert; Dolber, Paul C.; Ruiz, Phillip; Sparks, Matthew A.; Stegbauer, Johannes; Jin, Huixia; Gomez, Jose A.; Buckley, Anne F.; Lefler, William S.; Chen, Daian; Crowley, Steven D.

2014-01-01

336

Post-ischemic azotemia as a partial 'brake', slowing progressive kidney disease  

PubMed Central

Background Recent experimental work suggests a paradox: although uremia evokes systemic toxicities, in the setting of AKI, it can induce intrarenal cytoprotective and anti-inflammatory effects. Whether these influences can attenuate post-ischemic kidney disease progression remains unknown. Methods To explore this possibility, male CD-1 mice were subjected to a 30-min unilateral (left) kidney ischemia model, previously shown to reduce renal mass by ?50% over 2–3 weeks. Stepwise azotemia/acute uremia was superimposed by inducing different lengths of contralateral (right) kidney ischemia (0, 15, 18, 20 min). Subsequent loss of left renal mass (kidney weight) was assessed 2 weeks later and contrasted with the degree of initial azotemia 24-h BUN. Results A striking correlation between 24-h BUNs and 2-week left renal mass was observed (r, 0.77; P < 0.001). With 20 min of right kidney ischemia, left kidney size was completely preserved. This preservation did not result from increased tubular cell proliferation or decreased microvascular loss, as gauged by KI-67 and CD-34 immunohistochemistry, respectively. Rather, an early reduction in proximal tubule cell dropout (as judged by renal cortical N-acetyl-glucosaminidase content), with a subsequent preservation of tubule mass, was observed. Conclusions In summary, these findings advance a novel concept: acute uremia can confer early post-ischemic cytoprotection resulting in a slowed progression of post-ischemic kidney disease.

Zager, Richard A.; Johnson, Ali C.; Becker, Kirsten

2013-01-01

337

Recovery from unilateral labyrinthectomy in rhesus monkey.  

PubMed

1. We recorded eye movements in six rhesus monkeys before and after unilateral labyrinthectomy and quantified the compensation for both the static and the dynamic disturbances of the vestibuloocular reflex (VOR). 2. When first recorded after labyrinthectomy (18-20 h postlesion), all animals had a spontaneous nystagmus with mean slow-phase velocities ranging from 24 to 54 degrees/s measured in darkness and 0-4 degrees/s measured in the light. The level of nystagmus diminished quickly, and by postoperative day 25 mean values ranged from 4 to 22 degrees/s, measured in darkness. The waveform of individual slow phases was variable, but in the first postoperative week its trajectory usually showed an increasing, or an increasing then decreasing, velocity. This finding indicates that peripheral vestibular lesions can alter the function of the ocular motor eye-position integrator. 3. The VOR gain (eye velocity/head velocity, corrected for spontaneous nystagmus) during rotations (30-300 degrees/s) in the dark was diminished from nearly 1.0 preoperatively to approximately 0.5 when first measured after labyrinthectomy, except for rotations toward the lesioned side at high speeds for which the gain was even lower. Within the first few postoperative days, for rotations toward the intact side, the VOR gain increased rapidly, to approximately 0.8. For rotations toward the lesioned side similar behavior was noted for stimuli of 30-60 degrees/s, but at higher velocities compensation proceeded more slowly. By 3 mo postoperatively gains had reached values ranging from 0.77 to 1.03 for rotations toward the intact side and from 0.61 to 0.98 for rotations toward the lesioned side. Values were higher for lower-velocity stimuli. 4. Caloric testing with ice water in the unoperated ear elicited nystagmus with a mean value of maximum slow-phase velocity of 129 degrees/s preoperatively and 195 degrees/s 3 mo postoperatively. There was no caloric response on the lesioned side. From the increase in caloric responses from the intact ear we infer considerable restoration of spontaneous activity of vestibular neurons on the deafferented side. 5. The time constant of the VOR was a function of stimulus speed preoperatively with a maximum mean value of 35 s for a 60 degrees/s stimulus. After labyrinthectomy the VOR time constant was low (6.0-9.1 s) at all speeds. Subsequently, in three animals only, there was a small increase (2-3 s) in VOR time constant during the 3-mo period following labyrinthectomy. These results indicate that labyrinthectomy profoundly and persistently impairs the action of the vestibular velocity-storage mechanism.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3258362

Fetter, M; Zee, D S

1988-02-01

338

[Chylothorax: a rare complication of transaxillary thoracic sympathectomy].  

PubMed

Transaxillary upper thoracic sympathectomy is a safe surgical procedure for the treatment of palmar hyperhidrosis. Although thoracic complications such as hemothorax and pneumothorax occasionally occur following this procedure chylothorax is an extremely rare complication. From 1978 to 1991, 215 consecutive patients underwent upper thoracic sympathectomy for the treatment of palmar hyperhidrosis in our institution. We report the surgical management of one patient who developed an intractable chylous fistula which did not respond to non-surgical treatment. Attempts at non-surgical management of the disease, with aspiration therapy, tube thoracostomy and the administration of medium chain triglyceride diet, should be tried first. If, however, this is not successful within two weeks, one should not wait for further metabolic and nutritional impairment before instituting surgical treatment. We believe that proximal thoracic duct ligation is a relatively simple and effective means of controlling chylothorax. PMID:8311411

Levy, I; Ariche, A; Sebbag, G; Hoda, J

1993-01-01

339

Collateral Artery Aneurysm: A Unique Presentation of Thoracic Outlet Syndrome  

Microsoft Academic Search

Aneurysms of collateral arteries are unusual. A case of transverse cervical artery aneurysm as the sole presentation of vascular thoracic outlet syndrome is presented and the relevant literature reviewed.

A. D. Lee; N. K. Shyamkumar; S. Nayak; S. Agarwal; B. Perakath

2005-01-01

340

Video-assisted thoracic surgery (VATS) lobectomy: The Edinburgh experience  

Microsoft Academic Search

One hundred fifty video-assisted thoracic surgery (VATS) endoscopic hilar dissection lobectomy procedures are presented. Median blood loss was 65 mL and correlated with operative time (P 4 days) occurred in 17 patients, correlated (P

WS Walker

1998-01-01

341

[Perioperative pain management for abdominal and thoracic surgery].  

PubMed

Abdominal and thoracic surgical procedures can result in significant acute postoperative pain. Present evidence shows that postoperative pain management remains inadequate especially after "minor" surgical procedures. Various therapeutic options including regional anesthesia techniques and systemic pharmacotherapy are available for effective treatment of postoperative pain. This work summarizes the pathophysiological background of postoperative pain after abdominal and thoracic surgery and discusses the indication, effectiveness, risks, and benefits of the different therapeutic options. Special focus is given to the controversial debate about the indication for epidural analgesia, as well as various alternative therapeutic options, including transversus abdominis plane (TAP) block, paravertebral block (PVB), wound infiltration with local anesthetics, and intravenous lidocaine. In additional, indications and contraindications of nonopioid analgesics after abdominal and thoracic surgery are discussed and recommendations based on scientific evidence and individual risk and benefit analysis are made. All therapeutic options discussed are eligible for clinical use and may contribute to improve postoperative pain outcome after abdominal and thoracic surgical procedures. PMID:24903040

Englbrecht, J S; Pogatzki-Zahn, E M

2014-06-01

342

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

343

Neurologic thoracic outlet syndrome: summarizing a complex history and evolution.  

PubMed

Thoracic outlet syndrome (TOS) is a blanket term encapsulating many different clinical entities. Neurologic or neurogenic TOS (NTOS) is its main contributor, but it remains a complicated and sometimes controversial entity. NTOS incorporates numerous types, etiologies, clinical presentations, diagnostic findings, and therapeutic modalities. This article reviews the spectrum of disease within the thoracic outlet that affects the brachial plexus, with a special emphasis on the commonly afflicted sports medicine patient. PMID:24614423

Stewman, Chaney; Vitanzo, Peter C; Harwood, Marc I

2014-01-01

344

Thoracic outlet syndrome in the pediatric population: case series.  

PubMed

We present 4 patients, 4 months to 10 years of age, with thoracic outlet syndrome. All were referred to the brachial plexus clinic. Three patients were diagnosed with vascular thoracic outlet syndrome after clinical evaluation and diagnostic imaging. Three had a cervical rib and 1 had an anomalous first rib. All patients were treated surgically through a supraclavicular approach and had resolution of the symptoms. No postoperative complications were noted. PMID:24495625

Vu, Anthony T; Patel, Parit A; Elhadi, Haithem; Schwentker, Ann R; Yakuboff, Kevin P

2014-03-01

345

Thoracic epidural lipomatosis with associated syrinx: case report  

Microsoft Academic Search

A 54-year-old black male with a 15-year history progressive lower extremity weakness was evaluated with a thoracic MRI that revealed epidural lipomatosis extending from T1-T10 with an associated syrinx at T1–3. He was neither overweight nor taking steroids. A multilevel thoracic laminectomy with resection of lipoma was performed without directly addressing the syrinx. Postoperatively, his symptoms improved and an MRI

Jonathan S Citow; Leonard Kranzler

2000-01-01

346

Extraforaminal ligament attachments of the thoracic spinal nerves in humans  

Microsoft Academic Search

An anatomical study of the extraforaminal attachments of the thoracic spinal nerves was performed using human spinal columns.\\u000a The objectives of the study are to identify and describe the existence of ligamentous structures at each thoracic level that\\u000a attach spinal nerves to structures at the extraforaminal region. During the last 120 years, several mechanisms have been described\\u000a to protect the spinal

G. A. Kraan; P. V. J. M. Hoogland; P. I. J. M. Wuisman

2009-01-01

347

Women and kidney transplantation.  

PubMed

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

Adey, Deborah B

2013-09-01

348

The bioartificial kidney.  

PubMed

Renal failure has an exceedingly high mortality rate despite advances in dialysis technology. Current renal replacement therapies (RRTs) restore only the filtration function of the kidney. Replacing the critical transport, metabolic, and endocrine functions of the kidney may provide more complete RRT, changing the natural history of these disease processes. Primary human renal epithelial cells (RECs) have been isolated and expanded under conditions that enhance propagation, resulting in maximum cell yield for use in bioengineered applications. These RECs demonstrate differentiated absorptive, metabolic, and endocrine functions of the kidney when tested under in vitro and preclinical ex vivo animal studies. When incorporated into bioengineered systems, RECs have proved to provide effective RRTs in both preclinical and clinical studies. These engineered "bioartificial kidneys" demonstrate metabolic activity with systemic effects and improvement of survival in patients with acute kidney injury and multiorgan failure. Results also indicate REC therapy influences systemic leukocyte activation and the balance of inflammatory cytokines, suggesting that this REC therapy may improve morbidity and mortality by altering the proinflammatory state of patients. This innovative approach for treating renal and inflammatory disease states may become a groundbreaking, transformative platform to current standard-of-care therapies, enabling the advancement of numerous lifesaving technologies. PMID:24269374

Buffington, Deborah A; Westover, Angela J; Johnston, Kimberly A; Humes, Harvey David

2014-04-01

349

Digital radiography of crush thoracic trauma in the Sichuan earthquake  

PubMed Central

AIM: To investigate the features of crush thoracic trauma in Sichuan earthquake victims using chest digital radiography (CDR). METHODS: We retrospectively reviewed 772 CDR of 417 females and 355 males who had suffered crush thoracic trauma in the Sichuan earthquake. Patient age ranged from 0.5 to 103 years. CDR was performed between May 12, 2008 and June 7, 2008. We looked for injury to the thoracic cage, pulmonary parenchyma and the pleura. RESULTS: Antero-posterior (AP) and lateral CDR were obtained in 349 patients, the remaining 423 patients underwent only AP CDR. Thoracic cage fractures, pulmonary contusion and pleural injuries were noted in 331 (42.9%; 95% CI: 39.4%-46.4%), 67 and 135 patients, respectively. Of the 256 patients with rib fractures, the mean number of fractured ribs per patient was 3. Rib fractures were mostly distributed from the 3rd through to the 8th ribs and the vast majority involved posterior and lateral locations along the rib. Rib fractures had a significant positive association with non-rib thoracic fractures, pulmonary contusion and pleural injuries (P < 0.001). The number of rib fractures and pulmonary contusions were significant factors associated with patient death. CONCLUSION: Earthquake-related crush thoracic trauma has the potential for multiple fractures. The high number of fractured ribs and pulmonary contusions were significant factors which needed appropriate medical treatment.

Dong, Zhi-Hui; Shao, Heng; Chen, Tian-Wu; Chu, Zhi-Gang; Deng, Wen; Tang, Si-Shi; Chen, Jing; Yang, Zhi-Gang

2011-01-01

350

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

PubMed

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

Nagata, Koji; Yamashita, Hironori; Miyazaki, Mitsue

2004-02-01

351

Unilateral graft rejection after bilateral antigenically identical corneal transplantation.  

PubMed

A unique case of unilateral graft rejection after bilateral antigenically identical corneal transplantation is described. The local risk factors (corneal vascularity and elevated intraocular pressure) were present to a greater extent in the nonrejected eye. The influence of other factors on the corneal microenvironment and their relationship to graft/host interactions is discussed. PMID:2663349

Olkowski, J D; Belin, M W; Bozkir, N; Mannarino, A

1989-09-01

352

Experimental Unilateral Torsion of the Spermatic Cord in Guinea Pigs  

Microsoft Academic Search

A systematic investigation of the effects of unilateral torsion of the spermatic cord on the contralateral testis of the guinea pig was carried out for variable time peri- ods, ie, seven days, one, three and six months. Both histological and ultrastructural studies were made on all testicular autopsy materials collected from five groups of animals. Those five groups were: group

JYOTSNA CHAKRABORTY; JAGADISH JHUNJHUNWALA

353

Fertility and unilateral undescended testis in the rat model  

Microsoft Academic Search

Fertility potential in patients with unilateral (UL) undescended testis is a debated topic. An experimental study was done in rats by surgically creating a UL undescended testis and studying its effect on their potential to father offspring when housed with female rats. No difference in fertility potential was observed in the various groups in this study. Since fertility was tested

S. Agarwala; D. K. Mitra

1996-01-01

354

A case of unilateral burning mouth syndrome of neuropathic origin.  

PubMed

The neuropathic origin of a case of unilateral burning mouth syndrome, previously diagnosed as psychogenic, was ascertained by intra-oral mucosa biopsy, which showed a severe sensory fibers damage, probably caused by maxillary anesthetic block and dental surgery. PMID:20807251

de Tommaso, Marina; Lavolpe, Vito; Di Venere, Daniela; Corsalini, Massimo; Vecchio, Eleonora; Favia, Gianfranco; Sardaro, Michele; Livrea, Paolo; Nolano, Maria

2011-03-01

355

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

356

Bilateral Inferior Petrosal Sinus Sampling by Unilateral Femoral Venous Approach  

PubMed Central

Purpose Bilateral inferior petrosal sinus sampling (IPSS) is a direct method of distinguishing between pituitary and ectopic ACTH secretion. We present unilateral femoral route technique avoiding bilateral femoral venous puncture using two 4F catheters into both sides of IPSS in these obese patients. Materials and Methods Unilateral femoral puncture using 9F guiding catheter allowed two 4F catheters which can be introduced in each side of inferior petrosal sinus. To reduce bleeding in the gap between 2 catheters at the diaphragm of the 9F femoral sheath, we introduced a short guidewire provided along with femoral sheath. After removing the 9F sheath after procedure, we applied manual compression as usual. We evaluated any technical difficulty and other complications including the presence of hematoma at the puncture site 1 day and 30 days later. Results Bilateral IPSS by using two 4F catheters in both inferior petrosal sinuses was possible via unilateral femoral route via 9F sheath. There was no technical difficulty introducing 4F catheters into each IPS of both sides. After removing 9F femoral sheath, there was no other complication and no hematoma at the puncture site at 1 day and 30 days later. Conclusion Unilateral femoral venous approach with a 9-French sheath can be used in IPSS. This technique allowed to pass two 4F catheters for IPSS at both sides and could avoid unnecessary bilateral femoral puncture in these obese patients without any hematoma formation after the procedure.

Park, Jee Won; Park, Soonchan; Kim, Jong Lim; Lee, Ha Young; Shin, Ji Eun; Hyun, Dong Ho; Jang, Seung Won

2011-01-01

357

Hemostatic alterations in patients with acute, unilateral vestibular paresis  

Microsoft Academic Search

Objectives: The etiopathogenesis of acute unilateral peripheral vestibulopathy (APV) still remains a matter of debate; ischemic changes in the circulation of the labyrinth may play a role. We consequently looked for possible hemostasis alterations in a group of patients with APV of an unknown nature. Methods: We evaluated blood parameters known to be involved in circulation disorders, including total and

Bruno Fattori; Andrea Nacci; Augusto Casani; Renza Cristofani; Andrea Sagripanti

2001-01-01

358

Unilateral Transverse Arm Defect with Subterminal Digital Nubbins  

Microsoft Academic Search

We present a case of unilateral terminal transverse forearm deficiency with subterminal digit-like nubbins, identified in a fetus from a pregnancy terminated electively in the second trimester because the distal right arm and hand could not be seen by ultrasound and were presumed to be absent. Pathologic evaluation showed distal transverse shortening, tapering to a point in the mid-forearm. Five

Ronny I. Drapkin; David R. Genest; Lewis B. Holmes; Taosheng Huang; Sara O. Vargas

2003-01-01

359

Unilateral parathyroidectomy: The role of thallium-technetium subtraction scans  

SciTech Connect

The rationale for using the thallium-technetium subtraction scan as a preoperative localizing study in previously untreated patients with primary hyperparathyroidism is presented. The concept of unilateral parathyroidectomy is also presented, and the role of preoperative localizing studies in this approach to parathyroid surgery is carefully analyzed.

Davis, R.K.; Hoffmann, J.; Dart, D.; Datz, F.L. (Univ. of Utah School of Medicine, Salt Lake City (USA))

1990-06-01

360

An analytical methodology for magnetic field control in unilateral NMR  

Microsoft Academic Search

Traditionally, unilateral NMR systems such as the NMR-MOUSE have used the fringe field between two bar magnets joined with a yoke in a ‘U’ geometry. This allows NMR signals to be acquired from a sensitive volume displaced from the magnets, permitting large samples to be investigated. The drawback of this approach is that the static field (B0) generated in this

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

2005-01-01

361

Unilateral Cleft Lip-Nose Repair: A 33Year Experience  

Microsoft Academic Search

A 33-year experience with a proven method of re- pair for primary unilateral cleft lip-nose is pre- sented. The technique used by the authors has been improved by modifications that have led to better symmetry and balance with less scarring. The tech- nique involves ignoring the abnormal skeletal base, use of perisurgical passive orthopedics, and primary surgical correction of the

Kenneth E. Salyer; Edward R. Genecov; David G. Genecov

2003-01-01

362

[Two cases of rare unilateral sensorineural hearing loss].  

PubMed

We report a case of unilateral sensorineural hearing loss due to Borrelia burgdorferi infection and in a patient with haemophilia B and hepatitis C treated with alpha-interferon. An audiological check-up of that kind of patients is indicated in order to exclude hearing loss. PMID:12741155

Obrebowski, Andrzej; Walczak, Marta; Karlik, Micha?; Wojnowski, Waldemar

2003-01-01

363

Unilateral asterixis due to a lesion of the ventrolateral thalamus.  

PubMed Central

A case of unilateral asterixis in a man with a focal ischaemic lesion of the contralateral ventral thalamus is presented. Atypically, the movements were present at rest and had a pattern of activation that resulted in an initial misdiagnosis of epilepsia partialis continua. This case emphasises the importance of electromyographic analysis in establishing the correct diagnosis of involuntary movements before starting specific treatment. Images

Stell, R; Davis, S; Carroll, W M

1994-01-01

364

Management of Young Children with Unilateral Hearing Loss  

ERIC Educational Resources Information Center

Children with unilateral hearing loss (UHL) are at risk for academic, speech and language and social-emotional difficulties. To date, most of the evidence documented in the literature has been obtained from school-age children, most of whom were diagnosed with UHL after enrollment in school. Following the widespread institution of universal…

McKay, Sarah

2006-01-01

365

Unilateral parenchymal haemorrhagic infarction in the preterm infant  

Microsoft Academic Search

A unilateral parenchymal haemorrhage associated with a germinal matrix–intraventricular haemorrhage (GMH–IVH) is still an important problem in the preterm infant and especially in those who are very immature. This type of lesion is now considered mainly to be caused by impaired drainage of the veins in the periventricular white matter and is often referred to as a venous infarction. The

Linda S de Vries; Ariadne M Roelants-van Rijn; Karin J Rademaker; Ingrid C van Haastert; Frederik JA Beek; Floris Groenendaal

2001-01-01

366

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).

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

2014-01-01

367

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

368

Unilateral Pulmonary Agenesis and Gastric Duplication Cyst: A Rare Association  

PubMed Central

Lung agenesis and gastric duplication cysts are both rare congenital anomalies. Gastric duplication cysts can present with nausea, vomiting, hematemesis, or vague abdominal pain. Unilateral pulmonary agenesis can present with respiratory distress which usually occurs due to retention of bronchial secretions and inflammations. We report the unique case of right pulmonary agenesis associated with gastric duplication cyst.

Skokic, Fahrija; Hotic, Nesad; Husaric, Edin; Radoja, Gordana; Muratovic, Selma; Dedic, Nermina

2013-01-01

369

Acute kidney injury: a springboard for progression in chronic kidney disease.  

PubMed

Recently published epidemiological and outcome analysis studies have brought to our attention the important role played by acute kidney injury (AKI) in the progression of chronic kidney disease (CKD) to end-stage renal disease (ESRD). AKI accelerates progression in patients with CKD; conversely, CKD predisposes patients to AKI. This research gives credence to older, well-thought-out wisdom that recovery from AKI is often not complete and is marked by residual structural damage. It also mirrors older experimental observations showing that unilateral nephrectomy, a surrogate for loss of nephrons by disease, compromises structural recovery and worsens tubulointerstitial fibrosis after ischemic AKI. Moreover, review of a substantial body of work on the relationships among reduced renal mass, hypertension, and pathology associated with these conditions suggests that impaired myogenic autoregulation of blood flow in the setting of hypertension, the arteriolosclerosis that results, and associated recurrent ischemic AKI in microscopic foci play important roles in the development of progressively increasing tubulointerstitial fibrosis. How nutrition, an additional factor that profoundly affects renal disease progression, influences these events needs reevaluation in light of information on the effects of calories vs. protein and animal vs. vegetable protein on injury and progression. Considerations based on published and emerging data suggest that a pathology that develops in regenerating tubules after AKI characterized by failure of differentiation and persistently high signaling activity is the proximate cause that drives downstream events in the interstitium: inflammation, capillary rarefaction, and fibroblast proliferation. In light of this information, we advance a comprehensive hypothesis regarding the pathophysiology of AKI as it relates to the progression of kidney disease. We discuss the implications of this pathophysiology for developing efficient therapeutic strategies to delay progression and avert ESRD. PMID:20200097

Venkatachalam, Manjeri A; Griffin, Karen A; Lan, Rongpei; Geng, Hui; Saikumar, Pothana; Bidani, Anil K

2010-05-01

370

Acute kidney injury: a springboard for progression in chronic kidney disease  

PubMed Central

Recently published epidemiological and outcome analysis studies have brought to our attention the important role played by acute kidney injury (AKI) in the progression of chronic kidney disease (CKD) to end-stage renal disease (ESRD). AKI accelerates progression in patients with CKD; conversely, CKD predisposes patients to AKI. This research gives credence to older, well-thought-out wisdom that recovery from AKI is often not complete and is marked by residual structural damage. It also mirrors older experimental observations showing that unilateral nephrectomy, a surrogate for loss of nephrons by disease, compromises structural recovery and worsens tubulointerstitial fibrosis after ischemic AKI. Moreover, review of a substantial body of work on the relationships among reduced renal mass, hypertension, and pathology associated with these conditions suggests that impaired myogenic autoregulation of blood flow in the setting of hypertension, the arteriolosclerosis that results, and associated recurrent ischemic AKI in microscopic foci play important roles in the development of progressively increasing tubulointerstitial fibrosis. How nutrition, an additional factor that profoundly affects renal disease progression, influences these events needs reevaluation in light of information on the effects of calories vs. protein and animal vs. vegetable protein on injury and progression. Considerations based on published and emerging data suggest that a pathology that develops in regenerating tubules after AKI characterized by failure of differentiation and persistently high signaling activity is the proximate cause that drives downstream events in the interstitium: inflammation, capillary rarefaction, and fibroblast proliferation. In light of this information, we advance a comprehensive hypothesis regarding the pathophysiology of AKI as it relates to the progression of kidney disease. We discuss the implications of this pathophysiology for developing efficient therapeutic strategies to delay progression and avert ESRD.

Griffin, Karen A.; Lan, Rongpei; Geng, Hui; Saikumar, Pothana; Bidani, Anil K.

2010-01-01

371

Imaging in thoracic oncology: case studies from Multidisciplinary Thoracic Tumor Board  

PubMed Central

Abstract Multidisciplinary tumor board conferences foster collaboration among health care providers from a variety of specialties and help to facilitate optimal patient care. Generally, the clinical questions revolve around the best options for establishing a diagnosis, staging the disease and directing treatment. This article describes and illustrates the clinical scenarios of three patients who were presented at our thoracic Tumor Board, focusing on management issues and the role of imaging. These patients had invasive thymoma; concurrent small cell lung cancer and non-small cell lung cancer; and esophageal cancer with celiac lymph node metastases, respectively.

Reddy, Rishindra M.; Lin, Jules; Arenberg, Douglas A.; Speers, Corey; Hayman, James A.; Kong, Fengming P.; Orringer, Mark B.; Kalemkerian, Gregory P.

2013-01-01

372

[Kidney and thyroid dysfunction.  

PubMed

Thyroid hormones influence renal development, kidney structure, renal hemodynamics, glomerular filtration rate, the function of many transport systems along the nephron, and sodium and water homeostasis. Effects of hypothyroidism and hyperthyroidism on kidney function are the result of direct renal effects, as well as systemic hemodynamic, metabolic, and cardiovascular effects. Most of the renal manifestations of thyroid disorders, which are clinically most significant with hypothyroidism, are reversible with treatment. Patients with hypothyroidism can have clinically important reductions in GFR, so screening for hypothyroidism should be considered in patients with unexplained elevations in serum creatinine. Patients with thyroid disorders are also at risk for immune-mediated glomerular diseases. Finally, patients with nephrotic syndrome, as well as acute and chronic kidney injury, have alterations in thyroid gland physiology that can impact thyroid function and the testing of thyroid function status. Dialysis patients have frequently hypothyroidism whose biological diagnosis must be careful. PMID:23022287

Ponsoye, Matthieu; Paule, Romain; Gueutin, Victor; Deray, Gilbert; Izzedine, Hassane

2012-09-27

373

Are we running out of thoracic or cardiac surgeons? Demography of thoracic and cardiac surgeons in France in 2012†  

PubMed Central

OBJECTIVES The aim of the study was to accurately evaluate the inflow and outflow of thoracic and cardiac surgeons in France. METHODS The French Society of Thoracic and Cardiovascular Surgery (SFCTCV) built a database of the surgeons involved in thoracic and/or cardiac surgery in France. It included all surgeons who perform cardiac or thoracic surgery regardless of the number of operations performed per year, whether or not they are members of the SFCTCV and all trainees once they have expressed an interest in thoracic and/or cardiac surgery. RESULTS The database included 552 senior surgeons (professors, attending surgeons in public practice and attending surgeons in private practice) practicing cardiac and/or thoracic surgery. Of these, 206 practiced cardiac, 278 thoracic and 68 both. The ‘inflow’ includes 128 residents and 83 senior residents. Global analysis of age distribution showed a mean predictable outflow of 17.6 senior surgeons per year between 2013 and 2022. The ‘inflow’ of finishing senior residents for the next 5 years was 18 per year. The number of residents was 25 per year of residency. Cardiac surgeon ‘outflow’ was 7.7 per year and the inflow of finishing senior residents 10–11 per year. The difficult period will be 2015–19 with an excess of 5 finishing senior residents per year. Thoracic surgeon ‘outflow’ was 11.7 and inflow 10 per year. Gender distribution indicated an increasing feminization. The female proportion was 5, 23 and 31% among senior surgeons, senior residents and residents, respectively. CONCLUSIONS France will not run out of cardiothoracic surgeons. The inflow compensates for the outflow of surgeons liable to stop their activity in the next 10 years.

Laskar, Marc; Spinosi, Anne Marie; Bendjebla, Yamina; Moreau, Jeanne; Dahan, Marcel

2013-01-01

374

Aortic Dose Constraints when Reirradiating Thoracic Tumors  

PubMed Central

Background and Purpose Improved radiation delivery and planning has allowed, in some instances, for the retreatment of thoracic tumors. We investigated the dose limits of the aorta wherein grade 5 aortic toxicity was observed after reirradiation of lung tumors. Material and Methods In a retrospective analysis, 35 patients were identified, between 1993 and 2008, who received two rounds of external beam irradiation that included the aorta in the radiation fields of both the initial and retreatment plans. We determined the maximum cumulative dose to 1 cm3 of the aorta (the composite dose) for each patient, normalized these doses to 1.8 Gy/fraction, and corrected them for long-term tissue recovery between treatments (NIDR). Results The median time interval between treatments was 30 months (range, 1–185 months). The median follow-up of patients alive at analysis was 42 months (range, 14–70 months). Two of the 35 patients (6%) were identified as having grade 5 aortic toxicities. There was a 25% rate of grade 5 aortic toxicity for patients receiving composite doses ?120.0 Gy (vs. 0% for patients receiving <120.0 Gy) (P=0.047). Conclusions Grade 5 aortic toxicities were observed with composite doses ?120.0 Gy (NIDR ?90.0 Gy) to 1 cm3 of the aorta.

Evans, Jaden D.; Gomez, Daniel R.; Amini, Arya; Rebueno, Neal; Allen, Pamela K.; Martel, Mary K.; Rineer, Justin M.; Ang, K. Kian; McAvoy, Sarah; Cox, James D.; Komaki, Ritsuko; Welsh, James W.

2014-01-01

375

Acute lung injury after thoracic surgery.  

PubMed

In this review, the authors discussed criteria for diagnosing ALI; incidence, etiology, preoperative risk factors, intraoperative management, risk-reduction strategies, treatment, and prognosis. The anesthesiologist needs to maintain an index of suspicion for ALI in the perioperative period of thoracic surgery, particularly after lung resection on the right side. Acute hypoxemia, imaging analysis for diffuse infiltrates, and detecting a noncardiogenic origin for pulmonary edema are important hallmarks of acute lung injury. Conservative intraoperative fluid administration of neutral to slightly negative fluid balance over the postoperative first week can reduce the number of ventilator days. Fluid management may be optimized with the assistance of new imaging techniques, and the anesthesiologist should monitor for transfusion-related lung injuries. Small tidal volumes of 6 mL/kg and low plateau pressures of < or =30 cmH2O may reduce organ and systemic failure. PEEP may improve oxygenation and increases organ failure-free days but has not shown a mortality benefit. The optimal mode of ventilation has not been shown in perioperative studies. Permissive hypercapnia may be needed in order to reduce lung injury from positive-pressure ventilation. NO is not recommended as a treatment. Strategies such as bronchodilation, smoking cessation, steroids, and recruitment maneuvers are unproven to benefit mortality although symptomatically they often have been shown to help ALI patients. Further studies to isolate biomarkers active in the acute setting of lung injury and pharmacologic agents to inhibit inflammatory intermediates may help improve management of this complex disease. PMID:20060320

Eichenbaum, Kenneth D; Neustein, Steven M

2010-08-01

376

Molecular mechanisms of thoracic aortic dissection.  

PubMed

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

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

2013-10-01

377

An analytical methodology for magnetic field control in unilateral NMR.  

PubMed

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

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

2005-05-01

378

An analytical methodology for magnetic field control in unilateral NMR  

NASA Astrophysics Data System (ADS)

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

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

2005-05-01

379

Mesenchymal chondrosarcoma of kidney  

PubMed Central

Mesenchymal chondrosarcoma of the kidney is a very rare entity with no definite treatment protocol. Herein, we describe one such case with discussion of its diagnosis and management. The patient had a well circumscribed mass in right kidney extending into the inferior vena cava and metastasis to both the lungs. Right nephrectomy was performed and the histopathological examination confirmed the diagnosis to be renal mesenchymal chondrosarcoma. After surgical removal of the tumor, the patient was given chemotherapy with Cisplatin and Epirubicin, following which there was significant regression of lung nodules.

Tyagi, Ruchita; Kakkar, Nandita; Vasishta, Rakesh Kumar; Aggarwal, Mayank Mohan

2014-01-01

380

Mesenchymal chondrosarcoma of kidney.  

PubMed

Mesenchymal chondrosarcoma of the kidney is a very rare entity with no definite treatment protocol. Herein, we describe one such case with discussion of its diagnosis and management. The patient had a well circumscribed mass in right kidney extending into the inferior vena cava and metastasis to both the lungs. Right nephrectomy was performed and the histopathological examination confirmed the diagnosis to be renal mesenchymal chondrosarcoma. After surgical removal of the tumor, the patient was given chemotherapy with Cisplatin and Epirubicin, following which there was significant regression of lung nodules. PMID:24744526

Tyagi, Ruchita; Kakkar, Nandita; Vasishta, Rakesh Kumar; Aggarwal, Mayank Mohan

2014-04-01

381

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.

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

382

Incidence and risk factors for acute kidney injury after spine surgery using the RIFLE classification.  

PubMed

Object Earlier definitions of acute renal failure are not sensitive in identifying milder forms of acute kidney injury (AKI). The authors hypothesized that by applying the RIFLE criteria for acute renal failure (Risk of renal dysfunction, Injury to the kidney, Failure of kidney function, Loss of kidney function, and End-stage kidney disease) to thoracic and lumbar spine surgery, there would be a higher incidence of AKI. They also developed a model to predict the postoperative glomerular filtration rate (GFR). Methods A hospital data repository was used to identify patients undergoing thoracic and/or lumbar spine surgery over a 5-year period (2006-2011). The lowest GFR in the first week after surgery was used to identify and categorize kidney injury if present. Risk factors were identified and a model was developed to predict postoperative GFR based on the defined risk factors. Results A total of 726 patients were identified over the study period. The incidence of AKI was 3.9% (n = 28) based on the RIFLE classification with 23 patients in the risk category and 5 in the injury category. No patient was classified into the failure category or required renal replacement therapy. The baseline GFR in the non-AKI and AKI groups was 80 and 79.8 ml/min, respectively. After univariate analysis, only hypertension was associated with postoperative AKI (p = 0.02). A model was developed to predict the postoperative GFR. This model accounted for 64.4% of the variation in the postoperative GFRs (r(2) = 0.644). Conclusions The incidence of AKI in spine surgery is higher than previously reported, with all of the patients classified into either the risk or injury RIFLE categories. Because these categories have previously been shown to be associated with poor long-term outcomes, early recognition, management, and follow-up of these patients is important. PMID:24654744

Naik, Bhiken I; Colquhoun, Douglas A; McKinney, William E; Smith, Andrew Bryant; Titus, Brian; McMurry, Timothy L; Raphael, Jacob; Durieux, Marcel E

2014-05-01

383

[Miliary tuberculosis after kidney transplantation].  

PubMed

The authors describe a case of tuberculosis after kidney transplantation. They discuss diagnostic and therapeutical problems arising from the specific course of this disease which appears in patients with chronic renal insufficiency treated with immunosuppressives after kidney transplantation. PMID:2790890

Nouza, M; Jirka, J; Reneltová, I; Chadimová, M; Dráb, K; Krofta, K

1989-07-14

384

FastStats: Kidney Disease  

MedlinePLUS

... Data Related Links Accessibility 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 ...

385

Living with Kidney Disease: Frequently Asked Questions  

MedlinePLUS Videos and Cool Tools

... With Your Health Professionals Questions to Ask Your Health Care Professional Keep Your Kidneys Healthy Testing for Kidney ... Changes Medicines and Kidney Disease Working with Your Health Care Providers Questions to Ask Your Health Professional Kidney ...

386

Divergent phenotype of rat thoracic and abdominal perivascular adipose tissues  

PubMed Central

Perivascular adipose tissue (PVAT) is implicated as a source of proatherogenic cytokines. Phenotypic differences in local PVAT depots may contribute to differences in disease susceptibility among arteries and even regions within an artery. It has been proposed that PVAT around the abdominal and thoracic aorta shares characteristics of white and brown adipose tissue (BAT), respectively; however, a detailed comparison of the phenotype of these PVAT depots has not been performed. Using young and older adult rats, we compared the phenotype of PVATs surrounding the abdominal and thoracic aorta to each other and also to epididymal white and subscapular BAT. Compared with young rats, older rats exhibited greater percent body fat (34.5 ± 3.1 vs. 10.4 ± 0.9%), total cholesterol (112.2 ± 7.5 vs. 58.7 ± 6.3 mg/dl), HOMA-insulin resistance (1.7 ± 0.1 vs. 0.9 ± 0.1 a.u.), as well as reduced ACh-induced relaxation of the aorta (maximal relaxation: 54 ± 10 vs. 77 ± 6%) (all P < 0.05). Expression of inflammatory genes and markers of immune cell infiltration were greater in abdominal PVAT than in thoracic PVAT, and overall, abdominal and thoracic PVATs resembled the phenotype of white adipose tissue (WAT) and BAT, respectively. Histology and electron microscopy indicated structural similarity between visceral WAT and abdominal PVAT and between BAT and thoracic PVAT. Our data provide evidence that abdominal PVAT is more inflamed than thoracic PVAT, a difference that was by and large independent of sedentary aging. Phenotypic differences in PVAT between regions of the aorta may be relevant in light of the evidence in large animals and humans that the abdominal aorta is more vulnerable to atherosclerosis than the thoracic aorta.

Jenkins, Nathan T.; Vieira-Potter, Victoria J.; Laughlin, M. Harold

2013-01-01

387

Hypoxia in Diabetic Kidneys  

PubMed Central

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

Takiyama, Yumi; Haneda, Masakazu

2014-01-01

388

Aquaporins in kidney pathophysiology  

Microsoft Academic Search

Seven aquaporin water channels are expressed in human kidneys, and they have key roles in maintaining body water homeostasis. Impairment of their function can result in nephrogenic diabetes insipidus and other water-balance disorders. A lot of data have increased understanding of the functions and mechanisms of regulation of aquaporins both at the molecular and the clinical level. Research has also

Yumi Noda; Eisei Sohara; Eriko Ohta; Sei Sasaki

2010-01-01

389

[Acute kidney injury].  

PubMed

Acute kidney injury plays a pivotal role in intensive care medicine and exerts crucial adverse effects on the course of the disease and overall prognosis of the critically ill patient. Intensive renal support, including initiation of earlier dialysis or maximal uremic toxin removal by higher dosage and frequency of renal replacement therapy, and individualized selection of modality were not able to decrease excessive mortality in this population. Systemic acute inflammation, mediated, at least in part, by cytokines, and not secondary uremic side effects, seems to have a major impact on nonrenal organ damage. Assessment of short-term outcome in critically ill patients who develop acute kidney injury may underestimate the true burden of disease. The overall survival at 5 years in patients discharged alive after severe acute kidney injury necessitating renal replacement therapy is only 20-30%, comparable to cancer patients. In addition, acute renal damage was identified as an independent risk factor for progression of chronic renal insufficiency. Current research focuses on strategies for the prevention of acute kidney injury and on the establishment of effective biomarkers for the early recognition and accurate diagnosis of subclinical renal damage. PMID:22437194

Schmid, H; Schiffl, H; Lederer, S R

2012-03-01

390

Neurology and the kidney  

Microsoft Academic Search

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

D J Burn; D Bates

1998-01-01

391

Kidney Disease: Improving Global Outcomes  

Microsoft Academic Search

Kidney Disease: Improving Global Outcomes (KDIGO) is an independent organization with the mission to improve care and outcomes of patients with kidney disease worldwide through the development and coordination of clinical practice guidelines. KDIGO has established firm links with other organizations that have previously produced clinical practice guidelines in the field of kidney disease. The first three KDIGO guidelines—treatment of

Bertram L. Kasiske; Kai-Uwe Eckardt

2009-01-01

392

Prevention of acute kidney injury.  

PubMed

Acute kidney injury is common and carries a high mortality. Many drugs have been evaluated for their role in preventing acute kidney injury, of which some are of no benefit and others may be harmful. This review discusses current interventions to prevent acute kidney injury and reviews the evidence base for each. PMID:18783092

Brincat, Stephan; Hilton, Rachel

2008-08-01

393

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.

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

2014-01-01

394

Increasing cGMP-dependent protein kinase activity attenuates unilateral ureteral obstruction-induced renal fibrosis.  

PubMed

Our previous studies support the protective effect of cGMP and cGMP-dependent protein kinase I (PKG-I) pathway on the development of renal fibrosis. Therefore, in the present studies, we determined whether pharmacologically or genetically increased PKG activity attenuates renal fibrosis in a unilateral ureteral obstruction (UUO) model and also examined the mechanisms involved. To increase PKG activity, we used the phosphodiesterase 5 inhibitor sildenafil and PKG transgenic mice. UUO model was induced in wild-type or PKG-I transgenic mice by ligating the left lateral ureteral and the renal fibrosis was observed after 14 days of ligation. Sildenafil was administered into wild-type UUO mice for 14 days. In vitro, macrophage and proximal tubular cell function was also analyzed. We found that sildenafil treatment or PKG transgenic mice had significantly reduced UUO-induced renal fibrosis, which was associated with reduced TGF-? signaling and reduced macrophage infiltration into kidney interstitial. In vitro data further demonstrated that both macrophages and proximal tubular cells were important sources of UUO-induced renal TGF-? levels. The interaction between macrophages and tubular cells contributes to TGF-?-induced renal fibrosis. Taken together, these data suggest that increasing PKG activity ameliorates renal fibrosis in part through regulation of macrophage and tubular cell function, leading to reduced TGF-?-induced fibrosis. PMID:24573388

Cui, Wenpeng; Maimaitiyiming, Hasiyeti; Qi, Xinyu; Norman, Heather; Zhou, Qi; Wang, Xiaojun; Fu, Jian; Wang, Shuxia

2014-05-01

395

[The application value of dual-source CT in the preoperative evaluation of living donor kidneys].  

PubMed

This study was to evaluate the value of dual-source CT in the preoperative assessment of living donor kidneys. We collected fifty-five consecutive living kidney donors (male 35, female 20, average age, 39 years old), and performed dual-source CT scan. The plain scan, pre-enhanced arterial phase and venous phase examinations were performed, with the scan level ranged from the 11th thoracic vertebral body to the iliac crest. All the basic images were reconstructed using volume rendering(VR), maximum intensity projection (MIP), multi-planar reconstruction (MPR) techniques to evaluate the anatomical location and variation of renal arteries and veins, and the morphology and function of kidney and urinary tract. All the 55 cases were successful, with completion of CT scan and clear images. 46 cases among the all cases had normal renal arteries and veins, while 6 cases had accessory arteries, 2 cases had pre-hilar renal artery branching, and 1 case had vein variation. For the renal parenchymas, 48 cases were normal, while 2 cases had angiomyolipoma and 5 cases had cortical cyst. There were no variation and disease in upper urinary tract. Compared with the surgical findings, the diagnostic accuracy was 100% with dual-source CT. In conclusion, the dual-source CT can accurately evaluate the vessel of kidney, renal parenchyma and upper urinary tract of living renal donors, can provide reliable imaging information for screening of living donor kidney and can help make operation program in living kidney transplantation. PMID:22616172

Zhang, Wei; Chen, Guangwen; Song, Bin

2012-04-01

396

Transient increase in proteinuria, poly-ubiquitylated proteins and ER stress markers in podocyte-specific autophagy-deficient mice following unilateral nephrectomy.  

PubMed

Previous studies have revealed that podocytes normally can be associated with a very high degree of autophagic activity, and that a lack of autophagic activity in podocytes is associated with susceptibility to disease and to late-onset glomerulosclerosis. In the present study, we conducted unilateral nephrectomy as a surgical model for acute nephron reduction. First, using GFP-LC3 transgenic mice to monitor autophagy, we found that glomerular autophagy could be transiently suppressed by surgery, but that it was restored quickly. To further explore the significance of podocyte autophagy after unilateral nephrectomy, we investigated podocyte-specific Atg7-deficient mice. The knockout mice exhibited no pathological phenotype compared with wild-type mice before nephrectomy. However, 1 day after nephrectomy, significantly higher levels of proteinuria and ultrastructural changes that included foot process effacement and a significant reduction in podocyte number were detected in mice harboring Atg7-deficient podocytes. Moreover, biochemical and immunohistochemical analyses showed a robust increase in polyubiquitin levels and ER stress markers in the glomeruli of the mice with autophagy-deficient podocytes. These results show the importance of the autophagic process in podocytes for maintaining a normal degree of filtration function during the adaptation to compensatory kidney hypertrophy following unilateral nephrectomy. PMID:24680677

Oliva Trejo, Juan Alejandro; Asanuma, Katsuhiko; Kim, Eun-Hee; Takagi-Akiba, Miyuki; Nonaka, Kanae; Hidaka, Teruo; Komatsu, Masaaki; Tada, Norihiro; Ueno, Takashi; Tomino, Yasuhiko

2014-04-18

397

Radiation injury in the human kidney: A prospective analysis using specific scintigraphic and biochemical endpoints  

SciTech Connect

Renal function was prospectively analyzed in 26 evaluable patients, irradiated to various doses on their kidneys for neoplastic disease. Glomerular function was assessed by 99mTc-DTPA renography, creatinine clearance, and serum beta 2-microglobulin, whereas tubular function was monitored by 99mTc-DMSA scintigraphy, urine beta 2-microglobulin, urine N-acetyl glucosaminidase, and alanine aminopeptidase and a urine concentration test. In the patients given the highest irradiation dose to the entire left kidney, that is, 40 Gy in 5 1/2 weeks, glomerular and tubular functional impairment, as assessed scintigraphically, progressed at a rate of 2.0 +/- 1.0% (+/- 1 SD) and 2.0 +/- 0.5% per month, respectively, down to 30-40% after 3 to 5 years. The overall glomerular function, as assessed by creatinine clearance, decreased by only 20%. In the patients irradiated unilaterally on the upper pole to 40 Gy in 4 weeks, glomerular and tubular function in the left kidney deteriorated at 0.75 +/- 0.33% and 0.75 +/- 0.20% per month in the first 2 years, down to 75-80% at 5 years. This smaller reduction was due to shielding of a part of the left kidney. No changes were observed, thus far, after bilateral whole kidney irradiation to 17-18 Gy in 3 1/2 weeks. The concentration capacity of the kidney after total volume irradiation was not impaired. There was a trend for an increase in diastolic blood pressure in 3 out of 5 patients given the high dose irradiation to the entire left kidney and in 2 out of 7 patients irradiated on the upper pole of the left kidney. The progressive nature of the radiation nephropathy stresses the need for long term follow-up to determine more accurately the tolerance dose of the human kidney for irradiation.

Dewit, L.; Anninga, J.K.; Hoefnagel, C.A.; Nooijen, W.J. (Netherlands Cancer Institute, Antoni van Leeuwenhoek Huis, Amsterdam (Netherlands))

1990-10-01

398

Mechanism of the formation for thoracic impedance change.  

PubMed

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

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

2010-03-01

399

Anesthesia for thoracic surgery: A survey of middle eastern practice  

PubMed Central

Purpose: The main objective of this survey is to describe the current practice of thoracic anesthesia in the Middle Eastern (ME) region. Methods: A prospective online survey. An invitation to participate was e-mailed to all members of the ME thoracic-anaesthesia group. A total of 58 members participated in the survey from 19 institutions in the Middle East. Questions concerned ventilation strategies during one-lung ventilation (OLV), anesthesia regimen, mode of postoperative analgesia, use of lung isolation techniques, and use of i.v. fluids. Results: Volume-controlled ventilation was favored over pressure-controlled ventilation (62% vs 38% of respondents, P<0.05); 43% report the routine use of positive end-expiratory pressure. One hundred percent of respondents report using double-lumen tube (DLT) as a first choice airway to establish OLV. Nearly a third of respondents, 31.1%, report never using bronchial blocker (BB) in their thoracic anesthesia practice. Failure to pass a DLT and difficult airway are the most commonly cited indications for BB use. Regarding postoperative analgesia, the majority 61.8% favor thoracic epidural analgesia over other techniques (P<0.05). Conclusions: Our survey provides a contemporary snapshot of the ME thoracic anesthetic practice.

Eldawlatly, Abdelazeem; Turkistani, Ahmed; Shelley, Ben; El-Tahan, Mohamed; Macfie, Alistair; Kinsella, John

2012-01-01

400

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.

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

2009-01-01

401

Global suppression of electrocortical activity in unilateral perinatal thalamic stroke.  

PubMed

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

2014-07-01

402

Congenital Unilateral Deafness Affects Cerebral Organization of Reading  

PubMed Central

It is known that early sensory deprivation modifies brain functional structure and connectivity. The aim of the present study was to investigate the neuro-functional organization of reading in a patient with profound congenital unilateral deafness. Using event-related potentials (ERPs), we compared cortical networks supporting the processing of written words in patient RA (completely deaf in the right ear since birth) and in a group of control volunteers. We found that congenital unilateral hearing deprivation modifies neural mechanisms of word reading. Indeed, while written word processing was left-lateralized in controls, we found a strong right lateralization of the fusiform and inferior occipital gyri activation in RA. This finding goes in the same direction of recent proposals that the ventral occipito-temporal activity in word reading seem to lateralize to the same hemisphere as the one involved in spoken language processing.

Adorni, Roberta; Manfredi, Mirella; Proverbio, Alice Mado

2013-01-01

403

Solving the Beam Bending Problem with an Unilateral Winkler Foundation  

NASA Astrophysics Data System (ADS)

Our work is going to deal with the bending of a beam resting on an unilateral elastic foundation and develops further the ideas from the article [5]. In some cases the beam has fixed connection with the foundation. Such problems are linear. However there are applications where the beam is not connected with the foundation. This so-called unilateral case represents an interesting nonlinear problem and cannot be solved by easy means. We propose here first a new formulation of this problem which is based upon the idea of a decomposition. This way we can convert the usual variational formulation of our problem to a saddle-point formulation. In the second part of this paper we will deal with a numerical solution using the finite element method. The system of equations for the saddle point is nonlinear and nondifferentiable. It can be handled by the transformation to a complementarity problem which is solved by the nonsmooth Newton method.

Machalová, Jitka; Netuka, Horymír

2011-09-01

404

[Surgical voice rehabilitation in unilateral vocal fold paralysis].  

PubMed

Unilateral recurrent nerve paralysis leads to glottic insufficiency, significantly reducing vocal ability. Due to its unusually long course, the recurrent laryngeal nerve is prone to iatrogenic lesions involves many medical fields generally with little expertise in voice disorders. Whenever the etiology is uncertain, a complete diagnostic work-up is mandatory. Indirect laryngoscopy confirms the diagnosis. Laryngeal electromyography is of great value because it differentiates between paralysis and ankylosis of the cricoarytenoid joint. Moreover in many cases laryngeal electromyography yields a reliable prognosis of clinical outcome. While unfavorable results can be predicted with high accuracy, correct prognosis of complete recovery is more difficult. Speech therapy is the treatment of choice in cases of unilateral recurrent nerve palsy. Patients with persistent glottal gap may express the wish for surgical voice rehabilitation. Nowadays a broad spectrum of endoscopic and open approaches are available for this purpose. This review describes advanced techniques of voice-improving surgery available in specialized centers today. PMID:18509610

Sittel, C; Bosch, N; Plinkert, P K

2008-11-01

405

Secondary bilateral synchrony in unilateral pial angiomatosis: successful surgical treatment.  

PubMed Central

Three children with circumscribed unilateral pial angiomatosis had both generalised and partial seizures associated with bilateral synchronous spike-wave complexes. Dramatic control of the seizures was obtained by surgical removal restricted to the angiomas and underlying cortex. There was recurrence of seizures in one patient from whom only one of two angiomatous areas was removed but not in the two patients whose excision was total. These cases indicate that secondary bilateral synchrony can occur with lesions of the posterior and external parts of one hemisphere. Surgical removal of a definable lesion, without intracranial recording, can help patients with intractable epilepsy due to unilateral pial angiomatosis, even in the presence of wide diffusion of clinical and electroencephalographic abnormalities.

Chevrie, J J; Specola, N; Aicardi, J

1988-01-01

406

Unilateral incompatibility: hypotheses, debate and its implications for plant breeding  

Microsoft Academic Search

Unilateral incompatibility, its evolution and the hypotheses put forward to explain this phenomenon have been discussed. A new hypothesis is presented giving an easy explanation of the problems arisen and of the results obtained hitherto. The results to be expected from crosses between self-compatible and self-incompatible species and the crossability and (in)compatibility behaviour of their hybrids and segregating generations are

M. M. F. Abdalla

1972-01-01

407

Magnetic vestibular stimulation in subjects with unilateral labyrinthine disorders.  

PubMed

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

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

2014-01-01

408

Adrenal insufficiency following unilateral adrenalectomy: a case report.  

PubMed

We report a case of resection of a unilateral adrenal pseudocyst that precipitated life-threatening adrenal insufficiency. The patient had extremis unresponsive to pressor agents in the immediate postoperative period. Hydrocortisone administration produced temporary resolution and a cosyntropin-stimulation test confirmed adrenal insufficiency. Because of the presence of an adrenal mass, the preoperative evaluation included a formal endocrinological evaluation. Thus, we were able to document the occurrence of acute postoperative primary adrenal insufficiency. PMID:3944905

Mohler, J L; Flueck, J A; McRoberts, J W

1986-03-01

409

Sulfasalazine reduces inflammatory renal injury in unilateral ureteral obstruction  

Microsoft Academic Search

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

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

2007-01-01

410

Wms-r patterns among patients with unilateral brain lesions  

Microsoft Academic Search

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

Gordon J. Chelune; Robert A. Bornstein

1988-01-01

411

Unilateral, Isolated, Paediatric Lightning-Induced Cataract: A Case Report  

PubMed Central

A six-year-old girl presented with gradual loss of vision in the left eye a year after sustaining a lightning strike while in her home. Examination revealed healed burns to her cheek, left arm, and right leg and a dense left cataract. There was no evidence of other ocular sequelae, and her right eye was normal. Cataract surgery and lens implantation were performed on the left eye with good results. Isolated, unilateral, paediatric cataract due to lightning is discussed.

Rogers, G. J.; Grotte, R.

2011-01-01

412

Prosthesis rejection in children with a unilateral congenital arm defect  

Microsoft Academic Search

Objective: To determine the rate of rejection for prosthetic use in children and to investigate reasons for this rejection.Design: Cross-sectional study of a cohort of children.Setting: Rehabilitation centre, St Maartenskliniek, Nijmegen, the Netherlands.Subjects: Thirty-two children (0–18 years) with a unilateral congenital arm defect who visited the clinic between September 1991 and December 1996.Methods: Parents of all children and 19 children

K Postema; V van der Donk; J van Limbeek; R AJ Rijken; M J Poelma

1999-01-01

413

Beware of "curare cleft" like changes during unilateral capnothorax.  

PubMed

Capnography is a standard monitoring tool during general anaesthesia. Diaphragmatic movement with the weaning of muscle relaxant effect produces the characteristic "curare cleft" on capnography. Various artefacts can mimick this trace intraoperatively. Cautious interpretation and identification of these is essential to avoid any undue overdosing of the patients with muscle relaxants. We report "curare cleft" like artefact during ventilation with a single lumen tube in a patient with unilateral capnothorax undergoing minimally invasive esophagectomy. PMID:24132805

Singh, Manila; Chaudhary, Kapil; Uppal, Rajeev; Jain, Sachin

2014-06-01

414

Perioperative outcomes after unilateral and bilateral total knee arthroplasty  

PubMed Central

Background The safety of bilateral total knee arthroplasties (BTKA) during the same hospitalization remains controversial. We sought to study differences in perioperative outcomes between unilateral and BTKA, and further compare BTKAs performed during the same versus different operations during the same hospitalization. Methods Nationwide Inpatient Sample data from 1998 to 2006 were analyzed. Entries for unilateral and BTKA procedures performed on the same day (simultaneous) and separate days (staged) during the same hospitalization were identified. Patient and health-care system related demographics were determined. The incidence of in-hospital mortality and procedure related complications was estimated and compared between groups. Multivariate regression was used to identify independent risk factors for morbidity and mortality. Results Despite younger average age and lower comorbidity burden, procedure related complications and in-hospital mortality were more frequent after BTKA than after unilateral procedures (9.45% vs. 7.07% and 0.30% vs. 0.14%, P<0.0001 each). An increased rate of complications was associated with a staged versus simultaneous approach with no difference in mortality (10.30% vs. 9.15% (P<0.0001) and 0.29% vs. 0.26% (P=0.2875)). Independent predictors for in-hospital mortality included: BTKA (simultaneous: OR 2.23, CI=[1.69; 2.95], P<0.0001; staged: OR 2.01, CI=[1.28; 3.41], P=0.0031), male gender (OR 2.02, CI=[1.75, 2.34], P<0.0001), age above 75 years (OR 3.96 CI=[2.77, 5.66], P<0.0001), and the presence of a number of comorbidities and complications. Conclusion BTKAs carry increased risk of perioperative morbidity and mortality compared to unilateral procedures. Staging BTKA procedures during the same hospitalization offers no mortality benefit, and may even expose patients to increased morbidity.

Memtsoudis, Stavros G.; Ma, Yan; Gonzalez Della Valle, Alejandro; Mazumdar, Madhu; Gaber-Baylis, Licia K.; MacKenzie, C. Ronald; Sculco, Thomas P.

2009-01-01

415

Stability with unilateral external fixation in the tibia.  

PubMed

Unilateral external fixation can be used in the provisional or definitive treatment of tibial fractures. A properly applied fixator allows bony and soft tissue stability, whereas an improperly applied fixator achieves neither and can be a hindrance. The principles for the successful application of monolateral external fixation, including the rationale for choosing this type of device, the assembly of its components and deciding on planes of application, are discussed in this article. PMID:18427910

Giotakis, N; Narayan, B

2007-04-01

416

Proposal of unilateral single-flux-quantum logic gate  

Microsoft Academic Search

A new type of single flux quantum logic gate is proposed, which can perform unilateral propagation of signal without using three-phase clock. This gate is designed to be built with bridge-type Josephson junctions. A basic logic gate consists of two one-junction interferometers coupled by superconducting interconnecting lines, and the logical states are represented by zero or one quantized fluxoid in

H. Miyake; N. Fukaya; Y. Okabe; T. Sugano

1985-01-01

417

Patient rotation and resolution of unilateral cornual obstruction during hysterosalpingography  

Microsoft Academic Search

ObjectiveUnilateral obstruction of the proximal fallopian tube is identified in 10–24% of patients undergoing hysterosalpingography for evaluation of infertility. Upon further testing, this obstruction spontaneously resolves 16–80% of the time. We hypothesized that patient rotation during hysterosalpingography might resolve proximal tubal obstruction in some cases by altering either the location of intrauterine air bubbles or the spatial relationship of the

William W Hurd; Erich T Wyckoff; David B Reynolds; Lawrence S Amesse; Jack S Gruber; Gary M Horowitz

2003-01-01

418

Leprosy presenting as unilateral foot drop in an immigrant boy.  

PubMed Central

This is a case report of a boy who presented with unilateral foot drop approximately 1 year after traumatic injury from skateboarding. Exploratory surgical operation was eventually performed, and histological examination of the surgical specimen revealed leprous peripheral neuropathy of the peroneal nerve. The patient had immigrated from Vietnam to the United States 3 years previously. The occurrence, albeit rare, of this entity in the immigrants from endemic leprosy regions is discussed.

Choe, W.

1994-01-01

419

Anomalous unilateral single pulmonary vein mimicking pulmonary arteriovenous malformation.  

PubMed

Anomalies involving the pulmonary vein are so rare that most of them have been reported as a case or a series of several cases. Some of them often simulate pulmonary arteriovenous malformation (AVM), and patients undergo pulmonary angiography for embolization. Herein we report a case of anomalous unilateral single pulmonary vein that was confirmed on pulmonary angiography after initial diagnosis of pulmonary AVM on contrast medium-enhanced chest computed tomography. PMID:23989502

Hyun, Dongho; Do, Young Soo; Lim, Seong Joo; Park, Hong Suk; Park, Kwang Bo

2014-06-01

420

Midterm Outcomes of Open Surgical Repair Compared with Thoracic Endovascular Repair for Isolated Descending Thoracic Aortic Disease  

PubMed Central

Objective This study aimed to assess the surgical morbidity and mortality of thoracic endovascular repair (TEVAR) as compared with open surgical repair (OSR) for isolated descending thoracic aortic disease. Materials and Methods From January 1, 2006 through May 31, 2010, a total of 68 patients with isolated descending thoracic aortic disease were retrospectively reviewed for the presence of perioperative complication, 30-day mortality, and clinical success. The patients were divided into two groups (group 1, OSR, n = 40 vs. group 2, TEVAR, n = 28) and these groups were compared for major variables and late outcomes. Results The mean age was 58 years (group I = 54 vs. group II = 63 years, p = 0.011). Significant perioperative complications occurred in 12 patients: 8 (20%) in group I and 4 (13%) in group II (p = 0.3). There were five 30 day mortalities of which 4 occurred in group I and 1 in group II (p = 0.23). Clinical success (effective aortic remodeling and complete false lumen obliteration or thrombosis) was achieved in 20 patients (71%). Mean Kaplan-Meier survival rate at 1 year was similar for both groups (group 1 = 87% vs. group 2 = 80%, p = 0.65). Conclusion Thoracic endovascular repair for isolated thoracic aortic disease shows comparable results to OSR. However, the potential for endoleak or rupture remains a challenge that needs to be addressed in the future. Therefore, close follow-up study is needed for the evaluation of satisfactory long-term outcomes.

Lee, Seung Hyun; Chung, Cheol Hyun; Jung, Sung Ho; Lee, Jae Won; Shin, Ji Hoon; Ko, Ki young; Yoon, Hyun Ki

2012-01-01

421

Thoracic Aortic Dissection and Mycotic Pseudoaneurysm in the Setting of an Unstable Upper Thoracic Type B2 Fracture  

PubMed Central

Thoracic type B2 fractures are high-energy injuries. It is crucial to maintain a high index of suspicion for concomitant visceral injuries. A 33-year-old man presented after a motor vehicle accident with a T4 type B2.3 fracture with an associated sternum fracture. He was treated with a T4 corpectomy and an expandable titanium cage and lateral plate construct at T3–T5. Two months later he developed focal kyphosis and loosening of his screws. This was addressed with an instrumented posterior fusion from T1 to T8 complicated by a wound infection, pneumonia, and fungal esophagitis requiring several debridements and vacuum assisted closure therapy. Worsening back pain prompted a thoracic computed tomography scan, revealing a dissecting thoracic-aortic aneurysm, which was treated with an endovascular stent graft. Few months later, he presented with fevers, chills, and hemoptysis secondary to Staphylococcus aureus bacteremia, endovascular leak, and T3–T5 osteomyelitis. He was transferred to our institution and restented by the cardiothoracic service. Subsequently, he underwent a thoracotomy, evacuation of infected aneurysmal hematoma with removal of instrumentation. A revision corpectomy with iliac crest autograft reconstruction was performed without complications. The patient's infection and thoracic pain resolved. However, there was a significant delay in treatment, resulting in substantial morbidity. Patients with thoracic type B2 fractures require careful evaluation for concomitant aortic and visceral injuries. Missed associated injuries result in increased morbidity and mortality.

Chaudhary, Saad B.; Roselli, Eric; Steinmetz, Michael; Mroz, Thomas E.

2012-01-01

422

Thoracic aortic dissection and mycotic pseudoaneurysm in the setting of an unstable upper thoracic type b2 fracture.  

PubMed

Thoracic type B2 fractures are high-energy injuries. It is crucial to maintain a high index of suspicion for concomitant visceral injuries. A 33-year-old man presented after a motor vehicle accident with a T4 type B2.3 fracture with an associated sternum fracture. He was treated with a T4 corpectomy and an expandable titanium cage and lateral plate construct at T3-T5. Two months later he developed focal kyphosis and loosening of his screws. This was addressed with an instrumented posterior fusion from T1 to T8 complicated by a wound infection, pneumonia, and fungal esophagitis requiring several debridements and vacuum assisted closure therapy. Worsening back pain prompted a thoracic computed tomography scan, revealing a dissecting thoracic-aortic aneurysm, which was treated with an endovascular stent graft. Few months later, he presented with fevers, chills, and hemoptysis secondary to Staphylococcus aureus bacteremia, endovascular leak, and T3-T5 osteomyelitis. He was transferred to our institution and restented by the cardiothoracic service. Subsequently, he underwent a thoracotomy, evacuation of infected aneurysmal hematoma with removal of instrumentation. A revision corpectomy with iliac crest autograft reconstruction was performed without complications. The patient's infection and thoracic pain resolved. However, there was a significant delay in treatment, resulting in substantial morbidity. Patients with thoracic type B2 fractures require careful evaluation for concomitant aortic and visceral injuries. Missed associated injuries result in increased morbidity and mortality. PMID:24353965

Chaudhary, Saad B; Roselli, Eric; Steinmetz, Michael; Mroz, Thomas E

2012-09-01

423

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.

Muneretto, Claudio

2013-01-01

424

Measurement of airway resistance and thoracic gas volume in infancy  

PubMed Central

Airway resistance and thoracic gas volume were measured in 21 normal infants aged 1 to 10 months using a whole body plethysmograph. Precautions were taken to eliminate temperature changes of inspired and expired gas. The mean value of airway resistance was 22·6 ± 8·9 (SD) cm H2O/l. per sec, and the mean thoracic gas volume in relation to body weight 34·9 ± 5·8 (SD) ml/kg. The reproducibility of the technique was assessed by making repeated measurements in 5 subjects, when the mean coefficient of variation of airway resistance was 11·8% and of thoracic gas volume 10·1%. ImagesFIG. 2

Radford, M.

1974-01-01

425

Chylothorax treated via thoracic duct ligation and omentalization.  

PubMed

Chylothorax is an uncommon, potentially life-threatening disease of dogs and cats. Medical records of 12 animals (five dogs and seven cats) undergoing surgical management of chylothorax from 2001 to 2005 were reviewed. All animals received thoracic duct ligation and thoracic omentalization. In some cases, a combination of subtotal pericardectomy and/or pleural stripping was also employed. All animals survived surgery, and none was lost to follow-up. Median survival time for cats was 209 days (range 2 to 1328 days), and for dogs it was 211 days (range 7 to 991 days). Although postoperative mortality was higher than in other recent studies, no complications could be directly attributed to thoracic omentalization. A controlled, prospective study is needed to compare outcomes of this management method to those of other methods. PMID:20810551

Stewart, Kayla; Padgett, Sheldon

2010-01-01

426

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

427

Repair of a complex thoracic aneurysm from relapsing polychondritis.  

PubMed

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

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

2013-07-01

428

Relationships between inhalable, thoracic, and respirable aerosols of metalworking fluids.  

PubMed

The aim of the study described in this companion paper was to assesses relationships among inhalable, thoracic, and respirable aerosol fractions of metalworking fluids. A RespiCon sampler, which simultaneously collects all three fractions, was used at four Ontario plants to collect 37 samples of 120 to 400 min duration. The ratios of the slopes of the lines of a regression model forced through the origin between inhalable and thoracic, inhalable and respirable, and thoracic and respirable were 1.38, 1.51, and 1.13, respectively. These ratios would be useful in assessing metalworking fluid airborne exposure data based on different aerosol fractions and for interpreting occupational exposure standards based on different fractions. PMID:17365498

Verma, Dave K

2007-04-01

429

Safety of thoracic transverse process fixation: an anatomical study.  

PubMed

An anatomical study of the passage of the implant placed around thoracic transverse process was undertaken in human cadavers to investigate the safety of thoracic transverse process fixation. A simulated surgical procedure for implant placement around the transverse processes of T1-T10 was carried out in eight fresh human cadavers using a mock plastic implant, 7.0 mm wide and 1.5 mm thick. A total of 80 implanted thoracic vertebrae were dissected systematically. One implanted spinal column was sectioned sagittally through the costotransverse space. The parietal pleura, the intercostal vessels, and intercostal nerves were not injured by the implants in any of the specimens. All the implants were located posterior to the intercostal nerves and vessels, lateral to the pedicles, and outside the spinal canal. The transverse processes of T1-T10 are safe structures for implant anchorage in posterior spinal instrumentation. PMID:8877955

Thanapipatsiri, S; Chan, D P

1996-08-01

430

Unilateral periventricular leukomalacia in association with pyruvate dehydrogenase deficiency.  

PubMed

Pyruvate dehydrogenase (PDH) deficiency is a major cause of primary lactic acidosis and neurological dysfunction in infancy and early childhood. A deficiency of PDH E1 alpha, a subunit of the PDH complex, is a prominent cause of congenital lactic acidosis. We describe a female infant born at term and delivered by emergency Caesarean section because of fetal distress. There was no parental consanguinity. She presented at 5 months of age with failure to thrive, microcephaly, hypertonia, and developmental impairment. Her plasma and cerebrospinal fluid lactate were raised. She had raised plasma pyruvate with a normal lactate-pyruvate ratio. Magnetic resonance imaging of the brain showed a focal dilatation of the right lateral ventricle with unilateral periventricular leukomalacia (PVL) with subependymal cyst. Skin fibroblast culture assay revealed PDH deficiency, confirmed by mutation analysis of the E1 alpha subunit. At 18 months of age, she has hypertonia and global impairment and is making slow progress. Denver II assessment showed delay in gross motor, fine motor, adaptive, personal, social, and language categories. She has been treated with dichloroacetate and a ketogenic diet since the age of 10 and 13 months respectively, without any side effects. To our knowledge, unilateral PVL as a neuroradiological feature has not been described in children with PDH deficiency. PDH deficiency should be considered as a differential diagnosis if PVL is unilateral and if the perinatal history is not typical of PVL. PMID:21895644

Sharma, Ruchi; Sharrard, Mark J; Connolly, Daniel J; Mordekar, Santosh R

2012-05-01

431

Disappearance of unilateral spatial neglect following a simple instruction  

PubMed Central

OBJECTIVES—To clarify the reason why patients with left unilateral spatial neglect fail to copy the left side of a daisy like flower, not continuing to draw petals all around.?METHODS—A flower was simplified and a figure was made that consisted of a large central circle and small circles surrounding it. Four patients with typical left unilateral spatial neglect performed copying and arrangement tasks to make this figure. In the arrangement task, they were instructed to arrange small circles all around the printed central circle.?RESULTS—The patients' identification of the composition seemed flawless. In the copying task, they showed neglect, leaving a space on the left side. They seemed to adhere to their plan to place the same number of small circles as those of the model figure. By contrast, neglect disappeared in the arrangement task.?CONCLUSION—Patients with neglect can draw the figure satisfactorily if they use a spatial strategy to arrange small circles all around. This strategy seems to improve motivation for drawing and awareness for the left space. It is considered that in the copying of figures such as a daisy, failure to use a spatial strategy plays an important part in the appearance of left unilateral spatial neglect.??

Ishiai, S.; Seki, K.; Koyama, Y.; Izumi, Y.

1997-01-01

432

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

PubMed Central

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

2014-01-01

433

[Tuberculosis after kidney transplantation].  

PubMed

The authors deal with the problem of tuberculosis in patients after transplantation of the kidney. They give an account of eight cases of the disease in 647 patients where during the last 22 years transplantations where performed in the Institute for Clinical and Experimental Medicine. The lungs were affected in six patients, incl. three with miliary dissemination affecting also other organs incl. the graft. In one instance the patient's own kidney was affected and once the talar joint. The authors emphasize this atypical course of the disease and the necessity to search for BK in patients where the febrile condition does not recede after corresponding antibiotic treatment. In case of early antituberculotic treatment the prognosis is on the whole favourable. PMID:2790881

Nouza, M; Jirka, J; Dráb, K; Krofta, K

1989-07-01

434

The kidney research predicament.  

PubMed

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

Bryan, Lisa; Ibrahim, Tod; Zent, Roy; Fischer, Michael J

2014-05-01

435

Endovascular repair of thoracic aortic pathologies: Postoperative nursing implications.  

PubMed

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

Chen, Tanghua; Crozier, John A

2014-06-01

436

[Video-assisted thoracic surgery--experience with 586 patients].  

PubMed

Recent advances in optics, video systems and endoscopic operating instruments have led to increasing application of thoracoscopic surgery, as it has become easier to perform and more accurate. We performed 586 video-assisted thoracic surgical procedures for diagnosis and treatment (May 1992-Dec. 1998) 127 were for diagnostic thoracoscopy and 79 for pleurodesis. 380 cases of operative thoracoscopy included pulmonary wedge resection (for interstitial lung disease, benign and malignant pulmonary tumors and pulmonary metastases) bullectomy, management of empyema, pleural tumor biopsy, thoracic sympathectomy, pericardial window formation, thoracic spinal procedures and resection of posterior mediastinal cysts. Recently we have had good experience in evacuating blood and blood clots from the thorax which accumulated after cardiac and thoracic surgery. Patients were placed in the lateral thoracotomy position and were ventilated with a double-lumen endotracheal tube, enabling collapse of the operated lung. The operating approach was through 1-3 thoracic ports. Mean operation time was 55 minutes, chest-tubes remained for 2.2 days (mean) and mean hospitalization was 3.3 days. There were no wound infections or significant postoperative complications. 5 patients had air leaks longer than 7 days; none required further surgical intervention. There was intercostal neuralgia and Horner's syndrome after thoracic sympathectomy (1 each) In cases in-which localizing the parenchymal lesion was difficult, the lung was palpated directly by inserting a finger through a small incision or a mini-thoracotomy. Conversion to thoracotomy was performed when primary malignancy of lung was diagnosed by frozen section. Only 2 patients had thoracotomy for uncontrolled bleeding. Thoracoscopy is a minimally invasive surgical technique with very low morbidity and high diagnostic accuracy. Postoperative recovery is brief and uneventful. PMID:11242935

Galili, R; Nesher, N; Sharony, R; Uretzy, G; Saute, M

2001-02-01

437

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

438

Three-Dimensional Reconstruction of Thoracic Structures: Based on Chinese Visible Human  

PubMed Central

We managed to establish three-dimensional digitized visible model of human thoracic structures and to provide morphological data for imaging diagnosis and thoracic and cardiovascular surgery. With Photoshop software, the contour line of lungs and mediastinal structures including heart, aorta and its ramus, azygos vein, superior vena cava, inferior vena cava, thymus, esophagus, diaphragm, phrenic nerve, vagus nerve, sympathetic trunk, thoracic vertebrae, sternum, thoracic duct, and so forth were segmented from the Chinese Visible Human (CVH)-1 data set. The contour data set of segmented thoracic structures was imported to Amira software and 3D thorax models were reconstructed via surface rendering and volume rendering. With Amira software, surface rendering reconstructed model of thoracic organs and its volume rendering reconstructed model were 3D reconstructed and can be displayed together clearly and accurately. It provides a learning tool of interpreting human thoracic anatomy and virtual thoracic and cardiovascular surgery for medical students and junior surgeons.

Luo, Na; Tan, Liwen; Fang, Binji; Li, Ying; Xie, Bing; Liu, Kaijun; Chu, Chun; Li, Min

2013-01-01

439

Angiography in Kidney Cancer  

Microsoft Academic Search

From occupying a central role in the evaluation of kidney cancer, renal arteriography has been relegated to a problem-solving\\u000a secondary role in the modern era. This is partly due to the changing presentation of renal tumors; most are now identified\\u000a at an early stage, and renal arteriography is insensitive when compared with the cross-sectional modalities for evaluation\\u000a of small renal

Jocelyn A. S. Brookes; Uday Patel

440

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

441

Kidney disease in Paraguay  

Microsoft Academic Search

Kidney disease in Paraguay. Paraguay is a landlocked country located in South America with a total population of 5,884,491. Most of the population (95%) is mestizo, a mixture of Spanish and American\\/Indian races. The total number of indigenous people in the country has increased from 38,703 in 1981 to 85,674 in 2002. The gross domestic product per capita was US

FRANCISCO SANTA CRUZ; WALTER CABRERA; SUSANA BARRETO; MARÍA MAGDALENA MAYOR; DIANA BÁEZ

2005-01-01

442

Connexins and the kidney  

PubMed Central

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

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

2010-01-01

443

Minimally invasive kidney transplantation.  

PubMed

Minimally invasive kidney transplantation (MIKT) procedures, starting with lymphocele fenestration and continuing with laparoscopic donor nephrectomy, have been performed in recipients since 2006. From November 2011 to May 2012, we performed 86 consecutive renal transplantation with 43 conventional kidney transplantations (COKT) and 43 MIKTs using an apendectomy like, 4 to 5-cm incision. There were no significant differences between the groups according to age, sex, body mass index, donor type, surgical side, donor kidney or artery number. Mean operative time in the MIKT group was 164.2 minutes versus 153.5 minutes in the COKT group. The cold ischemia times in MIKT and COKT groups were 60.8 and 63.3 minutes, respectively. The lengths of hospital stay, blood creatinine levels at postoperative days 7, 30, and 90, and the 90th day creatinine clearances were similar. In conclusion, considering that the complication rate was equal and the graft functions equal, MIKT seemed to be a safe method for renal transplantation. PMID:23622589

Kaçar, S; Ero?lu, A; Tilif, S; Güven, B

2013-04-01

444

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.

Wehman, Brody; Taylor, Bradley

2014-01-01

445

Combined transaortic transcatheter valve replacement and thoracic endografting.  

PubMed

Direct transaortic (TAo) approach for transcatheter aortic valve replacement (TAVR) in patients with symptomatic, severe aortic stenosis (AS) with prohibitive transfemoral access is being increasingly performed. Furthermore, concomitant catheter-based procedures such as percutaneous coronary intervention (PCI) are also being increasingly performed during TAVR. We report a single-stage, catheter-based treatment of both critical AS and descending thoracic aortic aneurysm (DTA) by performing TAVR with concomitant thoracic aortic endovascular repair (TEVAR) through direct TAo access via a minimally invasive partial sternotomy approach. To our knowledge, this is the first report of a "hybrid" TAVR+TEVAR. PMID:24484814

Komlo, Caroline M; Vallabhajosyula, Prashanth; Bavaria, Joseph E; Desai, Nimesh D; Anwaruddin, Saif; Giri, Jay S; Herrmann, Howard C; Szeto, Wilson Y

2014-02-01

446

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

PubMed

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

Aw, G E; Mobbs, R J

2013-04-01

447

Osteoid osteoma of the rib presenting as thoracic outlet syndrome.  

PubMed

Osteoid osteoma of the rib is a rare condition mostly mentioned in case report studies as lesions involving posterior region of the rib causing scoliosis. This report presents a 22-year-old man who complained of neurologic thoracic outlet syndrome symptoms. The pathologic study of the resected mass of the first rib confirmed the diagnosis of osteoid osteoma. This unique presentation of the osteoid osteoma as thoracic outlet syndrome suggests that this pathologic involvement of the ribs is not confined to the symptoms of pain and scoliosis. PMID:24296190

Kargar, Saeed; Arefanian, Saeed; Ghasemi, Afsaneh; Binesh, Fariba; Heiranizadeh, Naeimeh

2013-12-01

448

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

449

Accidental pleural puncture by a thoracic epidural catheter.  

PubMed

We report the occurrence of an accidental pleural puncture by an epidural catheter that happened during the attempted induction of thoracic epidural anaesthesia using a paramedian approach in an awake patient. The incorrect placement of the catheter was recognised while the patient was undergoing thoracoscopic surgery. The possibility of accidental pleural puncture during attempted thoracic epidural catheter placement by either the paramedian or the midline approach should be borne in mind. A misplaced catheter may injure lung tissue and result in a potentially dangerous intra-operative tension pneumothorax. PMID:9505745

Zaugg, M; Stoehr, S; Weder, W; Zollinger, A

1998-01-01

450

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.

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

2013-01-01

451

Fight-or-flight: murine unilateral ureteral obstruction causes extensive proximal tubular degeneration, collecting duct dilatation, and minimal fibrosis  

PubMed Central

Unilateral ureteral obstruction (UUO) is the most widely used animal model of progressive renal disease. Although renal interstitial fibrosis is commonly used as an end point, recent studies reveal that obstructive injury to the glomerulotubular junction leads to the formation of atubular glomeruli. To quantitate the effects of UUO on the remainder of the nephron, renal tubular and interstitial responses were characterized in mice 7 and 14 days after UUO or sham operation under anesthesia. Fractional proximal tubular mass, cell proliferation, and cell death were measured by morphometry. Superoxide formation was identified by nitro blue tetrazolium, and oxidant injury was localized by 4-hydroxynonenol and 8-hydroxydeoxyguanosine. Fractional areas of renal vasculature, interstitial collagen, ?-smooth muscle actin, and fibronectin were also measured. After 14 days of UUO, the obstructed kidney loses 19% of parenchymal mass, with a 65% reduction in proximal tubular mass. Superoxide formation is localized to proximal tubules, which undergo oxidant injury, apoptosis, necrosis, and autophagy, with widespread mitochondrial loss, resulting in tubular collapse. In contrast, mitosis and apoptosis increase in dilated collecting ducts, which remain patent through epithelial cell remodeling. Relative vascular volume fraction does not change, and interstitial matrix components do not exceed 15% of total volume fraction of the obstructed kidney. These unique proximal and distal nephron cellular responses reflect differential “fight-or-flight” responses to obstructive injury and provide earlier indexes of renal injury than do interstitial compartment responses. Therapies to prevent or retard progression of renal disease should include targeting proximal tubule injury as well as interstitial fibrosis.

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

2012-01-01

452

Four miniature kidneys: supernumerary kidney and multiple organ system anomalies.  

PubMed

More than 350 years after Martius's first reported case in 1656, supernumerary kidney (SNK) continues to fascinate the world of medicine, generating new ideas in the domain of embryogenesis. Association of a normal kidney with a second or third ipsilateral smaller kidney is an extremely rare anomaly with only a total of 81 cases reported until today. We are reporting a case of SNK, clinically diagnosed as right hydronephrosis, associated with an ipsilateral ectopic ureter, a contralateral partially duplicated ureter, and a multiseptate gallbladder. Pathologic examination of the nephrectomy revealed 4 miniature kidneys, joining a dilated ureter through 4 separate conduits. Our patient is the first reported case of SNK with absent ipsilateral normal kidney, presence of more than 3 kidneys on 1 side, and associated anomaly in the gallbladder. This case represents a unique combination of rarities, suggesting insights in the domain of molecular embryology. PMID:24593866

Afrouzian, Marjan; Sonstein, Joseph; Dadfarnia, Tahereh; Sreshta, J Nicholas; Hawkins, Hal K

2014-05-01

453

Thoracoscopic direct clipping of the thoracic duct for chylopericardium and chylothorax  

Microsoft Academic Search

Background. Chylothorax is a challenging clinical problem. Untreated, it carries a high mortality and morbidity. Traditional surgical management for cases refractory to conservative treatment is thoracic duct ligation through a right open thoracotomy.Methods. We describe 4 patients treated successfully by video-assisted thoracic surgery, using ports and no thoracotomy, and precise ligation and division of the thoracic duct just above the

Peter N Wurnig; Peter H Hollaus; Toshiya Ohtsuka; John B Flege; Randall K Wolf

2000-01-01

454

Thoracoscopic plication for a huge thoracic meningocele in a patient with Neurofibromatosis  

PubMed Central

Intrathoracic meningoceles associated with neurofibromatosis type I are rare, and the optimal treatment is still unknown. Herein, we present the case of a 48-year-old Asian female with a huge thoracic meningocele associated with cutaneous neurofibromatosis type I and kyphoscoliosis of the thoracic spine. The large thoracic meningocele was successfully treated through thoracoscopic plication.

2014-01-01

455