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Sample records for unilateral thoracic kidney

  1. Office-Based Intracordal Hyaluronate Injections Improve Quality of Life in Thoracic-Surgery-Related Unilateral Vocal Fold Paralysis

    PubMed Central

    Fang, Tuan-Jen; Hsin, Li-Jen; Chung, Hsiu-Feng; Chiang, Hui-Chen; Li, Hsueh-Yu; Wong, Alice M.K.; Pei, Yu-Chen

    2015-01-01

    Abstract Thoracic-surgery-related unilateral vocal fold paralysis (UVFP) may cause severe morbidity and can cause profound functional impairment and psychosocial stress in patients with pre-existing thoracic diseases. In-office intracordal hyaluronate (HA) injections have recently been applied to improve voice and quality of life in patients with vocal incompetence, but their effect on thoracic-surgery-related UVFP remains inconclusive. We therefore conducted a prospective study to clarify the effect of early HA injection on voice and quality of life in patients with thoracic-surgery-related UVFP. Patients with UVFP within 3 months after thoracic surgery who received office-based HA injection were recruited. Quantitative laryngeal electromyography, videolaryngostroboscopy, voice-related life quality (voice outcome survey), laboratory voice analysis, and health-related quality of life (SF-36) were evaluated at baseline, and at 1 month postinjection. A total of 104 consecutive patients accepted office-based HA intracordal injection during the study period, 34 of whom were treated in relation to thoracic surgery and were eligible for inclusion. Voice-related life quality, voice laboratory analysis, and most generic quality of life domains were significantly improved at 1 month after in-office HA intracordal injection. No HA-related complications were reported. Single office-based HA intracordal injection is a safe and effective treatment for thoracic-surgery-related UVFP, resulting in immediate improvements in patient quality of life, voice quality, and swallowing ability. PMID:26448034

  2. Unilateral hypoplastic kidney and ureter associated with diverse mesonephric remnant hyperplasia

    PubMed Central

    Xiao, Guang-Qian; Jerome, Jean-Gilles; Wu, Guan

    2015-01-01

    Mesonephric remnants have been rarely reported in the genitourinary system and sometimes impose a diagnostic challenge both clinically and pathologically. We reported a case of mesonephric remnant hyperplasia with mixed acinar/tubular and epididymis/vas deferens-like morphologies occurring in the renal parenchyma of a unilateral hypoplastic kidney, which has not been previously described. PMID:26309900

  3. Unilateral Renal Ischemia as a Model of Acute Kidney Injury and Renal Fibrosis in Cats.

    PubMed

    Schmiedt, C W; Brainard, B M; Hinson, W; Brown, S A; Brown, C A

    2016-01-01

    The objectives of this study were to define the acute and chronic effects of 1-hour unilateral in vivo renal ischemia on renal function and histology in cats. Twenty-one adult purpose-bred research cats were anesthetized, and 1 kidney underwent renal artery and vein occlusion for 1 hour. Serum creatinine and urea concentrations, urine protein:creatinine ratio, urine-specific gravity, glomerular filtration rate, hematocrit, platelet concentration and function, and white blood cell count were measured at baseline and variable time points after ischemia. Renal histopathology was evaluated on days 3, 6, 12, 21, 42, and 70 postischemia; changes in smooth muscle actin and interstitial collagen were examined. Following ischemia, whole animal glomerular filtration rate was significantly reduced (57% of baseline on day 6; P < .05). At the early time points, the ischemic kidneys exhibited severe acute epithelial necrosis accompanied by evidence of regeneration of tubules predominantly within the corticomedullary junction. At later periods, postischemic kidneys had evidence of tubular atrophy and interstitial inflammation with significantly more smooth muscle actin and interstitial collagen staining and interstitial fibrosis when compared with the contralateral control kidneys. This study characterizes the course of ischemic acute kidney injury in cats and demonstrates that ischemic acute kidney injury triggers chronic fibrosis, interstitial inflammation, and tubular atrophy in feline kidneys. These late changes are typical of those observed in cats with naturally occurring chronic kidney disease. PMID:26319781

  4. Atrophy and Primary Somatosensory Cortical Reorganization after Unilateral Thoracic Spinal Cord Injury: A Longitudinal Functional Magnetic Resonance Imaging Study

    PubMed Central

    Manxiu, Ma; Zhao, Can; Xi, Yue; Yang, Zhao-Yang; Li, Xiao-Guang

    2013-01-01

    The effects of traumatic spinal cord injury (SCI) on the changes in the central nervous system (CNS) over time may depend on the dynamic interaction between the structural integrity of the spinal cord and the capacity of the brain plasticity. Functional magnetic resonance imaging (fMRI) was used in a longitudinal study on five rhesus monkeys to observe cerebral activation during upper limb somatosensory tasks in healthy animals and after unilateral thoracic SCI. The changes in the spinal cord diameters were measured, and the correlations among time after the lesion, structural changes in the spinal cord, and primary somatosensory cortex (S1) reorganization were also determined. After SCI, activation of the upper limb in S1 shifted to the region which generally dominates the lower limb, and the rostral spinal cord transverse diameter adjacent to the lesion exhibited obvious atrophy, which reflects the SCI-induced changes in the CNS. A significant correlation was found among the time after the lesion, the spinal cord atrophy, and the degree of contralateral S1 reorganization. The results indicate the structural changes in the spinal cord and the dynamic reorganization of the cerebral activation following early SCI stage, which may help to further understand the neural plasticity in the CNS. PMID:24490171

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

    PubMed Central

    2014-01-01

    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. PMID:24886545

  6. Renal glucose release during hypoglycemia is partly controlled by sympathetic nerves - a study in pigs with unilateral surgically denervated kidneys.

    PubMed

    Bischoff, Sabine J; Schmidt, Martin; Lehmann, Thomas; Schwab, Matthias; Matziolis, Georg; Saemann, Alexander; Schiffner, René

    2015-11-01

    Catecholamines are known to increase renal glucose release during hypoglycemia. The specific extent of the contribution of different sources of catecholamines, endocrine delivery via circulation or release from autonomous sympathetic renal nerves, though, is unknown. We tested the hypothesis that sympathetic renal innervation plays a major role in the regulation of renal gluconeogenesis. For this purpose, instrumented adolescent pigs had one kidney surgically denervated while the other kidney served as a control. A hypoglycemic clamp with arterial blood glucose below 2 mmol/L was maintained for 75 min. Arteriovenous blood glucose difference, inulin clearance, p-aminohippurate clearance, and sodium excretion were measured in intervals of 15 min separately for both kidneys. Blood glucose was lowered to 0.84 ± 0.33 mmol/L for 75 min. The side-dependent renal net glucose release (SGN) decreased significantly after the unilateral ablation of renal nerves. In the linear mixed model, renal denervation had a significant inhibitory effect on renal net glucose release (P = 0.036). The SGN of the ablated kidney decreased by 0.02 mmol/min and was equivalent to 43.3 ± 23.2% of the control (nonablated) kidney in the pigs. This allows the conclusion that renal glucose release is partly controlled by sympathetic nerves. This may be relevant in humans as well, and could explain the increased risk of severe hypoglycemia of patients with diabetes mellitus and autonomous neuropathy. The effects of denervation on renal glucose metabolism should be critically taken into account when considering renal denervation as a therapy in diabetic patients. PMID:26564063

  7. Renal glucose release during hypoglycemia is partly controlled by sympathetic nerves – a study in pigs with unilateral surgically denervated kidneys

    PubMed Central

    Bischoff, Sabine J; Schmidt, Martin; Lehmann, Thomas; Schwab, Matthias; Matziolis, Georg; Saemann, Alexander; Schiffner, René

    2015-01-01

    Catecholamines are known to increase renal glucose release during hypoglycemia. The specific extent of the contribution of different sources of catecholamines, endocrine delivery via circulation or release from autonomous sympathetic renal nerves, though, is unknown. We tested the hypothesis that sympathetic renal innervation plays a major role in the regulation of renal gluconeogenesis. For this purpose, instrumented adolescent pigs had one kidney surgically denervated while the other kidney served as a control. A hypoglycemic clamp with arterial blood glucose below 2 mmol/L was maintained for 75 min. Arteriovenous blood glucose difference, inulin clearance, p-aminohippurate clearance, and sodium excretion were measured in intervals of 15 min separately for both kidneys. Blood glucose was lowered to 0.84 ± 0.33 mmol/L for 75 min. The side-dependent renal net glucose release (SGN) decreased significantly after the unilateral ablation of renal nerves. In the linear mixed model, renal denervation had a significant inhibitory effect on renal net glucose release (P = 0.036). The SGN of the ablated kidney decreased by 0.02 mmol/min and was equivalent to 43.3 ± 23.2% of the control (nonablated) kidney in the pigs. This allows the conclusion that renal glucose release is partly controlled by sympathetic nerves. This may be relevant in humans as well, and could explain the increased risk of severe hypoglycemia of patients with diabetes mellitus and autonomous neuropathy. The effects of denervation on renal glucose metabolism should be critically taken into account when considering renal denervation as a therapy in diabetic patients. PMID:26564063

  8. Early changes in volume and function of the remaining kidney after unilateral donor nephrectomy.

    PubMed

    Shehab, A B; Shaheen, F A; Fallatah, A; Al-Jobori, A G; Sheikh, I A; Al-Koussi, M

    1994-01-01

    The early changes that occur in the volume and function of the remaining kidney, after uni-nephrectomy for organ donation, were studied in 25 living donors. Serum creatinine (S Cr), creatinine clearance (Cr Cl), renographic clearance tests for total and split renal functions as well as renal volume using ultrasound were determined before and three months after donation. In 76% of the donors, Se Cr showed an increase after kidney donation, but all values were within normal range. The total kidney function in terms of Cr Cl, showed a drop of 36% from the pre-donation value. After three months post donation, the clearance of the remaining kidney increased by 5% to 64% (mean 34%) of the pre-donation values, measured by Tc 99m DTPA renography. Compensatory hypertrophy of the remaining kidney also occurred as evidenced by the ultrasound evaluation which showed an increase in the renal volume by 15%. Our study shows that compensatory changes occur early i.e., within the first three months after uni-nephrectomy. However, prolonged follow-up of these donors is necessary to assess the long-term structural and functional changes in the remaining kidney. PMID:18583774

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

    PubMed

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

    2013-01-01

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

  10. Genetics Home Reference: Asphyxiating thoracic dystrophy

    MedlinePLUS

    ... understanding asphyxiating thoracic dystrophy? autosomal ; autosomal recessive ; cartilage ; cell ; cysts ; differentiation ; dysplasia ; gene ; inherited ; kidney ; pancreas ; polydactyly ; proliferation ; recessive ; ...

  11. Matrix Metalloproteinase-2 Knockout and Heterozygote Mice Are Protected from Hydronephrosis and Kidney Fibrosis after Unilateral Ureteral Obstruction

    PubMed Central

    Tveitarås, Maria K.; Skogstrand, Trude; Leh, Sabine; Helle, Frank; Chatziantoniou, Christos; Reed, Rolf K.; Hultström, Michael

    2015-01-01

    Matrix Metalloproteinase-2 (Mmp2) is a collagenase known to be important in the development of renal fibrosis. In unilateral ureteral obstruction (UUO) the obstructed kidney (OK) develops fibrosis, while the contralateral (CL) does not. In this study we investigated the effect of UUO on gene expression, fibrosis and pelvic remodeling in the kidneys of Mmp2 deficient mice (Mmp2-/-), heterozygous animals (Mmp2+/-) and wild-type mice (Mmp2+/+). Sham operated animals served as controls (Cntrl). UUO was prepared under isoflurane anaesthesia, and the animals were sacrificed after one week. UUO caused hydronephrosis, dilation of renal tubules, loss of parenchymal thickness, and fibrosis. Damage was most severe in Mmp2+/+ mice, while both Mmp2-/- and Mmp2+/- groups showed considerably milder hydronephrosis, no tubular necrosis, and less tubular dilation. Picrosirius red quantification of fibrous collagen showed 1.63±0.25% positivity in OK and 0.29±0.11% in CL (p<0.05) of Mmp2+/+, Mmp2-/- OK and Mmp2-/- CL exhibited only 0.49±0.09% and 0.23±0.04% (p<0.05) positivity, respectively. Mmp2+/- OK and Mmp2+/- CL showed 0.43±0.09% and 0.22±0.06% (p<0.05) positivity, respectively. Transcriptomic analysis showed that 26 genes (out of 48 examined) were differentially expressed by ANOVA (p<0.05). 25 genes were upregulated in Mmp2+/+ OK compared to Mmp2+/+ CL: Adamts1, -2, Col1a1, -2, -3a1, -4a1, -5a1, -5a2, Dcn, Fbln1, -5, Fmod, Fn1, Itga2, Loxl1, Mgp, Mmp2, -3, Nid1, Pdgfb, Spp1, Tgfb1, Timp2, Trf, Vim. In Mmp2-/- and Mmp2+/- 18 and 12 genes were expressed differentially between OK and CL, respectively. Only Mmp2 was differentially regulated when comparing Mmp2-/- OK and Mmp2+/- OK. Under stress, it appears that Mmp2+/- OK responds with less Mmp2 upregulation than Mmp2+/+ OK, suggesting that there is a threshold level of Mmp2 necessary for damage and fibrosis to occur. In conclusion, reduced Mmp2 expression during UUO protects mice against hydronephrosis and renal fibrosis. PMID:26673451

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

    PubMed Central

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

    2015-01-01

    A 12-year-old boy presented to the clinic of ophthalmology because of watering and discharge from his left lower eyelid. The inspection examination revealed an orifice that was associated with congenital lacrimal fistula (CLF). He underwent a complete ophthalmologic and systemic evaluation to explore possible associated findings. Systemic evaluation revealed multiple renal anomalies: right renal agenesis and left ectopic pelvic kidney. This case is unique because this is the first reported case of CLF accompanied with ectopic pelvic kidney in the literature. PMID:26090250

  13. [Prenatal diagnosis of a right thoracic congenital ectopic kidney with a diaphragmatic hernia: A combination with a good prognosis].

    PubMed

    Cessans, C; Pharamin, J; Crouzet, K; Kessler, S; Puget, C; Bouali, O; Galinier, P; Marcoux, M-O

    2015-11-01

    Ectopic intrathoracic kidney is a rare congenital anomaly, usually asymptomatic. This anomaly is sometimes associated with a diaphragmatic hernia. Few cases of this combination have been described, often in the absence of a prenatal diagnosis. We report on the case of a female newborn infant who was diagnosed with an ectopic intrathoracic right kidney and a diaphragmatic hernia upon 33weeks of gestation. The patient underwent surgery on the first day of life and the respiratory and renal outcomes were simple. We review the literature and discuss the seemingly good prognosis of this combination. PMID:26385648

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

    PubMed Central

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

    2015-01-01

    Objective Acute kidney injury (AKI) frequently occurs after catheter-based interventional procedures and increases mortality. However, the implications of AKI before thoracic endovascular aneurysm repair (TEVAR) of type B acute aortic dissection (AAD) remain unclear. This study evaluated the incidence, predictors, and in-hospital outcomes of AKI before TEVAR in patients with type B AAD. Methods Between 2009 and 2013, 76 patients were retrospectively evaluated who received TEVAR for type B AAD within 36 h from symptom onset. The patients were classified into no-AKI vs. AKI groups, and the severity of AKI was further staged according to kidney disease: improving global outcomes criteria before TEVAR. Results The incidence of preoperative AKI was 36.8%. In-hospital complications was significantly higher in patients with preoperative AKI compared with no-AKI (50.0% vs. 4.2%, respectively; P < 0.001), including acute renal failure (21.4% vs. 0, respectively; P < 0.001), and they increased with severity of AKI (P < 0.001). The maximum levels of body temperature and white blood cell count were significantly related to maximum serum creatinine level before TEVAR. Multivariate analysis showed that systolic blood pressure on admission (OR: 1.023; 95% CI: 1.003–1.044; P = 0.0238) and bilateral renal artery involvement (OR: 19.076; 95% CI: 1.914–190.164; P = 0.0120) were strong predictors of preoperative AKI. Conclusions Preoperative AKI frequently occurred in patients with type B AAD, and correlated with higher in-hospital complications and enhanced inflammatory reaction. Systolic blood pressure on admission and bilateral renal artery involvement were major risk factors for AKI before TEVAR. PMID:26089846

  15. Unilateral perseveration.

    PubMed

    Acosta, Lealani Mae Y; Goodman, Ira J; Heilman, Kenneth M

    2013-12-01

    The brain's action-intentional ("when") programming system helps to control when to and when not to initiate an action, when to persist at an action, and when to terminate an action. Motor perseveration is a failure to terminate an action. This disengagement disorder most often results from dysfunction of the executive frontal-subcortical networks that control the action-intentional programming system. Reports of unilateral perseveration are unusual. Here we describe a patient with a form of progressive supranuclear palsy (PSP) who exhibited continuous right-hand motor perseveration. This 68-year-old right-handed man had impaired walking and vertical gaze, consistent with PSP. He often repeated words, and on many motor tasks he showed continuous perseveration of his right but not his left hand. Unilateral motor perseveration may be a sign of PSP, the corticobasal syndrome, or a subtype of these disorders. Future studies of patients with both disorders should use tasks that assess for asymmetric hand perseveration. The mechanism of the unilateral perseveration must also be determined. Bilateral perseveration is found most often in patients with unilateral right frontal-subcortical (basal ganglia) or insula dysfunction. Because patients with PSP or corticobasal syndrome have callosal degeneration, their unilateral perseveration might result from a callosal disconnection of the right frontal lobe from the left hemisphere's premotor and motor as well as speech areas. PMID:24366105

  16. [Renal unilateral oncocytis: case report].

    PubMed

    Gryn, A; Roumiguié, M; Mazerolles, C; Bellec, L; Lagarde, S; Chauveau, D; Soulié, M; Beauval, J B

    2014-02-01

    The renal oncocytoma tumors are rare (5% of renal tumors). These benign tumors are incidentally diagnosed most often in an asymptomatic form. Sometimes it is multiple bilateral tumors affecting the renal parenchyma and forming a renal oncocytosis. We report the case of a unilateral right renal oncocytosis, very rare situation, characterized by a right renal parenchymal nodules with oncocytoma and a normal left kidney. PMID:24485085

  17. Unilateral hydronephrosis

    MedlinePLUS

    ... the body into a drainage bag) Antibiotics for infections People who have only one kidney, who have immune system disorders such as diabetes or HIV, or who have had a transplant will need prompt treatment. People who have long-term hydronephrosis may need ...

  18. Traumatic chylothorax following blunt thoracic trauma: two conservatively treated cases.

    PubMed

    Apostolakis, Efstratios; Akinosoglou, Karolina; Koletsis, Efstratios; Dougenis, Dimitrios

    2009-01-01

    Chylothorax is rare following blunt thoracic trauma; its diagnosis is usually delayed until the puncture or drainage of posttraumatic pleural effusion and its cause is not clear. Mostly, it is attributed to injury or overstretching of major thoracic duct by fractures or other injury of neighboring thoracic spine. We describe of two cases, one unilateral and one bilateral, of chylothorax, both after blunt thoracic trauma. In the first case, there were associated fractures of lower thoracic vertebrae, whereas in the other there was no obvious cause, except striking osteophytic degeneration alongside the thoracic spine. Both cases were successfully treated after 16 and 23 days, respectively, with drainage, starvation, reexpansion of the lung(-s), and total parenteral nutrition. We believe that with the "triad of RST" ("reexpansion, starvation diet, TPN"), conservative treatment will be successful in the majority of cases. PMID:19267837

  19. Thoracic aortic aneurysm

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    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 ...

  20. Kidney Failure

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    ... Details» www.kidneyfund.org > Kidney Disease > Kidney Failure Kidney Failure Kidney failure is when your kidneys stop ... are the tests for kidney failure? How is kidney failure (ESRD) different from chronic kidney disease (CKD)? ...

  1. Society of Thoracic Surgeons

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

  2. Ectopic Kidney

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    ... Ectopic Kidney Home Urologic Conditions Ectopic Kidney Ectopic Kidney Most people are born with two kidneys, which ... position as they develop. What is an ectopic kidney? Renal ectopia or ectopic kidney describes a kidney ...

  3. American Thoracic Society

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    ... Function Sleep & Respiratory Neurobiology Thoracic Oncology Committees Awards Clinical Practice Clinicians Advisory Council of Chapter Documents Development and Implementation Drug/Device Discovery and Development Education ...

  4. Kidney Cancer

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    ... Conditions Kidney Cancer Home Urologic Conditions Kidney Cancer Kidney Cancer It is important to realize that with ... impaired, dialysis may be required. What is a kidney tumor? A kidney tumor is an abnormal growth ...

  5. Thoracic Malignancy Steering Committee

    Cancer.gov

    The Thoracic Malignancy Steering Committee evaluates and prioritizes concepts for phase 3 and large phase 2 therapeutic clinical trials to be conducted in the NCI National Clinical Trials Network (NCTN).

  6. Acute Unilateral Vestibulopathy.

    PubMed

    Strupp, Michael; Magnusson, Mans

    2015-08-01

    Normal vestibular end organs generate an equal resting-firing frequency of the axons, which is the same on both sides under static conditions. An acute unilateral vestibulopathy leads to a vestibular tone imbalance. Acute unilateral vestibulopathy is defined by the patient history and the clinical examination and, in unclear cases, laboratory examinations. Key signs and symptoms are an acute onset of spinning vertigo, postural imbalance and nausea as well as a horizontal rotatory nystagmus beating towards the non-affected side, a pathological head-impulse test and no evidence for central vestibular or ocular motor dysfunction. The so-called big five allow a differentiation between a peripheral and central lesion by the bedside examination. The differential diagnosis of peripheral labyrinthine and vestibular nerve disorders mimicking acute unilateral vestibulopathy includes central vestibular disorders, in particular "vestibular pseudoneuritis" and other peripheral vestibular disorders, such as beginning Menière's disease. The management of acute unilateral vestibulopathy involves (1) symptomatic treatment with antivertiginous drugs, (2) causal treatment with corticosteroids, and (3) physical therapy. PMID:26231279

  7. Solitary Kidney

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    ... Institute, Inc., Kidney School National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Organizations?? . (PDF, 345 KB)????? Alternate Language URL Solitary Kidney Page Content On this page: What is a ...

  8. Kidney Biopsy

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    ... More Information American Kidney Fund National Kidney Foundation Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations?? . (PDF, 345 KB) Alternate Language URL Kidney Biopsy Page Content On this page: What is ...

  9. Kidney Cysts

    MedlinePLUS

    ... fluid-filled sac. There are two types of kidney cysts. Polycystic kidney disease (PKD) runs in families. In PKD, the ... place of the normal tissue. They enlarge the kidneys and make them work poorly, leading to kidney ...

  10. Kidney Transplant

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  11. Kidney Disease

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  12. Kidney Problems

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    ... the production of red blood cells. What are Kidney Diseases? For about one-third of older people, kidney ( ... are called nephrologists. The Most Common Types of Kidney Diseases If your kidneys are not working well, you ...

  13. Thoracic spine x-ray

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    Vertebral radiography; X-ray - spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films ... care provider's office. You will lie on the x-ray table in different positions. If the x-ray ...

  14. Understanding Thoracic Outlet Syndrome

    PubMed Central

    Freischlag, Julie

    2014-01-01

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

  15. Unilateral radiation pneumonitis in sheep: Physiological changes and bronchoalveolar lavage

    SciTech Connect

    Tillman, B.F.; Loyd, J.E.; Malcolm, A.W.; Holm, B.A.; Brigham, K.L. )

    1989-03-01

    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.

  16. Kidney Disease

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    ... version of this page please turn Javascript on. Kidney Disease What is Kidney Disease? What the Kidneys Do Click for more information You have two ... damaged, wastes can build up in the body. Kidney Function and Aging Kidney function may be reduced ...

  17. Kidney Dysplasia

    MedlinePLUS

    ... Dimes National Kidney Foundation Urology Care Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations?? . (PDF, 345 KB)????? Alternate Language URL Kidney Dysplasia Page Content On this page: What is ...

  18. Kidney School

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    ... copies? Read our licensing agreement Living Successfully with Kidney Disease People with kidney disease can live long ... Listen Printing multiple copies? Read our licensing agreement Kidneys: How They Work, How They Fail, What You ...

  19. Kidney Transplantation

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    ... kidney can be long. If you have a transplant, you must take drugs for the rest of your life, to keep your body from rejecting the new kidney. NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  20. Kidney transplant

    MedlinePLUS

    ... to help make sure your body will not reject the donated kidney Blood tests or skin tests ... kidney. People who receive a transplanted kidney may reject the new organ. This means that their immune ...

  1. Nonintubated anesthesia for thoracic surgery

    PubMed Central

    Wang, Bei

    2014-01-01

    Nonintubated thoracic surgery has been used in procedures including pleura, lungs and mediastinum. Appropriate anesthesia techniques with or without sedation allow thoracic surgery patients to avoid the potential risks of intubated general anesthesia, particularly for the high-risk patients. However, nonintubated anesthesia for thoracic surgery has some benefits as well as problems. In this review, the background, indication, perioperative anesthetic consideration and management, and advantages and disadvantages are discussed and summarized. PMID:25589994

  2. Kidney Cysts

    MedlinePLUS

    MENU Return to Web version Kidney Cysts Overview What do the kidneys do? The kidneys remove waste from your blood. They do this by filtering the blood and making urine. What are kidney cysts? As people get older, sacs filled with ...

  3. Thoracic outlet syndrome.

    PubMed

    Ozoa, Glenn; Alves, Daniel; Fish, David E

    2011-08-01

    Of the many clinical entities involving the neck region, one of the most intriguing is thoracic outlet syndrome (TOS). TOS is an array of disorders that involves injury to the neurovascular structures in the cervicobrachial region. A classification system based on etiology, symptoms, clinical presentation, and anatomy is supported by most physicians. The first type of TOS is vascular, involving compression of either the subclavian artery or vein. The second type is true neurogenic TOS, which involves injury to the brachial plexus. Finally, the third and most controversial type is referred to as disputed neurogenic TOS. This article aims to provide the reader some understanding of the pathophysiology, workup, and treatment of this fascinating clinical entity. PMID:21824588

  4. Multicystic dysplastic kidney complicated by pyelonephritis

    PubMed Central

    Cooper, Chad J.; Said, Sarmad; Khalillullah, Sayeed; Salameh, Hasan J.; Hernandez, German T.

    2013-01-01

    Patient: Female, 21 Final Diagnosis: Multicystic Dysplastic Kidney Disease complicated by pyelonephritis Symptoms: Left flank pain (CVAT) • dysuria • fever Medication: Levofloxacin Clinical Procedure: Dimercaptosuccinic acid scan • voiding cystouretrogram Specialty: Nephrology Objective: Rare disease Background: Multicystic dysplastic kidney (MCDK) is a renal dysplasia characterized by the presence of multiple cysts that are non-communicating, separated by dysplastic parenchyma that consumes the renal cortex resulting in a nonfunctional kidney. MCDK has an incidence of 1: 4300 of live births and is usually unilateral, most commonly occurring in the left kidney. Simple MCDK is defined as unilateral dysplasia with a normal contralateral kidney but with compensatory hypertrophy of the contralateral kidney, and no associated genitourinary anomalies. Case Report: A 21 year old Hispanic American female, presented with intermittent, sharp, severe left flank pain, fever and dysuria for two days but had gradually worsened within the last 24 hours prior to presentation. Previous history of multicystic dysplastic kidney, diagnosed four years ago. No pertinent physical examination findings except left costovertebral angle tenderness (CVAT). Urinalysis findings were positive for infection and urine culture grew pan sensitive Escherichia coli. A CT scan of abdominal and pelvis without contrast revealed a normal right kidney and left kidney had multiple non-communicating dilated cystic spaces, but no hydronephrosis, left ureteropelvic junction obstruction and finding were consistent with multicystic dysplastic kidney and also noted perinephric stranding. Conclusions: VUR is the most common renal abnormality in patients with MCDK, occurring in about 25% of contralateral kidney. Infections involving the MCDK are rare. In fact, cases of infections such as pyelonephritis or an infected renal cyst of MCDK are almost non-existent in the current literature. This patient presented with findings consistent with MCDK complicated by pyelonephritis. PMID:24349603

  5. Kidney Failure

    MedlinePLUS

    Healthy kidneys clean your blood by removing excess fluid, minerals, and wastes. They also make hormones that keep your ... strong and your blood healthy. But if the kidneys are damaged, they don't work properly. Harmful ...

  6. Ectopic Kidney

    MedlinePLUS

    ... Human Development March of Dimes National Office MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Organizations?? . (PDF, 345 KB)????? Alternate Language URL Ectopic Kidney Page Content On this page: What is an ...

  7. Kidney Diseases

    MedlinePLUS

    Your kidneys are two bean-shaped organs, each about the size of your fists. They are located near the ... back, just below the rib cage. Inside each kidney about a million tiny structures called nephrons filter ...

  8. Kidney removal

    MedlinePLUS

    ... kidney is then removed. Your surgeon will also take out the surrounding fat, and sometimes the adrenal gland ... of the cuts larger (around 4 inches) to take out the kidney. The surgeon will cut the ureter, ...

  9. Advancing Thoracic Spine Biomechanical Research

    E-print Network

    Mannen, Erin Mychael

    2014-12-31

    The long term objective of this research was to elucidate issues with current thoracic spine testing methods and develop more accurate ways to quantify the biomechanical impact of surgical procedures or medical devices. The ability to perform...

  10. Thoracic Paravertebral Block Ashley Meister

    E-print Network

    Peak, Derek

    - ! dorsal and ventral rami of spinal nerves ! sympathetic trunk !Unilateral sensory, motor and sympathetic ! Closed system with syringe of LA ! Pre-procedure scan #12;Performance of TPVB ! Scan in Para

  11. Surgical Sciences Cardiovascular Surgery, Thoracic Surgery ------------------------------------------------------

    E-print Network

    Miyashita, Yasushi

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

  12. Kidney Cancer

    MedlinePLUS

    You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and ... blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes ...

  13. Phosphatidylinositol 3-kinase signaling determines kidney size

    PubMed Central

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

    2015-01-01

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

  14. Kidney (Renal) Failure

    MedlinePLUS

    ... News Physician Resources Professions Site Index A-Z Kidney Failure Kidney failure, also known as renal failure, ... evaluated? How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain ...

  15. Chronic Kidney Diseases

    MedlinePLUS

    ... System How the Body Works Main Page Chronic Kidney Diseases KidsHealth > Kids > Health Problems > Bladder, Kidneys & Urinary ... re talking about your kidneys. What Are the Kidneys? Your kidneys are tucked under your lower ribs ...

  16. 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 ...

  17. Hemifacial Erythema in Right Unilateral Electroconvulsive Therapy.

    PubMed

    Kellner, Charles H; Pham, Tony V; Aloysi, Amy S; Majeske, Matthew F; Bryson, Ethan O

    2015-09-01

    We present a case of transient right hemifacial rash after right unilateral electroconvulsive therapy. This phenomenon may have similarities with the cranial dysautonomia, Harlequin syndrome. PMID:25634567

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

    PubMed Central

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

    2012-01-01

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

  19. Kidney Failure

    MedlinePLUS

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. October 2, 2013 Contact Us Health Information Center Phone: 1-800-860- ...

  20. Kidney stones

    MedlinePLUS

    ... M, Wolff M. Patient education: tips for preventing calcium oxalate kidney stones. J Ren Nutr . 2011 Nov;21( ... 2011:chap 46. Finkelstein VA. Strategies for preventing calcium oxalate stones. CMAJ . 2006;174:1407-1409. PMID: 16682705. ...

  1. Kidney stones

    MedlinePLUS Videos and Cool Tools

    ... ureter. As urine can become very concentrated as it passes through the kidneys. When the urine becomes ... being stretched, and when stones form and distend it, the stretching can be very painful. Often, people ...

  2. Kidney Tumors

    Cancer.gov

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

  3. UNILATERAL TECHNOLOGY SUPPRESSION: APPROPRIATE ANTITRUST AND

    E-print Network

    Shamos, Michael I.

    UNILATERAL TECHNOLOGY SUPPRESSION: APPROPRIATE ANTITRUST AND PATENT LAW REMEDIES Yee Wah Chin* This article reviews some of the antitrust and patent law remedies for improper unilateral suppression. The extent of any remedy under the antitrust or the patent laws for these types of activities is beyond

  4. Metabolomics of renal venous plasma from individuals with unilateral renal artery stenosis and essential hypertension

    PubMed Central

    Rhee, Eugene P.; Clish, Clary B.; Pierce, Kerry A.; Saad, Ahmed; Lerman, Lilach O.; Textor, Stephen C.

    2015-01-01

    Objective: To compare the metabolite profiles of venous effluent from both kidneys of individuals with unilateral atherosclerotic renal artery stenosis (ARAS) in order to directly examine how impaired renal blood flow impacts small-molecule handling in humans. Methods: We applied liquid chromatography–mass spectrometry based metabolite profiling to venous plasma obtained from the stenotic (STK) and contralateral (CLK) kidneys of ARAS patients (n?=?16), and both the kidneys of essential hypertensive controls (n?=?11). Study samples were acquired during a 3-day protocol that included iothalamate clearance measurements, radiographic kidney phenotyping (Duplex ultrasound, multidetector computed tomography, and blood-oxygen-level-dependent MRI), and controlled sodium and caloric intake and antihypertensive treatment. Results: Partial least squares-discriminant analysis demonstrated clear separation of essential hypertensive kidney metabolite profiles versus STK and CLK metabolite profiles, but no separation between metabolite profiles of STK and CLK samples. All of the discriminating metabolites were similarly elevated in the STK and CLK samples, likely reflecting the lower glomerular filtration rate in the ARAS versus essential hypertensive individuals (mean 66.1 versus 89.2?ml/min per 1.73?m2). In a paired analysis within the ARAS group, no metabolite was significantly altered in STK compared with CLK samples; notably, creatinine was the same in STK and CLK samples (STK/CLK ratio?=?1.0, P?=?0.9). Results were unchanged in an examination of ARAS patients in the bottom half of renal tissue perfusion or oxygenation. Conclusion: Metabolite profiling does not differentiate venous effluent from STKs or CLKs in individuals with unilateral ARAS, despite the measurable loss of kidney volume and blood flow on the affected side. These findings are consistent with the kidney's ability to adapt to ARAS to maintain a range of metabolic functions. PMID:25490710

  5. Acute unilateral facial nerve palsy.

    PubMed

    Yeong, Siew Swan; Tassone, Peter

    2011-05-01

    Mrs PS, 78 years of age, presented with acute left-sided otalgia, ear swelling and subsequent unilateral facial paralysis (Figure 1). She denied any otorrhoea or hearing loss. Past medical history relevant to the presenting complaint included: * Bell palsy diagnosed 20 years ago with no residual effect * biopsy confirmed benign parotid lump (diagnosed 3 years previously). Histopathology revealed a pleomorphic adenoma. Mrs PS declined surgical intervention at the time * chicken pox as a child * normal fasting blood glucose 1 month previously and no known immune compromise. Examination revealed yellow crusts and small vesicles on the external acoustic meatus (Figure 2). A 10 mm well defined firm and nontender nodule was palpable at the ramus of the mandible. PMID:21597548

  6. Aggravated Cardiac Remodeling post Aortocaval Fistula in Unilateral Nephrectomized Rats

    PubMed Central

    Gu, Ye; Zou, Wusong; Zhang, Mingjing; Zhu, Pengfei; Hu, Shao

    2015-01-01

    Background Aortocaval fistula (AV) in rat is a unique model of volume-overload congestive heart failure and cardiac hypertrophy. Living donor kidney transplantation is regarded as beneficial to allograft recipients and not particularly detrimental to the donors. Impact of AV on animals with mild renal dysfunction is not fully understood. In this study, we explored the effects of AV in unilateral nephrectomized (UNX) rats. Methods Adult male Sprague-Dawley (SD) rats were divided into Sham (n = 10), UNX (right kidney remove, n = 10), AV (AV established between the levels of renal arteries and iliac bifurcation, n = 18) and UNX+AV (AV at one week after UNX, n = 22), respectively. Renal outcome was measured by glomerular filtration rate, effective renal plasma flow, fractional excretion of sodium, albuminuria, plasma creatinine, and cystatin C. Focal glomerulosclerosis (FGS) incidence was evaluated by renal histology. Cardiac function was measured by echocardiography and hemodynamic measurements. Results UNX alone induced compensatory left kidney enlargement, increased plasma creatinine and cystatin C levels, and slightly reduced glomerular filtration rate and increased FGS. AV induced significant cardiac enlargement and hypertrophy and reduced cardiac function and increased FGS, these changes were aggravated in UNX+AV rats. Conclusions Although UNX only induces minor renal dysfunction, additional chronic volume overload placement during the adaptation phase of the remaining kidney is associated with aggravated cardiac dysfunction and remodeling in UNX rats, suggesting special medical care is required for UNX or congenital monokidney subjects in case of chronic volume overload as in the case of pregnancy and hyperthyroidism to prevent further adverse cardiorenal events in these individuals. PMID:26252578

  7. About Chronic Kidney Disease

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  8. Diet and Kidney Stones

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  9. National Kidney Foundation

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  10. Medullary Sponge Kidney

    MedlinePLUS

    ... Association of Kidney Patients National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... PDF, 345 KB)????? Alternate Language URL Medullary Sponge Kidney Page Content On this page: What is Medullary ...

  11. Pregnancy and Kidney Disease

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  12. Kidney Stones in Children

    MedlinePLUS

    ... Nephrology American Kidney Fund National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations?? . (PDF, 345 KB) Alternate Language URL Kidney Stones in Children Page Content On this page: ...

  13. Kidney Disease (Nephropathy)

    MedlinePLUS

    ... Text Size: A A A Listen En Español Kidney Disease (Nephropathy) Kidneys are remarkable organs. Inside them ... resulting in kidney disease. How Does Diabetes Cause Kidney Disease? When our bodies digest the protein we ...

  14. Horseshoe Kidney (Renal Fusion)

    MedlinePLUS

    ... Home Urologic Conditions Horseshoe Kidney (Renal Fusion) Horseshoe Kidney (Renal Fusion) Most people are born with two ... final position as they develop. What is horseshoe kidney? Horseshoe kidney occurs in about one in 500 ...

  15. Polycystic kidney disease

    MedlinePLUS

    Cysts - kidneys; Kidney - polycystic; Autosomal dominant polycystic kidney disease; ADPKD ... Polycystic kidney disease (PKD) is passed down through families (inherited), usually as an autosomal dominant trait. If one parent ...

  16. Acquired Cystic Kidney Disease

    MedlinePLUS

    ... Kidney Patients Life Options National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... PDF, 345 KB)????? Alternate Language URL Acquired Cystic Kidney Disease Page Content On this page: What is ...

  17. Acute arterial occlusion - kidney

    MedlinePLUS

    Acute arterial occlusion of the kidney is a sudden, severe blockage of the artery that supplies blood to the kidney. ... The kidneys need a good blood supply. The main artery to the kidney is called the renal artery. Reduced ...

  18. Polycystic Kidney Disease (PKD)

    MedlinePLUS

    MENU Return to Web version Polycystic Kidney Disease Overview What is polycystic kidney disease? Polycystic kidney disease (PKD) is an inherited disease that affects the kidneys. Sacs of fluid (called ...

  19. Kidney Stones

    MedlinePLUS

    ... t pass on its own, you may need treatment. It can be done with shock waves; with a scope inserted through the tube that carries urine out of the body, called the urethra; or with surgery. NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  20. Kidney pain (image)

    MedlinePLUS

    A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the size of sand or ... A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the ...

  1. Spontaneous intracranial hypotension manifesting as a unilateral subdural hematoma with a marked midline shift.

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  3. Computed Tomography Angiography of the Thoracic Aorta.

    PubMed

    Scheske, Jonathan A; Chung, Jonathan H; Abbara, Suhny; Ghoshhajra, Brian B

    2016-01-01

    This article reviews the multidetector-row computed tomography (MDCT) imaging appearance of common entities that are part of the wide spectrum of diseases involving the thoracic aorta. Electrocardiogram-gated MDCT is poised to become the reference standard method in assessing the thoracic aorta. Reproducible images of the aorta can be acquired independent of operator skill. PMID:26654389

  4. Evolution of thoracic surgery in Canada

    PubMed Central

    Deslauriers, Jean; Griffith Pearson, F; Nelems, Bill

    2015-01-01

    BACKGROUND: Canada’s contributions toward the 21st century’s practice of thoracic surgery have been both unique and multilayered. Scattered throughout are tales of pioneers where none had gone before, where opportunities were greeted by creativity and where iconic figures followed one another. OBJECTIVE: To describe the numerous and important achievements of Canadian thoracic surgeons in the areas of surgery for pulmonary tuberculosis, thoracic oncology, airway surgery and lung transplantation. METHOD: Information was collected through reading of the numerous publications written by Canadian thoracic surgeons over the past 100 years, interviews with interested people from all thoracic surgery divisions across Canada and review of pertinent material form the archives of several Canadian hospitals and universities. RESULTS: Many of the developments occurred by chance. It was the early and specific focus on thoracic surgery, to the exclusion of cardiac and general surgery, that distinguishes the Canadian experience, a model that is now emerging everywhere. From lung transplantation in chimera twin calves to ex vivo organ preservation, from the removal of airways to tissue regeneration, and from intensive care research to complex science, Canadians have excelled in their commitment to research. Over the years, the influence of Canadian thoracic surgery on international practice has been significant. CONCLUSIONS: Canada spearheaded the development of thoracic surgery over the past 100 years to a greater degree than any other country. From research to education, from national infrastructures to the regionalization of local practices, it happened in Canada.

  5. The Thoracic Shape of Hominoids

    PubMed Central

    Chan, Lap Ki

    2014-01-01

    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. PMID:24818026

  6. Bilateral internal thoracic artery grafting

    PubMed Central

    2013-01-01

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

  7. Thoracic organ transplantation: laboratory methods.

    PubMed

    Patel, Jignesh K; Kobashigawa, Jon A

    2013-01-01

    Although great progress has been achieved in thoracic organ transplantation through the development of effective immunosuppression, there is still significant risk of rejection during the early post-transplant period, creating a need for routine monitoring for both acute antibody and cellular mediated rejection. The currently available multiplexed, microbead assays utilizing solubilized HLA antigens afford the capability of sensitive detection and identification of HLA and non-HLA specific antibodies. These assays are being used to assess the relative strength of donor specific antibodies; to permit performance of virtual crossmatches which can reduce the waiting time to transplantation; to monitor antibody levels during desensitization; and for heart transplants to monitor antibodies post-transplant. For cell mediated immune responses, the recent development of gene expression profiling has allowed noninvasive monitoring of heart transplant recipients yielding predictive values for acute cellular rejection. T cell immune monitoring in heart and lung transplant recipients has allowed individual tailoring of immunosuppression, particularly to minimize risk of infection. While the current antibody and cellular laboratory techniques have enhanced the ability to manage thoracic organ transplant recipients, future developments from improved understanding of microchimerism and graft tolerance may allow more refined allograft monitoring techniques. PMID:23775735

  8. Preoperative Statin Use and Postoperative Acute Kidney Injury

    PubMed Central

    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

    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. PMID:23062398

  9. Thoracic Extraosseous Epidural Cavernous Hemangioma

    PubMed Central

    Asil, Kiyasettin; Ceylan, Davut; Erdem, Sahin

    2015-01-01

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

  10. Fetal and Postnatal Magnetic Resonance Imaging of Unilateral Cystic Renal Dysplasia in a Neonate with Tuberous Sclerosis.

    PubMed

    Tyagi, Vineet; Bornstein, Eran; Schacht, Robert; Lala, Shailee; Milla, Sarah

    2014-02-01

    Tuberous sclerosis (TS) is an autosomal dominant condition associated with mutations in the TSC1 and/or TSC2 genes. Clinical manifestations are multisystemic, and they often include lesions in the brain, skin, heart, kidneys, and bones. TSC2 gene mutations can be seen concomitantly with autosomal dominant polycystic kidney disease gene mutations. We present a case of a fetus with prenatal diagnosis of TS that had unique asymmetrical distribution of renal cystic disease. We describe the extensive work up with both fetal and neonatal magnetic resonance imaging with correlating images of the unilateral polycystic renal disease in addition to typical TS brain findings. PMID:24495558

  11. Kidney Disease Basics

    MedlinePLUS

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... kidneys work . Page last updated: March 1, 2012 ? ?????????????? Contact Us Health Information Center Phone: 1-800-860- ...

  12. Chronic kidney disease

    MedlinePLUS

    Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... Chronic kidney disease (CKD) slowly gets worse over months or years. you may not notice any symptoms for some ...

  13. Diabetic Kidney Problems

    MedlinePLUS

    ... too high. Over time, this can damage your kidneys. Your kidneys clean your blood. If they are damaged, waste ... in your blood instead of leaving your body. Kidney damage from diabetes is called diabetic nephropathy. It ...

  14. Acute kidney failure

    MedlinePLUS

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  15. Chronic Kidney Disease

    MedlinePLUS

    You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of ... help control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged ...

  16. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P.

    1980-01-01

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

  17. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P.

    1979-01-01

    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.

  18. Extraintestinal Complications: Kidney Disorders

    MedlinePLUS

    ... but some less serious ones occur more frequently. Kidney stones These are probably the most commonly encountered kidney complications of IBD—particularly oxalate stones. Kidney stones are more common in Crohn's patients with disease ...

  19. Medullary cystic kidney disease

    MedlinePLUS

    ... 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 can lead to kidney problems.

  20. Diabetes and kidney disease

    MedlinePLUS

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

  1. Modern impact of video assisted thoracic surgery

    PubMed Central

    D’Amico, Thomas A.

    2014-01-01

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

  2. Thoracic radiculopathy caused by a myodil cyst.

    PubMed

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

    2000-08-01

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

  3. Fractures of the Thoracic and Lumbar Spine

    MedlinePLUS

    .org Fractures of the Thoracic and Lumbar Spine Page ( 1 ) Spinal fractures can vary widely in severity. While some fractures are very serious injuries that require emergency treatment, other fractures can ...

  4. The Effectiveness of Preemptive Thoracic Epidural Analgesia in Thoracic Surgery

    PubMed Central

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

    2014-01-01

    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. PMID:24745020

  5. Nonintubated anesthesia in thoracic surgery: general issues

    PubMed Central

    Castillo, Maria

    2015-01-01

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

  6. Reversible acute renal failure after unilateral extracorporeal shock-wave lithotripsy.

    PubMed

    Liguori, Giovanni; Trombetta, Carlo; Bucci, Stefano; Salamè, Leonardo; Savoldi, Silvana; Belgrano, Emanuele

    2004-02-01

    Extracorporeal shock-wave lithotripsy (ESWL) is the treatment of choice for the majority of patients with renal or proximal ureteral stones. We describe an unusual case of anuric renal failure following ESWL, in absence of obstruction or myoglobinuria, in the presence of unilateral nephrolithiasis and two normally functioning kidneys. A mechanism for this patient's acute renal failure (ARF) is postulated. Although the frequency of ARF after ESWL is extremely rare and the mechanism responsible for ARF is not understood, the appearance of ARF, when ureteral obstruction or hematoma are absent, should be included among complications following EWSL. Attention should be paid to older patients. PMID:14520505

  7. Unilateral Pedicle Fracture Accompanying Spondylolytic Spondylolisthesis

    PubMed Central

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

    2015-01-01

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

  8. Keep Your Kidneys Clear: Kicking Kidney Stones

    MedlinePLUS

    Some say that passing a kidney stone is like delivering a baby made of razor blades. The good news is that, although they can be excruciatingly painful, kidney stones rarely cause permanent damage, and you may ...

  9. Vitamin D: can you have too much of a good thing in chronic kidney disease?

    PubMed

    Morris, Howard A

    2015-11-01

    Recommendation of vitamin D supplements is common although there is little information regarding the definition of the upper limit of safety. Kusunoki et al. now publish interesting data of a novel mechanism by which excess 25-hydroxyvitamin D exerts adverse effects on the kidney, using unilateral ureteral obstruction in the mouse as a model of kidney disease. Their report provides a new mechanism to be assessed as a surrogate measure of vitamin D toxicity that may be clinically relevant. PMID:26579677

  10. Functional evaluation of the remaining kidney in kidney donors by radionuclide dynamic imaging using a graphic method with factor analysis.

    PubMed

    Kakuta, T; Suzuki, Y; Hida, M; Wakabayasi, M; Fujisaki, T; Kitamura, M; Hiraga, S

    1997-10-01

    An uptake coefficient proportional to the glomerular filtration rate (GFR) can be estimated from dynamic renal images with 99Tcm-DTPA using Rutland's graphic method. We have developed a new method of extracting the input and retention functions by applying factor analysis to the renal dynamic images obtained with 99Tcm-DTPA, which we have called the 'factor uptake coefficient' (Factor UC). In the present study, we followed 13 living kidney donors (7 males, 6 females) by measuring the Factor UC in each kidney before nephrectomy and in the remaining kidney 3 weeks and 1 year after nephrectomy. The median Factor UC in the remaining kidney increased from a pre-nephrectomy value of 0.31 to 0.52 three weeks post-nephrectomy, which then remained unchanged for up to 1 year. These results indicate that functional compensation occurs following unilateral nephrectomy, and that this process is complete within 3 weeks after nephrectomy. PMID:9392795

  11. Kidney Disease: A Silent Problem

    MedlinePLUS

    ... Kidney Disease: A Silent Problem Heath and Aging Kidney Disease: A Silent Problem Kidney Disease Who Is ... hormones that your body needs to stay healthy. Kidney Disease Kidney disease can sometimes develop very quickly, ...

  12. Modification of unilateral otolith responses following spaceflight.

    PubMed

    Clarke, Andrew H; Schönfeld, Uwe

    2015-12-01

    The aim of the study was to resolve the issue of spaceflight-induced, adaptive modification of the otolith system by measuring unilateral otolith responses in a pre- versus post-flight design. The study represents the first comprehensive approach to examining unilateral otolith function following space flight. Ten astronauts participated in unilateral otolith function tests three times preflight and up to four times after Shuttle flights from landing day through the subsequent 10 days. During unilateral centrifugation, utricular function was examined by the perceptual changes reflected by the subjective visual vertical (SVV) and the otolith-mediated ocular counter-roll, designated as utriculo-ocular response (UOR). Unilateral saccular reflexes were recorded by measurement of collic vestibular evoked myogenic potentials (cVEMP). The findings demonstrate a general increase in interlabyrinth asymmetry of otolith responses on landing day relative to preflight baseline, with subsequent reversal in asymmetry within 2-3 days. Recovery to baseline levels was achieved within 10 days. This fluctuation in asymmetry was consistent for the utricle tests (SVV and UOR) while apparently stronger for SVV. A similar asymmetry was observed during cVEMP testing. In addition, the results provide initial evidence of a dominant labyrinth. The findings require reconsideration of the otolith asymmetry hypothesis; in general, on landing day, the response from one labyrinth was equivalent to preflight values, while the other showed considerable discrepancy. The finding that one otolith response can return to one-g level within hours after re-entry while the other takes considerably longer demonstrates the importance of considering the otolith response as a result of both peripheral and associated central neural processing. PMID:26358122

  13. Percutaneous radiofrequency upper thoracic sympathectomy.

    PubMed

    Wilkinson, H A

    1996-04-01

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

  14. Thoracic manifestations of collagen vascular diseases.

    PubMed

    Capobianco, Julia; Grimberg, Alexandre; Thompson, Bruna M; Antunes, Viviane B; Jasinowodolinski, Dany; Meirelles, Gustavo S P

    2012-01-01

    Collagen vascular diseases are a diverse group of immunologically mediated systemic disorders that often lead to thoracic changes. The collagen vascular diseases that most commonly involve the lung are rheumatoid arthritis, progressive systemic sclerosis, systemic lupus erythematosus, polymyositis and dermatomyositis, mixed connective tissue disease, and Sjögren syndrome. Interstitial lung disease and pulmonary arterial hypertension are the main causes of mortality and morbidity among patients with collagen vascular diseases. Given the broad spectrum of possible thoracic manifestations and the varying frequency with which different interstitial lung diseases occur, the interpretation of thoracic images obtained in patients with collagen vascular diseases can be challenging. The task may be more difficult in the presence of treatment-related complications such as drug toxicity and infections, which are common in this group of patients. Although chest radiography is most often used for screening and monitoring of thoracic alterations, high-resolution computed tomography can provide additional information about lung involvement in collagen vascular diseases and may be especially helpful for differentiating specific disease patterns in the lung. General knowledge about the manifestations of thoracic involvement in collagen vascular diseases allows radiologists to provide better guidance for treatment and follow-up of these patients. PMID:22236892

  15. [Thoracic actinomycosis: report of a case].

    PubMed

    Brizuela, Martín E; Latella, Antonio; Sancho Cano, Julieta; Litterio, Mirta; Berberian, Griselda

    2015-12-01

    Actinomycosis is a disease produced by bacteria of the genus Actinomyces. The thoracic form represents 30% of the cases. Signs and symptoms are generally unspecific. A previously healthy 11 year old girl was admitted with a chest mass of a month of evolution associated with fever, hyporexia and weight loss. Thoracic actinomycosis was diagnosed with the isolation of Actinomyces meyeri in the mass drainage. She received antibiotic treatment for a year with complete resolution. Although rare, it should be taken into account as a differential diagnosis in long evolution thoracic tumor affecting the general condition. The microbiologist must be warned about the suspected diagnosis because it is difficult to find it in routinely used culture media. PMID:26593814

  16. [Gunshot wound to the kidney: case report and therapeutic management].

    PubMed

    Maruschke, M; Hakenberg, O W

    2008-04-01

    Gunshot wounds to the kidney occur with different regional incidence. They are commonly combined with thoracic and abdominal injuries. Gunshot wounds may be caused by low-velocity or high-velocity bullets. The latter are usually used with military weapons and cause a higher degree of tissue damage. The therapeutic management of renal gunshot wounds has changed in recent decades resulting in more organ-preserving strategies. An imperative indication for surgical exploration of the kidney is critical renal bleeding with symptoms of hypovolaemic shock. We report the case of a 23-year-old male admitted to the hospital with combined gunshot wounds from a small-bore weapon with damage of the liver, stomach and the left kidney. There were no signs of thoracic injuries. The patient underwent transabdominal exploration with treatment of the liver and stomach lesions, removal of the bullet and preservation of the left kidney. A percutaneous nephrostomy and drainage of the retroperitoneal region were inserted; antibiotic prophylaxis was given. A 4-week postoperative intravenous pyelogram showed complete integrity of the upper left tract and good renal function. PMID:18210067

  17. 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 ... January 2015 What is familial TAAD? Familial thoracic aortic aneurysm and dissection (familial TAAD) involves problems with the ...

  18. Paramedian unilateral Le Fort I osteotomy

    PubMed Central

    Tauro, David P.; Uppada, Uday Kiran

    2015-01-01

    A novel maxillary osteotomy is designed which is a technical modification of the standard Le Fort I osteotomy, termed the paramedian unilateral Le Fort I osteotomy. This technique has been used to correct an anterior open bite in a given patient based on the current clinical scenario as described, secondary to post ankylosis surgery. Its use may be extrapolated to various clinical situations to correct occlusal discrepancies including distraction osteogenesis. PMID:26389040

  19. Accommodative Performance of Children With Unilateral Amblyopia

    PubMed Central

    Manh, Vivian; Chen, Angela M.; Tarczy-Hornoch, Kristina; Cotter, Susan A.; Candy, T. Rowan

    2015-01-01

    Purpose. The purpose of this study was to compare the accommodative performance of the amblyopic eye of children with unilateral amblyopia to that of their nonamblyopic eye, and also to that of children without amblyopia, during both monocular and binocular viewing. Methods. Modified Nott retinoscopy was used to measure accommodative performance of 38 subjects with unilateral amblyopia and 25 subjects with typical vision from 3 to 13 years of age during monocular and binocular viewing at target distances of 50, 33, and 25 cm. The relationship between accommodative demand and interocular difference (IOD) in accommodative error was assessed in each group. Results. The mean IOD in monocular accommodative error for amblyopic subjects across all three viewing distances was 0.49 diopters (D) (95% confidence interval [CI], ±1.12 D) in the 180° meridian and 0.54 D (95% CI, ±1.27 D) in the 90° meridian, with the amblyopic eye exhibiting greater accommodative errors on average. Interocular difference in monocular accommodative error increased significantly with increasing accommodative demand; 5%, 47%, and 58% of amblyopic subjects had monocular errors in the amblyopic eye that fell outside the upper 95% confidence limit for the better eye of control subjects at viewing distances of 50, 33, and 25 cm, respectively. Conclusions. When viewing monocularly, children with unilateral amblyopia had greater mean accommodative errors in their amblyopic eyes than in their nonamblyopic eyes, and when compared with control subjects. This could lead to unintended retinal image defocus during patching therapy for amblyopia. PMID:25626970

  20. Ependymal cyst of the thoracic spinal cord

    PubMed Central

    Gainer, J. V.; Chou, S. M.; Nugent, G. R.; Weiss, V.

    1974-01-01

    A unique case of an ependymal cyst on the anterior aspect of the thoracic spinal cord in a woman aged 68 years is described. Clinical signs were precipitated by trauma. Recovery of function, while incomplete, was remarkably good after extirpation of the cyst. Images PMID:4419009

  1. Testing for Kidney Disease

    MedlinePLUS

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. September 17, 2014?? Contact Us Health Information Center Phone: 1-800-860- ...

  2. Keep Your Kidneys Healthy

    MedlinePLUS

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. September 17, 2014???? Contact Us Health Information Center Phone: 1-800-860- ...

  3. Polycystic Kidney Disease

    MedlinePLUS

    ... and requires immediate medical attention. [ Top ] How do health care providers diagnose autosomal dominant polycystic kidney disease? Health ... when test results are available. [ Top ] How do health care providers treat autosomal dominant polycystic kidney disease? Although ...

  4. American Kidney Fund

    MedlinePLUS

    ... Navigator Awards American Kidney Fund 14th Consecutive 4-Star Rating for Sound Fiscal Management American Kidney Fund ... Work Consumers Digest Top Charity Consumers Digest 4-Star Charity (14th consecutive year) Charity Navigator Stay Connected ...

  5. Amyloidosis and Kidney Disease

    MedlinePLUS

    ... Foundation Genetic and Rare Diseases Information Center MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... PDF, 345 KB)????? Alternate Language URL Amyloidosis and Kidney Disease Page Content On this page: What is ...

  6. Kidney (Renal) Abscess

    MedlinePLUS

    ... the kidneys through the bloodstream or by a urinary tract infection traveling to the kidney and then spreading to ... can also be sources of renal abscess. Complicated urinary tract infections associated with stones, pregnancy, neurogenic bladder and diabetes ...

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

    PubMed Central

    2015-01-01

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

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

    SciTech Connect

    Kudoh, Kouichi Kadota, Masataka; Nakayama, Yoshiharu; Imuta, Masanori; Yasuda, Tsuyoshi; Yamashita, Yasuyuki; Inadome, Akito; Yoshida, Masaki; Ueda, Shouichi

    2003-09-15

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

  9. Dry needling for the management of thoracic spine pain.

    PubMed

    Fernández-de-Las-Peñas, César; Layton, Michelle; Dommerholt, Jan

    2015-07-01

    Thoracic spine pain is as disabling as neck and low back pain without receiving the same level of attention in the scientific literature. Among the different structures that can refer pain to the thoracic spine, muscles often play a relevant role. Trigger points (TrPs) from neck, shoulder and spinal muscles can induce pain in the region of the thoracic spine. There is a lack of evidence reporting the presence of TrPs in the region of the thoracic spine, but clinical evidence suggests that TrPs can be a potential source of thoracic spine pain. The current paper discusses the role of TrPs in the thoracic spine and dry needling (DN) for the management of TrPs in the thoracic multifidi and longissimus thoracis. This paper also includes a brief discussion of the application of DN in other tissues such as tendons, ligaments and scars. PMID:26309385

  10. [Unilateral surgically assisted rapid maxillary expansion using a transpalatal distractor].

    PubMed

    Roelofs, J; Breuning, K H; van't Spijker, A; Borstlap, W A; Bergé, S J; Kuijpers-Jagtman, A M

    2010-02-01

    A 46-year-old woman was referred for orthodontic surgery consultation because ofa retrognathic maxilla, unilateral cross bite and functional, aesthetic and speech problems. The maxilla was widened unilaterally by unilateral surgically assisted rapid maxillary expansion with a bone-borne transpalatal distractor. During post-operative orthodontic treatment, a temporary anchorage device was administered. With the help of composite veneers, crowns and a removable partial denture, a functionally and aesthetically satisfying result was achieved. PMID:20225701

  11. Management of Children with Unilateral Hearing Loss.

    PubMed

    Lieu, Judith E C

    2015-12-01

    Children with impaired hearing in one ear (unilateral hearing loss [UHL]) and normal hearing in the other ear experience challenges in understanding speech in noisy backgrounds and localizing the source of sounds in 3-dimensional space. They are at a high risk for speech and language delay and need educational help in school. However, definitive evidence of benefit from amplification is currently lacking to recommend placement of hearing aids or cochlear implants in all young children with UHL. Management of UHL in children should be guided by the child's development, performance in school, and personal/family values and preferences. PMID:26443488

  12. Spontaneous unilateral dizygotic twin tubal pregnancy.

    PubMed

    Tam, Teresa; Khazaei, Ali

    2009-02-01

    Spontaneous dizygotic unilateral twin tubal pregnancy is an extremely rare occurrence with a high risk for pregnancy-related mortality, and a diagnostic challenge for obstetricians. We present a case of a 27-year-old woman with spontaneous twin tubal pregnancy. Transvaginal color Doppler sonography revealed 2 separate gestational sacs within the right adnexa, each containing an embryo. Cytogenetic examination of the trophoblastic tissues confirmed the diagnosis of dizygotic twin ectopic pregnancy. Clinical signs and symptoms together with imaging studies help in the diagnosis of this rare variant of ectopic pregnancies. PMID:18465811

  13. Neurological asymmetries immediately after unilateral ECT.

    PubMed Central

    Kriss, A; Blumhardt, L D; Halliday, A M; Pratt, R T

    1978-01-01

    Twenty-nine right handed patients were examined neurologically before and immediately after each of 62 unilateral ECTs to the dominant and non-dominant hemispheres. Most convulsions were followed by signs of transitory neurological dysfunction referable to the treated hemisphere. These signs included deep tendon reflex asymmetry, hemiparesis, tactile and visual inattention, and homonymous hemianopia. After treatment to the right hemisphere some patients had left visuospatial neglect, while all patients who had dominant hemisphere ECT were transiently dysphasic. All neurological abnormalities tested resolved within 20 minutes of treatment. PMID:731257

  14. [Idiopathic and unilateral hypoglossal nerve palsy].

    PubMed

    Ibarra, Viviana; Jaureguiberry, Anabel; Moretta, Gabriela; Lazzarini, Gustavo; Ceruzzi, Roberto; Reich, Edgardo

    2015-01-01

    The isolated unilateral palsy of the hypoglossal nerve is an unusual sign in daily medical practice. We present the case of a 74 year old man, without relevant medical history, who started with headache and difficulty to swallow. On the physical examination, he had isolated hypoglossal nerve palsy without evidence of tongue atrophy or fasciculation. The patient had a good spontaneous evolution. Idiopathic isolated hypoglossal nerve palsy requires an exhaustive evaluation with neuroimages and complementary exams. It usually presents partial or total spontaneous remission. PMID:26117609

  15. The European educational platform on thoracic surgery

    PubMed Central

    Rocco, Gaetano; Venuta, Federico

    2014-01-01

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

  16. The European educational platform on thoracic surgery.

    PubMed

    Massard, Gilbert; Rocco, Gaetano; Venuta, Federico

    2014-05-01

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

  17. Kidney Regeneration in Mammals

    PubMed Central

    Yang, Hai-Chun; Liu, Shao-Jun; Fogo, Agnes B.

    2015-01-01

    Background Several organs such as the skin and liver have a great capacity for regeneration. However, many approaches only delay the progression of end-stage kidney disease and do not achieve efficient long-term stabilization, let alone regeneration. Summary In mammals, the kidney has an innate but limited capacity for regeneration which can only modify the nephron structure and function but not increase the nephron number. Several clinical and animal studies have indicated that functional improvements and/or structural regression can occur in chronic kidney disease. Cell reconstitution, matrix remodeling, and tissue reorganization are major mechanisms for kidney regeneration. Current approaches achieve only partial kidney regeneration, but this does not occur in all animals and is not sustained in the long term. Multipronged and early interventions are future choices for the induction of kidney regeneration. Key Messages Kidney regeneration in mammals is feasible but limited and may be enhanced by multitargeting key mechanisms. PMID:24854640

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

    PubMed

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

    2015-06-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2001-09-01

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

  2. Acute Aortic Syndromes and Thoracic Aortic Aneurysm

    PubMed Central

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

    2009-01-01

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

  3. Key Exchange with Unilateral Authentication: Composable Security Definition and Modular Protocol Design

    E-print Network

    International Association for Cryptologic Research (IACR)

    Key Exchange with Unilateral Authentication: Composable Security Definition and Modular Protocol Coretti ETH Zurich corettis@inf.ethz.ch Abstract Key exchange with unilateral authentication (short: unilateral key exchange) is an important primitive in practical security protocols; a prime example

  4. Clinical verification of a unilateral otolith test

    NASA Astrophysics Data System (ADS)

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

    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.

  5. Unilateral MRI using a rastered projection

    NASA Astrophysics Data System (ADS)

    Bray, Christina L.; Hornak, Joseph P.

    2007-09-01

    Unilateral magnetic resonance techniques, where magnet and radio frequency (RF) coil are placed on one side of the sample, can provide valuable information about a sample which otherwise cannot be accommodated in conventional high spectral resolution magnetic resonance systems. A unilateral magnetic resonance imaging approach utilizing the stray field from a disc magnet and a butterfly geometry RF coil is described. The coil excites spins in a volume centered around an arc through the sample. Translating the RF coil relative to the magnet and recording the signal at each translational location creates a projection of the signal in a tomographic slice through the sample. Rotating the RF coil relative to the sample and repeating the translation creates projections through the sample at different angles. Backprojecting this information yields an image. A proof of concept device operating on this principle at 12.4 MHz was constructed and characterized. Projections through three phantoms are presented with a 1.2-4 cm field of view, thickness of 102 ?m, and at a distance of 3 mm from the RF coil and 14 mm from the magnet. The edge spread function (ESF) was measured resulting in a 4 mm full width at half maximum (FWHM) line spread function (LSF) estimation using a Gaussian model. An example of one reconstructed image is presented.

  6. Unilateral medial dislocation of the temporomandibular joint.

    PubMed

    Avrahami, E; Rabin, A; Mejdan, M

    1997-08-01

    We present our experience of the rare condition of unilateral medial dislocation of the temporomandibular joint (TMJ) in 11 patients with head trauma who had received a direct lateral blow on the chin. The diagnosis was made by direct coronal CT of the TMJ performed from 6 h to 7 days following the injury. In 6 patients, subcondylar fracture of the ipsilateral mandibular ramus was also demonstrated. A second CT performed 11-16 months following the first one demonstrated pseudoarthrosis of the fractured ramus in these 6 patients. The second CT was identical to the first in the remaining 5 patients with pure dislocation of the condyle. All patients suffered from severe disability of the TMJ. The maximal vertical distance between the upper and lower incisors in patients with uncomplicated dislocation ranged between 8 and 12 mm. In cases with complicated medial condylar dislocation with fracture and pseudoarthrosis of the mandibular ramus, this distance ranged between 16 and 25 mm, probably because of additional movement in the area of the pseudoarthrosis. The maximal vertical distance between the incisors was compared with a control group of 20 normal adults who had values from 40 to 52 mm. Medial unilateral dislocation of the TMJ can appear in two forms: uncomplicated or complicated, with pseudoarthrosis of the ipsilateral mandibular ramus. PMID:9272501

  7. [Spontaneous unilateral adrenal hematomas. 10 cases].

    PubMed

    Hoeffel, C; Legmann, P; Luton, J P; Chapuis, Y; Bonnin, A

    1994-06-11

    Spontaneous unilateral adrenal haematoma is a very rare condition. We report 10 such cases in which the pathological examination confirmed the diagnosis and for which computed tomography (CT) (n = 10) and magnetic resonance imaging (MRI) (n = 5) were performed. The diagnosis of this condition was difficult because there was no specific clinical setting nor any specific functional disorder. CT most often revealed a large mass (> 4 cm) of one of the adrenal glands, most often displaying soft-tissue attenuation and thus not specific. However, MRI suggested the diagnosis, showing foci of hypersignal on T1-weighted images and heterogeneous masses on T2-weighted images, predominantly displaying hypersignal and not enhancing, after Gd-DTPA dynamic perfusion study. Pathologic examination of the surgical specimen confirmed either idiopathic haematoma (n = 5) or haematoma possibly associated with a small benign tumour (n = 5). The diagnosis of adrenal haematoma must be considered when an unilateral isolated large adrenal mass is discovered in an asymptomatic patient. MRI with Gd-DTPA dynamic perfusion study has to be performed and one may suggest waiting and repeat imaging (so as to follow decrease in size or signal changes) in order to avoid surgery. PMID:7971805

  8. The European general thoracic surgery database project

    PubMed Central

    Brunelli, Alessandro

    2014-01-01

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

  9. The European general thoracic surgery database project.

    PubMed

    Falcoz, Pierre Emmanuel; Brunelli, Alessandro

    2014-05-01

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

  10. Radiation response of the monkey kidney following contralateral nephrectomy

    SciTech Connect

    Robbins, M.E.C.; Stephens, L.C.; Gray, K.N.

    1994-09-30

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  12. EQUILIBRIUM PATHS OF MECHANICAL SYSTEMS WITH UNILATERAL CONSTRAINTS

    E-print Network

    Pellegrino, Sergio

    EQUILIBRIUM PATHS OF MECHANICAL SYSTEMS WITH UNILATERAL CONSTRAINTS PART II: DEPLOYABLE REFLECTOR M, by imple- menting the theory for tracing the equilibrium path of a mechanical system with unilateral had not been previously explained, is the existence of a corner limit point on the equilibrium path

  13. [New kidney transplants].

    PubMed

    Bergerat, S

    2015-11-01

    Chronic kidney failure and patients that require haemodialysis is increasing, mainly because of the increasing prevalence of diabetic nephropathy. Kidney transplantation is an alternative therapy for chronic renal failure in its terminal stage. Currently, in France and in the world, there is a shortage of kidney transplants. The evolution of the French legislation allows the organ donation from living donor, including awaiting cardiac arrest. PMID:26337224

  14. Papillary Kidney Carcinoma

    Cancer.gov

    The most common type of kidney cancer is called renal cell carcinoma. This cancer forms in the cells lining the small tubules in the kidney that filter waste from the blood and make urine. An estimated 58,240 Americans were expected to have been diagnosed with kidney cancer in 2010 and an estimated 13,040 to have died of this cancer.1 Most people with kidney cancer are usually over 55 years of age and this cancer is more common in men.

  15. Clear Cell Kidney Carcinoma

    Cancer.gov

    The most common type of kidney cancer is called renal cell carcinoma. This cancer forms in the cells lining the small tubules in the kidney that filter waste from the blood and make urine. An estimated 58,240 Americans were expected to have been diagnosed with kidney cancer in 2010 and an estimated 13,040 to have died of this cancer.1 Most people with kidney cancer are usually over 55 years of age and this cancer is more common in men.

  16. Unilateral condylar hyperplasia: a treatment strategy.

    PubMed

    Ferreira, Sabrina; da Silva Fabris, André Luis; Ferreira, Gabriel Ramalho; Faverani, Leonardo Perez; Francisconi, Giovanna Barbosa; Souza, Francisley Avila; Garcia, Idelmo Rangel

    2014-05-01

    Condylar hyperplasia (CH) is a pathologic condition that causes overdevelopment of the condylar head and neck as well as the mandible. Slowly progressive unilateral enlargement of the head and the neck of the condyle causes crossbite malocclusion, facial asymmetry, and shifting of the midpoint of the chin to the unaffected side. The etiology and the pathogenesis of CH remain uncertain. The diagnosis is made by clinical and radiologic examinations and bone scintigraph. A difference in uptake of 10% or more between condyles is regarded as indicative of CH, and the affected condyles had a relative uptake of 55% or more. When the diagnosis of active CH is established, the treatment consists of removal of the growth center by a partial condylectomy. The authors present the case of a 46-year-old male patient with right active type II CH or hemimandibular hyperplasia who underwent a high condylectomy. PMID:24820728

  17. Distraction osteogenesis of a unilateral hypoplastic mandible.

    PubMed

    Liaqat, Sahrish; Baig, Amir Mushtaq; Bukhari, Syed Gulzar Ali; Ahmed, Waseem

    2011-01-01

    Distraction osteogenesis (DO) is a surgical process in which two bony segments are gradually separated so new soft tissue and bone will form between them by applying tension through a fixation device. There are three phases to this process: latency phase, distraction phase, and consolidation phase. The technique was originally applied to long bones but in recent years the method has been adapted for use in maxillofacial surgery. Distraction osteogenesis is a new variation of more traditional; orthognathic surgical procedures which can be applied for the correction of dento-facial deformities and syndromes of the jaws, treating upper airway obstruction in paediatric patients with mandibualr retrognathia, due to tongue collapse and physical obstruction in the hypopharangeal region. It is an effective and powerful reconstructive surgical technique, which can be performed safely without the need of bone graft or blood transfusion. We present treatment of a child with severe facial asymmetry after unilateral TMJ ankylosis corrected bydistraction osteogenesis. PMID:24800374

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

    Study Design?Systematic review. Clinical Questions?(1) What is the comparative efficacy of unilateral instrumentation compared with bilateral instrumentation in spine surgery? (2) What is the safety of unilateral instrumentation compared with bilateral instrumentation in spine surgery? Methods?Electronic databases and reference lists of key articles were searched up to September 30, 2014, to identify studies reporting the comparative efficacy and safety of unilateral versus bilateral instrumentation in spine surgery. Studies including recombinant human bone morphogenetic protein 2 as adjunct therapy and those with follow-up of less than 2 years were excluded. Results?Ten randomized controlled trials met the inclusion criteria: five compared unilateral with bilateral instrumentation using open transforaminal or posterior lumbar interbody fusion (TLIF/PLIF), one used open posterolateral fusion, and four used minimally invasive TLIF/PLIF. There were no significant differences between unilateral and bilateral screw instrumentation with respect to nonunion, low back or leg pain scores, Oswestry Disability Index, reoperation, or complications. Conclusions?The existing literature does not identify significant differences in clinical outcomes, union rates, and complications when unilateral instrumentation is used for degenerative pathologic conditions in the lumbar spine. The majority of published reports involve single-level lumbar unilateral instrumentation. PMID:26131385

  1. Anemia in Chronic Kidney Disease

    MedlinePLUS

    ... Kidney Foundation U.S. Food and Drug Administration MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... 345 KB)????? Alternate Language URL Anemia in Chronic Kidney Disease Page Content On this page: What is ...

  2. Kidney Disease Risks among Hispanics

    MedlinePLUS

    ... Risk Factors > Race & Kidney Disease Race/Ethnicity and Kidney Disease African-Americans , Hispanic Americans , Native Americans and ... Disease Risks Among Asian Americans and Pacific Islanders Kidney Disease Risks Among African-Americans African-Americans are ...

  3. 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 ...

  4. Controversies related to living kidney donors

    PubMed Central

    Kamal, Ahmed I.; Harraz, Ahmed M.; Shokeir, Ahmed A.

    2011-01-01

    Background Increasing the living-donor pool by accepting donors with an isolated medical abnormality (IMA) can significantly decrease the huge gap between limited supply and rising demand for organs. There is a wide range of variation among different centres in dealing with these categories of donors. We reviewed studies discussing living kidney donors with IMA, including greater age, obesity, hypertension, microscopic haematuria and nephrolithiasis, to highlight the effect of these abnormalities on both donor and recipient sides from medical and surgical perspectives. Methods We systematically searched MEDLINE, ISI Science Citation Index expanded, and Google scholar, from the inception of each source to January 2011, using the terms ‘kidney transplant’, ‘renal’, ‘graft’, ‘living donor’, ‘old’, ‘obesity’, ‘nephrolithiasis’, ‘haematuria’ and ‘hypertension’. In all, 58 studies were found to be relevant and were reviewed comprehensively. Results Most of the reviewed studies confirmed the safety of using elderly, moderately obese and well-controlled hypertensive donors. Also, under specific circumstances, donors with nephrolithiasis can be accepted. However, persistent microscopic haematuria should be considered seriously and renal biopsy is indicated to exclude underlying renal disease. Conclusion Extensive examination and cautious selection with tailored immunosuppressive protocols for these groups can provide a satisfactory short- and medium-term outcome. Highly motivated elderly, obese, controlled hypertensive and the donor with a unilateral small stone (<1.5 cm, with normal metabolic evaluation) could be accepted. Donors with dysmorphic and persistent haematuria should not be accepted. A close follow-up after donation is crucial, especially for obese donors who developed microalbuminuria.

  5. Thoracic Outlet Syndrome Following Breast Implant Rupture

    PubMed Central

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

    2015-01-01

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

  6. Video-assisted thoracic surgery complications

    PubMed Central

    Kozak, Józef

    2014-01-01

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

  7. Bypass Surgery in Arterial Thoracic Outlet Syndrome

    PubMed Central

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

    2015-01-01

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

  8. Your Kidney Test Results

    MedlinePLUS

    ... is an eGFR less than 60 Your Serum Creatinine Result: Your eGFR Result: Urine Albumin-to-Creatinine Ratio (UACR) CKD is more than 30 Your ... filtering blood. As kidney disease gets worse, the creatinine goes up and the eGFR goes down. Urine albumin checks for kidney damage. The lower the ...

  9. Kidney Surgery Codes

    Cancer.gov

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

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

    PubMed Central

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

    2015-01-01

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

  11. Nonprogressive Unilateral Intracranial Arteriopathy in Children with Arterial Ischemic Stroke

    PubMed Central

    Yeon, Je Young

    2015-01-01

    The nonprogressive unilateral intracranial arteriopathy known as transient (focal) cerebral arteriopathy is not a well-recognized arteriopathy among practitioners of Korea and Japan, although it cannot be easily differentiated from early moyamoya disease. This review summarizes the nomenclature, pathophysiology, diagnostic evaluation, clinico-radiological features, and management of nonprogressive (reversible or stable) unilateral arteriopathy based on the relevant literature and our own experiences. Nonprogressive unilateral arteriopathy should be strongly suspected in children presenting with basal ganglia infarction and arterial beading. The early identification of patients likely to have nonprogressive or progressive arteriopathy would ensure proper management and guide further research for secondary stroke prevention. PMID:26180606

  12. Bioengineering Kidneys for Transplantation

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

    Kaiser, L R

    1994-01-01

    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. PMID:7986137

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

    E-print Network

    Smith, Stephen D.

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

  15. Thoracic manifestations of connective tissue diseases.

    PubMed

    Ruano, Carina A; Lucas, Rita N; Leal, Cecília I; Lourenço, João; Pinheiro, Sofia; Fernandes, Otília; Figueiredo, Luísa

    2015-01-01

    Connective tissue diseases (CTDs) comprise several immunologic systemic disorders, each of which associated with a particular set of clinical manifestations and autoimmune profile. CTDs may cause numerous thoracic abnormalities, which vary in frequency and pattern according to the underlying disorder. The CTDs that most commonly involve the respiratory system are progressive systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, Sjögren syndrome, polymyositis, dermatomyositis, and mixed connective tissue disease. Pulmonary abnormalities in this group of patients may result from CTD-related lung disease or treatment complications, namely drug toxicity and opportunistic infections. The most important thoracic manifestations of CTDs are interstitial lung disease and pulmonary arterial hypertension, with nonspecific interstitial pneumonia being the most common pattern of interstitial lung disease. High-resolution computed tomography is a valuable tool in the initial evaluation and follow-up of patients with CTDs. As such, general knowledge of the most common high-resolution computed tomographic features of CTD-related lung disease allows the radiologist to contribute to better patient management. PMID:25131613

  16. Unilateral ureteric stone associated with gross hydronephrosis and kidney shrinkage: a cadaveric report.

    PubMed

    Iravani, Omid; Tay, Ern-Wei; Bay, Boon-Huat; Ng, Yee-Kong

    2014-12-01

    Ureteric stones are a common cause of obstruction of the urinary tract, usually presenting with characteristic signs and symptoms, such as acute ureteric colic and hematuria. Occasionally, stones may present with non-specific symptoms such as low back pain and remain unidentified, leading to stone growth, chronic ureteric obstruction and complications such as hydronephrosis and renal damage. Here, we report a large ureteric stone in a cadaver with complete obstruction at the left ureterovesical junction, resulting in severe dilatation of the left ureter and renal pelvis. PMID:25548725

  17. Women in Thoracic Surgery: 30 Years of History.

    PubMed

    Antonoff, Mara B; David, Elizabeth A; Donington, Jessica S; Colson, Yolonda L; Litle, Virginia R; Lawton, Jennifer S; Burgess, Nora L

    2016-01-01

    Women in Thoracic Surgery was founded in 1986, with 2016 marking its 30th anniversary. Reflecting back on the last 3 decades of history, accomplishments, and enormous strides in our field, we review the past, present, and future of this organization. Although women still constitute a small minority of practicing surgeons in our field today, opportunities currently abound for women in thoracic surgery. Owing much to the early female pioneers in the field and to the support of male sponsors and our national societies, Women in Thoracic Surgery has grown and prospered, as have its members and the global community of female thoracic surgeons as a whole. In celebration of our 30th anniversary, we share with the readership the rich history of Women in Thoracic Surgery and its goals for the future. PMID:26694290

  18. When Your Child Needs a Kidney Transplant

    MedlinePLUS

    ... What to Expect When Your Child Needs a Kidney Transplant KidsHealth > Parents > Diseases & Conditions > Kidney & Urinary System > ... to monitor their new kidney function. About the Kidneys Kidneys are bean-shaped organs located near the ...

  19. Partial deletion of the ROCK2 protein fails to reduce renal fibrosis in a unilateral ureteral obstruction model in mice.

    PubMed

    Baba, Itsuko; Egi, Yasuhiro; Suzuki, Kazuo

    2016-01-01

    Renal fibrosis is a well?known cause for the progression of chronic kidney disease. Rho/Rho?associated coiled?coil kinase (ROCK) signaling is involved in renal fibrotic processes. Non?selective ROCK1/2 inhibitors have been reported to reduce renal interstitial fibrosis in a rodent unilateral ureteral obstruction (UUO) model. To clarify the role and contribution of ROCK2 in renal fibrosis, the present study used ROCK2 heterozygous knockout (HKO) mice to assess collagen deposition and fibrosis?associated gene expression in the kidney of the UUO model. In the ROCK2 HKO mice, the expression level of ROCK2 in the normal kidney was half of that in the kidney of wild?type (WT) mice. The expression levels of ROCK1 in the ROCK2 HKO mice and WT mice were equivalent. Furthermore, in the ROCK2 HKO and the WT mice, the hydroxyproline content and the gene expression levels of collagen I and transforming growth factor??1 in the obstructed kidneys were augmented following UUO. By contrast, the mRNA expression of ??smooth muscle actin decreased in the ROCK2 HKO mice, compared with that in the WT mice. The activity of ROCK in the obstructed kidneys, indicated by the phosphorylation of myosin phosphatase target subunit?1, which is a non?selective substrate of ROCK1 and ROCK2, was equivalent among the ROCK2 HKO and WT mice. In conclusion, no differences in renal interstitial fibrosis or UUO?induced ROCK activity were identified between the ROCK2 HKO and WT mice, indicating that the genetic partial disruption of ROCK2 is insufficient for protecting against renal fibrosis. PMID:26572751

  20. Keep Your Kidneys Healthy: Catch Kidney Disease Early

    MedlinePLUS

    ... please review our exit disclaimer . Subscribe Keep Your Kidneys Healthy Catch Kidney Disease Early Your kidneys aren’t very big—each is about the ... other substances inside your body. Unfortunately, if your kidneys start to malfunction, you might not realize it ...

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  2. Isolated, unilateral, reversible palsy of the hypoglossal nerve.

    PubMed

    Giuffrida, S; Lo Bartolo, M L; Nicoletti, A; Reggio, E; Lo Fermo, S; Restivo, D A; Domina, E; Reggio, A

    2000-05-01

    We report three patients with isolated unilateral hypoglossal nerve palsy who experienced an excellent outcome. In two patients no cause was found. Our study seems to confirm that the occurrence of benign and idiopathic isolated unilateral palsy of the hypoglossal nerve is more frequent than previously reported. We would like to stress that neuroimaging studies remain mandatory in order to exclude other common causes, such as tumour and spontaneous or traumatic vascular lesions, in which a specific treatment is necessary. PMID:10886321

  3. Prolonged adrenal insufficiency after unilateral adrenalectomy for Cushing's Syndrome.

    PubMed

    Kulshreshtha, Bindu; Arora, Arpita; Aggarwal, Anshita; Bhardwaj, Minakshi

    2015-01-01

    The contralateral healthy adrenal in patients undergoing unilateral adrenalectomy for Cushing's is known to be suppressed temporarily and forms the basis of peri and postoperative steroids. We present four cases of Cushing's who had prolonged adrenal insufficiency with continued requirement for steroids for periods ranging 1-4 years after unilateral adrenalectomy for Cushing's. We further review literature regarding the recovery of the hypothalamo pituitary adrenal axis postsurgery in patients with Cushing's syndrome. PMID:25932404

  4. Neurobrucellosis developing unilateral oculomotor nerve paralysis.

    PubMed

    I??kay, Sedat; Y?lmaz, Kutluhan; Ölmez, Akgün

    2012-11-01

    Brucellosis is a zoonotic infectious disease that is common around the world. Its clinical course demonstrates great diversity as it can affect all organs and systems. However, the central nervous system is rarely affected in the pediatric population. Neurobrucellosis is most frequently observed with meningitis and has numerous complications, including meningocephalitis, myelitis, cranial nerve paralyses, radiculopathy, and neuropathy. Neurobrucellosis affects the second, third, sixth, seventh, and eighth cranial nerves. Involvement of the oculomotor nerves is a very rare complication in neurobrucellosis although several adult cases have been reported. In this article, we present the case of a 9-year-old girl who developed unilateral nerve paralysis as a secondary complication of neurobrucellosis and recovered without sequel after treatment. This case is notable because it is a very rare, the first within the pediatric population. Our article emphasizes that neurobrucellosis should be considered among the distinguishing diagnoses in every case that is admitted for nerve paralysis in regions where Brucella infection is endemic. PMID:22244219

  5. Trigeminal neuralgia: unilateral episodic facial pain.

    PubMed

    Zakrzewska, Joanna M

    2015-06-01

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

  6. Influence of unilateral weight on bilateral cyclograms

    NASA Astrophysics Data System (ADS)

    Pellicer Costa, Juan José; Dusza, Jacek J.

    2014-11-01

    The paper presents the results of gait parameters as a function of unilateral weight. The object of the research was a woman walking on a stationary surface and carrying in his hand weights from 0 to 15 kg. Her movement was recorded by 6 cameras recording the location of 34 markers placed at appropriate points in the body. 3D reconstruction was performed for each of the reflecting markers. Tested signals were changes in the value the joint angles of ankle, knee and hip. On the basis of about 6 cycles of movement of each load, a model for the average gait cycle was developed. The result of the experiments are graphs of changes the joint angles as a function of time, bilateral cyclograms, synchronized bilateral cyclograms and regression lines. The conclusion of the study is to determine how one-sided load affects gait asymmetry. Simple and easy to interpret method of presentation of results were also shown. Studies were conducted using VICON system.

  7. Zinc-?2-Glycoprotein Exerts Antifibrotic Effects in Kidney and Heart.

    PubMed

    Sörensen-Zender, Inga; Bhayana, Sagar; Susnik, Nathan; Rolli, Veronique; Batkai, Sandor; Baisantry, Arpita; Bahram, Siamak; Sen, Payel; Teng, Beina; Lindner, Robert; Schiffer, Mario; Thum, Thomas; Melk, Anette; Haller, Hermann; Schmitt, Roland

    2015-11-01

    Zinc-?2-glycoprotein (AZGP1) is a secreted protein synthesized by epithelial cells and adipocytes that has roles in lipid metabolism, cell cycling, and cancer progression. Our previous findings in AKI indicated a new role for AZGP1 in the regulation of fibrosis, which is a unifying feature of CKD. Using two models of chronic kidney injury, we now show that mice with genetic AZGP1 deletion develop significantly more kidney fibrosis. This destructive phenotype was rescued by injection of recombinant AZGP1. Exposure of AZGP1-deficient mice to cardiac stress by thoracic aortic constriction revealed that antifibrotic effects were not restricted to the kidney but were cardioprotective. In vitro, recombinant AZGP1 inhibited kidney epithelial dedifferentiation and antagonized fibroblast activation by negatively regulating TGF-? signaling. Patient sera with high levels of AZGP1 similarly attenuated TGF-? signaling in fibroblasts. Taken together, these findings indicate a novel role for AZGP1 as a negative regulator of fibrosis progression, suggesting that recombinant AZGP1 may have translational effect for treating fibrotic disease. PMID:25788525

  8. Translational profiles of medullary myofibroblasts during kidney fibrosis.

    PubMed

    Grgic, Ivica; Krautzberger, A Michaela; Hofmeister, Andreas; Lalli, Matthew; DiRocco, Derek P; Fleig, Susanne V; Liu, Jing; Duffield, Jeremy S; McMahon, Andrew P; Aronow, Bruce; Humphreys, Benjamin D

    2014-09-01

    Myofibroblasts secrete matrix during chronic injury, and their ablation ameliorates fibrosis. Development of new biomarkers and therapies for CKD will be aided by a detailed analysis of myofibroblast gene expression during the early stages of fibrosis. However, dissociating myofibroblasts from fibrotic kidney is challenging. We therefore adapted translational ribosome affinity purification (TRAP) to isolate and profile mRNA from myofibroblasts and their precursors during kidney fibrosis. We generated and characterized a transgenic mouse expressing an enhanced green fluorescent protein (eGFP)-tagged L10a ribosomal subunit protein under control of the collagen1?1 promoter. We developed a one-step procedure for isolation of polysomal RNA from collagen1?1-eGFPL10a mice subject to unilateral ureteral obstruction and analyzed and validated the resulting transcriptional profiles. Pathway analysis revealed strong gene signatures for cell proliferation, migration, and shape change. Numerous novel genes and candidate biomarkers were upregulated during fibrosis, specifically in myofibroblasts, and we validated these results by quantitative PCR, in situ, and Western blot analysis. This study provides a comprehensive analysis of early myofibroblast gene expression during kidney fibrosis and introduces a new technique for cell-specific polysomal mRNA isolation in kidney injury models that is suited for RNA-sequencing technologies. PMID:24652793

  9. Unusual drainage of the main kidney on accessory kidney

    PubMed Central

    Erdem, Gülnur; U?ra?, Murat; Demiröz, Sevgi

    2014-01-01

    Patients with an accessory kidney are characterized by an excessive number of kidneys. The ureter of the accessory kidney either drains separately into the bladder or merges with the ureter of the main kidney. In our case, interestingly, the ureter of the left main kidney drained directly into the accessory kidney and the ureter of the latter was the common drainage route for both. The drainage of a normal kidney via the ureter of an accessory kidney has not been reported in the literature, so far. The aim of this report is to present the case with radiological findings and to emphasize the effects of this situation on planned surgical procedures. A 62-year-old female patient had an interesting abnormality on the left collecting system, which was revealed on excretory urography (EU), retrograde urography (RU) and multidetector computed tomography (MDCT). A kinky left ureter, which formed a U shape, was revealed on EU. On MDCT, an accessory kidney was revealed at the anterior aspect of the middle zone of left main kidney. The ureter of the main left kidney drained directly into the accessory kidney. The course of this drainage was confirmed by retrograde urography. An accessory kidney is a rare entity associated with horseshoe kidney, ectopic ureter draining into the vagina, bifid collecting system and coarctation of the aorta. In our case, an unusual association between the ureters of the main and accessory kidneys was revealed, which may have an impact on planned surgery in the groin and retroperitoneal areas. PMID:26328163

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

    PubMed Central

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

    2015-01-01

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

  11. Monitoring Your Kidney Health

    MedlinePLUS

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. ??September 17, 2014?? Contact Us Health Information Center Phone: 1-800-860- ...

  12. Medicines and Kidney Disease

    MedlinePLUS

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. ??September 17, 2014 Contact Us Health Information Center Phone: 1-800-860- ...

  13. Chronic Kidney Disease

    MedlinePLUS

    ... can also change the way your body uses minerals such as calcium and phosphorus that are used ... certain foods to help your body use these minerals better. If you have chronic kidney disease, you ...

  14. Kidneys and Urinary Tract

    MedlinePLUS

    ... through pores (tiny holes) in the skin. Water vapor and carbon dioxide are exhaled (breathed out) from ... receive enough water, the kidneys also regulate blood pressure and the level of vital salts in the ...

  15. Kidney Disease and Diabetes

    MedlinePLUS

    ... Blood Pressure Tools & Resources Stroke More Kidney Disease & Diabetes Updated:Nov 10,2015 One of the more ... disease. This content was last reviewed August 2015. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  16. Diabetes and Kidney Disease

    MedlinePLUS

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

  17. Kidney Replacement Therapy

    MedlinePLUS

    ... week, and lasts 3 to 5 hours each time. Blood travels through the artificial kidney, where waste products are ... eat a more normal diet and have more time for work and travel. Peritoneal dialysis is not for everyone, however. A ...

  18. Kidney Cancer in Children

    MedlinePLUS

    ... tumor fall into three categories: anaplasia, clear cell sarcoma and rhabdoid tumor of the kidney. Of the three, only clear cell sarcoma has been responsive to chemotherapy. Renal cell carcinoma ...

  19. Acquired Cystic Kidney Disease

    MedlinePLUS

    ... just below the rib cage. The kid neys filter wastes and extra fluid from the blood to ... treatments called dialysis. Kidney What causes ACKD? Dialysis filters out many, but not all, of the wastes ...

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

    SciTech Connect

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

    2009-07-15

    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.

  1. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P. W.

    1985-01-01

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

  2. Diagnosis and Management of Thoracic Aortic Disease.

    PubMed

    Dudzinski, David M; Isselbacher, Eric M

    2015-12-01

    Thoracic aortic aneurysms are typically asymptomatic and discovered incidentally on an imaging study ordered for other indications. Small aneurysms are managed with antihypertensive therapy and surveillance imaging, using either echocardiography, computed tomographic angiography (CTA), or magnetic resonance angiography (MRA). Aneurysms are repaired when the risk of rupture or dissection exceeds the risk of repair; size thresholds for repair are determined by the underlying etiology of the aneurysm, with lower thresholds for those with genetic aortopathies. In contrast to the silent and asymptomatic nature of aneurysms, acute aortic syndromes-which include aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer-are usually associated with recognizable symptoms and signs. Acute aortic syndromes involving the ascending aorta are treated with emergent surgery, whereas those involving the descending aorta are now often treated with endovascular stent-grafting techniques. After acute aortic syndromes have been successfully treated, prognosis is favorable with close follow-up that includes optimal medical management and regular surveillance imaging. PMID:26468124

  3. Endovascular treatment of thoracic aortic fistulas.

    PubMed

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

    2002-07-01

    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

  4. [Fractures of the thoracic and lumbar spine].

    PubMed

    Gonschorek, O; Hauck, S; Weiß, T; Bühren, V

    2015-09-01

    Fractures of the thoracic and lumbar spine result from high velocity trauma, assuming bone density is normal. The main location of fractures is the thoracolumbar junction. Most injuries can be treated conservatively; however, patients transferred to hospitals and spine centers represent a preselection with more severe trauma and a higher incidence of operative treatment. There is a large variety of operative techniques that can be used, which can be principally differentiated by the approach: posterior or anterior. Dorsal approaches are differentiated by the instrumentation for spondylodesis as open or percutaneous techniques. Minimally invasive options are favored more and more. For osteoporotic bone, cement augmented solutions may be used. Correct reduction of mainly kyphotic malalignment is crucial for the long-term outcome. Biomechanically stable reconstruction of the anterior spinal column is important mainly for the thoracolumbar junction. PMID:26307631

  5. Thoracic Bone Tumors Every Radiologist Should Know.

    PubMed

    Jokerst, Clint; McFarland, William; Swanson, Jonathan; Mohammed, Tan-Lucien H

    2016-01-01

    The thoracic cage provides the structural support that makes respiration possible, provides protection to vital organs such as the lungs, heart, liver, and spleen, and serves as an anchor point for the upper extremities. Neoplasms of the bony thorax are not an uncommon incidental finding at both radiography and cross-sectional imaging. Some tumors have a characteristic appearance and it is important that an accurate differential diagnosis be provided. Misidentification could lead to unnecessary imaging or procedures with associated cost, morbidity, and mortality. The purpose of this article is to serve as a quick review of bone tumors commonly encountered in the thorax and that every radiologist should know. Please note that there are also several non-neoplastic osseous lesions that may mimic bone tumors such as osteomyelitis and eosinophilic granuloma; however, these entities are beyond the scope of this review and would not be discussed. PMID:26254813

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

    PubMed Central

    2013-01-01

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

  7. Robotic thoracic surgery: The state of the art

    PubMed Central

    Kumar, Arvind; Asaf, Belal Bin

    2015-01-01

    Minimally invasive thoracic surgery has come a long way. It has rapidly progressed to complex procedures such as lobectomy, pneumonectomy, esophagectomy, and resection of mediastinal tumors. Video-assisted thoracic surgery (VATS) offered perceptible benefits over thoracotomy in terms of less postoperative pain and narcotic utilization, shorter ICU and hospital stay, decreased incidence of postoperative complications combined with quicker return to work, and better cosmesis. However, despite its obvious advantages, the General Thoracic Surgical Community has been relatively slow in adapting VATS more widely. The introduction of da Vinci surgical system has helped overcome certain inherent limitations of VATS such as two-dimensional (2D) vision and counter intuitive movement using long rigid instruments allowing thoracic surgeons to perform a plethora of minimally invasive thoracic procedures more efficiently. Although the cumulative experience worldwide is still limited and evolving, Robotic Thoracic Surgery is an evolution over VATS. There is however a lot of concern among established high-volume VATS centers regarding the superiority of the robotic technique. We have over 7 years experience and believe that any new technology designed to make minimal invasive surgery easier and more comfortable for the surgeon is most likely to have better and safer outcomes in the long run. Our only concern is its cost effectiveness and we believe that if the cost factor is removed more and more surgeons will use the technology and it will increase the spectrum and the reach of minimally invasive thoracic surgery. This article reviews worldwide experience with robotic thoracic surgery and addresses the potential benefits and limitations of using the robotic platform for the performance of thoracic surgical procedures. PMID:25598601

  8. Robotic thoracic surgery: The state of the art.

    PubMed

    Kumar, Arvind; Asaf, Belal Bin

    2015-01-01

    Minimally invasive thoracic surgery has come a long way. It has rapidly progressed to complex procedures such as lobectomy, pneumonectomy, esophagectomy, and resection of mediastinal tumors. Video-assisted thoracic surgery (VATS) offered perceptible benefits over thoracotomy in terms of less postoperative pain and narcotic utilization, shorter ICU and hospital stay, decreased incidence of postoperative complications combined with quicker return to work, and better cosmesis. However, despite its obvious advantages, the General Thoracic Surgical Community has been relatively slow in adapting VATS more widely. The introduction of da Vinci surgical system has helped overcome certain inherent limitations of VATS such as two-dimensional (2D) vision and counter intuitive movement using long rigid instruments allowing thoracic surgeons to perform a plethora of minimally invasive thoracic procedures more efficiently. Although the cumulative experience worldwide is still limited and evolving, Robotic Thoracic Surgery is an evolution over VATS. There is however a lot of concern among established high-volume VATS centers regarding the superiority of the robotic technique. We have over 7 years experience and believe that any new technology designed to make minimal invasive surgery easier and more comfortable for the surgeon is most likely to have better and safer outcomes in the long run. Our only concern is its cost effectiveness and we believe that if the cost factor is removed more and more surgeons will use the technology and it will increase the spectrum and the reach of minimally invasive thoracic surgery. This article reviews worldwide experience with robotic thoracic surgery and addresses the potential benefits and limitations of using the robotic platform for the performance of thoracic surgical procedures. PMID:25598601

  9. Vacancy for a PhD Student Departments of Biostatistics & Cardio-Thoracic Surgery

    E-print Network

    Davis, Jesse

    Vacancy for a PhD Student Departments of Biostatistics & Cardio-Thoracic Surgery The Position The Department of Biostatistics and the Department of Cardio-Thoracic Surgery of the Erasmus Medical Center.). The Department of Cardio-Thoracic Surgery provides cardiac and thoracic surgical services to more than 1500

  10. Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs.

    PubMed

    Osarogiagbon, Raymond U; Freeman, Richard K; Krasna, Mark J

    2015-08-01

    Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed. PMID:26380186

  11. Chimeric Anterolateral Thigh Flap for Total Thoracic Esophageal Reconstruction.

    PubMed

    Ruiz-Moya, Alejandro; Segura-Sampedro, Juan J; Sicilia-Castro, Domingo; Carvajo-Pérez, Francisco; Gómez-Cía, Tomás; Vázquez-Medina, Antonio; Ibáñez-Delgado, Francisco

    2016-01-01

    Gastric pull-up is generally the first choice for a total thoracic esophageal reconstruction. Malfunction of this gastric conduit is uncommon, but devastating when it occurs: it causes marked comorbidity to the patient, preventing oral intake and worsening quality of life. Secondary salvage thoracic esophageal reconstruction surgery is usually performed with free or pedicled jejunum flaps or colon interposition. We present a case of a total thoracic esophageal reconstruction with an externally monitored chimeric anterolateral thigh flap, extending from the cervical esophagus to the retrosternal gastroplasty remnant. Intestinal reconstructive techniques were not an available option for this patient. PMID:26694271

  12. Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs

    PubMed Central

    Freeman, Richard K.; Krasna, Mark J.

    2015-01-01

    Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed. PMID:26380186

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

    PubMed Central

    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

    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. PMID:24743144

  14. Initial experience in the treatment of thoracic aortic aneurysmal disease with a thoracic aortic endograft at Baylor University Medical Center

    PubMed Central

    Apple, Jeffrey; McQuade, Karen L.; Hamman, Baron L.; Hebeler, Robert F.; Shutze, William P.

    2008-01-01

    A retrospective review of 27 patients who underwent endovascular repair of thoracic aneurysms and of other thoracic aortic pathology with the thoracic aortic endograft (Gore Medical, Flagstaff, AZ) from June 2005 to July 2007 was performed. The mean follow-up period was 13.5 months (range, 2–25 months). Indications for thoracic endografting included descending thoracic aneurysms (n = 18), thoracoabdominal aneurysms (n = 3), traumatic aortic injuries (n = 3), penetrating aortic ulcers (n = 2), and contained rupture of a type B dissection (n = 1). One patient died during the procedure, for an overall mortality rate of 3.7%. The average length of stay was 8.1 days, with an average stay in the intensive care unit of 4.2 days. If patients with traumatic aortic injuries were excluded, the average overall and intensive care unit length of stay were 5.6 and 1.8 days, respectively. There was one incident of spinal cord ischemia (3.7%). There were five type I or type III endoleaks, three of which required revision (11.1%). In conclusion, thoracic endografting is a safe and viable option for the repair of descending thoracic aneurysms and other aortic pathologies. We have found it to be less invasive, even in conjunction with preoperative debranching procedures, with a shorter recovery time, decreased perioperative morbidity and blood loss, and decreased peri-operative mortality compared with standard open repair. PMID:18382748

  15. Faster imaging with a portable unilateral NMR device.

    PubMed

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

    2013-06-01

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

  16. Faster imaging with a portable unilateral NMR device

    NASA Astrophysics Data System (ADS)

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

    2013-06-01

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

  17. Segmental thoracic lipomatosis of nerve with nerve territory overgrowth.

    PubMed

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

    2014-05-01

    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

  18. Minimally invasive thoracic surgery: new trends in Italy

    PubMed Central

    2015-01-01

    In Italy there exists quite a long and rich history in minimally invasive thoracic surgery. Pioneer Italian surgeons have been amongst those who first adopted video-assisted thoracic surgery (VATS) to perform procedures such as lobectomy and esophagectomy, respectively and quite many others have provided important contributions related to minimally invasive thoracic surgery and have proposed innovative ideas and creative technical refinements. According to a web search on recent studies published in Italy on minimally invasive thoracic surgery along the last 3 years, uniportal, nonintubated, and robotic VATS as well as VATS lobectomy have been found to represent the most frequently investigated issues. An ongoing active investigation in each of these sub-topics is contributing to a better definition of indications advantages and disadvantages of the various surgical strategies. In addition it is likely that combination strategies including adoption of uniportal and nonintubated approaches will lead to define novel ultra-minimally invasive treatment options. PMID:26605315

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

    PubMed Central

    2014-01-01

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

  20. Thoracic and respirable particle definitions for human health risk assessment

    EPA Science Inventory

    Provides estimates of the thoracic and respirable fractions, for adults and children during typical activities during both nasal and oral inhalation, that may be used in the design of experimental studies and interpretation of evidence of health effects.

  1. The relative contribution of urine extravasation to elevate plasma creatinine levels in acute unilateral ureteral obstruction

    PubMed Central

    Rosenzweig, Barak; Pinthus, Jehonathan H.; Kleinmann, Nir; Joffe, Erel; Erlich, Tomer; Fridman, Eddie; Winkler, Harry; Mor, Yoram; Ramon, Jacob; Dotan, Zohar A.

    2015-01-01

    Introduction: Rising levels of plasma creatinine in the setting of acute unilateral ureteral obstruction (AUUO) often reflects acute renal failure, mandating kidney drainage. We hypothesize that re-absorption of peri-renal urine extravasation (PUE), a common result of UUO, contributes significantly to the elevation in plasma creatinine, rendering the latter an inaccurate benchmark for renal function. We explored this hypothesis in a rat model of AUUO and PUE. Methods: In total, 20 rats were equally divided into 4 groups. Groups 1 and 2 underwent unilateral ligation of the ureter with infiltration of rat’s urine (index group) or saline (control) into the peri-renal space. Two additional control groups underwent peri-renal injection of either urine or saline without AUUO. Plasma creatinine levels were determined immediately prior to the procedure (T0), and hourly for 3 hours (T1, T2 and T3). Renal histology was investigated after 3 hours. Results: Rats in the index group had a significantly greater increase in plasma creatinine levels over 3 hours compared to all other groups (p < 0.05). At T3, average plasma creatinine levels for the index group increased by 96% (0.49 ± 0.18 mg/dL) compared to 46% (0.23 ± 0.06 mg/dL increase) in the AUUO and saline group, and less than 15% rise in both the non-obstructed control groups. Our study limitations includes lack of spontaneous PUE and intraperitoneal surgical approach. Conclusions: Absorption of peri-renal urine in the presence of AUUO is a significant contributor to rising plasma creatinine levels, beyond those attributable to the obstruction alone, and may overestimate the extent of the true renal functional impairment. PMID:26279711

  2. Horseshoe kidney transplantation

    PubMed Central

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

    2015-01-01

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

  3. Kidney Sundays: A Toolkit A Guide for Faith-Based Communities on Making the Kidney Connection

    E-print Network

    Levin, Judith G.

    Kidney Sundays: A Toolkit A Guide for Faith-Based Communities on Making the Kidney Connection National Kidney Disease Education Program National Kidney Disease Education Program Enter #12;Kidney Sundays: The Contents NATIONAL KIDNEY DISEASE EDUCATION PROGRAM l KIDNEY SUNDAYS: A TOOLKIT 2 of 24 Kidney

  4. The Unilateral Below Elbow Test: a function test for children with unilateral congenital below elbow deficiency.

    PubMed

    Bagley, Anita M; Molitor, Fred; Wagner, Lisa V; Tomhave, Wendy; James, Michelle A

    2006-07-01

    The Unilateral Below Elbow Test (UBET) was developed to evaluate function in bimanual activities for both the prosthesis wearer and non-wearer. Nine tasks were chosen for each of four age-specific categories defined by development stages of hand function (2-4y, 5-7y, 8-10y, and 11-21y). Two scales, Completion of Task and Method of Use, were designed to rate performance. To measure reliability, four occupational therapists scored samples of videotaped UBET performances. For Completion of Task, an interval scale, agreement in scoring was measured with interclass correlation coefficients (ICC; n=9; five females, four males). For Method of Use, a nominal scale, chance-adjusted association was calculated with Cohen's kappa coefficients (interobserver n=198; 111 females, 87 males; intraobserver n=93; 56 females, 37 males). For Completion of Task, the average ICC was 0.87 for the prosthesis-on condition, and 0.85 for the prosthesis-off condition. ICCs exceeded 0.80 for eight out of nine tasks for the two older age groups, but for only five out of nine tasks in the younger age groups. Higher inter- and intraobserver kappa coefficients for Method of Use resulted when scoring children with their prostheses on versus off. The oldest age group had lower kappa values than the other three groups. The UBET is recommended for the functional evaluation of Completion of Task in children with unilateral congenital below elbow deficiency with and without their prostheses. Method of Use scoring can evaluate individuals for directed therapy interventions or prosthetic training. PMID:16780626

  5. [Risk factors of suppurative complications in case of thoracic injury].

    PubMed

    Danielian, Sh N; Abakumov, M M; Vil'k, A P; Saprin, A A; Tatarinova, E V

    2015-01-01

    It was performed retrospective analysis of 463 cases of suppurative thoracic complications after injury (232) and closed thoracic trauma (231) for 20-year period. Incidence of purulent complications was 3.2% and 1.6% in case of injury and closed thoracic trauma respectively including pleural empyema in 1.5 and 1.3%, pulmonary abscess in 0.3 and 0.4%, mediastinitis in 0.35 and 0.12%, pericarditis in 1.5 and 0.26%, osteomyelitis in 0.4 and 0.18% respectively. Factors preceding suppurative complications in case of injuries and closed trauma have been considered as predictors. Multivariant regression analysis established significant risk factors of suppurative thoracic complications. Clotted hemothorax, mediastinal hemorrhage, heart injury, late appeal for medical assistance and mechanical ventilation over 5 days were identified irrespective of character of trauma. In case of thoracic injury there were damage of osteochondrous frame, hollow thoracic and abdominal organs, gunshot wound of lung, delirium and injuries severity over 20 scores according to ISS scale. Pulmonary bleeding, sternal fracture and Glasgow Coma Scale rate<12 scores were identified as risk factors in case of closed trauma. PMID:26271559

  6. Minimally invasive unilateral arytenoid lateralization in dogs: A cadaveric study.

    PubMed

    Shipov, A; Israeli, I; Weiser, M; Kelmer, E; Klainbart, S; Milgram, J

    2015-10-01

    The aim of this study was to develop a minimally invasive thyroarytenoid lateralization technique (MITAL). Eleven unilateral MITAL procedures were performed on 11 canine cadavers. Two hypodermic needles were passed through the skin into the lumen of the larynx, penetrating the thyroid and arytenoid cartilages. Suture material was passed through the needles to lateralize the arytenoid cartilage. A rigid endoscope was used to visualize needle insertion and suture material placement. A key-hole approach to the larynx was performed and the suture material was knotted on the lateral aspect of the thyroid cartilage. The change in the rima glottidis area was recorded as were the duration of the procedure and complications encountered. The landmarks for needle insertion were easily palpated, and a significant increase in the area of the rima glottidis was documented after performing unilateral MITAL. In conclusion, unilateral MITAL is a quick, minimally invasive procedure which increases the area of the rima glottidis in cadaveric dogs. PMID:26412529

  7. Brain–kidney crosstalk

    PubMed Central

    2014-01-01

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

  8. Unilateral Breast Reconstruction Using Bilateral Inferior Gluteal Artery Perforator Flaps

    PubMed Central

    Muto, Mayu; Ogawa, Marina; Shibuya, Mai; Yasumura, Kazunori; Kobayashi, Shinji; Ishikawa, Takashi; Maegawa, Jiro

    2015-01-01

    Background: For reconstructing moderate-to-high projection breasts in nulliparous patients with insufficient abdominal tissue or prior abdominal surgeries, a unilateral inferior gluteal artery perforator (IGAP) flap is an alternative procedure. In patients with slim hips, however, unilateral gluteal tissue is insufficient and inferior gluteal crease displacement may develop postoperatively. Donor-site asymmetry is also a major disadvantage. In these circumstances, bilateral IGAP flaps provide sufficient tissue without significant gluteal deformity. Methods: We retrospectively reviewed 20 patients who underwent unilateral breast reconstruction using bilateral IGAP flaps by a single surgeon between November 2007 and December 2012. A quantitative outcome assessment was performed and compared with that of 22 unilateral IGAP flap patients operated on by the same surgeon. Results: Twenty patients underwent reconstruction with 40 IGAP flaps. Of the 40 flaps, 39 survived and 1 developed total necrosis due to repeated venous thrombosis. In 15 of 20 patients, the size of reconstructed breast was comparable to that of the contralateral breast. Final inset flap weight was 462.3 g for bilateral flaps and 244.3 g for unilateral flaps. Total operating time was 671.1 minutes (bilateral flaps) and 486.8 minutes (unilateral flaps). Conclusions: Use of bilateral IGAP flaps for breast reconstruction helps to avoid asymmetry of the inferior buttock volume and shape. Bilateral flaps provide sufficient tissue volume and allow for reconstruction of a breast comparable to the unaffected side. In patients with moderate-to-high projection breast whose abdominal tissue cannot be used for reconstruction, IGAP flaps may be a suitable alternative. PMID:25878925

  9. [Metastatic thoracic lymph node carcinoma from extra-thoracic malignancy or from unknown primary site].

    PubMed

    Bagan, P; Mordant, P; Pricopi, C; Le Pimpec Barthes, F; Riquet, M

    2013-12-01

    Malignant mediastinal lymph nodes without pulmonary disease may be lymphomatous or the metastases from thoracic or extrathoracic malignancy. More rarely, metastatic lymph nodes are without primary site. Surgery is generally diagnostic, restricted to confirming the metastatic process, because of too numerous and disseminated or unresectable lymph nodes. Radical surgery consisting in lymphadenectomy can be effective in case of mediastinal lymph node malignancy without other extra- and intrathoracic disease. We observed in our experience and in several case reports long-term good results in such cases. We suggest that including surgery in the multimodality treatment of mediastinal metastatic lymph nodes may be advisable in selected patients. PMID:24210159

  10. Immunosuppression in kidney transplantation

    PubMed Central

    MUNTEAN, ADRIANA; LUCAN, MIHAI

    2013-01-01

    For most patients with chronic kidney failure, kidney transplantation has the greatest potential for restoring a healthy and productive life. The risk of acute rejection is the highest in the first months after transplantation (induction phase) and diminishes afterwards (maintenance phase). Immunosuppression should be at the highest level in the early period and reduced for long-term therapy. At present, conventional immunosuppressive protocols consist of the triple therapy: a calcineurin inhibitor, an adjunctive agent, corticosteroids. The development of new immunosuppressives drugs is aimed not only at improving short-term outcomes, but also achieving better safety, less nephrotoxicity and minimal side effects. PMID:26527942

  11. Cold shivering activity after unilateral destruction of the vestibular apparatus

    NASA Technical Reports Server (NTRS)

    Kuzmina, G. I.

    1980-01-01

    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.

  12. Unilateral Crystalline Vitreoretinopathy: A Rare Entity Associated with Intraocular Inflammation

    PubMed Central

    Harshey, Kaustubh B.; Srinivasan, Karthik; Rengappa, Ramakrishnan; Ramasamy, Kim

    2015-01-01

    A 31-year-old Indian male presented with floaters and diminution of vision in the right eye. Ocular examination showed features of old anterior uveitis with posterior subcapsular cataract and fine, refractile crystals in the vitreous cavity and on the retinal surface. A thorough workup for all known causes of crystalline retinopathy was inconclusive. Unilateral crystalline retinopathy has been sparingly reported. This is the first report of unilateral, crystalline vitreoretinopathy in the absence of any demonstrable and known cause for intraocular crystals. PMID:26688764

  13. Reduced Renal Methylarginine Metabolism Protects against Progressive Kidney Damage.

    PubMed

    Tomlinson, James A P; Caplin, Ben; Boruc, Olga; Bruce-Cobbold, Claire; Cutillas, Pedro; Dormann, Dirk; Faull, Peter; Grossman, Rebecca C; Khadayate, Sanjay; Mas, Valeria R; Nitsch, Dorothea D; Wang, Zhen; Norman, Jill T; Wilcox, Christopher S; Wheeler, David C; Leiper, James

    2015-12-01

    Nitric oxide (NO) production is diminished in many patients with cardiovascular and renal disease. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of NO synthesis, and elevated plasma levels of ADMA are associated with poor outcomes. Dimethylarginine dimethylaminohydrolase-1 (DDAH1) is a methylarginine-metabolizing enzyme that reduces ADMA levels. We reported previously that a DDAH1 gene variant associated with increased renal DDAH1 mRNA transcription and lower plasma ADMA levels, but counterintuitively, a steeper rate of renal function decline. Here, we test the hypothesis that reduced renal-specific ADMA metabolism protects against progressive renal damage. Renal DDAH1 is expressed predominately within the proximal tubule. A novel proximal tubule-specific Ddah1 knockout (Ddah1(PT-/-)) mouse demonstrated tubular cell accumulation of ADMA and lower NO concentrations, but unaltered plasma ADMA concentrations. Ddah1(PT-/-) mice were protected from reduced kidney tissue mass, collagen deposition, and profibrotic cytokine expression in two independent renal injury models: folate nephropathy and unilateral ureteric obstruction. Furthermore, a study of two independent kidney transplant cohorts revealed higher levels of human renal allograft methylarginine-metabolizing enzyme gene expression associated with steeper function decline. We also report an association among DDAH1 expression, NO activity, and uromodulin expression supported by data from both animal and human studies, raising the possibility that kidney DDAH1 expression exacerbates renal injury through uromodulin-related mechanisms. Together, these data demonstrate that reduced renal tubular ADMA metabolism protects against progressive kidney function decline. Thus, circulating ADMA may be an imprecise marker of renal methylarginine metabolism, and therapeutic ADMA reduction may even be deleterious to kidney function. PMID:25855779

  14. Endovascular Management of Thoracic Aortic Aneurysms

    SciTech Connect

    Fattori, Rossella Russo, Vincenzo; Lovato, Luigi; Buttazzi, Katia; Rinaldi, Giovanni

    2011-12-15

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

  15. [Magnetic resonance imaging in thoracic diseases].

    PubMed

    Norès, J M; Monsegu, M H; Bergal, S; Ameille, J; Rémy, J M; Lacrosnière, L

    1994-10-01

    Most all the thoracic structures are visible with magnetic resonance imaging: the mediastin, the myocardium including the endocardium and the pericardium, the pulmonary parenchyma and hile and the pleural walls. In cases of mediastrinal masses, T1 images clearly delimit their relations with neighbouring organs and vessels. The intensity of the signal is compared with that of the muscles on T1 weighted images of the preceding sections and T2 weighted images of fat. Images of aneurysms and chronic dissections can be synchronized with the ECG allowing three-dimensional measurement of the size and thickness of the vessel walls. Thrombi or extension to other vessels can also be recognized. Small hilar tumours can be differentiated from vessels but the scanner is better for analyzing systematization and bronchial lesions. For lung tissue itself, magnetic resonance imaging can detect nodules greater than one centimeter in diameter, but the low proton density and respiratory movements hinder spatial resolution. MRI is indicated for localizing tumours situated anteriorly or posteriorly or at the apex and to identify parietal extension of peripheral cancers. Spinal, vascular, pericardial, diaphragmatic and lymph node metastases can be recognized. MRI is the noninvasive method of choice for evaluating left ventricular masse, intra and paracardiac mass studies and for investigating congenital and acquired cardiomyopathies. Technical advances have made it possible to evaluate myocardial perfusion and heart function. PMID:7984543

  16. Working with Kidney Disease: Rehabilitation and Employment

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  17. Lupus and Kidney Disease (Lupus Nephritis)

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  18. Treatment Methods for Kidney Failure: Transplantation

    MedlinePLUS

    ... Life Options Rehabilitation Program National Kidney Foundation, Inc. Kidney and Urologic Disease Organizations Many organizations provide support ... 345 KB)????? Alternate Language URL Treatment Methods for Kidney Failure: Kidney Transplantation Page Content On this page: ...

  19. Travel Tips: A Guide for Kidney Patients

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  20. Kidney stones - what to ask your doctor

    MedlinePLUS

    A kidney stone is a solid piece of material that forms in your kidney. The kidney stone may be stuck in your ureter (the tube that carries urine from your kidneys to your bladder). It also may be stuck ...

  1. At Risk for Kidney Disease?

    MedlinePLUS

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. March 5, 2014? Contact Us Health Information Center Phone: 1-800-860- ...

  2. Kidney Stone Treatment with Lithotripsy

    MedlinePLUS Videos and Cool Tools

    Kidney Stone Treatment with Lithotripsy Broward Health Medical Center Fort Lauderdale, FL November 11, 2011 I'm ... got at least three stones in his left kidney. He's been having pain and blood in his ...

  3. Kidney Failure and Vascular Disease

    MedlinePLUS

    ... with renal failure can be treated with an artificial kidney machine (dialysis) which removes toxins from the blood. Patients requiring ongoing dialysis use the artificial kidney machine up to three times a week ...

  4. Kidney stones - self-care

    MedlinePLUS

    Renal calculi - self-care; Nephrolithiasis - self-care; Stones - kidney - self-care ... You visited your health care provider or the hospital because you have a kidney stone. You will need to take self-care steps. Which steps ...

  5. Renal (Kidney) Manifestations in TSC

    MedlinePLUS Videos and Cool Tools

    ... with cysts. If kidney failure occurs, renal replacement therapy such as dialysis or transplantation is necessary. How kidney cysts develop is not known. The TSC genes are tumor suppressor genes. Normally, tumor suppressor genes ...

  6. Chronic Kidney Disease and Medicines

    MedlinePLUS

    ... Alternate Language URL Español Chronic Kidney Disease and Medicines: What You Need to Know Page Content What ... pharmacist and provider need to know about your medicine and supplement use Your kidneys do not filter ...

  7. Flu Season and Your Kidneys

    MedlinePLUS

    ... Sign up for our FREE magazine, Kidney Living Organ Donation & Transplantation Be an Organ Donor Living Donation Donor ... Giving Primary menu Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate Search Search Header ...

  8. FastStats: Kidney Disease

    MedlinePLUS

    ... this? Submit What's this? Submit Button NCHS Home Kidney Disease Recommend on Facebook Tweet Share Compartir Data are ... the U.S. Morbidity Number of adults with diagnosed kidney disease: 3.9 million Percent of adults with diagnosed ...

  9. Inhibitory effects of fasudil on renal interstitial fibrosis induced by unilateral ureteral obstruction.

    PubMed

    Baba, Itsuko; Egi, Yasuhiro; Utsumi, Hiroyuki; Kakimoto, Tetsuhiro; Suzuki, Kazuo

    2015-12-01

    Renal fibrosis is the major cause of chronic kidney disease, and the Rho/Rho-associated coiled-coil kinase (ROCK) signaling cascade is involved in the renal fibrotic processes. Several studies have reported that ROCK inhibitors attenuate renal fibrosis. However, the mechanism of this process remains to be fully elucidated. The present study assessed the inhibitory effect of fasudil, a ROCK inhibitor using immunohistochemistry, reverse transcription-quantitative polymerase chain reaction and western blot analyses, in vivo and in vitro, to elucidate the mechanisms underlying renal interstitial fibrosis. In mice induced with unilateral ureteral obstruction (UUO), collagen accumulation, the expression of fibrosis?associated genes and the content of hydroxyproline in the kidney increased 3, 7, and 14 days following UUO. Fasudil attenuated the histological changes, and the production of collagen and extracellular matrix in the UUO kidney. The expression of ??smooth muscle actin (??SMA) and the transforming growth factor?? (TGF?)?Smad signaling pathway, and macrophage infiltration were suppressed by fasudil in the kidneys of the UUO mice. The present study also evaluated the role of intrinsic renal cells and infiltrated macrophages using NRK?52E, NRK?49F and RAW264.7 cells. The mRNA and protein expression levels of collagen I and ??SMA increased in the NRK?52E and NRK?49F cells stimulated by TGF??1. Hydroxyfasudil, a bioactive metabolite of fasudil, attenuated the increase in the mRNA and protein expression levles of ??SMA in the two cell types. However, the reduction in the mRNA expression of collagen I was observed in the NRK?49F cells only. Hydroxyfasudil decreased the mRNA expression of monocyte chemoattractant protein?1 (MCP?1) induced by TGF??1 in the NRK?52E cells, but not in the NRK?49F cells. In the RAW264.7 cells, the mRNA expression levels of MCP?1, interleukin (IL)?1?, IL?6 and tumor necrosis factor ? were increased significantly following lipopolysaccharide stimulation, and were not suppressed by hydroxyfasudil. These data suggested that the inhibition of ROCK activity by fasudil suppressed the transformation of renal intrinsic cells into the myofibroblast cells, and attenuated the infiltration of macrophages, without inhibiting the expression or the activation of cytokine/chemokines, in the progression of renal interstitial fibrosis. PMID:26498136

  10. 12 CFR 950.11 - Capital stock requirements; unilateral redemption of excess stock.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...2011-01-01 false Capital stock requirements; unilateral redemption...Associates § 950.11 Capital stock requirements; unilateral redemption of excess stock. (a) Capital stock requirement for advances....

  11. 12 CFR 950.11 - Capital stock requirements; unilateral redemption of excess stock.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...2010-01-01 false Capital stock requirements; unilateral redemption...Members § 950.11 Capital stock requirements; unilateral redemption of excess stock. (a) Capital stock requirement for advances....

  12. Zoster sine herpete with thoracic motor paralysis temporally associated with thoracic epidural steroid injection.

    PubMed

    Schuchmann, John A; McAllister, Russell K; Armstrong, Christopher S; Puana, Rudolph

    2008-10-01

    Reactivation of latent varicella-zoster virus can occur when the immune system is weakened leading to the typical presentation seen with herpes zoster or shingles. In a small percentage of these patients, motor paralysis can be seen in the affected myotomal distribution. Zoster sine herpete, or shingles without the typical vesicular rash, is an uncommon variant of zoster. Systemic steroids are known to weaken the immune response. Two previous case reports have implicated epidural steroid injections as a precipitating cause of zoster. We present a case of serologically verified zoster sine herpete producing an abdominal wall bulge, which occurred 1 wk after thoracic epidural steroid injection. Electromyography documented the presence of abdominal wall denervation. Given the low incidence of serologically proven zoster sine herpete--especially with thoracic motor paralysis--and the equally rarely documented incidence of zoster related to epidural steroids, we present what we believe to be the first reported case of zoster sine herpete with a neuropathic abdominal wall bulge occurring in close temporal association to receiving epidural steroids. PMID:18806512

  13. ORIGINAL ARTICLE Kidney Cancer Mortality

    E-print Network

    California at Berkeley, University of

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

  14. HIV and Kidney Disease

    MedlinePLUS

    ... the MDRD or Modification in Diet in Renal Disease equation. These provide a measure called glomerular filtration rate (GFR). Doctors use the GFR to get a better picture of what your creatine level really means. People without kidney disease have a GFR of about 100. As ...

  15. Chronic Kidney Disease (CKD)

    MedlinePLUS

    ... your blood. Your doctor will then use your creatinine test result to figure out your eGFR. An eGFR less than 60 for 3 months or more may be a sign of kidney disease. Urine Test This test tells your doctor if there ...

  16. Kidney Stones (For Parents)

    MedlinePLUS

    ... in urine (pee) become extra concentrated and form crystals. Over a few weeks or months, the crystals can build up and become stones. Kidney stones ... changes the level of a substance in it, crystals can begin to form. The crystals can become ...

  17. Black kidney in Albinism

    PubMed Central

    Ardalan, Mohammad-Reza

    2014-01-01

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

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

    SciTech Connect

    Andratschke, Nicolaus; Schnaitera, Andrea; Weber, Wolfgang A.; Caia, Lu; Schill, Sabine; Wiedenmann, Nicole; Schwaiger, Markus; Molls, Michael; Nieder, Carsten . E-mail: cnied@hotmail.com

    2006-04-01

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

  19. Investigation of pulsatile flowfield in healthy thoracic aorta models.

    PubMed

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

    2010-02-01

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

  20. Kidney Size Comparison of BEN Victims

    USGS Multimedia Gallery

    Normal size kidney (left) and a Balkan endemic nephropathy (BEN) kidney (right). The BEN kidney is reduced by one third compared to a normal kidney. The collapse of the kidney structure in the BEN kidney causes the organ to cease to function, resulting in uremia (blood poisoning) and requiring dialy...

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

    SciTech Connect

    Dewit, L.; Anninga, J.K.; Hoefnagel, C.A.; Nooijen, W.J. )

    1990-10-01

    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.

  2. The Shoulder Gradient in Patients with Unilateral Shoulder Impingement Syndrome

    PubMed Central

    Kim, Hee-Sang; Lee, Jong Ha; Yun, Dong Hwan; Yun, Jee-Sang; Shin, Yong Won; Chon, Jinmann

    2011-01-01

    Objective To investigate the relationship between the shoulder gradient and acromiohumeral interval of both shoulders in patients with unilateral shoulder impingement syndrome. Method Using the angulometer, we measured the shoulder gradient in patients with unilateral shoulder impingement syndrome in a standing position. Using the radiography, we measured the acromiohumeral interval and the angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapula. Results In patients with unilateral shoulder impingement syndrome, the frequency of shoulder impingement syndrome was 76.2% (16 of 21) on the side of the relatively lower shoulder. The mean acromiohumeral interval on the side of the lower shoulder was 10.03±1.28 mm, compared with 10.46±1.50 mm for the higher shoulder. The angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapular of the side of the lower shoulder was -0.31±3.73 degrees, compared with 3.85±4.42 degrees for the higher shoulder. Conclusion The frequency of shoulder impingement syndrome was significantly higher on the side of the relatively lower shoulder, and there is no significant difference in the acromiohumeral interval between the side of the lower shoulder and that of the higher shoulder. In patients with unilateral shoulder impingement syndrome, the scapular on the side of lower shoulder was more rotated downward than on the side of the higher shoulder. PMID:22506196

  3. Bimanual Force Coordination in Children with Spastic Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  4. Utilizing Unilateral and Multilateral Groups to Enhance Program Development.

    ERIC Educational Resources Information Center

    Charuhas, Mary S.

    1993-01-01

    Program administration can be enhanced through the use of unilateral groups (focus groups, task forces, advisory committees) and multilateral groups (coalitions, cooperatives, consortia, alliances, subcontractors, partnerships). Groups can help plan programs; share or train staff; share facilities, materials, and equipment; and reduce service…

  5. Unilateral maxillary molar distalization with zygoma-gear appliance.

    PubMed

    Kilkis, Dogan; Bayram, Mehmet; Celikoglu, Mevlut; Nur, Metin

    2012-08-01

    The aim of this study was to present the orthodontic treatment of a 15-year-old boy with a unilateral maxillary molar distalization system, called the zygoma-gear appliance. It consisted of a zygomatic anchorage miniplate, an inner bow, and a Sentalloy closed coil spring (GAC International, Bohemia, NY). A distalizing force of 350 g was used during the distalization period. The unilateral Class II malocclusion was corrected in 5 months with the zygoma-gear appliance. The maxillary left first molar showed distalization of 4 mm with an inclination of 3°. The maxillary premolars moved distally with the help of the transseptal fibers. In addition, there were slight decreases in overjet (-0.5 mm) and maxillary incisor inclination (-1°), indicating no anchorage loss from the zygoma-gear appliance. Preadjusted fixed appliances (0.022 × 0.028-in, MBT system; 3M Unitek, Monrovia, Calif) were placed in both arches to achieve leveling and alignment. After 14 months of unilateral distalization with the zygoma-gear appliance and fixed appliances, Class I molar and canine relationships were established with satisfactory interdigitation of the posterior teeth. Acceptable overjet and overbite were also achieved. This article shows that this new system, the zygoma-gear appliance, can be used for unilateral maxillary molar distalization without anchorage loss. PMID:22858341

  6. Modified titration intratympanic gentamicin injection for unilateral intractable Ménière's disease.

    PubMed

    Liu, Bo; Leng, Yang-Ming; Shi, Hong; Zhou, Ren-Hong; Liu, Jing-Jing; Zhang, Wen-Juan; Zhang, Su-Lin; Kong, Wei-Jia

    2015-10-01

    This study looked into the efficacy of a modified titration protocol of intratympanic gentamicin injection (ITG) in the patients with unilateral intractable Ménière's disease (MD). Modified titration protocol of ITG at a low dose (20 mg/mL) was administered to 10 patients with definite unilateral intractable MD. After initial first two fixed ITGs on weekly basis, the patients might or might not be given any more injections, depending on the appearance of unilateral vestibular loss (UVL). ITG was terminated if the patients satisfied the criteria of UVL. All patients were followed-up for at least two years. The effects of ITG on the vertigo attack, functional level scores and postural balance were evaluated. Of the 10 cases, 8 showed the sign of UVL after receiving initial two ITGs and were not given any more intratympanic injections, and the other 2 patients were administered three ITGs. A two-year follow-up revealed that complete and substantial vertigo control was achieved in 9 cases, and limited vertigo control in 1 patient. Hearing level was lowered in 2 patients. The posture stability and functional level scores were improved. Our study showed that the modified titration protocol of ITG at a low dose could effectively control vertigo in patients with unilateral intractable MD. PMID:26489633

  7. Selective Color Constancy Deficits after Circumscribed Unilateral Brain Lesions

    E-print Network

    Selective Color Constancy Deficits after Circumscribed Unilateral Brain Lesions Lukas Ru¨ ttiger,1, Germany The color of an object, when part of a complex scene, is determined not only by its spectral reflectance but also by the colors of all other objects in the scene (von Helmholtz, 1886; Ives, 1912; Land

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

    ERIC Educational Resources Information Center

    Kopun, Judy G.; And Others

    1992-01-01

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

  9. Traumatic glaucoma with features of unilateral pigment dispersion

    PubMed Central

    Bowler, Gordon; Ellul, Antony; Gouws, Pieter

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. Lefty1 alleviates renal tubulointerstitial injury in mice with unilateral ureteral obstruction.

    PubMed

    Xu, Changgeng; Xu, Mingwei; Wang, Wei; Zhang, Jie

    2016-01-01

    Lefty is a member of the transforming growth factor (TGF) ? superfamily, which is implicated in left?right patterning during embryogenesis. Previous studies revealed that lefty attenuates the epithelial?mesenchymal transition in tubular epithelial cells. In the present study, the protective effect of lefty1 on renal interstitial injury was further assessed. Mice with a unilateral ureteral obstruction (UUO) were sacrificed on days 3, 5 and 7 following surgery, and the association between the expression of lefty1 and the degree of interstitial fibrosis was investigated. Subsequently, mice with a UUO were administered recombinant lefty1 (300 µg/kg body weight) or vehicle (0.9% saline solution; 100 µl) through tail?vein injection every other day for 6 days. The effects of lefty1 were assessed by measuring the degree of tubulointerstitial fibrosis, tubular injury and atrophy, and also by monitoring the expression levels of ??smooth muscle actin (??SMA), TGF??1, phosphorylated (p)?Smad2/3, kidney injury molecular?1 and endogenous lefty1. The expression of lefty1 in the kidney decreased in a time?dependent manner in mice with a UUO, which was inversely correlated with the degree of renal interstitial fibrosis. Furthermore, compared with vehicle treatment, lefty1 attenuated renal interstitial fibrosis. Ureteral ligation induced increased expression levels of ??SMA, TGF??1 and p?Smad2/3. However, these effects were reduced following treatment with lefty1. The UUO also induced tubular injury and atrophy, whereas lefty1 treatment exerted a marked suppressive effect on tubular injury. In addition, exogenous lefty1 administered to mice restored the endogenous expression levels of lefty1. The present study demonstrated that lefty1 attenuated renal interstitial injury by inhibiting the Smad?dependent TGF??1 signaling pathway. Lefty1 may therefore by a putative therapeutic agent in the treatment of renal injury. PMID:26647776

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

    PubMed

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

    2005-05-01

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

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

    PubMed Central

    2014-01-01

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

  16. Effect of Treatment on Body Fluid in Patients with Unilateral Aldosterone Producing Adenoma: Adrenalectomy versus Spironolactone

    PubMed Central

    Wu, Che-Hsiung; Yang, Ya-Wen; Hung, Szu-Chun; Tsai, Yao-Chou; Hu, Ya-Hui; Lin, Yen-Hung; Chu, Tzong-Shinn; Wu, Kwan-Dun; Wu, Vin-Cent

    2015-01-01

    Aldosterone affects fluid retention in the body by affecting how much salt and water that the kidney retains or excretes. There is limited information about the effect of prolonged aldosterone excess and treatment on body fluid in primary aldosteronism (PA) patients. In this study, body composition changes of 41?PA patients with unilateral aldosterone producing adenoma (APA) were assessed by a bio-impedance spectroscopy device. Patients with APA receiving adrenalectomy, as compared with those treated with spironolactone, had significantly lower relative overhydration (OH) and urine albumin excretion, and significantly higher urine sodium excretion four weeks after treatment. These differences dissipated 12 weeks after the initial treatment. Independent factors to predict decreased relative OH four weeks after treatment were male patients and patients who experienced adrenalectomy. Patients who underwent adrenaelctomy had significantly decreased TNF-? and increased serum potassium level when compared to patients treated with spironolactone 4 and 12 weeks after treatment. In this pilot study, we found that adrenalectomy leads to an earlier increase in renal sodium excretion and decreases in body fluid content, TNF-?, and urine albumin excretion. Adrenalectomy yields a therapeutic effect more rapidly, which has been shown to ameliorate overhydration in PA patients. PMID:26477337

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

    SciTech Connect

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

    1987-02-01

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

  18. Urinary candidate biomarker discovery in a rat unilateral ureteral obstruction model.

    PubMed

    Yuan, Yuan; Zhang, Fanshuang; Wu, Jianqiang; Shao, Chen; Gao, Youhe

    2015-01-01

    Urine has the potential to become a better source of biomarkers. Urinary proteins are affected by many factors; therefore, differentiating between the variables associated with any particular pathophysiological condition in clinical samples is challenging. To circumvent these problems, simpler systems, such as animal models, should be used to establish a direct relationship between disease progression and urine changes. In this study, a unilateral ureteral obstruction (UUO) model was used to observe tubular injury and the eventual development of renal fibrosis, as well as to identify differential urinary proteins in this process. Urine samples were collected from the residuary ureter linked to the kidney at 1 and 3 weeks after UUO. Five hundred proteins were identified and quantified by LC-MS/MS, out of which 7 and 19 significantly changed in the UUO 1- and 3-week groups, respectively, compared with the sham-operation group. Validation by western blot showed increased levels of Alpha-actinin-1 and Moesin in the UUO 1-week group, indicating that they may serve as candidate biomarkers of renal tubular injury, and significantly increased levels of Vimentin, Annexin A1 and Clusterin in the UUO 3-week group, indicating that they may serve as candidate biomarkers of interstitial fibrosis. PMID:25791774

  19. Urinary candidate biomarker discovery in a rat unilateral ureteral obstruction model

    PubMed Central

    Yuan, Yuan; Zhang, Fanshuang; Wu, Jianqiang; Shao, Chen; Gao, Youhe

    2015-01-01

    Urine has the potential to become a better source of biomarkers. Urinary proteins are affected by many factors; therefore, differentiating between the variables associated with any particular pathophysiological condition in clinical samples is challenging. To circumvent these problems, simpler systems, such as animal models, should be used to establish a direct relationship between disease progression and urine changes. In this study, a unilateral ureteral obstruction (UUO) model was used to observe tubular injury and the eventual development of renal fibrosis, as well as to identify differential urinary proteins in this process. Urine samples were collected from the residuary ureter linked to the kidney at 1 and 3 weeks after UUO. Five hundred proteins were identified and quantified by LC-MS/MS, out of which 7 and 19 significantly changed in the UUO 1- and 3-week groups, respectively, compared with the sham-operation group. Validation by western blot showed increased levels of Alpha-actinin-1 and Moesin in the UUO 1-week group, indicating that they may serve as candidate biomarkers of renal tubular injury, and significantly increased levels of Vimentin, Annexin A1 and Clusterin in the UUO 3-week group, indicating that they may serve as candidate biomarkers of interstitial fibrosis. PMID:25791774

  20. Effect of Treatment on Body Fluid in Patients with Unilateral Aldosterone Producing Adenoma: Adrenalectomy versus Spironolactone.

    PubMed

    Wu, Che-Hsiung; Yang, Ya-Wen; Hung, Szu-Chun; Tsai, Yao-Chou; Hu, Ya-Hui; Lin, Yen-Hung; Chu, Tzong-Shinn; Wu, Kwan-Dun; Wu, Vin-Cent

    2015-01-01

    Aldosterone affects fluid retention in the body by affecting how much salt and water that the kidney retains or excretes. There is limited information about the effect of prolonged aldosterone excess and treatment on body fluid in primary aldosteronism (PA) patients. In this study, body composition changes of 41?PA patients with unilateral aldosterone producing adenoma (APA) were assessed by a bio-impedance spectroscopy device. Patients with APA receiving adrenalectomy, as compared with those treated with spironolactone, had significantly lower relative overhydration (OH) and urine albumin excretion, and significantly higher urine sodium excretion four weeks after treatment. These differences dissipated 12 weeks after the initial treatment. Independent factors to predict decreased relative OH four weeks after treatment were male patients and patients who experienced adrenalectomy. Patients who underwent adrenaelctomy had significantly decreased TNF-? and increased serum potassium level when compared to patients treated with spironolactone 4 and 12 weeks after treatment. In this pilot study, we found that adrenalectomy leads to an earlier increase in renal sodium excretion and decreases in body fluid content, TNF-?, and urine albumin excretion. Adrenalectomy yields a therapeutic effect more rapidly, which has been shown to ameliorate overhydration in PA patients. PMID:26477337

  1. Pyelonephritis and obstructive uropathy: a case of acute kidney injury.

    PubMed

    Ashmore, Adam Edward; Thompson, Christopher James

    2016-01-01

    We present a case of a man in his late 50s with a history of metastatic prostate carcinoma requiring bilateral ureteric stenting. He was admitted with increasing confusion and lethargy. He was diagnosed with sepsis and an acute kidney injury (AKI). Clinical suspicions of an obstructive component to his AKI were not confirmed by an ultrasound scan, which showed a unilateral hydronephrosis unchanged from a scan 1?month previously. A nephrostomy was performed, and frank pus aspirated. The patient's clinical state improved steadily thereafter. Patients who are dehydrated, or who have suffered from malignant or fibrotic processes affecting the retroperitoneum, may present with urinary obstruction without a corresponding increase in urinary tract dilation. Additionally, there must be a suspicion of pyonephrosis in a symptomatic patient with known hydronephrosis. Clinicians should be aware that clinical suspicions of urinary obstruction not demonstrated on ultrasound scanning require further investigation. PMID:26733429

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

    PubMed

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

    2012-09-01

    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

  3. Radionuclide determination of individual kidney function in the treatment of chronic renal obstruction

    SciTech Connect

    Belis, J.A.; Belis, T.E.; Lai, J.C.; Goodwin, C.A.; Gabriele, O.F.

    1982-04-01

    Differential radionuclide renal scans can be useful in the management of patients with chronic partial obstruction of 1 kidney. The /sup 99m/Tc diethylenetriaminepentaacetic acid perfusion scan can be used to assess glomerular blood flow. The /sup 131/I orthoiodohippurate renal scan provides qualitative functional information from scintigrams and quantitative evaluation of effective renal plasma flow to each kidney, as well as a total excretory index. Sequential /sup 99m/Tc diethylenetriaminepentaacetic acid and /sup 131/I orthoiodohippurate renal scans were used to assess individual renal function before and after surgical correction of unilateral chronic renal obstruction in 31 patients. The preservation of cortical perfusion on /supb 99m/Tc diethylenetriaminepentaacetic acid scans indicated that potential existed for partial recovery of renal function. Effective renal plasma flow and excretory index determined in conjunction with the /sup 131/I orthoiodohippurate scans provided a quantitative assessment of preoperative renal function, an evaluation of the effect of surgery and a sensitive method for long-term evaluation of differential renal function. Correction of ureteropelvic junction obstruction usually resulted in improvement in unilateral renal function. Neither nephrolithotomy nor extended pyelolithotomy diminished renal function in the kidney subjected to an operation and often improved it. Patients with long-standing distal ureteral obstruction had the least improvement in renal function postoperatively.

  4. Acute kidney injury.

    PubMed

    Connell, Alistair; Laing, Chris

    2015-12-01

    Acute kidney injury (AKI) - an abrupt deterioration in renal function - causes a rise in serum creatinine (SCr) or fall in urine output. It is common, occurring in up to 20% of hospital admissions. Importantly, even small rises in SCr are associated with increased risk of death and longer hospital stays. A 2009 National Confidential Enquiry into Patient Outcome and Death report found that a proportion of AKI in secondary care was avoidable. In addition, management of established AKI was 'good' less than half the time. In practice, AKI represents a heterogeneous group of conditions, encompassing impairments in both kidney structure and function. Delivering disease-specific treatment early in the course of AKI may improve outcomes. The provision of best-practice care for all will rely on a better understanding of risk, and frameworks of care that can be applied across a diverse patient group. PMID:26621953

  5. Optimal tissue types in the thoracic electrical impedance model for thoracic electrical bioimpedance (TEB) studies.

    PubMed

    Akhand, M; Trakic, A; Terril, P; Liu, F; Wilson, S; Crozier, S

    2009-01-01

    In this study we have identified the tissues required to be included in the thoracic electrical impedance model for studies relating to impedance cardiography. This is a useful finding, as it expedites and simplifies the segmentation process when employed to construct digital human models from a set of magnetic resonance or computed tomography images. Laplace equations with inhomogeneous boundary conditions were solved within an anatomically accurate thorax model. When the number of tissue types in the model was reduced to only 7 (i.e. blood, fat, liver, lung, muscle, skin and bone) the calculations indicated a 3.6% error in the result. Addition of internal air reduced the error to as small as 1.3%. Further reductions in the number of tissue types introduced larger errors in the measurement. It was therefore concluded that 8 tissue types are essential to acceptably preserve the computational accuracy while facilitating a simplification of the segmentation process. PMID:19964319

  6. Kidney Cell Electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P.

    1985-01-01

    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.

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

    PubMed Central

    2014-01-01

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

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

    E-print Network

    Bukiet, Bruce

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

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

    PubMed Central

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

    2013-01-01

    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. PMID:24369489

  10. Strategies to treat thoracic aortitis and infected aortic grafts.

    PubMed

    Kahlberg, A; Melissano, G; Tshomba, Y; Leopardi, M; Chiesa, R

    2015-04-01

    Infectious thoracic aortitis is a rare disease, especially since the incidence of syphilis and tuberculosis has dropped in western countries. However, the risk to develop an infectious aortitis and subsequent mycotic aneurysm formation is still present, particularly in case of associated endocarditis, sepsis, and in immunosuppressive disorders. Moreover, the number of surgical and endovascular thoracic aortic repairs is continuously increasing, and infective graft complications are observed more frequently. Several etiopathogenetic factors may play a role in thoracic aortic and prosthetic infections, including hematogenous seeding, local bacterial translocation, and iatrogenous contamination. Also, fistulization of the esophagus or the bronchial tree is commonly associated with these diseases, and it represents a critical event requiring a multidisciplinary management. Knowledge on underlying micro-organisms, antibiotic efficacy, risk factors, and prevention strategies has a key role in the management of this spectrum of infectious diseases involving the thoracic aorta. When the diagnosis of a mycotic aneurysm or a prosthetic graft infection is established, treatment is demanding, often including a number of surgical options. Patients are usually severely compromised by sepsis, and in most cases they are considered unfit for surgery for general clinical conditions or local concerns. Thus, results of different therapeutic strategies for infectious diseases of the thoracic aorta are still burdened with very high morbidity and mortality. In this manuscript, we review the literature regarding the main issues related to thoracic infectious aortitis and aortic graft infections, and we report our personal series of patients surgically treated at our institution for these conditions from 1993 to 2014. PMID:25608572

  11. MAT2A mutations predispose individuals to thoracic aortic aneurysms.

    PubMed

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

    2015-01-01

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

  12. Acute kidney injury

    PubMed Central

    Müller, Gerhard Anton

    2015-01-01

    Abstract: Acute kidney injury is a frequent and serious complication in hospitalized patients. Mortality rates have not substantially been decreased during the last 20 years. In most patients AKI results from transient renal hypoperfusion or ischemia. The consequences include tubular cell dysfunction/damage, inflammation of the organ, and post-ischemic microvasculopathy. The two latter events perpetuate kidney damage in AKI. Clinical manifestations result from diminished excretion of water, electrolytes, and endogenous / exogenous waste products. Patients are endangered by cardiovascular complications such as hypertension, heart failure, and arrhythmia. In addition, the whole organism may be affected by systemic toxification (uremia). The diagnostic approach in AKI involves several steps with renal biopsy inevitable in some patients. The current therapy focuses on preventing further kidney damage and on treatment of complications. Different pharmacological strategies have failed to significantly improve prognosis in AKI. If dialysis treatment becomes mandatory, intermittent and continuous renal replacement therapies are equally effective. Thus, new therapies are urgently needed in order to reduce short- and long-term outcome in AKI. In this respect, stem cell-based regimens may offer promising perspectives. PMID:25618438

  13. Helical CT angiography of the thoracic aorta.

    PubMed

    Rubin, G D

    1997-04-01

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

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

    PubMed Central

    2015-01-01

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

  15. Impact of AMP-Activated Protein Kinase ?1 Deficiency on Tissue Injury following Unilateral Ureteral Obstruction

    PubMed Central

    Mia, Sobuj; Federico, Giuseppina; Feger, Martina; Pakladok, Tatsiana; Meissner, Adrian; Voelkl, Jakob; Groene, Hermann-Josef; Alesutan, Ioana; Lang, Florian

    2015-01-01

    Background AMP-activated protein kinase (Ampk) is a sensor of the cellular energy status and a powerful regulator of metabolism. Activation of Ampk was previously shown to participate in monocyte-to-fibroblast transition and matrix protein production in renal tissue. Thus, the present study explored whether the catalytic Ampk?1 isoform participates in the regulation of the renal fibrotic response following unilateral ureteral obstruction (UUO). Methods UUO was induced in gene-targeted mice lacking functional Ampk?1 (Ampk?1-/-) and in corresponding wild-type mice (Ampk?1+/+). In the obstructed kidney and, for comparison, in the non-obstructed control kidney, quantitative RT-PCR, Western blotting and immunostaining were employed to determine transcript levels and protein abundance, respectively. Results In Ampk?1+/+ mice, UUO significantly up-regulated the protein abundance of the Ampk?1 isoform, but significantly down-regulated the Ampk?2 isoform in renal tissue. Phosphorylated Ampk? protein levels were significantly increased in obstructed kidney tissue of Ampk?1+/+ mice but not of Ampk?1-/- mice. Renal expression of ?-smooth muscle actin was increased following UUO, an effect again less pronounced in Ampk?1-/- mice than in Ampk?1+/+ mice. Histological analysis did not reveal a profound effect of Ampk?1 deficiency on collagen 1 protein deposition. UUO significantly increased phosphorylated and total Tgf-ß-activated kinase 1 (Tak1) protein, as well as transcript levels of Tak1-downstream targets c-Fos, Il6, Pai1 and Snai1 in Ampk?1+/+ mice, effects again significantly ameliorated in Ampk?1-/- mice. Moreover, Ampk?1 deficiency inhibited the UUO-induced mRNA expression of Cd206, a marker of M2 macrophages and of Cxcl16, a pro-fibrotic chemokine associated with myeloid fibroblast formation. The effects of Ampk?1 deficiency during UUO were, however, paralleled by increased tubular injury and apoptosis. Conclusions Renal obstruction induces an isoform shift from Ampk?2 towards Ampk?1, which contributes to the signaling involved in cell survival and fibrosis. PMID:26285014

  16. Klotho Ameliorates Kidney Injury and Fibrosis and Normalizes Blood Pressure by Targeting the Renin-Angiotensin System.

    PubMed

    Zhou, Lili; Mo, Hongyan; Miao, Jinhua; Zhou, Dong; Tan, Roderick J; Hou, Fan Fan; Liu, Youhua

    2015-12-01

    Loss of Klotho and activation of the renin-angiotensin system (RAS) are common pathological findings in chronic kidney diseases. However, whether these two events are intricately connected is poorly understood. We hypothesized that Klotho might protect kidneys by targeted inhibition of RAS activation in diseased kidneys. To test this hypothesis, mouse models of remnant kidney, as well as adriamycin nephropathy and unilateral ureteral obstruction, were utilized. At 6 weeks after 5/6 nephrectomy, kidney injury was evident, characterized by elevated albuminuria and serum creatinine levels, and excessive deposition of interstitial matrix proteins. These lesions were accompanied by loss of renal Klotho expression, up-regulation of RAS components, and development of hypertension. In vivo expression of exogenous Klotho through hydrodynamic-based gene delivery abolished the induction of multiple RAS proteins, including angiotensinogen, renin, angiotensin-converting enzyme, and angiotensin II type 1 receptor, and normalized blood pressure. Klotho also inhibited ?-catenin activation and ameliorated renal fibrotic lesions. Similar results were obtained in mouse models of adriamycin and obstructive nephropathy. In cultured kidney tubular epithelial cells, Klotho dose-dependently blocked Wnt1-triggered RAS activation. Taken together, these results demonstrate that Klotho exerts its renal protection by targeted inhibition of RAS, a pathogenic pathway known to play a key role in the evolution and progression of hypertension and chronic kidney disorders. PMID:26475416

  17. Unilateral Loss of Spontaneous Venous Pulsations in an Astronaut

    NASA Technical Reports Server (NTRS)

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

    2014-01-01

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

  18. Unilateral Stance Strategies of Athletes With ACL Deficiency

    PubMed Central

    Di Stasi, Stephanie L.; Hartigan, Erin H.; Snyder-Mackler, Lynn

    2013-01-01

    Aberrant movement strategies are characteristic of ACL-deficient athletes with recurrent knee instability (non-copers), and may instigate premature or accelerate joint degradation. Biomechanical evaluation of kinematic changes over time may elucidate noncopers’ responses to neuromuscular intervention and ACL reconstruction (ACLR). Forty noncopers were randomized into a perturbation group or a strength training only group. We evaluated the effects of perturbation training, and then gender on knee angle and tibial position during a unilateral standing task before and after ACLR. No statistically significant interactions were found. Before surgery, the strength training only group demonstrated knee angle asymmetry, but 6 months after ACLR, both groups presented with similar knee flexion between limbs. Aberrant and asymmetrical tibial position was found only in females following injury and ACLR. Neither treatment group showed distinct unilateral standing strategies following intervention; however, males and female noncopers appear to respond uniquely to physical therapy and surgery. PMID:22983931

  19. Offspring of patients treated for unilateral Wilms' tumor in childhood

    SciTech Connect

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

    1982-01-01

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

  20. Framework Surgery for Treatment of Unilateral Vocal Fold Paralysis

    PubMed Central

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

    2014-01-01

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

  1. Congenital Unilateral Deafness Affects Cerebral Organization of Reading

    PubMed Central

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

    2013-01-01

    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. PMID:24961430

  2. Binocular function in unilateral aphakia. Correlation with aniseikonia and stereoacuity.

    PubMed

    Katsumi, O; Miyanaga, Y; Hirose, T; Okuno, H; Asaoka, I

    1988-08-01

    Aniseikonia and stereoacuity were measured in patients with unilateral aphakia, most of whom were postoperative senile cataract cases. The New Aniseikonia test was used to evaluate aniseikonia and the Titmus Stereotest to measure stereoacuity. Ninety cases were studied, 57 (63.3%) of which had intraocular lens (IOL) implants; 27 (30%) had extended-wear soft contact lenses; and six (6.7%) had spectacle lenses. In the IOL group, aniseikonia averaged 2.8%, and 39 patients (68.4%) had good stereoacuity. In the contact lens group, aniseikonia averaged 4.6%, and 11 (40.7%) had good stereoacuity. In the spectacle lens group, aniseikonia averaged 17.8%; none of the patients had good stereoacuity. The authors concluded that in cases with unilateral aphakia, correction with an IOL implant is superior to the other alternatives in achieving good binocular function. PMID:3231446

  3. CD40 Generation 2.5 Antisense Oligonucleotide Treatment Attenuates Doxorubicin-induced Nephropathy and Kidney Inflammation.

    PubMed

    Donner, Aaron J; Yeh, Steve T; Hung, Gene; Graham, Mark J; Crooke, Rosanne M; Mullick, Adam E

    2015-01-01

    Preclinical and clinical data suggest CD40 activation contributes to renal inflammation and injury. We sought to test whether upregulation of CD40 in the kidney is a causative factor of renal pathology and if reduction of renal CD40 expression, using antisense oligonucleotides (ASOs) targeting CD40, would be beneficial in mouse models of glomerular injury and unilateral ureter obstruction. Administration of a Generation 2.5 CD40 ASO reduced CD40 mRNA and protein levels 75-90% in the kidney. CD40 ASO treatment mitigated functional, transcriptional, and pathological endpoints of doxorubicin-induced nephropathy. Experiments using an activating CD40 antibody revealed CD40 is primed in kidneys following doxorubicin injury or unilateral ureter obstruction and CD40 ASO treatment blunted CD40-dependent renal inflammation. Suborgan fractionation and imaging studies demonstrated CD40 in glomeruli before and after doxorubicin administration that becomes highly enriched within interstitial and glomerular foci following CD40 activation. Such foci were also sites of ASO distribution and activity and may be predominately comprised from myeloid cells as bone marrow CD40 deficiency sharply attenuated CD40 antibody responses. These studies suggest an important role of interstitial renal and/or glomerular CD40 to augment kidney injury and inflammation and demonstrate that ASO treatment could be an effective therapy in such disorders. PMID:26623936

  4. Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Jang, Kyoung-Min; Kim, Young-Baeg; Park, Yong-Sook; Nam, Taek-Kyun; Lee, Young-Seok

    2015-01-01

    Objective Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed. PMID:26587189

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

    NASA Astrophysics Data System (ADS)

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

    2003-10-01

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

  6. Pharmacological GLI2 inhibition prevents myofibroblast cell-cycle progression and reduces kidney fibrosis

    PubMed Central

    Kramann, Rafael; Fleig, Susanne V.; Schneider, Rebekka K.; Fabian, Steven L.; DiRocco, Derek P.; Maarouf, Omar; Wongboonsin, Janewit; Ikeda, Yoichiro; Heckl, Dirk; Chang, Steven L.; Rennke, Helmut G.; Waikar, Sushrut S.; Humphreys, Benjamin D.

    2015-01-01

    Chronic kidney disease is characterized by interstitial fibrosis and proliferation of scar-secreting myofibroblasts, ultimately leading to end-stage renal disease. The hedgehog (Hh) pathway transcriptional effectors GLI1 and GLI2 are expressed in myofibroblast progenitors; however, the role of these effectors during fibrogenesis is poorly understood. Here, we demonstrated that GLI2, but not GLI1, drives myofibroblast cell-cycle progression in cultured mesenchymal stem cell–like progenitors. In animals exposed to unilateral ureteral obstruction, Hh pathway suppression by expression of the GLI3 repressor in GLI1+ myofibroblast progenitors limited kidney fibrosis. Myofibroblast-specific deletion of Gli2, but not Gli1, also limited kidney fibrosis, and induction of myofibroblast-specific cell-cycle arrest mediated this inhibition. Pharmacologic targeting of this pathway with darinaparsin, an arsenical in clinical trials, reduced fibrosis through reduction of GLI2 protein levels and subsequent cell-cycle arrest in myofibroblasts. GLI2 overexpression rescued the cell-cycle effect of darinaparsin in vitro. While darinaparsin ameliorated fibrosis in WT and Gli1-KO mice, it was not effective in conditional Gli2-KO mice, supporting GLI2 as a direct darinaparsin target. The GLI inhibitor GANT61 also reduced fibrosis in mice. Finally, GLI1 and GLI2 were upregulated in the kidneys of patients with high-grade fibrosis. Together, these data indicate that GLI inhibition has potential as a therapeutic strategy to limit myofibroblast proliferation in kidney fibrosis. PMID:26193634

  7. N-Acetyl-seryl-aspartyl-lysyl-proline Alleviates Renal Fibrosis Induced by Unilateral Ureteric Obstruction in BALB/C Mice

    PubMed Central

    Chan, Gary C. W.; Yiu, Wai Han; Wu, Hao Jia; Wong, Dickson W. L.; Lin, Miao; Huang, Xiao Ru; Lan, Hui Yao; Tang, Sydney C. W.

    2015-01-01

    To expand the armamentarium of treatment for chronic kidney disease (CKD), we explored the utility of boosting endogenously synthesized N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP), which is augmented by inhibition of the angiotensin converting enzyme. Male BALB/c mice underwent unilateral ureteral ligation (UUO) or sham operation and received exogenously administered Ac-SDKP delivered via a subcutaneous osmotic minipump or Captopril treatment by oral gavage. Seven days after UUO, there were significant reductions in the expression of both collagen 1 and collagen 3 in kidneys treated with Ac-SDKP or Captopril, and there was a trend towards reductions in collagen IV, ?-SMA, and MCP-1 versus control. However, no significant attenuation of interstitial injury or macrophage infiltration was observed. These findings are in contrary to observations in other models and underscore the fact that a longer treatment time frame may be required to yield anti-inflammatory effects in BALB/c mice treated with Ac-SDKP compared to untreated mice. Finding an effective treatment regimen for CKD requires fine-tuning of pharmacologic protocols. PMID:26508815

  8. Choroidal Thickness in Eyes with Unilateral Ocular Ischemic Syndrome

    PubMed Central

    Kim, Dong Yoon; Joe, Soo Geun; Lee, Joo Yong; Kim, June-Gone; Yang, Sung Jae

    2015-01-01

    Aim. To analyze the subfoveal choroid thickness and choroidal volume in unilateral ocular ischemic syndrome (OIS). Methods. A retrospective review was conducted for all patients with unilateral OIS from October 2010 through June 2014. The subfoveal choroidal thickness (SFChT) and choroidal volume of both eyes were compared. Results. 19 unilateral OIS patients were included in this study. The mean SFChT of OIS eyes was significantly lower than that of fellow eyes (OIS eyes: 208.89 ± 82.62??m and fellow eyes: 265.31 ± 82.77??m, P < 0.001). The choroidal volume of OIS eyes was significantly smaller than that of fellow eyes (OIS eyes: 0.16 ± 0.05?mm3 and fellow eyes: 0.21 ± 0.05?mm3, P < 0.001). Conclusion. The choroidal thickness and volume of OIS eyes were smaller than those of unaffected fellow eyes. Decreased choroidal circulation caused by carotid artery stenosis might affect the discordance of choroidal thickness and choroidal volume. PMID:26504596

  9. Reliability of the Melbourne assessment of unilateral upper limb function.

    PubMed

    Randall, M; Carlin, J B; Chondros, P; Reddihough, D

    2001-11-01

    This study examines the reliability of the Melbourne Assessment of Unilateral Upper Limb Function: a quantitative test of quality of movement in children with neurological impairment. The assessment was administered to 20 children aged from 5 to 16 years (mean age 9 years 10 months, SD 2 years 10 months) who had various types and degrees of cerebral palsy (CP). The performances of the 20 children during assessment were videotaped for subsequent scoring by 15 occupational therapists. Scores were analyzed for internal consistency of test items, inter- and intrarater reliability of scorings of the same videotapes, and test-retest reliability using repeat videotaping. Results revealed very high internal consistency of test items (alpha=0.96), moderate to high agreement both within and between raters for all test items (intraclass correlations of at least 0.7) apart from item 16 (hand to mouth and down), and high interrater reliability (0.95) and intrarater reliability (0.97) for total test scores. Test-retest results revealed moderate to high intrarater reliability for item totals (mean of 0.83 and 0.79) for each rater and high reliability for test totals (0.98 and 0.97). These findings indicate that the Melbourne Assessment of Unilateral Upper Limb Function is a reliable tool for measuring the quality of unilateral upper-limb movement in children with CP. PMID:11730151

  10. CD74 in Kidney Disease

    PubMed Central

    Valiño-Rivas, Lara; Baeza-Bermejillo, Ciro; Gonzalez-Lafuente, Laura; Sanz, Ana Belen; Ortiz, Alberto; Sanchez-Niño, Maria Dolores

    2015-01-01

    CD74 (invariant MHC class II) regulates protein trafficking and is a receptor for macrophage migration inhibitory factor (MIF) and d-dopachrome tautomerase (d-DT/MIF-2). CD74 expression is increased in tubular cells and/or glomerular podocytes and parietal cells in human metabolic nephropathies, polycystic kidney disease, graft rejection and kidney cancer and in experimental diabetic nephropathy and glomerulonephritis. Stressors like abnormal metabolite (glucose, lyso-Gb3) levels and inflammatory cytokines increase kidney cell CD74. MIF activates CD74 to increase inflammatory cytokines in podocytes and tubular cells and proliferation in glomerular parietal epithelial cells and cyst cells. MIF overexpression promotes while MIF targeting protects from experimental glomerular injury and kidney cysts, and interference with MIF/CD74 signaling or CD74 deficiency protected from crescentic glomerulonephritis. However, CD74 may protect from interstitial kidney fibrosis. Furthermore, CD74 expression by stressed kidney cells raises questions about the kidney safety of cancer therapy strategies delivering lethal immunoconjugates to CD74-expressing cells. Thus, understanding CD74 biology in kidney cells is relevant for kidney therapeutics. PMID:26441987

  11. Research and education in thoracic surgery: the European trainees’ perspective

    PubMed Central

    Ilonen, Ilkka K.

    2015-01-01

    Thoracic surgery training within Europe is diverse and a consensus may help to harmonise the training. Currently, training for thoracic surgery compromises thoracic, cardiothoracic and aspects of general surgical training. The recognition of specialist degrees should be universal and equal. Between different nations significant differences in training exist, especially in general surgery rotations and in the role of oesophageal surgery. The European board examination for thoracic surgery is one of the key ways to achieve harmonisation within the European Union (EU) and internationally. Further support and encouragement may be beneficial to promote diverse and engaging fellowships and clinical exchange programmes between nations. International fellowships may even benefit young residents, in both clinical and academic settings. Many studies currently would benefit from multi-centre and multi-national design, enhancing the results and giving better understanding of clinical scenarios. Educational content provided by independent organisations should be more recognised as an integral part in both resident training and continuing development throughout surgeons’ careers. During annual society meetings, trainees should have some sessions that are aimed at enhancing their training and establishing networks of international peers. PMID:25984356

  12. Normal Range of Thoracic Kyphosis in Male School Children

    PubMed Central

    Shamsi, MohammadBagher; Veisi, Korosh; Karimi, Loghman; Sarrafzadeh, Javad; Najafi, Farid

    2014-01-01

    Background. Although there are frequent studies about normal range of thoracic kyphosis, there is still a controversy about the exact values of this curve. In nine reported studies on 10 to 20 years of age boys, the value ranged from 25.1° to 53.3°. Objective for the Study. The aim of the present research was investigation of normal ranges of thoracic kyphosis in school children in Kermanshah, western Iran. Methods. 582 male students aged 13 to 18 years old using cluster random sampling were recruited from schools in Kermanshah city, 97 students for each age. Thoracic curves were measured using the flexicurve method. Results. Mean thoracic kyphosis for whole population was 35.49° SD 7.83 and plus or minus two standard deviations ranged from 19.83° to 51.15°. It increased gradually from 13 to 16 and then there was a little decrease to 18 years. Mean values for each age (13–16) were 13 (34.41 SD 7.47°), 14 (34.86 SD 8.29°), 15 (35.79 SD 7.93°), 16 (36.49 SD 7.85°), 17 (35.84 SD 8.33°), and 18 (35.55 SD 7.07°). Conclusions. Our results are in agreement with previous reports and can be used as normal values for local and regional purposes. PMID:24967122

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

    PubMed

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

    1989-01-01

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

  14. Boron and the kidney.

    PubMed

    Pahl, Madeleine V; Culver, B Dwight; Vaziri, Nosratola D

    2005-10-01

    Boron, the fifth element in the periodic table, is ubiquitous in nature. It is present in food and in surface and ocean waters, and is frequently used in industrial, cosmetic, and medical settings. Exposure to boron and related compounds has been recently implicated as a potential cause of chronic kidney disease in Southeast Asia. This observation prompted the present review of the published data on the effects of acute and chronic exposure to boron on renal function and structure in human beings and in experimental animals. PMID:16198928

  15. [Kidney toxicity's "HAART" therapy].

    PubMed

    Marino, Alfonsina; Ardu, Francesco; Dentone, Chiara; Secondo, Giovanni; Ferrea, G

    2015-01-01

    Human immunodeficiency virus (HIV) and antiretroviral therapy can damage the kidney. Highly active antiretroviral therapy (HAART) generally improves the renal function as it reduces the viral replication, although the renal function may be reduced by certain antiretroviral drugs. HAART causes acute tubular necrosis, acute interstitial nephritis, calculi, Fanconi Syndrome, crystal nephropathy, elevated lipid levels as well as calcium and phosphorus alteration. The physician must estimate renal function before and during antiretroviral therapy, especially when HIV-infected patients have some risk factors for renal damage such as high-blood pressure or hepatitis B or C infections. PMID:26480259

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

    NASA Astrophysics Data System (ADS)

    Mearon, T.; Brennan, P. C.

    2006-03-01

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

  17. Gromerulocystic Kidney Disease in a Transplanted Kidney: Case Report.

    PubMed

    Kwiatkowska, E; Domanski, L; Pawlik, A

    2015-09-01

    The patient was a 28-year-old man with chronic kidney disease in stage 5 and in the course of chronic membranoroliferative glomerulonephritis. The patient was treated for a period of 2 months using peritoneal dialysis. In September 2014, he had a kidney transplant from a deceased donor. Four months after transplantation the patient was admitted to the hospital for a protocol biopsy. His creatinine was 1.5 mg/dL and urea was 59 mg/dL, urinalysis was normal in blood count with a normocytic anemia-hemoglobin level of 7.8 mmol/L. We obtained a histopathological evaluation of the cortex and medulla of the kidney. Glomeruli dilatation of Bowman space with reduced glomerular capillary tufts was found in the section. Histopathological evaluation indicated gromerulocystic kidney disease in a transplanted kidney. PMID:26361692

  18. Radiographic evaluation of obesity-caused oppression of the thoracic cavity in beagles.

    PubMed

    Morooka, Toshio; Niiyama, Masayoshi; Kougo, Aki; Soya, Mayumi; Nunome, Katsunori

    2004-05-01

    Thoracic radiographs of fifteen beagles with mild-to-moderate obesity revealed that oppression of the thoracic cavity increased with increasing degree of obesity. Oppression of the thoracic cavity was evaluated based on the length, depth, width and area of the thoracic cavity. To obtain thoracic radiographs at the terminal inspiration and expiration phases, thoracic fluororadiographs were recorded with a digital video camera. Bodyweight and the depth of the back fat layer at the seventh lumbar vertebra (DB, measured by ultrasonography) were used as indicators of the degree of obesity. The length of the thoracic cavity tended to become shorter and the depth and width of the thoracic cavity tended to increase as bodyweight increased and as DB increased. On the other hand, the area of the thoracic cavity was not clearly related to bodyweight or DB. These results suggest that oppression of the thoracic cavity due to the cranial shift of the diaphragm is compensated for by increases in the depth and width of the thoracic cavity in beagles with mild-to-moderate obesity. PMID:15187357

  19. Obesity and kidney protection

    PubMed Central

    Chandra, Aravind; Biersmith, Michael; Tolouian, Ramin

    2014-01-01

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

  20. The kidney in space.

    PubMed

    Liakopoulos, Vassilios; Leivaditis, Konstantinos; Eleftheriadis, Theodoros; Dombros, Nicholas

    2012-12-01

    Renal adaptation in space has been studied during various space missions since the early 70s. Technical and financial disadvantages of performing experiments under real microgravity conditions have warranted the conductance of relative studies under simulated weightlessness on earth. Arriving in microgravity leads to a redistribution of body fluids to the upper part of the body and an exaggerated extravasation very early in-flight. Plasma volume as well as skin evaporation and oral hydration are reduced, while total body water seems to remain stable. Urinary sodium is diminished and a substantial amount of sodium is retained outside the intravascular space. Glomerular filtration rate shows a transient mild increase. Urinary albumin excretion is reduced although initial studies had demonstrated the opposite. Examination of renal histopathology after exposure to simulated microgravity in rats revealed glomerular atrophy, interstitial edema, and degeneration of renal tubular cells. Acute urinary retention which has been reported during spaceflights can lead to certain medical complications that could compromise an entire mission. Kidney stone formation is another important potential hazard for any manned spaceflight. Increased kidney stone formation in space is attributed to several factors including reduced fluid intake, hypercalciuria, and the presence of nanobacteria. Nutritional and pharmacological interventions are currently recommended as preventive measures against renal stone formation in space travelers. PMID:23001611

  1. Kidney paired donation.

    PubMed

    Wallis, C Bradley; Samy, Kannan P; Roth, Alvin E; Rees, Michael A

    2011-07-01

    Kidney paired donation (KPD) was first suggested in 1986, but it was not until 2000 when the first paired donation transplant was performed in the USA. In the past decade, KPD has become the fastest growing source of transplantable kidneys, overcoming the barrier faced by living donors deemed incompatible with their intended recipients. This review provides a basic overview of the concepts and challenges faced by KPD as we prepare for a national pilot program with the United Network for Organ Sharing. Several different algorithms have been creatively implemented in the USA and elsewhere to transplant paired donors, each method uniquely contributing to the success of KPD. As the paired donor pool grows, the problem of determining allocation strategies that maximize equity and utility will become increasingly important as the transplant community seeks to balance quality and quantity in choosing the best matches. Financing for paired donation is a major issue, as philanthropy alone cannot support the emerging national system. We also discuss the advent of altruistic or non-directed donors in KPD, and the important role of chains in addition to exchanges. This review is designed to provide insight into the challenges that face the emerging national KPD system in the USA, now 5 years into its development. PMID:21454351

  2. Pruritus in Kidney Disease.

    PubMed

    Combs, Sara A; Teixeira, J Pedro; Germain, Michael J

    2015-07-01

    Pruritus is a common and distressing symptom in patients with chronic kidney disease. The most recent epidemiologic data have suggested that approximately 40% of patients with end-stage renal disease experience moderate to severe pruritus and that uremic pruritus (UP) has a major clinical impact, being associated strongly with poor quality of life, impaired sleep, depression, and increased mortality. The pathogenesis of UP remains largely unclear, although several theories on etiologic or contributing factors have been proposed including increased systemic inflammation; abnormal serum parathyroid hormone, calcium, and phosphorus levels; an imbalance in opiate receptors; and a neuropathic process. UP can present somewhat variably, although it tends to affect large, discontinuous, but symmetric, areas of skin and to be most symptomatic at night. A variety of alternative systemic or dermatologic conditions should be considered, especially in patients with asymmetric pruritus or other atypical features. Treatment initially should focus on aggressive skin hydration, patient education on minimizing scratching, and optimization of the aspects of chronic kidney disease care that are most relevant to pruritus, including dialysis adequacy and serum parathyroid hormone, calcium, and phosphorus management. Data for therapy specifically for UP remain limited, although topical therapies, gabapentin, type B ultraviolet light phototherapy, acupuncture, and opioid-receptor modulators all may play a role. PMID:26355256

  3. Genetic kidney diseases

    PubMed Central

    Hildebrandt, Friedhelm

    2010-01-01

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

  4. Murine Kidney Transplant Technique.

    PubMed

    Plenter, Robert; Jain, Swati; Ruller, Chelsea M; Nydam, Trevor L; Jani, Alkesh H

    2015-01-01

    The first mouse kidney transplant technique was published in 1973(1) by the Russell laboratory. Although it took some years for other labs to become proficient in and utilize this technique, it is now widely used by many laboratories around the world. A significant refinement to the original technique using the donor aorta to form the arterial anastomosis instead of the renal artery was developed and reported in 1993 by Kalina and Mottram (2) with a further advancement coming from the same laboratory in 1999 (3). While one can become proficient in this model, a search of the literature reveals that many labs still experience a high proportion of graft loss due to arterial thrombosis. We describe here a technique that was devised in our laboratory that vastly reduces the arterial thrombus reported by others (4,5). This is achieved by forming a heel-and-toe cuff of the donor infra-renal aorta that facilitates a larger anastomosis and straighter blood flow into the kidney. PMID:26555373

  5. Risk Factors for Chronic Kidney Disease

    MedlinePLUS

    ... Renal. Home » Kidney Info » 1 in 9 Adults Risk Factors for CKD x What are you doing to ... to prevent or delay kidney failure. Kidney Disease Risk Factors You Can Change Diabetes Type 2 diabetes is ...

  6. Kidney Disease: Early Detection and Treatment

    MedlinePLUS

    ... Bar Home Current Issue Past Issues Special Section Kidney Disease: Early Detection and Treatment Past Issues / Winter ... called a "urine albumin-to-creatinine ratio." Treating Kidney Disease Kidney disease is usually a progressive disease, ...

  7. Kidney Disease Statistics for the United States

    MedlinePLUS

    ... also order print versions from our online catalog. Kidney Disease Statistics for the United States Page Content ... for Vascular Access Acknowledgments The Growing Burden of Kidney Disease Kidney disease statistics for the United States ...

  8. Genetics Home Reference: Polycystic kidney disease

    MedlinePLUS

    ... Recent literature OMIM Genetic disorder catalog Conditions > Polycystic kidney disease On this page: Description Genetic changes Inheritance ... Glossary definitions Reviewed May 2014 What is polycystic kidney disease? Polycystic kidney disease is a disorder that ...

  9. Treatment Methods for Kidney Failure: Hemodialysis

    MedlinePLUS

    ... Life Options Rehabilitation Program National Kidney Foundation, Inc. Kidney and Urologic Disease Organizations Many organizations provide support ... KB)????? Alternate Language URL Español Treatment Methods for Kidney Failure: Hemodialysis Page Content On this page: When ...

  10. High Blood Pressure and Kidney Disease

    MedlinePLUS

    ... Information Center National Kidney Foundation Smokefree.gov MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Alternate Language URL Español High Blood Pressure and Kidney Disease Page Content On this page: What is ...

  11. Progressive lymphangiectasis and recurrent chylothorax in a dog after thoracic duct ligation.

    PubMed

    Kerpsack, S J; Smeak, D D; Birchard, S J

    1995-10-15

    A 2-year-old Bernese Mountain Dog was examined to determine the cause of bilateral pleural effusion. Torsion was diagnosed, and a lobectomy of a lung lobe was performed. Chylothorax developed 12 days after lung lobectomy. Mesenteric lymphangiography revealed lymphangiectasis Lymphangiography immediately after surgical thoracic duct was completely obstructed, but chylothorax persisted after thoracic duct ligation. Lymphangiography was repeated 50 days after ligation of the thoracic duct and revealed multiple patent thoracic duct branches and progressive lymphangiectasis. A second attempt to ligate the thoracic duct caused the effusion to become serosanguineous. A pleuroperitoneal shunt with a manually operated pump chamber was used to remove the pleural effusion. Chylothorax was again detected 50 weeks after placement of shunt. Mesenteric lymphangiography revealed multiple patent thoracic duct branches and a lymphatic plexus that extended across the thoracic cavity. PMID:7559046

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

    SciTech Connect

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

    1985-01-01

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

  13. Amygdalin inhibits renal fibrosis in chronic kidney disease.

    PubMed

    Guo, Junqi; Wu, Weizheng; Sheng, Mingxiong; Yang, Shunliang; Tan, Jianming

    2013-05-01

    Renal interstitial fibrosis is a common outcome of chronic renal diseases. Amygdalin is one of a number of nitrilosides, the natural cyanide?containing substances abundant in the seeds of plants of the prunasin family that are used to treat cancer and relieve pain. However, whether amygdalin inhibits the progression of renal fibrosis or not remains unknown. The present study aimed to assess the therapeutic potential of amygdalin by investigating its effect and potential mechanism on the activation of renal interstitial fibroblast cells and renal fibrosis in rat unilateral ureteral obstruction (UUO). Treatment of the cultured renal interstitial fibroblasts with amygdalin inhibited their proliferation and the production of transforming growth factor (TGF)??1. In the rat model of obstructive nephropathy, following ureteral obstruction, the administration of amygdalin immediately eliminated the extracellular matrix accumulation and alleviated the renal injury on the 21st day. Collectively, amygdalin attenuated kidney fibroblast (KFB) activation and rat renal interstitial fibrosis. These results indicate that amygdalin is a potent antifibrotic agent that may have therapeutic potential for patients with fibrotic kidney diseases. PMID:23525378

  14. Reduced Klotho expression level in kidney aggravates renal interstitial fibrosis.

    PubMed

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

    2012-05-15

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

  15. Calcium Supplements and Kidney Health

    MedlinePLUS Videos and Cool Tools

    ... Calcium_Supplements_101415.html Calcium Supplements and Kidney Health HealthDay News Video - October 15, 2015 To use ... health news that matters to you. Related MedlinePlus Health Topics Calcium Dietary Supplements Kidney Stones About MedlinePlus ...

  16. Blood Kidney Injury Molecule-1 Is a Biomarker of Acute and Chronic Kidney Injury and Predicts Progression to ESRD in Type I Diabetes

    PubMed Central

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

    2014-01-01

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

  17. Kidney Failure - Multiple Languages: MedlinePlus

    MedlinePLUS

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

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

    PubMed

    Khan, Zeba; Pandey, Manoj

    2014-09-01

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

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

    PubMed Central

    Khan, Zeba; Pandey, Manoj

    2014-01-01

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

  20. APOL1 Localization in Normal Kidney and Nondiabetic Kidney Disease

    PubMed Central

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

    2011-01-01

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

  1. Kidney-lung cross-talk and acute kidney injury.

    PubMed

    Basu, Rajit K; Wheeler, Derek S

    2013-12-01

    There is a growing appreciation for the role that acute kidney injury (AKI) plays in the propagation of critical illness. In children, AKI is not only an independent predictor of morbidity and mortality, but is also associated with especially negative outcomes when concurrent with acute lung injury (ALI). Experimental data provide evidence that kidney-lung crosstalk occurs and can be bidirectionally deleterious, although details of the precise molecular mechanisms involved in the AKI-ALI interaction remain incomplete. Clinically, ALI, and the subsequent clinical interventions used to stabilize gas exchange, carry consequences for the homeostasis of kidney function. Meanwhile, AKI negatively affects lung physiology significantly by altering the homeostasis of fluid balance, acid-base balance, and vascular tone. Experimental AKI research supports an "endocrine" role for the kidney, triggering a cascade of extra-renal inflammatory responses affecting lung homeostasis. In this review, we will discuss the pathophysiology of kidney-lung crosstalk, the multiple pathways by which AKI affects kidney-lung homeostasis, and discuss how these phenomena may be unique in critically ill children. Understanding how AKI may affect a "balance of communication" that exists between the kidneys and the lungs is requisite when managing critically ill children, in whom imbalance is the norm. PMID:23334385

  2. Wars, disasters and kidneys.

    PubMed

    Lameire, N

    2014-12-01

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

  3. Unilateral nasal allergic reactions increase bilateral sinus eosinophil infiltration

    PubMed Central

    deTineo, Marcella; Naclerio, Robert M.

    2013-01-01

    We have previously shown that unilateral nasal challenge with antigen causes an increase in the number of eosinophils in the ipsilateral maxillary sinus. Here we aimed to determine whether there was an eosinophil response in the contralateral maxillary sinus after unilateral nasal challenge with antigen. Twenty subjects with a history of seasonal allergic rhinitis and a positive nasal challenge to ragweed or grass allergens were studied outside of their allergy season. Catheters were placed in both maxillary sinuses and the subjects were challenged with antigen via the left nostril. The subjects recorded nasal symptoms before and after each allergen challenge and hourly for 8 h afterward. We performed nasal lavages of the nose and sinuses at the same time as symptoms were recorded. The lavages were analyzed for the number of eosinophils and levels of albumin. Subjects showed a symptomatic response to challenge accompanied by an influx of eosinophils into the nose and increased vascular permeability. The number of eosinophils increased in both maxillary sinuses. The total change from diluent in eosinophils during the late phase response was higher in the ipsilateral maxillary sinus (median = 8,505; range = 0–100,360) compared with the contralateral sinus (median = 1,596; range = ?13,527–93,373; P = 0.03). We conclude that eosinophils increase in both maxillary sinuses after unilateral nasal challenge. We speculate that a central neurologic reflex initiated in the nose by the nasal challenge contributes to the bilateral eosinophil response in the maxillary sinuses. We further speculate that, since there are more eosinophils in the ipsilateral compared with the contralateral maxillary sinus, there is also an axonal reflex into the ipsilateral maxillary sinus that contributed to the eosinophil response. PMID:23970539

  4. Autologous bone plugs in unilateral total knee arthroplasty

    PubMed Central

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

    2013-01-01

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

  5. Unilateral Radiotherapy for the Treatment of Tonsil Cancer

    SciTech Connect

    Chronowski, Gregory M.; Garden, Adam S.; Morrison, William H.; Frank, Steven J.; Schwartz, David L.; Shah, Shalin J.; Beadle, Beth M.; Gunn, G. Brandon; Kupferman, Michael E.; Ang, Kian K.; Rosenthal, David I.

    2012-05-01

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

  6. MRI and unilateral NMR study of reindeer skin tanning processes.

    PubMed

    Zhu, Lizheng; Del Federico, Eleonora; Ilott, Andrew J; Klokkernes, Torunn; Kehlet, Cindie; Jerschow, Alexej

    2015-04-01

    The study of arctic or subarctic indigenous skin clothing material, known for its design and ability to keep the body warm, provides information about the tanning materials and techniques. The study also provides clues about the culture that created it, since tanning processes are often specific to certain indigenous groups. Untreated skin samples and samples treated with willow (Salix sp) bark extract and cod liver oil are compared in this study using both MRI and unilateral NMR techniques. The two types of samples show different proton spatial distributions and different relaxation times, which may also provide information about the tanning technique and aging behavior. PMID:25719858

  7. Unilateral onycholysis in a patient taking erlotinib (Tarceva)

    PubMed Central

    Stevenson, Robert; El-Modir, Ahmed

    2011-01-01

    Targeting epidermal growth factor receptor (EGFR)-mediated signalling pathways has become routine practice in the treatment of lung cancer. Erlotinib is an oral EGFR tyrosine kinase inhibitor, licensed for maintenance monotherapy treatment in patients with locally advanced or metastatic non-small cell lung cancer after first-line chemotherapy. The authors present the case of a 51-year-old patient who had an excellent response to erlotinib, but developed unilateral onycholysis as an unusual side effect. The authors discuss erlotinib-induced skin and nail changes and have provided a brief literature review on the available evidence for their management. PMID:22688477

  8. Image segmentation and registration algorithm to collect thoracic skeleton semilandmarks for characterization of age and sex-based thoracic morphology variation.

    PubMed

    Weaver, Ashley A; Nguyen, Callistus M; Schoell, Samantha L; Maldjian, Joseph A; Stitzel, Joel D

    2015-12-01

    Thoracic anthropometry variations with age and sex have been reported and likely relate to thoracic injury risk and outcome. The objective of this study was to collect a large volume of homologous semilandmark data from the thoracic skeleton for the purpose of quantifying thoracic morphology variations for males and females of ages 0-100 years. A semi-automated image segmentation and registration algorithm was applied to collect homologous thoracic skeleton semilandmarks from 343 normal computed tomography (CT) scans. Rigid, affine, and symmetric diffeomorphic transformations were used to register semilandmarks from an atlas to homologous locations in the subject-specific coordinate system. Homologous semilandmarks were successfully collected from 92% (7077) of the ribs and 100% (187) of the sternums included in the study. Between 2700 and 11,000 semilandmarks were collected from each rib and sternum and over 55 million total semilandmarks were collected from all subjects. The extensive landmark data collected more fully characterizes thoracic skeleton morphology across ages and sexes. Characterization of thoracic morphology with age and sex may help explain variations in thoracic injury risk and has important implications for vulnerable populations such as pediatrics and the elderly. PMID:26496701

  9. Systems biology of kidney diseases

    PubMed Central

    He, John Cijiang; Chuang, Peter Y.; Ma'ayan, Avi; Iyengar, Ravi

    2011-01-01

    Kidney diseases manifest in progressive loss of renal function, which ultimately leads to complete kidney failure. The mechanisms underlying the origins and progression of kidney diseases are not fully understood. Multiple factors involved in the pathogenesis of kidney diseases have made the traditional candidate gene approach of limited value toward full understanding of the molecular mechanisms of these diseases. A systems biology approach that integrates computational modeling with large-scale data gathering of the molecular changes could be useful in identifying the multiple interacting genes and their products that drive kidney diseases. Advances in biotechnology now make it possible to gather large data sets to characterize the role of the genome, epigenome, transcriptome, proteome, and metabolome in kidney diseases. When combined with computational analyses, these experimental approaches will provide a comprehensive understanding of the underlying biological processes. Multiscale analysis that connects the molecular interactions and cell biology of different kidney cells to renal physiology and pathology can be utilized to identify modules of biological and clinical importance that are perturbed in disease processes. This integration of experimental approaches and computational modeling is expected to generate new knowledge that can help to identify marker sets to guide the diagnosis, monitor disease progression, and identify new therapeutic targets. PMID:21881558

  10. Thoracic Vertebral Actinomycosis Secondary to a Pulmonary Origin

    PubMed Central

    Thango, Nqobile S; Ben Husein, Mohamed; Welsh, David

    2015-01-01

    Actinomycosis is a chronic infection caused by a gram-positive anaerobic bacteria from the species Actinomycesand causes a chronic colliquative inflammatory reaction known as actinomycotic granuloma, which is characterized macroscopically by suppuration, sinus tract formation, and purulent discharge containing yellowish sulfur granules. It can invade any part of the human body. This is a case report of a 40-year-old male patient known to the cardiothoracic team due to a sarcoma of the left lung. He presented with progressive thoracic myelopathy. Initially, the diagnosis was thought to be a spinal metastasis from the lung lesion. Further investigation revealed a thoracic actinomycosis with epidural granuloma tissue causing a spinal compression. PMID:26719834

  11. Right atrial tumor embolism from thoracic chondrosarcoma: A case report

    PubMed Central

    LV, LIYUAN; WANG, XUEQIAN; ZHANG, YING

    2015-01-01

    Chondrosarcoma accounts for ~15% of all primary malignant bone tumors. Chondrosarcoma of the spine is rare, while intra-atrial tumor embolisms as a result of chondrosarcoma are extremely rare. In the present study, the case of a 70-year-old male with thoracic chondrosarcoma, who presented with a fever and exertional dyspnea, is reported. Following anti-infection treatment with cefoperazone sodium and sulbactam sodium, the patient developed shock and a mass was identified in the right atrium by echocardiogram. The patient subsequently developed acute circular breathing failure and succumbed to the disease. To the best of our knowledge, this is the first case of thoracic chondrosarcoma with a tumor embolism in the right atrium to be reported in the literature. PMID:26722246

  12. Bilateral thoracic ganglion cyst : a rare case report.

    PubMed

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

    2013-05-01

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

  13. [Precise thoracic surgery: new era of minimally invasive surgery].

    PubMed

    Li, Hui

    2015-10-01

    Precise surgery is based on the integrated application of modern science and technology and integrated innovation of surgical technology revolution features. It is built in high-end digital medical bases. The purpose of precise surgery is to achieve accurate lesion resection, minimize injury, improve the quality of life and reduce the risk of surgery. In this paper we forward new concept of precise thoracic surgery. An overview was made on the development of precise surgery with great support of virtual reality technology, augmented reality technology and image acquisition technology. Finally the paper illustrated the prospect of precise of thoracic surgery from the following aspects: preoperative planning, the choice of surgical approach, precise tumor localization, postoperative immediate 3-dimension multi modality imaging evaluation. PMID:26654300

  14. The history of surgery of the thoracic aorta.

    PubMed

    Cooley, D A

    1999-11-01

    Until the late 19th century, treatment of thoracic aortic aneurysms relied on ligation of the parent vessel or introduction of foreign materials to promote coagulation or fibrosis. A major breakthrough occurred in 1888, when Rudolph Matas reported an internal repair technique known as endoaneurysmorrhaphy. In this approach, the clot was excised from the aneurysmal sac, and the orifices of the arteries that entered the sac were sutured from within, reestablishing continuous blood flow. At the beginning of the 20th century, Alexis Carrel and Charles Guthrie began to lay the foundation for modern vascular anastomotic techniques. Although isolated successes were reported, optimal treatment of thoracic aortic disease awaited the development of reliable synthetic grafts in the 1950s and 1960s. During the past 15 years, the treatment goal has reverted to endoaneurysmorrhaphy, involving the use of a suitable graft to restore aortic continuity. PMID:10589335

  15. [The university in the development of thoracic surgery in Spain].

    PubMed

    París, Francisco; Balibrea, José Luis

    2005-11-01

    The present article analyzes the figures of the university professors who, from 1911, formed part of one of the basic pillars in the development of "Spanish Thoracic Surgery". At that time, there was a certain amount of infighting between general and specialized surgery, which was resolved by allowing specialization after a period of training in general surgery. Universities should not be denied the great merit of having produced well-trained surgeons with a broad general foundation who would later choose a specialty. The figures of Ricardo Lozano Monzón, Francisco Martín Lagos, José Gascó, Benjamín Narbona, Carlos Carbonell Antolí, Rafael Vara López, Alfonso de la Fuente Chaos and José M. Beltrán de Heredia with their previous training, corresponding precursors and respective schools are described. Their teaching, surgical practice, and scientific activity are also described. A future article based on the contribution of Valencia to the specialty of general thoracic surgery is also outlined. PMID:16420845

  16. Acquired thoracic scoliosis following minimally invasive repair of pectus excavatum.

    PubMed

    Niedbala, Angela; Adams, Michael; Boswell, William C; Considine, John M

    2003-06-01

    The minimally invasive pectus excavatum repair as described by Nuss et al. is rapidly gaining acceptance as an effective method of repair of severe pectus excavatum deformities in the pediatric population. It potentially offers several advantages over previous techniques. The incidence of major complications of the procedure has been reduced by recent modifications including utilization of video-assisted thoracoscopy during placement of the Lorenz pectus bar as well as utilizing the pectus bar stabilizer that provides more rigid fixation of the strut. We report two cases of acquired thoracic scoliosis following minimally invasive repair of severe pectus excavatum deformity. This particular complication has not been reported in previous literature and warrants concern. In both cases the thoracic scoliosis slowly improved with physical therapy and range-of-motion exercises. PMID:12852514

  17. Single-Port Thoracic Surgery: A New Direction

    PubMed Central

    Ng, Calvin S. H.

    2014-01-01

    Single-port video-assisted thoracic surgery (VATS) has slowly established itself as an alternate surgical approach for the treatment of an increasingly wide range of thoracic conditions. The potential benefits of fewer surgical incisions, better cosmesis, and less postoperative pain and paraesthesia have led to the technique’s popularity worldwide. The limited single small incision through which the surgeon has to operate poses challenges that are slowly being addressed by improvements in instrument design. Of note, instruments and video-camera systems that are narrower and angulated have made single-port VATS major lung resection easier to perform and learn. In the future, we may see the development of subcostal or embryonic natural orifice translumenal endoscopic surgery access, evolution in anaesthesia strategies, and cross-discipline imaging-assisted lesion localization for single-port VATS procedures. PMID:25207240

  18. Evolutionary Reduction of the First Thoracic Limb in Butterflies

    PubMed Central

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

    2011-01-01

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

  19. Nephrotoxicity of ibandronate and zoledronate in Wistar rats with normal renal function and after unilateral nephrectomy.

    PubMed

    Bergner, R; Siegrist, B; Gretz, N; Pohlmeyer-Esch, G; Kränzlin, B

    2015-09-01

    A previous animal study compared the nephrotoxic effect of ibandronate (IBN) and zoledronate (ZOL), but interpretation of these study results was limited because of the model of minimal nephrotoxic dosage with a dosage ratio of 1:3. The present study investigated the nephrotoxicity of ibandronate and zoledronate in a 1.5:1 dose ratio, as used in clinical practice and compared the nephrotoxicity in rats with normal and with mildly to moderately impaired renal function. We compared rats with normal renal function (SHAM) and with impaired renal function after unilateral nephrectomy (UNX), treated either with ibandronate 1.5mg/kg, zoledronate 1mg/kg or placebo once (1×) or nine (9×) times. Renal function and markers of tubular toxicity were measured over a 27 week period. After last bisphosphonate treatment the rats were sacrificed and kidneys examined histologically. All bisphosphonate treated animals showed a significant tubular toxicity, which was temporary except in the ZOL-UNX-9×-group. Also the renal function was only transiently reduced except in the ZOL-UNX-9×-group. Histologically, bisphosphonate treatment led to cortical tubuloepithelial degeneration/necrosis and medullary tubuloepithelial swelling which were slightly more pronounced in ibandronate treated animals, when compared to zoledronate treated animals, especially with impaired renal function. In contrast to the previous study we found a similar nephrotoxicity of ibandronate and zoledronate in rats with normal renal function. In rats with impaired renal function the peak of toxicity had not even been fully reached until end of experiment in the zoledronate treated animals. The peak of toxicity seems to be more severe and delayed in rats with impaired renal function compared with rats with normal renal function. PMID:25976681

  20. Have Thoracic Endografting Outcomes Improved Since FDA Approval?

    PubMed Central

    Bhamidipati, Castigliano M; LaPar, Damien J; Mehta, Gaurav S; Kern, John A; Kron, Irving L; Upchurch, Gilbert R; Ailawadi, Gorav

    2011-01-01

    Objective Thoracic endovascular aneurysm repair (TEVAR) is gaining acceptance since Food and Drug Administration approval in 2005. We hypothesize that, compared to open repair (OPEN), mortality and complication rate after TEVAR have continued to improve. Methods All patients who underwent thoracic and/ or thoracoabdominal aneurysm repair from 2005 to 2007 in the Nationwide Inpatient Sample were examined. Patients were stratified by TEVAR or OPEN. Demographics, hospital characteristics, and outcomes were analyzed. Multivariable logistic regression models for complications and in-hospital mortality were developed. Results A weighted total of 7,644 had TEVAR, while 32,948 patients underwent OPEN. TEVAR utilization increased from 5.5% (2005) to 24.1% (2007). Mortality for all patients undergoing thoracic aneurysm repair decreased yearly (P<0.001). Mortality (TEVAR: 7.3%, OPEN: 9.8%, P<0.001) and complication rate (TEVAR: 24.3%, OPEN: 42.1%, P<0.001) were superior with TEVAR. The unadjusted annual mortality (7%) and complication rate (24%) following TEVAR did not improve each year, however, after risk adjustment mortality after TEVAR steadily decreased annually. Moreover, risk adjusted mortality for OPEN has improved since 2005. Multivariate analysis revealed age and ruptured aneurysm were highly predictive of death (P<0.001, respectively), while TEVAR lowered the adjusted odds of death by 18% (P<0.05). Conclusions Mortality in patients undergoing repair of thoracic aneurysms has decreased in the United States since FDA approval of stent grafts in 2005. This is due to wider adoption of TEVAR, and improved mortality in patients undergoing TEVAR or open repair. PMID:21439547

  1. Neurological Complications Following Endoluminal Repair of Thoracic Aortic Disease

    SciTech Connect

    Morales, J. P.; Taylor, P. R.; Bell, R. E.; Chan, Y. C.; Sabharwal, T.; Carrell, T. W. G.; Reidy, J. F.

    2007-09-15

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

  2. Medicare Coverage of Kidney Dialysis and Kidney Transplant Services

    MedlinePLUS

    ... services in a Medicare-certified hospital. ? Kidney registry fee. ? Laboratory and other tests needed to evaluate your ... Medicare, Medicare pays your dialysis facility a flat fee to supervise home dialysis training. After you pay ...

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

    PubMed Central

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

    2011-01-01

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

  4. Instantaneous Respiratory Estimation from Thoracic Impedance by Empirical Mode Decomposition

    PubMed Central

    Wang, Fu-Tai; Chan, Hsiao-Lung; Wang, Chun-Li; Jian, Hung-Ming; Lin, Sheng-Hsiung

    2015-01-01

    Impedance plethysmography provides a way to measure respiratory activity by sensing the change of thoracic impedance caused by inspiration and expiration. This measurement imposes little pressure on the body and uses the human body as the sensor, thereby reducing the need for adjustments as body position changes and making it suitable for long-term or ambulatory monitoring. The empirical mode decomposition (EMD) can decompose a signal into several intrinsic mode functions (IMFs) that disclose nonstationary components as well as stationary components and, similarly, capture respiratory episodes from thoracic impedance. However, upper-body movements usually produce motion artifacts that are not easily removed by digital filtering. Moreover, large motion artifacts disable the EMD to decompose respiratory components. In this paper, motion artifacts are detected and replaced by the data mirrored from the prior and the posterior before EMD processing. A novel intrinsic respiratory reconstruction index that considers both global and local properties of IMFs is proposed to define respiration-related IMFs for respiration reconstruction and instantaneous respiratory estimation. Based on the experiments performing a series of static and dynamic physical activates, our results showed the proposed method had higher cross correlations between respiratory frequencies estimated from thoracic impedance and those from oronasal airflow based on small window size compared to the Fourier transform-based method. PMID:26198231

  5. Sympathetic Nerve Fibers in Human Cervical and Thoracic Vagus Nerves

    PubMed Central

    Seki, Atsuko; Green, Hunter R.; Lee, Thomas D.; Hong, LongSheng; Tan, Jian; Vinters, Harry V.; Chen, Peng-Sheng; Fishbein, Michael C.

    2014-01-01

    Background Vagus nerve stimulation therapy (VNS) has been used for chronic heart failure (CHF), and is believed to improve imbalance of autonomic control by increasing parasympathetic activity. Although it is known that there is neural communication between the VN and the cervical sympathetic trunk, there are few data regarding the quantity and/or distribution of the sympathetic components within the VN. Objective To examine the sympathetic component within human VN and correlate these with the presence of cardiac and neurologic diseases. Methods We performed immunohistochemistry on 31 human cervical and thoracic VNs (total 104 VNs) from autopsies and we reviewed the patients’ records. We correlated the quantity of sympathetic nerve fibers within the VNs with cardiovascular and neurologic disease states. Results All 104 VNs contain TH positive (sympathetic) nerve fibers; the mean TH positive areas were 5.47% in right cervical, 3.97% in left cervical, 5.11% in right thoracic, and 4.20% in left thoracic VN. The distribution of TH positive nerve fibers varied from case to case: central, peripheral, or scattered throughout nerve bundles. No statistically significant differences in nerve morphology were seen between diseases in which VNS is considered effective (depression and CHF), and other cardiovascular diseases, or neurodegenerative disease. Conclusion Human VNs contain sympathetic nerve fibers. The sympathetic component within the VN could play a role in physiologic effects reported with VNS. The recognition of sympathetic nerve fibers in the VNs may lead to better understanding of the therapeutic mechanisms of VNS. PMID:24768897

  6. Endovascular Repair of Contained Rupture of the Thoracic Aorta

    SciTech Connect

    Morgan, Robert; Loosemore, Tom; Belli, Anna-Maria

    2002-08-15

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

  7. Advanced endovascular techniques for thoracic and abdominal aortic dissections.

    PubMed

    Kölbel, T; Diener, H; Larena-Avellaneda, A; Debus, S

    2013-02-01

    Endovascular treatment of aortic dissection is still in its infancy and consists usually of implantation of thoracic tubular stent-grafts to cover the proximal entry tear and redirect flow into the true lumen. Large registries comparing endovascular treatment by thoracic endovascular aortic repair (TEVAR) with open surgery for aortic dissection of the descending aorta have demonstrated a clear benefit for endovascular treatment with lower mortality and morbidity rates turning TEVAR into the standard treatment for complicated type B aortic dissection. With this momentum of success endovascular techniques continue to challenge open surgical techniques also in the aortic arch and the ascending aorta. TEVAR for aortic dissection has become more complex requiring an individualized treatment strategy as endovascular techniques have developed with the advent of new devices and increased experience of the operators. In many cases straight implantation of a thoracic tubular stent-graft is sufficient. But as rerouting of the blood flow can also change perfusion of vital side-branches the endovascular operator needs to have a large armamentarium of techniques and adjunctive procedures in order to sufficiently address the individual patient morphology. This chapter reviews a variety of endovascular techniques including access techniques, proximal sealing, the Petticoat-technique, false lumen deployment, fenestration techniques, branch vessel stenting and false lumen obstruction by various techniques. PMID:23443592

  8. Altered Contralateral Auditory Cortical Morphology in Unilateral Sudden Sensorineural Hearing Loss

    PubMed Central

    Fan, Wenliang; Zhang, Wenjuan; Li, Jing; Zhao, Xueyan; Mella, Grace; Lei, Ping; Liu, Yuan; Wang, Haha; Cheng, Huamao; Shi, Hong; Xu, Haibo

    2015-01-01

    Objective: To investigate the cerebral gray matter volume alterations in unilateral sudden sensorineural hearing loss patients within the acute period by the voxel-based morphometry method, and to determine if hearing impairment is associated with regional gray matter alterations in unilateral sudden sensorineural hearing loss patients. Study Design: Prospective case study. Setting: Tertiary class A teaching hospital. Patients: Thirty-nine patients with left-side unilateral sudden sensorineural hearing loss and 47 patients with right-side unilateral sudden sensorineural hearing loss. Intervention: Diagnostic. Main Outcome Measure: To compare the regional gray matter of unilateral sudden sensorineural hearing loss patients and healthy control participants. Results: Compared with control groups, patients with left side unilateral sudden sensorineural hearing loss had significant gray matter reductions in the right middle temporal gyrus and right superior temporal gyrus, whereas patients with right side unilateral sudden sensorineural hearing loss showed gray matter decreases in the left superior temporal gyrus and left middle temporal gyrus. A significant negative correlation with the duration of the sudden sensorineural hearing loss (R?=??0.427, p?=?0.012 for left-side unilateral SSNHL and R?=??0.412, p?=?0.013 for right-side unilateral SSNHL) was also found in these brain areas. There was no region with increased gray matter found in both groups of unilateral sudden sensorineural hearing loss patients. Conclusions: This study confirms that detectable decreased contralateral auditory cortical morphological changes have occurred in unilateral SSNHL patients within the acute period by voxel-based morphometry methods. The gray matter volumes of these brain areas also perform a negative correlation with the duration of the disease, which suggests a gradual brain structural impairment after the progression of the disease. PMID:26595717

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

    Takazawa, Ryoji; Kitayama, Sachi; Tsujii, Toshihiko

    2015-01-01

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

  11. The cyclic GMP-dependent protein kinase I? suppresses kidney fibrosis.

    PubMed

    Schinner, Elisabeth; Schramm, Andrea; Kees, Frieder; Hofmann, Franz; Schlossmann, Jens

    2013-12-01

    Cyclic guanosine monophosphate (cGMP) is synthesized by nitric oxide or natriuretic peptide-stimulated guanylyl cyclases and exhibits pleiotropic regulatory functions in the kidney. Hence, integration of cGMP signaling by cGMP-dependent protein kinases (cGKs) might play a critical role in renal physiology; however, detailed renal localization of cGKs is still lacking. Here, we performed an immunohistochemical analysis of cGKI? and cGKI? isozymes in the mouse kidney and found both in arterioles, the mesangium, and within the cortical interstitium. In contrast to cGKI?, the ?-isoform was not detected in the juxtaglomerular apparatus or medullary fibroblasts. Since interstitial fibroblasts play a prominent role in interstitial fibrosis, we focused our study on cGKI function in the interstitium, emphasizing a functional differentiation of both isoforms, and determined whether cGKIs influence renal fibrosis induced by unilateral ureter obstruction. Treatment with the guanylyl cyclase activators YC1 or isosorbide dinitrate showed stronger antifibrotic effects in wild-type than in cGKI-knockout or in smooth muscle-cGKI?-rescue mice, which are cGKI deficient in the kidney except in the renal vasculature. Moreover, fibrosis influenced the mRNA and protein expression levels of cGKI? more strongly than cGKI?. Thus, our results indicate that cGMP, acting primarily through cGKI?, is an important suppressor of kidney fibrosis. PMID:23760283

  12. Molecular Markers of Tubulointerstitial Fibrosis and Tubular Cell Damage in Patients with Chronic Kidney Disease

    PubMed Central

    Nakagawa, Shunsaku; Nishihara, Kumiko; Miyata, Hitomi; Shinke, Haruka; Tomita, Eri; Kajiwara, Moto; Matsubara, Takeshi; Iehara, Noriyuki; Igarashi, Yoshinobu; Yamada, Hiroshi; Fukatsu, Atsushi; Yanagita, Motoko; Matsubara, Kazuo; Masuda, Satohiro

    2015-01-01

    In chronic kidney disease (CKD), progressive nephron loss causes glomerular sclerosis, as well as tubulointerstitial fibrosis and progressive tubular injury. In this study, we aimed to identify molecular changes that reflected the histopathological progression of renal tubulointerstitial fibrosis and tubular cell damage. A discovery set of renal biopsies were obtained from 48 patients with histopathologically confirmed CKD, and gene expression profiles were determined by microarray analysis. The results indicated that hepatitis A virus cellular receptor 1 (also known as Kidney Injury Molecule-1, KIM-1), lipocalin 2 (also known as neutrophil gelatinase-associated lipocalin, NGAL), SRY-box 9, WAP four-disulfide core domain 2, and NK6 homeobox 2 were differentially expressed in CKD. Their expression levels correlated with the extent of tubulointerstitial fibrosis and tubular cell injury, determined by histopathological examination. The expression of these 5 genes was also increased as kidney damage progressed in a rodent unilateral ureteral obstruction model of CKD. We calculated a molecular score using the microarray gene expression profiles of the biopsy specimens. The composite area under the receiver operating characteristics curve plotted using this molecular score showed a high accuracy for diagnosing tubulointerstitial fibrosis and tubular cell damage. The robust sensitivity of this score was confirmed in a validation set of 5 individuals with CKD. These findings identified novel molecular markers with the potential to contribute to the detection of tubular cell damage and tubulointerstitial fibrosis in the kidney. PMID:26317775

  13. Acute Unilateral Vestibular Failure Does Not Cause Spatial Hemineglect

    PubMed Central

    Conrad, Julian; Habs, Maximilian; Brandt, Thomas; Dieterich, Marianne

    2015-01-01

    Objectives Visuo-spatial neglect and vestibular disorders have common clinical findings and involve the same cortical areas. We questioned (1) whether visuo-spatial hemineglect is not only a disorder of spatial attention but may also reflect a disorder of higher cortical vestibular function and (2) whether a vestibular tone imbalance due to an acute peripheral dysfunction can also cause symptoms of neglect or extinction. Therefore, patients with an acute unilateral peripheral vestibular failure (VF) were tested for symptoms of hemineglect. Methods Twenty-eight patients with acute VF were assessed for signs of vestibular deficits and spatial neglect using clinical measures and various common standardized paper-pencil tests. Neglect severity was evaluated further with the Center of Cancellation method. Pathological neglect test scores were correlated with the degree of vestibular dysfunction determined by the subjective visual vertical and caloric testing. Results Three patients showed isolated pathological scores in one or the other neglect test, either ipsilesionally or contralesionally to the VF. None of the patients fulfilled the diagnostic criteria of spatial hemineglect or extinction. Conclusions A vestibular tone imbalance due to unilateral failure of the vestibular endorgan does not cause spatial hemineglect, but evidence indicates it causes mild attentional deficits in both visual hemifields. PMID:26247469

  14. Apparatus for unilateral generation of a homogeneous magnetic field

    SciTech Connect

    Fukushima, E.; Rath, A.R.; Roeder, S.B.

    1988-01-26

    This patent describes an apparatus for generating within a selected volume a magnetic field having a uniform strength to a selected tolerance, comprising: a first electromagnet coil having a first number of turns N/sub 1/ at a first radius R/sub 1/ with a center of the first coil spaced axially a first distance from the selected volume; a second electromagnet coil axially concentric with and parallel to the first coil and having a second number of turns N/sub 2/ at a second radius R/sub 2/ greater than R/sub 1/ and spaced unilateral of the volume with the first coil a second distance greater than the first distance from the selected volume. The first radius and first distance and the second radius and second distance is functionally related to enable the first and second electromagnet coils to produce first and second electromagnet coils to produce first and second magnetic fields, respectively, having substantially linear gradients within the selected volume. N/sub 1/ and N/sub 2/ are effective when energized with predetermined first and second currents, respectively, to produce equal and opposite gradients of the respective first and second magnetic fields in the unilateral volume and a net magnetic field having a strength within the selected volume effective for nuclear magnetic resonance determinations.

  15. Unilateral Agenesis of the Lung: A Rare Entity

    PubMed Central

    Singh, Urvinderpal; Jhim, Daksh; Kumar, Sunil; Mittal, Vidhu; Singh, Navdeep; Gour, Hitesh; Ramaraj, Muralidharan

    2015-01-01

    Patient: Female, 15 Final Diagnosis: Unilateral agenesis of the lung Symptoms: Sore throat with dry cough Medication: — Clinical Procedure: Cect of the chest and bronchoscopy Specialty: Pulmonology Objective: Congenital defects/diseases Background: Agenesis of the lung, a rare congenital anomaly, arises or develops when there is disruption of evolution of the primitive lung bud, leading to complete absence of the lung, bronchi, and the main pulmonary artery. With right-sided agenesis, a variety of cardiac and other congenital malformations are more commonly seen, leading to a poor prognosis. Case Report: A young female, aged 15 years, presented with complaints of sore throat and cough. Her x-ray of the chest showed a homogeneous opacity in the middle and lower zones on the right side with marked shift of the mediastinum to the right side. Upon investigation, she was diagnosed with agenesis of the right lung with scoliosis, without any other congenital anomaly. Conclusions: Especially in adults, it requires a high level of good clinical judgement to identify and diagnose this congenital aberration, as they are often wrongly diagnosed as more common diseases associated with unilateral opaque hemithorax on x-ray. Hence, when confronted with an opaque hemithorax with shift of the mediastinum to the affected side in a young person, “agenesis of the lung” should be an important differential diagnosis while investigating the case. PMID:25659613

  16. Lymph flow pattern in the intact thoracic duct in sheep.

    PubMed Central

    Onizuka, M; Flatebø, T; Nicolaysen, G

    1997-01-01

    1. To study the lymph flow dynamics in the intact thoracic duct, we applied an ultrasound transit-time flow probe in seven anaesthetized and four unanaesthetized adult sheep (approximately 60 kg). In unanaesthetized non-fasting animals we found that lymph flow in the thoracic duct was always regular pulsatile (pulsation frequency, 5.2 +/- 0.8 min-1) with no relation to heart or respiratory activity. At baseline the peak level of the thoracic duct pulse flow was 11.6-20.7 ml min-1 with a nadir of 0-3.6 ml min-1. Mean lymph flow was 5.4 +/- 3.1 ml min-1. The flow pattern of lymph in the thoracic duct was essentially the same in the anaesthetized animals. 2. In both the anaesthetized and unanaesthetized animals, the lymph flow response to a stepwise increase in the outflow venous pressure showed interindividual variation. Some were sensitive to any increase in outflow venous pressure, but others were resistant in that lymph flow did not decrease until outflow venous pressure was increased to higher levels. This resistance was also observed in the high lymph flow condition produced by fluid infusion in the anaesthetized animal and mechanical constriction of the caudal vena cava in the unaesthetized animals. Pulsation frequency of the thoracic duct flow initially increased and then decreased with a stepwise increase in the outflow venous pressure. This initial increase might be a compensatory response to maintain lymph flow against elevated outflow venous pressure. 3. To test the effect of long-term outflow venous pressure elevation in unanaesthetized sheep, outflow venous pressure was increased by inflation of a cuff around the cranial vena cava for 1, 5 or 25 h. The cuff was inflated to a level where lymph flow was reduced. Lymph flow remained low or decreased further during the entire cuff-inflation period. We calculated the lymph debt caused by the outflow venous pressure elevation and the amount 'repaid' when venous pressure returned to normal. Lymph debt for 25 h was 6400 ml but only 200 ml was repaid. Since we observed no visible oedema formation in the lower body of the sheep, the non-colloidal components of the lymph must have been reabsorbed into the bloodstream, most likely in the lymph nodes. PMID:9288690

  17. Three dimensional model for surgical planning in resection of thoracic tumors

    PubMed Central

    Kim, Min P.; Ta, Anderson H.; Ellsworth, Warren A.; Marco, Rex A.; Gaur, Puja; Miller?, Jordan S.

    2015-01-01

    Introduction The computed tomography scan provides vital information about the relationship of thoracic malignancies to the surrounding structures and aids in surgical planning. However, it can be difficult to visualize the images in a two-dimensional screen to interpret the full extent of the relationship between important structures in the surgical field. Presentation of case We report two cases where we used a three-dimensional printed model to aid in the surgical resection of thoracic malignancies. Discussion Careful planning is necessary to resect thoracic malignancies. Although two-dimensional images of the thoracic malignancies provide vital information about the tumor and its surrounding structures, the three-dimensional printed model can provide more accurate information about the tumor and assist in surgical planning. Conclusion Three-dimensional printed model provide better visualization of complex thoracic tumors, aid in counseling the patient about the surgical procedure and assisted in surgical resection of thoracic malignancy. PMID:26453940

  18. End-stage kidney disease

    MedlinePLUS

    ... used to perform dialysis: During hemodialysis, your blood passes through a tube into an artificial kidney, or filter. During peritoneal dialysis , a special solution passes into your belly though a catheter tube. The ...

  19. 10 Symptoms of Kidney Disease

    MedlinePLUS

    ... anything, just totally drained." Symptom 4: Skin Rash/Itching Kidneys remove wastes from the bloodstream. When the ... of wastes in your blood can cause severe itching. What patients said: "It's not really a skin ...

  20. Acute kidney injury: current perspectives.

    PubMed

    Choudhury, Devasmita

    2010-11-01

    Acute kidney injury (AKI) increases morbidity and mortality, particularly for the critically ill. Recent definitions standardizing AKI to reflect graded changes in serum creatinine and urine output (per the Risk, Injury, Failure, Loss, and End-stage renal failure [RIFLE] and Acute Kidney Injury Network [AKIN] criteria) with severity of renal injury and developments in AKI pathobiology are being utilized to identify biomarkers of early kidney injury. These developments may be useful in the early intervention of preventing AKI. Although there has been progress in the management of AKI, therapeutic challenges include appropriate prophylaxis prior to contrast administration, use of diuretics, vasopressors, and the type and dose of renal replacement therapy. Future use of bioartificial dialyzers, plasma therapies, and the possibility of stem cell regeneration of injured kidney tissue are being actively investigated to provide alternative treatment options for AKI. This review aims to provide an overview of current practices, available therapies, and continued research in AKI therapy. PMID:21084779

  1. Living Donor Kidney Transplant Surgery

    MedlinePLUS Videos and Cool Tools

    ... prior to putting the patient on the immunosuppressive medicines to take care of their new kidney. But ... days, I think. And then they gave you medicine through the IV after that. Right. So the ...

  2. IdentityBased Key Agreement with Unilateral Identity Privacy Using Pairings

    E-print Network

    International Association for Cryptologic Research (IACR)

    Identity­Based Key Agreement with Unilateral Identity Privacy Using Pairings Zhaohui Cheng 1 TW20 0EX, UK qiang.tang@rhul.ac.uk Abstract. In most of the existing identity­based key agreement­based two­party key agreement scheme with unilateral identity privacy using pairing, and formally analyze

  3. Identity-Based Key Agreement with Unilateral Identity Privacy Using Pairings

    E-print Network

    International Association for Cryptologic Research (IACR)

    Identity-Based Key Agreement with Unilateral Identity Privacy Using Pairings Zhaohui Cheng1 , Liqun TW20 0EX, UK qiang.tang@rhul.ac.uk Abstract. In most of the existing identity-based key agreement identity-based two-party key agreement scheme with unilateral identity privacy using pairing, and formally

  4. Longitudinal Development of Hand Function in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Holmefur, Marie; Krumlinde-Sundholm, Lena; Bergstrom, Jakob; Eliasson, Ann-Christin

    2010-01-01

    Aim: The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral cerebral palsy (CP) aged between 18 months and 8 years. Method: A prospective longitudinal study of 43 children (22 males, 21 females) with unilateral CP was conducted. Inclusion age was 18 months to 5 years 4 months (mean 2y…

  5. Motor Learning of a Bimanual Task in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Hung, Ya-Ching; Gordon, Andrew M.

    2013-01-01

    Children with unilateral cerebral palsy (CP) have been shown to improve their motor performance with sufficient practice. However, little is known about how they learn goal-oriented tasks. In the current study, 21 children with unilateral CP (age 4-10 years old) and 21 age-matched typically developed children (TDC) practiced a simple bimanual…

  6. A Magnetoencephalographic Study of Sensorimotor Activity Differences during Unilateral and Bilateral Forearm Movements

    ERIC Educational Resources Information Center

    Nakagawa, Kei

    2010-01-01

    This study compared activation of the sensorimotor area using magnetoencephalography after unilateral and bilateral movements. Thirteen healthy individuals and a patient with mild hemiplegia performed unilateral and bilateral forearm pronation movements. Among healthy participants, there were no significant differences in motor-evoked field during…

  7. Bilateral Input Protects the Cortex from Unilaterally-Driven Reorganization in Children Who Are Deaf

    ERIC Educational Resources Information Center

    Gordon, Karen A.; Wong, Daniel D. E.; Papsin, Blake C.

    2013-01-01

    Unilateral hearing in childhood restricts input along the bilateral auditory pathways, possibly causing permanent reorganization. In this study we asked: (i) do the auditory pathways develop abnormally in children who are bilaterally deaf and hear with a unilateral cochlear implant? and (ii) can such differences be reversed by restoring input to…

  8. Biomechanical comparison of unilateral semi-rigid and dynamic stabilization on ovine vertebrae.

    PubMed

    Karakoyun, Dursun O; Özkaya, Mustafa; Okutan, Volkan C; Dalg?ç, Ali; Belen, Deniz; Demir, Teyfik

    2015-11-01

    Using the unilateral pedicle screw fixation was thought to decrease the stiffness of the fixed segments. Various prospective, randomized studies were performed to determine whether unilateral pedicle screw fixation provides the necessities of bilateral fixation in one- or two-segment lumbar spinal fusion. In this study, four different unilateral pedicle screw fixation systems were evaluated to determine which one best approximated an intact spine with respect to biomechanics and kinematics. The four groups included an intact group, a unilateral facetectomy group with no fixation, a unilateral semi-rigid pedicle screw fixation group with a poly-ether-ether-ketone rod, and a unilateral dynamic pedicle screw fixation group. The bone mineral densities of all specimens were measured and specimens were matched with groups randomly. Flexion, lateral bending, and axial rotation tests were performed to compare the groups. For the flexion, lateral bending, and axial rotation tests, the best biomechanical outcomes were in the control group. The unilateral facetectomy group had the poorest performance and was not stable enough, compared with the control group. The dynamic and semi-rigid groups showed performance closer to that of the control group. The biomechanical responses of these two groups were also in good agreement, showing no significant statistical differences. Based on these test results, it is concluded that the unilateral dynamic and semi-rigid pedicle screw fixations can be used to provide stability to the vertebrae. PMID:26503839

  9. 12 CFR 950.11 - Capital stock requirements; unilateral redemption of excess stock.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Capital stock requirements; unilateral redemption of excess stock. 950.11 Section 950.11 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL... Housing Associates § 950.11 Capital stock requirements; unilateral redemption of excess stock. (a)...

  10. Song Recognition by Young Children with Cochlear Implants: Comparison between Unilateral, Bilateral, and Bimodal Users

    ERIC Educational Resources Information Center

    Bartov, Tamar; Most, Tova

    2014-01-01

    Purpose: To examine song identification by preschoolers with normal hearing (NH) versus preschoolers with cochlear implants (CIs). Method: Participants included 45 children ages 3;8-7;3 (years;months): 12 with NH and 33 with CIs, including 10 with unilateral CI, 14 with bilateral CIs, and 9 bimodal users (CI-HA) with unilateral CI and…

  11. Unilateral cross bite treated by corticotomy-assisted expansion: two case reports

    PubMed Central

    2010-01-01

    Background True unilateral posterior crossbite in adults is a challenging malocclusion to treat. Conventional expansion methods are expected to have some shortcomings. The aim of this paper is to introduce a new technique for treating unilateral posterior crossbite in adults, namely, corticotomy-assisted expansion (CAE) applied on two adult patients: one with a true unilateral crossbite and the other with an asymmetrical bilateral crossbite, both treated via modified corticotomy techniques and fixed orthodontic appliances. Methods Two cases with asymmetric maxillary constriction were treated using CAE. Results In both cases, effective asymmetrical expansion was achieved using CAE, and functional occlusion was established as well. Conclusions Unilateral CAE presents an effective and reliable technique to treat true unilateral crossbite. PMID:20482859

  12. TEVAR for Flash Pulmonary Edema Secondary to Thoracic Aortic Aneurysm to Pulmonary Artery Fistula.

    PubMed

    Bornak, Arash; Baqai, Atif; Li, Xiaoyi; Rey, Jorge; Tashiro, Jun; Velazquez, Omaida C

    2016-01-01

    Enlarging aneurysms in the thoracic aorta frequently remain asymptomatic. Fistulization of thoracic aortic aneurysms (TAA) to adjacent structures or the presence of a patent ductus arteriosus and TAA may lead to irreversible cardiopulmonary sequelae. This article reports on a large aneurysm of the thoracic aorta with communication to the pulmonary artery causing pulmonary edema and cardiorespiratory failure. The communication was ultimately closed after thoracic endovascular aortic aneurysm repair allowing rapid symptom resolution. Early diagnosis and closure of such communication in the presence of TAA are critical for prevention of permanent cardiopulmonary damage. PMID:26522587

  13. Virtual anatomical three-dimensional fit trial for intra-thoracically implanted medical devices.

    PubMed

    Warriner, Renée K; Haddad, Michel; Hendry, Paul J; Mussivand, Tofy

    2004-01-01

    Our purpose is to develop a system that converts computed tomography (CT) scans into an interactive three-dimensional (3-D) model of the thoracic cavity. This study will allow for the preoperative determination of optimal anatomical fit of intra-thoracically implanted medical equipment such as circulatory support devices. From the radiology data bank, we consecutively selected 34 cardiac and 42 noncardiac patients who had CT scans of the chest. Anatomical structures of the electronic CT scans were manually extracted using software. These structures included the thoracic cage, lungs, heart, and the great vessels. The information was converted into a 3-D surface mesh model, which was imported into a 3-D viewer to acquire direct anatomical measurements. The thoracic cage and intra-thoracic organs were measured for data analysis. A methodology was successfully developed to convert a patient's thoracic CT scans into interactive 3-D models, permitting the collection of key anatomical measurements to assess intra-thoracic device fit feasibility. Extensive measurements of the reconstructed thoracic cavity were recorded in a database format and analyzed. This study demonstrated the feasibility of implementing a rapid preoperative screening method based on anatomical fit for the selection or rejection of patients who are candidates for an intra-thoracic mechanical device. This new method will allow for the virtual preoperative implantation of such devices within a patient's chest cavity. PMID:15307547

  14. Transplanting Kidneys from Deceased Donors With Severe Acute Kidney Injury.

    PubMed

    Heilman, R L; Smith, M L; Kurian, S M; Huskey, J; Batra, R K; Chakkera, H A; Katariya, N N; Khamash, H; Moss, A; Salomon, D R; Reddy, K S

    2015-08-01

    Our aim was to determine outcomes with transplanting kidneys from deceased donors with acute kidney injury, defined as a donor with terminal serum creatinine ?2.0?mg/dL, or a donor requiring acute renal replacement therapy. We included all patients who received deceased donor kidney transplant from June 2004 to October 2013. There were 162 AKI donor transplant recipients (21% of deceased donor transplants): 139 in the standard criteria donor (SCD) and 23 in the expanded criteria donor (ECD) cohort. 71% of the AKI donors had stage 3 (severe AKI), based on acute kidney injury network (AKIN) staging. Protocol biopsies were done at 1, 4, and 12 months posttransplant. One and four month formalin-fixed paraffin embedded (FFPE) biopsies from 48 patients (24 AKI donors, 24 non-AKI) underwent global gene expression profiling using DNA microarrays (96 arrays). DGF was more common in the AKI group but eGFR, graft survival at 1 year and proportion with IF/TA>2 at 1 year were similar for the two groups. At 1 month, there were 898 differentially expressed genes in the AKI group (p-value <0.005; FDR <10%), but by 4 months there were no differences. Transplanting selected kidneys from deceased donors with AKI is safe and has excellent outcomes. PMID:25808278

  15. Perioperative acute kidney injury.

    PubMed

    Goren, O; Matot, I

    2015-12-01

    Perioperative acute kidney injury (AKI) is not uncommon and is associated with considerable morbidity and mortality. Recently, several definition systems for AKI were proposed, incorporating both small changes of serum creatinine and urinary output reduction as diagnostic criteria. Novel biomarkers are under investigation as fast and accurate predictors of AKI. Several special considerations regarding the risk of AKI are of note in the surgical patient. Co-morbidities are important risk factors for AKI. The surgery in itself, especially emergency and major surgery in the critically ill, is associated with a high incidence of AKI. Certain types of surgeries, such as cardiac and transplantation surgeries, require special attention because they carry higher risk of AKI. Nephrotoxic drugs, contrast dye, and diuretics are commonly used in the perioperative period and are responsible for a significant amount of in-hospital AKI. Before surgery, the anaesthetist is required to identify patients at risk of AKI, optimize anaemia, and treat hypovolaemia. During surgery, normovolaemia is of utmost importance. Additionally, the surgical and anaesthesia team is advised to use measures to reduce blood loss and avoid unnecessary blood transfusion. Hypotension should be avoided because even short periods of mean arterial pressure <55-60 mm Hg carry a risk of postoperative AKI. Higher blood pressures are probably required for hypertensive patients. Urine output can be reduced significantly during surgery and is unrelated to perioperative renal function. Thus, fluids should not be given in excess for the sole purpose of avoiding or treating oliguria. Use of hydroxyethyl starch needs to be reconsidered. Recent evidence indicates a beneficial effect of administering low-chloride solutions. PMID:26658199

  16. Delayed Unilateral Adrenal Hemorrhage Complicating Pneumococcal Septic Shock.

    PubMed

    Wharton, Jeff; Cohen, David

    2015-10-01

    An 80-year-old male presented to the hospital after being found unresponsive at home. He was found to have pneumococcal pneumonia complicated by septic shock. He was treated in the medical ICU briefly with vasopressors and received intravenous antibiotics. He achieved a full recovery and was discharged after 10 days. He returned within 24 hours with vague abdominal and chest pain. His complaints of pain were difficult to localize--radiating from back to chest and abdomen. He received an extensive work-up to exclude acute coronary syndrome, pulmonary embolism, pancreatitis, cholecystitis, and rib fracture. He was ultimately found to have a symptomatic unilateral adrenal hemorrhage, likely secondary to the acute stress of septic shock. PMID:26638422

  17. Perioperative Outcomes Following Unilateral Versus Bilateral Total Knee Arthroplasty.

    PubMed

    Suleiman, Linda I; Edelstein, Adam I; Thompson, Rachel M; Alvi, Hasham M; Kwasny, Mary J; Manning, David W

    2015-11-01

    Simultaneous bilateral total knee arthroplasty (SB-TKA) is potentially a cost saving manner of caring for patients with bilateral symptomatic knee arthritis. We performed a retrospective analysis using the 2010-2012 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to evaluate the risk of perioperative complication following SB-TKA. Demographic characteristics, comorbidities, and 30-day complication rates were studied using a propensity score-matched analysis comparing patients undergoing unilateral TKA and SB-TKA. A total of 4489 patients met the inclusion criteria, of which 973 were SB-TKA. SB-TKA was associated with increased overall complications (P = 0.023), medical complications (P = 0.002) and reoperation (OR 2.12, P = 0.020). Further, total length of hospital stay (4.0 vs 3.4 days, P < 0.001) was significantly longer following bilateral surgery. PMID:26072300

  18. Isolated Unilateral Ptosis due to Paramedian Midbrain Infarction.

    PubMed

    Sugawara, Eriko; Nakamura, Haruko; Endo, Masanao; Tanaka, Fumiaki; Takahashi, Tatsuya

    2015-05-01

    A 59-year-old man who had hypertension, dyslipidemia, diabetes mellitus, and left eye glaucoma developed sudden vertigo and left ptosis; he did not notice diplopia. He visited our hospital on day 3 after onset and neurologic examination showed left ptosis. His left visual acuity was counting fingers, and the light reflex was sluggish owing to glaucoma. Pupil sizes were equal, and eye movements and the lower lid were unremarkable. Magnetic resonance images revealed an acute infarction of the left paramedian midbrain. We considered that selective damage to the oculomotor fascicles innervating the left levator palpebrae superioris caused ipsilateral ptosis. As the fascicles for this ocular muscle run in the small area adjacent to those for the medial rectus, inferior rectus and superior rectus muscles, this is an extremely rare case of midbrain infarction presenting with isolated unilateral ptosis. PMID:25817621

  19. Double localization of a unilateral sporadic vestibular schwannoma

    PubMed Central

    Barbara, M; Ronchetti, F; Manni, V; Monini, S

    2008-01-01

    Summary Vestibular schwannoma may present as a sporadic or genetically-based multi-localized benign neoplasm of the internal auditory canal and/or cerebello-pontine angle region. Multiple localization is generally regarded as genetic in origin and often affects the stato-acoustic bundle on both sides. A case of double vestibular schwannoma localized on the same stato-acoustic bundle is presented. After removal, slight histological differences were found between the two separate masses. From these findings, the possibility of a unilateral multiple localization of a vestibular schwannoma is considered plausible within the range of clinical presentation, with negative genetic features. Whether these individual masses might have an autonomous origin or a different growth pattern remains to be fully elucidated. PMID:18533554

  20. Unilateral adnexal agenesis and dermoid cyst: fertility implications.

    PubMed

    Fruzzetti, Franca; Bucci, Fiorella; Perini, Daria; Gadducci, Angiolo

    2015-06-01

    We report the loss of potential fertility in a 23-year-old nulliparous woman who attended the outpatient gynaecological endocrinology clinic for amenorrhea and hot flushes started after a laparoscopic surgery for dermoid cyst. During surgery an unilateral ovarian and fallopian tube agenesis were found. The hormonal evaluation was performed. The results evidenced high plasma levels of LH and FSH. Their values were 56.6 and 121.3?mUI/ml, respectively. The concentrations of plasma E2 were < 20?pg/ml and of AMH were <0.08?ng/ml. Genetic analysis showed normal karyotype (46, XX). We think that if an embryological defect is suspected, an appropriate counselling about fertility preservation along with the assessment of hormonal levels before ovarian surgery should be recommended to all women in the reproductive age in order to offer future reproductive chances. PMID:25893269

  1. Idiopathic unilateral adrenal hemorrhage in an elderly patient.

    PubMed

    Imachi, Hitomi; Murao, Koji; Yoshimoto, Takuo; Sugimoto, Mikio; Kakehi, Yoshiyuki; Hayashi, Toshitetsu; Kushida, Yoshio; Haba, Reiji; Tahara, Ritsuya; Ishida, Toshihiko

    2010-04-01

    We report the case of an 85-year-old woman who has been undergoing treatment for hypertension but has not received anticoagulation therapy. The patient was admitted to our hospital for the evaluation of a right adrenal tumor (size, 10 × 9 cm²). Preoperative contrast-enhanced computed tomography and magnetic resonance imaging findings were indicative of adrenal hemorrhage (AH). Laboratory data revealed mild anemia but no adrenal dysfunction. The final pathological diagnosis was simply idiopathic adrenal hematoma. There is no case report of exactly idiopathic AH over 80 years old. We report an unusual case of idiopathic unilateral adrenal hematoma in an elderly patient. It is important to distinguish this benign lesion from a neoplasm and to consider idiopathic AH in an adrenal tumor during differential diagnosis in elderly patients who have not received anticoagulation therapy or suffered from trauma. PMID:20960259

  2. Adaptations to unilateral lower limb suspension in humans

    NASA Technical Reports Server (NTRS)

    Dudley, Gary A.; Duvoisin, Marc R.; Adams, Gregory R.; Meyer, Ronald A.; Belew, Anne H.; Buchanan, Paul

    1992-01-01

    The effect of unilateral lower limb suspension (ULLS) on neuromuscular function in humans is analyzed. All ambulatory activity on crutches was performed by eight subjects for 6 weeks who wear a shoe with a 10 cm sole on the right foot to unweight the left lower limb. Results show that average muscle cross sectional area (CSA) of the left knee extensor (KE) decreased 16 percent whereas the KE of the nonsuspended right limb showed no changes. Maximal integrated electromyography of vastus lateralis and overall mean power frequency of gastrocnemius medialis and soleus for submaximal isometric actions were both decreased post-ULLS. It is concluded that six weeks of ULLS induces adaptations in the neuromuscular system of humans which are comparable to those induced by bed rest and spaceflight.

  3. Unusual unilateral presentation of pachydermodactyly: a case report.

    PubMed

    Ulusoy, Hasan; Tas, Nevsun Pihtili; Akgol, Gurkan; Gulkesen, Arif; Kamanli, Ayhan

    2012-06-01

    Pachydermodactyly is a rare digital fibromatosis characterized by asymptomatic fusiform soft-tissue swellings of the proximal interphalangeal joints of the hands. It usually affects healthy adolescent males with a negative family history. As a rule, clinical presentation of the disease is bilateral and symmetrical enlargement of the joints. So it can be misdiagnosed with inflammatory rheumatic diseases, especially with juvenile chronic arthritis. A prompt clinical diagnosis of the disease would prevent inappropriate treatment with immunosuppressive agents or steroids and unnecessary expensive diagnostic procedures such as biopsy or magnetic resonance imaging. Once diagnosed, patients should be advised in order to avoid repetitive traumas of the hands, rubbing and cracking of the fingers, obsessive-compulsive use of computer and video games. The joint outcome is always benign. Here, we report a case of pachydermodactyly differs from the typical clinical picture of pachydermodactyly in the unilateral distribution of the lesions. PMID:21442169

  4. Apparatus for unilateral generation of a homogeneous magnetic field

    DOEpatents

    Fukushima, Eiichi (Los Alamos, NM); Rath, Alan R. (San Diego, CA); Roeder, Stephen B. W. (La Mesa, CA)

    1988-01-01

    An apparatus for unilaterally producing a substantially homogeneous magnetic field. The apparatus includes two circular electromagnet coils, a small coil and a large coil, which are coaxial with one another and which are separated by a distance equal to one-half the difference in the radius of the two coils. By appropriate selection of electrical currents, which are passed through the coil in opposite directions, a region of homogeneous magnetic field is formed. This region is centered on the common axis of the two coils, at a point on the axis which is at a distance from the small coil equal to one-half the radius of the small coil, and which is on the opposite side of the small coil from the large coil. The apparatus has particular application in the field of diagnostic medical NMR and other NMR applications.

  5. Unilateral lateral mass compression fractures of the axis.

    PubMed

    Abel, M S; Teague, J H

    1979-06-01

    Lateral mass compression fractures of the axis involve compression of the pedicle and displacement of the overlying facet, with or without an accompanying fracture of the odontoid. These unilateral fractures are not rare. Correlation is made between clinical cases and cadaver material with analysis of microradiographs. Criteria for recognition of the resultant healed fracture deformity include: (1) Tilting of the odontoid; (2) Loss of the odontoid shoulder on the affected side; (3) Increased downward slope of the affected facet; (4) Lateral compression, possibly with buckling; (5) Asymmetrical apophyseal joints between axis and atlas; and (6) Tilting downward of occiput on affected side, often with evidence of rotation between the occiput and the axis. Not all criteria need be present. Clinical sequelae often include persistent neck pain, limited rotation of the head, and occipital headaches radiating anteriorly. PMID:505050

  6. Non Functional Unilateral Adrenal Myelolipoma, A Case Report

    PubMed Central

    Athanikar, Vidisha S.; Dinesh, U S; Nanjappa, Bhuvnesh; Patil, Preetam B.

    2015-01-01

    Adrenal myelolipoma is characterized by presence within the adrenal gland of mature adipose tissue and active bone marrow elements. Owing to their non functional nature most cases are incidental, either at autopsy or through computer tomography scan. Occasionally the lesions attain a large size to become clinically apparent. We present a case of a 58-year-old female with mass per abdomen. Preoperative computer tomography scan of abdomen, hormonal and urine analysis showed features of non functional adrenal myelolipoma. Gross specimen consists of unilateral ovoid mass, external surface having capsule with adherent fat and areas of congestion. Microscopic examination showed well encapsulated tumour tissue composed of mature adipose tissue with major blood forming elements like myeloid, erythroid and megakaryocytic series. The diagnosis was confirmed by histopathological examination of right sided adrenalectomy specimen. PMID:26266130

  7. Overexpanded viscous supersonic jet interacting with a unilateral barrier

    NASA Astrophysics Data System (ADS)

    Dobrynin, B. M.; Maslennikov, V. G.; Sakharov, V. A.; Serova, E. V.

    1986-07-01

    The interaction of a two-dimensional supersonic jet with a unilateral barrier parallel to the flow symmetry plane was studied to account for effects due to gas viscosity and backgound-gas ejection from the region into which the jet expands. In the present experiments, the incident shock wave was reflected at the end of a shock tube equipped with a nozzle. The jet emerged into a pressure chamber 6 cu m in volume and the environmental pressure ratio of the flow in the quasi-stationary phase remained constant. The light source was an OGM-20 laser operating in the giant-pulse mode. Due to background-gas ejection, the gas density in the vicinity of the barrier is much less than on the unconfined side of the jet. The resulting flow is characterized by two distinct environmental pressure ratios: the flow is underexpanded near the barrier, while on the other side it is overexpanded.

  8. Apparatus for unilateral generation of a homogeneous magnetic field

    DOEpatents

    Fukushima, E.; Rath, A.R.; Roeder, S.B.W.

    1984-05-01

    An apparatus for unilaterally producing a substantially homogeneous magnetic field. The apparatus includes two circular electromagnet coils, a small coil and a large coil, which are coaxial with one another and which are separated by a distance equal to one-half the difference in the radius of the two coils. By appropriate selection of electrical currents, which are passed through the coils in opposite directions, a region of homogeneous magnetic field is formed. This region is centered on the common axis of the two coils, at a point on the axis which is at a distance from the small coil equal to one-half the radius of the small coil, and which is on the opposite side of the small coil from the large coil. The apparatus has particular application in the field of diagnostic medical NMR and other NMR applications.

  9. Adult stem-like cells in kidney.

    PubMed

    Hishikawa, Keiichi; Takase, Osamu; Yoshikawa, Masahiro; Tsujimura, Taro; Nangaku, Masaomi; Takato, Tsuyoshi

    2015-03-26

    Human pluripotent cells are promising for treatment for kidney diseases, but the protocols for derivation of kidney cell types are still controversial. Kidney tissue regeneration is well confirmed in several lower vertebrates such as fish, and the repair of nephrons after tubular damages is commonly observed after renal injury. Even in adult mammal kidney, renal progenitor cell or system is reportedly presents suggesting that adult stem-like cells in kidney can be practical clinical targets for kidney diseases. However, it is still unclear if kidney stem cells or stem-like cells exist or not. In general, stemness is defined by several factors such as self-renewal capacity, multi-lineage potency and characteristic gene expression profiles. The definite use of stemness may be obstacle to understand kidney regeneration, and here we describe the recent broad findings of kidney regeneration and the cells that contribute regeneration. PMID:25815133

  10. Current Bioengineering Methods for Whole Kidney Regeneration

    PubMed Central

    Yamanaka, Shuichiro; Yokoo, Takashi

    2015-01-01

    Kidney regeneration is likely to provide an inexhaustible source of tissues and organs for immunosuppression-free transplantation. It is currently garnering considerable attention and might replace kidney dialysis as the ultimate therapeutic strategy for renal failure. However, anatomical complications make kidney regeneration difficult. Here, we review recent advances in the field of kidney regeneration, including (i) the directed differentiation of induced pluripotent stem cells/embryonic stem cells into kidney cells; (ii) blastocyst decomplementation; (iii) use of a decellularized cadaveric scaffold; (iv) embryonic organ transplantation; and (v) use of a nephrogenic niche for growing xenoembryos for de novo kidney regeneration from stem cells. All these approaches represent potentially promising therapeutic strategies for the treatment of patients with chronic kidney disease. Although many obstacles to kidney regeneration remain, we hope that innovative strategies and reliable research will ultimately allow the restoration of renal function in patients with end-stage kidney disease. PMID:26089921

  11. A clinical study of /sup 99m/Tc dimercaptosuccinic acid uptake in obstructed kidneys: comparison with the creatinine clearance

    SciTech Connect

    De Maeyer, P.; Simons, M.; Oosterlinck, W.; De Sy, W.A.

    1982-07-01

    We studied 17 hydronephrotic kidneys owing to stenosis of the pyeloureteral junction. Preoperative uptake of /sup 99m/Tc dimercaptosuccinic acid was compared to early postoperative unilateral creatinine clearance, measured by urine collection from the nephrostomy tube. An excellent correlation was found. Therefore, uptake of /sup 99m/Tc dimercaptosuccinic acid represents a reliable parameter of renal function even in the presence of severe urinary tract obstruction. However, /sup 99m/Tc dimercaptosuccinic acid uptake should be measured more than 24 hours after injection of the tracer.

  12. Emotional Perception of Music in Children with Unilateral Cochlear Implants

    PubMed Central

    Shirvani, Sareh; Jafari, Zahra; Sheibanizadeh, Abdolreza; Motasaddi Zarandy, Masoud; Jalaie, Shohre

    2014-01-01

    Introduction: Cochlear implantation (CI) improves language skills among children with hearing loss. However, children with CIs still fall short of fulfilling some other needs, including musical perception. This is often attributed to the biological, technological, and acoustic limitations of CIs. Emotions play a key role in the understanding and enjoyment of music. The present study aimed to investigate the emotional perception of music in children with bilaterally severe-to-profound hearing loss and unilateral CIs. Materials and Methods: Twenty-five children with congenital severe-to-profound hearing loss and unilateral CIs and 30 children with normal hearing participated in the study. The children’s emotional perceptions of music, as defined by Peretz (1998), were measured. Children were instructed to indicate happy or sad feelings fostered in them by the music by pointing to pictures of faces showing these emotions. Results: Children with CI obtained significantly lower scores than children with normal hearing, for both happy and sad items of music as well as in overall test scores (P<0.001). Furthermore, both in CI group (P=0.49) and the control one (P<0.001), the happy items were more often recognized correctly than the sad items. Conclusion: Hearing-impaired children with CIs had poorer emotional perception of music than their normal peers. Due to the importance of music in the development of language, cognitive and social interaction skills, aural rehabilitation programs for children with CIs should focus particularly on music. Furthermore, it is essential to enhance the quality of musical perception by improving the quality of implant prostheses. PMID:25320700

  13. Radioimmunoassay of inhibin: serum responses to unilateral and bilateral orchidectomy

    SciTech Connect

    Schanbacher, B.

    1988-11-01

    An overnight double antibody RIA using a rabbit antiserum to porcine inhibin alpha-chain (Tyr30) (1-30) NH2 (pI alpha(1-30)), radioiodinated pI alpha(1-30), and a preprecipitated second antibody complex has been developed to measure inhibin concentrations in sera and other biological fluids. The assay is accurate, precise (intraassay coefficient of variation, 4.8%), sensitive (25 pM; 2.5 fmol/tube), and specific for inhibin. The synthetic reference standard pI alpha(1-30) produced a displacement curve that paralleled intact male ovine and bovine sera, crude bovine follicular fluid, and a partially purified porcine follicular fluid reference preparation (WHO/NIH 86/690). Bilateral castration of prepubertal and postpubertal ram lambs resulted in a rapid decrease in serum inhibin concentrations and a subsequent increase in serum FSH. Inhibin levels were high in prepubertal lambs (approximately 375 pM), but these levels were not sustained near the time of puberty (approximately 180 pM). Intensive sampling by jugular venipuncture after castration indicated a 50% drop in circulating inhibin levels within 2 h of testes removal with chronic castrate levels (approximately 75 pM) achieved by 6 h postcastration. A rapid fall in circulating levels of inhibin was also observed after unilateral castration, but these values stabilized within hours to levels intermediate (i.e. approximately 200 pM) to those of intact and bilateral castrate rams. Hemicastrates exhibited a more subtle rise in serum FSH after testis removal, with FSH and inhibin levels of prepubertal hemicastrates returning to mature intact ram values by 15 weeks of age. Serum inhibin levels remained low and FSH levels high at 14 days in unilateral castrate postpubertal rams. Inhibin immunoreactivity increased abruptly in castrate ewes and rams injected iv with 5 ml bovine follicular fluid.

  14. Hereditary Causes of Kidney Stones and Chronic Kidney Disease

    PubMed Central

    Edvardsson, Vidar O.; Goldfarb, David S.; Lieske, John C.; Beara-Lasic, Lada; Anglani, Franca; Milliner, Dawn S.; Palsson, Runolfur

    2013-01-01

    Adenine phosphoribosyltransferase (APRT) deficiency, cystinuria, Dent disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) and primary hyperoxaluria (PH) are rare but important causes of severe kidney stone disease and/or chronic kidney disease in children. Recurrent kidney stone disease and nephrocalcinosis, particularly in pre-pubertal children, should alert the physician to the possibility of an inborn error of metabolism as the underlying cause. Unfortunately, the lack of recognition and knowledge of the five disorders has frequently resulted in an unacceptable delay in diagnosis and treatment, sometimes with grave consequences. A high index of suspicion coupled with early diagnosis may reduce or even prevent the serious long-term complications of these diseases. In this paper, we review the epidemiology, clinical features, diagnosis, treatment and outcome of patients with APRT deficiency, cystinuria, Dent disease, FHHNC and PH with emphasis on childhood manifestations. PMID:23334384

  15. Physiological Interaction of Heart and Lung in Thoracic Irradiation

    SciTech Connect

    Ghobadi, Ghazaleh; Veen, Sonja van der; Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen ; Bartelds, Beatrijs; Boer, Rudolf A. de; Dickinson, Michael G.; Jong, Johan R. de; Faber, Hette; Niemantsverdriet, Maarten; Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen ; Brandenburg, Sytze; Berger, Rolf M.F.; Langendijk, Johannes A.; Coppes, Robert P.; Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen ; Luijk, Peter van

    2012-12-01

    Introduction: The risk of early radiation-induced lung toxicity (RILT) limits the dose and efficacy of radiation therapy of thoracic tumors. In addition to lung dose, coirradiation of the heart is a known risk factor in the development RILT. The aim of this study was to identify the underlying physiology of the interaction between lung and heart in thoracic irradiation. Methods and Materials: Rat hearts, lungs, or both were irradiated to 20 Gy using high-precision proton beams. Cardiopulmonary performance was assessed using breathing rate measurements and F{sup 18}-fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG-PET) scans biweekly and left- and right-sided cardiac hemodynamic measurements and histopathology analysis at 8 weeks postirradiation. Results: Two to 12 weeks after heart irradiation, a pronounced defect in the uptake of {sup 18}F-FDG in the left ventricle (LV) was observed. At 8 weeks postirradiation, this coincided with LV perivascular fibrosis, an increase in LV end-diastolic pressure, and pulmonary edema in the shielded lungs. Lung irradiation alone not only increased pulmonary artery pressure and perivascular edema but also induced an increased LV relaxation time. Combined irradiation of lung and heart induced pronounced increases in LV end-diastolic pressure and relaxation time, in addition to an increase in right ventricle end-diastolic pressure, indicative of biventricular diastolic dysfunction. Moreover, enhanced pulmonary edema, inflammation and fibrosis were also observed. Conclusions: Both lung and heart irradiation cause cardiac and pulmonary toxicity via different mechanisms. Thus, when combined, the loss of cardiopulmonary performance is intensified further, explaining the deleterious effects of heart and lung coirradiation. Our findings show for the first time the physiological mechanism underlying the development of a multiorgan complication, RILT. Reduction of dose to either of these organs offers new opportunities to improve radiation therapy treatment of thoracic tumors, potentially facilitating increased treatment doses and tumor control.

  16. Treatment of middle-super thoracic fractures associated with the sternum fracture

    PubMed Central

    Huang, Zheyuan; Chen, Fengrong; Huang, Jianming; Jian, Guojian; Gong, Hao; Xu, Tianrui; Wang, Bowen; Chen, Ruisong; Chen, Xiaolin; Ye, Zhiyang; Wang, Jun; Xie, Desheng; Liu, Haoyuan

    2015-01-01

    To analyze the characteristics and treatment of middle-super thoracic fractures associated with the sternum fracture, twenty six patients with middle-super thoracic fractures associated with the sternum fracture were retrospectively reviewed. The intimate information of patients including age, gender, cause of injury, site of the sternal fracture, level and type of thoracic vertebral fracture, spinal cord injury and associated injuries were included in the analysis. There were 12 compressed fractures, 11 fracture-dislocations, two burst fracture and one burst-dislocation in this study. Six patients had a complete lesion of the spinal cord, nine sustained a neurologically incomplete injury and 11 were neurologically intact. Nine patients were treated non-operatively and 17 were underwent surgery. All patients were followed up for 8~99 months. Our results showed that road traffic accidents (RTA) and fall were the dominated in the causes. All six patients with a complete paralytic lesion were not recovered with any significant function. Four out of eleven neurologically intact patients had local pain although ten of them remained normal function and one patient turn up tardive paralysis. One of nine patients with incomplete paraplegia returned to normal and four recovered with some function. These study suggested that the sternum is one of the important parts in constructing thoracic cage and plays an important role in maintain the stabilization of the thoracic vertebra. Because of the unique anatomy and biomechanics of the thoracic cage, the classification commonly applied to thoracic vertebra fractures is not suitable for middle-super thoracic fractures associated with the sternum fracture. Middle-super thoracic fractures associated with the sternum fracture was marked by violent force, severe fractures of spine, severe injuries of spinal cord and high incidence of associated injuries. These cases confirm the existence and clinical relevance of the fourth column of the thoracic spine and its role for spinal stability in the patient with middle-super thoracic fracture. PMID:26309652

  17. The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis.

    PubMed

    Campbell, Robert M; Smith, Melvin D; Mayes, Thomas C; Mangos, John A; Willey-Courand, Donna B; Kose, Nusret; Pinero, Ricardo F; Alder, Marden E; Duong, Hoa L; Surber, Jennifer L

    2003-03-01

    1. Thoracic insufficiency syndrome is the inability of the thorax to support normal respiration or lung growth. 2. The rare condition of fused ribs and congenital scoliosis may result in a three-dimensional thoracic deformity with adverse effects on thoracic growth and function with development of thoracic insufficiency syndrome. 3. The normal thorax is defined by two characteristics: normal, stable volume and the ability to change that volume. Volume depends on the width and depth of the rib cage, and the thoracic spine provides height. The ability to change volume, termed thoracic function, is provided by the diaphragm and the secondary muscles of respiration. 4. On radiographs, the loss of the vertical height of the lung of the concave, restricted hemithorax is defined by the percentage of space available for the lung. 5. Spine rotation causes a windswept thorax, with both restriction of the volume of the convex hemithorax and restriction of the motion of the involved ribs. 6. Constrictive three-dimensional deformity of the thorax may cause extrinsic, restrictive lung disease. 7. Progressive thoracic insufficiency syndrome is diagnosed on the basis of clinical signs of respiratory insufficiency, loss of chest wall mobility as demonstrated by the thumb excursion test, worsening indices of three-dimensional thoracic deformity on radiographs and computed tomography scans, or a relative decline in percent predicted vital capacity due to thoracic "failure to thrive," as demonstrated by pulmonary function tests. 8. Treatment of progressive thoracic insufficiency syndrome should provide an acute increase in the thoracic volume with stabilization of any flail chest-wall defects and maintain these improvements as the patient grows, without the need for spine fusion. PMID:12637423

  18. Estimating Hemodynamic Responses to the Wingate Test Using Thoracic Impedance

    PubMed Central

    Astorino, Todd A.; Bovee, Curtis; DeBoe, Ashley

    2015-01-01

    Techniques including direct Fick and Doppler echocardiography are frequently used to assess hemodynamic responses to exercise. Thoracic impedance has been shown to be a noninvasive alternative to these methods for assessing these responses during graded exercise to exhaustion, yet its feasibility during supramaximal bouts of exercise is relatively unknown. We used thoracic impedance to estimate stroke volume (SV) and cardiac output (CO) during the Wingate test (WAnT) and compared these values to those from graded exercise testing (GXT). Active men (n = 9) and women (n = 7) (mean age = 24.8 ± 5.9 yr) completed two Wingate tests and two graded exercise tests on a cycle ergometer. During exercise, heart rate (HR), SV, and CO were continuously estimated using thoracic impedance. Repeated measures analysis of variance was used to identify potential differences in hemodynamic responses across protocols. Results: Maximal SV (138.6 ± 37.4 mL vs. 135.6 ± 26.9 mL) and CO (24.5 ± 6.1 L·min-1 vs. 23.7 ± 5.1 L·min-1) were similar (p > 0.05) between repeated Wingate tests. Mean maximal HR was higher (p < 0.01) for GXT (185 ± 7 b·min-1) versus WAnT (177 ± 11 b·min-1), and mean SV was higher in response to WAnT (137.1 ± 32.1 mL) versus GXT (123.0 ± 32.0 mL), leading to similar maximal cardiac output between WAnT and GXT (23.9 ± 5.6 L·min-1 vs. 22.5 ± 6.0 L·min-1). Our data show no difference in hemodynamic responses in response to repeated administrations of the Wingate test. In addition, the Wingate test elicits similar cardiac output compared to progressive cycling to VO2max. Key points Measurement of cardiac output (CO), the rate of oxygen transport delivered by the heart to skeletal muscle, is not widely-employed in Exercise Physiology due to the level of difficulty and invasiveness characteristic of most techniques used to measure this variable. Nevertheless, thoracic impedance has been shown to provide a noninvasive and simpler approach to continuously measure CO at rest and during exercise. Results show that measurements of CO are not different and highly reliable in response to repeated administrations of the Wingate test. Despite vastly different intensities and durations, maximal CO was similar between the Wingate test and graded exercise to VO2max. PMID:26664281

  19. Neurologic manifestations of compressive radiculopathy of the first thoracic root.

    PubMed

    Levin, K H

    1999-09-22

    Neurologic deficits in the first thoracic (T1) root distribution are uncommon and not easily defined. Myotomal charts indicate that distal arm and hand muscles receive significant contributions from both the C8 and T1 roots. A patient with focal T1 radiculopathy is presented who demonstrated motor axon loss isolated to the abductor pollicis brevis muscle. This finding provides another source of evidence that the abductor pollicis brevis is the primary T1 motor structure in the upper extremity, improving precision in clinical and electromyographic diagnosis. PMID:10496288

  20. Pancreatic cancer and chronic thoracic back pain: a case report

    PubMed Central

    Yurkiw, Dennis J

    1995-01-01

    A male with persistent thoracic spine pain and clinical symptoms suggesting a more grave condition than mechanical back pain is presented. The patient had previously been attended to by a medical doctor and a chiropractor. The symptom picture and the ineffectiveness of previously administered chiropractic care suggests a medical referral with further investigation. The importance of history taking is emphasized. An accurate diagnosis and administration of the appropriate treatment is paramount because the prognosis of detected pancreatic cancer is poor. ImagesFigure 1Figure 2

  1. Extracorporeal instrument knotting technique for minimal access thoracic surgery

    PubMed Central

    Tian, Jintao; Song, Xiaoping; Chen, Yan

    2015-01-01

    Knot-tying technique is essential for surgery. We described here a novel instrument knotting technique that is simple, safe and useful in minithoracotomy. This technique was used on 14 consecutive patients that underwent selective minithoracotomy during the past half year. Both knot security and loop security could be easily achieved with this technique. No unraveling or dislodgement of the knot was noted. This method is simple, convenient and reliable to achieve secure flat square knots in limited, deep operating spaces. Its clinical advantages render it as a promising knot-tying technique that can be routinely used in a variety of thoracic surgery. PMID:26716046

  2. Innovative technologies in thoracic radiation therapy for lung cancer

    PubMed Central

    Mantovani, Cristina; Ricardi, Umberto

    2012-01-01

    Radiation therapy plays a major role in the cure of patients affected with lung cancer, both in early and locally advanced disease. Local control and survival rates are still poor, even with the best combination with chemotherapy and/or targeted agents. The recent technical advances in radiotherapy changed the planning and delivery processes, enabling radiation oncologists to modify treatment schedules towards further dose intensification, while opening a new scenario for future clinical studies. In this paper we briefly review the major technical changes in the field of thoracic radiotherapy for primary lung tumors and their potential in improving clinical outcomes. PMID:25806191

  3. Limited Unilateral Decompression and Pedicle Screw Fixation with Fusion for Lumbar Spinal Stenosis with Unilateral Radiculopathy: A Retrospective Analysis of 25 Cases

    PubMed Central

    Zhang, Li; Miao, Hai-xiong; Wang, Yong; Chen, An-fu; Zhang, Tao

    2015-01-01

    Objective Lumbar spinal stenosis is conventionally treated with surgical decompression. However, bilateral decompression and laminectomy is more invasive and may not be necessary for lumbar stenosis patients with unilateral radiculopathy. We aimed to report the outcomes of unilateral laminectomy and bilateral pedicle screw fixation with fusion for patients with lumbar spinal stenosis and unilateral radiculopathy. Methods Patients with lumbar spinal stenosis with unilateral lower extremity radiculopathy who received limited unilateral decompression and bilateral pedicle screw fixation were included and evaluated using visual analog scale (VAS) pain and the Oswestry Disability Index (ODI) scores preoperatively and at follow-up visits. Ligamentum flavum thickness of the involved segments was measured on axial magnetic resonance images. Results Twenty-five patients were included. The mean preoperative VAS score was 6.6±1.6 and 4.6±3.1 for leg and back pain, respectively. Ligamentum flavum thickness was comparable between the symptomatic and asymptomatic side (p=0.554). The mean follow-up duration was 29.2 months. The pain in the symptomatic side lower extremity (VAS score, 1.32±1.2) and the back (VAS score, 1.75±1.73) significantly improved (p=0.000 vs. baseline for both). The ODI improved significantly postoperatively (6.60±6.5; p=0.000 vs. baseline). Significant improvement in VAS pain and ODI scores were observed in patients receiving single or multi-segment decompression fusion with fixation (p<0.01). Conclusion Limited laminectomy and unilateral spinal decompression followed by bilateral pedicle screw fixation with fusion achieves satisfactory outcomes in patients with spinal stenosis and unilateral radiculopathy. This procedure is less damaging to structures that are important for maintaining posterior stability of the spine. PMID:26279816

  4. Targeted disruption of TGF-?1/Smad3 signaling protects against renal tubulointerstitial fibrosis induced by unilateral ureteral obstruction

    PubMed Central

    Sato, Misako; Muragaki, Yasuteru; Saika, Shizuya; Roberts, Anita B.; Ooshima, Akira

    2003-01-01

    Tubulointerstitial fibrosis is the final common result of a variety of progressive injuries leading to chronic renal failure. Transforming growth factor-? (TGF-?) is reportedly upregulated in response to injurious stimuli such as unilateral ureteral obstruction (UUO), causing renal fibrosis associated with epithelial-mesenchymal transition (EMT) of the renal tubules and synthesis of extracellular matrix. We now show that mice lacking Smad3 (Smad3ex8/ex8), a key signaling intermediate downstream of the TGF-? receptors, are protected against tubulointerstitial fibrosis following UUO as evidenced by blocking of EMT and abrogation of monocyte influx and collagen accumulation. Culture of primary renal tubular epithelial cells from wild-type or Smad3-null mice confirms that the Smad3 pathway is essential for TGF-?1–induced EMT and autoinduction of TGF-?1. Moreover, mechanical stretch of the cultured epithelial cells, mimicking renal tubular distention due to accumulation of urine after UUO, induces EMT following Smad3-mediated upregulation of TGF-?1. Exogenous bone marrow monocytes accelerate EMT of the cultured epithelial cells and renal tubules in the obstructed kidney after UUO dependent on Smad3 signaling. Together the data demonstrate that the Smad3 pathway is central to the pathogenesis of interstitial fibrosis and suggest that inhibitors of this pathway may have clinical application in the treatment of obstructive nephropathy. PMID:14617750

  5. Radiation-Associated Kidney Injury

    SciTech Connect

    Dawson, Laura A.; Kavanagh, Brian D.; Paulino, Arnold C.; Das, Shiva K.; Miften, Moyed; Li, X. Allen; Pan, Charlie; Ten Haken, Randall K.; Schultheiss, Timothy E.

    2010-03-01

    The kidneys are the dose-limiting organs for radiotherapy to upper abdominal cancers and during total body irradiation. The incidence of radiotherapy-associated kidney injury is likely underreported owing to its long latency and because the toxicity is often attributed to more common causes of kidney injury. The pathophysiology of radiation injury is poorly understood. Its presentation can be acute and irreversible or subtle, with a gradual progressive dysfunction over years. A variety of dose and volume parameters have been associated with renal toxicity and are reviewed to provide treatment guidelines. The available predictive models are suboptimal and require validation. Mitigation of radiation nephropathy with angiotensin-converting enzyme inhibitors and other compounds has been shown in animal models and, more recently, in patients.

  6. Computational analysis of kidney scintigrams

    SciTech Connect

    Vrincianu, D.; Puscasu, E.; Creanga, D.; Stefanescu, C.

    2013-11-13

    The scintigraphic investigation of normal and pathological kidneys was carried out using specialized gamma-camera device from nuclear medicine hospital department. Technetium 90m isotope with gamma radiation emission, coupled with vector molecules for kidney tissues was introduced into the subject body, its dynamics being recorded as data source for kidney clearance capacity. Two representative data series were investigated, corresponding to healthy and pathological organs respectively. The semi-quantitative tests applied for the comparison of the two distinct medical situations were: the shape of probability distribution histogram, the power spectrum, the auto-correlation function and the Lyapunov exponent. While power spectrum led to similar results in both cases, significant differences were revealed by means of distribution probability, Lyapunov exponent and correlation time, recommending these numerical tests as possible complementary tools in clinical diagnosis.

  7. Thoracic Disc Prolapse Presenting with Abdominal Pain: Case Report and Review of the Literature

    PubMed Central

    Papadakos, Nikolaos; Georges, Husam; Sibtain, Naomi; Tolias, Christos M

    2009-01-01

    We report the case of a patient presenting with abdominal pain as a result of a thoracic disc prolapse. The literature is reviewed, highlighting the associated morbidity by the often extensive and invasive procedures patients may undergo when a thoracic disc prolapse presents with abdominal pain. PMID:19622252

  8. Chylous Ascites: A Rare Complication of Thoracic Duct Embolization for Chylothorax

    SciTech Connect

    Gaba, Ron C. Owens, Charles A.; Bui, James T.; Carrillo, Tami C.; Knuttinen, M. Grace

    2011-02-15

    Thoracic duct embolization represents a safe and effective method to treat postsurgical chylothorax. Complications of this procedure are rare despite transabdominal puncture of lymphatic channels for thoracic duct access, and chylous ascites is unreported. Herein, we describe a case of chylous ascites formation after lymphatic puncture and attempted cannulation. Our management approach is also discussed.

  9. TRIBUTE TO STANLEY DODSON Chytrid infection reduces thoracic beat and heart rate

    E-print Network

    Johnson, Pieter

    TRIBUTE TO STANLEY DODSON Chytrid infection reduces thoracic beat and heart rate of Daphnia observed simultaneously the heart rates and compared chytrid infected animals with uninfected gravid and non-gravid ones. We found in uninfected animals a thoracic beat rate of 3.81 ± 018 Hz and a heart rate

  10. Spontaneous decrease in the size of a residual thoracic intradural lipoma.

    PubMed

    Akyuz, Mahmut; Goksu, Ethem; Tuncer, Recai

    2005-02-01

    Intradural spinal lipomas of thoracic cord are quite rare. It is known that lipomas are hamartomas, which change their size with alterations of body fat. An 18-year-old male patient, with a thoracic intradural lipoma showing spontaneous decrease in the size of a residual lipoma and tethering of the cord 4 years after surgery, is presented in this report. PMID:16156032

  11. Immediate post-operative balloon dilatation of neonatal long segment stenosis of the descending thoracic aorta.

    PubMed

    Ebeid, M R; Sarris, G E; Drummond-Webb, J J; Prieto, L; Ratliff, N B; Latson, L A

    2001-01-01

    During surgical repair of a neonatal coarctation it was recognized that this was a rare, previously undescribed form of stenosis of the entire descending thoracic aorta. A few hours after the end-to-end surgical repair, the child underwent successful balloon angioplasty, involving the entire descending thoracic aorta, and in which we intentionally avoided the surgical site. PMID:11146688

  12. Mathematical Modeling of Kidney Transport

    PubMed Central

    Layton, Anita T.

    2013-01-01

    In addition to metabolic waste and toxin excretion, the kidney also plays an indispensable role in regulating the balance of water, electrolytes, nitrogen, and acid-base. In this review, we describe representative mathematical models that have been developed to better understand kidney physiology and pathophysiology, including the regulation of glomerular filtration, the regulation of renal blood flow by means of the tubuloglomerular feedback mechanisms and of the myogenic mechanism, the urine concentrating mechanism, epithelial transport, and regulation of renal oxygen transport. We discuss the extent to which these modeling efforts have expanded our understanding of renal function in both health and disease. PMID:23852667

  13. Mathematical modeling of kidney transport.

    PubMed

    Layton, Anita T

    2013-01-01

    In addition to metabolic waste and toxin excretion, the kidney also plays an indispensable role in regulating the balance of water, electrolytes, nitrogen, and acid-base. In this review, we describe representative mathematical models that have been developed to better understand kidney physiology and pathophysiology, including the regulation of glomerular filtration, the regulation of renal blood flow by means of the tubuloglomerular feedback mechanisms and of the myogenic mechanism, the urine concentrating mechanism, epithelial transport, and regulation of renal oxygen transport. We discuss the extent to which these modeling efforts have expanded our understanding of renal function in both health and disease. PMID:23852667

  14. Symptomatic Thoracic Spinal Cord Herniation: Case Series and Technical Report

    PubMed Central

    Hawasli, Ammar H.; Ray, Wilson Z.; Wright, Neill M.

    2014-01-01

    Background and Importance Idiopathic spinal cord herniation (ISCH) is an uncommon condition located predominantly in the thoracic spine and often associated with a remote history of a major traumatic injury. ISCH has an incompletely described presentation and unknown etiology. There is no consensus on treatment algorithm and surgical technique, and there is little data on clinical outcomes. Clinical Presentation In this case series and technical report, we describe the atypical myelopathy presentation, remote history of traumatic injury, radiographic progression, treatment, and outcomes of 5 patients treated at Washington University for symptomatic ISCH. A video showing surgical repair is presented. In contrast to classic compressive myelopathy symptomology, ISCH patients presented with an atypical myelopathy, characterized by asymmetric motor and sensory deficits and early-onset urinary incontinence. Clinical deterioration correlated with progressive spinal cord displacement and herniation observed on yearly spinal imaging in a patient imaged serially due to multiple sclerosis. Finally compared to compressive myelopathy in the thoracic spine, surgical treatment of ISH led to rapid improvement despite long duration of symptoms. Conclusion Symptomatic ISCH presents with atypical myelopathy and slow temporal progression and can be successfully managed with surgical repair. PMID:24871148

  15. Early structural changes in sheep lung following thoracic irradiation

    SciTech Connect

    Guerry-Force, M.L.; Perkett, E.A.; Brigham, K.L.; Meyrick, B.

    1988-04-01

    Using a large animal model of radiation lung injury--the sheep exposed to bilateral thoracic irradiation--we have recently shown the development of sustained pulmonary hypertension during the first 4 weeks following radiation. This is the period prior to the onset of pneumonitis and pulmonary fibrosis. In the present study, we have examined biopsy and autopsy lung tissue from these same sheep and assessed the sequential changes in lung morphology. Six unanesthetized sheep received bilateral thoracic irradiation (a total of 15 Gy); control sheep were sham irradiated. Lung biopsy tissue was taken prior to and at weekly or biweekly intervals during the 4 weeks immediately following radiation. The lungs were also removed at autopsy for light and electron microscopic examination. Our results show early (Week 1) interstitial and progressive intraalveolar edema accompanied by endothelial and epithelial injury. A gradual increase in number of interstitial mononuclear cells was evident from Week 1, both in the lung tissue and in perivascular cuffs. The number of peripheral lung interstitial mononuclear cells was twice baseline from Week 3 and included accumulation of lymphocytes, fibroblasts, and intravascular macrophages. The increased numbers of mononuclear cells paralleled the development of chronic pulmonary hypertension, perhaps suggesting their involvement in the pathogenesis of this disease. Alternatively, it may be that increased mononuclear cell number represents a stage of lung repair.

  16. Anatomic Variations of Cervical and High Thoracic Ligamentum Flavum

    PubMed Central

    Yoon, Sang Pil; Kim, Hyun Jung

    2014-01-01

    Background Epidural blocks are widely used for the management of acute and chronic pain. The technique of loss of resistance is frequently adopted to determine the epidural space. A discontinuity of the ligamentum flavum may increase the risk of failure to identify the epidural space. The purpose of this study was to investigate the anatomic variations of the cervical and high thoracic ligamentum flavum in embalmed cadavers. Methods Vertebral column specimens of 15 human cadavers were obtained. After vertebral arches were detached from pedicles, the dural sac and epidural connective tissue were removed. The ligamentum flavum from C3 to T6 was directly examined anteriorly. Results The incidence of midline gaps in the ligamentum flavum was 87%-100% between C3 and T2. The incidence decreased below this level and was the lowest at T4-T5 (8%). Among the levels with a gap, the location of a gap in the caudal third of the ligamentum flavum was more frequent than in the middle or cephalic portion of the ligamentum flavum. Conclusions The cervical and high thoracic ligamentum flavum frequently has midline intervals with various features, especially in the caudal portion of the intervertebral space. Therefore, the ligamentum flavum is not always reliable as a perceptible barrier to identify the epidural space at these vertebral levels. Additionally, it may be more useful to insert the needle into the cephalic portion of the intervertebral space than in the caudal portion. PMID:25317280

  17. Contralateral projections of thoracic respiratory interneurones in the cat.

    PubMed Central

    Schmid, K; Kirkwood, P A; Munson, J B; Shen, E; Sears, T A

    1993-01-01

    1. Retrograde neuronal transport following small iontophoretic injections of horseradish peroxidase was used to investigate the location of neurones projecting to the thoracic ventral horn of the cat. 2. A concentration of labelled neurones was seen in the contralateral medial ventral horn at the immediately opposite rostrocaudal position. 3. The participation of respiratory interneurones in the projection was investigated by means of spike-triggered averaging, as follows. 4. Spike trains of single interneurones whose firing patterns were related to the central respiratory cycle were recorded extracellularly in the thoracic ventral horn of anaesthetized, paralysed cats. Firing patterns were defined by the construction of cycle-triggered histograms. 5. Spike-triggered averaging of the signal from an extracellular tungsten microelectrode in the opposite ventral horn was performed to test for the presence of axonal, terminal or focal synaptic potentials. 6. At least one of these types of potential was found for 34/55 units. Terminal potentials were found for thirty-one units, accompanied by focal synaptic potentials for twenty-seven units. Potentials were found for units with all types of firing patterns. Units whose activity elicited these potentials were generally located in the medial half of the ventral horn. 7. We conclude that at least 60% of the respiratory interneurones project to the immediately opposite ventral horn. Images Fig. 1 PMID:8350278

  18. Systematic survey of opinion regarding the thoracic surgery residency.

    PubMed

    Wilcox, B R; Stritter, F T; Anderson, R P; Gay, W A; Kaiser, G C; Orringer, M B; Rainer, W G; Replogle, R L

    1993-05-01

    To summarize this rather wide-ranging study, let us review the high points. The future practice of thoracic surgery will be increasingly affected by governmental factors and will have even greater technological dimensions. To do this work, we must continue to attract high-caliber individuals, and this is best accomplished by the early and continuing involvement in the educational process of strong role models from our field. These future surgeons must be motivated to do good work and should have high ethical standards as well as maturity and high intelligence. Experienced, involved faculty leading the residents through a broad program that offers graduated assumption of clinical and leadership responsibilities will facilitate the development of mature clinical judgment. Residents must be taught the clinical skills necessary to do all thoracic operations, leaving subspecialization to postresidency fellowships. The educational program should be humane in its demands and collegial in its application. It should incorporate experiences beyond the operating room, including the opportunity to read, think, and interact with local mentors and colleagues from around the country. The requirements of certification should not be so rigid as to preclude the development of different pathways to the same end. Likewise, although the accreditation process must protect the resident from exploitation, it must not be so restrictive that it does not allow for educational innovation and justifiable differences among programs. These are the thoughtful opinions of our colleagues. They deserve serious consideration. PMID:8494460

  19. Interactive annotation of textures in thoracic CT scans

    NASA Astrophysics Data System (ADS)

    Kockelkorn, Thessa T. J. P.; de Jong, Pim A.; Gietema, Hester A.; Grutters, Jan C.; Prokop, Mathias; van Ginneken, Bram

    2010-03-01

    This study describes a system for interactive annotation of thoracic CT scans. Lung volumes in these scans are segmented and subdivided into roughly spherical volumes of interest (VOIs) with homogeneous texture using a clustering procedure. For each 3D VOI, 72 features are calculated. The observer inspects the scan to determine which textures are present and annotates, with mouse clicks, several VOIs of each texture. Based on these annotations, a k-nearest-neighbor classifier is trained, which classifies all remaining VOIs in the scan. The algorithm then presents a slice with suggested annotations to the user, in which the user can correct mistakes. The classifier is retrained, taking into account these new annotations, and the user is presented another slice for correction. This process continues until at least 50% of all lung voxels in the scan have been classified. The remaining VOIs are classified automatically. In this way, the entire lung volume is annotated. The system has been applied to scans of patients with usual and non-specific interstitial pneumonia. The results of interactive annotation are compared to a setup in which the user annotates all predefined VOIs manually. The interactive system is 3.7 times as fast as complete manual annotation of VOIs and differences between the methods are similar to interobserver variability. This is a first step towards precise volumetric quantitation of texture patterns in thoracic CT in clinical research and in clinical practice.

  20. Interventional bronchoscopy in the management of thoracic malignancy

    PubMed Central

    Hardavella, Georgia

    2015-01-01

    Educational Aims To highlight the various methods of interventional bronchoscopy. To inform about the indications for palliation and curative bronchoscopy in lung cancer. Interventional bronchoscopy is a rapidly expanding field in respiratory medicine offering minimally invasive therapeutic and palliative procedures for all types of lung neoplasms. This field has progressed over the last couple of decades with the application of new technology. The HERMES European curriculum recommendations include interventional bronchoscopy skills in the modules of thoracic tumours and bronchoscopy [1]. However, interventional bronchoscopy is not available in all training centres and consequently, not all trainees will obtain experience unless they rotate to centres specifically offering such training. In this review, we give an overview of interventional bronchoscopic procedures used for the treatment and palliation of thoracic malignancy. These can be applied either with flexible or rigid bronchoscopy or a combination of both depending on the anatomical location of the tumour, the complexity of the case, bleeding risk, the operator’s expertise and preference as well as local availability. Specialised anaesthetic support and appropriately trained endoscopy staff are essential, allowing a multimodality approach to meet the high complexity of these cases. PMID:26632425

  1. Thoracic sympathetic nerve reconstruction for compensatory hyperhidrosis: the Melbourne technique

    PubMed Central

    Hensman, Chris; Leong, James

    2014-01-01

    Background Compensatory hyperhidrosis (CH) is a potential complication following endoscopic thoracic sympathectomy (ETS) in the management of primary hyperhidrosis. CH is considered a permanent condition with significant psychosocial impacts but with few treatment options. Various reversal surgical techniques, aimed at reconstituting sympathetic pathways, have been developed but results have been inconsistent. Objective We present two case reports of a novel technique of reversal surgery, the Melbourne technique, which was employed to treat severe CH that developed within 3-5 months following ETS. Both patients were followed-up to 8 years. Methods The Melbourne technique employs an endoscopic approach to expose previously sympathectomized or sympathotomized thoracic sympathetic chains. In these two cases it was performed on the right side only. Instead of an interpositional nerve graft, an autogenous vein graft was simultaneously harvested and used as a nerve conduit to bridge the secondary nerve defect after neuroma excision. Long-term outcomes were assessed using the dermatology life quality index (DLQI) and the quality of life (QoL) questionnaires, which are validated for hyperhidrosis. Results In both cases, patients reported postoperative improvements in QoL scores. However, the improvement was more marked in one case compared with the other. There were no significant immediate and long-term postoperative complications. Conclusions The Melbourne technique shows promise as an alternative to interpositional nerve grafts or nerve transfers employed in other endoscopic reversal surgeries for CH. PMID:25333020

  2. Treatment of thoracic wounds with adapted vacuum therapy.

    PubMed

    de Abreu, Igor Renato L B; Pontes, Edgard P O; Tamagno, Mauro F L; Sardenberg, Rodrigo Afonso; Younes, Riad Naim; Abrão, Fernando Conrado

    2014-01-01

    This is a report of seven cases of infected thoracic wounds treated with an adapted low-cost vacuum therapy in the Thoracic Surgery Unit of Santa Marcelina Hospital. The vacuum system used was designed and adapted to our hospital due to financial limitations on the acquisition of commercial kits. The vacuum-assisted closure kit used in this study consisted of chlorhexidine sponges (which are usually used for antisepsis of the surgical team), a 16F nasogastric tube, and two sterile adhesive films (OPSITE) for surgical field reinforcement. The mean duration of vacuum therapy was 13.4 days (range, 10-20 days), with an average of three dressing changes (range, 1-5). After treatment with vacuum-assisted closure, three wounds (3/7) were closed with simple primary sutures, one of the lesions (1/7) was closed by muscle flap rotation, and three wounds (3/7) healed by second intention. This adapted vacuum therapy was safe and easy to apply in our institution, including its use in patients with thoracostomies. PMID:24026077

  3. Thoracic endometriosis with a long delay in diagnosis.

    PubMed

    Neme?, Roxana Maria; Paleru, Cristian; D?n?il?, Olga; Iano?i, Edith Simona; Pop, Corina Silvia; Di?escu, Damian; Streba, Costin Teodor; Ni?u, Mimi Floarea

    2015-01-01

    This paper describes a case of thoracic endometriosis in 36-year-old woman with a long delay in diagnosis. At the admission in the hospital, the patient had a medical history of persistent dysmenorrhea since the age of 13, infertility and an episode of total right pneumothorax two months ago successfully resolved by minimum pleurotomy of the right hemitorax. She came with moderate pain on right hemithorax and dyspnea, which occurred on the first day of menstruation but she did not have any other respiratory symptoms such as hemoptysis, cough. Radiological imaging (chest radiography and computer tomography) at the time of admission confirmed recurrence of the right pneumothorax. She underwent surgical treatment of the right pneumothorax using a single-port video-assisted approach. Intraoperative macroscopic lesions were found catamenial pneumothorax characteristic diagnosis and biopsy material taken (parietal pleura) for histopathology. Immuno-histochemical tests confirmed the diagnosis of thoracic endometriosis. The gonadotropin-releasing hormone analogue was received by the patient early after surgery and there was no clinical or radiological recurrence at a four months follow-up. PMID:25826520

  4. Uniportal video assisted thoracic surgery: summary of experience, mini-review and perspectives

    PubMed Central

    Calvo, Damiano; Criscione, Alessandra; Borrata, Francesco

    2015-01-01

    The uniportal-video assisted thoracic surgery (VATS) technique comprises operations which can be performed with skin incisions ranging from 2 to 8 cm and the manifest result of the introduction of the uniportal lobectomy had made possible to increase rapidly the number of published papers on this subject. Many of the large ensuing literature report incomplete historical information on uniportal VATS, and doubts exist about the indication of uniportal VATS for some thoracic oncologic pathologies. Known limitations have been overcome. On the other hand, the modern thoracic surgical team includes one surgeon, one assistant and a scrub nurse, and it is clear that the new generation of thoracic surgeons need to use the “less” used hand. The new technology which permitted the introduction of the uniportal VATS could influence the future need of thoracic surgeons worldwide. PMID:26543631

  5. Metabolic Syndrome after Kidney Transplantation - Are You at Risk?

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  6. Use of Herbal Supplements in Chronic Kidney Disease

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  7. What I Need to Know about Living with Kidney Failure

    MedlinePLUS

    ... American Kidney Fund Life Options National Kidney Foundation Kidney and Urologic Disease Organizations Many organizations provide support ... What I need to know about Living with Kidney Failure Page Content On this page: What is ...

  8. Detecting Kidney and Urinary Tract Abnormalities Before Birth

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  9. 42 CFR 409.18 - Services related to kidney transplantations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 2010-10-01 false Services related to kidney transplantations. 409.18 Section 409...Hospital Services § 409.18 Services related to kidney transplantations. (a) Kidney transplants. Medicare pays for kidney...

  10. 42 CFR 409.18 - Services related to kidney transplantations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 2011-10-01 false Services related to kidney transplantations. 409.18 Section 409...Hospital Services § 409.18 Services related to kidney transplantations. (a) Kidney transplants. Medicare pays for kidney...

  11. 9 CFR 310.19 - Inspection of kidneys.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 2013-01-01 false Inspection of kidneys. 310.19 Section 310.19 Animals...INSPECTION § 310.19 Inspection of kidneys. An employee of the establishment shall open the kidney capsule and expose the kidneys of all...

  12. 42 CFR 409.18 - Services related to kidney transplantations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 2014-10-01 false Services related to kidney transplantations. 409.18 Section 409...Hospital Services § 409.18 Services related to kidney transplantations. (a) Kidney transplants. Medicare pays for kidney...

  13. 9 CFR 310.19 - Inspection of kidneys.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 2010-01-01 false Inspection of kidneys. 310.19 Section 310.19 Animals...INSPECTION § 310.19 Inspection of kidneys. An employee of the establishment shall open the kidney capsule and expose the kidneys of all...

  14. 42 CFR 409.18 - Services related to kidney transplantations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 2012-10-01 false Services related to kidney transplantations. 409.18 Section 409...Hospital Services § 409.18 Services related to kidney transplantations. (a) Kidney transplants. Medicare pays for kidney...

  15. 42 CFR 409.18 - Services related to kidney transplantations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 2013-10-01 false Services related to kidney transplantations. 409.18 Section 409...Hospital Services § 409.18 Services related to kidney transplantations. (a) Kidney transplants. Medicare pays for kidney...

  16. 9 CFR 310.19 - Inspection of kidneys.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 2011-01-01 false Inspection of kidneys. 310.19 Section 310.19 Animals...INSPECTION § 310.19 Inspection of kidneys. An employee of the establishment shall open the kidney capsule and expose the kidneys of all...

  17. 9 CFR 310.19 - Inspection of kidneys.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 2012-01-01 false Inspection of kidneys. 310.19 Section 310.19 Animals...INSPECTION § 310.19 Inspection of kidneys. An employee of the establishment shall open the kidney capsule and expose the kidneys of all...

  18. 9 CFR 310.19 - Inspection of kidneys.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2014-01-01 false Inspection of kidneys. 310.19 Section 310.19 Animals...INSPECTION § 310.19 Inspection of kidneys. An employee of the establishment shall open the kidney capsule and expose the kidneys of all...

  19. Chronic Kidney Disease and Medicines: What You Need to Know

    MedlinePLUS

    ... www.clinicaltrials.gov . Notes: For more information National Kidney Disease Education Program 1-866-4 KIDNEY (1-866-454-3639) www.nkdep.nih.gov National Kidney Disease Education Program The National Kidney Disease Education Program ( ...

  20. Opdivo Approved for Advanced Kidney Cancer

    MedlinePLUS

    ... news/fullstory_155894.html Opdivo Approved for Advanced Kidney Cancer More than 14,000 projected to die ... renal cell carcinoma, the most common type of kidney cancer. The drug targets proteins that would otherwise ...

  1. Do We Know What Causes Kidney Cancer?

    MedlinePLUS

    ... Next Topic Can kidney cancer be prevented? Do we know what causes kidney cancer? Although many risk ... genes ? the instructions for how our cells function. We usually look like our parents because they are ...

  2. New Challenges in Multihospital Kidney Exchange

    E-print Network

    Ashlagi, Itai

    The growth of kidney exchange presents new challenges for the design of kidney exchange clearinghouses. The players now include directors of transplant centers, who see sets of patient-donor pairs, and can choose to reveal ...

  3. Kidney Transplant 'Tourism' Comes with Risks

    MedlinePLUS

    ... can buy a donor kidney on the black market. But beyond the legal and ethical pitfalls, experts ... chance on traveling abroad to buy a black-market kidney, according to Dr. Gabriel Danovitch, director of ...

  4. Kidney Disease Risks among African-Americans

    MedlinePLUS

    ... Partners Search This Site Kidney Disease Risks Among African-Americans African-Americans are more at risk for kidney ... Fund doing to help? More Information Why are African-Americans more at risk? Although we are not exactly ...

  5. Paying for kidneys: the case against prohibition.

    PubMed

    Gill, Michael B; Sade, Robert M

    2002-03-01

    We argue that healthy people should be allowed to sell one of their kidneys while they are alive--that the current prohibition on payment for kidneys ought to be overturned. Our argument has three parts. First, we argue that the moral basis for the current policy on live kidney donations and on the sale of other kinds of tissue implies that we ought to legalize the sale of kidneys. Second, we address the objection that the sale of kidneys is intrinsically wrong because it violates the Kantian duty of respect for humanity. Third, we address a range of consequentialist objections based on the idea that kidney sales will be exploitative. Throughout the paper, we argue only that it ought to be legal for an individual to receive payment for a kidney. We do not argue that it ought to be legal for an individual to buy a kidney. PMID:12211265

  6. Prevent Diabetes Problems: Keep Your Kidneys Healthy

    MedlinePLUS

    ... Fund National Kidney Foundation American Diabetes Association JDRF Diabetes Disease Organizations Many organizations provide support to patients ... PDF, 293 KB). Alternate Language URL Español Prevent diabetes problems: Keep your kidneys healthy Page Content On ...

  7. Ultrasound: Renal (Kidneys, Ureters, Bladder) (For Parents)

    MedlinePLUS

    ... of blockages or kidney stones complications of a urinary tract infection (UTI) cysts or tumors Preparation Usually, you don't ... Diseases in Childhood Kidneys and Urinary Tract Recurrent Urinary Tract Infections and Related Conditions Urinary Tract Infections Wilms Tumor ...

  8. What Is Kidney Cancer (Renal Cell Carcinoma)?

    MedlinePLUS

    ... of cancer, see our document Wilms Tumor . Renal sarcoma Renal sarcomas are a rare type of kidney cancer that ... up less than 1% of all kidney cancers. Sarcomas are discussed in more detail in our document ...

  9. Autophagy in Kidney Health and Disease

    PubMed Central

    Wang, Zhibo

    2014-01-01

    Abstract Significance: Autophagy is emerging as an important pathway in many biological processes and diseases. This review summarizes the current progress on the role of autophagy in renal physiology and pathology. Recent Advances: Studies from renal cells in culture, human kidney tissues, and experimental animal models implicate that autophagy regulates many critical aspects of normal and disease conditions in the kidney, such as diabetic nephropathy and other glomerular diseases, tubular injuries, kidney development and aging, cancer, and genetic diseases associated with the kidney. Critical Issues: The importance of autophagy in the kidney has just started to be elucidated. How the process of autophagy is altered in the pathogenesis of kidney diseases and how this alteration is beneficial or detrimental to kidney functions still need to be fully understood. Future Directions: Investigations that uncover the precise mechanism and regulation of autophagy in various kidney diseases may lead to new strategies for therapeutic modulation. Antioxid. Redox Signal. 20, 519–537. PMID:23642034

  10. A neural correlate of visceral emotional responses: evidence from fMRI of the thoracic spinal cord

    E-print Network

    Smith, Stephen D.

    A neural correlate of visceral emotional responses: evidence from fMRI of the thoracic spinal cord Functional magnetic resonance imaging (fMRI) of thoracic spinal cord neurons was used to examine the neural; functional MRI; spinal cord; thoracic spinal cord; emotion A core feature of emotional experience

  11. Albuminuria prediction of kidney function outcome in kidney transplant recipients.

    PubMed

    El Minshawy, Osama; El-Bassuoni, Eman

    2015-03-01

    To investigate the association of albuminuria and kidney function outcome in kidney transplant recipients, we studied 161 kidney transplant recipients; 95 (59%) of them were males and the mean age of the patients was 46 ± 13 years (range 18-70 years). All the patients received allografts from living related kidney donors. The mean body mass index of the patients was 25 ± 4 kg/m 2 . Forty (25%) patients were diabetic and 72 (45%) patients were hypertensive. All the patients had glomerular filtration rate (iGFR) determination by ( 99m Tc-DTPA) clearance and albumiuria was assessed using the first voided morning urine samples. According to the results of albuminuria, the patients were subdivided into three groups: One group of 90 (56%) patients with normoalbuminuria (<30 mg albumin/g. creatinine), a second group of 52 (32%) patients with microalbuminuria (30-300 mg albumin/g. creatinine) and a third group of 19 (12%) patients with macroalbuminuria (>300 mg/g. creatinine). There was a significant increase in the time post transplantation in the patients with macroalbumiuria in comparison with microalbuminuria and normoalbuminuria (90 ± 28, 60 ± 22 and 18 ± 6 months, respectively), P <0.05. There was a significant decrease of iGFR in the macroalbumiuria group as compared with the microalbumiuria and normoalbuminuria groups (57 ± 24, 74 ± 20 and 74 ± 28 mL/min/1.73 m 2 , respectively), P <0.05. We conclude that there was an association between albuminuria and the status of the renal function in our transplant population, which may reflect renal injury due to proteinuria. Prospective studies are warranted to evaluate the effect of albuminuria on the prognosis of the kidney allografts. PMID:25758867

  12. A Closer Look at Kidney Development THE KIDNEY: FROM NORMAL DEVEL-

    E-print Network

    Vize, Peter D.

    BOOK LOOK A Closer Look at Kidney Development THE KIDNEY: FROM NORMAL DEVEL- OPMENT TO CONGENITAL p, $159.95 Early stages of kidney development get relatively short shrift in many em- bryology textbooks, so when I first saw the galleys of The Kidney: From Nor- mal Development to Congenital Dis- ease

  13. Clinical experience in treatment of diffuse unilateral subretinal neuroretinitis

    PubMed Central

    Relhan, Nidhi; Pathengay, Avinash; Raval, Vishal; Nayak, Sameera; Choudhury, Himadri; Flynn, Harry W

    2015-01-01

    Purpose To describe the clinical features, management, and outcomes of patients with diffuse unilateral subacute neuroretinitis (DUSN). Methods A noncomparative, consecutive analysis of case series from two tertiary care campuses of LV Prasad Eye Institute, India, between January 2011 and April 2014 was performed. Medical records of the patients presenting with DUSN (early or late stage) were reviewed. Results The current study included 13 patients. The majority (10/13, 76.92%) of the patients were aged 20 years or less. All patients had unilateral eye involvement. Visual acuity at presentation was 20/200 or worse in 9/13 (69.23%) patients. A delay in diagnosis occurred in 6/13 patients, and initial diagnosis in these patients included retinitis pigmentosa (4 patients) and posterior uveitis (2 patients). Clinical features included early presentation (prominent vitritis, localized retinitis, and vasculitis) in 7/13 (53.85%) patients and late presentation (attenuation of vessels, retinal pigment epithelium atrophic changes, and optic atrophy) in 6/13 (46.15%) patients. Worm could not be identified in any of the cases. All the patients received laser photocoagulation of retina and oral albendazole treatment for a period of 30 days. With treatment, visual acuity improved in seven patients (six early stage, one late stage) and remained unchanged in six patients. Mean follow-up period was 8.69 months (range, 1–21 months). The mean central foveal thickness in the affected eye, done by optical coherence tomography, during the late stage of the disease was 188.20±40 µm (range, 111–242 µm), which was significantly thinner than the fellow eye, 238.70±36.90 µm (range, 186–319 µm), P=0.008. Conclusion DUSN is a serious vision threatening disease, which may progress to profound vision loss in the later stage of the disease. Visualization of subretinal worm is usually not possible. Treatment with high-dose albendazole therapy and laser photocoagulation may alter the blood–retinal barrier and may be useful in achieving visual recovery. PMID:26491239

  14. Quantification of single-kidney glomerular filtration rate with electron-beam computed tomography

    NASA Astrophysics Data System (ADS)

    Lerman, Lilach O.; Ritman, Erik L.; Pelaez, Laura I.; Sheedy, Patrick F., II; Krier, James D.

    2000-04-01

    The ability to accurately and noninvasively quantify single- kidney GFR could be invaluable for assessment of renal function. We developed a model that enables this measurement with EBCT. To examine the reliability of this method, EBCT renal flow and volume studies after contrast media administration were performed in pigs with unilateral renal artery stenosis (Group 1), controls (Group 2), and simultaneously with inulin clearance (Group 3). Renal flow curves, obtained from the bilateral renal cortex and medulla, depicted transit of the contrast through the vascular and tubular compartments, and were fitted using extended gamma- variate functions. Renal blood flow was calculated as the sum of products of cortical and medullary perfusions and volumes. Normalized GFR (mL/min/cc) was calculated using the rate (maximal slope) of proximal tubular contrast accumulation, and EBCT-GFR as normalized GFR* cortical volume. In Group 1, the decreased GFR of the stenotic kidney correlated well with its decreased volume and RBF, and with the degree of stenosis (r equals -0.99). In Group 3, EBCT-GFR correlated well with inulin clearance (slope 1.1, r equals 0.81). This novel approach can be very useful for quantification of concurrent regional hemodynamics and function in the intact kidneys, in a manner potentially applicable to humans.

  15. Increased albumin permeation in eyes, aorta, and kidney of hypertensive rats fed galactose

    SciTech Connect

    Tilton, R.G.; LaRose, L.; Chang, K.; Weigel, C.J.; Williamson, J.R.

    1986-03-01

    These experiments were undertaken to determine whether ingestion of galactose increases albumin permeation in the vasculature of hypertensive rats. 50% dextrin (control) or 50% galactose diets were fed to unilaterally nephrectomized, male Sprague-Dawley rats weighing 200 g. Hypertension (systolic pressure >175 mmHg) was induced by weekly IM injections of 25 mg/kg DOCA and 1% saline drinking water; 3 months later /sup 125/I-albumin permeation was assessed in whole eyes, aorta and kidneys. /sup 125/I-albumin permeation was significantly increased in all 3 tissues of hypertensive rats (n = 9) vs controls (n = 9): aorta (3.30 +/- 0.19 (SD) vs 2.87 +/- 0.14), eye (3.15 +/- 0.14 vs 2.59 +/- 0.11), and kidney (6.58 +/- 0.63 vs 3.85 +/- 0.50). Albumin permeation was increased still further in hypertensive rats fed the galactose diet (n = 8): aorta (3.75 +/- 0.38), eye (3.82 +/- 0.17), and kidney (10.74 +/- 3.13). Hypertension +/- galactose feeding had no effect on albumin permeation in lung, skin, or brain. These findings indicate that: (1) hypertension increases albumin permeation in vessels affected by diabetic vascular diseases, and 2) hypertension-induced increases in albumin permeation are increased still further by galactose ingestion, presumably mediated by imbalances in polyol/insitol metabolism (analogous to those induced by diabetes) independent of hyperglycemia and/or insulinopenia.

  16. RTN1 mediates progression of kidney disease by inducing ER stress

    PubMed Central

    Fan, Ying; Xiao, Wenzhen; Li, Zhengzhe; Li, Xuezhu; Chuang, Peter Y.; Jim, Belinda; Zhang, Weijia; Wei, Chengguo; Wang, Niansong; Jia, Weiping; Xiong, Huabao; Lee, Kyung; He, John C.

    2015-01-01

    Identification of new biomarkers and drug targets for chronic kidney disease (CKD) is required for the development of more effective therapy. Here we report an association between expression of reticulon 1 (RTN1) and severity of CKD. An isoform-specific increase in the expression of RTN1A is detected in the diseased kidneys from mice and humans, and correlates inversely with renal function in patients with diabetic nephropathy. RTN1 overexpression in renal cells induces ER stress and apoptosis, whereas RTN1 knockdown attenuates tunicamycin-induced and hyperglycaemia-induced ER stress and apoptosis. RTN1A interacts with PERK through its N-terminal and C-terminal domains, and mutation of these domains prevents this effect on ER stress. Knockdown of Rtn1a expression in vivo attenuates ER stress and renal fibrosis in mice with unilateral ureteral obstruction, and also attenuates ER stress, proteinuria, glomerular hypertrophy and mesangial expansion in diabetic mice. Together, these data indicate that RTN1A contributes to progression of kidney disease by inducing ER stress. PMID:26227493

  17. Kidney Tumors | Office of Cancer Genomics

    Cancer.gov

    Pediatric kidney tumors fall into four primary categories: Wilms tumors (~85% of all cases), clear cell sarcomas of the kidney (~5%), congenital mesoblastic nephromas (~4%), and rhabdoid tumors of the kidney (~3%). The TARGET initiative is investigating three of these tumor types.

  18. Proceedings Article Failure-Aware Kidney Exchange

    E-print Network

    Procaccia, Ariel

    Proceedings Article Failure-Aware Kidney Exchange JOHN P. DICKERSON, Computer Science Department in fielded kidney exchanges do not result in an actual transplant. In this paper, we address the problem that failure-aware kidney exchange can significantly increase the expected number of lives saved (i) in theory

  19. Forschungsprofil Primary cilia and polycystic kidney disease

    E-print Network

    Witzgall, Ralph - Naturwissenschaftliche Fakultät III

    Forschungsprofil Primary cilia and polycystic kidney disease Karin Babinger and Ralph Witzgall Situs inversus and polycystic kidney disease converge at primary cilia Although at first glance our body, the inv mouse, not only presents with situs inversus but also with polycystic kidneys. At the time of its

  20. INTRODUCTION Chronic kidney disease impairs glomerular filtration

    E-print Network

    Thompson, Paul

    INTRODUCTION Chronic kidney disease impairs glomerular filtration rate (GFR) which is detected as elevated serum levels of kidney biomarkers such as creatinine and cystatin C. Prior studies have related poor kidney function to cognitive decline and generalized brain atrophy. However, so far, there have

  1. Kidney Stones in Children and Teens

    MedlinePLUS

    ... stones may form in the bladder. While kidney stones can occur at any age, even in premature infants , most occur in teens , with teen girls having the highest incidence. Types of Kidney Stones There are many different types of kidney stones ...

  2. www.yalecancercenter.org Innovations in Kidney

    E-print Network

    O'Hern, Corey S.

    www.yalecancercenter.org Innovations in Kidney Cancer Guest Expert: Harriet Kluger, MD Associate look at kidney cancer. Ken Miller welcomes Dr. Harriet Kluger and Edward Uchio. Dr. Kluger is Assistant causes kidney cancer and why the incidence seems to be increasing. Uchio The issue is that, before

  3. Eating Right for Kidney Health

    MedlinePLUS

    ... foods. ? R inse canned vegetables, beans, meats, and fish with water before eating. Look for Food Labels that Say l Sodium ... or round l Poultry without the skin l Fish l Beans l Vegetables l Fruits l Low-fat milk, yogurt, cheese 2 Eating Right for Kidney Health THE NEXT STEPS TO ...

  4. Bacterial kidney disease (Renibacterium salmoninarum)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Bacterial kidney disease (BKD), caused by Renibacterium salmoninarum, is a prevalent disease of salmonid fish that impacts sustainable production for consumption and species conservation efforts. The disease is chronic in nature and mortality most often occurs in juvenile salmonids and prespawning a...

  5. Binocular fixation disparities in reading in people with unilateral strabismus: A case study. 

    E-print Network

    Inioutina, Marina

    2010-06-30

    Recent studies of binocular coordination during reading have discovered that the eyes do not always fixate on the same location. This current study explored the patterns of eye movement of participants with unilateral ...

  6. Acting alone: U.S. unilateral uses of force, military revolutions, and hegemonic stability theory 

    E-print Network

    Podliska, Bradley Florian

    2009-06-02

    The premise of this dissertation is straight-forward – the U.S., as hegemon, acts unilaterally given the power disparity between it and the rest of the world. In solving the puzzle of why presidents make the “wrong” ...

  7. Mutations of the SLIT2-ROBO2 pathway genes SLIT2 and SRGAP1 confer risk for congenital anomalies of the kidney and urinary tract.

    PubMed

    Hwang, Daw-Yang; Kohl, Stefan; Fan, Xueping; Vivante, Asaf; Chan, Stefanie; Dworschak, Gabriel C; Schulz, Julian; van Eerde, Albertien M; Hilger, Alina C; Gee, Heon Yung; Pennimpede, Tracie; Herrmann, Bernhard G; van de Hoek, Glenn; Renkema, Kirsten Y; Schell, Christoph; Huber, Tobias B; Reutter, Heiko M; Soliman, Neveen A; Stajic, Natasa; Bogdanovic, Radovan; Kehinde, Elijah O; Lifton, Richard P; Tasic, Velibor; Lu, Weining; Hildebrandt, Friedhelm

    2015-08-01

    Congenital anomalies of the kidney and urinary tract (CAKUT) account for 40-50% of chronic kidney disease that manifests in the first two decades of life. Thus far, 31 monogenic causes of isolated CAKUT have been described, explaining ~12% of cases. To identify additional CAKUT-causing genes, we performed whole-exome sequencing followed by a genetic burden analysis in 26 genetically unsolved families with CAKUT. We identified two heterozygous mutations in SRGAP1 in 2 unrelated families. SRGAP1 is a small GTPase-activating protein in the SLIT2-ROBO2 signaling pathway, which is essential for development of the metanephric kidney. We then examined the pathway-derived candidate gene SLIT2 for mutations in cohort of 749 individuals with CAKUT and we identified 3 unrelated individuals with heterozygous mutations. The clinical phenotypes of individuals with mutations in SLIT2 or SRGAP1 were cystic dysplastic kidneys, unilateral renal agenesis, and duplicated collecting system. We show that SRGAP1 is expressed in early mouse nephrogenic mesenchyme and that it is coexpressed with ROBO2 in SIX2-positive nephron progenitor cells of the cap mesenchyme in developing rat kidney. We demonstrate that the newly identified mutations in SRGAP1 lead to an augmented inhibition of RAC1 in cultured human embryonic kidney cells and that the SLIT2 mutations compromise the ability of the SLIT2 ligand to inhibit cell migration. Thus, we report on two novel candidate genes for causing monogenic isolated CAKUT in humans. PMID:26026792

  8. Automatic learning-based beam angle selection for thoracic IMRT

    SciTech Connect

    Amit, Guy; Marshall, Andrea; Purdie, Thomas G. Jaffray, David A.; Levinshtein, Alex; Hope, Andrew J.; Lindsay, Patricia; Pekar, Vladimir

    2015-04-15

    Purpose: The treatment of thoracic cancer using external beam radiation requires an optimal selection of the radiation beam directions to ensure effective coverage of the target volume and to avoid unnecessary treatment of normal healthy tissues. Intensity modulated radiation therapy (IMRT) planning is a lengthy process, which requires the planner to iterate between choosing beam angles, specifying dose–volume objectives and executing IMRT optimization. In thorax treatment planning, where there are no class solutions for beam placement, beam angle selection is performed manually, based on the planner’s clinical experience. The purpose of this work is to propose and study a computationally efficient framework that utilizes machine learning to automatically select treatment beam angles. Such a framework may be helpful for reducing the overall planning workload. Methods: The authors introduce an automated beam selection method, based on learning the relationships between beam angles and anatomical features. Using a large set of clinically approved IMRT plans, a random forest regression algorithm is trained to map a multitude of anatomical features into an individual beam score. An optimization scheme is then built to select and adjust the beam angles, considering the learned interbeam dependencies. The validity and quality of the automatically selected beams evaluated using the manually selected beams from the corresponding clinical plans as the ground truth. Results: The analysis included 149 clinically approved thoracic IMRT plans. For a randomly selected test subset of 27 plans, IMRT plans were generated using automatically selected beams and compared to the clinical plans. The comparison of the predicted and the clinical beam angles demonstrated a good average correspondence between the two (angular distance 16.8° ± 10°, correlation 0.75 ± 0.2). The dose distributions of the semiautomatic and clinical plans were equivalent in terms of primary target volume coverage and organ at risk sparing and were superior over plans produced with fixed sets of common beam angles. The great majority of the automatic plans (93%) were approved as clinically acceptable by three radiation therapy specialists. Conclusions: The results demonstrated the feasibility of utilizing a learning-based approach for automatic selection of beam angles in thoracic IMRT planning. The proposed method may assist in reducing the manual planning workload, while sustaining plan quality.

  9. Intrinsic response of thoracic propriospinal neurons to axotomy

    PubMed Central

    2010-01-01

    Background Central nervous system axons lack a robust regenerative response following spinal cord injury (SCI) and regeneration is usually abortive. Supraspinal pathways, which are the most commonly studied for their regenerative potential, demonstrate a limited regenerative ability. On the other hand, propriospinal (PS) neurons, with axons intrinsic to the spinal cord, have shown a greater regenerative response than their supraspinal counterparts, but remain relatively understudied in regards to spinal cord injury. Results Utilizing laser microdissection, gene-microarray, qRT-PCR, and immunohistochemistry, we focused on the intrinsic post-axotomy response of specifically labelled thoracic propriospinal neurons at periods from 3-days to 1-month following T9 spinal cord injury. We found a strong and early (3-days post injury, p.i) upregulation in the expression of genes involved in the immune/inflammatory response that returned towards normal by 1-week p.i. In addition, several regeneration associated and cell survival/neuroprotective genes were significantly up-regulated at the earliest p.i. period studied. Significant upregulation of several growth factor receptor genes (GFRa1, Ret, Lifr) also occurred only during the initial period examined. The expression of a number of pro-apoptotic genes up-regulated at 3-days p.i. suggest that changes in gene expression after this period may have resulted from analyzing surviving TPS neurons after the cell death of the remainder of the axotomized TPS neuronal population. Conclusions Taken collectively these data demonstrate that thoracic propriospinal (TPS) neurons mount a very dynamic response following low thoracic axotomy that includes a strong regenerative response, but also results in the cell death of many axotomized TPS neurons in the first week after spinal cord injury. These data also suggest that the immune/inflammatory response may have an important role in mediating the early strong regenerative response, as well as the apoptotic response, since expression of all of three classes of gene are up-regulated only during the initial period examined, 3-days post-SCI. The up-regulation in the expression of genes for several growth factor receptors during the first week post-SCI also suggest that administration of these factors may protect TPS neurons from cell death and maintain a regenerative response, but only if given during the early period after injury. PMID:20525361

  10. Three-Magnet Arrays for Unilateral Magnetic Resonance

    NASA Astrophysics Data System (ADS)

    Garcia Naranjo, Juan Carlos

    Unilateral Magnetic Resonance (UMR) has become, in different research areas, a powerful tool to interrogate samples of arbitrary size. The three-magnet array developed by the MRI Centre of the University of New Brunswick has features that make it a simple and robust approach for UMR. This thesis introduces a group of solutions to broaden the range of application of this design. Practical applications for non-destructive testing and reservoir core plug characterization are presented. We have shown that it is also possible to monitor the curing process of an epoxy/polyamidoamine system by employing a three-magnet array. A new version of the three-magnet array which features extended constant magnetic field gradients is also introduced. Constant gradients of more than 3 cm extent can be achieved in a very simple, compact and safe design. The application of the three-magnet array in combination with a solenoid as the RF probe for analysis of long core plugs has been presented. Core plugs of different diameter can be analyzed by simply changing the diameter of the RF probe employed for the measurement. Results of an initial survey of selective excitation in UMR are presented. The low SNR and inhomogeneities in the selective spot reduce the effectiveness of selective excitation for UMR.

  11. Primate translational vestibuloocular reflexes. IV. Changes after unilateral labyrinthectomy

    NASA Technical Reports Server (NTRS)

    Angelaki, D. E.; Newlands, S. D.; Dickman, J. D.

    2000-01-01

    The effects of unilateral labyrinthectomy on the properties of the translational vestibuloocular reflexes (trVORs) were investigated in rhesus monkeys trained to fixate near targets. Translational motion stimuli consisted of either steady-state lateral and fore-aft sinusoidal oscillations or short-lasting transient displacements. During small-amplitude, steady-state sinusoidal lateral oscillations, a small decrease in the horizontal trVOR sensitivity and its dependence on viewing distance was observed during the first week after labyrinthectomy. These deficits gradually recovered over time. In addition, the vertical response component increased, causing a tilt of the eye velocity vector toward the lesioned side. During large, transient lateral displacements, the deficits were larger and longer lasting. Responses after labyrinthectomy were asymmetric, with eye velocity during movements toward the side of the lesion being more compromised. The most profound effect of the lesions was observed during fore-aft motion. Whereas responses were kinematically appropriate for fixation away from the side of the lesion (e.g., to the left after right labyrinthectomy), horizontal responses were anticompensatory during fixation at targets located ipsilateral to the side of the lesion (e.g., for targets to the right after right labyrinthectomy). This deficit showed little recovery during the 3-mo post-labyrinthectomy testing period. These results suggest that inputs from both labyrinths are important for the proper function of the trVORs, although the details of how bilateral signals are processed and integrated remain unknown.

  12. Consideration of vocal fold position in unilateral vocal fold paralyses.

    PubMed

    Olthoff, Arno; Steinle, Julia; Asendorf, Thomas; Kruse, Eberhard

    2015-04-01

    The objective of this study was to improve the evaluation of unilateral vocal fold paralyses (uVFP) by means of an area measurement of the glottic plane, which describes the position of the paralysed vocal fold. The area measurements were related to electromyographic findings and clinical outcome (recovery, voice quality). In 56 patients (33 women and 23 men), uVFP were confirmed by endolaryngeal electromyography (EMG) of the paralysed vocal fold and cricothyroid muscles (CT). The EMG response was classified on a 4-point scale (from 0 to 3). Vocal fold position was divided into 'paramedian' and 'intermediate' and additionally quantified by measurement of the glottic area. An 'area quotient' (AQ) was calculated and related to the EMG findings and clinical outcome. Voice qualities were objectified regarding their additive noise (breathiness) and irregularity (roughness) using the 'Göttingen Hoarseness Diagram'. The majority of uVFP was due to iatrogenic lesions. The AQ of classically graduated 'paramedian' and 'intermediate' vocal fold positions was significantly different but did not correlate with objective voice quality values. There were no significant correlations regarding EMG findings, duration or recovery from paralyses. Laryngeal EMG remains the gold standard for verifying uVFP. But EMG did not correlate significantly with AQ or functional outcome of uVFP. The measurement of an AQ is suitable for obtaining continuous data describing the position of paralysed vocal folds beyond the terms 'paramedian' or 'intermediate' and provides the basis for clinical evaluations of diagnostic tools and therapeutic interventions. PMID:25519473

  13. Hearing and music in unilateral spatial neglect neuro-rehabilitation

    PubMed Central

    Guilbert, Alma; Sylvain Clément; Moroni, Christine

    2014-01-01

    Unilateral spatial neglect (USN) is an attention deficit in the contralesional side of space which occurs after a cerebral stroke, mainly located in the right hemisphere. USN patients are disabled in all daily activities. USN is an important negative prognostic factor of functional recovery and of socio-professional reinsertion. Thus, patient rehabilitation is a major challenge. As this deficit has been described in many sensory modalities (including hearing), many sensory and poly-sensory rehabilitation methods have been proposed to USN patients. They are mainly based on visual, tactile modalities and on motor abilities. However, these methods appear to be quite task-specific and difficult to transfer to functional activities. Very few studies have focused on the hearing modality and even fewer studies have been conducted in music as a way of improving spatial attention. Therefore, more research on such retraining needs is neccessary in order to make reliable conclusions on its efficiency in long-term rehabilitation. Nevertheless, some evidence suggests that music could be a promising tool to enhance spatial attention and to rehabilitate USN patients. In fact, music is a material closely linked to space, involving common anatomical and functional networks. The present paper aims firstly at briefly reviewing the different procedures of sensory retraining proposed in USN, including auditory retraining, and their limits. Secondly, it aims to present the recent scientific evidence that makes music a good candidate for USN patients’ neuro-rehabilitation. PMID:25566165

  14. Changes in contralateral protein metabolism following unilateral sciatic nerve section

    SciTech Connect

    Menendez, J.A.; Cubas, S.C.

    1990-03-01

    Changes in nerve biochemistry, anatomy, and function following injuries to the contralateral nerve have been repeatedly reported, though their significance is unknown. The most likely mechanisms for their development are either substances carried by axoplasmic flow or electrically transmitted signals. This study analyzes which mechanism underlies the development of a contralateral change in protein metabolism. The incorporation of labelled amino acids (AA) into proteins of both sciatic nerves was assessed by liquid scintillation after an unilateral section. AA were offered locally for 30 min to the distal stump of the sectioned nerves and at homologous levels of the intact contralateral nerves. At various times, from 1 to 24 h, both sciatic nerves were removed and the proteins extracted with trichloroacetic acid (TCA). An increase in incorporation was found in both nerves 14-24 h after section. No difference existed between sectioned and intact nerves, which is consistent with the contralateral effect. Lidocaine, but not colchicine, when applied previously to the nerves midway between the sectioning site and the spinal cord, inhibited the contralateral increase in AA incorporation. It is concluded that electrical signals, crossing through the spinal cord, are responsible for the development of the contralateral effect. Both the nature of the proteins and the significance of the contralateral effect are matters for speculation.

  15. Rehabilitation and neuroplasticity in children with unilateral cerebral palsy.

    PubMed

    Reid, Lee B; Rose, Stephen E; Boyd, Roslyn N

    2015-07-01

    Cerebral palsy is a childhood-onset, lifelong neurological disorder that primarily impairs motor function. Unilateral cerebral palsy (UCP), which impairs use of one hand and perturbs bimanual co-ordination, is the most common form of the condition. The main contemporary upper limb rehabilitation strategies for UCP are constraint-induced movement therapy and bimanual intensive therapy. In this Review, we outline the factors that are crucial to the success of motor rehabilitation in children with UCP, including the dose of training, the relevance of training to daily life, the suitability of training to the age and goals of the child, and the ability of the child to maintain close attention to the tasks. Emerging evidence suggests that the first 2 years of life are a critical period during which interventions for UCP could be more effective than in later life. Abnormal brain organization in UCP, and the effects of development on rehabilitation, must also be understood to develop new effective interventions. Therefore, we also consider neuroimaging methods that can provide insight into the neurobiology of UCP and how the condition responds to existing therapies. We discuss how these methods could shape future rehabilitative strategies based on the neurobiology of UCP and the therapy-induced changes seen in the brain. PMID:26077839

  16. Emergency Endovascular Treatment of Sac Rupture for Type IIIa Endoleak in Thoracic Aortic Aneurysm Previously Excluded with Endovascular Repair

    SciTech Connect

    Carrafiello, Gianpaolo Mangini, Monica Bracchi, Elena Recaldini, Chiara; Cocozza, Eugenio; Piffaretti, Gabriele; Pellegrino, Carlo Lagana, Domenico Fugazzola, Carlo

    2010-08-15

    Elective endovascular treatment of thoracic aortic pathology has been applied in a variety of conditions. The complications of thoracic aortic stenting are also well recognized. Endoleak after endovascular repair of thoracic aortic aneurysms is the most frequent complication; among them, type III is the least frequent. Endovascular treatment of type III endoleak is generally performed under elective conditions; less frequently, in emergency. We report a successful emergency endovascular management of post-thoracic endovascular repair for thoracic aortic aneurysm rupture due to type IIIa endoleak.

  17. Layer-specific residual deformations and uniaxial and biaxial mechanical properties of thoracic porcine aorta.

    PubMed

    Peña, Juan A; Martínez, Miguel A; Peña, Estefanía

    2015-10-01

    In this paper we hypothesize that the layer-separated residual stresses and mechanical properties of layer-separated thoracic aorta arteries may be dependent on arterial location of the vessel. To demonstrate any possible position differences, we measured the axial pre-stretch and opening angle and performed uniaxial and biaxial tests under physiological loads to study the mechanical behavior of both intact and layer-separated porcine aortic samples taken from thoracic region. In addition, we also provided constitutive parameters for each layer that can be used by biomedical engineers for investigating better therapies and developing artery-specific devices. We found that the opening angle for whole artery and adventitia layer are smaller and intima greater for proximal segments than for the distal thoracic ones. For the axial pre-stretch, our results showed significant increased values of the stretch ratios with location. We found that lower thoracic samples are stiffer than upper ones with the most important differences corresponding to those between the proximal and distal behaviors in the circumferential direction. The anisotropy represented by the different circumferential and longitudinal response is more remarkable in lower thoracic aorta. Finally, adventitia and intima samples present a tendency to be stiffer and more isotropic than the corresponding media samples in both directions for upper thoracic aorta and to be more anisotropic for lower thoracic aorta. PMID:26103440

  18. Thoracic outlet syndrome secondary to a mid-clavicle malunion.

    PubMed

    Beliaev, Andrei M; Fougere, Christopher

    2015-01-01

    A 22-year-old man presented with a painful 'clunking' sensation in the right mid-clavicle, and pain and dysaesthesia along the medial aspect of his right arm and hand. Three months earlier, he had been involved in a vehicle accident and sustained a right clavicle fracture. He had a large step off of the right clavicle with a medialisation of the right shoulder. At 90° abduction in external rotation of both shoulders he developed pain, paraesthesia and disappearance of the right radial artery pulsation. CT of the right shoulder in the neutral position demonstrated the clavicle-to-first rib distance of 5.5?mm, MRI showed the clavicular bone callus had a mass effect with effacement of anterior fat adjacent to the brachial plexus cords. He was diagnosed with thoracic outlet syndrome and underwent a corrective right clavicle osteotomy with the use of an AcuMed superior clavicle plate. PMID:26045517

  19. Compartmental responses after thoracic irradiation of mice: Strain differences

    SciTech Connect

    Chiang, C.-S.; Liu, W.-C.; Jung, S.-M.; Chen, F.-H.; Wu, C.-R.; McBride, William H.; Lee, C.-C.; Hong, J.-H. . E-mail: jihong@adm.cgmh.org.tw

    2005-07-01

    Purpose: To examine and compare the molecular and cellular processes leading to radiation fibrosis and pneumonitis in C57BL/6J and C3H/HeN mice. Methods and Materials: At indicated times after various doses of thoracic irradiation, the cell populations obtained by bronchoalveolar lavage of C57BL/6J mice were differentially analyzed by cytology and assessed by RNase protection (RPA) assay for levels of cytokines and related genes. The molecular responses in bronchial alveolar lavage (BAL) populations were compared with those in whole lung of C57BL/6J mice and with those of C3H/HeN mice. The former strain develops late radiation fibrosis, whereas the latter develop subacute radiation pneumonitis. Results: In C57BL/6J mice, a decrease in the total number of BAL cells was found 1 week after 6, 12, or 20 Gy thoracic irradiation with a subsequent dose-dependent increase up to 6 months. After 12 and 20 Gy, large, foamy macrophages and multinucleated cells became evident in BAL at 3 weeks, only to disappear at 4 months and reappear at 6 months. This biphasic response was mirrored by changes expression of mRNA for proinflammatory cytokines and the Mac-1 macrophage-associated antigen. As with BAL, whole lung tissue also showed biphasic cytokine and Mac-1 mRNA responses, but there were striking temporal differences between the two compartments, with changes in whole lung tissue correlating better than BAL with the onset of fibrosis in this strain. The radiation-induced proinflammatory mRNA responses had strain-dependent and strain-independent components. Thoracic irradiation of C3H/HeN induced similar increases in tumor necrosis factor (TNF)-{alpha}, interleukin (IL)-1{alpha}/{beta}, and interferon (IFN)-{gamma} mRNA expression in lung as it did in C57BL/6J mice during the 'presymptom' phase at 1-2 months. However, immediately preceding and during the pneumonitic time period at 3-4 months, TNF-{alpha} and IL-1{alpha}/{beta} mRNAs were highly upregulated in C3H/HeN mice, which develop pneumonitis, but not in C57BL/6J mice, which do not. At the onset of radiation fibrosis in C57BL/6J mice (5-6 months), irradiated lungs had increased levels of IL-1{alpha}/{beta} and IFN-{gamma} mRNA expression, but the TNF-{alpha} response was, notably, still muted. Conclusions: The major molecular and cellular events in lungs of C57BL/6J and C3H/HeN mice, which develop late fibrosis and subacute pneumonitis after thoracic irradiation respectively, take place within the interstitium and are not reflected within BAL populations. The initial proinflammatory responses are similar in the two strains, but later responses reflect the latent time to lesion development. TNF-{alpha} expression at 3-4 months may be important in radiation-induced pneumonitis, and its downregulation is important in avoiding this radiation-induced complication.

  20. Advances in Video-Assisted Thoracic Surgery, Thoracoscopy.

    PubMed

    Case, Joseph Brad

    2016-01-01

    Video-assisted thoracic surgery (VATS) is an evolving modality in the treatment and management of a variety of pathologies affecting dogs and cats. Representative disease processes include pericardial effusion, pericardial neoplasia, cranial mediastinal neoplasia, vascular ring anomaly, pulmonary neoplasia, pulmonary blebs and bullae, spontaneous pneumothorax, and chylothorax. Several descriptive and small case reports have been published on the use of VATS in veterinary medicine. More recently, larger case series and experimental studies have revealed potential benefits and limitations not documented previously. Significant technological advances over the past 5 years have made possible a host of new applications in VATS. This article focuses on updates and cutting-edge applications in VATS. PMID:26410560